Mindfulness-based pain management

Domain II · Behavioural & cognitive · Vidyamala Burch · 2001 · Manchester

What it is

Mindfulness-based pain management (MBPM) is a mindfulness and compassion programme for people with chronic pain, illness or fatigue. Vidyamala Burch developed it from her own experience of spinal injury and pain. It began as a 2001 pilot and has been run by Breathworks (Manchester, UK) since 2004.…

Format

• Format
• Session length: sessions were 2.5–3 hours in the original in-person format. Current online listings show about 90–120 minutes. Since 2020 most courses run live online.

Who practises it, and how they are trained or regulated

• Course: 8 weekly group sessions, run by an accredited Breathworks teacher. Clients self-refer. Typical conditions include back pain, arthritis, fibromyalgia, chronic fatigue, post-operative pain, cancer, MS and Parkinson's.
• Other formats: a self-paced online course (alone or with a web group led by an accredited teacher), suited to housebound clients. The book can also be used for self-guided practice.
• Training and accreditation

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• strong self-criticism. Start with a friend or pet as the object and come back to yourself later.
• the client turning "being mode" into another task to succeed at. It is working when the client spontaneously reports noticing the switch.
• spacing out or dissociation; return to the felt breath. It is working when the client describes the pain as "part of" experience rather than "all of it".
• practice falling off after the course ends; schedule a review. It is working when the client describes responding to setbacks with less panic and quicker recovery.
• diary-keeping itself feeding pain preoccupation (then simplify to two or three ratings a day) perfectionism It is working when clear links between activity and later symptoms emerge.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.