Mindfulness and Pain

 

This Thursday, June 15th, I will have surgery on my right wrist, or actually three surgeries. I did not want to undergo anesthesia multiple times so I thought I’d do them all at once, and the surgeon agreed. The first two are relatively simple: carpal tunnel (medial nerve in hand) and cubital tunnel (ulnar nerve, at elbow and blade of hand). The third is more complicated and is called a proximal row carpectomy; the surgeon removes three of the eight bones in my wrist. The surgeon predicts it will take two-three months to heal. I will be in a cast for two weeks, and writing may be difficult for an indeterminate length of time.

 

So, I am taking a vacation. I feel better approaching surgery as a vacation then as a dreaded time of suffering. It’s important, in difficult times especially, to be nice to yourself. For the next few weeks or more, instead of feeling an obligation to publish each week, I will do it only when it feels right. I have a blog prepared for next week, but after that—who knows. I will most probably miss writing, miss you as an audience, so I don’t know how long my “vacation” will last.

 

The wrist has been hurting on and off for many years. Driving, writing, certainly carpentry or splitting wood, but even holding a book or sleeping, could be painful. Karate has become problematic. My handwriting was never beautiful, but years ago, before I retired from teaching, I had trouble giving written feedback on student papers due to the pain. Students often commented that my writing was illegible.

 

Yet, I became sort of used to the pain—sort of. In early March, I pointed out to my acupuncturist the swelling in my wrist and she recommended I see a doctor. That led to x-rays and a CT scan, then nerve conduction tests. After seeing what my wrist looked like and reading the radiologist report, of “severe” this and torn that, the pain actually got worse.

 

I found this interesting. When I thought of the pain in my wrist as simply an unpleasant sensation that couldn’t be treated, I accepted it and lived with it. But once it had a label and a doctor’s evaluation, once I had the clear image of bones rattling bones, it became more solid and took on a life of its own. The sensations I felt became an alien presence I wanted removed. I scheduled the surgery.

 

This led me to use mindfulness training to study in more detail how my mind influenced the pain. I began to think of pain as a blatant and confounding puzzle, as a chance to learn more about how my mind and body worked. When pain arose, I breathed it in—if I could. I noticed whatever was there for me—how the beliefs and expectations I held influenced the sensations I felt and the thoughts about the sensations. My response to the pain influenced how much I suffered from it. When I let go of the thoughts and images, and focused on the breathing, the pain sensations moved to the periphery of awareness, and lessened in strength. Without resistance, pain decreased. It became one sensation among others. My response went from flight-flight-freeze to something a bit more open, and more relaxed.

 

And, over the last few days, as the fact of surgery sank in and the big day approached, the incidents of high level pain decreased. I don’t know what was most responsible. Was it the natural therapies, pain pills, or increased mindfulness? Was the anxiety over surgery masking the physical sensation?

 

I still need the surgery. But I have a few strategies to help me face it, and my fears about it, with a little more confidence and less anxiety. I have realized how fear can be useful. It tells me to wake up. This is my life on the line. The kindness I give to others I can give myself. I have also accumulated a few good movies and books to enjoy. And I am forever grateful that I still have good health insurance. (Please tell Republicans in Congress that you oppose their undermining-health-care legislation.) On Thursday, please wish for me a good result, a healing. Thank you and may you be well.

 

*Many Buddhist teachers write about how to face pain, or face whatever. Pema ChodronShinzen Young, and Jon Kabat-Zinn are three authors whose wonderful books I can recommend.

 

**My friend Eileen Ain recommended Peggy Huddleston’s Relaxation/Healing CD.

 

***Photo by Kathy Morris.

How To Better Understand Your Emotions

Last week, I talked about why understanding emotion is important in thinking critically and clearly. It is not just understanding emotion, however, that is important but being aware and able to monitor, and let them go. This week, I will discuss one perspective on what exactly an emotion is. This approach combines Western psychology and neuroscience with Buddhism. One practice I discussed last week is to use analysis or deconstruction. Analysis itself can be turned into a way to intervene in and let go of an emotion. To analyze or deconstruct an emotion, first understand the triggers and evolutionary uses of emotion and then go to the components of emotional experience. An intellectual understanding of the physiology and psychology of emotion can also be extremely helpful. Let’s use anxiety as an example.

 

Triggers: what can trigger anxiety in you or your students? Take a moment to think of times you were anxious. What set it off? Can you find any characteristics these triggers share?

 

Use: What use can anxiety have? When students understand that each emotion has a purpose or use, they can also come to understand when the emotion goes beyond the use. For example, students want to hold onto anger and don’t see why it might serve them better to let it go. When you prolong the emotions, they go awry. Anxiety and worry can help you prepare for something. It can energize you. To do something you care about, you need to be energized. The energy of anxiety, stress, is the energy of waking up to prepare. It is useful.

