This is the ninth in a series of posts about Toni Bernhard's How To Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and their Caregivers.
The second section of Toni's book, entitled Accepting Pain, delves into what I believe is the first step of in-the-moment pain management. Yet - as with most of my own pain management (PM from here on) practices - it is not just important during times of pain: it is important as a regular, recurring state of Being. This will be the foundational point of my posts about PM and one I will repeat. I found my PM practices to be more and more effective as I linked them to my spirituality and made them part of my every day.
NOTE: I am not a medical professional: this post is not intended to take the place of consultation with your doctor or pain management specialist.
Admittedly, it's hard to feel pain and think, "Oh, well, I'll just accept it." Our bodies and minds quite naturally and for good reasons - survival, for one - become alarmed at the onset of pain. Yet when pain becomes chronic, that state of alarm soon becomes the evil twin to pain, worsening the pain as the stress of our inherent reaction fights it. Thus, for those of us in chronic pain our best option is to learn to accept - or, at the very least, not to fight - the pain.
Toni writes succinctly about how Buddhism treats suffering in this section (pp 21-44) and since I want to get to actual practice, I will not try to repeat it all. Suffice it to say, for the purposes of this post, that the spirituality of accepting chronic physical pain is part of the spirituality of accepting that there is suffering in all of life: what redeems the suffering is not fighting it or fleeing from it, but accepting it as a truth of all life and allowing that breakthrough to lead us to enlightenment, to freedom from our self-imposed suffering.
In chronic pain, the physical pain is bad enough - why add to it with emotional suffering? Why deny we are in pain, or get nervous, upset, angry at the fact we are in pain when it is proved that stress increases our pain? In acknowledgment of this, the best PM practices (aside from medications and therapies, which I use concurrently with my PM practices) are those that seek to ease our emotional and mental suffering as well as our physical suffering.
To my mind, nothing does that better than meditation, or prayer, or centering, or whatever you might call it for yourself. Again, the methods I write about do best when part of life, not only part of PM.
I sometimes find it difficult to accept it when I feel the onset of yet another migraine, and at those moments I am just not capable of slipping effortlessly in meditation or centering prayer. But I found that the methods I learned to still mind and body for prayer and meditation work well for overcoming the initial dismayed, denying or angry response to physical pain.
We all breathe all the time - how handy a tool is that?
Step One: Sit upright or lie back straight.
Step Two: Conduct a body scan (more about that, below) and gently relax tense muscles.
Step Three: Turning your attention to your breath, and without changing or modifying it, simply notice the duration of the inhale ... then the duration of the exhale ... inhale ... exhale ... for three to ten breaths.
The purpose of a body scan is to get us in touch with our bodies and to learn to relax the (many, many) tense muscles that we don't even know we are tensing against the pain. I first learned about the body scan years ago from a CD that is written and narrated by Jon Kabat Zinn, and I continue to go back to that CD for a refresher. I recommend you find a CD that works for you - there are plenty out there - and learn how to conduct your own body scan. Once the habit is settled in, you hardly need to go through the steps - a quiet and relatively quick survey of your body is enough to start the relaxation. I cannot tell you how helpful and effective for PM the body scan is.
The effect of the body scan and breathing is partly to focus our upset minds away from the pain - that's why they work best if we practice them when we are not in pain. It gives our minds a fighting (so to speak) chance when we are in pain. Relaxing the tensed muscles helps to reduce the physical pain and also allows the mind to relax. Relaxation of body and mind allows us to slip into meditation, prayer, no-mind, acceptance or whatever we call it.
At the end of my previous post, I quoted from Toni's book to illustrate how simple meditation/centering practice can be. She doesn't even call it meditation or prayer - she calls it sky-gazing (page 42). She simply lies back in the bed or in her backyard, looks to the sky, and allows an openness, a spaciousness, to liberate her. Even if it only lasts a few seconds, those precious moments induce serenity and sense of well-being that stays with her.
I include this little story again because, to me, it takes a lot of the mystification and formality out of meditation and prayer. I think we tend to make such practices more formal, more site- and circumstance-specific than they need to be. Then we either stay away because they seem too formidable and inaccessible, or we only practice under particular circumstances because we assume we need the formality.
And sky-gazing can be done without the sky. When I have a migraine, I wear a blindfold because migraines make me extremely photo-sensitive. I cannot deal with ambient light, let alone gaze at the sky. So I put the blindfold on and imagine myself sky-gazing. To be sure, and back to my foundational point about these practices being part of a regular spiritual life, this would not be effective had I not made a habit of practicing meditation / centering / no mind while feeling relatively well.
Another characteristic of migraine pain - and perhaps other kinds of chronic pain - is that it makes it very difficult to focus the mind, even for the purpose of relaxation or prayer. So I have learned to let go of my inner do-it-perfectly-or-not-at-all critic and use audio (CD) assistance whenever I need it. There are many wonderful people out there who have created CDs and DVDs about meditation, relaxation, etc. The website Sounds True is my main source for these. Music and nature sounds also enhance our pain-restricted ability to relax and center.
In my next post, I'll continue the theme of pain management.
P.S. My spell-check is not working today, and I have a migraine coming on, so I'll publish this post hoping there are no glaring errors.
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