Buddhist Teachings for Pain Management

This is the sixth and final post in a series exploring the topics covered in the book You Are Not Your Pain*. See You Are Not Your Pain: An Introduction to learn more.

Mindfulness-based stress reduction is a secular approach that applies the Buddhist principle of mindfulness to pain, illness, and stress. The more I learned about mindfulness, the more curious I became about Buddhism. Many Buddhist practices can help with managing pain and illness. Vidyamala talks about the ones that she employs regularly. (If you want even more, How to Be Sick* by Toni Bernhard is a treasure trove.)

Kerrie Smyres: What other Buddhist teachings do you find helpful in managing chronic pain?

Vidyamala Burch: Along with mindfulness, loving kindness and compassion are other qualities that come from Buddhist teachings. Both mindfulness and loving kindness are integral to how I manage my pain and to all of Breathworks’ pain management programmes in “You Are Not Your Pain.”

Through Breathworks’ pain management programmes, we guide people very, very gently and with loving kindness – metaphorically holding someone’s hand – to help them move closer to what is actually happening in their bodies.

Loving kindness is about having a response to yourself that you would naturally have to a loved one who is hurting, so for example if your child fell over it’s completely instinctive to scoop that child up to comfort with love and tenderness. So, try and turn that instinctive emotional response back on to yourself; it is basically gentleness and tenderness and acknowledgement of the feeling of sorrow of what it’s like to live in a body that hurts. It’s not an easy thing. I often think one of the most heroic things that you can do in life is to inhabit a body that hurts.

In Buddhism mindfulness and loving kindness are articulated in some key Buddhist texts. The main one on mindfulness is the Satipatthana Sutta and this provides a theoretical basis for what we teach. The Brahma Viharas is a key teaching on loving kindness. The Salattha Sutta describes primary and secondary suffering very well. So all these are implicit in my approach to living with pain and illness.

*Amazon affiliate link


Mindfulness for Managing Non-Pain Symptoms

This is the fifth post in a series exploring the topics covered in the book You Are Not Your Pain [Amazon affiliate link]. See You Are Not Your Pain: An Introduction to learn more.

You Are Not Your Pain is, unsurprisingly, focused on pain. But the concepts in the book, which are those of mindfulness-based stress reduction, can apply to all sorts of physical symptoms (and to life well beyond illness). In the book, Vidyamala Burch mentioned that she uses mindfulness to reduce fatigue. While I employ mindfulness for managing pain—and in all other aspects of my life—I had never tried to experience fatigue mindfully. I was so intrigued that I asked Vidyamala to explain. 

Kerrie Smyres: I saw in an interview that you used to have severe fatigue. Did your fatigue decrease as part of your mindfulness practice?

Vidyamala Burch: Yes my fatigue has massively decreased over the years in which I have practised mindfulness and compassion. Really to a remarkable degree. I now have a lot of energy, in fact more than a lot of my able bodied friends! This is partly because of what I have learned about myself through meditation and awareness. There is so much less inner conflict. Also, I have learned to manage my energy in daily life much better through pacing myself. I used to go at things hammer and tongs and then have a big flare up, but I am now more balanced in my approach. I use the slogan “take a break BEFORE you need it” rather than keeping going at an activity until I am completely shattered. That’s made a big difference.


Migraine Medication Detox, Week Two: Transition Period

migraine medication detox“This too shall pass.” Those words provide immense comfort when my migraine attacks are severe and disabling. They have carried me through many difficult years. As encouraging as this phrase can be, there’s a flipside to it: the difficult, trying times in life pass, but so do the pleasurable ones we never want to end. “This too shall pass” means that everything passes.

When I had migraine attacks last Sunday and Monday after having a remarkable few days, I was too busy panicking to remind myself that they would pass. My mind churned on my most fear-filled thoughts: What if my new treatment isn’t working? What if it’s making me feel worse? What if I will never again feel as good as I did these last few days?

Although I was 100% sure I was overreacting, that did nothing to assuage my fears. My worry settled a bit on Tuesday after I stopped the oxytocin (which was definitely a migraine trigger for me), but I continued to fret.

I didn’t remember that this too shall pass until Wednesday. That’s when I finally realized that detoxing from medication overuse headache and trying new meds mean I’m in a transition period. That should have been obvious, but I was so caught up in excitement—and then the fear—for the future that I wasn’t paying attention to the present. I’d forgotten that progress is not linear.

