The Problem of Pain

The Buddha taught that the existence of pain is something we have to accept. Now, it’s true that we can do away with some of our pains with medicine or by changing our position, but there will be other pains that we cannot avoid. And it’s the case that we’ll have to meet up with pain in meditation, especially as we sit still for long periods of time. You may ask, “Why do we have to put up with the pain?” Part of it is in getting the body used to sitting in this position, because it’s a good position to sit in for a long period of time. It gives a balanced sense of space to all the organs in the body.

When you’re not accustomed to this position, there’s the initial problem that the blood in some of the major vessels in your legs or back gets blocked and pushed into the capillaries. That can be painful. But if we sit in this position long enough, the little capillaries begin to expand. Essentially, you reroute the blood down the back and the legs as the capillaries become larger vessels. So there’ll be a period of pain as you’re breaking the body in. With repeated practice, though, pains of this sort goes away.

However, there’s another reason why we sit with pain, and that’s because we need to understand how the mind relates to pain. When you figure that out, you can learn how not to suffer from pain. You get to see how your perceptions and the stories you tell yourself about the pain—your verbal and mental fabrications around it—are actually what make you suffer much more than the physical pain itself. And those are things you can change so that you don’t have to suffer even when physical pain won’t go away.

So even though we have to accept the fact of pain, the Buddha doesn’t leave us defenseless against it. He said we have to learn, when we experience pain, how not to let it invade the mind and remain. When we can see the pain as one thing, the body as another thing, and your awareness as something separate from both, then we can be with the pain without letting it invade the mind.

The first step in this direction is to realize that the pain doesn’t actually invade the mind of its own accord. We pull it in through our perceptions and thought fabrications: the images we have of pain and the stories we tell ourselves about it. So the key to keeping our minds uninvaded will be to perceive and think about the pain in new ways.

Unfortunately, the Buddha doesn’t give us detailed instructions on how to do this. He does, however, note that body, feeling, perceptions, thought constructs, and consciousness are all separate events. That gives us a clue as to how to take apart what seems to be a tangled mass of physical and mental pain. He also gives us a general outline of the steps for dealing with pain in the four steps of breath meditation associated with feelings as a frame of reference.

The steps are these:

Those are the four major steps.

For more detailed instructions on how to use these steps in dealing with pain, we have to look to the teachings of the forest ajaans. There we find that Ajaan Lee focuses most on the first two of the steps, being sensitive to rapture and pleasure, although he also gets you started on the remaining two steps, being sensitive to how feelings and perceptions affect the mind and learning how to calm that effect. Ajaan Maha Bua focuses a lot of attention directly on those last two steps,

Ajaan Lee starts by saying that when there’s pain in one part of the body, don’t focus there. Focus instead on the parts of the body that you can make comfortable by the way you breathe, and then make those the basis for your concentration. For the time being, you can let the pains be in the other part. The image he gives is of going into a house where the floor boards have some rotten spots. Don’t lie down on the rotten spots. Lie down on the areas where the boards are sound.

Another image he gives is of eating a mango. If the mango has some rotten spots with worms, don’t eat the parts with the worms. Eat just the good parts. In other words, if the pain is in your right side, focus on the left. If the pain is in the back, focus on the front. If there’s pain in the legs, focus on the torso.

As for generating feelings of rapture, Ajaan Lee equates these with feelings of fullness in the body. You can do a brief experiment with this. Focus on your hands right now. Think of relaxing every little muscle in your hands so as to allow the blood vessels to be totally open, and then they’ll be full of blood. As you breathe in, don’t tense them up. And as you breathe out, focus on not squeezing them. After a while, there’ll be a feeling of fullness in your hands. Let that feeling of fullness stay there for a while, and then think of it going up your arms. Or you can start in other parts of body, such as the little muscles around your eyes or in the middle of the chest, right at the area of the breastbone. Think of those areas being totally relaxed as you breathe in, totally relaxed as you breathe out. As you breathe in, breathe out, allow those areas to develop a sense of fullness, and then from there it can begin to expand.

That’s how you become sensitive to feelings of rapture in the body. You realize that there may not be feelings of rapture when you begin, but there’s a potential for a sense of rapture or fullness to develop. As for feelings of pleasure, these are feelings of ease and relaxation. The rapture is more intense, it’s more full. To induce feelings of ease, think of the breathing process as being smooth and easy: Hold in mind the perception that your body is like a big sponge. When you breathe in, the breath can come in and out of the body through every pore, with nothing to obstruct it at all.

Now, once these feelings are steady, think of the good breath energy going from them through the part of the body that’s in pain—and it’s important that you don’t stop at the pain. Often we have a subconscious sense of a wall around the pain, so you want to penetrate that wall. Suppose there’s a pain in your knee. As the feelings of comfortable breath go down the leg, have them go through the knee and then out the foot. If there’s a perception of a wall around the pain, remember that even stone walls are made out of atoms, and atoms contain a lot of space. Think of the breath going through those spaces.

When you use perceptions like this, you’re actually beginning to move into the third and fourth steps, being sensitive to mental fabrication and calming its effect. Another way to do this is to ask yourself if the pain was in that part of the body first, or was the breath? If your have the perception that the pain precedes the in-breath, that’ll create as sense that you have to push the breath through it, and that can create more tension around the pain. Try changing the perception, telling yourself that the breath was there first, and see if that makes things easier.

Sometimes when you dissolve the walls of tension around the pain, the pain itself will actually go away or get relieved to some extent. And sometimes not. The important thing is that these steps make you more confident in the face of pain. You don’t have to be afraid of the pain. You have some tools to use against it.

