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Crohn's Advice Column

How Much Crohn's Pain Are You In Today?

On a Scale of 1 to 10: How Much Crohn's Pain Are You in Today?

These words are often among the first you hear at your doctor appointments. Part of living with Crohn's disease means that at some point you will have physical pain. Caring friends, family members, and physicians will ask you how you are feeling, whether you are in pain. But how often has anyone talked with you about how to psychologically manage that pain the best way? The pain management method that I have found most helpful for my Crohn’s, a practice validated by empirical research, is that of mindfulness. Jon Kabat-Zinn, one of the most prolific writers in this area, tells us that the intentional knowing of our pain allows us to be a participant, not a victim, in our experience. (Read more about Crohn’s and your emotions in the Fall 2010 issue of Crohn’sAdvocate magazine.) But what constitutes intentional knowing? What hinges upon the distinction between participant and victim? Let me first offer a more precise definition of intentional knowing, or rather, what it means to be mindful. Being mindful means paying attention, in the present moment, and with acceptance—3 deceptively simple directions.

Whether or not you’re living with Crohn’s, consider for a moment how much of your life is spent on automatic pilot. We are wired to work this way, so bringing intentional awareness to even, and maybe especially, the most familiar moments takes a concerted effort. Because we so often operate on automatic pilot, subtle Crohn’s pain cues can go unnoticed. Noticing those cues earlier rather than later means that you can consult with your physician before symptoms get out of control.

The power of the present

Now to the second part of mindfulness: being in the present. This is trickier than it might seem. Recall the last time you felt a twinge in your belly, you had diarrhea, or perhaps you felt your joints ache a bit more because of your Crohn’s disease. These all may be signs of a flare, and they may just as likely be transient signals your body sends, materializing into nothing more ominous. But with any of those experiences, I would speculate that your mind jumped away from the present and began labeling what you were experiencing. That shift in attention is of the utmost importance.

Thus we come to the last part of the definition of mindfulness: acceptance. Acceptance, or "non-judging" as Kabat-Zinn calls it, means simply allowing for and being attentive to whatever experience we are having in the present moment. This runs counter to our habit of categorizing and judging our experience.

Take a mindfulness test drive

Try noticing, for the next 10 minutes, how often you label a thought, feeling, or action as good, bad, or just neutral. It is natural that you feel concerned, preoccupied, frightened, or maybe depressed about the physical Crohn’s symptoms you now have to face. The result is that you spend a lot of attention on your symptoms; sometimes that attention can be reactive, judgmental, fearful, and even self-blaming. Because we instinctively connect each symptom we experience to words like I and my, the mind is already creating a certain amount of trouble for us. Our task is to notice this identification with the physical pain when it happens and purposefully let go of it to free ourselves from our sometimes exaggerated (though perfectly understandable!) reactions. This way, rather than being the victim of pain, we can participate in what is happening with our bodies. That is the first step in taking control of our symptoms.