Mindfulness and Overcoming Chronic Pain – an Interview with Ed Halliwell

Ed Halliwell began practising mindfulness meditation in 2002, and found it an invaluable way to cultivate health and well-being. Working again with the Mental Health Foundation, he proposed, developed and wrote the Be Mindful Report, which looks at how mindfulness can be an effective treatment for depression and other health issues, spearheading a campaign to make it more available in the NHS.

Ed is the author of The Mindful Manifesto and Help Us Cope With the 21st Century, a book which examines how mindfulness can help us cope as individuals and as a society. It was co-authored with Dr Jonty Heaversedge, and published by Hay House in the UK in September 2010. The book has since been published in the USA, the Netherlands and Germany, and is currently being translated into Spanish.

Ed currently leads mindfulness-based stress reduction (MBSR) courses and retreats as well as many workshops and retreats. He is also a co-teacher on the Mental Health Foundation’s Be Mindful Online course.

 

 

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Naomi:Naomi from Life After Pain, and today we’re going to be talking to Ed Halliwell. Now, Ed is a practitioner of mindfulness, and the thing about the site that we have at Life After Pain is it specifically was set up to help people who have chronic pain.

And there’s been some very interesting developments recently in the field of chronic pain and mindfulness. So we’ll be discussing that today. Ed, welcome to the call, and it’s great to have you.

Edmund: Thank you. It’s good to be with you, Naomi.

Naomi:If we could start off, could you just tell me a little bit about yourself and how you first discovered mindfulness?

Edmund: Yeah, sure. I came to mindfulness and meditation practice, it would have been around about 10 or 11 years ago now. I was going through a period of quite prolonged anxiety and depression. I was looking for anyway, really, that I could relieve my pain, primarily which was emotional pain. I tried all sorts of things. I tried changing where I live, I had psychotherapy and I tried various alternative treatments, and I read probably hundreds of self-help books and nothing really shifted for me. And if fact, probably the way that I was searching, a kind of desperate search to try and get away from where I was at the time, which was in pain, probably wasn’t helping very much.

In the search, I came across meditation, and mindfulness was much less well known as a term for this at that time, but certainly meditation came up in lots of different places in many of the books and several people suggested to me, Ed, I think it would be a good idea for you to learn to meditate. So eventually, I went to a local meditation center.

I found that although I tried to make meditation make me better, as I had done with many other things, somehow something was different here. It was an approach where if I actually followed the instructions that I was given of how to practice, it was the reverse of what I’d been trying to do. So rather than actually trying to get somewhere, I was being advised to just be present with what was here, which was obviously a place of pain. So that was kind of challenging for me.

But at the same time, I thought, hang on, this is interesting. A bit of my struggle is starting to change and actually be let go of, and overtime that seemed to have an effect on how I was feeling.

So this was how I connected with mindfulness and meditation practice, and so that was the start of what became a much longer journey, which I can tell you more about if you want to know, but maybe that’s good to start with.

Naomi:Yeah, no, that’s certainly interesting because if you’re in pain, yeah, it’s a very natural human response to avoid pain. We spend our lives seeking pleasure and avoiding pain, and so the practice of being with the pain, it’s very counter-intuitive.

Edmund: Very much, yeah. Yeah, it’s kind of the last thing you want to do, perhaps. It’s also, at least for me, the kind of last thing that you would expect to work and to have an effect. I thought it was a bit like somebody saying to me, go against everything that your mind is telling you and everything that perhaps that your body is telling you and just accept what you’re experiencing at the moment.

As you say, if you’re in a place of pain, you don’t want to be in a place of pain, whether that’s a place of depression and anxiety in my case or whether it’s physical pain. So of course you want to not feel bad, but the irony seems to be that the not wanting to feel bad makes the feeling bad worse.

