Get Physical: Working With Body Sensation in Meditation

"Let's get physical, physical/I wanna get physical/Let's get into physical/Let me hear your body talk/your body talk." —Olivia Newton-John

For this post, we'll move from working with the phenomena of thoughts to another category of experience to attend to in mindfulness practice. Let's get...you know. (Readers under 40, you may want to seek out a sub-Reddit on "cliche exercise trends of the 80s" or something.)

Source: Fotorech/Pixabay

As Professor Newton-John aptly suggests, bodies do "talk," with interior signals (pain, grumbling guts, the heartbeat, menstrual signals) and the obvious pings reported in via our five senses, and we benefit from attending to the conversation.

Getting comfortable with using the body in gaining, losing, and regaining attention is good practice to recommend to our patients and students, and to work on for ourselves.

Why body meditation makes sense

• For newbie meditators, working with physical sensation is a sensible next step after gaining some facility in breath meditation. Watching the breath, after all, is engaging a subset of the physical, as is using, say, the heartbeat as an object for observation. We can open or adjust the "aperture" of attention from one aspect of the body to other ones, or even out to the whole physical self. In Practical Mindfulness, as with other training guides, my sequence of meditation exercises moves from the breath to the body, then to emotions and to thoughts.
• Another reason, more for doctors, nurses, and therapists, acknowledges the frequency of chronic states of physical suffering in many individuals with whom we work. Becoming better acquainted and adaptive to the various states of bodily "me" is a practical kind of practice for many, especially patients with pain, pulmonary, and GI illness. Working with physical suffering can help us adapt to the ebbs and flows, the impermanence of most sensations, and the varieties of ways we can spin up or cool down the basic signal by how we react to it emotionally and in thought. I cringe at the common, demeaning inference to patients from some health care professionals that their suffering is "all in the head." Yet, there is a partial truth there: Our physical experience is inevitably filtered through and modified by our state of consciousness in the moment. Especially with intense physical sensation, that hard-to-hold state can be amplified by anxiety over its cause or trajectory.
• One more reason involves a common struggle with meditators of all experience levels: the tendency toward "neck-up" meditating, focusing on and/or getting lost in thought phenomena. A facility with tending to the physical manifestations co-occurring with a flurry of thought (or a blizzard of them) is a fruitful way to get unstuck and maybe learn something about the weather front.

Tactically, tending to the physical is not particularly complicated. The esteemed Dr. Jon Kabat-Zinn famously uses a sequential scan of body regions to help his chronic pain patients adapt to the somatic component of the moment. This can be done head-to-toe, or the reverse, or whatever order works. I tend to lean on having students get solid practice on breath meditation first as a "home base" to return to when lost in any other practice, and that goes for somatic work. When distracted by, say, an intense pain signal, it's helpful to return to some basic wheezing awareness, then direct attention back to that sore spot.

Dealing with emotional associations and unhelpful thoughts

While sitting with sensation can be adaptive in its own right, one should be prepared for the prospect that certain recurrent physical sensations may generate their own emotional associations and thought narratives, sometimes as an echo of past trauma. I can share that this particular time of year has a personal association for me with past news of recurrent bone malignancy (gratefully now in remission for half a decade). That stretch of goodness, nevertheless, does not stop a quick conditioned association of my familiar left neck and arm pain from running a quick "maybe it's back" flurry in my mind and a minor burst of dread in my heart.

Working with individuals to deliberately "sit" with specific regions in discomfort can be fruitful, but also challenging. I recommend that patients work in brief stints—sitting with the breath for a few minutes, then directing attention to the spot and observing intensity, variability, and any added worries or ruminations that co-occur. If the moment is too difficult, attend for a minute or two, then back off to the breath; it's not meant to be self-punishment.

A variation of this technique that I find really effective and popular applies an ancient, imaginal tactic. My shorthand for it is "breathing into" practice. With each in-breath, imagine "gathering" awareness into the body center; with each out-breath, imagine exhaling awareness into the area under consideration, or even the whole physical self. A slow "in" to the home, then "out" to the angry knee or the tight and tense space between the shoulder blades. A kind of sustained rhythm develops as attention deftly moves to the breath, then to a snapshot of the body.

The sneaky subtext in this is that in working this way, we also develop a felt sense of mindful awareness as a capability. It's an interior skill we hone to attend to breath, body, thoughts, and even the whole mindscape.