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by Shinzen Young
The Good News and the Challenge
As soon as pain arises in the body, our minds become preoccupied with how to get relief. If we can remove the cause of the pain or numb it with analgesics, well and good. But most people, at some time in their lives, face significant pain from which they cannot escape, and millions of people, victims of disease or injury, must live each day in unavoidable and often excruciating pain.
If we cannot escape from the pain, must we then experience abject and meaningless suffering? No, there is an alternative, a way to escape not from pain but into it. We can apply mindfulness meditation to the pain.
Mindfulness meditation is a way of focusing awareness on the pain and observing it with precision, while at the same time opening up to it and dropping resistance. As we develop this skill, the pain causes less suffering, and may even "break up" into a flow of pure energy. This may sound too good to be true, but it is a fact that has been discovered by thousands of people. The technique of mindfulness takes time, effort and determination, but anyone can learn to develop this skill with regular practice. I want to be honest with you though. Managing pain through meditation is usually not a quick fix. But that is compensated for by the fact that it is a deep and broad fix. What I mean by "deep and broad" should become tangible to you as you proceed through this article.
The meditative approach to working with pain presents us with two challenges. The first challenge is conceptual: to understand the pain process in a new way, radically different from the usual. Often it takes time and struggle before this new paradigm is accepted, but it is well worth it, because this new way of looking at things gives us so much power and clarity.
The second challenge is practical: to acquire the focusing skills and concentration needed to experience pain in a new, empowering way. This involves the systematic, sustained practice of mindfulness exercises such as those given on the tape series Break Through Pain.
Pain comes in various "flavors" or types, such as burning, aching, shooting, itching, pressure or nausea. A person may experience several flavors simultaneously and a given flavor may vary in its intensity. For example, an burning may range from mild to fainting intensity.
What makes the method of "observing and opening" so extraordinary and powerful is that it works for all types of painful experiences, regardless of the type of pain, its intensity, or its cause: injuries, allergies, menstrual cramps, chronic fatigue syndrome, back pain and even the pain of terminal illness, such as cancer or AIDS. Indeed the same basic concepts and skills work equally well when applied to emotional pain such as anger, grief, fear and guilt.
What exactly do I mean when I say, "It works?" First, this method reduces the suffering caused by the specific pain you are dealing with. Secondand this is the really important pointworking with your pain in this way fosters rapid personal evolution. It is a way to release psychological and spiritual blockages, a kind of deep and permanent cleansing of the very substance of your soul. To borrow language from the Christian tradition, the experience of pain stops being "hell" (that is to say, meaningless suffering), and turns into "purgatory" (a purification which opens the way for direct encounter with the spiritual source).
As a result of this purification you will eventually experience an increased sense of oneness and connectedness with all things; a decrease in negative emotions; a sense of happiness independent of your circumstances; and the disappearance of imprints and limiting conditioning from the past. Associated with this transformation of consciousness is a distinct feeling which I call the "flavor of purification." It is the good feeling that comes as a person is experiencing painful feelings in a skillful way.
Once you begin to develop a taste for this flavor of purification, pain, even horrible pain, becomes meaningful. Suffering diminishes and eventually is completely eclipsed by the joy of purification. This is what I mean by escaping into pain. If the pain is severe, and you are able to escape into it, you will experience an egoless state, a direct communion with the spiritual source.
The method of mindfulness applied to pain may appear to be very challenging. At first you may not have good concentration. Your mind will wander a lot and you will have to bring it back over and over again. But just as in any other exercise, skill comes with time and practice.
Short Example of How to Meditate on Pain
I would like to give you a tangible sense of the experience of mindfulness. Close your eyes and let your whole body relax and settle in. Pick one area where pain is significant.
Get a clear sense of the size and shape of the painful region. Is it long, round, triangular or some other shape? Is it flat like a pancake or does it have a three-dimensional volume? Is it uniform or does it have areas of greater or lesser intensity within it? Are its borders sharp or diffuse? Does it spread any influence through the body or is it completely isolated? --- You now have a much clearer and more precise sense of the painful sensation.
