Mindfulness and Chronic Pain

“Have you tried mindfulness?”

This has become a common, catch-all response when someone expresses a mental health issue. While mindfulness can help with some mental health issues, it is not a perfect fix-all. It is a tool, and like any tool, it can cause more damage than support if it is used incorrectly or applied to the wrong job. A hammer and a paint brush are both tools, and you wouldn’t want someone using a hammer to paint your walls.

Or maybe you would. It’s your house.

hammer in paint lying on wooden floor
Photo by Polina Tankilevitch on Pexels.com

Anyway, one group for whom mindfulness activities can do more harm than good is those who experience chronic pain. (If you experience chronic pain and you love mindfulness, that is valid, and please keep doing what you find helpful! There are no absolutes. Except that one.) Because many mindfulness activities involve bringing your conscious awareness to your internal processes and body sensations, chronic pain patients often find their attention drawn to the pain itself. Suddenly, you are acutely aware of the constant, inescapable pain. That is hardly therapeutic.

Recently, I was asked if I know of any mindfulness activities that are helpful for folks with chronic pain issues. I did what I always do and asked social media for some tips to share here. As always, your mileage may vary, it’s okay if something is not a fit for you, consult your treatment team, et cetera. Take what works, and ignore what does not.

Externally-Focused Mindfulness

When we think about mindfulness, we often think about turning our focus inward, but this is not the only way to be mindful. Instead of tuning into your body sensations, you can be mindful by focusing on an object in your environment (like mindfully observing a rock or leaf) or listing every sound you can identify right now.

Even externally-focused mindfulness scripts often start with tuning into your body, so know that you can tweak any script or activity to meet your needs. For example, if deep breathing exercises that include a body check-in increase your pain level, you might prefer exercises that involve taking slow breaths without cuing you to the breath itself or your internal processes.

Radical Permission

“Radical permission” is a strategy used in Dialectical Behavioral Therapy. It refers to a distress tolerance skill aimed at accepting what is happening without creating further discomfort or pain.

The mental health treatment facility HopeWay puts it very well:

Radical acceptance is NOT approval, but rather completely and totally accepting with our mind, body and spirit that we cannot currently change the present facts, even if we do not like them. By choosing to radically accept the things that are out of our control, we prevent ourselves from becoming stuck in unhappiness, bitterness, anger and sadness and we can stop suffering.

Fully and radically accepting the reality of pain without sitting with or becoming “stuck” in our emotional response to the pain is radical acceptance.

Comfort Items

I would like to extend a special thank you to @MichellePraiz on Twitter/X/whatever they’re calling it when this goes live for this tip. Michelle said that using soft blankets and pillows, candles with comforting scents, and cushions for her body can help bring attention to the things that feel good in her body.


Several people I spoke with when writing this blog post recommended finding ways to distract yourself. Choose something engaging outside of yourself, like a show, movie, or other media that will pull your entire focus out of your body and onto something else. Find an activity, like stretching or another (non-painful) movement that takes your focus. Anything that requires your full attention can be a distraction from physical pain.

Leaning In To Familiarity

A great tip from @justmegg93 on That One Website is to recognize the familiarity and lean into the comfort that comes from knowing what to expect. Unfamiliar things are scary, and chronic pain can be predictable.

According to @justmegg93:

My chronic pain is known. I can process what I know. I craft a wall of pragmatism. When my pain flares up, it’s frustrating and I let myself feel that. However, I also firmly tell myself, “You know this pain. It is not new to you. Take comfort in the familiarity of it.”

Finding Community

Pain is so isolating, and it is hard to remember that you are not alone in your experience. Online communities in particular can connect you with others who understand your experience because they also live with pain. You can connect with people who “get” you, who will not downplay what you are going through or judge you for your disability, and exchange tips and advice for getting through your worst days.

Community support can open doors to better understanding your own experience and connect you with your people.

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. She completed her internship at the National Psychology Training Consortium with specializations in assessment and rural mental health. Currently, she specializes in trauma-informed and neurodiversity-affirming care, and she is certified in telemental health. Dr. Marschall runs a private practice, RMH Therapy, where she provides individual and family therapy as well as psychological assessments across the lifespan. Dr. Amy Marschall is an author and professional speaker.

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