Living with pain, not in pain.

Chronic pain is a very common and often debilitating condition that affects young and old alike. Western medicine struggles with pain management, we encourage modalities like physical therapy, massage, accupuncture, exercise, but often end up turning to opioids and other medications to manage chronic pain. Meditation has made its way into the treatment of pain, but even that has mixed results. 

Meditation seems to be touted as a cure-all these days, recommended for everything from treating hypertension, to mental illness, chronic pain, and improving overall well-being. There is a lot of good data supporting the practice of meditation for these purposes, but I think it is important to recognize that meditation is not a cure-all, but rather manages to make everything workable. 

This is a rather minor but significant shift. Meditation won't solve all your problems, but it will help make all your problems workable. Problems of all kinds are solved when we see them as workable. When we know that we can experiment, play around with things, try something new in a maybe slightly different way, we can solve problems. Maybe the problem goes away, maybe it just becomes less of a threat. 

Most of the power that problems have, and this is especially true of chronic pain, is that they seem inescapable. The pain doesn't go away, and it doesn't seem likely that it is going to go away tomorrow. This persistent experience in our lives is exhausting and drains a lot of our attention and energy. When we fight our pain, it always wins, because it gains power when we resist it. Try to escape its presence by using drugs and alcohol, and we just find it again on the other side of our stupor. Escape seems hopeless, we seem powerless, and it is very easy for depression to set it. 

The solution that meditation provides is to find some space with the pain. In meditation, we find that we can experience pain, but not be overwhelmed by the pain. The pain is there, dancing, doing its thing, but it is also a little distant from 'us'. We find that we don't need to identify with the pain, that we can live with the pain, rather than in pain. Pain in this sense becomes like a companion with us on the journey of life. Sure, it is often a nagging companion that we don't really want to hang out with, but alas, here we are. If they are going to join you on this journey, you might as well figure out how this relationship is going to work. 

If you are feeling stuck with a chronic problem like pain, start by trying to find a space where you can be present amidst the pain. Set out to discover a sense of peace and calm, a solid ground to stand (or sit), amidst the experience of pain. This ground is the basis of exploring and understanding your relationship with pain. When you start to realize that you can experience pain but not be dominated by its presence, then you have made the problem workable. Gradually, your presence overpowers the presence of pain. Sit with that, your presence overwhelms the presence of pain, rather than the other way around (the old way of our relationship with pain).

Then, like the Buddha said, our pain becomes like a teaspoon for salt in a large body of water, rather than a small cup. The salts still there, but not as distasteful.  

My last thought on the use of meditation for working with pain. Often, we are asked by the doctor how much pain we are in, 0-10. If the pain is held as a constant level of experience, what if we change our relationship to that pain. How can we move from a 7 to a 5? Or even a two? That's what meditation can do, I'm confident of that. 

Healing.

It is important to know that healing doesn't mean to cure.

We can have wounds, even open wounds, and be healed. 

Someday, this might be important to know. 

Our biggest challenge.

We are all looking for resolution to the problems in our life. 

Disease cured.
Work done.
Problem solved.

But resolution is momentary, impermanent.  Something is always arising. 

Problems keep coming up, more work needs to be done.  Aging, sickness and death continues to play itself out.

Our struggle is with the unresolved state.  It is uncomfortable, unpredictable, worrisome.  Not knowing how to work with it, we seek solutions in order to escape the unease.

Our biggest challenge is learning how to work with the unresolved state.   

Let's change how we orient ourselves to resolution.

Resolution does not equal done.
Resolution is allowing whatever is coming up to be free in its own place.

By changing our orientation we can work with whatever is coming up without being pushed over the edge.  The problem might not be solvable, maybe not even for many ages, but we simply work with our situation as it is. 

Then problems and illness become methods by which we engage in our practice of resolving whatever arises.  Resolving into their own place, we don't experience dissatisfaction from fighting against them.  We can occupy a space of presence, clarity and ease.  We allow for moments of enjoyment and reflection.  Generosity and abundance become possible amidst unfortunate conditions. 

The best part of learning to resolve phenomena in their own place is that we can enjoy the fruit of our practice now, not some day in the distant future when all of our problems are solved. 

A source of refuge?

Everyone who enters a healthcare setting is there because of hope and fear.

The 52yo male with high blood pressure.
The 46yo female with Type 2 Diabetes.
The 27yo male with generalized anxiety disorder.
The 4yo female with a nasty cough and an earache.

The are looking to get rid of the pain or discomfort.  They are hoping to feel better.  They don't know what their future holds and they are afraid of untimely death or medical complications.  The process of aging, sickness and death affects us all and it is a lot to handle.

So we ask the doctor, the pharmacist, the nurse or dietician to help us.  And they want to help.

So we give you a medication, set out some treatment goals that have been statistically proven to reduce your long term risk (even as those goals change every couple of years), and we enforce regular follow up and examination.

But we aren't in the business of curing things.

We can get rid of certain infections, cure your kids pink eye (if its bacterial).  We can remove certain tumors and benign growths, but we don't cure much of anything.

We can't even cure acid reflux (but here is a Prilosec).  Funny isn't it, how easy it is to direct you to a pill instead of doing the hard work of recommending a change in your diet and lifestyle and following up on that change.  What if a doctor's first words weren't as simple as take this?

So people come to us, looking for health, to feel better and to remove the fear of death and the unknown.  We give them a pill.  A subscription prescription for health.   A placebo would not be a moral treatment, but placebo or active medication the cure rate would remain the same.  Zero. 

That is because the cure lies in you.  If there is a cure at all. 

It is your choices, your decisions and actions.  It took a long while to get where you are, and it won't reverse over night.  But if you care about your health, your well being and happines, then you need to take responsibility for it. 

Do you turn the keys to your health, well being and happiness over to others?
Or do you own it?  Take the keys.  In the meantime, we are still here to help you manage your symptoms and reduce your long term risk while you make those changes. 

That is what we should be here for- helping you in the pursuit of your own health and well being.  Empowering you, providing the support and filling in the knowledge gaps. 

This is about our healthcare system, but it also applies to our work, religion, happiness- everything.

Take the keys.