Holistic Feathers

Mindfulness-based stress reduction

“It’s almost totally unintuitive to say the best approach to the things causing you to suffer is not to try to change them.” Jay Valusek is sitting crossed legged on a pillow in a corner of the Rocky Mountain Mindfulness Center’s conference room. The room is empty except for a semi-circle of pillows arranged across the floor. Valusek is soft spoken with a friendly manner and his voice rises only slightly as he explains the paradox central to the center’s message – our efforts to avoid pain often make the pain worse.

“Mindfulness brings a microscopic inspection to the mind’s reaction to pain,” he continues. “We trigger stress in our bodies by perceiving our own pain as a threat. That perception causes a stress response and then more pain.”

Valusek founded the Center, nestled in the Boulder foothills, last year. The method it uses is based on the work of best-selling author Jon Kabat-Zinn, a biologist at the University of Massachusetts and a Buddhist meditator. In the late 1970s, Kabat-Zinn began using his meditation techniques, stripped of religious connotation, as a stress and pain management tool for patients at the university’s medical school. Kabat-Zinn later wrote Full Catastrophe Living, an outgrowth of his work at the university’s renowned Stress Reduction Clinic and a kind of primer on mindfulness-based stress reduction.

“Kabat-Zinn’s innovation was to say the Buddhist training was intrinsically psychological. It’s a mental training,” Valusek notes. “People with chronic pain suffer mentally from the same things Buddhist meditators suffer from, but they don’t have the tools for dealing with it.”

Valusek is among some 400 teachers worldwide listed on the University of Massachusetts’ medical school website who offer programs modeled after Kabat-Zinn’s Mindfulness Based Stress Reduction. Valusek’s Rocky Mountain Center is one of growing number nationwide offering courses that combine meditative techniques, visualization and relaxation for stress reduction and relief of chronic pain.

Mindfulness can be described as a technique of purposeful attention to what is being experienced, without reacting to or judging that experience. The specific method often involves paying attention to the sensation of the flow of the breath in and out of the body. This is seen as helping the meditator learn to experience sensations, thoughts and emotions in normal daily life with greater balance and acceptance.

“Mindfulness is not about sitting on a pillow meditating; it’s about learning to be fully present to whatever is happening. It’s like coming down to earth,” Valusek explains. Although it’s not exactly clear why, studies show that the very act of awareness created through mindfulness training can be healing. He also points to his own experience of dealing with chronic back pain. “There are two components to the suffering of chronic pain. One is the actual unpleasant sensations. The second is that you don’t want those feelings so you try to push them away. In many ways it’s the resistance to pain that makes the pain so bad.”

Research on using mindfulness in dealing with chronic pain is promising and it’s gaining acceptance as a proven technique. The National Center for Complementary and Alternative Medicine – part of the National Institutes of Health – has sponsored several research projects on mindfulness meditation and major teaching hospitals are studying it too. One such study conducted by Jefferson University Hospital and reported in the journal General Hospital Psychiatry noted patients reduced their chronic pain, anxiety and depression, in addition to increasing their overall sense of vitality, using mindfulness-based stress reduction techniques.

Unfortunately, it is often a sense of desperation rather than promising research that finally leads people to mindfulness training.

Ariella Hartshorn took Valusek’s eight-week course after 12 surgeries to correct problems caused by osteoarthritis. Before the course, she was unable to work and was almost homebound. “I felt my life was probably gone,” Hartshorn explains.

Her pain came in spasms that radiated from her lower back down into her legs. “I never got out of the trauma of my last back surgery four years ago,” Hartshorn says. That surgery also led to anxiety attacks. “When I’d walk and have a great deal of pain, I’d see the scalpel hanging above me being lowered.”

Hartshorn, who says she’s an infrequent meditator, believes the first thing the course taught her was that she has a choice in how she reacts to pain. “My pain, even though it’s structural, a great part of it’s emotional too,” she says. “I decided to change my attitude and now I’m in a very different place. I’m not afraid anymore. I used to ask, ‘What will happen if the pain comes?’ but now I don’t go into panic mode. I’ve learned to deal with the pain from a different perspective.”

The mindfulness practice seems to have brought more than just a change of attitude for Hartshorn. “Before when someone would ask me to rate my pain on a scale of one to 10, I’d say ‘15.’ Now I say three to five.”

“I hope I’m done with surgery,” Hartshorn concludes. “Just a few weeks ago I hopped on a plane and went air ballooning with my daughter in New Mexico. When I do things with a lot of joy, I don’t notice the pain.”

Valusek is quick to point out that mindfulness techniques are not a substitute for traditional medicine. He characterizes mindfulness as a complementary rather than an alternative form of pain management.

Nowhere is that approach to mindfulness more evident than at Jefferson University Hospitals’ Myrna Brind Center of Integrative Medicine in Philadelphia. The Myrna Brind Center offers an array of classes on mindfulness-based stress reduction for students, health care professionals, and people seeking pain relief. The center also does extensive community outreach including scholarships and classes at homeless shelters.

“Twelve years ago mindfulness was the frontier,” explains Dr. Diane Reibel, the director of the Myrna Brind’s stress reduction program. “But now I have so many people who are referred by doctors or self-referred. I believe the integration of conventional and complementary medicine is the medicine of the future.”

Dr. Reibel says that the center tends to attract people who have been through many medical situations and are still searching for relief. “Mindfulness allows people to directly experience that they are more than their pain, their thoughts, or their emotions,” she explains.

What is the growing attraction of a method based on a simple – yet difficult to achieve – act of awareness? Why has the interest in such a technique matured to the point that major medical institutions now offer mindfulness training?

Dr. Reibel pauses a moment before answering. “There’s an ingredient that is often missing in our medical system. Physicians, in general, can’t give the kind of care they’d like to give. Medical professionals are under tremendous stress right now. Mindfulness training can empower both the medical professionals and patients. This approach can offer people real and true care of the whole human being.”

Holistic Feathers runs Art of Being Still deep guided relaxation workshops (and corporate workshops) which are based upon the mindfulness techniques.

Resources
To find a Mindfulness Based Stress Reduction course: http://www.umassmed.edu/cfm/mbsr
University of Massachusetts Center for Mindfulness: http://www.umassmed.edu/content.aspx?id=41252
Site for ordering stress reduction CDs and tapes of Dr. Jon Kabat-Zinn: http://www.mindfulnesstapes.com
Rocky Mountain Center for Mindfulness: http://www.rmcfm.org/about.html
Jefferson University Hospitals–Myrna Brind Center of Integrative Medicine (Mindfulness-based Stress Reduction Program): http://www.jeffersonhospital.org/cim/article5030.html
National Center for Complementary and Alternative Medicine (search meditation, mind-body medicine): http://nccam.nih.gov/

(c) Jim Mascolo