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In their words: Dr Bruno Cayoun & The power of equanimity for pain reduction

Thursday, August 27, 2015

It was 10 years ago, but I clearly remember walking in the corridor of the School of Psychology with Sara Lazar’s article in my hand and a strange sense of elation. I had seen the first biological evidence that mindfulness meditation can increase volume in parts of the brain used for sustaining attention and regulating our emotions.

The repeated observation of brain reorganization, also called ‘neuroplasticity’, was no longer limited to stroke rehabilitation and phantom limb phenomena. Since then, numerous studies have further revealed the brain mechanisms and beneficial effects of mindfulness meditation in a wide range of conditions. Among those, many have investigated the effects of mindfulness on the brain and behavior of pain sufferers.

When we are in pain, we perceive pain as a threat. We resent it and avoid it as much as possible, often forgetting that it is just a messenger of something unusual to attend to in the body. In other words, we take our pain personally. Three years ago, American neuroscientists Marwan Baliki and Vania Apkarian published compelling neurological evidence that 80 percent of people who transit from acute to chronic pain produce neuroplasticity linking pain pathways to learning areas of the brain, showing that chronic pain is largely learned. They concluded that future research should focus on finding ways of preventing the learning of pain.

Incidentally, for the past 14 years, my colleagues and I have not only done this, we have also trained chronic pain sufferers to unlearn their pain. We have done so by implementing a mindfulness-based exposure technique to increase distress tolerance during both physical and emotional pain. This method is derived from the Burmese vipassana tradition in the lineage of Ledi Sayadaw, Thetgyi, U Ba Khin and Goenka, and is an important skill learned by all mental health professionals training in Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT) at the MiCBT Institute.

Though the entire interaction with a client/patient lasts about four minutes, the actual exposure lasts only twice 30 seconds. No tricks, no distraction, no hypnosis, just a particular way of paying attention; with objectivity and equanimity. The results are more than amazing. They defy our common understanding of both physical and emotional pain. Following exposure, the usual average of pain reduction is about 50 percent, and our recent pilot trial shows that the benefits are maintained at 10-week follow-up.

It is understandable that not all chronic pain sufferers are able or amenable to undergo a full mindfulness-based program and maintain daily meditation practice. Accordingly, using such a short method that they could use on their own, following a brief demonstration with their GP or pain specialist, could be a wonderful way of assisting conventional treatments. I look forward to presenting our results in October at the forthcoming Mind and Its Potential conference in Sydney.

Dr Bruno Cayoun is a clinical psychologist and principal developer of Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT). He will be presenting at Mind & Its Potential 2015. For more information and to register, please click here.