Dial Down Your Pain

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This is Dr. Christiane Wolf. Is than an MD or a PhD, you ask? The answer is: yes (it is both; the latter being in psychosomatic medicine).

She also teaches Mindfulness-Based Stress Reduction, which as you may recall is pretty much the most well-evidenced* form of meditation there is, in terms of benefits:

No-Frills, Evidence-Based Mindfulness

*which is not to claim it is necessarily the best (although it also could be); rather, this means that it is the form of meditation that’s accumulated the most scientific backing in total. If another equal or better form of meditation enjoyed less scientific scrutiny, then there could an alternative out there languishing with only two and a half scientific papers to its name. However, we at 10almonds are not research scientists, and thus can only comment on the body of evidence that has been published.

In any case, today is going to be about pain.

What does she want us to know?

Your mind does matter

It’s easy to think that anything you can do with your mind is going to be quite small comfort when your nerves feel like they’re on fire.

However, Dr. Wolf makes the case for pain consisting of three components:

  • the physical sensation(s)
  • the emotions we have about those
  • the meaning we give to such (or “the story” that we use to describe it)

To clarify, let’s give an example:

  • the physical sensations of burning, searing, and occasionally stabbing pains in the lower back
  • the emotions of anguish, anger, despair, self-pity
  • the story of “this pain has ruined my life, is making it unbearable, will almost certainly continue, and may get worse”

We are not going to tell you to throw any of those out of the window for now (and, would that you could throw the first line out, of course).

The first thing Dr. Wolf wants us to do to make this more manageable is to break it down.

Because presently, all three of those things are lumped together in a single box labelled “pain”.

If each of those items is at a “10” on the scale of pain, then this is 10×10×10=1000.

If our pain is at 1000/10, that’s a lot. We want to leave the pain in the box, not look at it, and try to distract ourselves. That is one possible strategy, by the way, and it’s not always bad when it comes to giving oneself a short-term reprieve. We balanced it against meditation, here:

Managing Chronic Pain (Realistically)

However, back to the box analogy, if we open that box and take out each of those items to examine them, then even without changing anything, even with them all still at 10, they can each be managed for what they are individually, so it’s now 10+10+10=30.

If our pain is at 30/10, that’s still a lot, but it’s a lot more manageable than 1000/10.

On rating pain, by the way, see:

Get The Right Help For Your Pain

Dealing with the separate parts

It would be nice, of course, for each of those separate parts to not be at 10.

With regard to the physical side of pain, this is not Dr. Wolf’s specialty, but we have some good resources here at 10almonds:

When it comes to emotions associated with pain, Dr. Wolf (who incidentally is a Buddhist and also a teacher of same, and runs meditation retreats for such), recommends (of course) mindfulness, and what in Dialectical Behavior Therapy (DBT) is called “radical acceptance” (in Buddhism, it may be referred to as being at one with things). We’ve written about this here:

“Hello, Emotions”: Radical Acceptance In CBT & DBT

Once again, the aim here is still not to throw the (often perfectly valid) emotions out of the window (unless you want to), but rather, to neutrally note and acknowledge the emotions as they arrive, á la “Hello, despair. Depression, my old foe, we meet again. Hello again, resentment.” …and so on.

The reason this helps is because emotions, much like the physical sensations of pain, are first and foremost messengers, and sometimes (as in the case of chronic pain) they get broken and keep delivering the message beyond necessity. Acknowledging the message helps your brain (and all that is attached to it) realize “ok, this message has been delivered now; we can chill about it a little”.

Having done that, if you can reasonably tweak any of the emotions (for example, perhaps that self-pity we mentioned could be turned into self-compassion, which is more useful), that’s great. If not, at least you know what’s on the battlefield now.

When we examine the story of our pain, lastly, Dr. Wolf invites us to look at how one of the biggest drivers of distress under pain is the uncertainty of how long the pain will last, whether it will get worse, whether what we are doing will make it worse, and so forth. See for example:

How long does back pain last? And how can learning about pain increase the chance of recovery?

