Fibromyalgia: catastrophizing and mindfulness in women

Fibromyalgia: meditation and catastrophizing

I was excellent a catastrophizing. It was a skill. A very bad skill but I also have Major Depressive Disorder so it was a skill I was inclined to from MDD and fibromyalgia pain and migraine pain. I went to a pain clinic for the fibromyalgia and chronic migraines and there I saw a psychologist who specialized in pain. He helped me out with this issue and more and more I become aware when I do it. And I really do not do it much at all anymore. They also treated my depression and treating depression and pain at the Same time, is a very effective way to go about it.

He recommended mindfulness and I started doing it. At first, it was just like immersing myself in pain. But I found some good guided meditations. A few apps. And I got the hang of it. I find it soothing. I find it de-stressing. And I believe it helps me not with the physical feeling of pain but pain perception.

So there was a study on women, catastrophizing, mindfulness and pain intensity in fibromyalgia. Let’s take a peek at what they explored on the subject with their research.

Abstract:

Patients with fibromyalgia completed validated baseline and diary assessments of clinical pain, mindfulness, and pain catastrophizing. Multilevel modeling analyses indicated that the daily association between catastrophizing and pain intensity was moderated by certain mindfulness facets. Our findings suggest that various aspects of mindfulness may interact differently with pain and catastrophizing, which may have implications for the design and testing of interventions targeting mindfulness and catastrophizing in fibromyalgia patients.

It is important we think about what catastrophizing actual does. And they referenced some research on that.

Negative pain-related cognitions, also known as catastrophizing, are prominent in individuals with FM (). Catastrophizing is conceptualized as an negative pattern of pain-related thoughts (), including cognitions of helplessness, pessimism, rumination about pain, and magnification of pain complaints (). In patients with FM, catastrophizing is associated with enhanced nociceptive sensitivity and increased severity of FM symptoms ().

It is the ruminating on the pain and magnifying pain and deep pessimism. I would think things like ‘this pain is endless and I will always suffer’ and while it is true it is magnified. It is true my pain is chronic, unless some cure comes around the corner, and I will feel pain all the time. But pain is variable. Not every day is a high flare day. Some days are decent or baseline. Nothing to write home about since it is the ‘norm’. And by magnifying my worst days like that… the future seemed like literal torture.

It may deter us from trying treatments like exercise. It may increase our perception of pain. So magnify the experience of pain. It may affect our resiliency, which is something with chronic pain we need a boatload of. And mindfulness has been shown to help with this with many types of pain.

Mindfulness:

Mindfulness does not try to reduce negative thoughts but aims at developing awareness and refocusing every time the mind wanders (). Mindfulness is a way of paying attention to the present with non-judgmental awareness (). It comprises various tenets including attention to external experiences, conversion of internal experiences into words, attending to the present moment, not recognizing thoughts and feelings as negative or positive, and allowing thoughts and feelings to enter and leave the mind (). As a result, by adopting alternative, balanced cognitions, the patient’s distress and pain are likely to be reduced ().

Apparently, the research with fibromyalgia on whether it would help with catastrophizing has been mixed. And I don’t know if it helps. I do know I perceive pain differently with meditation and less inclined to magnify it with deep negative thoughts. I mean the pain is there. It is always there. And some days, weeks, months, years the pain can be really bad. I am flaring now and have been for weeks and it inhibits me a lot because moving is painful… and I have vestibular symptoms so I have troubles walking anyway. So how can we exist in some nasty pain but reframe how we think about it?

Study

Ended up with 88 people able to be subjects in the study. They looked at their age, their baseline pain and a lot of criteria to come up with this 88. It was a self-reported study based on trying mindfulness. Asked to report pain intensity and level of catastrophizing. And I can tell you this one very true fact there is a correlation between high pain and catastrophizing….and they did see that in the study as well. But anyway, that was the sort of thing they were asking for the duration of the study.

Results

In this study, we examined the relationship between mindfulness, catastrophizing, and clinical pain. Results of multilevel analyses indicated that the association between catastrophizing and pain intensity was moderated by certain mindfulness facets (Observe, Acting with awareness, and Non-judging), but not others (Describe, Detach). These findings are congruent with previous reports on the association between catastrophizing, pain, and mindfulness ().

So some aspects of the mindfulness experience did help, while others did not.

And in that sense:

Specifically, our results indicated that non-judgment and awareness may tend to amplify the negative effects of catastrophizing. This may occur because patients with high levels of these mindfulness characteristics may be more likely to accept negative, catastrophic thoughts and feelings which can lead to increased pain. The thought process associated with the Non-judging facet of mindfulness involves not recognizing thoughts as negative or positive. For patients with pain and high catastrophizing, adopting a non-judging attitude toward these negative thoughts about pain may allow them to have more impact and thus worsen pain (). Likewise, patients with higher awareness tend to be more aware of their symptoms and experience heightened pain (). In other words, patients with high levels of catastrophizing and awareness might be more attentive to their daily pain. In light of this, it is not surprising that patients with high catastrophizing and high awareness reported higher pain intensity than patients with low awareness and low catastrophizing.

And so in conclusion:

Collectively, mindfulness-based interventions for chronic pain seem to be effective via reductions in catastrophizing and increases in mindfulness. Although a number of issues remain in need of clarification, including the processes by which mindfulness works, the role of cognitive changes needs to be addressed in future clinical trials.

Although the limits of the study were the small number of people involved as well as its all too short duration. I mean it took me a bit to get the hang of mindfulness when in a lot of pain. And at first, it just made me think about the pain… because you have no distractions. And distractions are a proven way to deal with chronic pain. Without that… it was just pain and the more I sat there the more pain I noticed. Until I found things like the body scan and the ‘breathing into pain’ exercises. Then, yeah, I got some benefits from it. But I can tell you this was with cognitive therapy with my psychologist. Because I had a lot of different forms of negative self-talk and an immensely low self-worth.

It is a tool. And it has benefits. That is what we should get from this. And it is a free therapy. No out of pocket. So there is no harm no foul in giving it a go for a few months. I find the guided meditation works best for me.

Meditation Benefits

Other fibromyalgia posts:

Fibromyalgia and migraine can worsen depression

Challenges of fibromyalgia

Fibromyalgia is more than pain
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