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My name's Vidyamala Burch and I'm the co-founder and director of Breathworks, which is a mindfulness-based
organization. We're based in the UK, but we've got trainers in many other countries.
I like to describe mindfulness as simply being awake, being really present to your
life as it happens, not being lost in the future, worrying about the past, but just
being right here, right now, in your
body, aware of your thoughts, aware of your emotions and then you can
make choices how you respond to your experience. So it's that moment of choice that
comes out mindfulness, that's so life-changing. Mindfulness as a treatment, for example, in Mindfulness-Based
Pain Management, which is the program that I've developed. It's really very, very simple. Hard to do, but very simple
conceptually, and it is this idea of being really present to your experience.
If you've got discomfort in the body, if you've got pain in the body, it's learning to turn towards that
experience and to come into a relationship with it, because usually
we're pushing it away, which is the last thing we want to acknowledge. And because
we're resisting and pushing it away. Paradoxically, we're dominated by it, through omission. It's like having a monster in the room. So, you
turn towards it and you think, OK, what is going on here... And we have lots of methods
to train in that, we've got meditation practices, body scanning, breath awareness,
learning to work with you thoughts, learning to work with your emotions, and when you
come into a relationship with it, you can make choices about what is the
appropriate next step. If you're in a lot of pain, it might be to take break,
it might be to have a lie down, if you're feeling stiff, it might be to go for a little walk,
if you're hungry, it'll be to eat. If you're feeling very distressing thoughts, you
note those, and to look at your thoughts rather than from your thoughts is a very different
experience. If you're very, very, angry and you think, Ohh, I'm really angry, that's
different from being lost in anger, because you step back a little bit
and you're turning awareness
back in on your own mental, emotional, and physical experiences. So, the treatment
process, is you really just training in that again, and again, and again. We call it
practice. It's a little bit like learning a musical instrument. You have to do the
scales to become proficient. So we do meditation practice to become proficient, and
skilled at coming into relationship with our own direct experience and then learning
how to respond more and more creatively and helpfully over time. I've lived with
chronic pain since 1976 when I injured my spine in a lifting accident, and then I
had a car accident about five years later, and I've had three major surgeries over that period
between now and then. The pain's been constant and pretty severe most of that time. I've got
partial paraplegia, so I've got paralyzed bowel, paralyzed bladder, and mobility impairment, and of
course, I've got the normal degeneration that comes with age, joint problems and
so on
In terms of how I've lived with that pain, initially, I was just in denial. I pretended
that there was nothing wrong with me, I was angry with my body, I pushed my body and
then, eventually, I had a crisis about ten years after my original injury. Then I started to
learn how to work with my body, rather than fighting my body, and move more
towards accepting my situation. And I would say now that I've got a very good
quality of life, I've got a very rich life and I like to say that I feel I'm
flourishing now. I've still got pain, but my life is no longer dominated by it, and I've,
in a sense, befriended my situation and I have a good life with my pain as part of it.
The sort of pain I get each day is a combination of neuropathic pain, which is
a bit like toothache in my spine and down my legs, and then I also get joint pain
which is a kind of grinding bone pain in my back and mainly my legs and my feet.
In terms of the intensity of that pain, I would say it's normally between 5 and
8 out of 10, on a pain scale. It tends to get worse as the day goes on, because it's worse with
being upright and with activity, so I'm better in the mornings and I'm more tired and
achy in the evenings. Through my life journey of learning to live as well as I
can with my painful body, I've done a lot of reading and a lot of research about what
pain is, and I've learned that pain is an experience that's subjective. Everyone
pain differently, and it's in the nervous system of the body
and, in a sense in the mind. So, I used to think it was, my, my... I felt pain because
my back was damaged, but now I've learned that my back is damaged. There's certain signals that go
into my nervous system, and then my mind has become conditioned, if you like, to
feel pain. So, what I've learned is that when you live with chronic pain, you're
nervous system becomes very good at feeling pain, so in a sense it's a bit
like, if you turn, a bit like turning up the internal amplifier, so you become better and
better at experiencing pain, which is hardly a skill that we want to develop.
But that seems to be what happens, that we get more and more of our nervous system devoted to the pain
experience, and that's definitely my experience. I've got these spinal injuries and
back pain and joint problems, but the pain itself is also something that I've
needed to learn how to manage. I found it very interesting learning how to use my
mind to manage my pain, which wasn't something that w ould have occurred to me 38 years ago when I injured my spine.
