Eleven years ago, when Paul Kelly began to teach it as part of his hospital work with HIV-positive and AIDS patients, he found meditation “as effective as cognitive therapy for reducing distress.” When budget cuts axed the program two years ago, he went into private practice, where he leads meditation sessions for his patients in chronic pain.
As we spoke, he levered up his ergonomic chair to ease a bad back. “I have the good fortune to have had a pain problem,” he says cheerfully, referring to a prolapsed disc, “which has given me more insight into my patients.” Exactly. The quality of relationship between patient and therapist, Kelly concludes, is more important to successful treatment than the type of therapy undertaken. If a current of compassion isn’t there, all the knowledge in the world won’t help someone in pain. And they don’t teach compassion in grad school.
Kelly began studying and practising Buddhist meditation as a psychology student — a “bit of a disembodied, intellectual chap” — at Brock University in St. Catharines, Ont. His professional training and what he calls his “spiritual curiosity” stayed on parallel tracks until 1988, when he began to teach meditation to his clinic patients. Now, while he maintains a “profound respect for natural science,” Kelly also works with methods that are 2,500 years old — a focus on breathing and awareness. “In my practice,” he says, “we shift from the idea of solving their pain to exploring the experience of it. It’s about non- judgmental awareness.”
Working with groups of about 12, Kelly teaches his patients how to meditate in eight two-hour sessions and one full-day workshop. He draws on resources such as a cassette called Break Through Pain recorded by Shinzen Young, a Buddhist monk, and the stress-busting classic Full Catastrophe Living, written by Jon Kabat-Zinn. The sessions begin simply by focusing on the breath. This turns awareness inward, and puts people in touch with how they feel — a connection that pain may have made them fear. “People who have been in pain for some time can even end up with a sensation of being outside their bodies,” Kelly says. “Meditation helps them reclaim their bodies, and to feel less victimized.” The goal is to “get intimate with your pain.”
Someone with a screaming migraine may say they already feel plenty intimate with their pain. Kelly’s response, strange as it sounds, is that going further into awareness of pain can make it easier to bear. “I try to give the person some sort of stable ground on which to meet the pain,” he says. “That way he knows that there is more to him than the pain.” Young talks of “taking the suffering out of pain,” Kelly says. “In other words, you can learn to experience the sensation of pain without having the mind add commentary. The more we come to observe the quality of our sensations, the less likely we are to get caught up in the feelings. People in pain have to find a way to feel some control over their lives, no matter how hopeless their situation might seem.”
This is the new frontier of medicine, where the patient, rather than the doctor, the drug or the latest technology, becomes the most important factor in getting better. What Kelly and others are discovering is that meditation is one strategy for anchoring the self, in the face of pain’s obliterating power.