Naomi:Yes. It’s a cycle in some ways. To go down to a really basic level, in the essence it’s almost coming down to the basic human condition. We’re these creatures, we feel pain, we’re trying to have happy lives and there’s all these things that come in the way of that. So the purpose of mindfulness has this huge potential really for transforming your life.

Edmund: Yeah, no, I would just echo what you said, that this isn’t just about — like even the wonderful things about mindfulness and mindfulness practice is that it’s not just about specific conditions. It’s actually, as you so rightly say, it’s about the whole way that we approach our lives, most of us. We’re trying to get somewhere.

We’re trying to get the good stuff and push away the bad stuff. That comes from a place of wanting to be happy. It just doesn’t work very well. It might work for a short time, but it doesn’t work in the long term, it seems. And so mindfulness turns that on its head and actually says, okay, how would it be if we could just be with what’s happening and flow with what’s happening. And whether that’s pleasure or pain, can we experience it without grasping or pushing away?

Naomi:So as of today, right now, you are an expert in mindfulness and you coach people singly or in groups on how to practice mindfulness in their life?

Edmund: Yes, mostly groups. I teach mindfulness courses. I do occasionally see people one-to-one and through distance learning over Skype and the phone as well, but primarily I work with groups.

Naomi:And do you come in contact with many people who have chronic pain or possibly a mix of chronic pain and anxiety in their lives?

Edmund: Yeah, it’s very common. I wouldn’t describe myself as a great expert in chronic pain certainly in itself, but my understanding is that something like between one in four, one in five people, you may know the correct number, experience chronic pain.

A mindfulness course draws people who want to work with the stress in their lives, in one form or another, and so of course that includes people who are working with chronic pain.

So yes, it’s very common and yes that’s often mixed with anxiety or issues with mood, and that obviously being in pain is not a pleasant experience so it’s often mixed in with lots of other stuff that’s either making it worse or perhaps is making the pain worse, too.

Naomi:Yeah, that’s absolutely true. It’s interesting how medicine’s evolved. So perhaps many, many, many centuries ago there wasn’t as much distinction between the mind and the body, how you’re thinking and how you’re feeling and your physical health. And then with the rise of evidence-based medicine, those two became quite separate.

A lot of good things came out of that, but now it’s very interesting to see how the mind/body connection and mindfulness-based stress reduction that’s coming back into that. Because they really are, they’re inextricably linked. You can’t really separate the two.

Edmund: Yeah, I think that’s right. One of the wonderful things about evidence-based medicine and the scientific approach to wellness is that you can really get to see what’s working and what’s not working, but yet for a number of reasons probably, part of that, because it’s about looking at what’s there and obviously the body is generally visible and explorable, there’s been this focus on the obviously physical side of it.

But actually, as research has become more sophisticated, there’s been this realization that actually it’s possible to see what’s happening on the mind side of it as well and do good research on that. And of course once people started doing research on mindfulness and a mindfulness-based approach is discovering they’re effective for many things.

Then we’ve got, as you say, this integration now, which is wonderful. It’s kind of like — because that seems to make things even more effective, if we can actually integrate how we’re working with the mind and the body and to see that they are so intimately connected. This old idea that there is split between mind and body and that they’re separate is just not true. How we feel physically affects how we feel in our minds and vice versa.

Naomi:Just off the top of your head, if you happen to, can you think of any studies that come to mind to deal with mindfulness and how it’s helpful in health or in alleviating stress?

Edmund: There are so many. It’s really difficult to pinpoint one or two, and perhaps what might be helpful is just to look at some of the overviews. I don’t have the exact *** (08:44). I can probably find them quite quickly on my computer.

There was a review of the mindfulness-based stress reduction course which was published by the Campbell Collaboration last year, which pooled together about 35,40 different studies on mindfulness-based stress reduction and was looking at measures of anxiety and depression, of well-being and personal development and of pain and also what affect it has on peoples’ mindfulness.