But, I was lucky enough to be taught a meditation practice when I was in
hospital when I was 25, and it was quite a revelation for me. I was a young girl
lying in a hospital bed, loads and loads of pain, and then this person taught me or asked me
to place my mind on a certain image. He asked me to remember a time I'd been happy and a place
I'd been happy. I took my mind back to the southern alps of New Zealand, where
I'd done loads of climbing and been extremely happy as a teenager. I did that with the
teacher. He brought me back to the present. I was still the same girl, still lying in the
same hospital bed, and yet my experience had profoundly changed, through what I'd done with my mind, and that
was a complete revelation to me, and I got the bug for mind-training, or I got
hooked into training my mind, because I realized that what I did with my mind changed
my experience of the pain in my body. Now it's very important not to think, therefore, if you're
experiencing pain, it's all in the mind and it's your fault. We experience pain
because there's an injury, the nervous system's become sensitized, as I said earlier. However, we can
use our minds to unwind that sensitivity. We can use our minds to turn
down the volume control in the nervous system. We can use our minds to calm everything
down using meditation techniques, and so on, and I found that extremely effective
for myself, very, very, empowering. So, if anyone had ever told me it's all in the
mind, I would have felt very, very, angry, because I would have said, but my body is damaged, how can you say
that it's all in my mind. So, it's quite a subtle distinction. I have pain because
my body is damaged and my nervous system experiences pain, and my mind can either make
it worse, or it can make it better.
depending on what I do with my mind. So, the model that I've developed at Breathworks
works is to divide the experience
of pain or discomfort into two components , and we call that primary pain and secondary suffering. The primary pain or the
primary suffering is the actual unpleasant sensations that I'm feeling
in my back at any given moment. The secondary suffering, which is often much
much more distressing, is all the ways I make that pain worse, through my
unconscious resistance, through the internal "I don't want this experience. I don't
want it", going on. And that can happen mentally, with things like catastrophic
thinking, allowing my mind to just go over and over the kind of "Oh, my god, it's ruined my life,
why me, poor me, it's not fair, how I am I going to cope how am I going to earn a living" , etc., etc.
I can allow my mind to do that, or I can train my mind not to do that.
Emotionally, it's things like fear, anxiety, depression, despair... all, very, very
understandable emotions and yet we can learn to have a sense of choice around
whether we fall into those emotions or whether we simply note the presence of
them, and they may just allow to be there, just let them go. And then, physically, secondary
suffering is secondary tension, so you've got, I've got pain in my back. I don't
want it, I tense against it, and then guess what, I get more pain, so I have pain plus tension
equals more pain. So, if I use my mind to learn how to soften into my body, soften
into my breath, then I don't get the secondary tension, so I'm just left with
the primary sensations. And what I've learned through all the years of practice, of
mindfulness practice, is two important things. One is, you only experience pain one moment at a time,
because, of course, a lot of the distress is thinking, oh, my god, how am I going to get through the day,
or the week, or my life... But, you only experience it one moment at a time, and the other is
that the present moment is bearable. Because when you allow the mind to run away with itself, you could think I
can't stand it, it's going to kill me. When it's just in the moment, and you're just staying with
the basic experience without adding on all the secondary things, then it is bearable. It's not
nearly as bad as I fear it will be, and that's a tremendous relief, just to live with it
moment by moment by moment, breathing with it, and accepting it as it is, without
adding anything. If I think of my own experience of back pain, there's
definitely a component which is just the raw physical sensations, and then there's a
component which is my mental and emotional reactions to that discomfort,
the kind of "I don't like it" reactions.
Before I learned mindfulness, I would say most of the pain
I experienced was the mental and emotional aspect of it, which is quite a shocking
thing to acknowledge, because..... I wouldn't have agreed with that then, obviously,
no, no, no, it's just my back pain. But now that I've become much more aware of my inner
processes, I can see how the mental and emotional side was very intense and very
strong. Now that I've got more agility with my own mind, let's call it that, more of mind training, mindfulness has
helped me get to know my own mind better, get to know my reactions. The mental and
emotional aspect has calmed down massively. So, my overall experience of
pain has diminished, so I don't suffer anything like the way I used to, even though the painful
sensations are still there. And, there's a very important distinction, I think, between pain
suffering. It's interesting. Pain, you can live with, suffering is where you are kind of
tormented by the pain. So, you can have pain without suffering, and that's very much what we teach in
mindfulness training, how to accept the pain and reduce or overcome the suffering dimensions
to that pain. There's a nice quote that I think came from Christopher Reeve, who was the guy who
broke his neck, who'd been superman, and he said pain is inevitable, misery is a choice, and I think that's
very good, actually. That we're all gonna have pain in life, but misery is not compulsory. We can learn to tone
down the reactive aspect to our pain, our discomfort in life. When we talk about the mental and emotional aspect of working
with pain, or learning how to train one's mind to turn down the reactive distress
around pain. That might sound a bit esoteric, complicated, even religious. But I've got a really good
little exercise that will help you get a sense of that in a very, very, simple way.
And it's using the breath, how we use the breath. You remember that earlier on
I said that you can divide pain into primary secondary suffering. Primary is your basic sensations,
and secondary is all the ways you react to those sensations, and usually that's caused by resistance, the kind of, "I don't want this", and when we resist,
we almost always hold the breath, as well, and when we hold the breath, we get more
tension. So, I'd just like you to make a fist with one hand..... and what's happened to your breath?
and you're probably finding that you're holding the breath, that's what almost everybody does.
You make a fist, and you stop breathing.
The fist is a metaphor for the pain in the body.
