Managing discomfort

The intentions for this group are to help people to understand pain a little better, and for them to have a new way to explore it and work with it if they want to. For people detoxing or newly off substances, pain will doubtless crop up at some point: opioids are a strong painkiller, cocaine and crack are fantastic local anaesthetics, cannabis can improve muscle pain and spasm, and alcohol can mask a whole host of physical conditions, to name just a few. So when people are starting to go without these coping strategies it helps if they know they can learn to cope in other ways. It needs to be emphasised that this is alongside any medical treatment that may be appropriate – we are not suggesting that people simply sit in pain and do nothing if they may need medical help. But part of becoming abstinent is also about needing to increase one’s pain threshold, both physically and emotionally, and if we can help people to discover ways to do this, kindly, then they will have a greater chance of remaining abstinent.

A body-based practice is used for this group, including a little time spent just noticing if any intense sensations may be pulling for attention and seeing if it feels safe to explore them or not, with the option always being to return to the breath or another part of the body which is not feeling discomfort if not. This paves the way for a more experiential discussion of body sensations, whether discomfort is noted or not.

Note the group title does not mention ‘pain’, but rather ‘discomfort’. Despite the second half of the group explicitly covering pain, once we label sensation as ‘pain’ it can be easy to lose the curiosity and open-mindedness needed to explore it. For this reason the word “pain” is not mentioned until after the meditation, so that they can explore their experience in a slightly less ‘loaded’ way during the meditation, with the invitation being to simply explore sensations.

Then in the exercise talk turns to the theory and science behind pain, and possible coping strategies. I find it helps to do the two arrows theory first, as a simple theoretical introduction – then the medical explanation makes more sense to people in that context. Eliciting and encouraging discussion and questions about how it works helps to keep people engaged, and means that hopefully what you’re saying makes sense to them.

Resources

• Download the printable group outline and handout here.

Flipcharts

• Title and running order of group
• One with stick person for two arrows and pain diagram