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NICABM and MInd-Body Medicine

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Both Native American philosophies and Buddhism teach us to focus in the present to reduce pain and suffering and this is, of course, what mindfulness meditation allows us to accomplish. Buddha said that clinging to what we desire and aversion to what we don't want is the cause of much of our suffering. The hypnotherapist Milton Erickson wrote that one-third of the pain that people feel is the memory of pain they have felt and one-third is the fear of pain they will feel. If we eliminate dwelling in the future or the past, we eliminate 2/3s of the sensation of pain.

I believe we are on the verge of discovering that a number of our contemporary afflictions are disorders of central mapping and processing and not illnesses that exist outside the body independent of the brain. I suspect that fibromyalgia is such a disease. The multiple painful spots that are found on the surface of the body are often migratory and evanescent. We are wiser to search for the disorganized maps and exagerated neural circuits that perceive pain within the brain. I think many of the post-Lyme disease syndromes operate on the same basis. The brain learns to experience symptoms and continues to do so long after the Lyme Disease is eradicated. The person does not require years of intravenous antibiotics or complicated antibiotic, herbal, and/or other potion remedies, but rather, a sensible way to teach his or her brain that the illness has ended and it's all right to stop feeling the symptoms of the illness. Perception can also be illusion.

The danger in all this is that we pathologize human experience. We do this when we create diagnoses. Then people have to meet so-called objective criteria to fall into these diagnoses and we insist upon proof. Pain is a story, not a disorder. Pain is a dynamic performance which has a beginning (often the actual tissue injury or an inciting event), a middle (it builds upon itself) and an end (the pain resolves or it becomes completely unmanageable). Pain happens to someone (the main character of the story) and involves many supportive characters (doctors, family members, friends, co-workers). Denouements and resolutions occur. A plot unfolds, often of valiant suffering against the implacability and insensitivity of the medical system. Meaning and purpose is found occasionally in bearing up against this adversity or in overcoming it. As is true with any large story, multiple smaller stories or vignettes exist that together comprise the larger pain story. And, there is definitely an audience who watches the characters fulfill their roles. This audience and the sense of their appreciation of the story and its plots and meanings contributes to the dynamics of pain perception by reorganizing the brain and its neural circuitry as surely as learning to read creates circuitry that was never there before (See Boston neuroscientist Wolf and her excellent book, Proust and the Squid, for a description of how this works).

These are ideas that I discuss in more detail in my newest book, Healing the Mind through the Power of Story: the Promise of Narrative Psychiatry, ideas that will be discussed by Dr. Buszynski on Wednesday in the teleseminar, and during at the actual conference during the second weekend of December. For more details, of course, see

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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and (more...)
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