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Mindfulness, Emotion, and Pain Webinar Follow-Up

10/18/2016 3:00 PM

​Mindfulness, Emotions, and Pain Treatment Webinar Follow-Up

On October 11, 2016, Dr. Mel Pohl presented in our Chronic Pain Webinar series on Mindfulness, Emotions, and Pain Treatment.

You can view a recording of the webinar as well as download the powerpoint.

Dr. Pohl left us with some key facts to remember about chronic pain:

  • All pain is real.
  • Emotions drive the experience of chronic pain.
  • Opioids often make pain worse.
  • Treat to improve function.
  • Expectations influence outcomes.

As well as some key points about how to use mindfulness and it's effects:

  • Willful directed attention to present moment without judgment
  • Daily practice – like tuning an instrument
  • Changes the brain – neuroplasticity
  • Enriches the brain’s neuronal structures

Questions and Answers

Dr. Pohl was kind enoungh to answer a few of the remaining questions that we didn't have time for during the webinar.

Q: I've read that there is some risk in teaching mindfulness to those who have a history of trauma; knowing this can sometimes be an underlying factor for patients with chronic pain how do ensure it is safe and appropriate to teach/encourage mindfulness? i.e. screening, restricting type of mindfulness used etc.  

A: There is the phenomenon of people with trauma histories struggling with mindfulness practices. We offer the practices but always work with clients regarding their trauma histories and ways of finding safety for themselves. Some opt out of meditation groups because when their minds quiet, the intrusions are intolerable, but most of our clients with serious trauma use variations - eg eyes open, sit near a safe person, leave if necessary - and do ok developing these skills.

Q: Has evidence shown any connection between mindfulness meditation and decrease symptoms of chemotherapy like fatigue and nausea?  

A: I am not familiar with the data, but I can imagine the same benefits discussed would be similar with a person on chemotherapy - leaning into the experience without judgement in the present moment.

Q: Dear Dr Pohl, would you suggest to have a specific meditation routine (focus on the breath, body scan, etc.) Or rather go for an unspecific "random" meditation practice.

A: Yes, I think as a beginner, it pays to find a routine that you are comfortable with and practice regularly for a while (perhaps a few months) - then be less rigid about it. That said, many meditators use a variety of techniques, depending on the day and how they are feeling.  So no right or wrong way to do it, whatever makes it easier to get in the habit with practice.

Q: How about loving-kindness and compassion practice? Is there any data on that!  

A: There are fantastic practices - Sharon Salzburg and others write and teach about them. I am not aware of data about the efficacy. There have been studies on those who cultivate compassion with positive outcomes.

Q: Do you notice a difference between the psychology of patients who suffer from chronic pain that stems from a chornic condition? E.g. CRPS (complex regional pain syndrome patients) are very adamament to have their condition understood as physiological with psychology being an influence (but not cause) - any recommendations on handling those patients?  

A: I think all pain is real, regardless of whether we find a tissue driver or not. In my experience clinically, they present similarly. The manifestations are similar (eg catastrophization) depending on the client, and the treatment is similar as well.

Yoga for Chronic Pain Management References

Tilbrook, H, Cox, H. et.al. Yoga for Chronic Low Back Pain: A Randomized Trial; Ann Intern Med. 2011;155(9):569-578.

Williams,K., Abildso, C., Steinberg, L., Doyle, E., Epstein, B., Smith, D. et al. Evaluation of the effectiveness and efficacy of Iyengar yoga therapy on chronic low back pain. Spine; 2009: 3420; 66-76.

Saper, B., Sherman, K., Cullum-Dugan, D., Davis, R.B., Phillips, R.S., Culpepper, L.Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial. Altern Ther Health Med 2009: 151; 827.

Cox, H., Tilbrook, H., Aplin, J., Chuang, L., Hewitt, C., Jayakody, S. et. al.  A pragmatic multi-centered randomized controlled trial of yoga for chronic low back pain: trial protocol; 2010: 67 -68.

We hope you'll join us for our next Chronic Pain Webinar!​

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Last Modified: 10/18/2016 4:07 PM