Being here: A Buddhist approach to pain

Twenty-four years ago, when I was sixteen, I lifted someone out of a swimming pool in lifesaving practice and seriously injured my spine. The injury left me with constant pain that has gradually worsened over the years. This injury, and an additional spinal injury in a car accident five years later, have changed me into a more thoughtful person. I went from being an athletic, active young woman who had not had to think deeply about life, into a woman facing intractable questions about the nature of humanity, sickness, aging and the inevitability of human suffering.

My main area of inquiry has been exploring the distinction between unavoidable suffering that is a natural consequence of having a body that will get ill and age, and the sharper suffering of reacting to this fact. Is this secondary level of suffering – either pushing away unpleasant experience or blindly grasping after pleasant ones – at the root of the restless unhappiness and discontent we so often feel? How do we transform this knee-jerk reactive momentum and create instead a sense of space and the possibility of choice in each moment, no matter what our circumstances? Is this what the spiritual life is essentially about? Is the key to freedom?

In my case the options are stark and immediate: do I have physical and mental misery, which is truly horrible; or do I have physical pain and a sense of space and choice in my mental and emotional responses? I cannot make the pain go away, but I can change how I respond to it. The motivation for finding a creative, positive response is extremely high. This need for creativity in our responses applies to all of us. It is just particularly obvious to me in my circumstances.

These are big questions, but ones I feel fortunate to have had to face, despite the inner struggles they provoked. I would never have had the strength to choose such intensity if there had been an alternative, yet, in a strange way, the pain that is so hard to live with is the very thing drives me closer to the truth of the human condition. That is what keeps those searching questions constantly alive. Sometimes I feel impaled on these questions about the nature of life and human suffering, but the more I grapple with them – probing them, taking them deeper – the closer I am to coming to terms with life, just as it is, and finding peace and understanding.

Although I had experienced physical pain since my first injury, these deeper reflections on responses to pain didn’t emerge in any conscious or urgent sense for 10 years, when I became very ill. Prior to this I had never dealt with my condition nor faced it in a mature way. I lived in an invented reality much of the time that pretended the pain wasn’t real and simply blocked it out with medication and unawareness. I was able to keep this up for a decade but then, inevitably, came a time of reckoning.

I was 25 years old and in an intensive care ward with neurological complications and acute pain. I was plunged into a strange and frightening world. Perhaps the shock of what was happening shattered my defenses for a time – I am not sure – but I had intense and vivid experiences that changed the course of my life. The way I perceived the world suddenly altered, and I see my spiritual life, in any conscious sense, as having started at that time.

The experiences were so intense and vivid that I could not but be changed by them and they have informed much of my questioning ever since. Of course I did not sustain the acuteness of perception that arose in that life-and-death time, but the memory of those perceptions has driven much of my subsequent practice. Since then I have been on a quest for truth, wishing to live more and more in harmony with the human condition in all its complexity.

I had four experiences in hospital. The first was when I understood for the first time the necessity of taking responsibility for myself. I was confronted with the medical reality that there was no wholly successful treatment for my condition and that at best I should think about coming to terms with it – “management” rather than cure. It was the first time in my life that the concept of taking full and complete responsibility for myself held any weight. Until then I had indulged the fantasy that my difficulties would just go away, or I bargained, or I lived in plain, deluded denial of what I was experiencing.

It was shocking and difficult to realize “this is it” – that my life did indeed contain physical pain and limitation when I was only 25 years old. It was extremely hard to let this fact in, but even then I knew there was something liberating in beginning to acknowledge this; and I felt galvanised to make the best of my life. Looking back I could see that in avoiding responsibility for myself I had precluded the possibility of improving my circumstances because I had essentially been passive. It was vital to realise this.

The result of the second experience was that I made an active decision to move towards life. I woke up one morning and felt sort of distant and thin. I felt that I could easily let go of my life if I so chose. I looked out of the window at the city of Auckland and it seemed far away and unreal. I felt gripped by a huge, existential choice. Did I want to live, and take responsibility for my life, or did I want to give up and die? I felt that if I had chosen death I really could have died. I don’t know if this is actually true but it was certainly metaphorically true. It is quite possible to be spiritually dead while physically still alive.

At this crucially important axis I made a decision to live, and my life has felt qualitatively different ever since. It is as if prior to that point I was alive because I hadn’t got around to dying, but since then I have been alive because I have actively and consciously chosen to be. Some weeks later I remember driving along Ponsonby Road, a main thoroughfare in Auckland, and looking at my hands, alive and vital on the steering wheel. I became acutely aware that the next time I confronted death I might have no choice about the outcome and I realised I’d better make the most of my life now I had chosen to live it.

The third major experience occurred during one long, long night. This was when I glimpsed for the first time, with a shattering impact, the meaning of living in the present. I had had a medical test during the day that meant I had to sit upright in my bed overnight. At this stage I hadn’t sat up for months because of the severity of my back pain. It seemed impossible and yet I had no choice. I was between a rock and a hard place.

I was in an intensive care ward, surrounded by critically ill people who were moaning and fighting death. It was like a hell realm. I had never been in this sort of situation before, so there was also the shock and bewilderment of unfamiliarity. In the midst of all this suffering, there I was, sitting up in bed, wide awake, wondering how I could possibly survive the next few hours, and willing myself just to cope.