Now observe even more carefully, as though the pain were a living being in its own right, as though it were, for example, a lizard on a wall. How and when will this creature move? Will its borders change? Will it get stronger or weaker? Will its center shift? Watch very carefully for a while and notice that every few seconds the pain may change, if only in a tiny way. Every time the pain changes in any little way, relax your whole mind and body into it and just observe it without judgment. You may have to try this exercise many times but eventually the pain will reveal its wave nature. When it does, surf the waves!
This is a first step in developing the skill of mindfulness of pain. It is true that sometimes the pain may seem to get worse as you focus on it. This, however, is a temporary phenomenon.
How Pain Becomes Suffering
In order to understand how pain becomes suffering, you need to know a deep truth about the nature of suffering. Most people equate suffering with pain, but suffering is a function of two variables, not just one. Suffering is a function of pain and the degree to which the pain is being resisted. (S = P x R)
Your nervous system has built-in structures that produce and transmit pain signals. We might refer to them as "pain circuits." They are part of you, and left on their own, they function spontaneously and effortlessly as part of the flow of nature, like wind through the trees or ripples on a lake. They have one job and one job only: when stimulated they produce a kind of energy wave which we humans call "pain."
But as the result of a long conditioning process, human beings have also developed another part of ourselves, "resistance." Resistance interferes with that energy wave, fights against it, tries to beat it back. Thus deep within our being there is a kind of violent conflict, a veritable civil war between two parts of the same system.
This produces a pressure called "suffering." Since suffering is produced by one part of you fighting with another part of you, there is obviously a deep link between the physical process of learning to experience pain without suffering and the psychological process of becoming more integrated.
According to this view, resistance is a kind of internal friction; the system is grinding against itself. Such friction produces useless suffering and wastes physical and psychological energy.
Resistance occurs in both the body and the mind, and may be either conscious or unconscious. Conscious resistance in the mind takes the form of judgment, wishes, fearful projections, etc.: "I hate the pain. I can't stand this pain. When is it going to stop?"
Conscious resistance in the body takes the form of tension and holding. You have pain in the leg, but you may be tightening the jaw, tensing the breath, perhaps clenching throughout the whole body, not letting the pain spread and circulate. "Opening to the pain" is the practice of dropping the conscious resistance by letting go of the judging thoughts and continually relaxing your whole body as much as possible.
As for the unconscious resistance, by definition we have no control over this, as it occurs in the deep preconscious level of neural processing moment by moment. However, careful observation of the pain allows the unconscious to gradually unlearn its habit of resistance. This is why the practice of mindfulness involves intently pouring awareness on the pain as well as "opening up" to the pain.
The formula "suffering equals pain multiplied by resistance" contains both good news and bad news. The good news is that (at least in theory) no one ever has to suffer, because resistance can be made very small and eventually be reduced to zero through mindfulness exercises. When the resistance factor becomes zero, suffering is zeroed out, no matter how big the pain factor may be.
What's the bad news? In many cases resistance grows if the pain persists. Even though the pain may stay the same, the perceived suffering becomes unbearable because the resistance has become so large. Furthermore, according to this formula, even tiny subliminal pain can cause immense suffering if you strongly resist it. The suffering that underlies many forms of compulsive behavior such as substance abuse is often caused by subtle subliminal pain that is subject to immense subconscious resistance. In working with pain remember: subtle is significant!
Dropping resistance to the subjective flow of pain in no way implies that you stop resisting the objective source of the pain. In fact, as you get more and more skillful in opening to the pain, the energy that was being wasted in fighting with the pain is now freed up to fight for recovery and to live your life despite the pain. Although you need not necessarily surrender to the objective situation of being ill, you do surrender to the subjective sensations of pain that the illness causes. This reduces your suffering and increases your energy.
Pain Without Suffering
Although the suffering diminishes as resistance drops, the pain may stay, preserving the proper function of pain as a warning, motivation, etc. In other words, it is sometimes necessary to feel pain, but it is never necessary to suffer.
