Pain versus Suffering

Dr. Charles T. Tart, Mindfulness, Institute of Transpersonal Psychology,

Lecture 2, Part 12 of 15 parts. To start class from beginning, click here.

Student: Could say more about moving away from pain, and trying to get pleasure? But I found, oh, with my ankle a little bit of a pop and I feel so much better now that I’m noticing the pressure on it; or oh, if I just shift my hips a little bit, that’ll feel, you know. I needed to attend to it.

CTT: Right. Something I call fidgeting.

Student: Yeah. I’m a fidgeter.

(Laughter)

CTT: If we objectively looked at ourselves or at each other, we actually all fidget all the time. It’s like our body is sort of preprogrammed to constantly maximize the pleasure and minimize the pain. Now I’ve got nothing against that, because I certainly like to maximize my pleasure and minimize my pain! But to be a slave to that desire, to never be able to sit still if there’s the slightest discomfort, because you always give into the urge to make yourself feel comfortable — that not only keeps you enslaved, it keeps you from becoming acquainted with the full range of your experience.

I’m going to give you an equation. I bet you didn’t expect an equation in a course on mindfulness. So I’m going to write something on the board again.

Student: Well you were an engineer, right?

CTT: That’s right. I was an engineer. I like equations but this one is actually easy.

S = P x R

S equals P multiplied by R. This equation was originally created by my friend Shinzen Young, one of the best meditation teachers around, and one who’s deliberately worked to make traditional spiritual practices more accessible to Westerners.

This equation was part of his putting it into a language that Westerners understand. S is suffering. You all know what suffering is, because you’ve suffered a lot and suffering is a psychological, experiential matter. It’s how you feel. Pain, P, refers to actual physical pain. Which presumably we could measure quite precisely with the right equipment, measuring which nerve fibers are firing, how rapidly, and what kind of chemicals are being released as a result of that nerve firing, and so forth. So P, pain is the actual physical sensation.

R is a psychological factor again. R is what we might call resistance. It’s your attitude toward pain. So suffering equals pain multiplied by resistance.

Imagine that we can rate these things accurately and come up with numerical values.

Let’s say you have a pain of 2, rating on a 10 point scale. An actual physical pain of 2. It’s kind of annoying, but not a very big deal as physical pain goes. And you have a resistance of 10 because you hate pain. Your suffering is 20. You are really suffering greatly from what amounts to a small physical discomfort. This happens all the time.

Because of this psychological factor, this resistance factor, the automatic withdrawal from pain, we suffer much more than we need to… For instance, my ankle hurts. I don’t want anything to do with my ankle! That automatically ups the R factor right away. The opposite of making yourself suffer a lot more than is necessary, given your actual physical condition, is if you can keep that R factor low. You may have very high physical pain levels, but not suffer much. And in fact, you can develop the full Vipassana attitude and skill so R is essentially zero. No matter how big your physical pain, you don’t suffer from it.

Wild idea, yes?

One of the causes for Shinzen developing this particular formulation was a woman, Shirley, I know this story from both sides of it, who came to speak to him about the Buddhist attitude towards suicide. She had so much physical pain that medicine couldn’t do anything about, that she was ready to take her life. She had — I don’t fully understand this medical condition, but you get spurs growing out along the bones of your spine that press directly on the nerves. They could dope her up on all the opium and morphine and she was still in excruciating pain. So she wanted to die. Instead he taught her Vipassana.

He taught her this attitude of, “Look at something moment by moment, clearly, with precision. What actually is it, at this very instant, with equanimity? Try not to have this attitude of pushing it away or grabbing it, but just look at it exactly like it is.”

If you can’t look at the pain in full at first, break it down into components and learn to attend to one of the components (exact location, moment-by-moment, say) with clarity and equanimity. Shirley learned to live with her pain, to reduce her suffering to essentially zero, to go on and continue a very active career instead of suicide.

And it’s worked that way with a lot of other people. He has a book out now on dealing with pain through these meditative techniques. It’s called Break Through Pain. I wrote a forward to it. If any of you have chronic pain problems, I recommend the book strongly. There’s a CD with it, too, that has guided meditations on it.

Shinzen is an outstanding Vipassana teacher, so ITP gave him an honorary doctorate degree three, four years ago or so. Were any of you at that seminar he gave? We had him give a weekend on meditation and everybody loved it. A transpersonal teacher who defined the terms of what the hell he was talking about: Whoa! Such a refreshing change from the typical vagary of meaning in the spiritual world!

Student: Who’s the author?

CTT: Shinzen, S-H-I-N like, you know, like your shin. ZEN like in Buddhism. Young, Y-O-U-N-G. Shinzen Young. A boy from Los Angeles who spent a lot of time studying this stuff in the East, but then realized he had to bring it back to the West.

