It is that change in relationship that makes meditation a potent tool in pain management. With mindfulness we purposefully observe our experience as it takes place, including any pain that may be present. The mind naturally tends to see pain as being a "thing," and to give it a degree of solidity, permanence, and coherence that it doesn't in fact have. In mindfulness meditation we train ourselves to see the many different sensations that we collectively label as "pain." We may even gently make mental notes of the most prominent sensations that we notice. For example, we may note the presence of "tingling," "pulsing," "throbbing," "heat," "cold," "aching," "tightness," etc. When we let go of the rather crude label "pain" in this way and instead note what is actually present, we can find that each individual sensation is easier to bear. Sometimes we notice that there is no pain present, or that the sensations that we're experiencing are neutral or even pleasurable. Additionally, in exercising curiosity about our pain we are also gaining another important benefit in the form of the quality of acceptance. The mind, quite understandably, tends to see pain as something that is undesirable and therefore to be pushed away. This pushing away shows in the body as physical tension in and around the area of pain, causing additional discomfort and even intensifying the original pain. It's as if, having accidentally touched a hot stove, we were to react by trying to push the stove away. In doing so we would of course simply intensify our pain. So, in mindfulness meditation an attitude of curiosity allows us to let go of our resistance and to see the pain for what it is: an ever-changing variety of interwoven sensations. Much of our resistance to pain is mental rather than physical. When we experience pain the mind can, like the body, try to push it away. We experience desire for the pain just to go away. We crave its absence. Unfortunately, as we all know, wishing that something were so does not make it so, and our frustrated desires do nothing but add mental suffering to our physical distress. In mindfulness meditation we observe more than just any pain that may happen to be present. We become aware of the whole physical body, emotions, and thoughts, and of how each of these interacts with the others. One thing we can then begin to see is that although pain is present in our experience it isn't the whole of our experience. Mindfulness gives us a sense of the physical and mental "landscape" within which our pain is experienced, and which helps to give a sense of perspective to our experience of it. At times of stress it may seem as if pain is the only thing that we experience, but this comes about because we have a kind of mental "zoom lens" that is closely focused on the pain. Change that zoom lens for a wide-angle lens and the pain seems much smaller and therefore more manageable. Without mindfulness, our experiences tend to proliferate in an unhelpful way. We may experience physical pain, and this leads to thoughts such as "This is never going to end," "This is just going to get worse," "I can't bear this," or "I must be a bad person to deserve all this pain." In turn, these thoughts lead to anxiety, despondency or anger, because we tend to believe the stories we think when we are unmindful, and this adds further to our suffering. The practice of mindfulness includes becoming aware of our thoughts and seeing that our thoughts are indeed just thoughts and are not facts. Thoughts are not facts. This can be a revolutionary discovery, and also a liberating one. When we learn to see thoughts as just another experience coming and going against the background of our overall physical and mental experience, we free ourselves from the kind of runaway thinking that is so characteristic of stress. We can see thoughts like "I can't stand this" coming into being, realize that they are thoughts rather than facts, and instead of indulging in them and encouraging them we simply note them and let go of them. But do these approaches actually have medical benefits? Do they reduce pain, or do they simply allow us to handle our pain better? Clinical studies are unequivocal in demonstrating that the practice of mindfulness meditation both increases the ability to deal with the effects of pain and reduces pain overall. A study published in General Hospital Psychiatry followed 51 chronic pain patients who had not improved with traditional medical care. The dominant pain categories were low back, neck and shoulder, headache, facial pain, angina pectoris, non-coronary chest pain, and GI pain. After a 8-week program of meditation, 65% of the patients showed a reduction in pain of greater than 33%, and half of the patients showed a reduction in pain levels of more than 50%. It should be remembered that these were patients whose pain had shown no improvement with traditional medical care. In other words, people with the most difficult cases of chronic pain still showed dramatic improvements in their condition. The practice of mindfulness is particularly effective because it "decouples" the physical sensations of pain from mental and emotional processes that heighten suffering. Pain comes to be seen as "just another sensation" and the fear of pain is significantly reduced. The development of mindfulness, as people have been practicing it for 2,500 years, can bring about mental and emotional freedom and a decrease in suffering.