Meditation with chronic pain

General discussion of issues related to Theravada Meditation, e.g. meditation postures, developing a regular sitting practice, skillfully relating to difficulties and hindrances, etc.
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Meditation with chronic pain

Post by simplemind » Fri Mar 26, 2010 3:17 am

Hi everyone,
I'm new to this forum, but I've reading posts here for a while. I really appreciate the resources that everyone has made available. I've been sitting daily for the past month (I'm new to the consistent practice, but have been studying Buddhism for about a year or so). I was wondering if anyone has any suggestions on sitting when you are dealing with chronic pain. The pain is not a result of my posture, but rather frequent headaches that are very intense. I've been tested by several doctors for more than I care to think and that has turned up nothing useful in terms of a diagnosis.

So, I'm wondering if anyone has any advice when meditating with frequent pain. It's quite a challenge to be mindful of ones pain (especially when my frequent desire is to avoid it at all costs). I'm curious to hear about others experiences or any useful teachings on this topic.

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Re: Meditation with chronic pain

Post by Sobeh » Fri Mar 26, 2010 3:49 am

I have dealt with severe abdominal pain, but meditation isn't very easy at all when pain is so forceful. In fact, there are Suttas in the Samyutta Nikaya which describe bhikkhus unable to sustain jhana because of it. In cases such as this, mindfulness is recommended of the sort which recalls "my body is sick, my mind needn't also be". It might also help to review the six sense bases when the headaches strike.

In any event, however, you will notice the mind retract and push away awareness of the headache as it approaches as well as during the worst of it, but in my experience this 'pain resistance' actually makes things feel worse. Some might describe the alternative as 'embracing' the pain, but I prefer the word 'allowing'. Finally, try to hold the principles of anicca and faith in the Dhamma at the same time in your mind during these bouts, as a reminder that "this too shall pass."


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Re: Meditation with chronic pain

Post by jcsuperstar » Fri Mar 26, 2010 4:45 am

i don't do it. i see no reason to meditate with extreme pain, doesn't seem like the middle way to me. when i got really bad headaches while living in a Wat in Thailand my ajahn just told me to go walk around, not to sit.
สัพเพ สัตตา สุขีตา โหนตุ

the mountain may be heavy in and of itself, but if you're not trying to carry it it's not heavy to you- Ajaan Suwat

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Re: Meditation with chronic pain

Post by Ben » Fri Mar 26, 2010 5:00 am

Hi simplemind

If you haven't already done so, get it checked out by a medical professional and don't be scared about taking pain medication. If the symptoms are so intense as to make practice impossible - be pragmatic -take the medicine and then meditate when the symptoms have alleviated.

As for meditating with the pain - Sobeh's recommendations are sound. Had he not written his post, i would have suggested something very similar. Having had vedana (sensation) as a my main meditation subject for nearly 25 years, I can confirm that the suffering we experience as a result of pain, is primarily a result of our anticipation of it, our aversion towards it and the craving for its disappearance. If you can sit with the pain, observe it with calm equanimous objectivity (try focusing on its changing nature) then you slowly find yourself becoming less imprisoned by it.
Wishing you well.


PS: having suffered from migranes in the recent past, so bad that i ended up in hospital and getting ct-scans, and recurring headaches, I sympathize with you.
“No lists of things to be done. The day providential to itself. The hour. There is no later. This is later. All things of grace and beauty such that one holds them to one's heart have a common provenance in pain. Their birth in grief and ashes.”
- Cormac McCarthy, The Road

Learn this from the waters:
in mountain clefts and chasms,
loud gush the streamlets,
but great rivers flow silently.
- Sutta Nipata 3.725

Compassionate Hands Foundation (Buddhist aid in Myanmar) • Buddhist Global ReliefUNHCR


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Re: Meditation with chronic pain

Post by simplemind » Fri Mar 26, 2010 1:56 pm

Thanks for your thoughts. I am taking medication for the pain, which helps a bit. One solution for me is to not sit at all, but given that this problem has been around for about six months, I'm thinking it may just be a new part of my life. Rather than suspend my practice, I wanted to try to work with it. For now, I will try some of the suggestions that you've mentioned Sobeh.

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Re: Meditation with chronic pain

Post by andrewuk » Sat Mar 27, 2010 4:21 pm

Hi simplemind,

I have had pain for the past few weeks and it got to the point that even sitting was not possible. Sometimes I still cannot cover my feet with a duvet while asleep because the light weight of a duvet is causing soreness on my feet. It is quite difficult to sit and meditate for me now so I sometimes lie down and meditate. I haven't been physically active for weeks so I am feeling lethargic sometimes. And lying down meditation can be difficult be awake! But I think one has to do whatever he/she can to meditate, whichever posture is possible.

