Self regulation is something we learn to do to achieve goals – it’s all about establishing what the goal is, find out how close we are to the goal, the gap between where we are and where we want to be, and what we need to do to get there. This is a reasonably good overview of the concept, although related to sports goals, but worth a read.
In pain management, self regulation includes working out how much physiological arousal is needed to achieve activities – and how to settle that arousal level down as required. For many people with pain, their physiology becomes over-aroused in response to pain (or as part of the development of the chronic pain condition), while others find it difficult to increase their level of arousal sufficiently to be able to engage in activity. This is a simple explanation of some of the concepts of physiological arousal, in relation to ‘stress’.
We often teach strategies such as relaxation (this is a helpful book) and diaphragmatic breathing to people, but I find that those who are ‘pushers’ (over-active) as compared to those who are ‘busters’ (under-active) can have difficulty using traditional methods to s l o w d o w n…
Another option, and one that has been used for thousands of years by religious orders of many persuasions is a ‘walking meditation’. Many monastery gardens as well as buddhist gardens were formed to enable the monks to walk in quiet meditation. And I don’t know how many nights parents have spent walking the floors with babies, rocking them to sleep! So it’s certainly something that has stood the test of time!
How do you do it?
Well the basis of a walking meditation is to spend time without distractions being fully aware of the body, the ground, the environment while walking at a steady pace. The length of time isn’t as important as the open awareness of the mind while doing it.
For those who perhaps haven’t spent time in meditation before, here is a simple set of ‘instructions’ that you can use for yourself or for a client, to start the process of a walking meditation. If you’re going to introduce this to a client, you’re best to do it with him or her the first few times, using your voice to guide the attention.
In one way this practice is simpler than the sitting meditation – but in other ways it’s more complex — simply because there is a lot you can be aware of while doing walking meditation. It doesn’t matter where you do this – in a busy place, a quiet place, level ground, uneven ground – but to begin with, try to find somewhere quiet, and on even ground so you have a little less to think of.
So, to start of this meditation, first of just stand still. Become aware of your weight through the soles of your feet into the ground. Become aware of the constant small movements that keep you balanced and standing upright. Notice your weight through each foot, through your knees, your hips. Notice your buttocks, your abdomen and how your arms all work together to hold you upright.
Then start to walk, at a steady pace, not hurrying, just stepping left foot, right foot, one after the other. Notice the soles of your feet, being aware of the alternating patterns of contact and release; being aware of your foot as the heel first makes contact, as your foot rolls forward onto the ball, and then lifts and travels through the air. Notice the way your toes touch each other, the fabric of your socks and shoes, or if you’re barefoot, the texture of the path. And notice how your ankle bends and the way your lower legs tense and release with each step.
You can become aware of your lower legs – your shins, your calves. You can be aware of the contact with your clothing: be aware of the temperature on your skin; you can be aware of the muscles. The movement at your knees, the bending, the stretching. The thighs tensing and releasing with each step, and the way the hips move. Your pelvis, the rise and fall as you take each step.
And you can be aware of the complex movements that your pelvis is carving out through space as you walk forwards. The lowest part of your spine – your sacrum – is embedded in the pelvis. So as you feel your spine extending upwards – the lumbar spine, the thoracic spine – you can notice how it moves along with the pelvis. Your spine is in constant motion. It’s swaying from side to side. There is a twisting motion around the central axis. Your spine is in constant, sinuous, sensuous motion.
Notice your belly – you might feel your clothing in contact with your belly – and notice how your belly is the center of your body. Very often it feels like it’s “down there” because we are so much in our heads. Notice how your abdominal muscles move with each step. And the movement of your chest as you breath in and out – be aware of how long each breath takes, how many steps it takes to breathe in, how many to breathe out.
And be aware of your shoulders and your arms as they move to counter the steps you take, and how you bend at the elbow and how you hold your hands.
Become aware of your neck – and the muscles supporting your skull. Notice the angle of your head. And notice that as you relax the muscles on the back of your neck, your chin slightly tucks in and your skull comes to a point of balance. Relax your jaw. Relax your eyes — and just let your eyes be softly focused, gently looking ahead – not staring at anything, not allowing yourself to be caught up in anything that’s going past you.
Then while you’re still walking, notice the sounds you can hear, the sights and the smells. Notice the wind and the sun, the temperature – and breathe in, breathe out as you walk for as long as you need or want.
When you’re ready to stop, don’t return to normal life too quickly. Spend a moment or two standing still and allowing yourself to enjoy the moment.
As for any meditation, if you notice your thoughts straying way from experiencing the sensations, perhaps naming feelings, planning a meal, pondering a problem – gently bring your mind back to your breath.
I hope this is helpful to you and your clients. While this specific meditation hasn’t, as far as I know, been researched in terms of pain management, the benefits of meditation have been well-established. If you’ve enjoyed reading this, and would like more (or perhaps something different!), you can subscribe through the RSS feed (above left), or bookmark the blog so you can find it again! And do feel free to comment and let me know what you think.