“Transition period” became a mantra of sorts in the last week. When I start to panic, I remind myself that I could still be detoxing from my meds (especially since I gave in to Amerge last Monday) and that the effects of my new treatment tends to build over months. Even more turbulence comes from experimenting with new treatments (Compazine, oxytocin, and some new-to-me preventives), changes in my meal frequency, and introducing new foods. I still have a ton of variables to work out. “Transition period” is now shorthand to remind myself that it will take time to sort out all these confounding factors.

It’s kind of an odd mantra, but I like its hopefulness. It tells me that I’m on my way to somewhere new, somewhere that could be great. (It could also be awful, but I’m not dwelling on that.) This too shall pass. I have no idea where I’ll be when it does. That’s a little scary, but it’s mostly exciting.

Learn more about my migraine medication detox:


Mindfulness Practice: Overcoming Discouragement

This is the fourth post in a series exploring the topics covered in the book You Are Not Your Pain [Amazon affiliate link]. See You Are Not Your Pain: An Introduction to learn more.

My orange silk eye pillow is still tearstained from the first time I tried to meditate. After three minutes of attempting the homework for the mindfulness-based stress reduction (MBSR) course I was in, I went to Hart in tears. I said, “She doesn’t have any idea how hard this is! How can she possibly expect someone to meditate when they feel as bad as I do? This can’t work for someone who is as sick as I am.” Eight years later, that memory is still so strong that I asked Vidyamala Burch about it during our interview.

Kerrie Smyres: The first time I tried meditation was homework for an MBSR course. I was crying within minutes, angry that the teacher had no idea how hard it was to be in my body. How do you encourage participants who have a similar reaction?

Vidyamala Burch: I know how you feel because when I first started doing body scans I felt much worse afterwards, like I had been run over by a train, because my body was holding so much tension that when I came into my body, I was completely flooded by the tension. But I just intuited that I needed to keep doing it and those feelings eased off over time.

If you have got a body that you don’t like because it hurts you, because you feel let down by it or whatever—it is one of the hardest things in the world to come into that body and it should never be dismissed as something that is easy.

At Breathworks, we really know how hard it is, so we put a lot of emphasis on comfort, making sure people have the blankets and cushions that they need, we are sort of loving people, tucking them in literally and metaphorically, and if people cry or get angry, we say ‘Yes, of course,’ that is a totally appropriate response. We put a lot of emphasis on love and kindness which is very important. Otherwise body awareness can seem a bit more mechanical—you are trying to just come into your body and go through the different body parts without this attitude of love. Well, that will be a really hard thing to do.


Migraine Medication Detox, Week One: Easier Than Expected

migraine medication detoxMy first week of migraine medication detox began with a final dose of Amerge (naratriptan) and two Midrin after breakfast on Sunday, August 21. Despite a rough start, the week’s been surprisingly easy.* I feel better than I have in almost two years! Here’s how the week of detox went.

The treatments to get me through the week were:

  • Compazine 30 minutes before each meal. Although it’s a nausea med, some people get migraine relief from Compazine. (It only made me tired and helped the nausea; it did not give me any migraine relief.)
  • Oxytocin as an acute medication once a day. (Which I discovered is a migraine trigger for me.)
  • A new treatment I’ve been using since June 22. It is a preventive treatment that can also be used acutely. That’s all I can tell you right now, but will share more as soon as I can.

Day 1: Monday was the worst day by far. I was too nauseated and dizzy to eat breakfast until 1 p.m. and that required dosing with Zofran and Compazine. The pain, which felt cold and high on my head, hovered around a 4 and peaked at a 5, which lasted a couple hours. Ice exacerbated the pain. Thanks to Compazine, I slept from 2 p.m. to 7 p.m. I definitely had a migraine attack in the night and didn’t sleep well (probably because of the Compazine-induced nap).

Day 2: I started Tuesday with a decent amount of energy and little pain. I even showered and did housework before eating. The migraine attack that followed breakfast was slight, but definitely present. Between it and the Compazine, I was laid up until I took a nap. Within 30 minutes of waking from my nap, I was perky and functional. I spent three hours working on chores and even did some writing. All with overcast skies! I once again had a migraine attack in my sleep, but it didn’t keep me up. Night sweats and vivid dreams were the only evidence that an attack happened at all.

