Pain, On Your A**

Quick News Update:  PM is now available widely in print and e-book forms.  The audible version is in process, available soon. I’m gratified by the early positive buzz for the book and its intention to get more of us learning to meditate and cultivating this trainable capacity of mindful awareness.  On to a painful topic…


A core intention of the no-nonsense approach in Practical Mindfulness is about accessibility, about lowering “the bar to entry.”  That includes questioning and even knocking down some of the unhelpful rule-making “ideals” that have come to be associated with meditation practice.  Funky hand positions and origami leg postures are examined, as are wishful notions about attaining fully “empty” minds or turbocharged states of unending bliss.  In PM, the daily obstacles to clear attention and their management get more attention (heh… see what I did there?) than some rarefied states to strain for.

Upselling that peak stuff runs counter to the more mundane but sustainable benefits of meditation, mostly off the cushion:  a more tuned-in, adaptive you, more alive and aware. and better able to both ride through stress and also to embrace the blessings of daily life that come along, when they present themselves. 

This week, in trolling for the topic to blather on about, one such obstacle was commandeering my conscious life, and by happenstance the lives of a subset of folks I worked with this week in my day job.  That obstacle (which is not necessarily an obstacle… see below!) is physical suffering.  I’ll shorthand it as “pain.”  Mine is a persistent angry hum in my neck from four surgeries for cancer, which I’ve become more adapted to, and less so, unpredictable, painful weirdness due to dysautonomia, an after-effect of life-saving radiation treatment I received five years ago.  For me, an unbidden abdominal pain wave can wash in; it’s usually tolerable, but this week was threatening to swamp the boat.  The blunt sensory input likely marinated my outlook as some patients noted their own degrees of suffering – degenerative lumbar nerve roots screaming, shingles-driven sizzling pain on one patient’s cheek, healing pain from a knee replacement. 

Scads of studies pint to the benefit of mediation in managing and adapting to chronic pain.  Of course, that cause/effect inference means that many of us have various kinds of pain that are a prominent aspect of our momentary experience, to sit with on the cushion and deal with, off. 

And…pain can also be generated by the act of meditation (see my “origami” comment above.) Knees and backs can yell back, especially on longer sittings or early on in starting a practice, as the body adapts.

So, yes, to explain the title of this blog entry we can “sit with pain.”  Many of us have to.

To place pain in a mindful context, it is one aspect of the physical “bin” of stuff we may observe in the landscape of experience, along with the breath, the heartbeat, an itchy nose, or the uncomfortable concerto of pre-menstrual symptoms.  (So I hear… another way that men have it good, and another moment for empathic awareness, dudes.)

Yet to frame pain as an “aspect of experience” can minimize how this sensory display can highjack a life, let alone meditation practice.  So, how to sit with pain?

There’s a more thorough discussion of this in Chapter 9 of PM, “Body and Heart,” which focuses on a series of exercises in tuning into bodily sensations and states.  I use a metaphoric hierarchy hopefully familiar to young parents, or perhaps to our own toddlerhood memories: a tantruming little one impacting an adult interaction, like at a park or restaurant.  Briefly, I advance four options and one no-no.

First, the no-no:  don’t play act at ignoring the pain (or the toddler, for that matter.) Pain is an unfortunate visitor in the landscape of the moment, and all phenomena have admission tickets, maybe even a lesson. Trying to ignore discomfort may have its place in some circumstances (finishing a marathon, fighting off an attacker, carrying a loved one to safety.) But in an intentional practice of observing our experience, pretending that a part of that experience is not there is neither logical nor very effective.

So, do we dwell in it?  Give in?  I can hear your pushback.  Here are four levels of response, cribbed from the book.

Level one: besides any discomfort from the outset of a sitting, physical suffering can arise during the sitting.  At the very least, if the suffering is mild but present and distracting you from your intended awareness practice, “give it a seat nearby,” akin to sitting your upset kid down within smiling distance, perhaps with an occupying toy.  

(With our three boys, neither my wife nor I traveled without an EHW – “Emergency Hot Wheel” – in the pocket. Oddly, none of our sons are now on the NASCAR circuit.) 

Note the suffering sensation briefly, as you would a passing thought or other distractor in breath meditation. Give it a little attention, then return to your intention as the main event.  If the suffering occasionally intrudes, turn briefly to it and witness it; then back to the plan.  It’s what you got today, and that’s OK.

Level 2:  if the suffering if more intense, more “code yellow” in terms of intruding on your intended practice, well, the toddler metaphor here changes to “sit on your lap and jiggle.”  

The intention becomes, “there that’s pain and my other intention” – watching them both, together. It’s not easy, but not impossible, either.  As your well-laid plan to focus on three-point breath practice is intruded upon by some persistent and distracting shoulder pain, grievance or disappointment may well arise, as can pity or self-criticism.  It’s all worth observing, or trying to.

On to the third tier:  if the squalling wavicle is truly overcoming your efforts to hold to the plan, you likely need to, as they say in football, “call an audible” and  attend fully to your squalling kiddo.  One can “turn into” the pain – switching specifically and fully to the painful experience as the object of your attention.  Focusing on it,  you may experience its ebbs and flows of intensity, and what emotional tones the sensation may co-generate – grievance, helpless sadness, anxiety or dread – even some gratitude if a certain physical tension eases toward relief. 

(See last week’s blog, on grief and relief, for pointers on that state.)

The painful sensory input can be a signal leading to understanding and resolution or adaptation.  Sometimes some directed attention into the suffering, some calming of it, can then allow for a return to the prior scheduled programming.

Lastly:  one other option needs noting, for reasons of compassion and common sense: sometimes if it hurts too much to continue, then just stop and call it done for now.   Pay the bill and take your little one back home for a nap. You can take a break and, if in better shape afterward, try to come back to sitting with the prior intention; or even check back in with the pain as the anchor.  You may try to shift into a walking meditation that allows for holding the pain better.  

Or you may permit yourself the kindness to call it a day, try again tomorrow.  This is healthy training in coping, not the Spanish Inquisition.  (No one expects that advice.)

Take care and keep each other safe.  GCS