Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness

The author suggests that people see brief moments of acute pain, such as stubbing a toe, as an opportunity to learn how to observe one’s reactions and separate oneself from the painful experience. Chronic pain is more difficult to manage with medicine, and meditation can be a way to learn to live with chronic pain. The author emphasizes that meditation should never be used as a replacement for medical treatment, but as an additional tool alongside whatever treatment may be necessary. While people tend to demonize pain, humans’ pain circuitry is a vital messenger and “effective teacher” which protects people from threats in their environments (363). In addition to the significant economic cost of chronic pain, this condition can make people depressed and ruin their quality of life. Sadly, many people with chronic pain explore a variety of treatments before being told to live with their condition, without receiving mentorship on how to do this. Many people visualize their bodies as machines and believe that doctors can simply fix their broken “parts,” but the author explains that chronic pain is complex and cannot be easily resolved by targeting one area or nerve.

In studies on people’s experience of induced pain, experienced meditators experience the same amount of physical sensation as other people, but do not find it as painful. Kabat-Zinn attributes this to their skill at staying in the moment and not anticipating certain feelings before they happen. Another study showed that even short mindfulness lessons can make a difference to decreasing pain. These findings are echoed in the author’s own data from the Stress Reduction Clinic; his patients experience substantial reductions in their pain after eight weeks in the program, and report improved body image.

The author advises the reader to begin their own pain reduction meditation by “uncoupling” their thoughts about their pain from the pain itself, in addition to regularly performing the other meditative exercises in the book (374). He particularly recommends the Body Scan for chronic pain patients. When pain is too intense to perform this meditation, practitioners should focus their awareness on the pain and try to accept its presence, letting go of judgment and anger towards their pain. He reiterates that “mindfulness does not bulldoze through resistance” and that regular practice is necessary for progress (384).

Chronic pain can spiral into other problems, such as an inability to work, feeling isolated, or being constrained in terms of physical mobility. The author claims that mindfulness is very helpful for some chronic pain issues, such as back problems, because it helps people be aware of what is and isn’t safe for their body. Kabat-Zinn encourages the reader to consider themselves athletes who are in “long-term training” at “befriending your body as it is” (388). The author urges the reader to take care of the rest of their bodies as much as possible and not assume that they must be sedentary because of their chronic pain, for example, to pursue physical therapy or take up appropriate exercises like yoga or swimming. He asks the reader to “experiment mindfully” and never give up completely on their body just because they have pain, since neglecting life tasks and enjoyment will not make their pain better (393). The author argues that through meditation people can learn how their mind and thought patterns might be contributing to their pain. Indeed, meditation itself can be an uncomfortable experience, depending on one’s surroundings and inner state. Meditators not only report reduced painful sensations, but also have brain changes in “mapping sensation” and “regulating emotional expression” (397).

The author discusses how athletes and coaches tend to use mental training to deal with the physical pain of professional athletic careers, and that they recognize the connection between mind and body in creating health and peak performance. He analyzes how MBSR can help people with headaches, especially by generating new awareness about what is triggering their pain. He relays several stories of his patients using meditation to cope with headaches and finding that the frequency of their headaches was significantly reduced. For instance, one patient experienced severe headaches that required her to use medication, and she was sometimes hospitalized for pain. With MBSR she was able to read her body’s warning signs and take care of herself before her pain developed into full-blown headaches.

Emotional distress can be as painful as physical pain, and mindfulness can help people cope with these experiences as well. It is normal to deny or avoid painful feelings, but Kabat-Zinn warns that this causes more problems. He suggests that emotional pain should also be interpreted as a message and fully felt in the moment, or else people may start to create stories and thought patterns around them and become entrenched in certain feelings. The author suggests that people try to distance themselves from their emotional pain by observing it with curiosity and acknowledging that this pain experience may not resolve itself like the other ones before it. He asks the reader to accept that painful events have already occurred and cannot be changed; people do not have to like it, only accept that it has happened. Kabat-Zinn believes that painful thoughts tend to have beginnings, middles and ends and come in waves that feel a bit different each time. By paying attention to the exact nature of their thoughts people realize that, like everything, emotional pain does change and does have an end. Throughout these observations people can have compassion for themselves, which Kabat-Zinn argues is a form of meditation.