I spent some hours on what felt like the edge of madness debating with myself whether I could get through the night – one voice saying, “I can’t do this. It is impossible. I can’t last until morning. I’ll go mad.” Another voice was saying, “you have to” over and over again, for what felt an age. It was one of the most intense and demanding experiences my life.

Then, suddenly, out of that chaos and tightness there irrupted a sense of lucidity that contained the message, again as a voice: “You don’t have to get through till morning, you only have to get through the present moment.” Simultaneously my experience completely changed. It was like a house of cards collapsing, and all that was left was space. Suddenly the moment had changed from an agonised, desperate, contracted state to one that was soft, full, relaxed and rich – despite the physical pain.

In that second I knew I had experienced something real, reliable and trustworthy. I also intuited that I would spend the rest of my life making sense of it. It contained such questions as, “What is time? What is space? What is the past? What is the future?” But these questions came later as I considered the experience more conceptually. In the experience itself there was just a knowledge that much of my pain and distress were caused by my reactions and fears, along with a knowledge that I could be utterly free of these things. I also saw for the first time that “the present moment is always bearable”, and this continues to sustain me all these years later.

The fourth experience occurred some days later and was the first time that I clearly understood that it is possible to be mentally creative and work consciously with the mind in order to transform one’s experience and perception – even in the grip of physical pain. It occurred when the hospital chaplain, an elderly Anglican, came to my bedside to offer help and guidance. I was not a believer in any sense of word, but none the less he gave me a tremendous gift. He took my hand and led me through a guided meditation in which I experienced peace and joy, even while in a lot of pain.

My curiosity was aroused by this initial experience of meditation, and after going home from hospital I had a very good social worker who helped me further that interest. With meditation I sensed I had been handed a key that could help me make sense of what I was dealing with. I spent a year or so lying for hours a day on my bed at home exploring my mind and its reactions and responses, while gradually physically rehabilitating myself. I attended the Auckland Buddhist Centre a couple years later and at last found a context to make sense of what I had uncovered. This process of exploration still continues some 13 years later with the help and guidance of the philosophy and methodology the Buddha taught.

As the years go by I’m clearer about what essentially I am working on with the “physical pain practice”. It boils down to aversion and reactivity. I experience something I dislike in the form of physical pain, so I react with aversion – sometimes grossly, sometimes more subtly. It is as simple and destructive as that, and my moment-by-moment practice consists of trying to re-train this negative attitude and instil a more positive response.

This is what we are all up against in life. I happen to have back pain that makes what I am up against very obvious, but we all have aspects of our lives that we find unpleasant – from the sharp pain and bitter loss of the death of a loved one to the milder frustrations of being stuck in a traffic jam on a winter’s day in a car without a heater. And we all have the basic tendency to push away what we dislike and thereby to increase the experience of tightness and restriction – pulling tighter the densely woven layers of unhappiness.

I was very fortunate to glimpse a more creative perspective in hospital all those years ago. My daily task ever since has been to transform my moment-by-moment reactions so that gradually I can cultivate a positive mental state even when my body is causing me trouble. We all have situations every day in which we can’t make pain disappear, and we will have them as long as we live in this unstable world. But in this very instability we can always find freedom in our responses. We can change our experience of pain – be it mental, physical or emotional – from a “thing” we recoil from into a dynamic and fluid experience of the rising and falling moments of sensations within a broad and gentle awareness.

Change comes slowly, imperceptibly, like building a mountain out of grains of sand. It is not easy. Sometimes I am shocked at how insistent and seemingly intractable the knee-jerk reactions are, how loud the voice in the night that says ” I don’t want this.” But one thing that gives me heart is the confidence and strength that arises when I am able to meet what is happening with honesty – even if it is difficult – neither cutting off from the experience nor indulging it. Just letting it be there as a momentary experience that has space around it and choice within it.

It is said that when Atisa, a great Indian Buddhist teacher, went to Tibet to teach the Dharma he took his tea boy along with him because he found him so irritating and difficult to get along with. Atisa was concerned that he might not have enough irritants in Tibet and he wanted to maintain an edge in his practice. He wanted to see when he reacted and to release the energy tied up in those reactions. I am heartened by his story; it shows me how working with pain keeps me honest because the taste of aversion is never far away, so the opportunity to transform it is always nearby as well.

Say I am sitting with a friend in the sun. Yes, there is physical discomfort, but there is also the pleasure of being with a friend, the sensation of the sun, the awareness of the environment, feelings of love. It is interesting to see this. I think we often become miserable because we have an unwillingness to engage wholeheartedly with life as it is happening now and experience its freedom and abundance no matter what our immediate circumstances. The possibility of there being a spacious, beautiful quality to life is present in all circumstances for anybody. I am sure of this.

Another way of “using” personal suffering is to see it as a moment of empathy with others who are suffering. For me, this is the most tender and fascinating aspect of living with pain, and it goes to the heart of our shared humanity. When I have been able to stay in touch with my own suffering in the moment with a light and kindly touch, I have felt that I sink through the particulars of my own condition into an empathy with that which is universal. I feel in touch with all beings that suffer and I care deeply about them. We no longer feel so separate.

First published in ‘Dharma Life’, Winter 2000