And of course, many things we do specifically in response to pain can indeed make our pain worse, and spread:

How To Stop Pain Spreading

Dr. Wolf’s perspective says:

  1. Life involves pain
  2. Pain invariably has a cause
  3. What has a cause, can have an end
  4. We just need to go through that process

This may seem like small comfort when we are in the middle of the pain, but if we’ve broken it down into parts with Dr. Wolf’s “box method”, and dealt with the first two parts (the sensations and the emotions) as well as reasonably possible, then we can tackle the third one (the story) a little more easily than we could if we were trying to come at it with no preparation.

What used to be:

“This pain has ruined my life, is making it unbearable, will almost certainly continue, and may get worse”

…can now become:

“This pain is a big challenge, but since I’m here for it whether I want to be or not, I will suffer as I must, while calmly looking for ways to reduce that suffering as I go.”

In short: you cannot “think healing thoughts” and expect your pain to go away. But you can do a lot more than you might (if you left it unexamined) expect.

Want to know more from Dr. Wolf?

We reviewed a book of hers recently, which you might enjoy:

Outsmart Your Pain – by Dr. Christiane Wolf

Take care!

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  • Black Beans vs Pinto Beans – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing black beans to pinto beans, we picked the pinto beans.

    Why?

    Both of these beans have won all their previous comparisons, so it’s no surprise that this one was very close. Despite their different appearance, taste, and texture, their nutritional profiles are almost identical:

    In terms of macros, pinto beans have a tiny bit more protein, carbs, and fiber. So, a nominal win for pinto beans, but again, the difference is very slight.

    When it comes to vitamins, black beans have more of vitamins A, B1, B3, and B5, while pinto beans have more of vitamins B2, B6, B9, C, E, K and choline. Superficially, again this is nominally a win for pinto beans, but in most cases the differences are so slight as to be potentially the product of decimal place rounding.

    In the category of minerals, black beans have more calcium, copper, iron, and phosphorus, while pinto beans have more magnesium, manganese, selenium, and zinc. That’s a 4:4 tie, but the only one with a meaningful margin of difference is selenium (of which pinto beans have 4x more), so we’re calling this one a very modest win for pinto beans.

    All in all, adding these up makes for a “if we really are pressed to choose” win for pinto beans, but honestly, enjoy either in accordance with your preference (this writer prefers black beans!), or better yet, both.

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    What’s Your Plant Diversity Score?

    Take care!

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  • Caramelized Caraway Cabbage

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    Cabbage is an underrated vegetable for its many nutrients and its culinary potential—here’s a great way to make it a delectable starter or respectable side.

    You will need

    • 1 medium white cabbage, sliced into 1″ thick slabs
    • 1 tbsp extra-virgin olive oil
    • 1 tbsp caraway seeds
    • 1 tsp black pepper
    • ½ tsp turmeric
    • ¼ tsp MSG or ½ tsp low-sodium salt

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 400℉ / 200℃.

    2) Combine the non-cabbage ingredients in a small bowl, whisking to mix thoroughly—with a tiny whisk if you have one, but a fork will work if necessary.

    3) Arrange the cabbage slices on a lined baking tray and brush the seasoning-and-oil mixture over both sides of each slice.

    4) Roast for 20–25 minutes until the cabbage is tender and beginning to caramelize.

    5) Serve warm.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • In the Realm of Hungry Ghosts – by Dr. Gabor Maté

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    We’ve reviewed books by Dr. Maté before, and this one’s about addiction. We’ve reviewed books about addiction before too, so what makes this one different?

    Wow, is this one so different. Most books about addiction are about “beating” it. Stop drinking, quit sugar, etc. And, that’s all well and good. It is definitely good to do those things. But this one’s about understanding it, deeply. Because, as Dr. Maté makes very clear, “there, but for the grace of epigenetics and environmental factors, go we”.

    Indeed, most of us will have addictions; they’re (happily) just not too problematic for most of us, being either substances that are not too harmful (e.g. coffee), or behavioral addictions that aren’t terribly impacting our lives (e.g. Dr. Maté’s compulsion to keep buying more classical music, which he then tries to hide from his wife).

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    Click here to check out In the Realm of Hungry Ghosts, and learn about this much-misunderstood health condition!

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    It’s Q&A Time!