Much of people’s emotional pain stems from not getting what they want; the author asks people to question this pain by reflecting on what they really want and if it would bring them happiness. They might consider practical steps they can take to change their life in positive ways; this is called “problem-focused coping” (420). When people see that some of their pain is the result of their own actions or lack of action, it provides a window for them to develop their “ability to grow and to make changes, to transcend our hurts and our deepest losses” (420). If no action can be taken to resolve the pain, then Kabat-Zinn suggests embracing non-doing and simply observing the hurt feelings; this is called “Emotion-focused coping” (421). The author recalls a frightening experience he had with his son on a hike, and how by honoring their fear they were able to safely retreat during a storm and make a successful attempt on the mountain the next day. Another strategy is “reframing,” which means to try to interpret the painful feelings differently in a new “frame” of mind (426).

The author explains that Mindfulness Based Cognitive Therapy has been shown to decrease relapses in people who have experienced depression. This program teaches people to avoid trying to fix themselves and instead become aware of their feelings and accept them.

Kabat-Zinn attributes the increase in anxiety to the fast pace of life in the “digital age” (430). He claims that most people live on an “ocean of fear” for themselves and others, whether they are conscious of it or not (431). Chronic anxiety can cause people to avoid experiences which trigger fearful feelings, or morph into depression over time. Fear can trigger panic, which unfortunately only makes matters worse as it prevents people from acting rationally. Some people feel worried all the time, even when there is nothing immediately wrong, and can experience a range of physical symptoms along with thoughts, this is often diagnosed as “Generalized Anxiety Disorder” (433). Some people also experience panic attacks, which can be very surprising and debilitating. Kabat-Zinn reports that his patients who attended his Stress Clinic to deal with their anxiety reported a decline in the “frequency and severity” of their panic attacks (435).

The author relays a story about Claire, a woman who had chronic anxiety punctuated by frequent panic attacks. Claire’s anxiety restricted her life, as she developed significant phobias about crowds and being in public. After years of taking medication that was ineffective for her problems, Claire attended the MBSR Clinic and soon reduced her anxiety. Eventually she completely stopped having panic attacks, even in highly distressing situations. The author claims that sometimes drugs can be useful for people with anxiety and depression but reiterates that meditation is a highly useful tool that does not come with negative side effects.

Kabat-Zinn builds on this discussion by offering several ways people can use meditation to live with anxiety. By observing sensations and feelings, people recognize that they do not feel anxious all the time and stop assuming that their anxiety is a permanent fixture in their life. He asks the reader to not “feed” their anxieties, but instead, watch them “dissolve” (443). Another way to distance oneself from anxious feelings is to change one’s thoughts from “I am anxious” to “It is anxious,” in the same way that one might observe that “It is raining” (445).

The author argues that many people are suffering from more “time related” stress due to the busy nature of modern life. Meanwhile, others may find that they have too much time on their hands. Regardless, the author suggests that “intentional non-doing” is an antidote to either of these time-related pressures (452). The more people explore non-doing, the more aware and intentional they can be in the rest of their day, even during typically habitual tasks such as emails and texts. The author suggests that people should stay mindful of how they are using their devices and observe their own impulses to send messages or post on social media—to fully experience their lives for themselves before they share it. On the other hand, mindfulness can also impact people’s relationship to time and reduce loneliness and the anxiety and sadness that tend to accompany it. Through mindful reflection people can create a sense of “timelessness” and become more aware of how they might pursue something meaningful or positive (458).

