People in pain are commonly told that the pain is “in their head.” You argue in your book that this does not mean what most people think it means -- but that understanding the mind-body relationship can be the key to ending pain. What do you mean by this?
There are few things more frustrating to a person with chronic pain than hearing someone say, “Your pain is in your mind.” I get that. It’s a way to dismiss the reality of what someone is experiencing, and it also feels like you are being blamed for your own pain. As if, If you were a good enough person, you could make the pain go away.
But the truth is, ALL pain is in the mind. Even if I were to slap you in the face right now—that’s as real and physical as pain can get, and yet the entire experience of pain happens in your mind. There is no feeling of pain until your brain does something with the signals it receives from your body. Pain is your brain’s interpretation of what’s going on in your body and in your life.
Medicine used to think that information from the body was received by the brain with perfect fidelity. But we now know that the brain and the nervous system play an active role in interpreting, amplifying or quieting, and sometimes even creating very real experiences of physical pain.
Most people with chronic pain have both some real injury or trauma in the body, and a brain and nervous system that is amplifying, or is oversensitive to, sensation. For example, a viral infection or an injured joint can make the nerves of the body more sensitive to potential threat. Even after you’ve healed from the initial illness or injury, your nervous system may misinterpret normal sensation as pain, and send a message to your brain that something is terribly wrong with your body. The same thing can happen when you are under a lot of stress—stress sensitizes pain receptors throughout the body. Negative emotions like anger and loneliness also make the brain more likely to listen to signals of pain from the body.
This pain is very real, and it’s biological, not psychological. But your state of mind does play a big role in how much you suffer, because every thought and emotion changes the biology of your brain and body.
This can be good news. It means that trying to fix the body with surgeries, pain medications, or physical therapy is not your only hope. If you are like most people with chronic pain, these strictly body-based approaches have helped only minimally or failed miserably. But by working with the body and mind together, you can reduce your suffering even if you do not know the physical cause of your pain.
How can practicing yoga ease chronic pain?
Yoga emphasizes the innate capacity each person has to experience health and joy. Yoga practices are the tools to awaken this capacity and heal your pain. Although most people think of yoga as being a bunch of stretches or pretzel poses, there is far more to the tradition that contorting your body.
Yoga starts with the breath, which is the central tool of healing in the yoga tradition. You can use simple breath awareness to develop a sense of control and safety in any moment, including acute pain. Yoga also teaches you how to befriend your body. People with pain often feel betrayed by their body. Yoga can help you restore trust and learn how to listen to your body and develop intuition about what it needs. By taking care of your body in a gentle way, yoga can help you make peace with your body and overcome the anger, sadness, and frustration that are common responses to chronic pain. The physical exercises of yoga, including stretches, have been shown to help reduce pain and restore physical health and function. Finally deep relaxation and meditation are key to unlearning chronic muscle tension, pain sensitivity, stress, and anxiety. Relaxation and meditation have also both been shown to tap into the body’s natural healing and pain-reducing responses.
If you’re the loved one of someone with chronic pain you may feel completely helpless. How can loved ones can help?
First, believe what your loved one is telling you—especially if the doctors can’t explain the pain or fatigue. When a person with pain or illness feels unsupported or doubted, the stress will exacerbate their symptoms, and the strain can permanently damage your relationship. Second, treat them someone who is suffering, but not like a child, and not like someone who is crazy. People who are sick often get treated as incompetent or worse yet, inadequately strong to handle what life has thrown at them. Your loved one needs help, but ask them what would be truly helpful, and then do it. Don’t make assumptions about what they want, or what they can or can’t do. Third, don’t forget to focus on the good. Pain and illness can become the dominant theme in the person’s entire life, and life can start to feel like triage—constantly trying to fix what’s wrong, no time to slow down, take a breath, and remember what’s still working, or what matters most.
One of the great things about yoga is that it makes room for connecting to the good, whether it’s by taking care your body in a loving way, making time for some personal prayer, or meditating on your own courage. You can help loved ones by encouraging acts of self-care or meaning, whether its practicing yoga with them (or watching the kids so they can practice yoga!), cooking for or with them, taking time to be creative or playful, and so on. One reader of my book wrote me that he read aloud the meditations and breathing exercises to his wife as a way to do something positive and empowering with her.
For more information about how yoga can help people with pain, visit http://yogaforpainrelief.com.