Breathworks Blog

Stories, tips, and articles about mindfulness, daily meditation, compassion, living well with illness and chronic pain, and more.

Emergency mindfulness for tough times

Vidyamala - Blog Image.jpg

I have lived with spinal pain for 40 years and have practised mindfulness for 30 years. Over that time I have devised and come to rely on three mindfulness techniques that I use when times are tough. I remember these three slogans when I am in need of something that that is fast acting and effective – the mindfulness versions of fast-acting painkillers.

So, whether you are in physical or emotional pain, or you feel as though you are being buried under the stress of work or exams; or if you are facing something difficult in your life, please try my 'emergency mindfulness for tough times' slogans and I am sure they will help.

'When in doubt, breathe out'

When we experience pain - be it mental, emotional or physical - we inevitably hold our breath against the pain. Try this short exercise to see what I mean:

Make a fist with one hand. Notice what's happened to your breathing. You'll probably notice you're holding it. Now imagine breathing into the fist. What does it want to do? You'll probably find it wants to release a little.

The fist in this exercise is a metaphor for any kind of discomfort. When we are not aware, we automatically tense against the discomfort with associated breath holding. Then we get into a vicious cycle of more tension, more breath holding, more pain, more tension etc. and this can feel really unpleasant. By consciously directing the breath into this cycle of contraction, the tension will gradually soften and the pain will ease.

A good way to do this is to allow each out-breath to sigh into the full length of the natural exhalation. When you notice you are getting wound up in this kind of cycle say gently to yourself "when in doubt, breathe out". Let go and soften.


This leads to the next slogan FOFBOC which stands for: Feet on Floor, Bum on Chair. This is used when teaching mindfulness to kids but it is also a great mindfulness reminder for us big people coping with desperate moments.

When we are caught up in habits of resisting and fighting pain, we unconsciously strain away from experiencing the body and end up fighting gravity. We sort of pull away from the floor and the chair with the breath holding and tension I write about in the previous point. As you soften your breath and let the out-breath go all the way out of the body, you could also say to yourself "FOFBOC" and see if you can really feel your feet on the floor and your bum on the chair and cultivate more of a quality of rest and ease.

'Take a break BEFORE you need it'

It is counter-intuitive to stop doing something before you really feel the need, but learning to pace my activities has been one of the key ways I have learned to manage my pain and live a full life with a very demanding but satisfying job.

Pacing is learning to balance activity with rest, so you don't swing wildly between over-doing it when you feel OK and then having a big crash as a consequence. For example, when I am working at the computer, I use a timer set for 20 minute spells. When the timer goes off I pause, stretch, move about a little and give my body a break from being in one posture. This has been revolutionary for me and I have been able to write three books by working in 20 minute spells.

Before I learned to pace I used to do an activity until my body forced me to stop - usually at the point of agony. So I might work for 2-3 hours at a stretch but then be wiped out for the rest of the day. By pacing, I can now work for many more hours without ever reaching this pitch of agony. Think of it as never quite draining your bank account but always having a little bit of cash in reserve!

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Launch of APPG Mindful Nation UK Report 2015 - What does this mean for Breathworks?

On 20th October Vidyamala and Singhashri made their way to Portcullis House, part of the UK Parliament, for the much anticipated launch of the 'Mindful Nation' report. This was the result of many months of work by a dedicated team under the auspices of the 'Mindfulness Initiative'

All the great and the good of the UK mindfulness field were there along with a number of Government ministers who spoke about the value they see in mindfulness as a way of addressing some of the problems in our society.

Mark Williams spoke first about the benefits of mindfulness followed by a number of other speakers:

·       Tracy Crouch, Minister for Sport, spoke movingly and honestly about how the mindfulness courses at Parliament had helped her manage her own depression.

·       Alistair Burt, a Minister in the Department of Health spoke specifically about the role mindfulness could play in physical health amongst other things:

“Mindfulness can help people with physical health problems – an area I am very interested in exploring further. Since becoming a Health Minister, I have seen evidence showing that mental health interventions can be an important part of supporting someone with a long term health condition, including diabetes and musculoskeletal problems. I am keen to find out more about how mindfulness can contribute to this”.

Obviously Breathworks is well placed to help people with physical health conditions and I have written to Alistair Burt since the launch telling him about our work.