One needs to have physical pain/disease treated just as Bhikkhu Bodhi settled in the US because one of the reasons was because he had chronic migraine or as Bhikkhu Samahita had his knees treated. Treating physical pain helps me meditate when I am not an experienced meditator!

I have found the followings helpful:

1) Reading suttas or listening to Dhamma talks. These alleviate my physical pain and very often it gives me a sense of joy which stays very strongly with me for quite a long time.

2) Understand pain better. There are a few suttas that talk about physical pain and mental pain. (I must thank Dmytro for this....)

3) Pali chanting. When there was really strong pain, I turned on my speaker and listening to chanting of Vandana and Tisarana. (sometimes metta bhavana chanting) It usually helped me gather myself together and it had an excellent calming effect. Sometimes I also listen to Satipatthana chanting too.

4) Brahma Viharas meditations especially metta, mudita and upekkha. I sometimes use the pain (when it's mild) as a subject of meditation... It definitely makes me realise there is physical suffering!

5) Try to observe how I react to pain. When physical pain arises, other parts of the body react to it too -- other muscle tension, the thought and the action of lips moving, forehead frowning, shoulder leaning forwards, head dropping, fist tightening etc to the actual opening my mouth and make the sound ouch... It may happen within a fraction of a second. But knowing how I react to it and the whole process lessens the pain.

I must admit I haven't been successful in focusing on one point of the body and ignore the pain and I still don't know how to breathe through pain.

The following books, dhamma talks, articles etc have helped me and I hope they help you too. (Thanks to Dmytro who sent me some of the suttas about pain!)

Bhikkhu Bodhi - In the Budha's Words
Rupert Gethin - Sayings of the Buddha
Bhikkhu Analayo - Satipatthana
Articles from Bhikkhu Pesala's website" onclick=";return false;

Sallatha Sutta
Patala Sutta: The Bottomless Chasm
Gilana Sutta: Ill (1)
Anathapindikovada Sutta

Some people find this helpful Keeping the Breath in Mind and Lessons in Samadhi

I find Ajahn Jayasaro's talks on Buddhist Meditation very soothing... This is a specific topic on physical pain Buddhist Meditation (9) Physical Pain Note that dealing with physical is very exhausting.. You can find Ajahn Jayasaro's other talks in dhammatube.

Using Meditation to Deal with Pain, Illness & Death
Ministering to the Sick and the Terminally
Pali chanting of Vandana and Tisarana

Satipatthana chanting

If anyone knows more suttas or Dhamma about this, please share with me.

With metta,

Meditate, don't be negligent, lest you may later regret it!

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Re: Meditation with chronic pain

Post by simplemind » Wed Mar 31, 2010 4:13 am

Thank you for your suggestions and all the links you provided! I look forward to spending some time working with your suggestions and some of the suttas/ talks that you've linked to. I've been listening to some good Dhamma talks (in general) and this has been very helpful since I cannot always read well with my headaches. Pain is a difficult teacher, but I have learned more about myself in the last year than I have in my entire life.

Again, much thanks!

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Re: Meditation with chronic pain

Post by PeterB » Wed Mar 31, 2010 10:19 am

I have nothing practical to add to the above, just my good wishes and metta.


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Re: Meditation with chronic pain

Post by tiltbillings » Wed Mar 31, 2010 10:25 am

>> Do you see a man wise [enlightened/ariya] in his own eyes? There is more hope for a fool than for him.<< -- Proverbs 26:12

This being is bound to samsara, kamma is his means for going beyond. -- SN I, 38.

“Of course it is happening inside your head, Harry, but why on earth should that mean that it is not real?” HPatDH p.723

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Re: Meditation with chronic pain

Post by andrewuk » Sun Apr 11, 2010 10:22 pm

Full catastrophe living is an excellent book... In fact, I started with the course (Mindfulness Based Stress Reduction) and it brought me into insight meditation. Since then I have had deep interested in the Theravada tradition and I would like to dedicate myself to it.

This is an article by Bhikkhu Bodhi and I hope it helps others too.

May you all be free from sufferings.

___________________ ... /pain.html" onclick=";return false;

Built-in Buddha

Bhikkhu Bodhi on the stern but eloquent teachings of chronic pain.

When I write about living with pain, I don’t have to use my imagination. Since 1976 I have been afflicted with chronic head pain that has grown worse over the decades. This condition has thrown a granite boulder across the tracks of my meditation practice. Pain often wipes a day and night off my calendar, and sometimes more at a stretch. The condition has cost me a total of several years of productive activity. Because intense head pain makes reading difficult, it has at times even threatened my vocation as a scholar and translator of Buddhist texts.

In search of a cure, I have consulted not only practitioners of Western medicine but also herbal physicians in remote Sri Lankan villages. I’ve been pierced countless times by acupuncture needles. I’ve subjected my body to the hands of a Chinese massage therapist in Singapore, consumed Tibetan medicine pills in Dharamsala, and sought help from exorcists and chakra healers in Bali. With only moderate success, I currently depend on several medications to keep the pain under control. They cannot extricate it by the root.

