An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results
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Abstract
The practice of mindfulness meditation was used in a 10-week Stress Reduction and
Relaxation Program to train chronic pain patients in self-regulation. The meditation
facilitates an attentional stance towards proprioception known as detached observation.
This appears to cause an "uncoupling " of the sensory dimension of the pain experience
from the affective/evaluative alarm reaction and reduce the experience of suffering
via cognitive reappraisal. Data are presented on 51 chronic pain patients who had
not improved with traditional medical care. The dominant pain categories were low
back, neck and shoulder, and headache. Facial pain, angina pectoris, noncoronary chest
pain, and GI pain were also represented. At 10 weeks, 65% of the patients showed a
reduction of greater than or equal to 33% in the mean total Pain Rating Index (Melzack)
and 50% showed a reduction of greater than or equal to 50%. Similar decreases were
recorded on other pain indices and in the number of medical symptoms reported. Large
and significant reductions in mood disturbance and psychiatric symptomatology accompanied
these changes and were relatively stable on follow-up. These improvements were independent
of the pain category. We conclude that this form of meditation can be used as the
basis for an effective behavioral program in self-regulation for chronic pain patients.
Key features of the program structure, and the limitations of the present uncontrolled
study are discussed.