The Role of Mindfulness in the Midst of Pain: the Importance of Present-Focus Attention

Grief Beach

We all experience psychological pain—heartache, grief, loneliness, loss, disappointment, sorrow. Some pain may feel large and all-consuming. Broken relationships. Unfulfilled dreams. Dashed hopes. Loss of health.

Pain can also stem from seemingly ordinary and common matters. For me, it came in the form of postpartum depression. I knew parenting would be hard, but I was blindsided by the darkness I felt during the first year of motherhood. Part of the struggle stemmed from my son’s many medical problems. I moved from worrying that something might be wrong with my child, to searching for what was wrong so I could simply fix the problem, to constantly feeling defeated, hopeless, and inadequate as a parent. Most of my energy for the first year was spent worrying rather than enjoying my time with my son.

Regardless of how big or small our pain might seem, most of us have a hard time sitting still and being patient with our pain. We have a knee-jerk reaction to rid ourselves of pain and the associated unpleasant feelings. As a result, we often find our minds traveling to the past or the future. On the one hand, we may indulge in regrets and what-ifs. We replay and analyze our past. Why did this happen to me? What could I have done differently? A clinical term for this is rumination: being entangled in a web of thoughts, replaying past dynamics, conversations, or decisions.1 While it may create an illusion that we are gaining insight and discovering the root of the “problem,” research shows that rumination is associated with greater depression, anxiety, and stress, and lower life satisfaction.2 Rumination paralyzes us. It renders us captive to the past.

On the other hand, our minds may take us to the future. We may come up with every possible contingency and plan accordingly. We may conjure up the worst-case scenario and find ways to minimize its likelihood. Or, feeling like we are stuck in a perpetual waiting period, we long for this season of pain to end and for things to become “normal” or “right” again. Whenever our mind goes to the past or the future, we are not living in the present moment. Future and past are not antonyms of each other. In fact, the opposite of past and future is the present.

How can we be fully present with pain? Mindfulness offers an alternative approach. Over the past several decades, there has been a proliferation of scientific and media attention on the topic of mindfulness. But what is it, and what does it mean for us as Christ followers?

Mindfulness was primarily introduced to Western health practitioners through Jon Kabat-Zinn in the early ’90s. Kabat-Zinn is a physician at the University of Massachusetts Medical School and a trained Dharma (meaning “suffering”) teacher whose work primarily involves patients with chronic pain. He observes that while having chronic pain is objectively challenging, the desire to get rid of the pain paradoxically causes one to fixate even more on the pain, which in turn magnifies it and exacerbates the negative experience. It is like when we have an itch; the more we scratch, the more it irritates us. Mindfulness introduces a new way of relating to pain.

According to Kabat-Zinn, mindfulness is the practice of paying attention to the present moment without judgment.3 There are three important components to this definition: (1) attention, (2) present moment, and (3) nonjudgmental compassion. First, the synonym of mindfulness is alertness or awareness. Our minds often function on autopilot. While that can be beneficial, especially in a society that prioritizes efficiency, it comes with a cost. Mindfulness is slowing down and developing greater awareness of one’s internal and external experiences as they unfold. Second, mindfulness focuses on the present moment. It resists the natural temptation to visit the past or future—especially when things are hard. Third, mindfulness replaces judgment with curiosity and compassion. We are to simply observe our feelings and thoughts as they arise without feeling the need to judge or evaluate them. With mindfulness, we create some healthy distance with pain so we can accept and respond with greater thoughtfulness rather than fearing future pain or recalling the memory of past pain.

Given that mindfulness focuses on the present moment, most practices center on the body. The rationale is simple: while our minds and thoughts can easily lead us to the past or future, our bodies are always rooted in the here and the now. Our body anchors us in the present moment. One of the signature mindfulness practices is mindful breathing. It is the practice of resting one’s attention on one’s breath. Usually done sitting still, eyes closed, we turn our attention to our breath as we breathe slowly and naturally. Whenever our mind wanders, rather than actively engaging with the thoughts, we gently but firmly return our attention back to our breath.

Simple attention to the breath can play an important role in Christian contemplative practices that go back many centuries, such as the Jesus Prayer. While the body’s physical stillness acts as an anchor and facilitates inner stillness, the breath can be combined with a word (e.g., “Abba,” “God,” “Father”) or phrase (e.g., “Lord Jesus Christ, Son of God, have mercy on me”). Father Martin Laird, in Into the Silent Land: A Guide to the Christian Practice of Contemplation, writes, “Eventually the attention, the breath, and the prayer word will form a unity. This will be your anchor in the present moment, a place of refuge and engaged vigilance.”4 St. John of the Cross, Laird points out, takes it one step further: “The soul that is united and transformed in God breathes God in God with the same divine breathing with which God, while in her, breathes her in himself.” As we learn to unite our breath with the constant awareness of God’s presence in our lives, we realize the mystery and power of “praying without ceasing” (1 Thess 5:16). More importantly, our enhanced awareness allows us to more readily meet God in the present moment.