How did he express it nicely once? He came back as a monk with a shaven head, wearing robes and all that, and began to teach in Los Angeles. People loved him, but they didn’t really practice much because they thought, “Yeah, it works for him, but he’s a monk, somebody special, not like us.” So, as he said, he let his hair grow, got rid of his robes, and got jeans and a girlfriend. Then he became a person that people listened to.

(Laughter)

And the meditation teaching works much better for him.

10 comments

  1. “It’s like our body is sort of preprogrammed to constantly maximize the pleasure and minimize the pain.”

    Yes, but that programming is there for a reason. It exists to prevent injury to the body. I would not advise anyone to sit still and just observe while the cartilage in their knee tears or to remain still while a muscle in their back goes into spasm.

    Otherwise, I agree with the post.

    But if someone is fidgety, after the meditation is over they might want to see if they can learn why. They might have a back problem that can be helped by exercise or by a chiropractor. They might have restless leg syndrome that can be caused by diabetes, anemia, or Parkinson’s disease. They might get muscle cramps which can be a symptom of a vitamin deficiency or poor blood circulation which can be an symptom of something serious.

    Sometimes we should do something about the sensations, emotions, and thoughts we observe during meditation. When you are meditating it is fine to meditate and just observe and let go. But after the meditation session is over, it can be a good idea to deal with what you experienced during the meditation.

    Part of the purpose of meditation is to help people develop mental habits that they can apply during daily life. However it is not necessarily obvious to the beginner what aspects of meditation should be continued after the session is over. Sometimes people think that the lesson of meditation is to do nothing about physical and emotional pain. This is not necessarily correct.

  2. @anonymous:
    Sometimes we should do something about the sensations, emotions, and thoughts we observe during meditation. When you are meditating it is fine to meditate and just observe and let go. But after the meditation session is over, it can be a good idea to deal with what you experienced during the meditation.
    Excellent reminder, anonymous! Meditation may teach many things, such as how to not be an automatic slave to every unpleasant sensation and how to see more deeply into sensations, but it’s goal is NOT to get stupid about ordinary things. That is actually one of the perversions/distortions of meditation, you can be attracted to it because you don’t like your ordinary suffering so you think it’s a way to learn to become so habitually dull that you never suffer. Dullness, like when you get Novocaine for dental work, is fine at time, but not as a way of life….
    There’s a popular saying going around now: No brain, no pain! ;-(

  3. Part of the purpose of meditation is to help people develop mental habits that they can apply during daily life. However it is not necessarily obvious to the beginner what aspects of meditation should be continued after the session is over.

    I kind of wondered about this post a bit too…

    I fidget. Quite a bit in fact. I haven’t been stopping myself from moving around at least a bit while meditating. I figured as long as I felt relatively quiet inside, it would be OK to move a little. I find it helps me feel connected to my physical sensations, because if I don’t I sort of get lost. I want to connect to the bigger stuff without losing track of me in this body in this place. Is that a bad thing? Because sometimes it is too easy to just become disconnected.

    I do agree with what you said about pain. I had to learn to cope with pain after the accident, and really, you do just learn to let it go. Chronic pain is different than everyday aches and pains that may be clues to things you should pay attention to, isn’t it? When I was learning to walk again, I knew that it would hurt and that the hurting didn’t mean that I was getting worse, it meant I was trying to get better. So I didn’t need to give the pain so much importance. But now if I put too much stress on my leg, it hurts in a way that means I need to give it a rest. That pain is meaningful and useful.

    When I woke up in intensive care after the first round of surgery, I became very disconnected from my body in order to essentially flee the pain. They couldn’t give me morphine or any of the really useful pain medications because I turned out to have allergies. So I retreated into the NDE place for much of my initial recovery process. It wasn’t to the same level as my true NDE when they pulled me out of the wreck that was my car. But I was still able to get to the edges of the NDE place and take refuge with my grandmother. It took me a long time to reconnect with this reality, and I still have problems staying connected. I had to learn to lessen the importance of the pain. I also had to learn to remember how it felt to be OK. That was something my grandmother kept emphasizing. I think that was a big part of being able to recover as well as I did. I had to remember what OK was like in order to become OK.

  4. “I fidget. Quite a bit in fact. I haven’t been stopping myself from moving around at least a bit while meditating…. Is that a bad thing?”

    My belief is that a person should understand how meditation works and what the consequences are for different components of the practice. Then a person can decide for themselves what type of meditation to practice and how to impliment that practice in their own life.

    So,to answer Sandy’s question, I would say, “KATZ!

