Mindfulness is a powerful tool for managing chronic pain, but somatic tracking takes it a step further. While Mindfulness-Based Stress Reduction (MBSR) is moderately effective, Pain Reprocessing Therapy (PRT) incorporates psychoeducation, exposure, fear-approach techniques, and safety signaling – key elements that retrain the brain and break the pain-fear cycle.
What exactly is somatic tracking? It’s a practice that combines mindful awareness with cognitive reappraisal to shift the way pain is perceived. Instead of avoiding or bracing against pain, somatic tracking teaches individuals to observe sensations with interest and neutrality, reducing the brain’s threat response. This process helps reframe pain as non-threatening, creating the opportunity for a corrective experience where pain can decrease or even dissipate.
The key to success? Psychoeducation and evidence-building. Before engaging in somatic tracking, understanding how pain works, where it comes from, and why it persists helps to shift fear into curiosity, maximizing the chances of a corrective experience where a normally painful sensation is present without the added layer of fear and danger. By first gathering personalized evidence to reinforce the message that your body is safe and that it is the brain creating pain, you can authentically neutralize the fear response to pain.
“It is only when the mind is open and receptive that learning and seeing change can occur”
– Jon Kabat Zinn
What’s Somatic Tracking All About?
There are three components of somatic tracking: mindfulness, safety reappraisal, and positive affect induction.
Mindfulness is the awareness that emerges through paying attention intentionally, in the present moment, without judgment. You can use mindfulness to attend to physical sensations without fear, judgment, or desired outcomes. Although mindfulness is a proven tool to increase feelings of safety, you cannot rely solely on mindfulness when using somatic tracking for pain symptoms. This is because it is challenging to be authentically mindful when paying attention to something that feels inherently threatening. For example, imagine you’re at the lion’s enclosure at the zoo. You can curiously and safely marvel at the lion because you are located outside the bars of the cage. But imagine that the lion breaks free. You can no longer mindfully pay attention; instead, you are frantically running away! If you believe a painful stimulus is dangerous, like a lion that has escaped, it becomes nearly impossible to objectively watch with a sense with ease, curiosity, and interest.
That is where safety reappraisal comes in. You communicate safety to remind yourself that you are not in danger and that the painful sensations are not dangerous. This is best done by drawing on your evidence list to communicate safety authentically. Perhaps you will recall inconsistencies in your pain presentation, increased pain with stress, decreased pain with calm or joy, or a clean bill of health from your medical provider. Gathering your personal evidence will reinforce to your brain that you are safe from a cognitive perspective.
Lastly, positive affect induction is when you actively lighten the mood. You want to attend to sensations with curiosity, effortlessness, and ease rather than intensity. You don’t want to glare at your pain like a hawk glaring at its prey. In a heightened state, you are more likely to interpret everything, including neutral sensations, through a lens of danger. So, inducing positive affect involves putting on your safety glasses by doing something that you know will lighten your emotional state. This can be thinking of positive memories or something you are looking forward to. You can lean into an easy sensation, like your breath coming in and out, or you can grab something that makes you feel calm and content, like a pet, soft blanket, or scented candle.
Research
Meditation: A Promising Approach for Alleviating Chronic Pain
The relevance of psychological, social, and environmental elements of chronic pain are essential, yet often disregarded. Meditation improves the body’s natural pain-relieving processes, lowers stress levels, and boosts body awareness. Mindfulness meditation is not a permanent solution for chronic pain, but is a useful tool for managing pain, reducing stress, improving sleep, and boosting general health and well-being. It can help to lessen stress, worry, and anxiety – factors commonly associated with chronic pain.
Mindfulness meditation is the practice of concentrating on the present moment while accepting any thoughts or sensations that arise without judgment. Practicing mindfulness meditation can lead to self-kindness, increased optimism, and decreased resentment, rage, and hostility – emotional states that impact pain! After practicing mindfulness meditation, those with chronic low back pain experience less pain, sadness, and anxiety.
Randomized controlled trials have shown that mindfulness meditation techniques can lead to significant reductions in pain intensity and increased pain tolerance, allowing patients to endure pain for longer durations without experiencing the same levels of distress. That being said, PRT treatment aims for pain elimination, not only management and increased tolerance to live with pain. When patients recognize they are physically safe and can induce positive affect, their fear subsides, and the pain loses its fuel source, subsequently eliminating their pain.