Meditation as Possible Therapy in Conjunction with Traditional TN Medications

1

Dear Group,

This topic may be very delicate to discuss for many reasons. Among them, suggesting that meditation may be helpful to those of us who suffer from TN or ATN may seem to lend credibility to those ill-informed healthcare practitioners and laymen to those who would suggest that our pain is psychosomatic. Knowing what it is like to experience this condition, I would not dare to even appear to take the side of those who say, "it's all in your head". Also delicate is appearing as though I believe that those of us on narcotic pain killers do not really need them. That opiates and benzodiazepines are a crutch of some kind and with proper self-discipline are not needed is patently false. I believe that each of us is truly in pain and has a right to any reasonable drug that helps. My knowledge of my own condition/treatments and the challenges I have faced since becoming ill have left me firmly entrenched in the battle to be taken seriously and treated humanely with proper medication. (Along with my initial disclaimer, I must also include that I am a terrible, sometimes incoherent writer who is further hindered by an increase in her Tegretol dose. If I am not making sense, I hope the reader will forgive me if they can tolerate reading this at all.)

That being said, and in the interest of helping others, I believe that meditation has been beneficial to me during my most recent flare of ATN. I have noticed that when my pain starts to worsen, if I am able to completely stop everything that I am doing and fully relax my muscles (especially my facial muscles), the pain is seemingly arrested and does not go into a full-blown, paralyzing attack that so many of us have grown accustomed to.

I learned to meditate 20 years ago as a teen, relaxing every muscle in my body as I simply focused on counting my breaths. The face was most often the last area I paid attention to as I started my exercises with my toes and worked upward, eventually releasing the tension in my jaw, cheeks, temples, and forehead before reaching the final area of focus: the crown of my head. The face, for me, was the hardest area to completely relax as it is hard for me to simply let my jaw go slack and hang open. Allowing my eyes and eyelids to simply rest presented further difficulty as it is tempting to try to force them to stay shut. I cannot say that I ever mastered the art of meditation but I did practice daily for about a year and then on and off in the many years since then. Among other things, having the ability to relax my body because it had been so conditioned has been useful to me in combating such problems as anxiety-related issues. I am very glad that I picked up this skill and have practiced it enough to see real benefits.

Now I am 35 and have dealt with (and am currently suffering from) classic TN on one side of my face and ATN on the other side for two years now. ATN in the right side of my face is the most recent and enduring manifestation. Meditation may be helpful, I realized recently, for at least a couple reasons. (All of these reasons may simply be conjecture but I believe there may be some credibility behind them. Please chime in and correct me where I am completely off-base. I am only guessing.) First, it is quite common, I noticed, both in my reading and in my experiences, for the (A)TN sufferer to experience a respite from pain while asleep and for a short period after awakening. There is a commonality between what is experienced during sleep and during deep meditation: that is, the muscles of the body are completely relaxed. Second, I take opiate pain relievers and benzos in addition to my Tegretol and noticed that, although these medications do not alleviate my pain, they do help me to relax and not focus so heavily on the pain. The cycle of pain which makes me tense up and cause more pain, which in turn causes me to tense up, etc. is arrested thereby causing me to suffer a lot less. The theme is the same: relaxation equals less pain. Therefore, I concluded that I should begin to practice meditation to promote relaxation wherever possible to aid in pain relief and, much to my delight, it helps considerably.

Now, when I feel the first twinges of pain, I stop, lie down, and enter a deep state of relaxation. This state can be difficult if I am already cringing in agony (which, unfortunately, is still all-too-often the case but I am getting better about it), so I attempt to catch it at the first tiny electrical twinges or fasciculations. It is unfortunate that I had to lose my job in order to afford the luxury of being able to halt all activity at the slightest hint of pain, but that is something that I have accepted and I know many share that experience. Having the capacity to at least reign in some of the arbitrary, horrific pain and not feel completely at the whim of the "demon" helps me to not feel as helpless and hopeless.

I hope that what I have just shared about my experiences will be of some use to somebody who is suffering. My heart goes out to everybody who shares this condition.

Sincerely,

Melissa

2

I certainly do not feel this is a delicate issue at all Melissa. When I was at my anti- natal classes they repeatedly told us to learn ways of relaxing into the pain to ease our labour. It worked for me along with some pain relief in the latter stages.Until I developed TN I have used regular deep, steady breathing to relax out of strong pain. I now utilise breathing but try not to pull the air in too strongly as that is a trigger for me. I would not dream of stopping my meds and tackling TN with meditation but I do not have the feeling that is what you are advocating. Relaxing the body seems a good complimentary to pain meds for TN/ ATN to me.

3

Melissa, as Jackie has noted, you're not treading on anybody's toes. Meditation and mindfulness have long been recognized by both science and religion as pathways to calm in a world of storms. In our article on "Coping With Crisis" (under the Face Pain Info tab on our menus), we offer the following views parallel to your own:

-- Explore the spiritual and mindful dimensions of pain management

The phrasing of this advice might be a little unfamiliar both to some patients and to their doctors. However, there truly is both a spiritual and mindful dimension in pain management. The spiritual dimension is familiar to many people as prayer, and the mindful dimension as meditation or "centering of consciousness". [Ref 8]

What might not be as familiar is that there is emerging scientific evidence that prayer and meditation may actually influence the vulnerability of the body to pain, and the intensity with which pain is felt. A large body of medical and scientific literature is now devoted to what is called "placebo effect". [Ref 9, 10] When patients who have pain are told by a doctor or other figure of authority that a therapy "is known to help many patients", and then given an inert pill that has no medical properties, a substantial proportion of them will report improvement in their sensations of pain or discomfort, their levels of measurable depression, and their overall feelings of well-being.

