This week, Christiane Wolf offers a guided practice to meet your own body in pain and relieve that sense of isolation by internally connecting with others who understand your experience.
Having chronic pain often feels incredibly lonely. You might not know anybody else who has the same condition. In addition, most people you’re close to, even though they might be well-intentioned, might not understand what you’re going through.
But the fact is that probably thousands and thousands of people all over the world know exactly what you’re feeling. In this meditation, Christiane Wolf offers a guided practice to meet your own body in pain and relieve that sense of isolation by internally connecting with others who could relate to, have empathy for, and care deeply about your experience.
A Meditation to Meet the Body In Pain
Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.
Start by finding a comfortable position, or as comfortable as possible. You can lie down for this meditation or sit in a chair. You can close your eyes or just soften your gaze, whatever feels best to you in this moment. If you’re sitting, place your feet on the ground. Feel the solid ground under your feet, or maybe have a sense of the floor or the carpet through your shoes or bare feet. Let your back be straight and upright, if that is possible. Lean against the back of the chair and feel the support of that.
Allow the body to relax, if that is possible. Maybe the jaw, the shoulder, the belly. Take a few deep slow breaths and feel the sensations of the breath in the body, like the chest or maybe the belly. See if you can release a little more tension with each exhalation.
Now, notice any amount of pain that you’re in right now, either physically or emotionally. No need to be specific here, just getting a broad sense of what you’re carrying with this pain, with this condition. As a first step, see if it might be possible to acknowledge how hard and difficult it is to experience this pain, to have this pain and to take care of the pain. If it feels right to you, you could say something to yourself like, This is hard. It is so rough to feel this way. Use words that you would find helpful to hear from a dear friend who really gets what you’re going through.
If you like, repeat this a few times. See if you can really listen to yourself saying this and meaning these words. It might feel good to hear these words, or maybe you notice yourself moving a little away and having a hard time accepting this. Whatever your experience is, it’s okay. There is no right or wrong way to do this.
Having chronic pain often feels lonely. You might not know anybody else who has the same condition. Most people you’re close to, even though they might be well-intentioned, might not understand what you’re going through. But the fact is that probably thousands and thousands of people all over the world know exactly what you’re feeling. Because they do, too. And they might even suffer from the same condition as you do.
Now, in your mind’s eye, invite all these people into your awareness. Maybe as a few people, maybe as a big group, all standing with you or being with you in solidarity with this pain. I personally like to imagine them at my shoulders, reaching back and back. They get me. They know exactly how I feel. They’re feeling the same thing or have felt it before. I don’t have to explain or defend anything, because they already understand.
Keep practicing this in a way here that makes the most sense to you. Consider what makes it easy or maybe just possible to connect with this idea that there are truly so many people out there who get you, who get this pain. You’re not alone with this. If you notice the mind wandering off, just gently keep bringing it back. Allow this sense of your inner support group.
When you’re ready, allow the image to dissolve. Take another few deeper and longer breaths, longer on the exhale than the inhale. Bring the meditation to an end by starting to move and stretch the body in any way that feels good. Open your eyes if you had them closed.
Why is the incidence of side effects from statins so low in clinical trials while appearing to be so high in the real world?
“There is now overwhelming evidence to support reducing LDL-C (low-density lipoprotein cholesterol)”—so-called bad cholesterol—to reduce atherosclerotic cardiovascular disease (CVD),” the number one killer of men and women. So, why is adherence to cholesterol-lowering statin drug therapy such “a major challenge worldwide”? Researchers found “that the majority of studies reported that at least 40%, and as much as 80%, of patients did not comply fully with statin treatment recommendations.” Three-quarters of patients may flat out stop taking them, and almost 90 percent may discontinue treatment altogether.
When asked why they stopped taking the pills, most “former statin users or discontinuers…cited muscle pain, a side effect, as the primary reason…” “SAMSs”—statin-associated muscle symptoms—“are by far the most prevalent and important adverse event, with up to 72% of all statin adverse events being muscle-related.” Taking coenzyme Q10 supplements as a treatment for statin-associated muscle symptoms was a good idea in theory, but they don’t appear to help. Normally, side-effect symptoms go away when you stop the drug but can sometimes linger for a year or more. There is “growing evidence that statin intolerance is predominantly psychosocial, not pharmacological.” Really? It may be mostly just in people’s heads?
“Statins have developed a bad reputation with the public, a phenomenon driven largely by proliferation on the Internet of bizarre and unscientific but seemingly persuasive criticism of these drugs.” “Does Googling lead to statin intolerance?” But people have stopped taking statins for decades before there even was an Internet. What kinds of data have doctors suggested that patients are falsely “misattribut[ing] normal aches and pains to be statin side effects”?
Well, if you take people who claim to have statin-related muscle pain and randomize them back and forth between statins and an identical-looking placebo in three-week blocks, they can’t tell whether they’re getting the real drug or the sugar pill. The problem with that study, though, is that it may take months not only to develop statin-induced muscle pain, but months before it goes away, so no wonder three weeks on and three weeks off may not be long enough for the participants to discern which is which.
However, these data are more convincing: Ten thousand people were randomized to a statin or a sugar pill for a few years, but so many more people were dying in the sugar pill group that the study had to be stopped prematurely. So then everyone was offered the statin, and the researchers noted that there was “no excess of reports of muscle-related AEs” (adverse effects) among patients assigned to the statin over those assigned to the placebo. But when the placebo phase was over and the people knew they were on a statin, they went on to report more muscle side effects than those who knew they weren’t taking the statin. “These analyses illustrate the so-called nocebo effect,” which is akin to the opposite of the placebo effect.