When I was a college student, the college allowed the psychology department to call randomly on students to do psych experiments. I was called in once for an experiment after I had learned to meditate. The experiment was this: They had you put your right hand into a pail of ice water and they said, “Imagine that the warmth in your left hand is going to warm up your right hand, and that the coolness from the right hand is going over to the left hand.” So I sat there for five minutes. And they said, “Okay, you can stop now. You’re breaking the curve.” Most people couldn’t do it for that long.

I found out later that they had divided the people coming in for the experiment into three groups. One group was told, “Keep your hand in the ice water until it gets painful, then take it out.” The second group was told, “Try to keep your hand in the ice water as long as you can,” but they were not given any techniques for dealing with the pain. The third group, which I was in, was given this technique to help them endure the pain.

They found that the third group in general was able to stick with the ice water much longer than the other two groups, which shows that if you have a sense that you have some tools to use against the pain, you can actually withstand the pain much more effectively.

Going back to Ajaan Lee’s method: The fact that you have this comfortable spot in the body that you’ve been able to maintain with your breath will help you in the next step, in which you’re actually going to focus directly on the pain. You know that if the pain gets too bad to deal with, you can always go back to your comfortable spot. That enables you to be even more courageous in the face of the pain. Your perceptions about the breath energy also give you some practice for the next steps, which involves exploring the relationship between the pain and your perceptions.

When you feel ready, you can attempt Ajaan Maha Bua’s steps of actually investigating your perceptions around the pain. In other words, this is where we move fully into the steps of being sensitive to mental fabrications around the pain and calming those fabrications. Investigating your perceptions require your asking some strange questions. But only when you ask some strange questions will you uncover the strange attitudes you’ve picked up around the pain.

After all, your first experience of pain in this lifetime was before you even had language. When you were a baby, you had to deal with pain when you couldn’t explain it to yourself, and nobody could explain it to you. So you probably came up with some strange images around the pain, and you may still be relating to your pain in pre-linguistic ways or with some pre-linguistic assumptions.

So, some of the questions you might ask are these: “Is the pain the same thing as the body?” In other words, if there’s a pain in your knee, does the pain feel as if it’s the same thing as the knee? If it does, you can remind yourself that the experience of the body is composed of the four elements of earth, water, wind, and fire: earth, solidity; water, liquid or cool sensations; wind, the feeling of energy; and fire, warmth. Actually, the pain is none of these, but we may have glommed it on, especially to the feeling of solidity. Sometimes pain feels warm, but pain and warmth are actually two separate things.

Another question you might ask is, “Does the pain have a shape?” The pain doesn’t really have a shape, but it may have a shape in your mind. So question the image that “This pain right here is occupying this territory of the body.”

“Does it have any bad intentions towards you?” Question that idea.

“Is the pain solid and lasting? Or does it come as individual moments, arising and passing away?” If you can see it as individual moments, then the next question is, “Are those moments coming at you? Or can you perceive them as going away from you, even as they arise?” Try to see them going away. It’s like sitting in the back of a station wagon—one of those old station wagons with the back seat facing back. You’re going down the road with your back toward the driver, and as soon as anything comes into the range of your vision, it’s already going away.

Years back, I was in Singapore, and one of my students took me to see a Chinese doctor to treat a pain in my back. The doctor started rubbing some oil into my back, and at first it felt nice. Then he rubbed harder and harder and harder until my skin was raw. Then he took some bamboo whisks and started beating my back. My first thought was, “What bad kamma have I done to deserve this?” Then I realized he wasn’t going to stop any time soon. But I also realized that if I had the perception that as soon as the bamboo whisk hit my back, the pain was already going away, it wasn’t coming at me, then I found it much easier to deal with. The treatment took 10 to 15 minutes. It cured the back pain because the skin hurt so much. But I learned a good skill, and I’ve used it ever since.

Another question you can ask is, “Does the pain have one spot that’s sharper than the others?” You find that if you start focusing on finding the sharpest point of the pain, it runs away from you. So you keep following it. You chase it here and chase it there, and in doing that, you’re changing the balance of power. You’re not so afraid of the pain, you’re not trying to run away from it, you’re no longer playing the role of a victim, so it’s harder for the pain to hit you. As you do this, the pain may disappear entirely, and sometimes it disappears in really strange ways.

One time I was chasing a pain in my knee. It stayed in the knee area for a while, and then it went running up my leg into my chest and disappeared into my heart.

So sometimes the pain will disappear. But other times it will separate out. In other words, the body and the pain become separate things. It’s as if the body is here and the pain is there, an inch or so away from it. And your awareness is still something else.

This way, you learn some important lessons about the role of perception in shaping even your most basic and immediate experiences.

You also see how the Buddha’s instructions on dealing with the pain parallels instructions on dealing with the mind. Remember, the steps in taking the mind as a frame of reference are: you gladden it, you concentrate it, and you release it.

Ajaan Lee’s recommendations for establishing focus on parts of the body that you can make comfortable correspond to the steps of gladdening and concentrating. His instructions for using pleasure and concentration to dissolve the shell around the pain, and Ajaan Maha Bua’s instructions for questioning perceptions, correspond to the step of releasing.

In this way, we can see how the Buddha’s instructions for mindfulness of breathing reinforce one another for the sake of building inner strength. They focus your desire for freedom from suffering on how to deal with specific problems of pain and suffering right now, in the immediate present. In other words, his meditation instructions don’t save all their rewards for the end of the path. They can help make you stronger, and they help in releasing you from individual pains, both physical and mental, right here and now.