·       Nicky Morgan, Minister of Education, spoke about the role mindfulness can play in the education system, particularly helping to build character and resilience – two areas that she is keen to promote in the young people in the education system.

The session was wrapped up by three school children speaking eloquently about how mindfulness has helped them. Of course they stole the show!

What the report means for Breathworks

What immediately springs to mind when reading the report is the importance of having a high quality evidence-base. The authors decided to prioritise this when making recommendations.

In the health section, one of the recommendations is:

NICE should review the evidence for Mindfulness-Based Interventions (MBIs) in the treatment of irritable bowel syndrome, cancer and chronic pain when revising their treatment guidelines.

This is an area where Breathworks may be seen as a treatment of choice given our areas of speciality are chronic pain and illness.

We were pleased to see Breathworks mentioned in quite a few places in the report:

·       On page 26 there is a full-page case study featuring Anu Gautam.

·       On page 73 in the section ‘the challenges of implementation in the NHS’ it says:

“Another model is Breathworks, a social enterprise founded in 2001 that is based in the north-west of England and works nationally, and which offers eight-week courses, adapted from the MBSR programme, for people living with chronic pain and other long-term physical health conditions. Their courses are not generally available on the NHS and cost £200 (with some partial bursaries for those who cannot afford to pay). They have also established a programme of courses and teacher training”.

·       On page 80 in the section ‘Where will the mindfulness teachers come from?’ the following statement says:

“Excellent models also exist of “in house” training within the NHS, as well as independent training organisations such as Breathworks, the Mindfulness Association and London Meditation (which together train a further 140 people per year)”.

Following the launch of the report I see the following as our key priorities and work is underway to strategise this:

·       Promote mindfulness for Long Term Conditions (LTCs).  70% of the NHS budget is now spent on LTCs and it is an area of tremendous interest in terms of finding innovative models of self-management.  And, as seen from the above quote from Alistair Burt, ministers within the Department of Health are interested in mindfulness.

·       Connect our work more directly to MBSR. Our programme is a direct adaptation of MBSR/CT for people living with chronic pain/health conditions and is highly prasied by Jon Kabat-Zinn, the person who developed MBSR. He said: ‘Mindfulness-Based Pain Management (MBPM) is the most comprehensive, in-depth, scientifically up-to-date and user-friendly approach to learning the how of living with chronic pain and reclaiming one’s life that I know of…I admire Vidyamala Burch tremendously. Her approach could save your life and give it back to you’ Jon Kabat-Zinn

·       Prioritise high-quality research to build our own evidence base.  Colin Duff and I jointly oversee research at Breathworks and we currently have the following relationships underway with outside researchers/clinicians:

University of Manchester School of Psychological Sciences & Maggie’s – designing study of MfH for Cancer patients and carers, with a view to ongoing research partnership

University College London Hospital – MfH book programme trialled for gastrointestinal in-patients, study completed and being written up for publication under supervision of Amanda Williams

National Spinal Injuries Centre and University of Buckingham – MfH online for spinal patients, controlled trial in progress

Leeds PhD study of MfH grads – Extensive interview-based study of MfH course grads now written up as PhD thesis, findings being written up for journal submission

De Montfort University – preparing bid to research MfH for LTC patients and carers

Universities of York and Glasgow – bid in development to trial MfH for patients with multiple conditions as part of an integrated care pathway 

University of Manchester Institute of Population Health – bid submitted to evaluate MfH online on prescription within General Practice in Greater Manchester

Salford university student – analyzing our MfS questionnaire data

Oxford University – post doc study of MBCT for IBS sufferers to incorporate Breathworks compassion meditation

Stanford University and Betty Irene Moore School of Nursing exploring detailed evaluation of MfH online, with a view to researching MfH group courses for pain unit patients to follow

A States of Jersey Pain Management Programme is running and evaluating regular MfH and MfS courses for patients, finding very positive outcomes for patients.

If you are aware of any possible research collaborations, then please do contact to discuss taking this forward.

To view the report and read more visit the Mindfulness Initiative website.  Here you will also find special interest pages where Breathworks is strongly featured on the pain page , cancer page and teacher training page.

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The suffering of living with fibromyalgia can be eased through practising mindfulness - Fibromyalgia Awareness Day, May 12, 2016

When I first began my journey with mindfulness for health, my personal knowledge was limited to spinal and leg pain. I wasn't really aware that there are pain conditions that can affect the whole body - such as fibromyalgia.

