To understand how these psychological concepts relate to Mindfulness-Based Pain Management (MBPM), it is necessary to first understand just how complex pain really is, and how mindfulness changes the way we “relate” to it.
The Complexity of Pain
Pain is a complex, multi-faceted experience that has physical, emotional and cognitive components to it. For many years, pain-management programmes focused solely on trying to reduce or eliminate the physical component or sensation of pain. This made the mistake of overlooking the emotional and cognitive aspects of pain, because it is these aspects that make the sensation of pain into an “experience” of pain. This is where the concepts of “doing mode” and “being mode” come in.
“Doing Mode” – Struggle Against Pain
Doing mode involves reacting to experiences, including pain, by going on to “automatic pilot,” and doing whatever comes most naturally or habitually. So when pain is present in this mode, the mind may focus on trying to avoid the pain and lamenting the fact that it is there and causing the suffering that may be present. This almost inevitably leads to a spiral of ever more negative thoughts and emotional stress, which in turn leads to the development of physical tension and the body’s production of chemicals such as the stress hormone, cortisol, which heighten the levels of pain on the body’s pain amplifier and deplete the levels of the body’s natural pain- killers, the endorphins, and so the experience of pain is intensified and prolonged.
The “doing mode” fosters a particular relationship to our experiences. Participants in the MBPM program learn to relate to their pain sensations in a different way. Without judgment and with an attitude of acceptance, they practice “observing, accepting, and being with painful sensations with openness.” The essence of this training is to be fully present with pain, acknowledging that the story we often add to our pain that says, “I can’t stand this, it’s horrible,” is often more of a source of suffering than the pain itself.
Transformation Through Mindfulness
Mindfulness training in an MBPM program is training in shifting from “doing mode” to “being mode” — a shift essential to effective pain management. In building the muscle of mindful presence, individuals are trained to hone in on the many interrelated layers of their pain experience — for instance, differentiating physical pain from the emotional and mental reaction to it. With this recognition, they more deliberately choose how to respond to pain. For example, a recognition of tension, a secondary reaction to pain, may lead to a conscious engagement of tension release or a shift in a certain activity.
The Role of Acceptance and Compassion
Central to the development of the “being mode” in MBPM is developing acceptance toward oneself. Accepting pain means acknowledging the reality of the present moment without struggle; it does not mean resigning oneself to endless, unchanging suffering. One extends this acceptance through self-compassion by responding to moments of suffering with the kindness and care one would offer to a friend, recognizing the pain in oneself and responding with comfort and support rather than with criticism and judgment.
Integration and Daily-Life Application
The ultimate goal of practicing mindfulness and strengthening the “being mode” is not limited to periods of formal sitting meditation. Real transformation comes when these practices become integrated into daily life, when mindfulness is applied to ordinary activities, to the very moments of pain and emotional difficulty themselves, leading to a deeper resilience and an enhanced capacity to manage pain.
Summary
Integration of the “being mode” through MBPM programs in pain management offers a new dimension of pain management, one beyond the mere elimination of pain and a deeper understanding of the human experience of suffering through mindful and compassionate relationship with pain so that individuals can feel a greater peace and well-being and live their life with a greater sense of agency even in the presence of chronic pain. This integrative approach does not just alleviate the pain but enriches the relationship with oneself and with life, providing pathways for a life more filled and fulfilled.