Finding Joy Amidst The Pain - Darlene Cohen | Arthritis Information

 

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Finding Joy Amid the Pain

By Darlene Cohen

Even while we suffer, says Darlene Cohen, we can experience joy in life by opening up fully to our experience, not closing down. Drawing on her training as a Zen teacher and her own long experience with chronic pain, she offers an awareness approach to living well with suffering.

Catherine was a highly successful financial consultant in downtown San Francisco, a young woman thriving in a man’s world, reveling in all the rewards business acumen can bring: luxurious condo, designer wardrobe, everything but disability insurance. After her car accident, she found herself living with and financially dependent on her mother again, just as she had been as a child.

Ricardo played soccer every weekend before he herniated a disk at work; soccer games had been the center of his social world and his prowess the cornerstone of his identity. He had been married only a year, but he could no longer make love to his energetic, vivacious wife. Forced into the role of househusband while his wife supported them, he was depressed and humiliated.

Two years after her adored sister died of cancer, Emily seemed to be functioning just fine. She worked, had a family life, pursued hobbies. But suddenly and unpredictably, she still burst into tears and cried effusively. It was as if her sister’s death had opened up some old, deep wound that would never heal.

Many of us in the course of living our everyday lives endure terrible suffering: grief or anxiety or depression or physical pain that won’t go away. I think of this kind of suffering as “mundane” anguish, affliction rendered bearable only because it’s part of our everyday lives, like drawing breath or doing the dishes. If we ever got relief from it, we would suddenly apprehend how dreadful it actually is.

It doesn’t even take a specific loss to experience mundane anguish. We humans suffer just because everything changes all the time. Having once achieved some goal, we can’t rest on our laurels. All of life’s circumstances are dynamic, ever evolving into something else. We clutch at security in vain.

I myself have had rheumatoid arthritis, a very painful and crippling condition, for twenty years, and the stress of the disease—the fear of the future and the despair at what has been lost already—is often worse than the physical pain that I am suffering at any particular moment.

How do we deal with the mundane anguish of our everyday lives? How do we continue to live under crushing stress? And even further, how do we not just get through these things but have rich, full, and worthwhile lives that we actually want to live—under any circumstances?

Our intelligence and dignity themselves are developed by our being alive for everything, including the mundane anguish of our lives. Just our awareness of our sensations, of our experience, with no object or idea in mind, is the practice of not preferring any particular state of mind. Such intimacy with our activity and the objects around us connects us deeply to our lives. This connection—to the earth, our bodies, our sense impressions, our creative energies, our feelings, other people—is the only way I know of to alleviate suffering. To me, our awareness of these things without preference is a meditation that synchronizes body and mind. This synchronization, the experience of deep integrity, of being all of a piece, is a very deep healing.

I’ve often heard people in pain say, “I know it would be better if I could accept my pain, and I keep trying and trying, but I can’t! I can’t accept it; I hate it!” I think many people have a skewed idea of what “accepting” pain is. If you have the idea that coping well should resemble serenity or equanimity, something like the proverbial “grace under fire,” then you think you should resign yourself with a big cosmic grin, no matter what horrors are being visited upon you.

Actually, “accepting” pain sounds to me too passive to accurately describe the process of successfully dealing with chronic pain. It fails to convey the tremendous energy and courage it takes to accept physical pain as part of your life. Truly accepting pain is not at all like passive resignation. Rather, it is active engagement with life in its most intimate sense. It is meeting, dancing with, raging at, turning toward. To accept your pain on this level, you must cultivate particular skills. After you have developed some proficiency, dealing with pain feels much more like an embrace, or the bond that forms between sparring partners, than like resignation.

What are the skills necessary for dealing with chronic pain, pain that you have day in and day out and probably will have for a long time? If you have chronic pain, your job is to (1) acknowledge that pain and its burden, and (2) enrich your life exponentially. This is coming at chronic pain from two angles: one is acknowledging it and understanding what it costs you in terms of suffering; the other is opening up your life, making it so rich that no pain can commandeer it.

Before you lose your creative energy to depression and before you are disabled by somatic manifestations of your anxieties, you can begin to live with your suffering in such a way that life’s frustrations and disappointments are part of the rich tapestry of living. In order to have such an attitude, you need to cultivate skills that enable you to be present for all of your life, not just the moments you prefer.

