Zen Buddhist Mindfulness Meditation in Chronic Illness, Chronic Pain and Anxiety States by Barry Farrin, Forest Way Zen Care

Introduction. 

This short article will explore the use of mindfulness meditation in helping people with chronic pain, chronic illness, arthritis, cancer, other life- threatening issues and carer issues. This paper looks at the rationale and process of mindfulness meditation in controlling and mediating emotional issues for people with chronic illness and pain. The review of the literature reveals that mindfulness meditation produces credible results in relaxing and creating peace and restoring a sense of hope, calm and feelings of safety in this group of people. There is evidence to show that mindfulness meditation is also effective in controlling dread and fear. This paper also reflects my own experiences when working in cancer care and palliative care. The members of the Forest Way Zen Care are financially supporting all the costs of conducting this series of mindfulness meditations. Some sangha members are also attending these groups for their own experience.

What is Mindfulness Meditation?

Aitken R. (1982) describes a series of breathing exercises that become more sophisticated as the students advance in their training. More specifically mindfulness meditation can be described as a way of paying attention. Mindfulness involves bringing your attention to the internal and external experiences in the present moment in a non-judgmental way. Some mindfulness meditation techniques focus on breathing, walking, sensations, sounds, and other techniques focus mainly on being aware of thoughts, and emotions that arise during the meditation. The mindfulness meditation practitioner learns to observe these thoughts and emotions in a non-judgmental way. Baer, R. (2003) suggests that the wandering of the mind into thoughts, memories and fantasies are noted briefly and then attention is returned to the present moment. One is encouraged to have an attitude of pure observation. The intention is to bring the mind under control. Malcolm Huxter (2009) states that the goal is to pay attention in an objective fashion to the arising and passing away of all conditions of mind and body. Harris, R. (2006) defines mindfulness as “consciously bringing awareness to your “here/now” experience with openness, interest and receptiveness.

Mindfulness has become popular since the release of Jon Kabat-Zinn’s book in 1990; “Full Catastrophe Living”. This brought mindfulness meditation to the general population and it is now used widely in the United States of America and around the world. This book describes the use of mindfulness meditation in stress and pain control.

The Role of the Autonomic Nervous System in Stress, Anxiety and Depression.

The Autonomic Nervous System is responsible for the maintenance of the optimal internal environment for the body.  The autonomic nervous system consists of two divisions, the sympathetic and the parasympathetic. The sympathetic division acts as the arousal mechanism for the entire body and prepares it for vigorous action. For example, the heart rate increases faster than normal when there is increased activation in the sympathetic division.  This is the classical fight or flight response out of perceived danger.  You can stand a certain amount of continued stress but eventually everyone reaches a level and they can no longer go on coping as they normally do. This is what often happens to soldiers during war. They cope for a long time, but the impact of stress is delayed but its effects do catch up eventually when they have come home many months or even years later. In this situation the stressor has been relived and is often re-occurring “over and over again” and there seems to be no escape. This is the effect of post traumatic stress disorder which occurs in returning soldiers and it can occur in patients with cancer and other life-threatening illnesses and chronic pain.

Activation of the parasympathetic nervous system tends to produce the opposite effects and lowers the heart rate, though it is not as clear cut as that. Most of the body organs have both sympathetic and parasympathetic nerves. The autonomic nervous system is under the direct control of various nuclei in the brain stem. This system is the peripheral motor system that mediates the actions of the brain structures directly involved in the emotional and motivational aspects of behaviour. Thediagnosis of cancer and other life-threatening illnesses and aspects of chronic pain are often interpreted as losing control. This news is a “stressor” for most people and thus their response is almost always interpreted as stress and/or other emotional responses. People feel they have lost control of their life, and consequently they feel stress and other strong emotions such as depression, anxiety, panic, fear, and loss of hope.

The more knowledge you have the more you will feel in control and thus you have less stress. When patients are working within the treatment phase, they are very much focused, and they learn all about their illness and the treatment. During this early phase people are stressed but their focus is on their treatment and this mediates the amount of stress they feel. This could be a time of getting control back as people focus on their treatment and they are learning about their treatment and they appear more calm and relaxed. When they move through into the survival phase, stress, depression and other strong emotions are likely to re-occur. This is the phase when post traumatic stress disorder might appear as mentioned earlier. Mindfulness meditation helps facilitates patients to get some control back in their life.

How Effective Is Mindfulness Meditation?

