Mindfulness for chronic pain
Unpleasant feelings rarely ever just go away on their own, in fact, the more we try to push away what is unpleasant, the more it pushes right back. For example, if I told you NOT to think about a red Ferrari, what will you inevitably do? It doesn’t matter how hard you try, attempting to NOT think about something only makes the thought grow. So pushing away from uncomfortable thoughts, feelings, emotions and sensations just doesn’t work. Moving towards what is uncomfortable is the only way we can understand truth. And mindfulness for chronic pain can help this. We must start to get familiar with these unpleasant experiences, become aware of them, notice their qualities, understand where they come from and then learn to let them go.
Uncomfortable feelings are part of what it means to be human. Suffering is very much a part of our existence and so it makes no sense to try to avoid it. The good news is that unpleasant feelings and emotions are impermanent. They don’t last forever so when we can observe their fleeting nature, we don’t attach to them so rigidly and they ultimately have less power over us.
What is more, when we can move towards uncomfortable feelings and emotions without judgment, we recognize that the narrative we tell ourselves about the feelings is really not true. We rest in a state of total awareness and acceptance and watch as those challenging experiences begin to lift. We stop attaching to them, we stop analyzing them, we stop believing the movie in our mind and just observe.
These mindfulness for chronic pain techniques can help you to accept uncomfortable feelings and stop telling untrue stories in your mind.
What is RAIN
RAIN, which is an acronym for a 4 step process, is a tool adapted by mindfulness teacher Michelle McDonald and is used by many mindfulness practitioners across the globe. It is a cognitive process that helps us recondition the habitual ways in which we resist unpleasant experiences and cultivates the ability to be comfortable with what is uncomfortable. This practice will help to undo unconscious patterns of aversion and avoidance and helps us to be open, curious, and non-judgmental to what is arising in the present moment. Whether it’s an intense or difficult thought, emotion, or physical sensation, RAIN allows us to observe what we are experiencing without reaction.
Rather than push away, ignore, or distract from what is unpleasant, we can mindfully learn to recognize what is happening to us, allow the sensations to be there, investigate what they are, and nurture ourselves in the process. The 4 steps on mindfulness for chronic pain give us somewhere to turn in a painful moment and as we call on them more regularly, they strengthen our capacity to accept and adapt to life’s challenges without stress or anxiety.
How to do it
RAIN is a mindfulness for chronic pain exercise that is best done when in the grip of something uncomfortable. Perhaps you had a tough conversation with a colleague and your head is reeling over what was discussed. Maybe you just got some bad news. You might be experiencing physical pain in your body. Or perhaps you are ruminating over the same persistent negative thoughts of unworthiness or unhappiness. Whatever the experience, RAIN can be done in real time, as you are feeling what is coming up.
Get comfortable: The best way to practice RAIN is with full attention and intention. Find a comfortable spot in your home or office, turn off your phone, eliminate distraction, sit down, and close your eyes. Commit to spending the next 10-15 min in quiet contemplation.
Start by taking a few moments to focus on your breathing, the sensation of inhalation and exhalation through your nostrils. Really try to relax so that you can enter in a state of self-reflection in a calm and equanimous way.
1. Recognize: Take a moment to discover what it is that you are feeling. Be non-judgmental and open to the experience. Are you worried about something that may happen in the future? Are you anxious or stressed about an event that just occurred? Is the Gremlin acting up again and saying things in an effort to protect you? What are you feeling in your body? Focus your attention to whatever thoughts, feelings, emotions and body sensations that are arising right now.
Some sensations may call your attention first; for example, you may notice worried thoughts before becoming aware of physical response in your body. Or you may become aware of the jittery nervousness in your gut before you recognize emotions. Start by asking yourself “ What is happening inside me right now physically, mentally, and emotionally?”
Name it. Describe it. Call on your natural curiosity as you focus inward. Try to let go of any preconceived ideas or judgments. Be kind, receptive and open hearted.
2. Allow. Allowing means letting the thoughts, emotions, feelings or sensations you discover be just as they are. You are not trying to change them or make them go away. You may feel a natural sense of aversion, wishing that the unpleasant feelings leave, but as you become more willing to be present with “what is” a different quality of attention will emerge.
Allowing may seem counter-intuitive. You might wonder how it makes sense to allow uncomfortable stuff to be there, isn’t the point to get rid of it? In actuality, resisting suffering is what makes us suffer even more. So learning to ease into the suffering and witness it, rather than identify with it, will help loosen its grip.
It is natural to want to avoid the unpleasantness of anxiety or the discomfort of pain, but allowing gives us the ability to create space for what is real in the moment. What is calling our attention and what needs acknowledgment.
It may be helpful to support this act of allowing by whispering to yourself an encouraging word or phrase. For example, while in the grip of anxiety you may whisper “yes” or “I consent to this” or “I allow this”. At first it may seem that you are putting up with unpleasant feelings with the hopes that they will magically disappear but in reality we must consent again and again to what is real in the moment.
