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A few more thoughts on pain and introducing Savouring
It takes a long time before there is a shift our own and society’s thinking about strong new evidence about something that matters to us or challenges our previous held beliefs and assumptions. Take a look at climate science as an example. This is often because challenging ideas are unpleasant to have to think about and difficult to deal with, and we are trying to reduce unpleasantness in our bodies, which are our feelings.
Pain science is also at a crossroads. We now know that chronic pain (pain lasting more than 3 months) is not simply acute pain that has kept going for a long time. It is actually a very different thing altogether, with changes in our nervous, immune and hormonal systems. Chronic pain is now termed a disease, and can mean that pain feeds off itself, with whatever caused it to start often having healed. The mechanism has not properly switched off. Pain is now the problem, not the previous underlying tissue damage.
Whilst we know little about why this happens, there are things that we do know about. We know people with chronic pain have a tendency to lower levels, as a baseline, of dopamine, a neurotransmitter that gives us a sense of reward if a task went well, and lower circulating levels if things went worse than expected. Weirdly that can mean if you performed an action, say met with friends and you had a great time, but not as good as you thought it would be, you would actually get lower levels of circulating dopamine and if things went badly, but not as badly as thought, you would get a burst of dopamine. It gives us a guide as to whether an action or behaviour is something you would like to do again. It is motivational and helps keeps us safe and moving forward to find more resources. If we have as a baseline less dopamine circulating, it will be harder to do things that are good for us as we won’t experience the motivation to do so. People often don’t feel joy when having a positive experience. This is called anhedonia and is a common symptom of pain and depression.
Psychology researcher Michelle Craske has tested a treatment programme, called Positive Affect Treatment using savouring as a major element of the programme. Savouring the moment is simple in concept. It means to fully appreciate whatever we’re experiencing. It also means we must slow down and be aware of it when it’s happening.
Anything you like can be savoured. In positive psychology, one component of wellbeing is accomplishment and one way to increase feelings of accomplishment is to savour them. But you can also savour any moments, even common and ordinary moments like the first colourful day of autumn, the taste of a favourite dessert, or the silly behaviour of the family pet. There are 4 words to keep in mind when savouring:
Basking – “bask” in the physical pleasure of the experience
Marvelling – “marvel” at the wonder of the beauty before you
Luxuriating – “luxuriate” in something desirable but not necessary – the sweetness of the dessert.
Thanksgiving – Giving thanks for what you are offered or experiencing
Her trial has shown a return towards near normal levels of anxiety and depression in the groups being studied specifically for those conditions. These are startling results. More studies need to replicate these findings before they can be given a strong evidence base and the course had other aspects to it, like loving kindness, appreciative joy and visualisations. This must mean that people are getting their reward circuitry to fire up, suggesting that they are adaptable (what is termed “plastic” in neuroscience).
All of these elements are contained within M.A.P mainly as a result of this research. It is important I feel to use what works and there is a logic that as well as using M.A.P for anxiety, stress and low mood/depression, savouring should be equally useful for people suffering with chronic pain.
Here is a simple savouring technique for you to try, taken from “Savoring” by Fred Bryant:
Life Review Exercise
Identify an activity or experience that you currently savour.
2. Think of the last time you had such a savouring experience and write down in as much detail as you can the situation you were in, the people who were there, the place you were, the time of day, the time of year etc. Think about the smells that were or might have been present, any noise or conversations happening and the feelings you were experiencing at the time. What made it special and what were your own actions that helped make the event special?.
3. Do the same as step 2 for another time you remember savouring something similar to the previous experience and all the accompanying data.