Placebo effects are positive consequences falsely attributed to a treatment, whereas nocebo effects are negative consequences falsely attributed to a treatment, as was evidently seen here. There was an excess rate of muscle-related adverse effects reported only when patients and their doctors were aware that statin therapy was being used, and not when its use was concealed. The researchers hope “these results will help assure both physicians and patients that most AEs associated with statins are not causally related to use of the drug and should help counter…exaggerated claims about statin-related side effects.”
These are the kinds of results from “placebo-controlled randomised trials [that] have shown definitively that almost all of the symptomatic adverse events that are attributed to statin therapy in routine practice are not actually caused by it (ie, they represent misattribution.)” Now, “only a few patients will believe that their SAMS are of psychogenic origin” and just in their head, but their denial may have “deadly consequences.” Indeed, “discontinuing statin treatment may be a life-threatening mistake.”
Below and at 4:46 in my video How Common Are Muscle Side Effects from Statins?, you can see the mortality of those who stopped their statins after having a possible adverse reaction compared to those who stuck with them. This translates into about “1 excess death for every 83 patients who discontinued treatment” within a four-year period. So, when there are media reports about statin side effects and people stop taking them, this could “result in thousands of fatal and disabling heart attacks and strokes, which would otherwise have been avoided. Seldom in the history of modern therapeutics have the substantial proven benefits of a treatment been compromised to such an extent by serious misrepresentations of the evidence for its safety.” But is it a misrepresentation to suggest “that statin therapy causes side-effects in up to one fifth of patients”? That is what is seen in clinical practice; between 10 to 25 percent of patients placed on statins complain of muscle problems. However, because we don’t see anywhere near those kinds of numbers in controlled trials, patients are accused of being confused. Why is the incidence of side effects from statins so low in clinical trials while appearing to be so high in the real world?
Take this meta-analysis of clinical trials, for example: It found muscle problems not in 1 in 5 patients, but only 1 in 2,000. Should everyone over a certain age be on statins? Not surprisingly, every one of those trials was funded by statin manufacturers themselves. So, for example, “how could the statin RCTs [randomized controlled trials] miss detecting mild statin-related muscle adverse side effects such as myalgia [muscle pain]? By not asking. A review of 44 statin RCTs reveals that only 1 directly asked about muscle-related adverse effects.” So, are the vast majority of side effects just being missed in all these trials, or are the vast majority of side effects seen in clinical practice just a figment of patients’ imagination? The bottom line is we don’t know, but there is certainly an urgent need to figure it out.
Sham surgery trials prove that procedures like non-emergency stents offer no benefit for angina pain—only risk to millions of patients.
Angioplasty and stents—percutaneous coronary intervention (PCI)—for stable, non-emergency coronary artery disease are among “the most common invasive procedures performed in the United States.” Though they appeared to offer immediate relief of angina chest pain in stable patients with coronary artery disease, that didn’t actually translate into a lower risk of heart attack or death. This is because the atherosclerotic plaques that narrow blood flow tend not to be the ones that burst and kill us. Symptom control is important, though, and is much of what we do in medicine, but cardiology has a bad track record when it comes to performing procedures that don’t actually end up helping at all.
Case in point: internal mammary artery ligation. Though it didn’t make much anatomical sense—why would tying off arteries to the chest wall and breast somehow improve coronary artery circulation?—it worked like a charm with immediate improvement in 95 percent of hundreds of patients. Could it have just been an elaborate placebo effect, and surgeons were cutting into people for nothing? There’s only one way to find out: Cut into people for nothing.
As I discuss in my video Do Heart Stent Procedures Work for Angina Chest Pain?, people were randomized to get the actual surgery or a sham (or fake) surgery where patients were cut open and the surgeon got to the last step but didn’t actually tie off those arteries. The result? “Patients who underwent a sham operation experienced the same relief.” Check out the testimonials: “Practically immediately, I felt better.” “I’m about 95 percent better.” “No chest trouble even with exercise.” “Believe I’m cured.” And these are all people who got the fake surgery. So, it was just an extravagant placebo effect. Think about it. “The frightened, poorly informed man with angina [chest pain], winding himself tighter and tighter, sensitizing himself to every twinge of chest discomfort, who then comes into the environment of a great medical center and a powerful positive personality and sees and hears the results to be anticipated from the suggested therapy is not the same total patient who leaves the institution with the trademark scar.” He hears how great he’s going to feel, goes through the whole operation, and leaves a new man with that trademark scar.
One sham patient was actually cured, though. “The patient is optimistic and says he feels much better.” The next day’s office note reads: “Patient dropped dead following moderate exertion.” This has happened over and over.
What if we burn holes into the heart muscle with lasers to create channels for blood flow? It seemed to work great until it was proven that it doesn’t work at all. Cutting the nerves to our kidneys was heralded as a cure for hard-to-treat high blood pressure until sham surgery proved that procedure was a sham, too. “The necessity for placebo-controlled trials has been rediscovered several times in cardiology, typically to considerable surprise.” Before they are debunked, “often a therapy is thought to be so beneficial that a placebo-controlled trial is deemed unnecessary and perhaps unethical.” That was the case with stents.
Hundreds of thousands of angioplasties and stents are done every year, yet placebo-controlled trials have never been done. Why? Because cardiologists were so unquestioningly sure it worked “that it might be unethical to expose patients to an invasive placebo procedure.” Why perform a fake surgery to prove something we already know is true? “When patients are aware they have had PCI, they have a clear reduction in angina and improved quality of life.” But what if they weren’t aware they had a stent placed inside them? Would it still work?
Enter the ORBITA trial. After all, “anti-anginal medication is only taken seriously if there is blinded evidence of symptom relief” against a placebo pill, so why not pit stents against a placebo procedure? “In both groups, doctors threaded a catheter through the groin or wrist of the patient and, with X-ray guidance, up to the blocked artery. Once the catheter reached the blockage, the doctor inserted a stent or, if the patient was getting the sham procedure, simply pulled the catheter out.”
