How to Support Those with Trauma-Based Chronic Pain

It's important to be mindful in the way we engage and communicate with chronic pain populations. Here are strategies to approach chronic pain sufferers with sensitivity and awareness.

This article features important details from the audio clip above by Jackie Gardner-Nix, MB.BS., PhD, MRCP(UK), where she talks about the importance of trauma-informed and trauma-sensitive language in mindfulness facilitation and inquiry for chronic pain populations. 

Chronic pain affects millions of people worldwide, and many who suffer from it often have a history of past traumatic experiences. While mindfulness has been shown to be an effective way to manage pain, it's important to be mindful and sensitive in the way we approach and communicate with chronic pain populations.

Many chronic pain patients are often reluctant to share their sensitivities with their physicians or caregivers. However, when approached in a different setting, such as within a mindfulness course, they may feel more comfortable opening up and sharing their experiences. By being attentive and listening to their needs and concerns, we can better understand their pain and help them manage it more effectively.

Mindfulness-based stress reduction (MBSR) is a widely recognized approach to treating chronic pain. However, some of the practices used in MBSR, such as the body scan, may be traumatic for some individuals. It's essential to acknowledge these sensitivities and take steps to accommodate and tailor practices to meet the individual's needs. Gradual exposure to practices may help individuals better tolerate them and avoid triggering traumatic memories or flashbacks.

Additionally, those with chronic pain often have heightened sensitivities to external stimuli such as sounds and smells. Mindfulness facilitators need to be mindful of these sensitivities and adapt the environment and practices accordingly. This may include avoiding strong smells or even bells during meditations. Dr. Jackie Gardner-Nix shared that some of her patients who were prone to migraines or fibromyalgia would go straight into a migraine or exacerbation of pain when they smelled perfumes or smoke on smoky clothing.

Here are the main points to consider when treating individuals with trauma-based chronic pain:

• It is crucial to be mindful of the trauma and sensitivities that chronic pain patients may have. Trauma-informed and trauma-sensitive language is important in mindfulness facilitation and inquiry for chronic pain populations. 
• It is important to really listen to patients. Only then can we truly understand their needs and tailor our interventions to meet those needs. Certain practices, even if just a few minutes, can potentially induce flashbacks or nightmares and should be monitored closely. Some exercises, such as body scans can have adverse effects and should be introduced cautiously or not at all. 
• We need to be mindful of the environment in which we are facilitating mindfulness interventions. Bells and smells can be triggering for many patients, and we need to be sensitive to these issues and work to create an environment that is safe and welcoming for all patients. 

In conclusion, mindfulness can be a powerful tool for managing chronic pain, but it's essential to approach sufferers with awareness of their past experiences and sensitivities. By being trauma-informed, listening to patients, and creating a safe and welcoming environment, we can ensure that mindfulness interventions are effective for all patients.

Dr. Gardner-Nix is the Medical Director of NeuroNova Centre for Mindful Solutions Inc. and an Associate Professor in the Department of Anaesthesia at the University of Toronto. She has been a chronic pain consultant physician at Toronto’s St Michael’s Hospital and Sunnybrook Health Sciences Centre and instructs Mindful Society Global Institute’s Managing Chronic Pain with Mindfulness course.

 Michael Apollo MHSc RP is the founder of the Mindful Society Global Institute. Prior to founding MSGI in 2014, he was the Program Director of Mindfulness at the University of Toronto. He is an educator, licensed mental health clinician and certified facilitator in Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy.