It's in Your Head
Reviewed By Gary Vogin
Oct. 9, 2001 -- Pick up a raisin. Look at it. Really look at it -- like you've never seen a raisin before. Roll it between your fingers. What do you notice about its texture, its color? Hold the raisin to your ear. Squish it a bit. Does it make a sound? Bring it to your lips. Take note of any stray thoughts you might have, but always come back to the raisin. Place it on your tongue. When you finally swallow it, appreciate the fullness of its flavor. Now imagine that your body is exactly one raisin heavier.
Sound like an odd exercise? Then consider this: For thousands of people who suffer from chronic pain, spending quiet time with a raisin has proven to be the first step to learning how to cope with their pain.
The raisin exercise serves as an entree to meditation -- an approach that is gaining popularity among people in pain. In 1997, Americans made more than 100 million visits to alternative practitioners for relaxation therapies such as meditation, according to a study by David Eisenberg, MD. That study is available in the Nov. 11, 1998, issue of The Journal of the American Medical Association. Just how meditation relieves pain is not entirely clear, though researchers are beginning to enumerate and examine potential mechanisms. What is clear is that for millions seeking treatment for headaches, arthritis, and many other conditions, meditation seems to work.
Mind Controls Body
"It changed my life," says Imogene Benson, who suffers from the chronic, painful condition called fibromyalgia. Benson signed up for the stress reduction program at the University of Massachusetts in Worcester after a bad fall left her with neck and back injuries, too. "I've learned to relax and be more in control of my body, instead of having my body controlling me," she says.
An avid runner before the accident, Benson says that the pain kept her from working for months at a time and made climbing even a short flight of stairs a nightmare. Meditation has given her a sense of inner peace, she says, and has improved her physical condition as well. "I have less pain, my muscles are more relaxed, and I have much better mobility," she says.
Over the past 20 years, thousands of individuals have sought help at the U. Mass. Stress Reduction Clinic, which has pioneered methods for teaching meditation techniques to people with pain. Their symptoms vary -- from headaches and back pain to anxiety and eczema -- but their stories are remarkably similar.
"Most of the people we see have had long experiences with pain clinics, doctors, and medications," says Elana Rosenbaum, a social worker at the clinic. "But nothing has relieved their suffering."
Before coming to the clinic, Benson tried medication, physical therapy, and a device that electrically stimulates nerves to reduce pain: none offered more than temporary relief.
And then she tried meditation. "It's just wonderful. No matter how stressed you feel before, afterward you feel relaxed, calm, and filled with energy," says Benson. And meditation doesn't always require a mantra or mystical music. For Benson, the key thing is finding a quiet place to focus for 30 minutes.
Scientists Weigh In
According to one early study by Jon Kabat-Zinn, director of the Stress Reduction Clinic, 65% of the patients who spent 10 weeks in his program reported that their pain was reduced by at least one-third. (The study was published in the April 1982 issue of General Hospital Psychiatry.) Their mood improves and they experience significantly fewer overall symptoms, says Shreyas Patel, MD, a neurologist who trained with Kabat-Zinn before joining the Marino Center for Progressive Health in Cambridge, Mass. Indeed, an independent technology assessment panel, convened in 1995 by the National Institutes of Health, confirmed that behavioral approaches -- including relaxation techniques and hypnosis -- can be quite effective for chronic pain.
But how might meditation work to relieve pain? First off, the relaxation that's at the heart of meditation relieves the muscle tension that most certainly contributes to pain, says Howard Fields, MD, of the University of California, San Francisco, who sat on the NIH technology assessment panel. And the anxiety involved in anticipating pain -- or thinking it will never leave -- causes additional muscle tightening, says Patel. Relieving that anxiety is another way meditation can help people cope with physical sensations.
In addition, meditation most likely alters a person's emotional response to pain. Remember, pain is more than just a physical sensation -- it is an experience steeped in emotion. "I'm still in constant pain," says Benson. "But meditation makes the pain more bearable. It's taught me how to live with it and to find ways to better manage it."
Altering Emotions and Sensations
This makes sense, physiologically speaking, because the sensations and the emotions associated with pain are processed by different parts of the brain, says Catherine Bushnell, PhD, of McGill University. So relaxation techniques, including meditation and hypnosis, might allow people to tolerate pain they would ordinarily describe as unbearable. In her studies of hypnosis, Bushnell has found that people can be taught to reinterpret painful sensations, regarding them as "warm and pleasant" rather than "burning and unpleasant."
"So it's not just that people are being trained to ignore pain" when hypnotized or meditating, says Bushnell. She's concluded that relaxation techniques can alter the way the brain responds to a painful sensation and the way a person feels about it.
Further, meditation also may change the neural pathways that control the physical sensation of pain. Perhaps it works like morphine, says Bushnell, dampening pain by stimulating the inhibitory nerves that extend from the brain to the spinal cord, where they block the sensation of pain.
A raisin might not always be a substitute for morphine, but it appears that meditation can help people control their response to pain -- and their outlook on life. "The raisin exercise makes you aware of sights, sounds, scents, and tastes," says Benson. "Now I relax, slow down, and take time to appreciate things around me -- a bird or a cricket, the wind in the trees. Meditation makes my life a little more peaceful. It's made me a better me."
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