Over the years I've had the privilege to meet many people living with fibromyalgia, such as Lesa Vallentine, 52, Derbyshire. Fibromyalgia is a painful and unpleasant condition. It can drag you down, leaving you exhausted and desperate. People tell me that living with fibromyalgia feels like it wrecks your entire life: sleep, being awake, relationships, and mental wellbeing – basically carpet bombing everything you hold dear.

As Lesa said to me, "I suffered from fibromyalgia for over five years before getting diagnosed. It was like having the flu and your worst hangover rolled into one and on top of that I had the uncertainty of not having a proper diagnosis, I was struggling with incredibly bad anxiety as I really didn't know what was happening to me."

However, there is hope, through our Breathworks programmes, time and time again I have seen that fibromyalgia is a condition that responds well to mindfulness. Mindfulness is a 'whole life' approach where you learn how to work with your mental and emotional reactions to your pain and exhaustion; you learn how to bring mindfulness into daily life and pace your activities; you learn how to become more emotionally positive and re-claim your relationships and rediscover the joys and pleasures in your life again.

Lesa also told me about the impact that practising mindfulness now has on her life and living with fibromyalgia: "Now, I do live in the moment, and it is quite beautiful, I feel at peace, I feel much more confident and I am able to look to the future with confidence. I am much more compassionate with myself and everyone else.

I now accept that this illness is not my fault and it is now 100 per cent easier to deal with the primary pain that comes with fibromyalgia by eliminating the secondary suffering of worry and anxiety.

There is so much guilt about being ill. But, illness is not something to be ashamed of. It is not a sign of misfortune or defeat. Through illness, we can gain insight into the meaning of life, its value and dignity and strive to lead more fulfilling lives."

I'm looking forward to joining top speakers from around the world at the Fibromyalgia Online Summit which begins on the 12th May 2016 (Fibromyalgia Awareness Day) and carries onto the 14th May.  So please, if you live with fibromyalgia or if you care for someone with the condition, tune in to the Fibromyalgia Online Summit. I know that even in the worst states of chronic pain and mental anguish, mindfulness will help.

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Fibromyalgia & Mindfulness, a powerful case study of how it helps ease the suffering


Julie Franklin, 58, North Manchester lives with fibromyalgia and attended Breathworks' first mindfulness course for pain management in 2001.

Fibromyalgia Awareness Day is May 12th and Vidyamala is taking part in the Fibromyalgia Online Summit from May 12th to 14th.

Julie's Story:

I first started with symptoms of fibromyalgia after I fractured my lower spine, thirty years ago. I was still experiencing lower back pain, some months after an accident, and I began to notice pain in other areas of my body, including upper body pain and pain in my arms and hands. I was in the surgical corset as a result of fracturing my spine, but ongoing pain, as the fracture healed was down to Spina Bifida Occulta.  A consultant recommended surgery on my lower back but was dismissive of the pain in the rest of my body.

The pain across my body worsened. The consultant had dismissed me and my GP was totally unsupportive, telling me that people often got left in pain and I would just have to get used to it. However, I did get a referral to a local Pain Clinic where they called me the 'woman with the mystery pain'.

By this time I was getting very despondent and began to question how much pain I was really in. Consequently I pushed myself through the pain to continue working. I was also experiencing constant headaches, had developed IBS and felt constantly fatigued, along with what I now know as brain fog.

Within months of getting a new job, it became obvious that I couldn't continue working. I was spending all my evenings and weekends in bed. I was also totally disillusioned with the medical profession and started to explore alternative health. I took up yoga, tried to learn relaxation techniques and used massage when I could afford it but I was also still pushing through my pain. As a result, I developed depression. I was becoming so overwhelmed by the pain that it was difficult to see beyond that. I now rarely went to the GP about my symptoms, even though I had been living with them for about eight years.

I attended a course at a specialist pain clinic at Walton Hospital in Liverpool and found the course really helpful, especially mentally. It was the first time I was completely open about all my symptoms and my depression and also the first time I felt the medical profession really took on board how much pain I was in. I came back feeling mentally rejuvenated and with various techniques, including relaxation, to manage my condition more effectively.

Unfortunately, true to form, I didn't take on board the pacing element of the course. I convinced myself that I could go back to work and went into business with my now ex husband. I found being self employed in a demanding business, made it difficult to keep up with all the practices and techniques I had learnt.

