Mindfulness has been shown in numerous studies to effectively attenuate pain, but a new study about to be published suggested that the way in which this reduction happens is much different than other, more typical coping mechanisms. These findings go to the heart of the difference between pain and suffering, by elucidating the different patterns of brain activation associated with each and showing how suffering is reduced throughout the practice of mindfulness, even when the sensation of pain is present.
In a study comparing meditators to non-meditators by researchers from Giessen University in Germany, Maastricht University in the Netherlands, and Massachusetts General Hospital, much was learned about the neural processes involved in the reduced suffering in the face of pain experienced by meditators. The findings of this study were recently published ahead of print in the journal Cerebral Cortex.
Mindfulness refers to a specific inner stance of purposefully paying attention to experiences in the present moment in a nonjudgmental way. For example attention is focused on the sensory aspects of a sensation alone, rather than the cognitive and emotional reactions to those sensory experiences. In mindfulness, these sensory aspects are investigated with curiosity and acceptance. Instead of being reactive and judgmental of sensations, people become fully aware of the experience in the present moment and relate to it in an objective and neutral way.
Thirty-four healthy individuals participated in the study; 17 of them were experienced mindfulness meditators. While brain activation of participants was measured in the MRI scanner at Giessen University, participants received mildly painful electric shocks on the left lower arm. Participants were instructed to relate to the shocks in different ways: with mindfulness, and with a normal, daily life stance. Participants were then asked to rate the intensity and unpleasantness of the shocks, and the anticipatory anxiety in regard to receiving the shocks.
During the practice of mindfulness, experienced meditators experienced the pain as significantly less unpleasant. In addition they reported less anticipatory anxiety, even though they didn’t perceive the intensity of the sensations differently. The MRI images revealed interesting changes in brain activation during the state of mindfulness in mindfulness meditators: increased activation in brain regions that are involved in processing the sensory aspects of the pain experience (posterior insula/secondary somatosensory cortex), but decreased activation in brain regions that are involved in regulating pain through reappraisal (lateral prefrontal cortex). Thus, the meditators fully experienced the pain, but they suffered less from it.
This pattern of brain activation is in sharp contrast to other psychological pain modulation strategies: When participants reduce pain by reappraising it (i.e., a cognitive reinterpretation), there is an increase in activation in the lateral prefrontal cortex. Activation in sensory brain areas on the other hand typically decreases. While the pattern of brain activation revealed in this new study is in sharp contrast to other pain modulation strategies, it is well-aligned with theories of mindfulness.
“The increased activation in sensory pain areas in the brain, that we found during the practice of mindfulness seems to be aligned with the increased focus on the sensory aspects of the pain that meditators report”, says Tim Gard, first author of the study. “Simultaneously we saw decreased brain activation in brain regions that are involved in reappraisal. During the state of mindfulness, meditators seem to be in contact with the present moment experience as it is, without reappraising or evaluating it.”
“It is very interesting that the pattern of brain activation that we observed during the attenuation of pain in a state of mindfulness is in sharp contrast to other forms of pain modulation”, says Tim Gard. “It indicates that mindfulness really is a different way of reducing pain. These findings might have interesting clinical implications. The revealed unique mechanisms of pain modulation might be utilized to improve or develop new strategies for the management of chronic pain”, according to Tim Gard. “While the current study investigated the effects of the state of mindfulness on pain perception in healthy subjects, future studies are required to test whether the findings can be generalized to chronic pain.”
Gard, T., Hölzel, B.K., Sack, A.T., Hempel, H., Lazar, S.W., Vaitl, D., & Ott, U.: Pain attenuation through mindfulness is associated with decreased cognitive control and increased sensory processing in the brain. Cerebral Cortex, published online on December 15 2011, doi: 10.1093/cercor/bhr352