And it’s interesting, what they found was that mindfulness has a big effect on stress and on anxiety and depression. So if you imagine 100 people and you had a list of them with the most happy or the least stressed at the top and then the most stressed and the most unhappy at the bottom, the equivalent change through taking a mindfulness course is a rise of about 20 places in that ladder, which is a bigger effect.

Then actually interestingly with pain, pain is slightly less so, so the effect would be about a rise of about 12 places in that ladder, in terms of working with pain, but as you say, often the two are very connected and a huge jump in peoples’ mindfulness, which is perhaps not surprising. You’d hope that a mindfulness course would help you to be more mindful.

So there have really been lots and lots of clinical studies showing a good effect, and that’s probably why, as I say, we live in a world of evidence-based medicine and why there has been such a resurgence of interest in meditation and mindfulness-based approach is because the results seem to be so good.

Naomi:Yeah, absolutely.

Edmund: And also in so many different areas as well. So those were just looking at stress and anxiety and pain, but practicing mindfulness can be — actually if you go back to one of the great mindfulness teachers of all time, which would be the Buddha, he said that mindfulness is all helpful. So in the sense that actually by practicing this, learning how to work with your mind and your body, which is what mindfulness practice helps you to do, this effects every aspect of our experience.

If we can learn how to use our minds and work with our bodies in skillful ways, then that’s likely to impact every different aspect of our experience, whether it’s our physical or mental health or whether it’s our relationships or whether it’s our ability to appreciate the beautiful in life. We can use our mind and our attention and our bodies skillfully. Then we’ve got greater potential for enjoying life and living a good life.

Naomi:Yeah, we’re looking at the real fundamentals of existence. How you perceive reality is how you live, really.

Edmund: Yeah.

Naomi:Can you describe to me a little bit about what mindfulness practice looks like?

Edmund: Yeah, not much. [Laughter]

Naomi:[Laughter]

Edmund: It looks like not much is happening. If you were to drop in on an average mindfulness class, you’d probably go, there’s nothing happening. There’s nothing happening there. A lot of people just sitting there and doing nothing. But what’s actually happening under the bonnet, if you like, is quite a lot.

What we’re doing is practicing and training the mind and body and training the mind to pay attention, but to pay attention, as Jon Kabat-Zinn says in his definition, in a particular way. So we’re learning to use our attention intentionally. So by practicing paying attention to different objects of focus, so that might be the breath, we might be paying attention to the breath and practicing staying with the breath, and when the mind wanders away from the breath coming back to the breath.

So training the mind in stability and doing this very gently. So we’re also practicing self-compassion as we do this, and we are working with the mind’s tendency to fly away into the past and the future, into kind of a conceptual thinking about our experience, rather than actually sensing and being with our experience.

So we’re coming into a mode of sensing and being, rather than concept and thought in which we get caught up in usually thinking about things that either have happened and we wish they hadn’t happened or things that we are worried are going to happen which might not happen. But we get caught up in, oh what if this happens and then this might happen and what if this pain gets worse and I can’t bear this, and that’s the stuff that actually creates that cycle that you were talking about, which then rebounds back on how we feel physically and tightens us up and tenses us and is likely to make our pain, of whatever kind it is, more rather than less intense.

So we’re working with the tendency of the mind to fly off and we’re coming back and coming back again and coming back again and framing the mind, just training our attention, just like you might train in any other skill, whether it might be learning a new language or learning to drive a car or learning to play a sport or whatever it might happen to be.

Training and practicing, and through that training and practice we can become more skilled in being here and not being drawn away into those plights of things we’re worried about and to do that in a way that is not hard on ourselves, because we’re often so hard on ourselves even when we train in something, like constantly beating ourselves up that we should be doing better.

We’re letting go of those judgments as we do that.

So we’re just paying attention in this purposeful, non-judgmental present moment, centered, heartfelt and compassionate way, again and again and again. And when we wander off, coming back again and hopefully over time seeing the affect that that can have on our experience and really have a *** (14:40) into that mode of being, rather than the doing mode that our world is so good at telling us we should be speeding up into.

