How can I endure crippling intolerable physical pain?

If it is possible to relieve mental anguish by transforming one’s mind, how can this process be applied to physical suffering? How do we endure crippling, virtually intolerable pain? Here again we should distinguish between two types of suffering: physiological pain and the mental and emotional suffering it unleashes. There are certainly a number of ways to experience the same pain with more or less intensity.

Neurologically, we know, emotional reactions to pain vary significantly from person to person, and a considerable percentage of pain sensation is linked to the anxious desire to suppress it. If we allow that anxiety to overwhelm our mind, the most benign pain will soon become unbearable. So our assessment of pain also depends on our mind. It is the mind that reacts to pain with fear, rejection, despondency, or a feeling of powerlessness; instead of being subjected to a single agony, we accumulate a host of them.

Having come to grips with this idea, how do we learn to control pain instead of being its victim? Since we can’t escape it, it is better to embrace it than to try to reject it. The pain persists whether we succumb to dejection or hold on to our resilience and desire to live, but in the latter case we maintain our dignity and self-confidence, and that makes a big difference.

There are various methods to achieve that end. One method uses mental imagery; another lets us transform pain by awakening ourselves to love and compassion; a third involves developing inner strength.

The Power of Images

Buddhism has traditionally turned to what modern psychology calls mental imagery to modify the perception of pain. We may visualize, for instance, a soothing, luminous nectar that soaks into the center of pain and gradually dissolves it into a feeling of well-being. The nectar then permeates our entire body and the pain fades away.

A synthesis of the results published in some fifty scientific articles has demonstrated that in 85 percent of cases recourse to mental methods enhances the capacity to endure pain.- Among these diverse techniques, mental imagery has proven to be the most effective, although its efficacy varies depending on the visual support. For instance, one may visualize a neutral situation or a pleasant one, such as a beautiful landscape. There are other ways for a patient to be distracted from pain, such as concentrating on an exterior object (watching a slide show, for instance), practicing a repetitive exercise (counting from one hundred to zero by threes), or consciously accepting the pain. The three methods cited, however, yield inferior results. The disparity is explained by the fact that mental imaging is a greater focuser of attention than methods based on exterior images, intellectual exercises, or an attitude. A group of researchers has found that within a month of guided practice of mental imaging, 21 percent of patients claim a notable improvement in their chronic migraines, as opposed to 7 percent of the control group that did not undergo training.

The Power of Compassion

Another method that allows us to manage suffering, emotional as well as physical, is linked to the practice of compassion. Through compassion we take control of our own suffering, linked to that of all others, in the thought that “others besides me are afflicted by similar hardships to mine, and sometimes far worse. How I wish that they too could be free of their pain.” After that, our pain does not feel as oppressive, and we stop asking the bitter question: “Why me?”

But why should we deliberately dwell on other people’s suffering when we go to such extremes to avoid our own? In so doing, aren’t we pointlessly increasing our own burden? We are not. When we are completely self-absorbed, we are vulnerable and fall easy prey to confusion, impotence, and anxiety. But when we experience a powerful sense of empathy with the suffering of others, our impotent resignation gives way to courage, depression to love, narrow-mindedness to openness toward all those around us. Increasing compassion and loving-kindness, the ultimate in positive emotions, develops our readiness to offer relief to the suffering of others while reducing the importance of our own problems.

Developing Inner Strength

When we feel severe physical or emotional pain, we may simply look at the experience. Even when it is crippling, we must ponder whether it has any color, shape, or any other immutable characteristic. We find that the more we try to bring it into focus, the more the pain’s definition becomes blurred. Ultimately we come to see that behind the pain there is a pristine awareness that does not change and that is beyond pain and pleasure. We may then relax our mind and try to allow our pain to rest in that state of pure awareness. This will allow us to stop being the passive victim of pain and to resist or reverse its devastation of our mind.

After the Chinese invasion of Tibet in 1959, Tenzin Choedrak, the personal physician of the Dalai Lama, was first sent to a forced labor camp in northeastern Tibet along with some one hundred others. Five prisoners, himself among them, survived. He was transferred from camp to camp for nearly twenty years and often thought that he would die of hunger or of the abuse inflicted on him. A psychiatrist who specializes in post-traumatic stress and who treated Doctor Choedrak was astonished that he showed not the least sign of post-traumatic stress syndrome. He was not bitter, felt no resentment, displayed serene kindness, and had none of the usual psychological problems, such as anxiety, nightmares, and so on. Choedrak acknowledged that he occasionally felt hatred for his torturers, but that he always returned to the practice of meditation on inner peace and compassion. That was what sustained his desire to go on living and ultimately saved him.

Another example of someone who underwent physical ordeals that were scarcely imaginable is Ani Pachen. After twenty-one years in detention, Ani Pachen, a Tibetan princess, nun, and member of the resistance, was held in total darkness for nine months. Only the birdsong that penetrated her cell allowed her to tell day from night. She insisted that while she certainly was not “happy” in the usual sense of the word, she was able to sustain the main aspects of sukha by looking within and relating again and again to her meditation practice and to her spiritual teacher, by contemplating the meaning of impermanence and of the laws of cause and effect, and by becoming more aware than ever of the devastating consequences of hatred, greed, and lack of compassion.

We are not talking here about an intellectual and moral stance that differs culturally and philosophically from our own, and which we could debate endlessly. The people just described are proof that it is possible to maintain sukha even under repeated torture. They lived this experience for years on end, and the authenticity of that experience is far more powerful than any theory.

Another example is that of a man I have known for twenty years who lives in Bumthang province at the heart of the Himalayan kingdom of Bhutan. He was born without arms or legs, and he lives on the outskirts of a village in a little bamboo hut of just a few square yards. He never goes out and barely moves from his mattress on the floor. He came from Tibet forty years ago, carried by fellow refugees, and has lived in this hut ever since. The mere fact that he is still alive is extraordinary in itself, but even more striking is the joy that radiates from him. Every time I see him, he is in the same serene, simple, gentle, and unaffected frame of mind. When we bring him small gifts of food, blankets, a portable radio, he says that there was no need to bring him anything. “What could I possibly need?” he laughs.

There is usually somebody from the village to be found in his cabin — a child, an elder, a man or woman who has brought him water, a meal, some gossip. Most of all, they say, they come because it does them good to spend a little time in his company. They ask his advice. When a problem arises in the village, they usually come to him to solve it.

Dilgo Khyentse Rinpoche, my spiritual father, would sometimes stop and visit him when he passed through Bumthang. He would give him his blessing because our friend asked for it, but Khyentse Rinpoche knew that it was certainly less necessary for him than for most. The man had found happiness within himself, and nothing could take it from him.

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