Pain informs and motivates; suffering drives and distorts. Pain experienced skillfully brings us closer to our spiritual source; suffering alienates us from our spiritual source and our fellow human beings. Suffering obscures the perfection of the moment; pain experienced skillfully is the perfection of the moment.
For most people the notion of pain which is not suffering may sound like a contradiction in terms. People have difficulty imagining what the experience of pain without suffering would be like. Does it hurt? Yes. Is that a problem? No.
People have difficulty understanding this because they are not familiar with the experience of pure pain, that is, pain without resistance. Since much of our habitual resistance to the flow of pain begins at the pre-conscious level, by the time we consciously experience a wave of pain, it has already been converted into suffering by unconscious resistance. In other words, most of us cannot remember experiencing pure pain. What people call "pain" is actually a combination of pain and resistance.
I might add that most people are also not familiar with the experience of pure pleasure. What people call "pleasure" is actually a mixture of pleasure and grasping. Just as consciousness is purified by experiencing pain without resistance, it is equally purified by experiencing pleasure without grasping. The dropping of resistance to pain and the letting go of grasping onto pleasure are sometimes called "equanimity."
Pain and Spiritual Purification
Many spiritual traditions involve the practice of asceticism, which means voluntarily taking on discomfort or deprivation. The hair shirt and self-flagellation of Christian Europe, as well as the sweat lodges and sun dances of the Native Americans, are examples of asceticism.
Unfortunately even people who practice asceticism sometimes do not clearly understand the underlying principles. This has led the entire endeavor to be looked upon as somehow perverse. It is often said that the Buddha rejected asceticism. I would rather say that he refined it, both conceptually and in terms of practice. Crude asceticism often involves a sense of oneself being sinful and worthless or an attempt to get tough or to achieve special powers through inducing altered states. But properly understood, asceticism is done for spiritual purification, i.e. softening the substance of the solidified self.
Pain multiplied by resistance equals suffering, but pain multiplied by acceptance equals cleansing. This tells us two important things. First, when pain is very intense, if you are able to maintain even a small degree of acceptance, then purification is still going on; that is, the pain is productive and meaningful. Second, even a small pain can bring significant purification if your attentiveness and equanimity are high. Thus, even though you may never do intense practices such as the Christian renunciates or the Native American spiritual warriors, you may attain comparably deep purification. This can be achieved by bringing an extraordinary amount of openness to the ordinary aches and discomforts of daily life.
Once you clearly understand that pain multiplied by equanimity equals purification, you are able to make a "conceptual reframing" of the pain. You are able to sacramentalize it, to see it as a kind of imposed monastery or sacred ceremony. Seeing pain as a natural monastery or imposed retreat for spiritual growth is particularly significant for those in chronic pain.
I have spoken of mindfulness meditation as being composed of two elements: an opening up to the pain, and a careful observing of the pain. The opening up fosters a process of spiritual purification. The careful observation leads to deep insight. This insight is like a many-sided jewel. One facet of this jewel is insight into impermanence.
Pain and Impermanence
I sometimes ask my students an odd sort of multiple choice question: Are the mountains moving? The possible answers being yes, no and it depends. I suggest that the correct answer is "it depends." It depends on how carefully and patiently you observe the mountains.
Certainly from the ordinary scale of time and space a mountain seems very solid. Indeed, mountain is a metaphor for permanence. Yet, viewed microscopically, even mountains are a dance of energy. Vibrating molecules are made up of even more rapidly vibrating atoms, which are made up of even more rapidly vibrating particles, and so forth, and viewed with the patience of centuries, the earth's surface resembles rippling protoplasm.
In the same way, your pain may seem as solid and permanent as a mountain. But as your powers of observation sharpen and your patience grows, you begin to perceive aspects of change or impermanence. The sensation of pain shifts shape or position every few seconds, becomes stronger or weaker, expands, contracts and circulates. Flavors change; a burn becomes an itch, the itch becomes a pressure, and so on. Eventually you come to realize that even the most horrible pain is in fact made up of pure vibrant energy. At this point, not only the pain but the whole sense of a suffering self dissolves and becomes part of the flow of nature, as effortless and refreshing as ripples spreading on a pond.