Naomi:It sounds, in essence, like it’s extremely simple, but at the same time not at all easy.

Edmund: Absolutely. Yeah, that’s a really good description. Yeah, it’s not complicated at all, but we are quite complicated. So it’s a very simple practice or a simple way for very complicated beings, and so that’s what the challenge is. To apply the simplicity when actually we often are drawn into lots of complication.

Naomi:Yeah, I think for people in chronic pain, that’s a huge problem because there’s this constant anxiety of are they going to get better or regret about not being able to do the things that you can normally do. That, I think, can also put your body into a stress mode, where it’s very difficult to turn down the pain response and actually heal. So I could see how useful that would be, having that practice.

Edmund: Yeah, and when people in pain come to mindfulness practice, it will often be suggested that you actually give up the focus on trying to get rid of your pain, because it’s the trying to get rid of the pain that can make us feel even more tense and constricted in our bodies, which of course will not be good for the pain because we’ll feel tighter and more contracted. So actually to say, okay, I’m not going to do this to try and feel better; I’m just going to do this for its own sake and to see what happens.

And sometimes, very often in fact, that will have the byproduct of helping with the pain. But as soon as we have that goal, that goal orientation, I want to get rid of my pain, we’re actually out of the present moment and actually into the future of wanting a desired result which isn’t here at the moment. And so actually what we do in mindfulness practice is counter intuitive and perhaps difficult, as it may seem, to say okay, I’m going to work with accepting what’s here right now, even if that is very uncomfortable right now.

Naomi:That’s very subtle. I can see how it’s a lifelong thing but very valuable as well.

Edmund: It’s why the gentleness is so important as well, because it’s not a quick fix. It’s not, oh okay now I’ve got it thing, and that can set us up for even more frustration and even more tightening. It’s actually about saying, okay we are human, we do have these patterns which are built up probably in our own lives over years and decades, in our evolution over many, many thousands of years.

So it’s not going to be fixed in a day, but it can be worked with and often the beginnings of shifting those patterns can come sometimes quite quickly, but we have to kind of not crave for them to come, if you see what I mean. You have to just see what happens.

Naomi:So it’s like letting go. Could you talk to me a little bit about self-compassion? Because that’s a term that I haven’t really heard much before and I imagine it’s very different from self-pity. So I’m just wondering if you can clarify that.

Edmund: Yeah, I would almost not distinguish it from just compassion actually, because generally how we relate to the world is often how we relate to ourselves as well.

We tend to be particularly hard on ourselves. And that’s the problem I guess, is that we judge ourselves and our experience often very harshly, particularly when we perceive something to have gone wrong. Our bodies have failed us or our minds have failed us or we have failed in some way. And those remnants of thoughts of kind of, oh this is my fault, I must have done something wrong to be feeling like this, is not very helpful. It doesn’t actually — the mind is trying to solve the problem by trying to say, okay well if I’ve done something wrong there must be something I can do to solve this problem.

But sometimes there isn’t something you can do to just solve the problem, and we end up running round and round in a kind of ruminative spiral of negative thinking.

So what compassion does, and self-compassion does is it counters this by helping us to open up a space of, okay, we’re here where we are. It’s actually fundamentally, as Jon Kabat-Zinn says, if you’re breathing there’s more right with you than wrong with you. So if we’re alive, and we are alive, then things are if not perfect, and they’ll never be perfect, then actually we can work with this. We may not like where we are, but there’s a lot going on that’s good. Our bodies are live and working.

So if we can start practicing kindness to our bodies, even when we don’t like what’s happening in them, or kindness to our minds when we don’t like what they’re telling us. And there’s the possibility of opening up some space, opening up some *** (19:34) in the air a little bit, and perhaps we don’t have to do so much and fight so much and beat ourselves up so much, or at all.

