It’s been awhile since we discussed using DBT skills to help us cope with the challenges of life with migraine. If this is your first visit to the series, please start at the beginning so you have a good foundation for our discussion.
Participation is the last of the “what” Mindfulness skills. It is the natural extension of Observe and Describe. Anyone can sit on the sidelines observing an experience and describing it. Immersing oneself in the experience invites us to be authentic participants in our own lives.
To participate with mindfulness requires our undivided attention. We do not multitask. We throw ourselves completely into one experience at a time. This is often in conflict with cultural norms. To participate mindfully is an act of modern rebellion. The first time you try it may evoke feelings of boredom or a sense that you should be doing more. Just notice the feeling (observe), acknowledge its presence (describe), and keep on going (participate).
How many times have we felt the early presence of migraine only to ignore it, hoping that it will go away? Who has not pushed down the pain in a race to complete a task before the pain passes that invisible point of no return? That is not mindful participation. That is repression, denial, and avoidance. Mindful participation involves acceptance of the truth and a willingness to experience that truth in action.
Mindful participation is not surrender. You remain an active participant in the experience. There’s nothing about this skill to prevent you from using medication and other measures to ease the pain and shorten the duration of an attack. When using this skill to cope with migraine, you stop trying to finish up that last project. A mindful migraine experience is one in which all other experiences do not exist.
When we participate with mindfulness, there is an ease to our movements. We don’t have to think about our next move because there is no next move — only here and now. We glide effortlessly through the experience. In terms of migraine, this is played out when we do not resist its arrival. Our response to medicate is instinctive, without doubt or hesitation. We simply enter the treatment process, trusting our instincts to guide us. Acting with intuition is the opposite of anxiety, self-doubt, or hesitation.
We can twist ourselves into mental knots with every migraine attack wondering when to start treating the attack and with what. Even though we’ve been through thousands of attacks, we often withhold even the simplest comfort measures. Instead of reaching for that ice pack and turning off the lights, we hesitate. We waste time trying to stop the inevitable rather than allowing ourselves to do what is best in the moment.
Let go of self-consciousness
Most of the time our minds are filled with self-assessments, particularly when it comes to migraine. By letting go of this internal observer, we can participate in the experience with carefree abandon. We do what feels right at the time instead of being held back by our self-conscious critic.
I didn’t really understand how this could apply to migraine until I experienced a cluster headache attack. I have described in other posts that the pain of a cluster attack forces me to behave in ways that contradict my personality. Normally stoic in the face of pain, a cluster attack is so intense that I can no longer contain my behavior. I rock, pace, scream, curse, and otherwise make a loud mess in a desperate attempt to manage the pain. Migraine does not require that of me. In fact, the more stoic I behave, the less throbbing and pounding I experience. Migraine is invisible, in part, because silence and stillness ease the pain. None of us start out trying to hide the pain. We learn from experience that the pain of migraine is lessened when we are quiet and still. Migraine becomes its own reinforcer — rewarding us for staying quiet and punishing us for stepping out of line.
There are also cultural pressures that place value on “suffering in silence.” The social stigma of migraine encourages our silence, too. The real question to ask yourself is, “How do I behave with migraine when all alone?” When you think no one can see your pain, far from the critical eyes of society, what do you do? Mindful participation invites us to behave in ways that are consistent with who we really are, not with what we think is expected of us. When in public, do you conceal your medication, try to cope without comfort measures, and pretend that everything is fine even when your head is pounding so badly that you can’t see straight? Would you do this if you were at home alone? Of course you wouldn’t! Mindful participation allows us to be as genuine in public as we are in private.