Their expectations literally change their experience of medical therapy as well as daily life.

However, this effect is more than a matter of emotions or a positive attitude at work (as helpful as a positive attitude can be). By means of functional MRI, the activity levels of small areas of the brain can now be monitored and traced in real time. The activities of the brain display substantially different patterns when a person is expecting a positive result from medical treatment, versus when they are simply given a pill in a randomized trial. Different centers of physical regulation and response in the brain are involved when expectations are engaged, versus when they are not. Pain regulating centers are significantly reinforced by expectations of a positive outcome.

Less known to popular and medical literature, is the phenomenon of "nocebo effect". When patients are offered a therapy by physicians or other providers toward whom they have negative feelings or expectations, even valid medical therapies are less effective than when offered by a provider toward whom the patient has positive feelings. This effect has been documented in several pain conditions. [Ref 9]

These effects are not marginal or second-order to some "real" level of medical treatment. In many medication trials, it is found that the range of positive outcomes attributable to the patient's expectations can be larger than the effects produced by the medication itself. And when a positive relationship is established to the therapy provider, the amount of positive "placebo effect" in some trials may double. [Ref 10]

These effects have two rather profound implications. First, a positive approach and expectations of successful medical treatment on the part of the patient can have a direct and constructive impact in generating better outcomes. Second, your doctor needs to listen to the science and realize that it is no longer permissible within the guidance of modern medical ethics to objectify patients or distance themselves emotionally from the patient's pain and suffering. The stronger the patient's trust and positive feelings are toward the doctor, the more likely it is that the patient will get an improved result from treatment.

"Bedside manner" and a positive doctor patient relationship matter in patient outcomes. Caring is an important resource in effective care-giving.

For many people, one of the strongest resources in coping with bad events or experiences in life, may be prayer. [Ref 8] By "giving the problem to God", or praying for personal strength and healing, some people are able to step back from their anxiety and fearfulness, reduce their stress levels and feel significantly less pain. Whether one believes in the intervention of a Divine Creator in such outcomes or not, patients benefit from reduced stress. For those who are believers, prayer can thus become a part of healing or reducing pain.

The positive effects of stepping back and letting go are not restricted to the religious. Another avenue to similar results exists side by side with prayer. Across the world, millions of people meditate for 20 minutes at least once per day, to achieve a mental state of quiet mindfulness and release of stress. There are both religious and non-religious forms of meditation, and they work to generate positive outcomes in reducing pain and reclaiming mental clarity even under the influence of drug side effects. Quite possibly, prolonged mindfulness and release of the ego-mind may positively affect the same centers of neuro-biological activity that are engaged in placebo effect.

4

I read the article above last week. For me it rang so so true. I really had a problem finding a way to manage my TN. I saw several Max Fax doctors and a neuro. I never felt a “connection”. Then I met my present neuro and see her twice a year. I somehow feel well understood by her and hence I seem to have very good pain management in place. I am lucky in that she sends me a copy of the letter that she sends my GP about our appointment. I have the opportunity to dispute any mistakes in her perceptions. There has been none. She has the very best diagnostic tools which some Dr’s are very lacking in, EARS. She actually listens to everything I report to her which is not easy with my multi neuro problems, TN being the primary. I just feel looked after.

5

Not treading on toes, there has long been a strong suggestion and some evidence in psychological studies that meditation can change the way the brain behaves, changes in the various brain waves, so it isn't a huge limit if it doesn't change the way the brain process pain.

This said I do find that relaxing, by focusing on breath and how I breathe helps also. If in the process I am also changing my brain waves - which EEG's have proven does happen - helps me adjust or process the pain so much the better. What I also think does happen is that I show other things including my blood pressure and pulse rate and I think that helps as well.

I am willing to be contradicted as well.

6

Angela, as I noted earlier, there is quite a bit of support in medical literature for the points you make about meditation. I've seen papers on the effects of transcendental meditation in moderating high blood pressure, that go back as far as the 1970s. And the emerging tools of functional MRI seem to offer even deeper understanding of the mechanisms involved.

So I'd think that you and I largely agree. Of course, there's a lot more still to be discovered and understood. I'm just as eager as you are to see those new developments.

Regards and best,

Red

7

I am looking for some books on deep breathing techniques as well. It is extremely effective. i even have my hubbie involved. Illness is stressful, as well as his job, so it helps solidify our marriage. I want a plan, much more info from my drs., because decisions need to be made. I cant help but dread a NEW YEAR without some type of plan as well as greater knowledge of what I am facing.

8

A classic out of the 1970s in the fields surrounding meditation and mindfulness is "How To Meditate", I recall by Lawrence LeShawn. Another is "Transcendental Meditation". Both should give you an introduction to breathing techniques.

9

I too had found that relaxation can help ward off severe pain. Just before I was first diagnosed with TN my dentist warned me that I was grinding my teeth at night. I then tried to become very conscious of the muscles in my face and sure enough, they were usually very tense. I began practicing yoga positions (not meditation) and Thai Chi in the morning when first getting up so I could get brkfst in me w/o too much pain. Although I just had MVD (great relief so far!) I still do the relaxation exercises and recommend it . I think it helps.