... mindfulness requires focusing on unpleasant and painful sensations when they are present and discourages efforts to escape them by distraction or by absorption in some other object of attention. ...
The potential benefit of using meditation for the self-regulation of chronic pain would depend on the patient's developing an ability to observe intense feeling in the body as bare sensation. By repeated practice the patient might learn to assume intentionally an attitude of detached observation toward a sensation when it becomes prominent in the field of awareness, and to observe with similar detachment the accompanying but independent cognitive processes which lead to evaluation and labeling of the sensation as painful, as hurt. By maintaining a perspective during periods of formal meditation ... in which no mental event (including perceptions) is accorded any content value, the strong alarm reaction (the interpretation of the sensation as pain, i.e., "It's killing me", often accompanied by future thinking, i.e., the thought that it will last for a long time or forever) can lose considerable power and urgency simply by being observed as separate. This is because the associated thoughts can be perceived simply as events in the mind, not necessarily any more accurate or important than any other thoughts passing through the mind ... . In effect, assuming this attentional stance appears to produce a spontaneous (and momentary) uncoupling of the sensory component of the pain from the affective and cognitive dimensions (alarm reaction). If assumed regularly in the presence of pain, the attentional stance of detached observation can result in a specific deconditioning of alarm reactivity to primary sensation. This amounts to a learned recognition of primary sensation. The nociceptive signals (sensory) may be undiminished, but the emotional and cognitive components of the pain experience, the hurt, the suffering, are reduced.
Kabat-Zinn, "An Outpatient Program," 35
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