The researchers had problems getting the study funded. They were told: “We know the answer to this question—of course, PCI works.” And that’s even what the researchers themselves thought. They were interventional cardiologists themselves. They just wanted to prove it. Boy, were they surprised. Even in patients with severe coronary artery narrowing, angioplasty and stents did not increase exercise time more than the fake procedure.
“Unbelievable,” read the New York Times headline, remarking that the results “stunned leading cardiologists by countering decades of clinical experience.” In response to the blowback, the researchers wrote that they “sympathize with our community’s shock and its instinct to invalidate the trial. Applying a positive spin could have smoothed the reception of the trial, but as authors we have a duty to preserve scientific integrity.”
While some “commended them for challenging the existing dogma around a procedure that has become routine, ingrained, and profitable,” others questioned their ethics. After all, four patients in the placebo group had complications from the insertion of the guide wire and required emergency measures to seal the tear made in the artery. There were also three major bleeding events in the placebo group, so they suffered risks without even a chance of benefit. But “far from demonstrating the risks of sham-controlled PCI trials, this demonstrates exactly what patients are being subjected to on a routine basis, without evidence of benefit.”
Those few complications in the trial “are dwarfed in magnitude” by the thousands who have been maimed or even killed by the procedure over the years. Do you want unethical? How about the fact that an invasive procedure has been performed on millions of people before it was ever actually put to the test? Maybe “we should consider the absence, not the presence, of sham control trials to be the greater injustice.”
When a former commissioner of the U.S. Food and Drug Administration was asked at the American Heart Association meeting “whether sham controls should be required for device approval, he thought that it was more of a decision for the clinical community: ‘Do you want to get the truth or not?’”
In this guided meditation, longtime meditation teacher and pain expert Vidyamala Burch offers a tender practice to help us be with our whole selves with openness and kindness, even when we are experiencing pain.
Being in pain makes being present extra challenging.
On a physical level, being in the present moment while our body is in pain is often extremely unpleasant. There is a part of us, understandably, that wishes we could escape from it entirely.
At the same time, the experience of pain itself can be overwhelming—to our senses, our thoughts, our emotions. It can feel like drowning, when what we long for is just a moment of peace to rest in.
In today’s guided meditation, longtime meditation teacher and pain expert Vidyamala Burch offers a tender practice to find a middle way—one that doesn’t veer into denial or give in to overwhelm, but rather allows all that is happening to be gently met, as Vidyamala says, with “wholeness, integration, and kindliness.”
A Meditation for Finding a Middle Way When We Are In Pain
Read and practice the guided meditation script below, pausing after each paragraph. Or listen to the audio practice.
Start by establishing a meditation posture. You can do it sitting; you can do it lying down. The main thing is to choose a position where you can be as relaxed as possible and yet alert. Once you’ve chosen your position, begin to settle. Allow the weight of the body to rest down into the support beneath you. If you’re sitting, it’ll be through the bottom, into the chair, through the feet, into the floor. For lying down, it’ll be through the back of the body, into the bed or the floor, and then the head resting into the pillow or cushion.
See if you can cultivate a sense of rest, allowing the body to be held. Let go of gripping. Receive the support of whatever’s beneath you. To help this, you could take a few deep breaths and then on each outbreath release a little bit more, letting the next in-breath flow back in in its own time.
With each in-breath, breathe in freshness and vitality. With each out-breath, let go of gripping. When you’re ready, allow your breathing to find its own natural rhythm. Allow your awareness to pour out of the head, where it so often seems to be located, and feel the body resting inside the movements and sensations of breathing.
Allow your awareness to fill in the body a little bit more. Let it pour down through the torso, through the hips, feet, and legs. We’re not looking in from the outside or thinking about the legs and the feet as a concept or an object. Rather, we’re resting inside sensations of contact with the floor, with the chair, or the bed. Maybe there’s a sense of tingling, buzzing energy. Maybe there’s dullness or numbness. Whatever our experience is, allowing awareness to fill the feet and the legs. If there’s pain or discomfort, see if we can meet this with an attitude of kindliness and care, softening automatic habits of resistance and tension. Allow awareness to come to the buttocks, letting the buttocks be soft, resting into the chair, into the bed.
Allow awareness to fill the whole torso—including the belly, the chest, the front and the whole back of the body and the back, the whole spine. Have a sense of the torso opening a little bit in all directions on the in-breath and subsiding on the outbreath. Be careful not to force or strain. Receive on an in-breath, letting go on the outbreath. Again, if you’ve got pain or discomfort anywhere in the back or the front of the whole torso, see if you can allow it into awareness with an attitude of care and kindliness. Let it be part of our experience, softening the resistance and the automatic tension that can so quickly arise.
Now bring awareness to the shoulders, arms, and hands. Let your hands be supported, resting on the legs or in the lap if sitting. Rest them at the sides of the body, palm upwards (if lying down) or on the legs, palm downwards (if sitting). Let go of gripping in the arms with tension, just letting them rest into gravity. Let the shoulders fall away from the midline of the body into gravity. Allow shoulders, arms, and hands to be full of awareness. This might show up as discomfort, tingling, heat. It could be sensing the contact with clothes, contact with the surface the hands are resting on. Receive all this into awareness with kindliness.
Now come up through the arms and up to the neck and the head. If you’re sitting, let the head be poised on the top of the spine, maybe tucking the chin in just a tiny bit, so there’s a release through the base of the skull and yet openness in the throat. If you’re lying down, see if you can let the weight of the head be fully held by the pillow or the cushion. Let go of holding on, gripping in the head, letting it rest. Let the jaw be soft, the lips and tongue be soft so the wind of the breath can flow freely through the back of the throat on the way into the body and then back out again on the way out of the body. Let the cheeks be soft, eyes soft, forehead soft. We could imagine the brain resting inside the head softly.