As insight into impermanence deepens you come to realize that not only pain, but indeed all seemingly solid experiences, are in fact elastic, vibratory, porous and transparent. With this realization, your understanding of yourself and the world goes through a remarkable and empowering shift in perspective.
This is analogous to the paradigm shifts of modern physics. The material body dissolves into a field of energy. The self as a separate particle dissolves into a vibrating wave which can unite both with your spiritual source and with all things. You become spiritual in the literal sense of the Latin word spiritus, which means "breath" or "wind," something insubstantial yet powerful.
Begrudging Down Time
Now I'd like to cover a few specific areas where people often have questions about working with pain. For instance, people often resent the fact that the pain takes time away from life, preventing them from participating in the meaningful activities of work and play. And indeed, unless you understand how to use the situation to evolve and purify consciousness, time spent in pain is mostly wasted and meaningless.
Fortunately, you can make a "conceptual reframing" of the meaning of time spent with pain. If nature (or "God") has given you so much pain that you cannot do anything else other than be with it, then there is a message here: you are not expected to be doing anything else!
In other words, spending timeeven long periods of timejust feeling pain is a legitimate calling in the eyes of God and nature. Assuming that you are making at least some effort to purify and evolve consciousness by being with the pain in a skillful way, you are engaged in productive and meaningful work. You perform an important service to others by becoming an example to them, a source of hope, inspiration and empowerment.
Consider even the most extreme case, a person in so much pain that they can do nothing but lie in bed, seeing very few people, perhaps with no prospect of recovery, perhaps dying. You might think that in such an extreme case, even if the meditation were to help the victim, there would not be any broader benefit to humanity, but this is not necessarily the case.
Some scientists postulate the existence of "morphogenic fields." Put simply, this theory states that whenever a person does something, it makes it easier for all others to do the same thing, even though the others may have no direct contact with or even knowledge of the original person's work. This is sometimes referred to as the "hundredth monkey effect." According to this theory, a person isolated and cut off from contacts, who is working to purify through pain, is in some way making it easier for all other sufferers in the world to do the same; a worthwhile and meaningful job indeed!
When and Where to Meditate
People sometimes ask me, "How many hours a day do you meditate?" They are, of course, referring to the amount of time I spend in formal sitting practice. I answer, "Usually about an hour a day," but often I feel like saying, "I meditate twenty-four hours a day, hopefully." In other words, meditation can be carried on during the daily activities of life, as well as during set formal periods. Both forms of practice are useful.
If your focus of meditation is pain, then you can be meditating any time you feel the pain, because whenever you are observing and opening to it you are by definition meditating. If pain is always present, then you have a reminder and motivation to be in a meditative state all your waking hours, like the monks and nuns in monastic training. For you, pain is your monastery. This is another way in which your pain can be looked upon as an ally.
Of course it takes practice to meditate on pain while at the same time engaging in other activities. At first it will be challenging enough to meditate quietly by yourself, but as the state of concentration becomes habitual, you will be able to meditate in the midst of life activities.
Try to set aside a period of time most days for formal meditation, perhaps a half an hour each morning. Of course, if your pain prevents you from doing other activities, you may be formally meditating for many hours each day. You can meditate sitting in a chair, on the floor or lying down. During your periods of formal meditation, make sure that there will be no distractions. Turn off the phones. Let friends and family know that you need to be alone for a period of time.
Meditation is a state of both relaxation and alertness. If you meditate in a seated posture, try to keep the spine straight. This will help you to remain alert. If you meditate lying down, you must have very strong determination not to let your mind sink into sleepiness or even fuzziness. If you become even slightly drowsy, open your eyes and stare at infinity without getting involved with visual objects. This will help you remain aware and alert.
Some conditions that produce pain are made worse by prolonged periods of motionlessness. If this is true for you, be sure to move appropriately. But in between moving, try to be very still and focused.
The most important moment in any period of formal meditation comes when you get up to resume your daily activities. Your ability to maintain a meditative state throughout the day (and hence reduce the suffering from your pain) depends on how you handle this transition. Instead of thinking, "The meditation is over, now it's time to do this or that," think, "I have become somewhat more calm and focused. Now my job is to try to preserve this state."
