The power of equanimity for pain reduction

Wednesday, October 28, 2015

Written by  Bastian Fox Phelan in Wellness

“Pain is a serious health issue,” Dr Bruno Cayoun says.

Pain is complex and subjective, however it is required for survival. “Interestingly, there are no pain receptors and no pain fibres in your body,” Bruno says. “Pain is a response to the perception of threat.”

The medial prefrontal cortex is the part of the brain responsible for self-referential processing. It’s the part that ruminates, remembers past experiences and projects future experiences. When we’re engaged in a task, this part of the brain goes to sleep. However, when scientists studied people with chronic pain, they found that while engaging in concentration tasks, this part of the brain remained active. People who transition from acute to chronic pain have created links within the brain between the experience of pain and learning.

“So, can we unlearn pain?” Bruno asks. “Mindful studies have shown that chronic pain can be unlearned.” Mindfulness is heightened sensory awareness without identifying with or judging what you are experiencing.

However, not all clinicians are skilled enough in mindfulness to teach their patients who suffer chronic pain, and not all people with chronic pain want to sit down and contemplate their pain – “it really is hell sometimes,” Bruno says.

Bruno tells us about a study that aimed to extract the most active component of mindfulness – equanimity – and see whether this was something they could teach pain specialists, so they could teach their patients.

Scientists asked people in the study to observe their pain objectively. A mindful exercise involved observing and measuring the pain using very different characteristics: “Is it very heavy, very hot, very still, very dense, very loose, very tight? Does it move? What shape is it?”

Bruno shares with us the experience of a woman with chronic pain after a car accident. After doing the mindful exercise, she had a significantly lower estimation of the amount of pain she was in: 3 out of 10 on the pain scale rather than 6 to 9 out of 10. The next part of the exercise was to introduce an element of unconditional acceptance. Much of the ‘negative’ qualities (heavy, dense, hot) were diffused after this, and her pain was rated only 1 out of 10. Even after the exercise had finished, she said that the pain was gone. “For years, we have been teaching this approach for emotional regulation,” Bruno says. Because there are no pain receptors and no pain fibres, this also works for physical pain.

Looking at pain, for just 30 seconds each time, and continuing to practice this mindful exercise with pain was highly successful. “It may change habits that lead to chronification, especially if we start early, before chronification begins,” Bruno says, “It is also a cost-free practice.”

MiCBT Teaching - Japan

Wednesday, October 21, 2015
主催 MiCBT 日本研究会

昨年度に引き続き、今年度もオーストラリアの MiCBTInstitute ブルーノ・カイユン博士の 許可の元、内藤美加子先生による「マインドフルネス統合認知行動療法(MiCBT)」トレー ニングコースを2つ実施するご案内をすることとなりました。
「2日間体験入門ワーク・ショップ」と、そこで学んだことを実際に臨床現場で活用した い方のための「臨床実践基本コース」です。ご関心のあるみなさん、ぜひ MiCBT を一緒に 学びましょう。 MiCBT 日本研究会事務局長 馬見塚珠生
① 日間体験入門ワーク・ショップ MiCBT を基礎からじっくり学ぶコースです。
時 :2015 年 11 月 21 日(土)&22 日(日) 10 時~17 時 ところ :ドーンセンター(大阪府男女共同参画・青少年センター)
最寄駅:京阪「天満橋」駅、地下鉄谷町線「天満橋」駅から徒歩 5 分
受講料 :26,000 円(基礎編+上級編の CD 付※1) 定 員: 40 名 参加資格:医師、臨床心理士、精神保健福祉士
② 臨床実践基本コース※2

MiCBT を実際に臨床現場で活用したい方のためのコースです。①の 日間体験

入門 で学んだ知識をもとに、7 回分のスカイプによるグループ・セッション※3 を行 います。
時 : 2015 年 11 月29 日(日),12 月 13 日(日),20 日(日),27 日(日)、
2016 年 1 月 10 日(日),17 日(日),24 日(日) いずれも 10 時~12 時 受講料 :21,000 円 定員: 10 名(先着順とさせていただきます※4) 参加資格:医師、臨床心理士、精神保健福祉士

※1: 2014 年 7 月 6 日に京都で開催された WS を受講された方はすでに基礎編をお持ちですので、上級編のみの配
布になります。受講料は 2,000 円の割引となります。
※2:①の MiCBT2 日間体験入門 WS を履修された方のみお申込みいただけます。
※3:MiCBTInstitute の規約により、2 日間体験入門 WS の履修だけでは MiCBT を患者さんに適用することはできませ ん。必ず、7 回分のスカイプによるグループ・セッションを修了される必要があります。なお、スカイプによるグル ープ・セッションは、全日程への参加が必要です。


●申し込み方法:MiCBT 日本研究会事務局までメールにて
理士の方は臨床心理士番号(研修ポイント申請予定) を明記の上、お申込みください。

* 日間体験入門 と臨床実践基本コースの同時申込みも可能です。
●申し込みメールアドレス:MiCBT 日本研究会事務局
●申込み期日:2015 年 11 月8日(日) 【定員になり次第〆切らせていただきます】

BRISBANE: Upcoming 8-week MiCBT courses with Patrea O'Donoghue.

