Health Mind over matter Can meditation and other mind therapies alter our perception of pain? Words: Pete Stannett How we perceive sensory information is shaped by past experiences, our current ability to process information and our expectations. A very good example of this is the experience of pain. It has been shown that our psychological activity – how we think, feel and perceive – can be self-regulated through the practice of mindful meditation. Both meditation and pain alter sensory, cognitive (thought processes) and emotional aspects of our experience. This suggests that the regions of the brain involved in meditation are also concerned with pain processing, although the regions associated with meditation have not been clearly identified. Exactly how these might influence pain perception remains unknown. In one study that compared measures of pain intensity in those who had undergone meditation training, it was found pain decreased by 11 to 70 per cent compared with those who had not received training. The pain relief was directly associated with the regions of the brain identified by Magnetic Resonance Imaging (MRI) as those that are involved with how thought processes influence the perception of pain. Although there are many forms of meditation, several methods focus attention on the breath, monitoring thoughts as they arise but not engaging with them, and returning attention to the breath. Be mindful Mindfulness mediation has been characterised as having two cognitive (thought) processes – focused attention and a non-evaluative awareness. The non-evaluative awareness has been shown to reduce the unpleasantness or pain, but not the intensity. The focused attention, however, enhances cognitive control, which may reduce the intensity of pain. There has been an increasing interest in recent years in ‘acceptance-based’ therapies that focus on the acceptance of pain rather than controlling or fighting it. Meditation is more frequently being offered as part of pain management programmes. Cognitive behavioural therapy (CBT) has been used as a standard approach to help manage chronic pain. Although CBT is effective for many, it has been found only to have a limited effect on chronic pain for people with rheumatoid arthritis, and a few studies show that some people do not gain much benefit. Another form of acceptance-based training is acceptance and commitment therapy (ACT). Here, people are helped to stay in contact with unpleasant emotions and thoughts. Developing mindfulness is one of the strategies used, but how effective is it? A systematic review of 22 studies found that mindfulness-based stress reduction programmes and ACTs with meditation were not superior to CBT. However, this could be due to the quality of studies reviewed. One study showed that mindfulness meditation with emotional regulation therapy showed some benefit over education and CBT in those with rheumatoid arthritis and depression. Evidence suggests that meditation may be helpful in pain relief – why not give it a try? There are plenty of free online examples to try, or take a look in your local bookshop for a guide to how to practise mindfulness meditation. Peter Stannett is information officer at Arthritis Care; for more info click here Regions of the brain involved in meditation are also concerned with pain processing