In 2010, Fadel Zeidan and a team of researchers from University of North Carolina published a study of “the effects of brief mindfulness meditation training on experimentally induced pain.” I asked Zeidan, now based at the Wake Forest School of Medicine, to tell me about that first study and its findings, and explain how his research has progressed since.
What is mindfulness meditation?
Mindfulness meditation is a mental practice associated with stabilizing one’s attention and promoting the ability to regulate one’s emotions. This practice is intended to cultivate an awareness of oneself and one’s sensory environment.
How is it practiced?
Practitioners are taught to focus on a dynamic and changing stimulus, such as the breath. They’re also taught to recognize when the mind has drifted away from this focus and to control their emotional responses to these “distractions.” Continual practice with this mental technique improves their ability to control the way they react to all kinds of daily stressors like pain and anxiety.
We’re all familiar with the idea of exercising or training a certain muscle, like a bicep. Mindfulness meditation is similar to going to the gym for a physical work out, but instead you’re “working out” the mind.
How did you conduct your initial experiments?
We examined the effects of three days (20 minutes/day) of mindfulness meditation training in the presence of pain, which was administered in the form of electrical stimulation to the forearm.
We asked people to rate the pain that they experienced before and after meditation training and compared these ratings both to a control group and to a group that had performed math problems in their head (subtract 7 from a 1000 in a serial fashion, 993, 986, 979, 927, and so on) during pain stimulation.
And what did you discover?
We found that the meditation group had significantly reduced pain ratings during meditation when compared to the group practicing math distraction (a well-validated practice found to reduce pain), and the control group. Surprisingly, we also found that after training the meditation group was less sensitive to pain even when not meditating, compared to the control group.
These findings suggest that brief training in meditation effectively reduces pain during meditation and after training, leading us to believe that some of the effects of meditation can persist even when one is not formally meditating.
More recently you’ve been investigating the brain mechanisms underlying “the modulation of pain by mindfulness meditation.” What are those mechanisms?
Yes, we employed functional Magnetic Resonance Imaging (fMRI) to see which brain regions are involved in meditation-related pain relief and we found that mindfulness meditation reduces pain through a number of different mechanisms.
For one, we found that activity in an area of the brain that’s associated with registering where and how intense a feeling is (called the primary somatosensory cortex) was significantly diminished when people meditated in response to heat pain. This area was highly active when people were not meditating. This suggests that meditation alleviates pain by altering low-level processing in the brain.
We also found that meditation-related pain relief was associated with areas of the brain involved in changing the context of pain (the orbitofrontal cortex and anterior cingulate cortex). Participants in mindfulness meditation are taught to look at distracting thoughts (in this case pain) as “momentary and fleeting,” and to accept these feelings, so these results fit well with what we know of mindfulness techniques.
The subjects of your studies experience pain in measured doses, under controlled conditions. Do you think people with painful injuries or chronic pain would experience similar effects?
I imagine their experience would be different because chronic pain is unpredictable and causes a number of other ailments, such as depression.
There are a number of studies that have shown that training in mindfulness meditation can alleviate chronic pain. However, it’s important to note that mindfulness meditation doesn’t necessarily take away pain, it just teaches the practitioner to look at pain from a different perspective. For example, meditators are taught not to react to pain, to accept pain and be in the present moment as opposed to dwelling on the feeling. This approach can dramatically alter the way one experiences the feeling of pain.
Do you think your research may impact the way pain is managed in clinical medicine?
I’ve heard from a number of clinical labs that brief training in mindfulness meditation is gaining steam for the treatment of pain and anxiety. However more research is needed to understand why mindfulness meditation alleviates pain.
Pain is very debilitating for individuals and for our healthcare systems. Pain costs the United States over $150 billion dollars a year in health and work-related costs, and many patients find themselves physically addicted and mentally dependent on their medications. If we can find a cost-effective and reliable method of pain relief, such as meditation, then I have no doubt that it would be utilized extensively in medical settings. But as I said, more research needs to be conducted to really understand the active mechanisms of mindfulness.
What’s the next step?
I’m really interested in examining if the brain mechanisms employed by mindfulness meditation in alleviating pain are distinct from other robust and well-validated techniques. I’m also interested in understanding how much meditation is needed before one can experience immediate pain relief.
If one can experience some of the benefits of meditation even after brief training, then clinicians may feel more inclined to recommend the practice to their patients. Moreover, the patient may feel more motivated to continue to practice if the effects can be realized immediately.
However it’s important to realize that the more one practices meditation, the stronger its effects will be. Neuroimaging research has clearly demonstrated this relationship. Four days of meditation training is by no means a cure-all and mindfulness meditation requires discipline and continual practice to reap its full benefits.