During the day, whenever you become agitated or start to suffer a lot from pain, drop everything for a few minutes. Sit down or lie down and do a short but high quality "mini-meditation" to re-ground yourself. Do this as many times a day as needed throughout the day.
The combination of setting aside at least a half an hour each day for formal meditation together with frequent mini-meditations will eventually allow you to maintain a state of deep calm and high focus for much if not most of your day.
Melting and Freezing
I'd like to say a few words about the phenomenon of "melting and freezing." Sometimes as you are observing and opening to the pain, you may experience the pain softening. Sometimes it softens just slightly, flowing like thick molasses or lava. Other times it may become quite fluid and vibratory, expanding and contracting like an amoeba or even breaking up into a shower of champagne bubbles and subtle energy like an atomizer spray. If that happens, enjoy it and concentrate on the vibrations and undulations, letting them relax you, massage you, and take you into a place of peace and safety.
After long and consistent practice of mindfulness meditation, such experiences of impermanence happen more frequently. However, it is of the utmost importance not to make this the goal of your meditation. The only goal is to do your best to observe carefully and to open to the pain as it is. Whenever you do this, you are helping along a natural process of purifying and evolving yourself, whether or not you consciously experience any change in pain at that moment.
Along the course of this purification the pain may melt, but it may also "freeze up" again for various lengths of time. When the pain "melts" there is a tendency to think that the meditation is working, that you're making progress, or that you're doing it right. But if the pain "re-freezes," you may think the meditation is not working or that you are doing it wrong. Always remember the definition of a successful meditation session: a successful meditation is any meditation you did!
Consciousness is a many-layered structure. Like the geological strata of the Earth, the deeper layers contain older fossils. As you are pouring clarity and openness on your pain, the pain is actually functioning as a conduit or tunnel into the deepest reaches of your subconscious mind. As a layer of psychological blockage comes to the surface, it may cause the pain to solidify or get worse. Just open to that and keep on observing as much as possible, without an agenda that the pain soften or go away. It is part of nature's wry sense of humor that the quickest way to "break up" pain is to observe it without the slightest desire that it be different in any way.
So if the pain melts and then gets hard and harsh once again, you have not gone backwards, but rather a deeper level of blockage has percolated upward. You may go through many cycles of softening and re-congealing. The English poet, T. S. Eliot, who was also a Christian mystic, vividly described this aspect of the spiritual path in his "Four Quartets," where he writes, "Between melting and freezing, the soul's sap quivers."
When pain is extreme, you may feel like you are going to faint. Lie down and open up to that. Try to maintain your meditation technique through the fainting. Then the fainting will turn into an experience of deep meditative trance. You will feel that you have gone beyond the body and transcended suffering.
Admittedly this can be very frightening. It may take some practice before you can really "let go" into the faint. Eventually you will learn that there is nothing whatever to fear, as long as you keep a level of mindfulness and openness.
Primary Pain and Secondary Sensations
I would like to mention an important phenomenon which I call "secondary sensations." In addition to the primary sensation of pain, you may have secondary sensations such as heat, nausea, fatigue, agitation, heebie-jeebies, jerking, creepy-crawly feelings, etc. You may feel like your marrow is itching everywhere, bugs are crawling in your veins or that you're going to jump out of your skin. You may have pressures or tensions over your whole body. In some ways this may seem worse than the pain itself. These global secondary sensations are sometimes quite subtle. Remember, subtle is significant!
Often these secondary sensations are associated with emotionally charged resistance to the pain. Try to notice that your fear, hatred or annoyance is not continuous but tends to well up then subside for a moment then well up once again. As an experiment, feel your whole body and carefully observe what happens there each time annoyance or hatred of the pain arises. You may feel a wave of sensation spread for a moment through your body, perhaps so subtly that you aren't even sure it was there. That is the secondary sensation associated with resistance. Try not to resist the resistance!