Day 3: I switched from taking oxytocin at night to taking it after breakfast on Wednesday. It was a remarkably good day. I slowed down for a couple hours after eating, but am unsure if migraine or Compazine was the culprit. I even ran errands in the afternoon. After dinner was the first time I felt like my new treatment actually aborted a migraine attack! It was also the first night in almost a year where I didn’t fall asleep minutes after getting into bed.

Day 4: I woke up feeling fine Thursday and skipped the pre-breakfast Compazine hoping that I would be less sluggish without it. I used my new treatment after eating and it once again appeared to abort the migraine attack. I felt a little slow for maybe an hour afterward, but was able to write all day. My mind got a little fuzzy in the late afternoon, so I decided to rest. Before I did, I cleaned up a mess in the laundry room and put a coat of sealant on the bathroom tile… and discovered I no longer needed to rest. I finally stopped “doing” for the day at 7 p.m.

The other big news of the day: I ate three meals instead of two! I can use my new treatment three times a day, so I wanted to see if it would abort all three eating-triggered attacks. It did!

I then stayed awake the entire night. It wasn’t one of those maybe-I-slept-maybe-I-didn’t kind of nights. I read and did housework all night long. What kept me up? NOT having a migraine attack. I’m one of those fortunate folks who gets sleepy during an attack. After 17 months of nightly attacks, I think my body had gotten used to using migraine as a sleep aid.

Day 5: Despite not sleeping one wink, Friday was another remarkable day. It was house-focused, including signing the paperwork to have the grass removed from our yard and replaced with waterwise plants. (I’m so excited!) And I finally fixed the mess created when shelves in the laundry room fell a few months ago. Nothing to write home about… except that having a day of normal chores is absolutely worth writing home about.

I’m trying to temper my excitement about how much better I feel (Hart is, too). I feel so different, so much better, that I want to believe the ketogenic diet, my new treatment, and getting out of MOH have made a huge, lasting difference. And maybe they have, but I don’t want to go (too far) down that path until I have more data. I don’t want to be (too) crushed if this improvement turns out to be a fluke. Then again, I know my body really, really well. This feels different. (I might hate myself later for writing those words.)

Day 6: I felt great all day Saturday! I woke up at 8 a.m. and organized the house until 11 p.m. I didn’t even check Facebook. I slept well, too.

Days 7 & 8: Both days started well, but migraine attacks crept up through each morning. Both attacks made me so tired I couldn’t avoid napping. Both times, the migraine attack lifted within 30 minutes of waking up. Napping usually gives me some degree of migraine relief, but it only began aborting attacks completely this summer. I’m still surprised when it happens. (I was so afraid of losing another day that I took one Amerge (naratriptan) as soon as I felt symptoms on Monday. My background headache was more painful that day.)

Day 9: I spent this morning preoccupied with Sunday and Monday’s migraine attacks and obsessing over whether an attack was coming on. As I sifted through potential triggers, I kept worrying that my new treatment is backfiring. Although that is unlikely (I’ve been using it for two months with no problem), it’s my biggest fear, so it’s what my mind settled on. Other possibilities are that oxytocin is a trigger, I’ve developed reactions to some foods I thought were OK, or that merely touching cleaning product bottles now triggers attacks. I went with the oxytocin hypothesis and skipped my dose this morning. I’m going strong at 3 p.m., so I’m guessing oxytocin was the culprit.

Future weeks: Medication overuse headache symptoms can last six months after the final dose. Given how easy my migraine medication detox has been and that I’ve only been using excessive amounts of medications for 16 months, I doubt I’ll have symptoms that long. Still, I’m hopeful that the next few weeks or months could bring even more improvement. Maybe I’ll one day be able to eat without having a migraine attack at all.

*My experience does not represent the typical migraine medication detox. It has been easy because of the preventives I was on before I started (and possibly because I was only in MOH for a year). The drugs I used as a bridge were ineffective—Compazine only made me sleepy and oxytocin made my migraine attacks worse. In the six months before starting the detox, my pain rarely got above a 4 and my most disabling symptoms were fatigue and cognitive dysfunction.