During my decades of working with people affected by cancer, we observed many issues that were regarded as difficult or impossible to manage which actually resolved in large part or even completely disappeared. Chronic pain, sleeplessness, anxiety, depression, PTSD; the list actually does go on… And this is not being immodest – our groups were presented by an excellent team and involved a multi-layered, fully integrated approach that seemed to work for many people. You could describe this as radical healing.
Every now and then a new research article comes along that provides an explanation, an insight into something that has been observed like this over time, and in doing so, points to a whole range of new possibilities.
The research in question addresses chronic pain. It demonstrates how a combination of mindfulness and instruction in how underlying stressors and psychological contributors to persistent pain as well as conditioned pain responses and fear avoidant behaviours outperform other forms of treatment for chronic pain.
So this week we examine the insights this specific research provides, and then examine the more general question – what is the potential for this combination to work for other conditions? But first
Thought for the day
Even in the greatest yogi,
The difference between an ordinary person and the yogi
Is how they view their emotions and react to them.
An ordinary person will instinctively accept or reject them,
And so arouse the attachment or aversion
That will result in the accumulation of negative karma.
A yogi, however, perceives everything that rises
In its natural, pristine state,
Without allowing grasping to enter their perception.
Sogyal Rinpoche
FIRST THE SPECIFIC EXAMPLE OFFERED BY BACK PAIN
64% pain free six months after new treatment
Chronic back pain is the leading cause of disability worldwide. In the United States, patients spend up to $300 billion each year to treat the condition. However, common therapies such as surgery and steroid injections intended to address the physical origins of back pain have not been clearly proven to work in randomized clinical trials.
Researcher Dr. Michael Donnino : “The current paradigm of pain management focuses mostly on treatment of a physical origin of pain, however, in many cases of chronic back pain a physical source of pain cannot be identified. Our group focused on the hypothesis that non-specific back pain is the symptomatic manifestation of a psychological process, substantively driven by stress, repressed emotions and other psychological processes. The exact mechanism remains unclear, but an analogy could be made to other known effects of acute emotional states, such as how the emotion of embarrassment may result in the capillary vasodilation we know as blushing.”
Therapy (PSRT), is designed to address the psychological aspects of chronic pain.
Treatment strategies include educating patients about the links between stressors and pain.
Armed with this knowledge, participants learn healthier ways to process stress and express emotions.
The program also focuses on desensitization or reverse conditioning to help patients break the associations that often are formed with triggers of pain such as bending or sitting.
“Often these triggers are assumed to be the cause of pain, but they are perhaps better described as associations that can be unknowingly conditioned in a way similar to how Pavlov conditioned dogs to salivate to a bell by pairing the bell with food,” Donnino noted. “Our program works to reverse these conditioned responses and thus improve pain and pain disability.”
Eight weeks of mindfulness-based stress reduction training, or MBSR, is included in the program.
Participants in the study were randomly assigned to receive either the novel 12-week PSRT intervention, eight weeks of MBSR only, or usual care under the guidance of their physicians without influence from the study team.
After just 4 weeks, researchers saw an astonishing 83% decrease in reported pain disability in the PSRT group compared to 22% and 11% in the MBSR and usual care groups respectively. With regard to pain bothersomeness over the same time period, the PSRT group had a 60% drop compared to 8% and 18% decreases in pain bothersomeness for the mindfulness and usual care groups, respectively.
every time interval.
Moreover, at the end of 6-months, 64% of patients with chronic back pain in the PSRT group were completely pain free (reporting 0 out 10 on a pain scale) whereas only 25% and 17% reported being pain free in the mindfulness and usual care arms, respectively.
Donnino said “When patients recognize the relationship between the mind and their physical pain, this orientation sheds new light and provides them a basis to engage with the multifaceted program that works interchangeably to improve pain and disability. This study shows that our program has the potential to be highly beneficial when compared to both usual care as well as usual care plus additional treatments such as MBSR.”
The research details - with link to the original paper:
Donnino, M W et al: Psychophysiologic symptom relief therapy for chronic back pain: a pilot randomized controlled trial, PAIN Reports: Sept/Oct 2021 - Volume 6 - Issue 3 - p e959
THE WIDER IMPLICATIONS
People often came to our cancer groups feeling hopeless, having the belief there was nothing that could be done for them or that they could do for themselves; plus they knew no self-help techniques with the potential to effect change. The groups first provided a paradigm – a way of thinking about or understanding their situation that made sense of how their problems had arisen, what was going on at a physiological, psychological and spiritual level, and provided real hope based on the experience of others that they could recover. Then we taught them a range of self-help techniques, along with ways to evaluate and get the best out of conventional medical treatments and appropriate natural therapies.
My contention is this study helps explain why people in our cancer groups reported a wide cross section of excellent results. The health education we provide helped make sense of what they were experiencing – where their issues came from, what had been perpetuating them, and how they might diminish or drop them altogether.
This new piece of research triggered the insight : the essential elements required for major self-healing are hope, belief and technique.
The contention is this study helps explain why the people in our cancer groups did report such a wide cross section of excellent results. As in the study, the health education we provided helped make sense of what our people were experiencing and what could be done about it. This provided belief.
Armed with this knowledge and the belief it created, they still needed tools (things to do) to break old, unhealthy patterns and to create new healthy ones that heal. So we encouraged good nutrition, affirmations, imagery, deep relaxation, mindfulness, contemplation on the beliefs, the meaning and the purpose of their illness, and of course, meditation as the mainstay.
Their belief opened the way to hope, and once they began to engage with the techniques and personally felt the benefit, their hope became solid.
With hope, belief and technique all actively engaged, radical healing flows.
THE SADNESS
The programs the team and I offered at the Foundation for decades are to my knowledge, no longer available in their entirety. Happily, individual elements of them are widely available – as in the freshly researched and excellent pain management approach that combines a good paradigm with mindfulness – but I wonder when it might be that rather than testing just 2 things, the whole gamut of possibilities is investigated?
We were unable to obtain funding for such research back in the day; what will the future bring?
A WIDER RELEVANCE
What we are discussing here is the basis of self healing. These 3 elements of hope, belief and technique apply to a wide range of disease conditions and symptoms that accompany those diseases. This is why we observed people turning around sleeplessness, anxiety, depression, PTSD and so on.
My own hope is we will see more research in these other areas, and a wider uptake of the principles at a mainstream level. The potential is vast…
POSSIBILITIES
i) The books
The program we used is detailed in my book You Can Conquer Cancer. There is a specific chapter on pain management and all the other techniques are clearly set out.
The audiobook is available for downloading HERE. Many people tell me they worked it out for themselves from this book.
You might find extra help with meditation from my book Blue Sky Mind.
Also, The Mind that Changes Everything examines how the mind works and how we can use it to best advantage. It includes details of 50 Mind-Body Medicine techniques.
ii) The downloads
Downloads are available detailing every aspect of the program and can be obtained HERE
iii) The App – Allevi8
Allevi8 is a mindfulness and meditation based practice app where you can access specific healing techniques to address the symptoms associated with significant physical and mental illness. Deep relaxation, mindfulness, contemplation, guided imagery and meditation are all featured.
With options to listen to the voice of my wife Ruth or myself, it has short video introductions setting out the paradigm for each of the symptoms and many other features including access to one-to-one online teaching from excellent meditation teachers.
Download from your app store – Allevi8.
Bon Chance!
RELATED BLOG
If you are interested in my rather radical way of treating my own back pain, here it is…
Something I would not recommend
