When Pain Persists: Navigating Life When Suffering In The Body Is Unceasing

Uncomfortable with Discomfort

My relationship with physical exercise is shaky. I am not very fond of energetic physical activity, especially exercises like yoga that need you to bend and lie flat on the floor, contorting my body into various uncomfortable postures.

Around eight years ago, I had a reluctant and rigorous fitness regime with a personal trainer. Because I was strength training various times a week, the trainer urged me to stretch and do yoga at least once weekly. I hesitantly stepped into the fitness studio and positioned myself at the door to walk off quietly if the class became uncomfortable.

A new instructor that day took us through what he called “Yin Yoga”. He got us into various poses and made us stay in that pose for 5-7 minutes! I was restless as soon as the warm-ups were complete and we got into the first pose.  I had a steady monologue in my head, “What nonsense is this? I don’t want to do yoga anymore, even if it means I will be stiff all my life. This is so uncomfortable. This is abnormal; how can I be in the same pose for 5 minutes? I want to get up and go home now. I can’t do this. I can’t do this. I can’t do this…”

I was interrupted by the yoga instructor who stood beside me. “You don’t seem very comfortable.” I glared at him, not trusting myself to say a word that won’t be rude.

“Relax into the pose.”

“How do I do that?”

“Breathe in and go a little deeper. Relax your body; there is no need to hold your body so tight. Just breathe in.”

“I can’t go any deeper.”

“Just try. Breathe and go down a little bit deeper.”

I wasn’t convinced, but he was towering over me, and I had to try. I took a deep breath and let it out slowly through my mouth. I slacked my muscles, and to my great surprise, I went deeper. I was able to stay in that pose for 7 minutes.

I didn’t know then that I was taught my first lesson to lean into discomfort to find comfort. This would come in handy, along with various other practices, many years later as I worked with chronic pain.

The Two Arrows of Pain

One of the most helpful teachings of Buddha that is very relevant to chronic illness (which includes both mental and physical illnesses) is the teaching of the two arrows of pain in the Sallatha Sutta.

The Buddha explains that the experience of pain results from two factors - bodily and mental factors. When something happens to the body and affects the body, the pain is inevitable. This is the first arrow. But when we react to the pain and resist the pain and its experience, we are adding mental suffering on top of the physical suffering.

Jon Kabat-Zinn interprets this teaching in this quote, which is helpful to remember.

Dealing with The Second Arrow

In her book, “How To Be Sick”, Toni Bernhard focuses on how to work with the suffering in the mind when the body is sick and suffering relentlessly.

When you get chronically ill, it takes time to settle in with the reality of the illness and the choices you have to make around it. Your life changes.

Along with physical illness, there is a great deal of change, and not all of it is to our liking. This is fertile ground for mental suffering to multiply and magnify physical suffering.

Toni talks about the core Buddhist teachings and practices that focus on ending or reducing the suffering in the mind. They are

Acceptance of what is

Toni introduces the foundational concepts of Buddha’s teachings, which serve as a base, and practices further illuminate and strengthen. She introduces the three marks of existence to the reader.

She gives us insights and interpretations of these teachings from various teachers, with a key focus on working with chronic illness.

Expansion of what is good in life

When one’s health deteriorates and stays so for an extended period, it also accompanies a deterioration in mental wellness. But it need not be so.

Toni introduces the reader to the concept of sublime states (brahmaviharas) and how the cultivation of these qualities of mudita (sympathetic joy), loving-kindness (metta), compassion (karuna) and equanimity (upekka) can help us work with challenging states of mental suffering.

She also gives a remarkable and insightful way of how to use these practices “on the spot” to work with mental states like envy, anger, and agitation that arise when these arise as a consequence of being chronically ill.

Transformation of Suffering

A consequence of being chronically ill is that it narrows our view of our tiny world. Pain can narrow focus and keep it that way. It becomes hard to see beyond ourselves after a point.

Toni introduces the reader to concepts of how to redirect attention from pain, how to “turn straw into gold”, transform thoughts into making peace with our state as it is, and how to expand our minds and hearts to include everyone else who is suffering just like we are.

Resistance to Being Sick

One of the critical objections that comes when we talk about acceptance of pain as it is, is,  “Should I just accept the pain? Should I not do anything to relieve the pain?”

Accepting the pain doesn’t mean we don’t do anything to relieve it. This book underscores the space and the intention with which we work with ourselves. With chronic illness, most of them don’t have a cure and don’t have straightforward ways of management. We are going to be trying various things that help deal with the illness, but if we are working from a space of acceptance, then we can see things clearly and work with it instead of rushing into doing things out of desperation or denial.

The Choice We Have

We may not always be able to end the suffering of the body, but the end of the suffering of the mind is not so out of reach. We can do so by working with acceptance, expansion and transformation of what is.

Exploration of the book

We will continue exploring this book in the next edition, too.

Write to Me!

I’d love to know if you will pick this book up to read. If you have a chronic illness, please do let me know what would be helpful topics to cover as I write this newsletter.

As a parting thought, I will finish this edition with a story.

The Thief Who Became a Disciple

One evening, as Shichiri Kojun was reciting sutras, a thief with a sharp sword entered, demanding either money or his life.

Shichiri told him: “Do not disturb me. You can find the money in that drawer.” Then, he resumed his recitation.

A little while afterwards, he stopped and called: “Don’t take it all. I need some to pay taxes with tomorrow.”

The intruder gathered up most of the money and started to leave. “Thank a person when you receive a gift,” Shichiri added. The man thanked him and made off.

A few days afterwards, the fellow was caught and confessed, among other things, to the offence against Shichiri. When Shichiri was called as a witness, he said: “This man is no thief, at least as far as I am concerned. I gave him money, and he thanked me for it.”

After he had finished his prison term, the man went to Shichiri and became his disciple.