When I was forty, my marriage broke down and I had a hysterectomy, as well as having to manage a difficult divorce and ongoing financial problems. I returned to Manchester to be near family and I enrolled on various courses to keep me busy. One day I wandered into the Manchester Buddhist Centre and saw a notice for a day of Mindfulness for people in pain.

After the day, I didn't really understand what Mindfulness was. However, I also came away feeling that I had been told something of importance which if I fully understood could help me see life in a different way. When I got a notification of the first course to be run by Breathworks, I immediately booked.

The course did indeed change my life. I had used various techniques over the years to help with my symptoms but not used them in an integrated way. Breathworks gave me a model to use, underpinned with the idea of Mindfulness. I took to meditation easily after years of practicing relaxation but it was the idea of Mindfulness that transformed how I thought and behaved.

The idea of primary and secondary suffering was integral to that. It helped that eventually I got a diagnosis of fibromyalgia, years after my initial accident. It gave me some insight into all the various symptoms, which I couldn't necessarily do anything about. However, what I could do was stop looking at my body in a negative way and work with it in the Body Scan. This transformed my experience of pain.

Where the pain had always felt solid and overwhelming, I could actually see how the pain differed in intensity and sensation throughout my body. It became something to explore rather than block. As I continued with that exploration I was able to again take pleasure in small things, like the sun shining through a window or the sounds of the birds in the garden. By pushing through the pain rather than simply being with it, I had lost the ability to see that I was more than the pain and if I widened my focus beyond that, there was pleasure as well as pain.

I have continued with a regular meditation practice, and I bring Mindfulness into my day, by being mindful of daily activities like brushing my teeth, brewing a cup of tea or simply stroking my cat and feeling the softness of his fur, and the sound of his purring. I have become much less reactive. I was often angry and irritable, the more pain and fatigue I had. By being aware of my mental states, I can catch myself much earlier and respond more skilfully in whatever situation I am in.

In terms of my Fibromyalgia symptoms, they haven't improved overall, and I have developed respiratory problems linked to it. However, by pacing and having appropriate rest, including stopping to meditate, I can influence my pain levels within a particular day. I am much more aware of the ebb and flow of my pain and fatigue and can respond more creatively, with those and other symptoms. I have a lot of insomnia but rather than worrying about it, I meditate in bed on nights where I am getting little sleep.

I still suffer from depression on and off but because I am much more aware of my mental states, I can be aware of when I am ruminating which makes it worse. I can also see that as with my pain, the depression isn't solid and I am more aware of the nuances of my emotions.

My quality of life has certainly improved since learning Mindfulness. I still have difficult times but I'm also much more aware of the joy in life. Living with a chronic illness isn't easy but it is still possible to have a life enriched by living in the present moment. For anyone living with fibromyalgia, I would advocate learning mindfulness, for through it we can learn the pleasure that is still present, amidst the pain.

Register for the Fibromyalgia Online Summit from May 12th to 14th.

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Mindfulness & Compassion for Nurses, Breathworks' article in the Nursing Times, co-authored by Vidyamala Burch

How Mindfulness Can Benefit Nursing Practice - May 2016

Mindfulness for Health Professionals Image

Breathworks has recently had an article published in the Nursing Times and we are happy to be able to show you the full article in PDF format by clicking here.

To visit the article on the Nursing Times website, please visit here.

Co-authored by Vidymala Burch and Elaine Brass, Breathworks.

Breathworks runs its 3-day courses for Health Professionals in Manchester and London. The next dates for 2017 are as follows;

  • 22 – 24 February, Introduction to Mindful Compassion as a Healthcare Intervention - Manchester - Book Here
  • 3 - 5 April, Introduction to Mindfulness as a Healthcare Intervention - Manchester Book Here
  • 15 - 17 May, Introduction to Mindful Compassion as a Healthcare Intervention - London Book Here
  • 16 June - 18 June,  Introduction to Mindfulness as a Healthcare Intervention - Dublin Book Here
  • 28 June - 30 June, Introduction to Mindfulness as a Healthcare Intervention - London Book Here
  • 18 September - 20 September, Introduction to Mindfulness as a Healthcare Intervention - Manchester Book Here
  • 13 November - 15 November, Introduction to Mindful Compassion as a Healthcare Intervention - London Book Here

For 2018 and beyond please click here  to be taken to the Health Professionals course webpage.

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