Meditation and Pain

One of the goals of the Feldenkrais Method is to develop greater awareness of your movement patterns. Why? According to Moshe Feldenkrais "if you know what you are doing you can do what you want." Sounds reasonable enough. I was reminded of this quote after reading about a line of research which attempts to show exactly how meditation can help with chronic pain. The message seems to be that if you know how to focus your attention, you can focus on what you want - in this case, something besides your pain. Here's some detail on this research, which is summarized in an awesome full text paper here. (courtesy of Diane Jacobs.)

Inputs, outputs and filtering

First some background. At any particular moment, our brains are bombarded by a massive amount of information from the sensory organs of the body - visual data, auditory data, information about body position, balance, and potential threats to tissues from mechanical, thermal or chemical stimuli. This information goes to the brain for processing, and often results in a subjective perception, such as sight, sound, kinesthetic sense or pain. So the sensory information can be considered an input to the brain and the sensation is an output of the brain. This is an important distinction.

Not all the inputs from the body actually result in a perceptive output. For example, just because your brain receives auditory information, this doesn't mean you will hear a sound. A good deal of sensory information gets filtered out before becoming an actual sensation, because the information is deemed to be redundant, irrelevant or for whatever reason not worth turning into a perception. The result is that a good deal of the sense data gathered by our bodies never becomes part of the movie in our heads.

This is probably because if we subjectively perceived all the information that was available to us at one time, we would be completely overwhelmed. Like watching four movies at once, we wouldn't get the message from any of them. So the brain picks and chooses what streams of information to turn into actual perceptions based on what it considers to be useful. This filtering process is sometimes called the cocktail party effect, based on the familiar experience of being able to tune in and out of different conversations at a party based on where your attention goes. Wouldn't it be great to be able to focus on the good not the bad, the happy not the sad, the pleasure not the pain? Didn't Bobby McFerrin write a song about that?

Meditation trains the filter

New research suggests that meditation trains the ability to optimally filter sensory information. Specifically, a series of studies described in detail here have shown:

• When attentional focus is shifted, alpha wave activity in the brain changes. Specifically, greater amplitude alpha waves means more filtering of information. For example, research shows that focusing attention on the left hand is associated with a drop of alpha wave amplitude in the brain map for the left hand.  
• Persons trained in an eight week mindfulness program display quicker and larger amplitude changes in alpha waves when shifting their attention from the foot to the hand.

So, to use the cocktail party analogy, meditation can help you improve your alpha wave function, which can make it easier for you to stop hearing the boring talker next to you and listen in on a more interesting conversation nearby.

The authors of this research state that skill in filtering is related to "metacognition":

 ... metacognition is an emergent property of mindfulness practice in ST-Mindfulness that is derived from training in subsidiary mechanistic processes including attention and emotion regulation. Drawing on this emergent metacognitive capacity, ST-Mindfulness practitioners learn to monitor their moment-by-moment experience so that they can “step back” from negative, distressing thoughts and feelings in order to view them as “mental events” rather than as unmediated reflections of reality.

Whoa. Sounds deep. And it sounds like the Feldenkrais quote about knowing what you are doing and doing what you want.

Mindfulness helps with ... everything

But can shifting your attention from your hand to your foot really make you better at shifting your attention from negative thoughts or physical pains to happy thoughts and good vibrations? I have previously written about how the brain was originally  designed for movement, and therefore we shouldn't be surprised that practicing movement has transfer to other mental domains. For example, practicing the skill of inhibiting unwanted movement through a "stop task" improves impulse control related to addictions. And here's a quote from the authors describing some of the impressive research that has been developed showing that meditation has benefits far outside the realm of just getting better at sitting and watching your breath:

Based on multiple randomized clinical trials, there is good evidence for the efficacy of these ST-Mindfulness programs for preventing mood disorders in people at high risk of depression (Teasdale et al., 2000a,b;Ma and Teasdale, 2004; Segal et al., 2010; Fjorback et al., 2011; Piet and Hougaard, 2011), improving mood and quality of life in chronic pain conditions such as fibromyalgia (Grossman et al., 2007; Sephton et al., 2007; Schmidt et al., 2011) and low-back pain (Morone et al., 2008a,b), in chronic functional disorders such as IBS (Gaylord et al., 2011) and in challenging medical illnesses, including multiple sclerosis (Grossman et al., 2010) and cancer (Speca et al., 2000). ST-Mindfulness has also been shown to decrease stress in healthy people undergoing difficult life situations (Cohen-Katz et al., 2005), such as caring for a loved-one with Alzheimer's disease (Epstein-Lubow et al., 2006).

...

...ST-Mindfulness is reported to reduce self-reported rumination (Ramel, 2004; Deyo et al., 2009), which is the negative repetitive, self-related internal cognitions that predominate in major depression (Nolen-Hoeksema, 2000). In chronic pain and functional disorders, ST-Mindfulness is reported to reduce patients' tendency to catastrophize and engage in repetitive negative cognitions such as, the pain is “terrible and I feel it's never going to get better” (Garland et al., 2012).

Is there a drug that can do all this? Meditation seems like powerful medicine indeed, perhaps second only to general exercise in its health benefits. I find it fascinating that this all purpose mental muscle can be developed by something as simple as focusing attention on bodily sensations.

So don't just sit there!

Pay attention to just sitting there! You might get better at playing the mental movies you want to watch.