We can say, okay, I’m doing the best I can. We can practice and learn and over time perhaps develop and change, but where we are right at the moment is where we are and at least from the perspective of mindfulness, that’s okay. That’s doing the best that we can with the tools that we have in this moment.

So we can say, actually — and even the kind of desire to try and feel better or trying to sort something out is admirable. We’re trying to find answers. Maybe it’s just the way we’re trying to find them hasn’t been always skillful or as skillful as it might be. So if we can apply this sense of compassion to ourselves of being gentle with ourselves and include that also in the mindfulness training, then that, too, seems to perhaps loosen some of the tightening that goes on in our minds and bodies and be helpful. It’s also not a bad way of living your life, to open up to the fact that we’re all in this human predicament and we’re all trying to find ways to be happy.

There are more or less skillful way of doing that, but if we can *** (20:48) connection with ourselves and others, then that seems to be conducive to well- being.

Naomi:That’s a beautiful way of putting it. We are all wonderfully flawed human beings.

Edmund: Human doings, as the cliché goes.

Naomi:Oh yeah, that’s right. We don’t spend enough time being. It’s interesting, too, because that brought to mind several people I’ve talked to who have had the experience of being in chronic pain or having a condition like fibromyalgia, and it’s really interesting how a lot of them are very high achievers, very exacting standards that they hold themselves to, and then after getting this condition or having the experience of working through their chronic pain it’s so interesting how a lot of them see that they changed a lot of their outlook.

And through that, they actually became happier, which from the outside, the thing is we can’t even compare what we see of somebody’s exterior with what they’re actually feeling inside, because we can’t know that.

So maybe from the outside beforehand they were high achieving, but people that I’ve talked to have said that afterwards they didn’t have the same outward appearance but they felt happier through accepting themselves and working through some emotional things. I can see how the practice of mindfulness in that kind of situation could be just a wonderful tool to pick up and then to carry on using throughout your life, really.

Edmund: Yeah, it’s a shift in view and outlook. That’s a very important part of what mindfulness is. It’s a practice that helps you to make that shift, that transformation. It’s very different from the way that we’re taught often in our education and in our media and often in our families. We’re taught to strive and struggle and to achieve and to get and to hold onto, and it doesn’t work because our bodies do get ill and we do — if we view life in that way, then life is doomed to failure because so far none of us have escaped death.

Naomi:That’s true. That’s a *** (23:02).

Edmund: Yeah. So actually what we’re doing here with mindfulness is actually looking with courage, because it takes a certain amount of bravery to see life in this way, I think, to look at the reality of where we are and say, hang on a minute.

This way of striving and achieving and getting doesn’t seem to produce the happiness that I think most of us would say, all of us I think, would say that we want for ourselves and perhaps for everyone.

So hang on a minute. How can we access this? Perhaps it’s a different mode from the one that we’re taught will bring us happiness. It works up to a certain point. Of course, we do need to look after *** (23:41). We need purpose in our lives and our work, perhaps, or our families. That’s important. But the problem is, is what’s true at that level, that basic level that brings happiness, it then doesn’t work beyond that. So more and more and more doesn’t make us more and more happy.

So actually, once we’ve got those basics, then there’s perhaps some other way of finding well-being, and it’s the people that are most wired into, that doing, goal- setting mode that we — I include myself in somebody who was very driven.

One way or another, many of us break down. For me it was more of my mind that broke down, rather than my body, although my body felt pretty rough. But one way or another something can snap, and then it’s a case of, okay what am I going to learn from this experience. And if you can make that shift into a different way of being and viewing life, then that can over time start to shift things.

Naomi:Do you have any stories of people that spring to mind that over the years that you’ve been teaching mindfulness that particularly stand out to you as interesting or quite revealing in some way to do with how mindfulness works or how it helps people?

Edmund: Yeah, sure. There are so many and I would probably not be doing them justice by trying to their stories, but in The Mindful Manifesto, the book that I wrote with Jonty Heaversedge, we spoke to a guy who suffered depression and had several episodes of depression through his adult life and he also was physically exhausted and had various physical diagnosis as well, and he was referred to a mindfulness course.