Wednesday, October 07, 2015

These 8-week courses offer a structured method that effectively re-trains your brain and starts extinguishing unhelpful automatic thinking and reactive patterns. You’ll develop greater self-awareness and self-acceptance, the ability to settle yourself and stay calm, and be more assertive.   

CAPALABA starting: Wed 14th Oct 2015 (evenings). Address: Redland Community Centre, 29 Loraine St, Capalaba. 

PADDINGTON (Brisbane) starting: please express your interest for 2016 programs. Address: The Old Church Hall, 78 Enoggera Tce (cnr Surrey St), Paddington

Contact: 0410 264 224 or

Early Bird Registration ends next week ~ October 7 ~ Don't miss out!

Monday, September 28, 2015

Specialised MiCBT Workshops


These workshops are specifically designed to assist MiCBT therapists who have completed the Foundation Course as well as those with more advanced MiCBT training.

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MiCBT for Chronic Pain

This is a specialised workshop on the specific use of MiCBT for chronic pain and its common co-morbid disorders. This hands-on workshop will describe the important theoretical framework underlying the use of MiCBT for pain, both chronic and acute. It will also involve real case video demonstrations of distress reduction in clients with different types of chronic pain. 

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MiCBT for Children

The aim of this specialised workshop is to introduce the use of MiCBT for children with behaviour difficulties, especially those associated with anxiety, ADHD and oppositional behaviour. It will describe the important theoretical framework underlying the use of MiCBT for impaired executive functions and demonstrate the application of the four therapeutic stages. This practical workshop will include video demonstrations of behaviour change in a 12-year old boy with anxiety, ADHD and mild Autism following MiCBT. 

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MiCBT for Chronic Pain 
MiCBT for Children

Interested in both workshops? 

Further discounts apply!

CPD Hours: 7 CPD hours / workshop may be claimed, but please check eligibility with your professional body regarding other criteria, e.g. active, special college,  etc. (For Psychologists, this course meets APS criteria for 7 Active CPD hours.)

Come and share your experience with other skillful MiCBT practitioners and colleagues!


Hotel Mercure Melbourne
Treasury Gardens


Dr Bruno Cayoun is Director of the MiCBT Institute and a Clinical Psychologist in private practice in Hobart, Tasmania. He is the principal developer of Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT) and has been teaching this approach to mental health professionals in Australia, New Zealand, Hong Kong, Singapore, Canada and Ireland since 2003.  He has practised mindfulness meditation and undergone intensive training in mindfulness centres in France, Nepal, India, and Australia for since 1989.

In their words: Dr Bruno Cayoun & The power of equanimity for pain reduction

Thursday, August 27, 2015

It was 10 years ago, but I clearly remember walking in the corridor of the School of Psychology with Sara Lazar’s article in my hand and a strange sense of elation. I had seen the first biological evidence that mindfulness meditation can increase volume in parts of the brain used for sustaining attention and regulating our emotions.

The repeated observation of brain reorganization, also called ‘neuroplasticity’, was no longer limited to stroke rehabilitation and phantom limb phenomena. Since then, numerous studies have further revealed the brain mechanisms and beneficial effects of mindfulness meditation in a wide range of conditions. Among those, many have investigated the effects of mindfulness on the brain and behavior of pain sufferers.

When we are in pain, we perceive pain as a threat. We resent it and avoid it as much as possible, often forgetting that it is just a messenger of something unusual to attend to in the body. In other words, we take our pain personally. Three years ago, American neuroscientists Marwan Baliki and Vania Apkarian published compelling neurological evidence that 80 percent of people who transit from acute to chronic pain produce neuroplasticity linking pain pathways to learning areas of the brain, showing that chronic pain is largely learned. They concluded that future research should focus on finding ways of preventing the learning of pain.

Incidentally, for the past 14 years, my colleagues and I have not only done this, we have also trained chronic pain sufferers to unlearn their pain. We have done so by implementing a mindfulness-based exposure technique to increase distress tolerance during both physical and emotional pain. This method is derived from the Burmese vipassana tradition in the lineage of Ledi Sayadaw, Thetgyi, U Ba Khin and Goenka, and is an important skill learned by all mental health professionals training in Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT) at the MiCBT Institute.

Though the entire interaction with a client/patient lasts about four minutes, the actual exposure lasts only twice 30 seconds. No tricks, no distraction, no hypnosis, just a particular way of paying attention; with objectivity and equanimity. The results are more than amazing. They defy our common understanding of both physical and emotional pain. Following exposure, the usual average of pain reduction is about 50 percent, and our recent pilot trial shows that the benefits are maintained at 10-week follow-up.

It is understandable that not all chronic pain sufferers are able or amenable to undergo a full mindfulness-based program and maintain daily meditation practice. Accordingly, using such a short method that they could use on their own, following a brief demonstration with their GP or pain specialist, could be a wonderful way of assisting conventional treatments. I look forward to presenting our results in October at the forthcoming Mind and Its Potential conference in Sydney.

Dr Bruno Cayoun is a clinical psychologist and principal developer of Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT). He will be presenting at Mind & Its Potential 2015. For more information and to register, please click here.

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