See if you can feel into the physicality of the head. So often the head can feel split off from the body. The head is just a thought factory, and then the body’s just this kind of thing that we drag through life. But the head is a limb of the body, just like the arms and the legs. Sense the feelings, the sensations in the head. Temperature, tingling, buzzing, softness, maybe even contact with the air brushing against the skin.
See if you can have a sense of wholeness in the legs, torso, arms, neck, and face. This experience of embodiment, moment by moment by moment, the flow of sensations in the whole body arising and passing, arising and passing.
If you’ve got pain or discomfort right now, let’s attend to that part of the body. Take your awareness to that part of the body and notice if it’s surrounded by resistance or hardness. Let’s see if we can find this sweet spot between denial on the one hand and overwhelm on the other. Denial will be a kind of turning away, a hardening and not wanting, a pushing away. Maybe there’s a little bit of breath holding. Maybe there’s tension in the head, tension in the bottom. If you notice that, then see if you can turn a little bit more towards the experience, metaphorically speaking, adding it into awareness a little bit more, very gently and tenderly, breath by breath. Let it be part of this flow of experience in the whole body. Breathe into that area and imagine that the breath is bathed in kindliness.
If, on the other hand, you’re feeling overwhelmed, the only thing in experience is the pain or the difficulty. The practice here is to broaden. Feel the bottom on the chair or the bed. Feel the support beneath us. Feel breath in the whole body. Feel the whole range of sensations in the whole body. The pain is just one aspect of this multifaceted experience of being alive right now. If you notice yourself hardening up again, tensing, turning away, suppressing, denying, blocking—use awareness to interrupt that process and soften. Relax the palms. Relax the hands. Come closer. Breathe kindly.
This is a training in wholeness, integration, and kindliness. We’re able to be with all of our experience with presence and kindliness. If we have a wound, we broaden. If we’re blocking off, we come closer. That is the practice. Our awareness is dynamic, subtle, receptive, fluid.
You can keep on practicing if you’d like to, but I’ll bring this guided meditation to a close. Let’s bring the weight of the body to the foreground of awareness, feeling, resting into the support beneath us. Feel breathing in the whole body. Broaden awareness to be aware of sounds around your environment. Open the eyes if they’ve been closed. Bring a tiny bit of movement into the body, maybe the fingers and the toes or some other part of the body. Notice any tendency to immediately halt the breath and immediately start pushing and rushing. Stay inside this subtle movement with a soft brow. And when you’re ready, come into bigger movement. In your own time, reengage with the activities of the day.
You may never realize how often water touches our lives until you have a disorder like the 25-year-old young mother from the U.K. who describes simple daily activities such as washing hands, drinking water, or taking a bath as “excruciatingly painful”.
An extremely rare condition called aquagenic urticaria makes the life of Kendall Bryce, from Durham, UK, a real struggle. As a young mother of one, pregnant with her second child, she finds it difficult to take care of herself and or her child while battling the condition.
“I’ve never been able to give my one-year-old son a bath. My mom has to do it for me. And I even feel my throat burning when I drink water,” she said.
“It really is a daily struggle. I can only have a bath or take a shower twice a week because of how excruciating the pain is, so I constantly worry I stink,” said Bryce.
Bryce’s condition began when she was just 15 when she started noticing hives after she took a bath. But little did she realize that was the beginning of her battle with water allergy until she was diagnosed with the condition four years back.
“The GP didn’t have a clue what to do. It’s just such a rare condition, so not many people have it and not many people know about it,” Bryce recalled, still living with the constant pain. The pain is so severe that her body sometimes goes into shock.
“My life is dictated by the weather as I have to avoid rain — and even hot humid days. I check the forecast every day and stay home if it’s raining or going to rain, but if I get caught out by surprise, my body reacts and it’s really painful,” she added.
There is currently no cure for water allergy, but treatment options are available to manage the symptoms. Treatments include the use of oral antihistamines, topical medications like creams or emulsions, phototherapy using artificial UV light, and sometimes other medications like asthma drugs, anabolic steroids, or SSRIs.
While pregnant, Bryce’s treatment options are however limited. “They’ve tried lots of different medications but I kept reacting. I still haven’t found something that helps,” Bryce said. However, she hopes that by sharing her story, she might connect with someone who knows how to treat her condition.
The U.S. Food and Drug Administration (FDA) has approved Suzetrigine, a new non-opioid pain relief drug sold under the brand name Journavx, to treat moderate to severe acute pain in adults.
Journavx from Vertex Pharmaceuticals marks the first new class of pain reliever to receive FDA approval in over two decades. It will be sold as 50-milligram prescription pills that work by blocking pain signals at their source by targeting sodium channels in the nervous system and stopping pain before it reaches the brain.
“Today’s approval is an important public health milestone in acute pain management. A new non-opioid analgesic therapeutic class for acute pain offers an opportunity to mitigate certain risks associated with using an opioid for pain and provides patients with another treatment option. This action and the agency’s designations to expedite the drug’s development and review underscore FDA’s commitment to approving safe and effective alternatives to opioids for pain management,” Dr. Jacqueline Corrigan-Curay, acting director of the FDA’s Center for Drug Evaluation and Research said in a news release.
Non-opioid pain relief is a crucial step forward in addressing the ongoing opioid crisis. With over 80 million Americans requiring pain relief, around half are prescribed opioids. However, nearly 10% of those initially prescribed opioids end up using them long-term, and about 85,000 develop opioid use disorder each year. Non-opioid alternatives offer a safer option for pain management, reducing the risk of dependency.