So, I've got back pain and it's like I've got a fist in my body. Then, if I'm not careful, I've got back pain plus
breath holding, more tension, more pain. If I have my fist and I imagine
directing my breathing into the fist,
if you do that at home, imagine directing your breath into the fist. What does the fist
want to do?... and you'll probably find that the fist wants to
open. It's quite natural, when we direct breath into a n area of contraction in the body, it wants to soften,
and then we're just left with the basic sensations of pain, plus healthy, free flowing breath.
and, of course we breathe to deliver oxygen to the cells, which is energy, which is life
force, and to get rid of carbon dioxide,
which is the waste product. So, if you're breathing optimally, then that's
going to be better for energy, better for your health. If you've
got tension in the body, contraction in the body, discomfort in the body, plus breath-
holding, inhibited breath, that's a recipe for a lot more distress and suffering. So,
really, learning to bring awareness to our experience of the body, awareness of how we live with
pain can be as simple as coming into the breath and the body, and allowing the breath to soften
towards, soften towards, soften towards the areas of discomfort, and to let them settle, and
unwind that cycle of tension and breath-holding, and tension and breath-holding that can become very, very
intense. I feel that I now, finally, after 38 years, I've learned how to manage my pain well
and I've learned how to create the conditions in my life to support what I want to do with my life, and to bring
my pain with me in such a way that it doesn't dominate. And the things I do are very, very
simple. It's not fantastic rocket science, it's breath awareness, being as aware as I can
of my breath, as often as I can in my life, and noticing the breath-holding, and dropping back into my
body, dropping back into my breath. That has changed my life, that's changed my life
enormously. Meditation practice has been extremely important to my journey, so I
do a meditation practice in the morning, every day, where I settle into my body, I
come into relationship with my discomfort in a way that's gentle, tender,
caring. I look at my mind, what are my thoughts doing, how can I manage my thoughts... I look at my
emotional states, and I spend some time trying to cultivate more positive and supportive
emotional states. So, I do that in the morning, and then after lunch every day, I do a body scan,
which is where I lie down on my bed, or on the floor, and I scan through my whole body
with my awareness, and I soften
my whole body with the breath. And that's been enormously
important as well, those two things, the morning's meditation practice, and body scan
after lunch. The other thing that's changed my life, very much for the better
is pacing, and the phrase that I use there, is, take a break before you need it.
Take a break before you need it, and that's been a very difficult thing for
me to learn as a person, because I'm a person who pushes the envelope. That's my
character. So, the idea of stopping something before I was in a state of
complete exhaustion, was odd. I thought you just keep doing something until you
can't do it anymore, and then you collapse. That's what I thought was an intelligent way of living.
So that's what I used to do, day after day, after day, pushed myself to complete
exhaustion. So, what I use now, what I do now is use a timer, when I'm at my computer, I
work for twenty minutes, the timer will go off and then I have a rest for 10 or 15
minutes, then I go back to my computer. And I've written two books in this method, so you
can get a lot done in twenty minutes spells. What I used to do, was I would sit at my
computer for maybe two or three hours in the morning, until I was in agony. I'd have
sweat dripping off me, my breathing would be incredibly contracted, I'd be in very tired mental
states, and then I'll be completely wiped out for the rest of the day. So, I might have two
or three hours of relative productivity, then I'd be just shattered. This method of
taking a break before I need it, means I can keep going all day long, so I can get
much more done in a day, and it means I never get to that point of complete
exhaustion. So, if you think of it like energy is money in the bank, I never
completely drain the account, I never go into debt. So, you just always had a
little buffer in there. So, that's been really, really important, learning how to pace my activities. And I'd
just like to repeat that, for my character and my personality type, that did not come
easily. So, I always say, if I can do it, anyone can do it, yeah.
And once I started to experience the benefits, then it became easier, and that was
quite soon, quite early on. So, breathing meditation, pacing, taking a break before I
need it, and then it's very simple things like three meals a day. That's very
important. And, I think that when we're on medication, we wake up in the morning, we
take our drugs, we feel sick, we don't eat, we feel wiped out, and then the
whole day is in ruin already. So, having a good breakfast, a good lunch, a good dinner, that's been very
very important. Living a routined life. Again, that's not my nature, but I'm a great fan
of routine these days, going to bed at the same time, getting a decent night's
sleep. That's been important. And, then lastly, exercise. So, I do stretches every
day, just very, very, gentle stretches. If I didn't do my stretches everyday, my
back will be much, much, worse. I know that, because every day, I spend the time kind
of unlocking my back, because of the condition, I spend the time just limbering up, and then I
can manage through the day. So, I do stretches and I also swim, so aerobic exercise is also important. And, again, you know, I'm not talking
about swimming a mile or anything, it's just a few lengths, three times a week, makes a big difference.
So, these are the ways I've learned to manage my pain. And another point about that actually is, I used to think
that a miracle was like one big thing that happened, you know, blinding light, and your life's changed.
If I look at the way I am now compared with twenty years ago, it is a
bit like a miracle. I'm so much better, my quality of life is so much better, but that's
come about through little changes across a very broad front. So, lots and
lots of little changes across a broad front adds up to very, very, significant and
profound change, and that's been a really great thing for me to realize as well.
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