Why meditate when you can medicate?
A friend of mine had back pain chronically for many years, nearly a decade. And on some days, the pain was really debilitating. He couldn't do normal things and it interfered massively with his life. He tried different doctors. None of them were not able to figure out what it was. At some point he even had an x-ray fluoroscopy procedure done where they gave him an injection to numb out the pain for a bit of time. After a few months of relief, the pain was back.
Then one fine day, he discovered the pain was gone. He had started a new psychiatric drug which was given to him for some mental health issue. And within a week of taking that medicine, the back pain that he'd been struggling with for years disappeared. Just like that.
Now, I found that super interesting that a physical pain was eradicated by a medicine for mental health. And of course, my first thing was, oh, was it a psychosomatic pain then?
My curious brain somehow felt there was some some similarity with what was happening with this psychiatric drug and Vipassana meditation. And I went down the rabbit hole to figure things out. I studied the mechanism of pain, what actually happens in the body, in the brain. And this is what I learned, you can read about it here
So I learned there was some similarity between what was happening in Vipassana meditation and what was happening as a result of taking that psychiatric drug. And there were some major differences as well. For the similarity, you should read the post that I linked above, and for the differences, keep reading.
Essentially, Vipassana and the specific psychiatric drug can both reduce the grip that a painful or troubling signal has on us. But they do it very differently.
1. The drug acts broadly. Vipassana is selective. The psychiatric drug changes brain chemistry across the brain. It cannot choose to affect only one thought or one sensation. Vipassana is directed deliberately at one experience, for example a pain in the knee. You choose where to place your attention.
2. The drug can reduce attention. Vipassana increases it. With Vipassana, you actually pay more attention to the sensation. You examine it very closely. What decreases is not attention itself, but the fear, unpleasantness and urge to react. So Vipassana can make the sensation clearer while making it less disturbing.
3. The mechanisms are different. The psychiatric drug works mainly through dopamine and serotonin receptors. Vipassana works through attention, perception, emotional regulation and the brain’s own pain-control systems. There is no good evidence that they use the same chemical pathway.
4. A drug is always working while it is in the body. Vipassana is a skill. The psychiatric drug keeps acting for many hours after you take it. Vipassana is something you consciously enter into and practise. Over time, the skill may also change how you respond to sensations generally.
5. Vipassana can do things the drug does not. During meditation, pain may:
- break down into sensations like heat, pressure, pulsing, movement etc.
- shift location
- reduce as muscles stop bracing
- become less threatening
- sometimes disappear
These are not all the same thing. Some involve physical relaxation, some involve changes in perception, and some involve the sensation having less emotional grip.
So the overlap between the two is actually quite narrow: Both can reduce how strongly a signal controls your experience. But the route is very different. A simple analogy: The specific psychiatric drug changes the settings of the sound system. Vipassana teaches you how to listen differently.