Welcome. It's Vidyamala here. And I've been asked to answer the question, what can I do when the pain is overwhelming? First of all, if you're listening to this, I'm guessing you're going through this experience yourself. And I want to say that I really feel for you. I know what it's like living with long-term spinal pain myself that has led to many dark, overwhelmed moments.

And it's my real privilege to reach out to you at this time. I'm going to cover two main areas. First of all, the place of medication when the pain is bad, if we're also practicing mindfulness. And secondly, how mindfulness itself can help. And I'm going to offer various things you can try with the hope and wish that some of them may particularly speak to you and you can add them to your pain toolkit for those moments when you really, really need them.

So, first of all, let's talk about medication. What I've noticed over the years with the many people that I've taught is that people can sometimes think that if you're trying to be mindful, then you shouldn't take medication. And I have to say, I don't agree with that based on my own experience. I'm highly pragmatic in how I use mindfulness to work with pain. And sometimes the pain can be so overwhelming that it's really, really hard to work with the mind.

So I personally don't have any issue or problem with people using pain medication to dial the pain down to a level where you can then work with the mind. And in my own experience, I do still take some pain medication, but I take much, much less than I used. And that's because I've learned to work with the mental and emotional and physical reactions over the years, but I still need to take some pain medication to keep my neuropathic pain under control. If I didn't take any medication, I wouldn't get any sleep because I'd have awful electric shocks running down my legs at night, burning in my feet and so on. And then it would be almost impossible to work with my mind.

So it's up to you to calibrate and work that out for yourself, but it may be if your pain is overwhelming, then it's really useful and helpful to take some pain medication to dial the pain back a little bit, and then you can implement the mindfulness strategies that I'm about to outline. And I really hope that like me, over time, you do find a way to reduce the actual pain medications that you take. Because, of course, these can have a dulling effect. But please don't feel bad if you still need to take pain medication. They definitely have a place, even when we're practicing mindfulness.

I've got no doubt about that. So what mindfulness strategies do I recommend in the heat of the moment when the pain is overwhelming? The first one is to take it one moment at a time. One moment at a time. And this insight or this experience is what got me onto the whole mind training or mindfulness journey many, many years ago, way back in 1985. I was in an intensive care ward in excruciating pain.

And I was absolutely tormented by how I was going to get through til the morning. This became something that absolutely dominated my mind. And I was in a state of panic, a state of distress. It was truly awful. And then at a certain point, a voice came to me and the voice said, you don't have to get through til the morning.

You just have to live this moment, and this one, and this one, and this one. Just take it one moment at a time. And this had a huge and profound effect on. My experience changed. It softened a little bit.

And I thought, oh yes, I can do this. I can't get through till the morning as a concept, but I can live this moment. I can manage the pain in this moment. I can bear the pain in this moment. So perhaps that's my main central tip in terms of mindfulness when the pain is overwhelming is to chunk it right down and just take it moment by moment by moment.

And often say the present moment is bearable. Lots of moments, that's unbearable as a thought, as an idea, as a concept. But we ever only experience the pain right now. That's the only moment of pain that we really experience directly. Past pain is a memory.

Future pain, is an idea. So just stay with what's happening right now, this moment. Take it one moment at a time. So that's my first and central tip for when the pain is overwhelming. Chunk it down to moments.

Break it down to moments. The second tip that you could try is to soften resistance. Very often when we've got an experience of pain, we've got unpleasant sensations in the body. We automatically contract against those. We resist those.

And this leads to more tension, more distress, more difficulty, more suffering. And the resistance can happen physically, a secondary tension in the body. It can happen mentally as out of control thinking, catastrophizing thinking and so on. And it can happen emotionally as anxiety, fear, depression, overwhelm. It's all totally normal.

Totally understandable. But with mindfulness, we can learn how to stay with the actual sensations in the body and to let go of all the secondary stuff that so quickly arises when we resist the pain, when we can't be with it directly. So soften resistance, that's my second. And how do we do that? That's all very nice as an idea, but how do we actually do that? So my third tip is to yield and befriend gravity. Generally when we're resisting the pain, we're tensing against the pain, we're kind of subtly or even grossly pulling away from the body.

We don't want to be in the body. So maybe our awareness, our energy shifting up into our head, we're getting carried away by thoughts. It's all very hectic, very difficult. So just yield, soften, rest, befriend gravity. See if you can give the weight of your body up to the chair, up to the bed, up to the floor.