I know firsthand that chronic bodily pain can eat deeply into the entrails of the spirit. It can cast dark shadows over the chambers of the heart and pull one down into moods of dejection and despair. I cannot claim to have triumphed over pain, but in the course of our long relationship, I’ve discovered some guidelines that have helped me to endure the experience.

First of all, it is useful to recognize the distinction between physical pain and the mental reaction to it. Although body and mind are closely intertwined, the mind does not have to share the same fate as the body. When the body feels pain, the mind can stand back from it. Instead of allowing itself to be dragged down, the mind can simply observe the pain. Indeed, the mind can even turn the pain around and transform it into a means of inner growth.

The Buddha compares being afflicted with bodily pain to being struck by an arrow. Adding mental pain (aversion, displeasure, depression, or self-pity) to physical pain is like being hit by a second arrow. The wise person stops with the first arrow. Simply by calling the pain by its true name, one can keep it from extending beyond the physical, and thereby stop it from inflicting deep and penetrating wounds upon the spirit.

Pain can be regarded as a teacher—a stern one that can also be eloquent. My head pain has often felt like a built-in buddha who constantly reminds me of the first noble truth. With such a teacher, I hardly need to consult the sermon in Deer Park at Benares. In order to hear the reverberations of the Buddha’s voice declaring that whatever is felt is included in suffering, all I have to do is attend to the sensations in my head.

As a follower of the dharma, I place complete trust in the law of karma. Therefore, I accept this painful condition as a present-life reflection of some unwholesome karma I created in the past. Not that I would advise someone who develops a painful illness to immediately resign themselves to it. Although it may be the inevitable fruit of some past karma, it might also be the result of a present cause that can be effectively eliminated by proper medical treatment. However, when various types of treatment fail to help with an obstinate and defiant condition, one can be pretty sure there is a karmic factor. Personally, I don’t lose sleep trying to figure out what this past karma might have been, and I would advise others against succumbing to such obsessive concerns. They can easily lead to self-deluding fantasies and superstitious practices. In any case, by trusting the law of karma, one can understand that the key to future good health lies in one’s hands. It is a reminder to refrain from harmful deeds motivated by ill will and to engage in deeds aimed at promoting the welfare and happiness of others.

Chronic pain can be an incentive for developing qualities that give greater depth and strength to one’s character. In this way, it can be seen as a blessing rather than as a burden, though of course we shouldn’t abandon the effort to discover a remedy for it. My own effort to deal with chronic pain has helped me to develop patience, courage, determination, equanimity, and compassion. At times, when the pain has almost incapacitated me, I’ve been tempted to cast off all responsibilities and just submit passively to this fate. But I’ve found that when I put aside the worries connected with the pain and simply bear it patiently, it eventually subsides to a more tolerable level. From there I can make more realistic decisions and function effectively.

The experience of chronic pain has enabled me to understand how inseparable pain is from the human condition. This is something that we in America, habituated as we are to comfort and convenience, tend to forget. Chronic pain has helped me to empathize with the billions living daily with the gnawing pain of hunger; with the millions of women walking miles each day to fetch water for their families; with those in Third World countries who lie on beds in poorly equipped, understaffed hospitals, staring blankly at the wall.

Even during the most unremitting pain—when reading, writing, and speaking are difficult—I try not to let it ruffle my spirits and to maintain my vows, especially my vow to follow the monastic path until this life is over. When pain breaks over my head and down my shoulders, I use contemplation to examine the feelings. This helps me see them as mere impersonal events, as processes that occur at gross and subtle levels through the force of conditions, as sensations with their own distinct tones, textures, and flavors.

The most powerful tool I’ve found for mitigating pain’s impact is a short meditative formula repeated many times in the Buddha’s discourses: “Whatever feelings there may be—past, present, or future—all feeling is not mine, not I, not my self.” Benefiting from this technique does not require deep samadhi or a breakthrough to profound insight. Even using this formula during periods of reflective contemplation helps to create a distance between oneself and one’s experience of pain.

Such contemplation deprives the pain of its power to create nodes of personal identification within the mind, and thus builds equanimity and fortitude. Although the technique takes time and effort, when the three terms of contemplation—“not mine, not I, not my self”—gain momentum, pain loses its sting and cracks opens the door to the end of pain, the door to ultimate freedom.

BHIKKHU BODHI, an American Buddhist monk, was ordained in Sri Lanka in 1972. He has translated several important works from the Pali Canon, including the Sumyatta Nikaya (The Connected Discourses of the Buddha, Wisdom Publications). He currently lives at Bodhi Monastery in Lafayette, New Jersey.
Meditate, don't be negligent, lest you may later regret it!

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