Treat these secondary reactions in the same way you treat the pain itself. Observe them carefully and open up to them. Indeed, honor and welcome them because they are an important part of the purification process.
There is a deep relationship between these secondary sensations and the process of releasing blockages stored in the unconscious. I don't have time to really explain the theory at this point, but here's the gist, overly simplified.
Physical pain tends to activate your body's subtle memory of past pains, both physical and emotional. These will magnify your sense of suffering from the present pain unless you are able to detect them and open up to them. All you have to do is observe and open up to such secondary sensations the same way you observe and open up to the primary pain. This creates an optimal environment within which your unconscious can unburden itself. For years, unbeknownst to you, these subtle body memories have been continuously subliminally present, preventing each moment from being as fully satisfying as it could be. Now the pain has brought them clearly to the surface where they can be "felt through."
Suffering may warp your perceptions and behavior, and this distortion can be a big part of the horror of the pain. If the pain persists or is chronic, a person may begin to act out of character and alienate friends, family and caregivers. There are a number of ways to deal with this.
First, try to remember that it is the suffering which is making the world look so grim and causing you to act out of character. As you learn to develop mindfulness, these distorting effects drop away.
Second, be willing to forgive yourself and others, over and over again. You aren't expected to get it right the first time around. It doesn't matter if you stray from the path, as long as you always return.
Third, remember impermanence. The periods of distortion don't last forever. As the Bible says, "This too shall pass."
Fourth, you can create and use a support structure of individuals and organizations who can give you objective feedback and get you back on track when you become mired in subjective suffering.
What to Do If Meditating on the Pain Makes It Worse
It is important to acknowledge the fact that the act of observing and opening to pain sometimes causes the pain to become dramatically aggravated. The pain may intensify or spread over the whole body. Sometimes it both intensifies and spreads; the hardest, worst flavor of the pain which previously had been confined to one region now fills the entire body, turning it into a single condensed mass of uniform sting. This sounds frightening and would seem to belie the claim that mindfulness helps one to cope with pain. Concerning this phenomenon, which I call "inflation", several points need to be remembered.
First, observing and opening usually lessens suffering. Inflation takes place only occasionally. Many people never experience this phenomenon. Second, when it does happen, it represents a stage in a natural process of liberation. Basically the body has now become a single sensation, unified and integrated. It has become "one", a necessary step before it can become "zero". Many victims of chronic pain are familiar with the cycle of the pain spreading and intensifying before it finally goes away, perhaps over a period of several hours or several days. The seeming aggravation of the pain as the result of meditating is in fact just the speeding up of this cycle. If you can somehow keep meditating through this inflation, the pain does not merely go away, but rather "breaks up", leaving insight and purification in its wake.
This should not be taken to imply that you must necessarily keep meditating on the pain if meditation is causing it to intensify and spread. When to do so is a subtle decision and depends on many factors. Allowing the pain to inflate too much too soon may create aversion to the meditative process or use up valuable energy that you need for healing or life's activities. So sometimes you may want to switch to a different kind of meditation, one that relaxes you or perhaps focuses away from the pain. You may even need to stop meditating entirely for a short time; use your own judgment.
When you finally do gain enough experience to stay with the pain no matter how much this worsens it, something like the following will happen.
Time slows down, the thinking mind more or less shuts off, the external world fades and the sense of a controlling self is neutralized. The entire stinging mass of the body slowly begins to lose its rigidity and to flow, first like dense lava then like honey each wave of sensation seems to break up another kink in the substance of your soul.
The perception of the body "being material" is in fact produced largely by our habit of congealing around the flow of body sensation. The inflation of pain brings the body to a state of maximum uncontrollable congealing. When this finally gives, one comes to understand that there never was a "material body" in the ordinary sense. Body is just coagulated spirit.
Summing It Up
As soon as pain arises in the body, the mind becomes preoccupied with how to get relief. There are two kinds of relief, both of which are valid. There is the temporary relief that comes through eliminating a particular pain, and there is the permanent relief that comes through retraining your relationship to any and all pain. If temporary relief is not possible, then become ardently preoccupied with the noble quest for permanent relief!
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