This helps soften the harsh edges of your pain as your entire being is not tensing up in resistance. Offer the phrase gently and patiently and in time your defences will relax and you may experience a physical sense of letting go. After all, we are human beings that experience a plethora of human emotions. Each one valid, each one needing its time and space. So allow whatever is arising to be exactly as it is.
3. Investigate (with non-judgment): In many cases, working with the first two steps of RAIN is enough to provide relief and reconnect you with presence. In other cases, the simple intention to recognize and allow is not enough.
Sometimes we encounter ongoing and persistent struggles, like divorce, chronic illness, or the loss of a loved one, and we can become easily overwhelmed by these intense feelings as they often are triggered again and again. In these cases you may need to further awaken and strengthen awareness with a deeper investigation in order to improve mindfulness for chronic pain.
This requires us to call on our natural interest to understand truth and directing a more focused attention to our present experience. Pause and ask yourself:
- What most wants attention?
- What am I believing?
- How true is this thought?
- What does this feeling want from me?
- Is this within my control?
- What’s another way of perceiving the situation?
- How might my own judgments be interfering with the truth?
Through RAIN, we practice being aware and observant of uncomfortable emotions, allowing them to pass through, but understanding that the thoughts we connect to them are rarely ever true. Thoughts may feel real because the emotions feel real but they are not a genuine representation of reality. They are chemical reactions in the brain, typically oriented around past or future events. Thoughts are skewed by our own biases, our own interpretations of the world, our upbringing, our past experiences, our traumas. When we recognize that the thought is not true, we can allow ourselves to be with the pain of the emotion in a very open-hearted and accepting way, knowing full well that it will eventually pass. Challenging the validity of the thought behind the emotion is important.
It is essential to approach this step with true kindness. We must be able to accept our experience with an intimate quality of attention and a gentle welcome of whatever surfaces.
4. Nurture: The 4th step of RAIN is Nurture. What this means is that you give yourself the space to offer self-compassion, kindness and love in this difficult moment. As I mentioned earlier, humans are so easily self-critical and harsh. We can be nasty toward ourselves, which does nothing other than make us more stressed out. Nurturing ourselves in a difficult moment is an offer of self-compassion. We can acknowledge that we are human, we feel human emotions, we make mistakes, and there is nothing wrong with that. Yes, failure is okay!
Nurturing requires a sense of tenderness and that is why offering yourself gentle touch can help promote kindness and love. Touch triggers the hormone Oxytocin, associated with the mammalian caregiving part of the brain, which helps humans to experience connection and promotes feel-good sensations that foster a sense of well-being and happiness. We know babies require human touch for survival, it only makes sense that self-compassion is bolstered with the tenderness of touch.
Here are a few options to try:
- Place your hand on your heart and hold it there. Feel your own heartbeat, feel the warmth of your hand, feel your humanness
- Wrap your arms around yourself, giving yourself a hug
- Place your hands on your cheeks and hold them there for a few moments
- Get into the fetal position, wrapping your arms around your legs
Gentle sounds can also be effective during the nurturing step. Even just a soft sigh or a slight hum can also send a signal to your brain that fosters peacefulness and calm. And of course, offering yourself compassionate words or phrases is important. Say kind words to yourself such as “it’s ok”, “you are deserving of love”, “I accept you as you are”, “everything is going to be alright”, “this too shall pass”, “you are doing the best you can”. Treat yourself like you would a good friend.
When we can achieve this sense of nurturing, we find that the grip of the unpleasantness starts to weaken and we are more capable of being with whatever is arising without aversion.
After you have gone through the 4 steps of RAIN, it is important to spend a few minutes in contemplation recognizing that the unpleasantness that you just experienced does not define you and it will naturally and gradually lift. Everything in life, and I mean everything, is in a constant state of flux and flow and even the most uncomfortable sensations will go away in time.
We often get entangled in unpleasant thoughts, feelings and sensations, believing that they are part of us and that they somehow define who we are. When we express anger we say “I AM angry”. When we express sadness we say “I AM sad”. An “I AM” statement is a declaration of ownership. Do you own your emotions?
When you define yourself by your emotions, you are choosing to identify with whatever you are feeling. You are NOT our thoughts. You are NOT our emotions. You are NOT the physical sensations you experience. You are NOT your Gremlin messages. You are merely the conduit through which they flow.
Non-identification means that your sense of who you are is not defined by any limited set of sensations or stories. Imagine watching a scary movie in a theatre. You most likely have a reaction to the frightening images. Your heart rate will increase, you may start to sweat, you may be fearful in that moment but when the movie is over, you will go home and live your life like you usually do. You don’t believe that what you just saw was real. You know that you just had an experience, it came and it went, it was total fantasy. So too can you observe unpleasantness of thoughts, feelings and emotions just like projections on a screen. They can have an impact on you, they may rattle you, but they are not real and they are certainly not the definition of who you are.
Working with RAIN takes time and practice but the more dedicated you are to doing it, the more benefit it will have. If you resolve to go inward instead of outward, mindfulness for chronic pain can help you tackle unpleasantness with a strong mind and an open heart.