Vidyamala's All Party Parlimentary Group Talk I know more than I would like about pain. I was 16 in 1976, when pain came into my life, and for many years, took it over. Before this, I was a fit, sporty, young woman. I loved to be outside as much as possible engaging in activities like climbing and hiking. Being active, moving without having to think about it, and enjoying what my body could do, were absolute fundamentals in my life. Like most people, I took these things for granted. My first accident was pulling a friend out of a swimming pool. This revealed a back problem where one of my vertebrae fractured and slipped forward on the one below. I went on to have two major spinal surgeries when I was just 17. Things got worse in 1983, when I was 23. I was a passenger in a car accident and fractured another vertebrae. Once again I found myself in hospital, and one back injury on top of the other was pretty much catastrophic for me. By now, I was living with constant pain and the only response I knew was to fight against it. I have always been very driven, so now I turned that energy against the pain. I drove my mind and body hard – I worked night and day establishing myself in the film industry. I was determined not to let severe back injuries and chronic pain stop me from achieving my goals. But, of course, they did. My body eventually broke down and I ended up in intensive care for yet more treatment after my bladder became paralysed. During this time I had one particularly gruelling night when I had to sit upright after a treatment, which was very painful. I thought the pain would drive me mad. I honestly didn’t know how I could get through till morning. Then, something extraordinary happened that changed my life forever. I was locked into an internal debate where one voice was saying “I can’t bear this, I can’t sit up like this till morning”; while another voice was saying “you have to, you have no choice”. These two voices were screaming at each other inside my head, making me feel like I was going crazy. Then, suddenly, a third voice came in that calmly said, “you don’t have to get through till morning, you just have to live this moment”. Suddenly everything changed and I relaxed because I knew that I could live in this moment, and this one, and this one – that each moment was bearable. By focusing my attention on living in the moment, I was able to pull myself back from the brink and this experience changed my life. In fact, it profoundly changed my outlook on everything. During that period I was also taught a meditation practice and glimpsed, very powerfully, that what I did with my mind and awarenes dramatically changed my subjective experience for the better. I hadn’t previously considered that self-awareness was possible – the ability to look ‘at’ my own thoughts and emotions and consciously choose to change my behaviour. So it was a complete revelation to discover that my own mind could be a tool to reduce my distress and ease my pain. From that time on, back in 1985, I have been committed to understanding more and more deeply how I can use my mind as a tool to help me live well with my pain and disability and I have meditated almost daily. Although my condition worsened in the late 90s so now my bowel, bladder and, to some extent my legs, are paralysed – I have gone on to enjoy what I consider to be an extraordinary quality of life. This in part arose through encountering the work of Jon Kabat-Zinn in the nineties. He is the founder of MBSR, and his approach strongly resonated with what I had discovered through my own life. I went on to found Breathworks, teaching Mindfulness-Based Pain and Illness Management (MBPM), in 2001. This draws on the core principles of MBSR, with the addition of some approaches that are pain and illness specific (such as pacing from traditional pain management programmes). Jon Kabat-Zinn has endorsed my approach and has been a tremendous support. I have been dedicated to making Breathworks available as widely as possible ever since. In 2004 I set up a social enterprise Community Interest Company (CIC) with two colleagues and there are now over 150 Breathworks teachers in 25 countries offering the Breathworks programme. I have written two books and the latest one, offering our 8 week programme and including a CD of guided meditations, has just won first prize at the 2014 BMA book awards, in the category of clinical books aimed at the general public. I wrote this with a journalist, Danny Penman, as I wanted it to be written in a very accessible way so as many people as possible could benefit. I would love to see this widely available as a Book on Prescription through the NHS and am pleased to know many pain clinics and Health Professionals are recommending it. We have also developed internet programmes at Breathworks, again with the aim of reaching as many people as possible, including those who are house-bound or hospitalised. Given 1 in 3 of us live with pain or a Long Term Condition (LTC), I would love to see the Breathworks programme more widely available in the NHS. We have a developing evidence-base in peer-reviewed journals and a number of research collaborations with NHS Trusts and universities are ongoing. In terms of NHS implementation there are two models evolving: Firstly, some Health Professionals are offering Breathworks courses as part of their role. For example, in Dorset, an Occupational Therapist who is a certified Breathworks teacher runs our programme as the main activity within her post. I would like to see this approach replicated much more widely. The second option is for independent Breathworks teachers to be contracted to work within the NHS. We have successfully run projects in this way such as working with people in recovery from addiction, all of whom had significant pain and health problems. We also run regular training events for pain clinic staff and other Health Care Professionals. Again, I would like to see this replicated much more widely. We have also set up a charity – the Breathworks foundation - to raise funds to provide bursary places for those unable to afford courses or to train to deliver our programme. Many people who live with LTC themselves are excellent mindfulness teachers using the ‘expert patient’ model. This is another way of ensuring those who really need it, many of whom have scant financial resources, are able to benefit from our approach. In summary: I see mindfulness as an excellent example of a low cost health-care intervention that provides training in self-management. This will be increasingly needed with our aging population and rising numbers of people living with pain and LTCs placing an ever-greater burden on the health service. Mindfulness has completely transformed my life. I am passionate about enabling other people living with difficult health conditions and pain to likewise benefit. I have gone from being unable to work for many years due to my condition, to now being Managing Director of a rapidly expanding Social Enterprise that is growing internationally. I hope that through events like this round table, and the increased awareness of mindfulness in society, many more people in situations like I was in will be able to benefit from the transformative power of mindfulness to get their lives back on track.