“Pain is inevitable, suffering is optional” – Buddhist aphorism
In a recent podcast, Vidyamala Burch, an ordained Buddhist with chronic back problems, talks about the nature of pain. She identifies two components to her experience of pain, the first being the actual sensation of pain, the second arising because of her resistance to it and thoughts which arise because of the pain. After we have had physical treatment and taken the appropriate medication, there is little else that we can do for the first part. The second component, however, is completely within our power to change through our attitude to the sensations we are experiencing.
The Buddha gave an analogy for this kind of resistance to unpleasant sensations as being like a man who after being shot with an arrow, deliberately shoots himself with a second arrow. Put in this way it seems like madness to increase our own level of suffering but, in purely human terms, we can understand why we do it, and also know that our mind is prone to extrapolate pain into catastrophic scenarios. Who has not woken in the middle of the night with a headache and feared they had a brain tumour, or reasoned that an unsightly mole might be the first signs of melanoma?
Very few people like to experience pain and resisting things that we don’t like is a fundamental part of human nature, as is clinging to that which brings us pleasure. Usually, we tense our muscles around the painful area and produce negative thoughts based on our worst fears without even thinking. However, tensing reduces blood supply to the affected area and increases the sensation of pain even more, and negative thoughts feed back into our anxious state of mind and prolong the tightness. Such responses have probably evolved to deal with short term pain in which tensing the muscles might restrict blood loss and thinking the worst would release adrenaline to help us get through the pain and to safety. However, for long-term pain, it is a badly maladaptive response.
Instead of letting our automatic bodily responses rule us, it is possible to use our mind to direct better behaviour which can reduce the amount of suffering we experience. This knowledge is what is taught in pain clinics which are now available in most areas of the UK, reducing the amount of medication which is needed for pain relief and giving control back to sufferers of chronic pain. The advice is counterintuitive but nonetheless effective for that – we need to bring our attention to the pain itself and relax into it.
I can imagine that for most of us, the idea of relaxing is not our first thought when we are experiencing chronic pain in our back, neck, legs or wherever. However, the advice is sound. Buddhist meditators have long known that both physical and mental experiences tend to diminish when approached with an attitude of acceptance, and persist when pushed away. The same method is utilised here. Viewed from a mental distance, pain usually appears as a solid unchanging block of soreness and not something that we would like to get closer to. By bringing out attention to the pain, though, it can be seen that the reality is rarely like that. Pain levels will vary over time and also around the area it is felt. Some parts will be tenser and sorer than others, sensations will vary and some might actually be almost pleasant. By relaxing the breath and gently maintaining the attention on the painful part(s) of the body, pain can usually be felt to soften. It rarely disappears altogether, but most people usually report an improvement in their ability to manage pain by using this kind of mindful approach of accepting rather than rejecting their experience. In physiological terms, a relaxed person will have dilated blood vessels which accelerates healing processes just as being blood deprived will increase levels of pain. Breathing slowly will further increase the level of relaxation and ability of the body to heal, and also tends to lead to far less negative thoughts being produced and a more realistic attitude.
Vidyamala reports two kinds of responses she has noticed that people develop in response to pain. One is blocking it out through distracting behaviour (talking, working, watching endless amounts of television, drinking etc) and the other is drowning in it. Blocking is best dealt with by using the mindfulness approach I have detailed above, whereas when a person is overwhelmed by the pain (drowning) they need to focus on external things more, especially small moments of joy. Although the distraction behaviour of blocking may be seen to work in the short-term, it is impossible to block out the bad stuff forever (and this applies to other negative things happening in out lives as well as physical pain). In the quiet moments we will come face-to-face with what we are seeking to avoid. As a pain avoidance strategy, blocking can also make us numb to the pleasures of life as well as the bad parts. If we are intent on not noticing bodily sensations then the feel of our head on a pillow as well as any other pleasurable sensations will also tend be to become dulled or missed altogether.
Dealing with pain is something I have been interested in for quite some time in relation to my own chronic affliction, and is what originally lead me into Buddhism. As a spiritual path which arose from the need of one man to find a way out of suffering, how we deal with pain was also a topic close to the Buddha’s heart. The Buddhist approach of gentle acceptance is a good one here, and being in the moment also removes comparisons of whether the pain has lessened or improved and just takes it as it is. If we can have compassion for ourselves and the pain we experience, then this can help us to deal with injury and illness in a positive way. It often also leads to the development of compassion for others in the same or similar positions.
Having experienced physical pain on a pretty much day-to-day basis for the last 14 years, I can tell you that changing your approach to pain does not happen overnight and there are still many times in which I recoil from what I am feeling. Usually I am able to come to my senses and accept what is happening and know that they are just sensations like any other. Pain can be very wearing on both the body and mind, though, and using distraction as a technique to take a break is no bad thing as part of an overall strategy.
The good thing is to know that you have a choice in how to deal with your pain. You don’t have to suffer. Through the practice of gentle mindfulness, the majority of pain, which is not so severe to be completely overwhelming, can be transformed into something which is a least bearable and enables you to carry on living your life.