And I love this word, yield because it's got a kind of soft, soft yet alive, dynamic quality. And something I've been saying recently in my teaching is seeing if we can rest into the surface rather than perching on the surface. So, if you're lying on your bed, can you rest right into the bed? Give your weight up to the bed. If you're sitting on a chair, can you rest into the chair rather than perching on top of the chair? It's a very subtle distinction, but it has more of a quality of yielding when we rest into the surface and befriend gravity. Gravity is this mysterious force, which is always pulling us down towards the surface of the earth.

And I think when we live with pain or when the pain is overwhelming, if you check in on your experience, the chances are you're straining against gravity, you're lifting away from your body. You don't want to be in your body and you're straining against gravity, which is exhausting and will lead to lots of extra fatigue and tension. What's that like to befriend gravity, to release into gravity as you yield down into the surface that you're resting upon? So that's another tip, to soften resistance, yield and befriend gravity. Another tip is to engage the support of breathing. Very often when the pain is overwhelming, if you check in on your breathing, you'll probably notice you're holding your breath.

There's a tension around the breath and that the out-breath will be inhibited. This is very, very common. So maybe right now you could take a deeper breath in. And on the out-breath, aah, release, let go, and then let the in-breath flow back in, in its own time. So allowing the out-breath to have its full expression can also be very, very helpful because it unwinds this habit of breath holding.

And you can refer to the slogan, the very helpful slogan, when in doubt, breathe out. And you can allow your breathing to find it so natural rhythm, but seeing if you can allow the breathing to drop very deep in the body. Feeling it in the back of the body, as well as the front of the body. And allowing the breathing to soothe the hard edges of the pain. When the pain is overwhelming, it often feels quite jagged, quite stuck, quite hard, quite solid, quite rigid.

But just as the breathing is flowing, seeing if you can begin to tease apart this experience of pain one moment at a time and allow the sensations to also flow through the moments. And allowing the breathing to help with that experience of softening. So breathing in softness. And breathing out softness. Breathing in softness.

Breathing out softness around the pain. A lovely image or metaphor for this is if you take water and then water when it's frozen becomes spiky icicles. And water when it's melted, is flowing freely. Same stuff, same molecules, H2O, but when it's like ice and it's very solid, it's spiky, it's jagged. And maybe our pain feels a little bit like that.

But just as ice can melt and become flowing water, can you bring that kind of attitude or feeling, or perception a little bit to your experience of pain? Let it melt. Let it soften. Let it flow. And then as you bring this more fluid, open perception to your pain, see if you can bring an emotional quality of warmth and kindliness to this engagement with your experience of pain. Perhaps imagining how you would naturally respond to a friend who had the pain that you're experiencing right now.

And the chances are you'll been naturally kind, naturally soothing, naturally tender. And can you bring that kind of quality towards your own experience of pain. So we've got the fluid breath, the pain is softening. And can we imagine that all this flow is completely saturated with a quality of kindliness towards ourselves, tenderness towards ourselves, a soothing quality towards ourselves. So that's another thing you can try.

Softening the breath, releasing into flow, softening the pain, and then bringing this quality of kindliness towards the whole experience. Treating yourself the way you would naturally treat a loved one who was hurting. And another thing you can try is what I call the S O S, which is to stop, open and smile. Stop-open-smile.. So by stop, I simply mean stop whatever you're doing, come into the present.

Rest, settle. Open means to open your awareness, you know what's going on in the whole body, your thoughts, your emotions. Just beginning to tune into that with a more open, more receptive, less judgmental, less contracted quality of awareness. And then just bring a little smile to your face. And I don't mean pasting on some kind of fake smile.

I'm referring to something that's hardwired into our brains and nervous system. And when we smile that releases endorphins, which are our natural pain relievers and to also release serotonin, which is a mood lifter, a mood enhancer. So by physically remembering to bring a little smile into your expression that may in fact take some of the sting out of the pain. So that's another tip, SOS, stop-open-smile. So just referring back to what I said right at the very beginning.

I'm so sorry that your pain is overwhelming. I really feel for you, I feel with you. And I really hope that these tips have resonated or at least some of them have resonated and you can start to implement them straight away. To recap, maybe the first thing you need to do is to take some pain meds to dial down the pain a little bit. And then you can implement mindfulness strategies to help you work with your mind, to help you work with your response to the pain.

And I covered taking things one moment at a time, chunking it down to moments. Softening resistance. Yielding, befriending gravity. Releasing around breathing. Letting the breath be soothing.

Releasing around tendencies to hold the breath against the pain. Releasing in to flow, letting the icicles of hardness melt into flowing water. Well, that's the metaphor. Bringing kindness to your experience. Treating yourself the way you would naturally respond to a loved one who was hurting.

SOS, stop-open-smile. I wish you all the very, very best. And thanks so much for wanting to engage with your pain, even when it's overwhelming in the most conscious and creative ways possible. I wish you all the very best.