Letting go of the struggle


A new book outlines how to manage chronic and incurable pain through mindfulness, writes Sylvia Thompson

ACCEPTANCE-BASED approaches to coping with chronic and incurable pain are sometimes described as the third wave of psychological therapies. Rather than seeking to reduce or remove pain (either through changing behaviour, thoughts, beliefs or emotions), these approaches instead encourage individuals to let go of the struggle with pain and live a productive, valued life despite the pain.

Vidyamala Burch, author of a new book, Living Well With Pain and Illness, the mindful way to free yourself from suffering(Piatkus, stg£16.99), is a strong advocate of an acceptance-based approach to chronic pain which uses meditation as a starting point.

"Mindfulness -based approaches are becoming much more accepted by mainstream health professionals now," says Burch, who is the co-founder of Breathworks, a British organisation which helps those with chronic pain, illness and stress to manage their condition through meditation, body awareness and creative approaches to living.

A sufferer of chronic pain herself, New Zealand-born Burch is well aware of periods in her life when she fought her pain and used work as a way of running away from herself.

"At aged 16, I injured my lower spine which led to months in a body cast and two major operations. At aged 23, I damaged my spine in a car crash and then at 25, I had another crisis with my spine when I reached a stage of exhaustion which led to a hospital stay of three weeks," she explains.

A guided meditation session with a hospital chaplain at that time led her to the realisation that even though her body was damaged, her mind was healthy and could be used as a tool.

Therein followed the start of a lifelong exploration of meditation which saw her become ordained into the Western Buddhist Order (Vidyamala is her Buddhist name, her birth name was Prue) and ultimately led to the founding of Breathworks in 2004.

Breathworks claims to be the largest organisation of its kind in Britain which delivers courses to health professionals as well as residential retreats and three-week residential training programmes to become an accredited Breathworks trainer.

The new book, Living Well with Pain and Illness, is the next step in spreading the word about how successful these mindfulness-based approaches to chronic pain can be.

"Studies of people with chronic pain show that mindfulness reduces the level of pain they report and improves other medical and psychological symptoms. Our own work shows improvement in pain experience, quality of life, depression, the tendency to catastrophise, the ability to control and decrease one's experience of pain and confidence in activity despite pain," she explains.

In the book, Burch examines the concepts of primary and secondary suffering and looks at how focusing on the exact nature of pain in the present moment (primary pain) can liberate people from secondary suffering that comes from the longer term emotional and mental attitude to pain.

However, Burch fully acknowledges the difficulties of pain and, in fact, she wrote the book in spells of 20 minutes at the computer and 15 minutes rest time because, otherwise, she would have suffered from a build-up of pain.

In the book, she encourages chronic pain sufferers to pace themselves and move away from the "boom and bust cycle" in which they overdo things when they feel well and later suffer the consequences. She also stresses that the techniques and methods in the book can be used alongside medical treatment and not as a substitute.

Throughout the book, there are comments from people who attended Breathworks courses which might inspire others. For example, Alan who was overwhelmed by pain following a car accident and felt it had destroyed his life. Burch writes, "But when he investigated his pain directly, he experienced it as a wave of sensations flowing up his leg that were continually changing and not nearly as bad as he feared.

"He also noticed pleasant elements alongside the pain such as the softness of his breath and the warmth of his hands. His face lit up as he told the class that, for the first time in years, he felt some freedom in how he related to his pain."

Burch admits that it has taken her many years of living with chronic pain to integrate the lessons learned from meditation in a practical and sustainable way.

She describes three phases - denial, bargaining and finally acceptance - that she went through over 30 years. So, how difficult will it be for other sufferers of chronic pain who, through her book, will be attracted to giving mindfulness meditation a go?

"Although you may sense the value of mindfulness, it doesn't often come naturally. It needs to be consciously cultivated and takes discipline and commitment. Over time, you can learn to adopt a kindly non-judgmental attitude to the whole of your experience and allow painful sensations simply to be present," she says.

According to Burch, committing to regular meditation practice (even 10 minutes a day will do) will be difficult for those people with chronic pain who believe that "there is still someone out there who will make them better".

"You need to have reached the point in yourself that there isn't any magic wand - even though there may be medical therapies that will help - and that life always contains difficult aspects. Mindfulness will be a difficult thing to gain benefit from for someone who is still in rampant denial."

In terms of the practice itself, Burch adds that being part of a group-based course is the best start. "This is a friendly, kind environment where you will gain support and encouragement to stick with the practice," she says.

However, aware that group classes are impossible for some sufferers of chronic pain, Burch is currently putting free downloadable audio tracks on the website (www.breathworks-mindfulness.co.uk) for use at home.

Companion booklets and DVDs on mindfulness in daily life are also in production.

• Living Well With Pain Illness - the mindful way to free yourself from sufferingby Vidyamala Burch (Piaktus) is published this week