Acknowledging your suffering—exactly what it is costing you to live with your painful situation—is the first step on the path of penetration into the wellspring of your experience, and it holds tremendous potential for your liberation from depression and anxiety.

How do you learn to acknowledge your suffering? I think it lies in practicing respect for all your feelings. You must treat your anxiety, pain, or hatred gently, respectfully, not resisting it but living with it. When you do resist it, you need to treat that with respect, too. You must develop your capacity to appreciate each thing as it is now, while inundated with suffering. Nothing should be treated with more respect than anything else.

When you are able to give all your feelings your full attention, without believing that one feeling is good and another bad (even if you think it is), then compassion, irritation, pain, hatred, and joy are all sacred. When our way is very hard, we have an opportunity to use every flicker of our imaginative fire. This attitude gives us a tremendous sense of freedom and creativity. We feel as if we can imbue any situation with the richness of our own poetry.

After I was bedridden with rheumatoid arthritis, my mobility was so impaired that volunteers from the San Francisco Zen Center began cleaning my room, doing my laundry, and washing my hair. As my body got weaker and my pain greater, and I could no longer deny my situation, I realized that this is the life I have been given. This is the body I have to live the rest of my life with. Within my experience, this is my reality. Every day, I woke up and began to say, “What part of my body can I use today to do the things I have to do?” Strangely, I found relief in just being the suffering. Because I was so ill, nothing was demanded of me: no function, no performance, no self-sufficiency, no heroics. Just me living and breathing. This baseline life allowed me to live in a very simple, nondemanding way.

At first, my conscious life was all pain. Acknowledging the pain and its power eventually allowed me to explore my body fully and find there actually were experiences in my body besides the pain—here is pain, here is bending, here is breath, here is movement, here is sun warming, here is unbearable fire, here is tightness—something different wherever I looked.

My life began to be filled with sensation. Not just pain but sensation of all kinds: children’s voices outside my window; subtle changes in the shadows on the wall as the day passed; feeling my entire body when I turned over in bed; noticing the temperature differences in the various parts of my body, those inside and outside the covers; the contours of a familiar face. Rather than shrinking, my world was as intricate as ever, just on a much more subtle level. Because I was no longer goal-directed, sensation and feeling filled my consciousness. I kept telling myself this must be the world of babies and animals. Everything is fresh and fascinating.

Valuing these subtle experiences is very unconventional thinking; it is extraordinary to be willing to be involved with ordinary things, to be willing to live in the mundane. We don’t have a lot of role models for this kind of attention in our society. Thus, we are very deeply touched when they appear to us. It is so moving when it does happen that it can inspire us for years. When I was first very sick, lying in bed, I happened to hear a recording of Mississippi Fred MacDowell’s Delta blues music. He strums a guitar and sings in a rough voice. He plucks each string of his guitar as if it were his own heartstring he’s vibrating to express his pain. When I heard him, I felt that if he could manage to touch a guitar string that way, I could try to live as sincerely as possible.


If you are in great pain much of the time, it becomes absolutely necessary that you create a life for yourself that you can not only tolerate but love and enjoy. I am probably in more pain than most of the people I know, yet I see my life as one of the most pleasant ways of living currently available to human beings. I believe my life is enjoyable and satisfying because I take my pleasure as seriously as my pain. And what I take most seriously is living each moment of my life, to the extent that I am able to pay that much attention.

Another way to put this is that I try to do each thing for its own sake, to experience every motion, every endeavor, every contact, for what it is. Washing the dishes is not just about getting the dishes clean; it’s about feeling the warm, soapy water soothing my arthritic fingers and noticing the brief discomfort in my elbow joints when I lift a clean dish into the dish drainer. Folding the laundry is an opportunity for smelling its cleanness and luxuriating in the simple movements as a counterpoint to my complex life. There need be no better reason than that I am alive and doing these activities. This is engagement that arises out of a commitment to live as thoroughly as a human can.

When we concern ourselves with the problem of chronic pain, whether psychological or physical, we also need to talk about pleasure. If we are in great pain, often the first step is simply noticing that we have any pleasure at all in the midst of terrible suffering. Then we need to learn how to notice that pleasure is actually present in the experience of pain. Not that pleasure distracts us from the pain or chases it away but that it is able to send little tendrils of relief or comfort into the pain, in the same way that darkness interpenetrates light, that death interpenetrates life.