The author argues that the stress that “time pressure” creates has devastating effects for physical health, and that many adults live every day in a rushed way with their eyes on the clock. He laments that children notice this form of stress and feel it themselves, preventing them from feeling their own “inner rhythms” (462). While human life used to be governed by the natural rhythms of the sun and living in community, industrialized societies no longer must “slow down” (463). The author lists four ways to “Free yourself from the tyranny of time.” The first is to consider how your mind is creating a certain perception of time, and how time feels different depending on what we are doing. The next method is to not waste time by living in the past or future, but focus on the present, and the third method is to devote time each day to meditation to build this skill. Finally, the author suggests simplifying one’s life by eliminating unnecessary time wasters, such as watching TV.

Sleep problems are an early sign of building stress, and sleep deprivation can cause mood and cognitive problems. Stressors such as plane travel or doing shift work can impact people’s natural circadian rhythms and result in disturbed sleep cycles. Sleep issues should be interpreted as messages from the body that something is not right. The author recommends regular exercise, which can help the body succumb to rest at night. He advises the reader not to “catastrophize” their sleep problems, and to enjoy a gentle activity in the night, or meditate, if they can’t fall asleep (473). Some people find meditation relaxing to the point of falling asleep, since they are so sleep deprived. As they practice, they learn to be relaxed and aware at the same time, without falling asleep.

The author recalls how he coped with the discomfort of frequent nights awake while his children were little by focusing on being mindfully present with them and not resisting the experience. He continues to try to accept the nights when he wakes up involuntarily and focuses on the enjoyable parts of the experience, such as the stillness of the night, or the beauty of the sunrise.

One major stressor in people’s lives is relationships. Sometimes even relationships with loved ones can be stressful and painful. Kabat-Zinn argues that people must reflect on their part of creating certain situations and relationship dynamics. People deal with relationship stressors in different ways; some people repress negative feelings or act submissively to others to avoid conflict while some tend to pick fights to feel more in control. The author argues that because these behaviors tend to be subconscious, people must be mindful of their thoughts and reactions to create healthier responses to “people stress” (480). Communication is the only way to express oneself and truly understand someone else’s perspective too, and it is a crucial aspect of individual and group relationships. The author warns against becoming subconsciously attached to one’s own perspective, making communication “impossible” (480).

The author describes how his MBSR clinic uses aikido exercises to demonstrate the dysfunction that submission, avoidance, and domination create in relationships. Using aikido as an analogy for conflict, the author recommends stepping into arguments with awareness and trying to see the other person’s perspective without caving to their demands. The author recalls a professional conflict which he resolved with this method, explaining that he named a colleague’s insulting behavior and told him how these rude comments affected him. This emotionally intelligent approach to conflict helped to change his colleague’s behavior and in turn caused Kabat-Zinn much less “people stress” at work (488).

The author suggests that the reader try an exercise in which they log stressful communications for one week in a journal and think about why these interactions were so negative. This helps people identify their own pattern of reactions, and how their interpersonal problems could be resolved. The author notes that men may struggle to express their feelings due to cultural stigma around men expressing sadness or hurt feelings. The author recommends “assertiveness training” for people who struggle to stand up for themselves and encourages them to focus on making “I” statements that clearly communicate their own needs and wishes.

The author defines “role stress” as feeling burdened by the perceived requirements of certain relationships or identities. This may include the professional roles, family dynamics, or even gender roles or political identities. By being mindful of their feelings people can understand why they are unhappy and broaden their perspective and get “unstuck” from their perception of their roles (496). Everyone plays multiple roles in their lives, and it is important to keep them in balance. For example, one’s role as an employee should not detract from one’s role as a spouse or parent. The author argues that roles should be changeable and flexible, such as the changing dynamic between parents and kids as they grow into adults.

Work is a common source of stress in people’s lives, though being out of work can be equally stressful. In addition to the pressure of earning enough income, jobs can be dangerous or demeaning. Even people who are satisfied with their work must endure changes and cannot control every facet of their professional life. The author argues that mindfulness prevents people from doing their job on “autopilot” and becoming bored or ineffective at their position. Meditation can help people shift their perspectives on their job, figuring out how to enjoy it more without needing to leave their position. The author relays a story about one patient whose work stress caused him to feel dizzy and weak at work, and unable to sleep at night. Using mindfulness, he was able to reduce his stress without leaving his position and found that he could relax at work even though he had the same level of responsibility as before.