And he was very much not the sort of person you would say would tend to, when you described it as is this going to be like the Beatles and meditation and all that kind of stuff, but he was open enough to say, well I’m going to go along and if that stuff starts happening I can leave.

It really shifted things for him, and unfortunately after he took the course, he discovered that he had bone cancer. So very, very critical, serious illness, potentially life threatening, and he found mindfulness practice very, very helpful for working with his pain, and I remember him saying to me, before this I thought pain was just pain and the idea that pain could be influenced by practice such as meditation, he thought was kind of *** (26:18).

But actually, he began to see that by working with his mind he could certainly not eradicate pain and clearly he was going to be in chronic pain, but to be able to work with that pain and perhaps give it space to be, which might actually change his experience of it. And he said he used on the hospital bed while he was undergoing chemotherapy and also the fear of having a life-threatening illness and what might happen to his family and himself and so on.

His example really has stuck with me, because he came to it with a history of depression, but actually even after that he found that mindfulness practice is very helpful for working with his cancer diagnosis and treatment. But that’s just one example of many. But you know, you’ve got to find it for yourself. I think that’s another thing I just want to say, is everybody else’s experience is everybody else’s experience.

So it’s really important that if this is something that you feel you might connect with and might want to try, then let go of all — you can obviously let go of what you want from the experience, also to let go, perhaps, what other people are saying has worked for them and say, okay well this is my experience.

And you can approach this from where you are in this time. So not to get hung up on, well it worked on that person so again, there must be something wrong with me if I’m not immediately getting results; it should be a very easy thing to do.

So again, to not treat mindfulness as something that should make you better. It’s not like that. It’s practice and a way of being, to enter into, if possible, without preconceptions, with what’s sometimes called beginner’s mind. From there you can see. Find out if there’s something in there for you. Maybe there won’t be. But if we can come with that open-mindedness, then it gives the greatest possibility for something to unfold, as long as we let go of needing that to happen.

Very difficult to do, and particularly when we are in pain. Again, Kabat-Zinn, he says these are not *** (28:25) relaxation techniques; this takes work of a kind, not the usual kind of work ***, but it takes courage and a willingness and openness and a gentleness. And so we need to be gentle with that, too.

Naomi:Well, Ed, thank you so much for sharing your knowledge of mindfulness, and especially because I can see it’s a topic that you could say a lot about or you could say very little. It’s very hard to — you can’t really express it. It seems like it could be quite a personal experience, and perhaps it’s important to discuss it and to teach the principles of it, but it also defies description. Words could actually get in the way of it as well.

Edmund: Very much, yeah. If you feel inspired by this, then by all means read and listen and explore, but actually it comes down to experience. So finding a teacher or a course or ways of connecting with this in an experiential way, because that’s the mode that we are moving into. So yeah, words can point us to the experience, but it isn’t the experience itself.

Naomi:Where could people find out more? You teach mindfulness courses and you have a website, and I know you’ve written a Mindful Manifesto. But have you got any other publications out?

Edmund: Well, I’m working on some more to come, but at the moment a good place to start, perhaps you’re very welcomed to look at my website, which is EdHalliwell.com, or The Mindful Manifesto website, which is TheMindfulManifesto.com.

Those sites have links to other things that I’m doing, and of course there is an increasing array of mindfulness courses and approaches available around the world. So you can also look at what’s available in your area, and if there’s nothing available in your area, then I and others do work with people through distance learning. Skype can be a good way of connecting over the phone. It’s doable that way, although I would always recommend, if possible, if you can find a group in a live space. It’s very powerful to be with others who are learning with you. So yeah, is that okay for starters?

Naomi:Absolutely. Yeah, I’ll put a link to your site on our site as well. Thank you very much. You’ve been very generous with your time.

Edmund: You’re welcome. Thank you for having me.

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