 

One of the things many emotions do is orient us in time. How does anxiety orient us in time? Usually, it orients you to the future. You think of how things might go wrong. But the “future” is an idea, right? Anxiety can orient us out of the present experience to an idea of another experience.

 

Components: A Buddhist teacher named Shinzen Young has a great description of the components of emotion that influenced (but is not exactly the same as) my own approach. What are the components of emotional experience? I will discuss feelings, sensations, thoughts and images, and motivated actions.

 

Feelings can be defined as the sensation of touch, or as the initial orienting energy, or awakening of attention. This energy later develops into taking something as good, bad, or neutral, pleasant or unpleasant, to like or dislike; then a state of mind, or emotion, and holding on, pushing away, or being indifferent.

 

Sensations are the experience of your physiological responses or changes. When you learn the sensations of an emotion, you can learn to spot or feel them and can more easily let them go before they become overwhelming. It is also important, and can be tremendous fun, to ask students what an emotion looks like in someone else. For example, what does an anxious person look like? A moment-by-moment awareness of your own experience can help you better observe and understand what someone else might be experiencing. Emotion is not just felt but communicated. What are the sensations of anxiety?

1. Where are the sensations in your body? A technique I learned from a fellow teacher is to     ask students to draw a human figure and circle places where they feel anxiety.

2. How– Describe the sensations of anxiety. For example, are they like pins and needles, tight or loose, cold or warm?

3. How much-How intense are the sensations?

What goes on physiologically with anxiety? The fight-flight-freeze response, our body system that deals with threats, becomes active. You treat your own sensations as a threat. The sensations are uncomfortable and you flee the discomfort. You don’t just feel uncomfortable—you fear the discomfort and what it might mean.

 

Thoughts: What thoughts or images arise when you’re anxious? We humans have a powerful ability to plan for the future, think, imagine. Language increases the power of these abilities. But that power can be helpful, or go awry. It is the power of thought and imagination and language that helps us develop an idea of our self and others. How does it go awry with anxiety?

 

When anxious, you think you are unable to face what you think is coming. You imagine others have a negative image of you. You leave behind your present experience. You think of yourself as a house of cards, easily broken, or as a fake, because you have lost contact with yourself. When you fear yourself and your sensations and thoughts, how does the world appear to you? When you flee discomfort, you live the sense of fleeing, of running away. And what happens to thoughts that go against the emotion? Do you hear them? See them?

 

Actions: What actions does the emotion motivate you to take?

 

Interventions: How do you intervene in, let go of, anxiety? Since anxiety can be feeling and imagining you can’t handle a future state or event, you flee from your awareness. Your imagination can create distressing images of your future, or wonderful ones. It can undermine or increase your strength depending on how you use it.

 

When you take action directed at increasing your self-awareness in the present, and better understand whatever is the trigger for anxiety, you can reduce anxiety. When you utilize mindfulness, compassion and imagination practices, you learn how to treat whatever arises as something to learn from. You learn how to inquire into a question, face a challenge and better understand your thinking process.

 

Inquiry Practice: What happens to your thinking if you feel you can face any idea, anything that arises? Let’s explore that.

 

Just sit back and take it easy. Close your eyes now or in a minute or so, and take a few slow, calm breaths. Notice how it feels to breathe in—and breathe out. Focus on your face, around your mouth. How do the muscles around your mouth respond as you breathe? As you breathe out? Do you notice any tension, heat, or joy? As you breathe in, can you feel your body expand a little bit? As you breathe out, can you feel your body let go, relax, and settle down? Then focus on your shoulders. Notice what sensations you feel as you breathe in, and breathe out. As you breathe in, do you feel your body expand a little bit? As you breathe out, can you feel your body let go, relax, and settle down? Maybe go to your belly next and simply notice how your belly breathes in—and out. If any thoughts come up, just calmly notice them and appreciate the noticing, and let them go as you return attention to the sensations of breathing.

 

And now engage your imagination. Let come to your mind an image or memory of a courageous action of your own, or one you witnessed or read about. What was the courageous act? Who did it? What made it courageous? What does courage mean to you? Does it have to be dramatic, like in some movies? Or can it be something simple, like sticking up for someone or speaking out? Or doing something you never did before but was frightening? Or putting yourself at some risk? What does it feel like to be courageous? Imagine feeling courageous. Imagine feeling that you could face whatever came up in your life and just sit for a moment with that feeling.

 

If you’re doing this with students, have them write down the thoughts or images that came up for them and what it felt like to feel they could face whatever arises. Then let them share their thoughts.

 

Can you imagine doing something like this with your students?

 

 

**For a fuller development of the components of emotion and the role of emotion in thinking, see my soon to be released book, Compassionate Critical Thinking: How Mindfulness, Creativity, Empathy and Socratic Questioning Can Transform Teaching.

**Here is a link to Mindful Schools, to see a video on using mindfulness to help MS children deal with anxiety.