Mindfulness meditation is effective in reducing pain in cancer patients and other illnesses when pain becomes a problem. The Ven. Pende Hawter from the Karuna Hospice Brisbane describes methods of mindfulness meditation that are effective in reducing pain (1993 Unpublished Paper).  Carlson, Linda, et al (2001) produced a very well researched paper on pain in cancer patients. They contend that, “This program was effective in decreasing mood disturbance and stress symptoms for up to six months in both male and female patients with a wide variety of cancer diagnoses, stages of illness and educational background, and with disparate ages.” They go on to say that, “It also enhanced feelings of vigour in this population and decreased a wide variety of symptoms of stress particularly depression and anger”. My own personal experience as a psychotherapist in practice over 20 years working with many hundreds of patient contacts and a further 40 years as a meditation practitioner and teacher has demonstrated to my satisfaction that mindfulness meditation produces excellent results in controlling psychosocial and emotional conditions in many chronic illnesses. Baer, R.A. (2003) in a review of mindfulness meditation found significant improvements in chronic pain and in anxiety disorders.

Williams, M. (2002) and Baer, R (2003) both found during their research into mindfulness meditation that people with recurrences of depression do well when meditating. They suggest that patients begin to see during their mindfulness meditations, that the patterns of thoughts in their mind can be controlled. These two researchers found that patients are alsoable to recognize when their moods begin to take on a “downward pattern” and they suggest these people began totake some actions to head off their declining mood and depression. Mindfulness meditation is best used in chronic recurring depression and not in the acute phase.

Contraindicated in certain people

People suffering from major psychological illness should not be introduced to mindfulness meditation unless they are being closely supervised “one on one” by a health care professional. Mindfulness meditation should not be used in acute depression and care is needed with people with panic attacks. People with a history of panic attacks often find it hard to meditate and need special attention. Some particularly highly panicked people may be unable to meditate.

Mindfulness Meditation Working with Fear, Grief and Loss.

Existential suffering or fear of death can be reduced by practicing mindfulness meditation. Existential suffering may manifest as “loss of hope” and the appearance of “non-relenting fear”. This state produces considerable anxiety, anger, depression and a state of flux and uncontrollable fearthat seems to go on and on. People find that they can deal with the physical pain but not the thoughts of disaster. In these cases, people give up hope and feel that nothing can help them. In my own psychotherapy with people with cancer, life threatening illnesses, chronic pain, and carer issues I found mindfulness meditation very valuable when anxiety became difficult to control. Mindfulness meditation can help patients find relief from overwhelming feelings of grief and catastrophic thoughts.

Conclusion

The literature on mindfulness meditation suggests that mindfulness is an effective process for controlling 1) emotional stress caused by cancer, 2) is useful in controlling chronic pain, 3) is useful in life-threatening illnesses and 4) other emotional states. Mindfulness meditation is a gentle, easy, non-invasive process that has been used with good results in chronic illness.  There are very few side effects and contraindications. Mindfulness is effective in reducing anxiety, stress and depression. Patients also report a reduction in fear and a return to hope, peace and calm. Mindfulness meditation allows people experiencing a life-threateningillness to find a safe place in the “here and now” allowing each moment to become more peaceful.

References

Aitken, R. (1982) Taking the Path of Zen: North Point Press, New York.

Baer, R.A. (2003) Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. American Psychological AssociationD12, 25-143.

Carlson, L.E., Ursuliak, Z, Goodey, E, Angen, M. and Speca, M. (2001). The Effects of Mindfulness Meditation Based Stress Reduction Program on Mood and Symptoms of Stress in Cancer Outpatients: six month Follow- up. Support Care Cancer, (: 112-123.Published on Line20th December [email protected] Verlag 2000).

Harris, R. (2006). Embracing Your Demons: An Over view of Acceptance and Commitment Therapy. Psycho therapy in Australia, vol 12, no 4, August 2-8.

Hawter, P. (1993) Relaxation Therapy and Meditation in Pain Control. The Karuna Hospice Service: Queensland Australia.

Huxter, M. (Undated) Grief and the Mindfulness Approach. Buddhist Info Network. Buddha Dharma Education Association: Haymarket, Australia, 1-7.

Kabat-Zinn, J (2005). Full Catastrophe Living. Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Bantam, New York.

King, R. (2006). Mindfulness-based Stress Management: Finding from Randomized Trials. Psycho therapy In Australia. Vol 12 No. 4 August .

Williams, M. (2002) A Mindfulness Based Cognitive Therapy and the Prevention of relapse In Depression. Summary of Training in Mindfulness Meditation. Unknown Publication