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    Have something you’d like to ask us, or ask us to look into? Hit reply to any of our emails, or use the feedback widget at the bottom, and a Real Human™ will be glad to read it!

    Q: As I am a retired nurse, I am always interested in new medical technology and new ways of diagnosing. I have recently heard of using the eyes to diagnose Alzheimer’s. When I did some research I didn’t find too much. I am thinking the information may be too new or I wasn’t on the right sites.

    (this is in response to last week’s piece on lutein, eyes, and brain health)

    We’d readily bet that the diagnostic criteria has to do with recording low levels of lutein in the eye (discernible by a visual examination of macular pigment optical density), and relying on the correlation between this and incidence of Alzheimer’s, but we’ve not seen it as a hard diagnostic tool as yet either—we’ll do some digging and let you know what we find! In the meantime, we note that the Journal of Alzheimer’s Disease (which may be of interest to you, if you’re not already subscribed) is onto this:

    Read: Cognitive Function and Its Relationship with Macular Pigment Optical Density and Serum Concentrations of its Constituent Carotenoids

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  • Algorithms to Live By – by Brian Christian and Tom Griffiths

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    As humans, we subconsciously use heuristics a lot to make many complex decisions based on “fuzzy logic”. For example:

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    Order your copy of “Algorithms To Live By” from Amazon today!

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  • An Addiction Expert’s Insights On Festive Drinking

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is Dr. Christopher Kahler. He’s Professor of Behavioral and Social Sciences, Director of Alcohol and Addiction Studies, Professor of Psychiatry and Human Behavior, all at Brown University.

    What does he want us to know?

    It’s the trickiest time of the year

    Per stats, alcohol sales peak in December, with the heaviest drinking being from mid-December (getting an early start on the Christmas cheer) to New Year’s Eve. As for why, there’s a collection of reasons, as he notes:

    ❝The main challenge is there’s an extra layer of stress, with a lot of obligations and expectations from friends and family. We’re around people who maybe we’re not usually around, and in larger groups. It’s also a time of heightened emotion and, for some people, loneliness.

    On top of that, alcohol use is built into a lot of our winter holiday traditions. It’s often marketed as part of the “good life.” We’re expected to have alcohol when we celebrate.❞

    As for how much alcohol is safe to drink… According to the World Health Organization, the only safe amount of alcohol is zero:

    Can We Drink To Good Health?

    Dr. Kahler acknowledges, however, that many people will wish to imbibe anyway, and indeed, he himself does drink a little, but endeavours to do so mindfully, and as such, he recommends that we…

    HALT!

    Dr. Kahler counsels us against making decisions (including the decision to drink alcohol), on occasions when we are one or more of the following:

    • Hungry
    • Angry
    • Lonely
    • Tired

    He also notes that around this time of year, often our normal schedules and habits are disrupted, which introduces more microdecisions to our daily lives, which in turn means more “decision fatigue”, and the greater chance of making bad decisions.

    We share some practical tips on how to reduce the chances of thusly erring, here:

    How To Reduce Or Quit Alcohol

    Set your intentions now

    He bids us figure out what our goal is, and really think it through, including not just “how many drinks to have” if we’re drinking, but also such things as “what feelings are likely to come up”. Because, if we’ve historically used alcohol as a maladaptive coping mechanism, we’re going to need a different, better, healthier coping mechanism (we talked more about that in our above-linked article about reducing or quitting alcohol, too, with some examples).

    He also suggests that we memorize our social responses—exactly what we’re going to say if offered a drink, for example:

    ❝It’s important to know what you’re going to say about your alcohol use. If someone asks if they can get you a drink, good responses could be: “A glass of water would be great” or “Do you have any non-alcoholic cider?” You don’t have to explain yourself. Just ask for what you want, because saying no to someone can be difficult.❞

    See also:

    December’s Traps To Plan Around

    Mix it up and slow it down

    No, that doesn’t mean mix yourself a sloe gin cocktail. But rather, it’s about alternating alcoholic and non-alcoholic drinks, to give your body half a chance to process the alcohol, and also to rehydrate a little along the way.

    We talk about this and other damage-limitation methods, here:

    How To Reduce The Harm Of Festive Drinking (Without Abstaining)

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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