According to the manufacturer, Journavx is a well-tolerated, effective pain reliever with no signs of addictive potential, designed for all types of moderate to severe acute pain.
The efficacy of the drug was tested in two clinical trials involving surgical pain, one after tummy tuck surgery (abdominoplasty) and the other after bunion surgery. Participants were randomly given either Journavx or a placebo. If pain control was not enough, they could also take ibuprofen for extra relief. Both trials showed that Journavx worked significantly better than a placebo in reducing pain.
The safety of Journavx was evaluated based on data from two main trials with 874 participants who had moderate to severe acute pain after a tummy tuck or bunion surgery, along with additional data from a smaller study with 256 participants in various acute pain conditions.
The most common side effects reported were itching, muscle spasms, elevated creatine phosphokinase levels, and rash. Journavx should not be taken with strong CYP3A inhibitors, and patients should avoid grapefruit or grapefruit-containing foods and drinks while using it. The drug will be priced at $15.50 per 50mg pill.
Losing weight can reduce sciatica, hypertension, and cancer risk, as well as reverse type 2 diabetes.
In the ABCs of the health consequences of obesity, A is for Arthritis, as I discussed in my previous blog post, and B is for Back Pain. Being overweight is not just a risk factor for low back pain, but it is also a risk factor for sciatica (a radiating nerve pain), as well as degenerating lumbar discs and disc herniation. Similar to what we learned in the arthritis story, this may also be due to a combination of the excess weight, high cholesterol, and inflammation associated with being overweight. Why cholesterol? Studies of autopsies and angiographies show that the lumbar arteries that feed our spine can get clogged with atherosclerosis and starve the disks in our lower back, as you can see below and at 0:47 in my video The Effects of Obesity on Back Pain, Blood Pressure, Cancer, and Diabetes.
B is also for Blood Pressure. Excess visceral fat—for example, internal abdominal fat—can physically compress our kidneys. The increased pressure can effectively squeeze sodium back into our bloodstream, increasing our blood pressure. Together, the combination of obesity and hypertension can have “disastrous health implications,” but the good news is that just a few pounds of weight loss can help take off the pressure. Losing excess weight has been described as “a vital strategy for controlling hypertension.” In fact, researchers found that losing around nine pounds (4 kg) may lower blood pressure about as much as cutting salt intake approximately in half can.
C is for Cancer. As many as three-quarters of people surveyed “were unaware that being overweight or obese increased a person’s risk of cancer,” when, in fact, based on a comprehensive review of more than a thousand studies, excess body fat raises the risk of most cancers, including esophageal, stomach, colorectal, liver, gallbladder, pancreatic, breast, uterine, ovarian, kidney, brain, thyroid, and bone marrow (multiple myeloma) cancers, as you can see below and at 2:00 in my video.
It could be the chronic inflammation of obesity or perhaps it is the high insulin levels due to insulin resistance. (Besides controlling blood sugars, insulin is also “a potent growth factor” that can promote tumor growth.) In women, it could also be the excess estrogen.
After the ovaries shut down at menopause, fat takes over as the principal site of estrogen production. That’s why women who are obese have up to nearly twice the estrogen levels circulating in their bloodstream, which is associated with an increased risk of developing breast cancer and dying from it. The data on prostate cancer aren’t as strong, though obesity is associated with increased risk of invasive penis cancer.
One of the reasons we’re confident the link between obesity and cancer is cause-and-effect—and not just an indirect consequence of eating poorly—is that the overall risk of cancer goes down when people lose weight, even through bariatric surgery. Researchers found that those experiencing a sustained weight loss of about 40 pounds (19.9 kg) after surgery went on to develop around one-third fewer cancers over the subsequent decade, compared with matched individuals in the nonsurgical control group who continued to slowly gain weight over time. The exception, though, is colorectal cancer.
“Colorectal cancer is the only known malignancy where the risk of being diagnosed with disease seems to increase after obesity surgery.” Indeed, after bariatric surgery, the rate of rectal cancer death may triple. The rearrangement of anatomy involved in one of the most common surgeries—Roux-en-Y gastric bypass—is thought to increase bile acid exposure along the intestinal lining. This causes sustained pro-inflammatory changes even years after the procedure, which is thought responsible for the increased cancer risk. In contrast, losing weight by dietary means has the potential to decrease obesity-related cancer risk across the board.
D is for Diabetes. As presented in a consensus statement from the International Diabetes Federation, obesity is considered the single most important risk factor for the development of type 2 diabetes, which is the leading cause of kidney failure, lower-limb amputations, and adult-onset blindness. Ironically, many of the leading drugs used to treat diabetes (including insulin itself) cause further weight gain, creating a vicious cycle.
So, again, using lifestyle medicine to treat the underlying cause is not only safer, simpler, and cheaper, but can also be most effective.
Based out of the UK, Vidyamala Burch is an award-winning teacher whose courses and work in the field of mindfulness and pain management have been recognized for the measurable ways they have served the common good. She recently launched a new program, HEALS, which offers a comprehensive, holistic approach for managing and living with chronic pain and illness.
As a writer who loves interviewing, I came to my conversation with Burch with my list of questions and a healthy dose of journalistic curiosity. I felt a little starstruck to get to meet her.
If I’m honest, though, these weren’t the only things I brought, because this conversation also felt personal.
So many people I know, myself included, have had experiences living with chronic pain and illness. I was nearly 40 years old when I finally found healing from more than 20 years of recurring and increasingly debilitating low back issues. I have many friends, some just in their 30s or 40s, who deal with fibromyalgia, chronic fatigue syndrome, recurring migraines, and other adrenal and nervous-system challenges.
My mother survived polio as a young child and lived with relentless chronic conditions for her entire life as a result. She passed away suddenly a decade ago, at the young age of 67. Polio wasn’t technically the thing that killed her, but I knew from many conversations with her in her final years that the long slogging decades of complications, disability, and pain made her long for relief. I was with her when she took her last breath, and I felt the surrender in her body, finally.