Mindfulness also changes the way we relate to our thoughts. Our minds can be racing with many thoughts in all directions at any given moment. In fact, we are so used to it that we may not even be aware of it. Whenever I lead a mindfulness practice, people are often surprised by how difficult it is to quiet their minds. (You may have experienced your chattering mind when you have trouble falling asleep at night.) It is even more exhausting added to the fact that we tend to place judgments or evaluations on our thoughts. Mindfulness offers a different approach in which we hold an open, curious, and compassionate posture toward our thoughts.

A signature practice is called mindfulness of thoughts. As we sit silently, we pay attention to whatever thoughts come up. Instead of actively engaging with them or judging them as “good” or “bad,” we simply notice them and let them go. We envision our thoughts as clouds moving across the sky, or leaves floating down the stream. We may connect our thoughts with physical sensations we experience in our bodies. Over time, it allows for the “renewal of our minds” (Rom 12:2).

I would like to offer a few reflections on some implications of mindfulness in the face of pain:

It helps us foster a healthier relationship with our emotions. Psychological pain often brings forth unpleasant emotions, sometimes leading people to cope in unhelpful ways. We may avoid or suppress them, which may provide short-term relief but harm us in the long run. Or we may get preoccupied by our emotions, which results in more stress. With mindfulness, we learn to celebrate and embrace the fullness of all human emotions. Instead of being terrified by our darker emotions or feeling the need to hide or run away from them, we have the courage to face them and be honest about them before God. Pain encourages us to practice lament, which draws us closer to the very heart of the suffering Christ.

Mindfulness allows us to “be” in the face of someone else’s pain. There are no quick fixes for pain. As much as we are intelligent or creative problem-solvers, there is no easy solution to racial tension, social injustice, or broken relationships. The “5 steps to success” or “7 effective ways to manage” rarely bring forth true healing and restoration. We are broken people in need of redemption. Mindfulness allows us to see and accept the world with all its beauty and chaos. As we learn to surrender our need to offer solutions, we realize the biggest gift we can offer is our selves.

Mindfulness enhances our prayer life. Our prayer lives tend to rely more on our intellect and less on our bodies. In C. S. Lewis’s The Screwtape Letters, Screwtape writes to the younger demon-in-training, Wormwood, that humans “can be persuaded that the bodily position makes no difference to their prayers; for they constantly forget . . . whatever their bodies do affects their souls.”5 Mindfulness encourages and enhances the experience of ancient spiritual disciplines such as the Prayer of Examen, which cultivates our daily awareness of the presence of God in our daily lives, or the disciplines of solitude and stillness.

Mindfulness creates space within ourselves. With greater margins in our lives, we are better able to see how our story is held by the larger story of God. It may also mean waiting and learning to be patient with ourselves and with what God is doing in our lives in the midst of pain. We learn to see and accept pain as sacred.

We learn to receive waiting as a gift. Pain is often associated with waiting, which goes against our culture of productivity and efficiency. Rather than trying to minimize ambiguities, we learn to be more tolerant of them. In the words of Henri Nouwen in A Spirituality of Waiting: “Active waiting means to be present fully to the moment, in the conviction that something is happening. . . Patient living means to live actively in the present and wait there.”

Afterword

Most of this article was written while wearing my second son, whose reflux was worse than that of his older brother (something I didn’t think could be possible). The unexpected and much earlier arrival of my second child, which initially felt like a disruption to my plans (I am a planner!), in many ways proved to be a gift. It was as though, through writing this article, God was gently reminding me of the importance of turning my head knowledge into heart knowledge. My home for the past four months has become the training ground for me to practice mindfulness and the awareness of God’s presence in the daily diaper changing, burping, and nursing. I practice being mindful and fully present with my son, not just when he is joyful or relaxed, but also when he is in pain or distress (which is often). Whenever I catch myself wondering when he will stop crying and go to sleep so I can get on to my next chore, I practice returning to the present moment, knowing that God is meeting me in this current time and space. I do not want my scurried state to rob me of my encounter with Christ. Some days I am still my usual anxious self, but like with any other spiritual discipline, the key is consistent and persistent practice.

Endnotes

S. Nolen-Hoeksema, B. E. Wisco, and S. Lyubomirsky, “Rethinking Rumination,” Perspectives on Psychological Science 3, no. 5 (September 2008): 400–424.
L. C. Michl, K. A. McLaughlin, K. Shepherd, and S. Nolen-Hoeksema, “Rumination as a Mechanism Linking Stressful Life Events to Symptoms of Depression and Anxiety: Longitudinal Evidence in Early Adolescents and Adults,” Journal of Abnormal Psychology 122, no. 2 (May 2013): 339.
J. Kabat-Zinn, Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life (New York: Hyperion, 1994).
M. Laird, Into the Silent Land: A Guide to the Christian Practice of Contemplation (Oxford: Oxford University Press, 2006).
C. S. Lewis, The Screwtape Letters (San Francisco: HarperSanFrancisco, 2001).