Can you have pain without suffering?

What Zen meditators don’t think about won’t hurt them. That was the title of the press release written by the Université de Montréal public relations department for a recent research study Dr. Pierre Rainville and I conducted. I begin with this because of the subtle way it captures exactly what we “think” we’re measuring.

Over the past five years we have been studying the influence of meditation on the experience of physical pain. Despite numerous claims in ancient Hindu and Buddhist texts that meditative practices have powerful effects on pain, little scientific work had been done at that time. Our work, along with the work of others, is shedding light on these claims and may prove valuable to those seeking alternative methods of pain relief.

It will be instructive to first look a little deeper into the nature of pain. At best pain may be annoying and at worst excruciating and debilitating. Nevertheless, it’s an extremely important warning system telling us that action needs to be taken. The sensation is ancient, being carried through evolution as a result of its importance. However, one could ask: must such a warning system necessarily involve suffering to be effective?

This brings us to another fact about pain – it has many dimensions. It is well recognized that there are separate sensory and emotional aspects to pain. Where the sensory aspect reflects your ability to know where your body hurts and how much pain you’re in, the emotional aspect accounts for how it makes you feel; annoyed, scared, anxious. We know these are different things and that different parts of the brain allow these experiences to be felt.

Typically they’re hard to separate since severe pain likely involves a strong sensation (perhaps a broken leg) as well as high fear or anxiety. However, it may be possible to train the mind to see and experience the sensory and emotional aspects of pain separately. This is exactly what certain meditation techniques seem to do.

Zen is one of many Buddhist meditation traditions aiming to quiet the mind to allow one to see things more clearly. In our first study we applied a painful thermal stimulus (roughly equivalent to very hot bath water) to participants’ calves and compared Zen meditators and non-meditators. Our first finding was that the temperature had to be much hotter for the meditators to report that it was painful. Next, when asked to simply observe the sensation, rather than judge or fret about it, the meditators were able to lower their pain an additional 20 per cent.

This prompted us to use MRI to scan the brains of the two groups while they experienced pain. What we found was quite surprising. Rather than having lower activity in parts of the brain that underlie pain, as might be expected, meditators had much higher activity. This tells us that they are likely experiencing an extremely strong sensation. Importantly, other areas of the brain such as prefrontal ‘thinking’, ‘judging’, or ‘planning’ areas as well as emotion centers like the amygdala, appeared to be switched off during pain.

The meditators with the most experience were the ones that lowered the brain activity in these areas the most and also had the lowest pain ratings. Remarkably, we could predict pain tolerance by the degree to which they disconnected (not literally but functionally) prefrontal cortex with a central pain processing region. As far as we know, this pattern of brain activity has not been seen before, certainly in terms of pain reduction. Given the results and the mindset described in Zen, we suggest that the meditators have learned to separate the emotional and sensory aspects of pain. It seems that they may do this by not thinking or judging the stimulus as painful, even though it is extremely hot. Unlike pain killers which abolish the sensation, it seems the sensation remains but the experience of the stimulus, as painful, is changed.

Our group is not alone in showing analgesic effects of meditation. Several studies now exist showing that meditation techniques learned over a couple of months can help suffers of chronic pain. Other groups have demonstrated that different forms of meditation (i.e. Tibetan Buddhism) are also effective. Quite incredibly, work by Dr. Fadel Zeidan suggests as little as four days of meditation training can result in large reductions in pain.

In summary, pain is undeniably important but the suffering associated with it can be oppressive. The Buddha is attributed with claiming that through meditative training the suffering can be removed leaving a more neutral sensation. Cutting edge scientific research is beginning to validate that claim offering exciting options for individuals seeking alternative treatments for pain. About the Study: “A non-elaborative mental stance and decoupling of executive and pain-related cortices predicts low pain sensitivity in Zen meditators” was authored by Joshua A. Grant, Jérôme Courtemanche and Pierre Rainville from the Université de Montréal and was published in March in PAIN ® The Journal of the International Association for the Study of Pain.