Presentation is loading. Please wait.

Presentation is loading. Please wait.

Pain, Mood, & Meditation- Where does Spirituality fit? Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009.

Similar presentations


Presentation on theme: "Pain, Mood, & Meditation- Where does Spirituality fit? Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009."— Presentation transcript:

1 Pain, Mood, & Meditation- Where does Spirituality fit? Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009

2 Outline 1. Bio-psycho-social-spiritual model of pain 2. What are the mechanisms linking meditation and pain? 3. Who uses Prayer/Meditation to cope with pain? 4. When do people use Prayer/Meditation for pain? 5. What does spirituality add to meditation for pain coping?

3 Question #1 What is Pain?

4 Typical Pain Cycle

5 Gate/Neuromatrix Theory of Pain Injury Signals Gate Thoughts Emotions Behaviors Ouch! I feel good! Melzack & Wall, 1965

6 Influences on Chronic Pain Chronic Pain Biological Factors Psychological Factors Social Factors Spiritual Factors

7 Question #2: What are the mechanisms linking meditation and pain?

8 What role does meditation play? Secular meditation & pain Secular meditation & pain –MBSR (Kabat-Zinn) –Relaxation response (Benson) Spiritual meditation & pain Spiritual meditation & pain –TM –Yoga –Loving-Kindness –Beyond the Relaxation Response –Religious Tradition based meditation

9 Meditation Pathways and Pain Meditation Positive Mood Internalized Locus of Control Self-Efficacy Anxiety Distraction from Problems Decreased Focus on the Body Reduced Pain Frequency Increased Pain Tolerance Decreased Pain Sensitivity

10 Altered Perceptions Changed Mood Changed Social Interactions Changed Behaviors Physiological/Neurological Changes Altered neurotransmitter levels Altered sleep Altered HPA activity levels Altered threshold for recognizing distress signals Psycho-Social Changes Meaning Making Attributions Self-Efficacy Distraction Social Support Instrumental Support Relaxation Possible Unique R/S Factor Spiritual Support Spiritual Growth Spiritual Meaning Making Attributions Additional Efficacy Beliefs Spiritual Beliefs and Practices Positive vs. Negative Public vs. Private Intrinsic vs. Extrinsic Existential vs. Religious (Adapted from: Wachholtz, Pearce & Koenig, 2007)

11 Common R/S Coping Tools 1. Prayer 2. Spiritual Meditation 3. Hope 4. Reading faith-based literature 5. Finding spiritual role models for coping 6. Seeking spiritual support/connection 7. Church attendance 8. Seeking instrumental support 9. Religious reappraisal

12 Question #3: Who uses prayer/meditation to cope with pain?

13 National Health Interview Survey 2002-2007 (Wachholtz & Sambamthoori, 2009) Older (>33 years) Female More Educated (> High School) African-American (vs. white) Have chronic mental or physical health issues: depression, chronic headaches, back and/or neck pain

14 Question #4: When do people use prayer/meditation to cope with pain? Pain

15 The initial spiritual pain coping response to acute pain (self-directive), is the least likely spiritual coping response to chronic pain (collaborative) (Dunn & Horgas, 2004) The initial spiritual pain coping response to acute pain (self-directive), is the least likely spiritual coping response to chronic pain (collaborative) (Dunn & Horgas, 2004) –Terminal stage illnesses with co-morbid pain (Yates, et al., 1981; Ironson, et al, 2002) –Long-term chronic pain (Abraido-Lanza, et al., 2004; Glover-Graf, et al., 2007) –Uncontrollable, intermittent pain (Harrison, et al., 2005) When other coping mechanisms fail and spiritual coping is efficacious (Keefe, et al., 2001; Pargament, 2002) When other coping mechanisms fail and spiritual coping is efficacious (Keefe, et al., 2001; Pargament, 2002) Religious/spiritual coping AND secular coping- not either/or Religious/spiritual coping AND secular coping- not either/or

16 Question #5: What does spirituality add to meditation?

17 Intervention Studies Spiritual interventions affect physiological outcomes (Carlson, Bacaseta, and Simanton, 1988; Ironson, et al., 2002, Pargament et al., 2005; Wenneberg, et al., 1997 ) Spiritual interventions affect physiological outcomes (Carlson, Bacaseta, and Simanton, 1988; Ironson, et al., 2002, Pargament et al., 2005; Wenneberg, et al., 1997 ) Increase pain tolerance in healthy, non-chronic pain individuals (Wachholtz & Pargament, 2005) Increase pain tolerance in healthy, non-chronic pain individuals (Wachholtz & Pargament, 2005) –Doubled pain tolerance to laboratory induced acute pain task –Meditation inherently spiritual?

18 Improved pain tolerance among a chronic pain group (Wachholtz & Pargament, 2008) Improved pain tolerance among a chronic pain group (Wachholtz & Pargament, 2008) –4 weeks –Decreased pain frequency –Greater pain tolerance Acute- laboratory induced pain Acute- laboratory induced pain Chronic- decreased rescue medication usage Chronic- decreased rescue medication usage –Limited change in pain sensitivity –Greater decrease in negative mood –Greater decrease in anxiety Intervention Studies

19 Buddhist Loving-Kindness Cancer patients (Carson, et al, 2008) Cancer patients (Carson, et al, 2008) Migraineurs Pilot Study (Wachholtz, 2009) Migraineurs Pilot Study (Wachholtz, 2009) –4 week class, 4 week follow up –Increased spiritual experiences –Elevated pain tolerance –Fewer headaches (n.s.)

20 Summary Pain a multi-dimensional disorder including physiological, psychological, social and spiritual components Pain a multi-dimensional disorder including physiological, psychological, social and spiritual components Prayer and spiritual meditation used by many with chronic pain Prayer and spiritual meditation used by many with chronic pain Multiple psychological and physiological pathways that support its use Multiple psychological and physiological pathways that support its use Spiritual meditation may be a useful resource with unique additive components for patients with a spiritual/religious background Spiritual meditation may be a useful resource with unique additive components for patients with a spiritual/religious background

21 Thank You Amy.Wachholtz@umassmemorial.org


Download ppt "Pain, Mood, & Meditation- Where does Spirituality fit? Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009."

Similar presentations


Ads by Google