I think that if you are overwhelmed by emotional stress or physical pain, it is advisable to think about cultivating the ability to recognize pleasure wherever the potential for its existence may lie. I say this not because I am a thrill-seeking hedonist but because somebody has to say it. Not so many Zen lecturers or stress reduction teachers or arthritis doctors do, so I have to fill the breach.

It would be useful to first explore the relationship between pleasure and pain. Like a lot of pairs—light/dark, life/death, love/hate, sickness/health—pleasure and pain are interdependent. That is, they have meaning only in relation to each other. Our ability to perceive each of them is totally dependent on our understanding of the other. Their existence is so commingled in our consciousness that if we decide to concentrate our attention on one of them, the other comes into our consciousness eventually, whether we intend it or not.

Sickness and health are an example I use often, because I work with people who have chronic physical problems. When I began to recuperate from the worst ravages of rheumatoid arthritis, and spent more and more time out of bed, I climbed onto the ever-turning wheel of the sickness-health dichotomy. Every morning when I awoke, I’d think, “Am I better or worse today?” Because I was emotionally involved with the answer—I was repelled by my sickness and clinging to any signs of good health—I was either cast down and disappointed, or raised up and elated, depending on whether I was feeling better or worse.

So the problem with pain is aversion, and the problem with pleasure is clinging. The solution is to just live your life without getting tripped up by all these fixations, but “just” means living your whole life. It’s being alive for all the details of your life and not picking out the moments that you’re going to attend to and those you’re going to ignore. You can take care of your body simply because it yearns to be taken care of and you are alive, listening to its yearnings, flowing in and out of its intelligence, not making it into a separate being apart from yourself. You can attend to your relationships with friends and mates with a heart open to all their various characteristics, those you enjoy and those you find annoying.

There is an absence of struggle when you pay attention this way. What is really going on is that you are doing what needs to be done for your body and for your relationships; it’s not you against sickness or pain or your friends’ personalities.

When you do prefer one state of mind over another, whether it’s pleasure or pain, you lose your capacity to be present in the moment. When you’re making love, you’re taking time out to think, “Can we do this again before morning?” Instead of tasting every morsel in your mouth during the birthday dinner lovingly prepared by your friends, you’re thinking, “What’s the next course?” You’re constantly living somewhere else, in the past or the future.

If you do see your cycle of craving and aversion, and regard it with some humor or detachment, bemused at the fact that you’re always running after something or away from something, you can begin to practice the disinterested pursuit of pleasure. This is pleasure recognized and fostered rather than frantically and compulsively grasped at. You can cultivate pleasure in the same way that you eat sensibly or put on your jacket when it’s cold. This is just something you do for your and others’ wellbeing.

Why should you cultivate pleasure in this disinterested way? Recent research indicates that pleasure is good for you. Pleasure is biochemically better for your health than pain is; it produces a different blood chemistry than pain does. Pleasurable experiences make you breathe deeper, and some of them make your immune system function better. Pleasure relaxes your body, so that your muscles are more flexible and responsive. They can gently pull your joints apart as you move, keeping you from getting arthritis or easing the arthritis you already have.

The technique that many of us use to become more conscious of the fundamental elements of our lives is meditation, which can be defined simply as awareness. There is an infinite variety of things to be aware of: our breath, body sensations, thoughts, moods, physical movements; the animal presence of other people in the room; the sounds we hear—to name a few.

Learning how to pay this kind of attention can radically change the quality of pain or stress, because the kind of mind it produces is clear and focused compared to our usual churning, busy, jumbled mind. This lucid mind gives us a perspective from which we can set priorities in our lives based on our real values rather than mere habit. A great deal of our daily stress stems from confusion over what is really important to us. Do we actually need to get dinner on the table as fast as possible, or is that just a habit we could reevaluate? It is good to become conscious of our actual values. We might really believe that our well-being is more important than living efficiently, but we might have forgotten our beliefs in the crush of daily demands.

So how do you begin to develop this ability to pay attention and use it to cultivate your healing, your sense of ease, your capacity to discover the happiness that is already there?

Every day you can practice paying attention to the world in which you live this very moment. Sit still for twenty to thirty minutes and just notice your sensations, thoughts, and sense impressions. Practice noticing them without worrying about what they are. After some weeks of this sort of practice, you will find it easier to shift into this mode of attention whenever you wish. Even though the stress of pain or anxiety is very compelling, the more you practice bringing to it your full attention, the more skilled you become. When you become able to include this awareness in all your everyday interactions, you will notice that your life takes on a more wholehearted quality, as though you had more of yourself available for each thing that you do.