The author lists several ways to decrease stress, including acknowledging that going to work is a choice, and to be mindful of one’s morning routine of getting ready and walking into work. Use breathing to slow down and become present  and try to smile. Try to work on one thing at a time, since multitasking increases stress while decreasing efficacy. Frequent healthy breaks, such as walking or stretching, are also beneficial, as is socializing with people you like. When arriving back at home, the author suggests saying hello to one’s family with intention and mindfulness and changing out of work clothes right away.

People’s relationship to food has changed significantly in the last few generations as people in industrialized societies are more disconnected from the land and have many options of what to eat. While modern advancements in food production have liberated many people from hunger, the downside is an increase in pollution and a proliferation of unhealthy foods. Such foods have contributed to the obesity “epidemic” in countries such as the US, and have also increased exposure to harmful chemical pesticides, fertilizers, and preservatives. The author laments that Americans’ health is continuing to worsen, with obesity, diabetes, and heart conditions on the rise. Countries with more traditional diets that contain less animal fat tend to have better health.

Kabat-Zinn endorses author Michael Pollan’s mantra, “Eat food, mostly plants, not too much” (522). He argues that by being mindful of what they eat the reader can consider if what they are eating is really food, or something much more processed and unhealthier. Dr. Dean Ornish’s research has demonstrated that major diet changes can reverse significant diseases such as coronary heart disease and prostate cancer. Dr. Ornish includes meditation and mindfulness as a part of the lifestyle change for his patients, acknowledging the connection between mental and physical health.

The author gives advice for people who are addicted to certain foods, telling them to “become more aware of your automatic and even addictive behaviors around eating, of your thoughts and feelings, and of the social customs associated with food and eating” (526). This awareness should help people overcome unhealthy eating patterns, which can be deeply entrenched and “emotionally charged” for people (528). This mindfulness can begin during the eating experience, as people can consider the sight, texture, and taste of their food and how it makes them feel. Patients at the MBSR clinic report that keeping track of their food helps them understand how to make changes in their diets and how different foods make them feel.

The author argues that people’s relationship with food is also corrupted by high beauty standards, which drives some people to develop eating disorders. The author recommends a diet low in processed meats and high in vegetables, fruits, and whole grains to thrive. He suggests eating a meal in mindful silence, paying attention to each bite, and considering where the food came from. He also recommends considering one’s feelings and energy levels before and after eating, and to practice mindfulness while cooking meals.

The author compares climate change to a “fever” which is the result of human activity. The author argues that when humans have self-knowledge and awareness, they are constructive and produce art, science, technology, but without mindfulness they can be violent and destructive. Kabat-Zinn notes the interconnectedness of all human activity, for example, eating processed food grown with chemical sprays is bad for individual health as well as the health of the planet. Air and water are other kinds of “food” and people should be mindful of their quality as well. The author argues that because these large-scale issues can only be solved through legislation, people should put some effort into being socially engaged. Everyone should care about these issues since everyone’s health can be affected by them. For instance, newborn babies meet toxins through breastmilk that their mothers are exposed to. The author reveals that the US alone is treated with over five billion pounds of pesticides each year.

The author urges the reader to become aware of these issues and act in whatever ways they are able, from their actions as consumers to political activism. Other examples of “world stress” include political hostility and the possibility of conflict or even nuclear war. While people have access to more information than ever, if it is not mindfully processed, or it desensitizes people to violence, it is doing more harm than good. Kabat-Zinn writes, “We are constantly shoveling into our minds more things to react to; more things to think, worry and obsess about; and more things to remember, as if our daily lives did not produce enough on their own” (547). The author argues that as the world becomes busier and there are more distractions and demands on one’s time, non-doing will become increasingly important to maintain health. He points to thinkers such as Jeffrey Sachs, and politicians like Tim Ryan, who have promoted mindful living as a societal solution. The author concludes this chapter with suggestions to channel world stress into positive changes, such as considering one’s digital diet and becoming informed about environmental contamination.