    1. I have debated this many times. It seems to me that “rising above the physical pain” in the ways described here is simply unavailable to most people, to whom the equation [suffering = (physical) pain] is instinctual, the normal animal response of the neurological system. It is built into our brains and bodies, presumably for adaptive evolutionary reasons. Some rare individuals, through long term practice of meditation, can achieve the states described here where this root equation doesn’t apply, but instead S = P + R. I think this capacity is related to the known statistic that a small percentage of the population can be hypnotised deeply enough to achieve anesthesia. But most of us have no choice but to suffer. Look at the history of attempts to reduce pain during surgery. Nothing really worked, including hypnosis, until the discovery of ether and nitrous oxide.

      Idealism tends to decline in direct proportion to the proximity to the actual situation, of some person going through great physical pain. Such a person is most likely to angrily reject someone proposing that that all it takes is the inner work you describe. Unfortunately they were never exposed to these teachings, or certainly not early enough for the extended dedicated practice to have ingrained the proper response. As if their life situations even allowed enough time and energy to devote to it.

      1. >It seems to me that “rising above the physical pain” in the ways described here is simply unavailable to most people, to whom the equation [suffering = (physical) pain] is instinctual,<
        I agree “rising above the pain” is certainly unavailable to most people, but Shinzen is talking about what’s possible as you become proficient in vipassana meditation techniques. That, for most of us, will take months or more of regular practice of 20 minutes or so a day, to give a very broad estimate of what’s required.
        It may also be the case that the equation
        S = P*R
        is only an approximation. It’s a mathematical way of saying wrong attitude can make pain a lot, lot worse! Just assuming it’s a linear function, it could be that
        S = P+R or maybe, much worse, S = P*R2 (I’m trying to represent R as R squared here but don’t know how to get a superscript in this program. It may be that that Shinzen’s equation works over a lower pain range but not a higher one, although he has had students who’ve dealt with extreme pain this way.
        As a researcher, I say let’s investigate.
        As a person who does not like pain, I love any idea which says my attitude can be used to reduce my suffering!
        Note too the the “rising above pain” is a tricky phrase, for the vipassana method involves going into the pain with clearer, more equanimous observation, not “escaping” it…..

  5. To understand how vipassana can help with cronic pain I think you have to experience it youself.

    Once when I had a shoulder injury, I saw how attitude was a big factor in whether pain is experienced as suffering or not. After I would do a type of spiritual healing meditation my attitude improved and I felt more like doing things etc. Even though the pain continued – my suffering was lessened. For this reason I think any type of meditation, including simple concentration meditation can help with pain if it helps with one’s attitude.

  6. “S = P x R”

    How do you apply this to psychological pain? How can you tell if an emotion is pain or resistance? If it’s resistance you might be able to let go of it. If it’s not then you might try to give up resistance to the emotion. When do you surrender (give up resistance) to emotions and when do you try to let go of them?

    If an emotion was due to an organic problem like some forms of depression, I think then the emotion would be like pain in the equation. If the emotion was due to a cognitive distortion then it might be resistance. But the line isn’t always that clear. For example, grief is normal and natural. If you don’t grieve over a significant loss it is probably unhealthy, but “loss” is still a subjective mental state, and some people might need to grieve more than others.

    Thanks

  7. @anonymous:
    “S = P x R”
    How do you apply this to psychological pain? How can you tell if an emotion is pain or resistance? If it’s resistance you might be able to let go of it. If it’s not then you might try to give up resistance to the emotion. When do you surrender (give up resistance) to emotions and when do you try to let go of them?
    Good Q! The S = P * R equation is a very general form, and in specific cases the terms have to be expanded and explored. Suffering, Pain, Resistance.
    For instance R, Resistance, is a psychological factor that can be pretty complex. Some simple stubborn attempt just to avoid pain, and/or a psychological fear of pain based on past personal experiences, and/or a determined desire to be in control, and/or…
    P, Pain, there are different types and qualities of physical pain, and S, Suffering, there are different flavors of suffering. So the question of application comes down to what are you capable of discriminating and how much focusing ability do you have and how much insight do you have into Resistance factors such that you might ease up on them?
    The more you develop some skill at vipassana meditation in general, the more all of the above develop. If you’ve developed no meditative skills at all, this approach will only help a little. If you get depressed or pissed off that it doesn’t help much, that’s liable to increase your Resistance factor too….
    And yes, the approach can be applied to psychological pain. I think there are several papers on Shinzen’s websites that go into more detail about this, as well as in his book.
    Buddhism talks a lot about developing “skillful means,” what works for you? Fool around and find out.
    We all dream, of course, that the drug companies will quickly develop drugs that will make all pain go away – with no side effects. Sure….. Don’t hold your breath waiting for it, so it’s good to have a backup strategy like vipassana to ease the suffering.

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