To suffer ourselves, or to watch people we love suffer over long periods of time, often without real answers or effective treatments—the questions that bubble up aren’t academic. They sit close to the bone and the heart.
Why did this happen? Why did it go on for so long? Why does it feel so lonely? Where do these ailments come from, and why are they often so mysterious and so intractable, even in the face of intense medical interventions? Can practices like mindfulness reallyoffer anything meaningful into this complicated, messy world of living with chronic illness and pain?
Yes, I wanted to talk to Vidyamala, the expert on mindfulness and pain management. But I also didn’t want to waste the opportunity to talk to Vidyamala, the human being who has traveled this long road herself, and who understands intimately that the clinical ways we think and talk about physical suffering can’t meet us fully where we need to be met.
The clinical ways we think and talk about physical suffering can’t meet us fully where we need to be met.
Siri Myhrom: I’m curious about where the HEALS Program got its start for you. How do you see it as unique from and also working together with your other programs?
Vidyamala Burch: I developed Mindfulness for Health, which is our eight-week mindfulness program for people living with chronic pain and long-term health conditions. So the seeds for HEALS were way back in 2000, when I started running that [Mindfulness for Health] as an experimental course in 2001.
In my own experience as somebody who’s lived with chronic pain and disability for nearly 50 years now, mindfulness has been absolutely crucial to that journey because my life, my quality of life now, is really pretty good, notwithstanding my disability.
So mindfulness is foundational. And when I look at my own journey of reclaiming my quality of life, I realized that it was mindfulness-plus. So what I’ve done is I’ve worked on my nutrition. I’ve worked on how I move. I’ve looked at my sleep habits. I try to have time in nature. So if I looked at what’s worked for me, it was mindfulness plus these other dimensions. I felt that it would be really helpful to come up with an applied mindfulness program.
This is my vision, that people come through either doorway. You might come through the HEALS doorway or you might come through the Mindfulness for Health doorway. I see them as definitely complementary and as two doorways into the same room.
SM: Mindfulness talks a lot about awareness, and I have a question around that that’s maybe more personal. The people I know who live with chronic pain would likely say, I’m already very aware of my pain. I’m curious how you understand that word awareness, especially within a mindful context, and how does that serve to alleviate the suffering, rather than creating a focus on it?
VB: That’s an excellent question because it’s very counterintuitive. People might think, I’m very, very aware of it. And I don’t want to be more aware of it. And maybe people might think, The last thing I want to do is become aware of my body. My body is my tormentor. I want to just split off from my body.
So those are all very reasonable things to think about. What we do is right up front in both Mindfulness for Health and HEALS, we talk about how by using awareness, you can investigate this experience that you label pain. Investigate that and realize that it’s got two components. One component is your basic unpleasant sensations.
The other component is all things that you do to create extra suffering when you resist those basic unpleasant sensations. What most people call pain would be that whole set of sensations, plus resistance, plus depression, plus anxiety, plus secondary tension, plus breath holding, plus poor sleep.
Most people think that’s what their pain is. But actually, the only thing that’s a given in any moment are the unpleasant sensations. Everything else is added through our reactions. So you’re learning to accept the unpleasant sensations with kindliness, tenderness, to soften the resistance, and a lot of that secondary stuff can fall away. You’re just left with unpleasant sensations. People find that a very optimistic message.
We put that right up front in all our programs. Week one, we talk about primary and secondary suffering. The other thing about awareness that we really strongly emphasize— again, in week one—is that it’s awareness that gives us agency. If we’re aware, we have choices. If you’ve got no choices, you know, you’re just swept along by this thing that’s ruining your life as if it’s a kind of enemy.
Awareness doesn’t make it pleasant. I think this is one of the ways people misunderstand this: that if I’m mindful, I’m aware, then suddenly I’m going to love my pain. You probably aren’t, because your pain is unpleasant, but you’re going to learn to relate to the unpleasantness with much more spaciousness, much more kindliness, more acceptance.
One of the things I say is by coming closer and examining this experience, you realize it’s a process, not a thing. One of the ways I talk about that is to experience it as a river rather than a rock, because everything is changing all the time. Most people relate to their pain as a solid lump, like it’s a big boulder that’s kind of taken up residence. But it’s amazing to be able to experience it as a river rather than a rock. Just let it flow through the moments and then have this less-reactive mindset. That’s very liberating.
SM: Do you attract people who already have experience with mindfulness, or is it a mix of people?
VB: I iteratively develop my programs with potential audiences. The first one was a six-week program with people who know about mindfulness, who have a health condition and have worked with us before. I really wanted them to have a sense of co-creation. They gave me lots of feedback. Out of that, I made it longer, 10 weeks.
My second cohort was with people who didn’t know anything about mindfulness, but did have a health condition. It was people who were recruited from a cancer charity and a fibromyalgia charity, and that was very interesting as another test case. It went down very well with both those audiences.
Then the third pilot was with physicians from a primary care medical center. A lot of them didn’t know anything about meditation, didn’t have a health condition, but were trying it out for themselves, thinking about their patients. Again, very positive feedback. So I feel confident now that you don’t need to know anything about mindfulness to do this program.
SM: Where does HEALS fit into general medical care?
VB: I don’t know what it’s like in the States, but certainly over here there’s a crisis in our healthcare system—not enough money, aging population, multiple chronic health conditions.
Western medicine is particularly good with acute care. But with multiple chronic conditions all happening at the same time, Western healthcare isn’t brilliant. There’s more of a move towards a recognition that lifestyle has an enormous impact on our health and well-being, particularly with people being sedentary, eating a poor diet, scrolling on their phones late at night, not being able to sleep, all these kinds of things. There’s a whole field emerging of what’s called lifestyle medicine over here, which is called integrative care in the States. So we’re very well placed to be able to offer this program.
