Reduce the Psychological Distress Produced by Chronic Pain with Mindfulness
By John M. de Castro, Ph.D.
“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it; a regular meditation practice is the best ongoing foundation for working with pain.” – Christiane Wolf
We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have common chronic pain conditions. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.
The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patients ability to cope with the pain. Pain is affected by the mind. The perception of pain can be amplified by the emotional reactions to it and also by attempts to fight or counteract it. Pain perception can be reduced by aerobic exercise and mental states, including placebo effects, attention, and conditioning. Additionally, mindfulness has been shown to reduce both chronic and acute pain and are safe. Mindfulness may be an effective treatment to be used in combination with other treatments. Hence, it is important to study mindfulness practice effects on chronic pain and the psychological distress it produces.
In today’s Research News article “A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls.” See:
or see summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037934/
Andersen and Vægter recruited patients with chronic non-malignant pain who entered a pain clinic for treatment and a control group on the waiting list for treatment at the clinic. Both groups received medical treatment as usual, but the intervention group in addition received a 13-week Mindfulness-Based Cognitive Behavior Therapy (MBCT) program. Therapy was conducted once a week in a 2.5-hour session, combined with homework assignments supported with written and recorded materials. Patients were measured for pain intensity, pain catastrophizing, pain acceptance, anxiety, depression, mindfulness, and psychological distress prior to and after treatment.
It was found that the Mindfulness-Based Cognitive Behavior Therapy (MBCT) program produced a significant decrease in depression, anxiety, psychological distress, and pain catastrophizing, and an increase in pain acceptance and mindfulness. There were no significant changes in pain intensity. The change in mindfulness and also in pain acceptance were highly correlated with the reduction in psychological distress. Hence, MBCT reduced the psychological impact of chronic pain without changing the perception of pain. It appears to do so by increasing mindfulness and pain acceptance.
These are interesting results that suggest that Mindfulness-Based Cognitive Behavior Therapy (MBCT) is a safe and effective adjunct treatment for patients with chronic pain. The fact that MBCT improved mindfulness is expected as mindfulness training is targeted to do just that. The fact that MBCT also improves pain acceptance is also expected as Cognitive Behavioral Therapy is targeted to do so. In addition, mindfulness training and MBCT have been shown to reduce anxiety, depression, and worry and catastrophizing. So, the results would be expected. But, it is always important to confirm even expected outcomes.
So, reduce the psychological distress produced by chronic pain with mindfulness.
“It is still early days in terms of understanding why meditation can be so helpful in coping with pain, although the ancient origins of meditation in the different yoga and contemplative traditions suggests that people have known of these benefits for hundreds of years.” – Jean Byrne
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Andersen, T. E., & Vægter, H. B. (2016). A 13-Weeks Mindfulness Based Pain Management Program Improves Psychological Distress in Patients with Chronic Pain Compared with Waiting List Controls. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 12, 49–58. http://doi.org/10.2174/1745017901612010049
Abstract
Background:: Eradication of pain is seldom an option in chronic pain management. Hence, mindfulness meditation has become popular in pain management.
Objective: This pilot study compared the effect of a 13-weeks cognitive behavioural therapy program with integrated mindfulness meditation (CBTm) in patients with chronic non-malignant pain with a control condition. It was hypothesised that the CBTm program would reduce pain intensity and psychological distress compared to the control condition and that level of mindfulness and acceptance both would be associated with the reduction in pain intensity and psychological distress.
Methods: A case-control design was used and data were collected from a convenience sample of 70 patients with chronic non-malignant pain. Fifty patients were consecutively recruited to the CBTm intervention and 20 patients matched waiting list controls. Assessments of clinical pain and psychological distress were performed in both groups at baseline and after 13 weeks.
Results: The CBTm program reduced depression, anxiety and pain-catastrophizing compared with the control group. Increased level of mindfulness and acceptance were associated with change in psychological distress with the exception of depression, which was only associated with change in level of mindfulness. Surprisingly, changes in level of mindfulness did not correlate with changes in acceptance.
Conclusions: The results indicate that different mechanisms are targeted with cognitive behavioural therapy and mindfulness. The finding that changes in level of mindfulness did not correlate with changes in acceptance may indicate that acceptance is not a strict prerequisite for coping with pain related distress.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037934/