Another form of meditation practice is to focus your attention on just one thing, like your breath, carefully counting your inhalations and exhalations and noticing the pauses in between. Focusing on anything to the exclusion of everything else is called a concentration practice. You are developing your ability to focus all your attention on one particular thing and let everything else, no matter how potentially riveting, drop away.

When you are doing a concentration practice, you not only notice when your attention is steadily focused on the object you have chosen, but you also notice when it wanders away. If you are new to meditation, you will probably be amazed at how often your mind wanders away from the object on which you have chosen to concentrate. This wandering quality is a basic propensity of the mind. I call it “puppy mind,” a tendency to run about and sniff everything.

It doesn’t matter how many times your mind wanders away, perhaps thousands in a single half-hour meditation session. What’s important is that you notice that your mind has wandered, and specifically where it has wandered to, then you gently disengage from that diversion and guide your attention back to your chosen focus, whatever that is.

I think of concentration practice as developing the “coming-back” muscle. The more times your mind wanders away, the more opportunities you have to develop your ability to refocus your attention, to strengthen your coming-back muscle. Concentration meditation practice is not a matter of ruthlessly eliminating the random thoughts that tug at your attention; it is a matter of patiently and kindly, ideally without self-criticism or irritation, abandoning the side roads and turning your attention back to the object of your concentration.

The following is a good practice to build up your coming-back muscle:

1.Arrange yourself in a position that is both stable and comfortable.

2. Settle yourself and begin to notice your breath, specifically the inhalations and exhalations.

3. Without changing the rhythm or pace of your breath, begin to count the inhalations and exhalations from one to ten. An inhalation and an exhalation count as a pair. That is, the first time you breathe in, you say “one” in your mind; when you breathe out, you say “one” again. The next inhalation is “two”; the next exhalation is “two.”

4. When you get to ten, start over again, so that you are counting a continuous series of one to ten. Continue this throughout your period of meditation—say, for twenty to thirty minutes.

Whenever your attention leaves your counting, note specifically where it goes—for example, to what you have to do after this period of meditation, to a fantasy of what you’d rather be doing, to thoughts of irritation or agitation, to sleepiness, to a work project, whatever. It doesn’t matter where it goes; what’s important is that you gently return it to your breath and your counting. The counting is to help you notice that your attention has strayed.

What may be especially interesting to you is where your attention goes. You may notice obsessive patterns and habits of mind you weren’t aware of before starting this practice. No matter how many times you lose track of your counting, note where your attention goes, over and over again, and then gently bring it back to your counting. This exercise both develops your coming-back muscle and reveals your own particular habits of mind, the favorite places you revisit again and again.

When we become skillful at noticing our habits of mind and letting them come and go without disturbing us, we realize that each state of mind, including strong emotions, only lasts for seconds before being replaced by another one. Anger turns to sadness, which turns to melancholy, which turns to comfort, which turns to relaxation, which turns to enjoyment, and so on. We come to appreciate that the underlying nature of puppy mind is actually a ceaseless, uninterrupted flow of thoughts and feelings. When we understand this truth, we can choose to settle into the awareness of each thought or feeling as it arises and passes. In this way, we cultivate some freedom from the frantic imbalance created by each one.

In general, it is very important to be patient with yourself when you are beginning a meditation practice. You are attempting something that is inherently very difficult: breaking old habits. And these habits aren’t even as blatant as biting your fingernails or smoking cigarettes. They’re habits of mind. The rule of thumb is that it takes ten thousand times to notice that you have a bad habit, ten thousand more times to catch yourself doing it, and ten thousand more times to substitute an alternative behavior. The ancients who derived this dictum understood the coercive power of habit. With this practice, you will begin to as well.
            
©2000 Darlene Cohen. Used by permission of Shambhala Publications.


Darlene Cohen is a Zen teacher at the San Francisco Zen Center. She counsels chronic pain clients and gives workshops and lectures in the Bay area on arthritis and living with pain. This article is adapted from her book, Finding a Joyful Life in the Heart of Pain, published by Shambhala Publications.
 
Finding Joy Amid the Pain, Darlene Cohen, Shambhala Sun, July 2000. No problem. My pleasure SnowOwl. 
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