What’s unique about our program is that it’s got mindfulness as the foundation. I think a lot of people know what they should be doing for their health and well-being. They’ve got the information, but they don’t know how to make it stick. So my thesis is that mindful awareness is really crucial to that, because you have to know what you’re experiencing to have some facility and agency, instead of just being swept away by habitual behaviors. These people in general practice who tested the program said, “You’re absolutely on the right track. You’re ahead of the field. Keep going.”
SM: I notice, again relating to other people I’ve known with chronic conditions, that there’s an emphasis on tiny steps. Why is that effective?
VB: This has come out of my experience, and what I’ve observed is that a lot of people think you need to make big changes all at once—get another job, change your diet, change the way you exercise. When you do these big changes all at once, you don’t sustain any of them. You don’t know what’s affecting what because you’ve changed too many variables all at once. Very often you just need to change a tiny thing. In the program, I use a model called Tiny Habits, which is developed by B.J. Fogg. It’s a lovely model where you have a prompt, a behavior, and a celebration.
For example, for me to do a little bit more strengthening in my arms outside my office, I’ve got some straps. Every time I go in and out my office door, that’s the trigger. I go to my straps. It might be three to five movements, just a few. That’s the behavior. Then the congratulations, and you get a little dopamine hit, and then you’re going to want to do it again.
One of the things I’ve really learned from my own life, and this is a very important point, I think, is that you can bring about major transformation through tiny little nudges across a broad front for a long time. I always say to people that we won’t do any of these things perfectly, but if you’re doing all of them adequately, you’re going to experience change.
SM: It looks like the most recent cohort for HEALS is October 25th? Is that right?
VB: Yes, the first course booked out in 24 hours. That seems to be going very well. One of the things we’re doing in this program is using buddy groups testing. We divide into groups of four or five people based on geography. They decide for themselves how they want to keep in touch. Most of them are using WhatsApp. The idea is that they will contact each other daily, ideally so they can let people know how they’re getting on.
SM: Is the buddy system partly addressing the sense of isolation that can come with being in pain?
VB: Yes, I think so. Also, with these online programs, it helps to have something that’s more intimate, a daily reminder so that people are really forming connections. I think that’s very helpful in this tiny-habits method for behavior change.
SM: If someone came to you looking for help, but they were feeling skeptical, how would you describe this work in a way that would open up the possibility for them?
VB: We’ve used validated questionnaires in our three pilots and we’ve got hard data. Doing this work has measurable results. It makes people catastrophize about their pain less. It makes people able to function better in daily life. They’re less depressed, less anxious.
For people who live with chronic pain or health conditions, I say just try it and see what you think. You can have your pain and your illness and be miserable and have a very difficult life. Or you can have your pain and illness and be happier and have a more fulfilling life. So which one would you rather have?
By doing these very simple, evidence-based approaches, we know that it can help you reclaim your life. It doesn’t take long, 10-15 minutes a day, with a very supportive group for 11 weeks. We know that people are experiencing quite a strong improvement in quality of life. So it doesn’t seem like a big risk. It’s training and getting your mind working with you rather than against you. Most people don’t even realize that their mind is working against them. In the untrained mind, 75% of our thoughts are negative. It’s staggering. 95% of our thoughts, we’ve had before. We’ve got the same old undermining rubbish, just going around and around like the spin cycle on a washing machine, and you can do something about that. You can do something about it through these small changes across a broad front.
Would that be convincing to you if you were skeptical?
SM: Well, I dealt with chronic low back pain for about 25 years. I went to all kinds of different doctors. I tried all sorts of different modalities, and it was not an uncommon experience to go to an allopathic doctor and kind of feel like they don’t quite believe you. Especially in the US, there’s a tendency to prescribe opiates or recommend surgery, which I knew had a very low success rate.
For me, finding contemplative practice really did make a difference. But I think being able to speak to the exhaustion is important, because a lot of people who have been dealing with chronic issues, especially for a long time, it’s not that they want to give up. It’s that they’ve already tried 10 or 15 different things that haven’t worked.
VB: Yes, absolutely. Something we do at Breathworks is we believe people first, because I’m not interested in your diagnosis. I’m interested in your experience. With chronic health conditions, it’s sometimes hard to get a diagnosis. People are often not believed, and it’s awful. If someone says they’re suffering, I believe them. I think it’s really important that it’s an experience orientation rather than a diagnostic orientation.
We all have our habits of sort of resisting and fighting our experience. We can all learn to be more at peace with whatever’s happening. In my own case, you know, I’ve still got disability, I’ve still had all the surgeries, I’ve still got pain, but my overall pain has massively improved.
A lot has gradually fallen away over the years. My breathing is much more regulated, soft, and open. I’m fitter, I’m stronger. You get out of a downward spiral into a more opportunistic spiral.
You don’t have to be stuck with what you’ve got. There will be small changes you can make that will have an impact on your quality of life, because this quality of life is the thing that I think is most important, not whether you can walk or run. You know, I can’t walk and run, but I have a quality of life. I find that deeply, deeply moving. It’s unimaginably better than it was 30, 40 years ago.
SM: Yes, being with people who can just be with you and see you—that in itself is humane and tender and can initiate healing.
VB: Absolutely. One of the things that we hear again and again at Breathworks is that there’s a quality of lightness. One woman who came back the second week said, “I feel I’m learning to laugh again.”
She’d done awareness practice. She was in a lot of pain, had a difficult life, quite a lot of sadness, I think. It wasn’t like, Well, I’m becoming more aware. It was, I feel I’m ready to laugh.
