09. Stress Management as a Top Priority in Your Rehabilitation Process

Through relaxation you can break the vicious circle of pain and stress. This podcast takes you through some easy to learn methods of relaxation, helping it to become part of your daily life and improving your wellbeing. It also lists the benefits of meditation and looks at the supporting scientific evidence, examining why relaxation should be an integral component in your recovery.

Relaxation

Relaxation is an integral component of cognitive behavioral treatment programs for chronic pain.1 Taking care of stress and anxiety as a chronic pain patient is crucial for your recovery.

Meditation

Meditation is also a great way to built relaxation into your daily life. There are many different ways of practicing meditation and you have to find what works best for you.

Many people enrich their lives through practicing meditation.

When you read interviews with successful CEO´s, entrepreneurs or celebrities who have incorporated meditation routines in their lives it is astonishing to see the huge benefits they experience.

Personal benefits of people who meditate regularly:

more happiness

having more energy

having more creativity

living more efficiently

a better understanding of ones own emotions

more sensitivity to the feelings and emotions of others

more control over ones own emotions

less pressured by your experiences

less stressed

feeling more relaxed

more calming thoughts

control over your sensory filtering

improved memory and executive function

increased ability to concentrate

increased emotional intelligence

Thinking about relaxation, mindfulness and awareness during our recovery can't be done without looking at some important evidence and thoughts about meditational practices:

Mindfulness meditation programs improve anxiety, depression and pain over the course of 2–6 months. The effects are comparable with those you can expect after taking antidepressants for the same period of time, but without the associated toxicities.2

47 placebo-controlled trials all found small to moderate improvements in pain, anxiety and depression. What is really great about this review (Meditation programs for psychological stress and well-being from 2013) is that it demonstrates that the meditation group attained better results compared to the control group undertaking an equally intense treatment regarding focus and time, such as lectures, talks and art therapy sessions.

If we consider this evidence, then it seems a good reason to check out mindfulness for yourself and see if meditation could be something for you to try.

A definition of mindfulness

Mindfulness has been described as a "non-elaborative, non-judgmental awareness" of present moment experience.3

Maybe you have heard of Zen, it´s very closely related to the mindfulness approach.

In general mindfulness techniques can be divided into two styles:

focused attention

"Focused attention is associated with maintaining focus on a specific object, often the changing sensation or flow of the breath or an external object. When attention drifts from the object of focus to a distracting sensory, cognitive or emotional event, the practitioner is taught to acknowledge the event and to disengage from it by gently returning the attention back to the object of meditation".3

open monitoring

"By contrast, open monitoring is associated with a non-directed acknowledgement of any sensory, emotional or cognitive event that arises in the mind. Zen meditation is considered to be one form of open monitoring practice. While practicing open monitoring, the practitioner experiences the current sensory or cognitive 'event' without evaluation, interpretation, or preference".3

Many guided meditation programs consist of a mix of those two styles. Often changing from one to the other within a meditation session.

I also think that it's really important to know that clinical research into mindfulness has been going on since the early 1980s. For me this means that there is a good scientific evidence for using meditation techniques detached from religious beliefs or dogma for health purposes.

How to start

There is plenty of good content on the Internet available for free, simply search for mindful meditation. Check out some talks about meditation on TED.com and be inspired, or check out www.mindful.org

Here are some great resources: Free guided meditations from UCLA:

Each week has a different theme, and usually includes some introductory comments, a guided meditation, some silent practice time, and closing comments. Presented by the UCLA Mindful Awareness Research Center.

http://marc.ucla.edu/body.cfm?id=107

http://marc.ucla.edu/body.cfm?id=22

UCSD Center for Mindfulness:

Guided audio files for practicing Mindfulness-Based Stress Reduction (MBSR) from the UC San Diego Center for Mindfulness.

http://health.ucsd.edu/specialties/mindfulness/programs/mbsr/Pages/audio.aspx

Basic meditation with Tara Brach
Free meditations that you can stream or download.

https://www.tarabrach.com/guided-meditations/

Contemplative Mind in Society
Guided practices from Mirabai Bush, the center's director, Diana Winston from UCLA's Mindfulness Awareness Research Center, and Arthur Zajonc, president of the Mind & Life Institute.

http://www.contemplativemind.org/practices/recordings

Insight Meditation Society
Selected talks, podcasts, and audio streams, including various lengths of guided meditation.

http://www.dharma.org/resources/audio#guided

John Kabat Zinn on youtube:

Professor of Medicine Emeritus and creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School.

https://www.youtube.com/watch?v=8HYLyuJZKno

Literature:

1. Morley S, Williams A. New Developments in the Psychological Management of Chronic Pain. CanJPsychiatry. 2015;6060(44):168-175.
2. Goyal M, Singh S, Sibinga E, et al. Meditation programs for psychological stress and well-being : a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357-368. doi:10.1001/jamainternmed.2013.13018.Meditation.
3. Zeidan F, Grant J., Brown CA, et al. Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain. Neurosci Lett. 2012;520(2):165-173. doi:10.1016/j.neulet.2012.03.082.