Husband offered up the topic for this edition of Word War Won (which, sadly, has not been on the radar for quite some time). To refresh your collective memory, WWW is when I delve into the meanings of words that we use and how some words are better than others for those working through chronic pain. It helps to re-frame negative thought patterns into positive ones (like the techniques used in cognitive behavioral therapy).

Careful: adjective. [kare-full] The state of avoiding potential danger or mishaps.

Mindful: adjective. [myend-full] To be fully aware and present in the moment.

I was reading through some of my medical records when I came across a shrink’s blurb who’d made a point of noting that I am afraid of interacting with the world. To paraphrase: “She is scared to go out in crowds, and in the wintertime she thinks that if she is not careful, she will slip on ice and injure herself further.”

I might as well live in bubble wrap. For the record, I have tried. Please refer to Exhibit A below.

Husband framed the idea nicely. His physical therapist told one of her other clients to be careful when going for a hike or something. She corrected herself and said to the client, “Be mindful.”

There is a large difference. Being careful brings to mind being tentative and timid. You shuffle forward slowly instead of taking confident steps. You are in a constant state of apprehension. Being mindful, on the other hand, means that you are aware of your actions without being afraid of them as well. The mind doesn’t wander; it is fully attentive and precise. When you are in that state, there is no need to be afraid.

A great article by Psychology Today just came out about mindfulness. When you are in the shower, do you think about the water droplets running over your skin and the way that feels? The heat as it sinks into your tense muscles? The relaxation resulting from that release? No, you’re thinking about your day ahead (if you’re a morning shower type of person) or you’re thinking about the day you just had (if you shower at night … or twice like me, because it feels delicious).

Carefulness is about fear; mindfulness is about presence. There’s that old saying (which Google tells me is actually from Michael J. Fox?): If you have one foot in the past and one foot in the future, you’re pissing on today.

It doesn’t pay to be afraid, even if you have a chronic illness. Wistfully remembering your pain-free/illness-free self won’t do you any good. This is you — this is now. You have this pain, and no amount of wistful remembrance is going to do anything to change it. In fact, the only thing it will do is make you miserable. And fearing the future (“Will I get worse?” “Is this the best it’s going to get?” “What if I never get better?”) does nothing to benefit you, either. Medicine moves at a startling rate. There is no telling what will be approved by the FDA in one month, six months, one year, or five years. Hell, I wrote that post about western medicine shutting the door on me, and days afterward I saw that article about MGH and their new pain scanning system.

Life is glorious suffering. Our meat sacks degrade from the moment we are born. As soon as we are born, we start to die. Somewhere between the beginning and the end we are going to be battered and bruised, broken and bashed. Some of us get better. Some of us don’t. But because we can be hurt, we also have the capacity to heal. Our state of being is constantly changing. If you felt bad yesterday, you might feel better today. You could even feel better tomorrow. Pain is not forever. It does nothing but harm you to be afraid of what is coming, and it only hurts worse to cling to what you used to be.

Mindfulness de-magnifies pain. When you are hurting, it can feel like that pain is the entire universe. By giving the pain precise attention, you can tease apart what is catastrophic thinking, what is fear, what is anger, and so on — until you are left with the pain itself. By then, it’s not quite so bad.

To give an example: Being careful while hiking evokes an image of moving slowly, testing surfaces before putting any weight on them, and fearing what lies ahead. Maybe there are bears. Nobody wants to be alone with a bear.

Being mindful while hiking means that your steps are sure. Your attention is undivided. You are focused on the ground in front of you and the scenery around you. Should you come across a bear, you will have the presence of mind to back away slowly instead of fleeing.

THE WINNER: BEING MINDFUL!