I thought, that is so good, because we have a big group of people, many of them with really difficult circumstances. If we can help them find a way to bring some lightness into how they deal with their heaviness, they’re getting a great gift. I think particularly when one lives with difficulty, it is healing to find a way to relate to it in a more light, but not trivial way.
SM: In the process of discovering meditation and studying more deeply, did you have a moment where you thought, I really want to teach this to other people? Or did it happen in a more subtle way?
VB: I always go back to when I was 25 in intensive care in hospital, and I had this really big experience about the present moment, which changed my life. I knew that my pain was only happening one moment at a time and that most of my torment was about the future or the past.
That’s the very short version. I thought, I really, really want to figure out what it means to be present. How can I train in that, and how can I train my mind?
And interestingly that experience rose up out of hell. It was not an experience that happened in the bliss of a meditation retreat. No, it was an absolute existential kind of moment.
I had a social worker who was wonderful. She got me some tapes in the library, sort of beginning to meditate. I became a Buddhist a couple of years later, moved to England to live in a retreat center, and I was finding as I wasn’t really getting much guidance on how to meditate in the painful body. There weren’t many people around who seemed to know how to do that. I was always having to figure it all out for myself. People were very kind and very helpful, but the specifics of, how do you meditate when your back is absolutely screaming? It was a really hard thing to do.
Gradually I worked out how to do that with the help of Jon Kabat-Zinn. Actually, when I came across his book Full Catastrophe Living, that was massively helpful. I realized that I needed to learn to tend towards my experience and soften around it and release all this kind of extra suffering that I’m bringing through my evasion and my craving, really in my grasping for a different experience and my aversion to this experience.
With those two things together, I figured something out here, painfully and slowly over decades. And there’s going to be lots of other people like that young woman in hospital in intensive care, not knowing what the hell to do. There wasn’t any medical solution for my spine at that point. It was just like, we’re going to have to learn to live with it.
That’s why I wanted to teach, because I wanted to offer these to other people who were in the situation I was in so they didn’t have to have this 15 years of long, lonely journey. I was surrounded by incredible friends, and people couldn’t have been more supportive—but the specifics of how to meditate with pain, I wasn’t getting much.
When I started, I just wanted to help people. Now, 25 years later, I just want to help people. It’s a very, very simple motivation. And if I can help one person suffer less, that’s my journey.
When I started, I just wanted to help people. Now, 25 years later, I just want to help people. It’s a very, very simple motivation. And if I can help one person suffer less, that’s my journey.
SM: And it seems like it’s working. The response is there.
VB: It’s just very meaningful. It reframes all my suffering. More importantly, it helps others.
And what I really love about Breathworks and the HEALS program is, it’s not rocket science. It’s not some sort of advanced, metaphysical, complicated teaching. It’s: Be present. Know what’s happening. Let go of aversion and clinging. Release into the flow of love. Breathe and breathe out. And relax your bum. That’s my highest teaching now: Relax your bum.
That’s the whole. That’s it. You don’t really need much more than that. It’s very practical, very pragmatic. You don’t meditate to have a good meditation. You meditate so that you can cope with the moments in your daily life with a little bit more ease and grace and kindness and connection with others.
You don’t meditate to have a good meditation. You meditate so that you can cope with the moments in your daily life with a little bit more ease and grace and kindness and connection with others.
People quite rightly say, It saved my life, and I know it saved mine.
All orders are protected by SSL encryption – the highest industry standard for online security from trusted vendors.
JointEternal – Premium Joint Supplement Supports Pain Relief is backed with a 60 Day No Questions Asked Money Back Guarantee. If within the first 60 days of receipt you are not satisfied with Wake Up Lean™, you can request a refund by sending an email to the address given inside the product and we will immediately refund your entire purchase price, with no questions asked.
Severe menstrual cramps can affect a woman’s mood and her mental well-being. However, a new study reveals a surprising twist: depression may actually trigger severe period pain, with sleep deprivation worsening its severity.
Dysmenorrhea, or severe period pain, affects around 15% of women and typically occurs just before menstruation, and subsides after a few days. If the menstrual cramps occur without any underlying condition, it is called primary dysmenorrhea. This type of period pain is often caused by high levels of prostaglandins, hormone-like substances that increase uterine contractions. Secondary dysmenorrhea, however, is caused by medical conditions like endometriosis or uterine fibroids.
In the latest study published in Briefings in Bioinformatics, researchers discovered that depression significantly impacts primary dysmenorrhea after evaluating around 600,000 cases from European populations and 8,000 from East Asian populations, finding a strong link in both groups. The researchers also conducted a genome-wide association study and identified key genes and proteins involved in this interaction.
“Our findings provide preliminary evidence that depression may be a cause, rather than a consequence, of dysmenorrhea as we did not find evidence that period pain increased the risk of depression,” said lead author Shuhe Liu from China’s Xi’an Jiaotong – Liverpool University.
Another interesting observation was that sleeplessness, commonly experienced by those with depression, played a key role in connecting depression and dysmenorrhea.
“We found that increased sleep disturbances could exacerbate menstrual pain. Addressing sleep issues may therefore be crucial in managing both conditions,” Liu said.
However, larger studies and biological experiments are needed to fully understand the causal association between menstrual pain and depression. Meanwhile, based on the current findings, the researchers are calling for improved mental health screening for individuals suffering from dysmenorrhea. Liu explained that this could lead to more personalized treatment options, reduced stigma, and better healthcare for those affected.
“Depression and menstrual pain significantly impact women’s lives across the world, yet their connection remains poorly understood. Our collective goal is to critically investigate these issues and improve care for women by uncovering these complex connections and finding better ways to address them,” lead author Dr. John Moraros, from the Xi’an Jiaotong-Liverpool University in China told CNN.
