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What advice (or techniques e.g. of meditation) does Buddhism (of any tradition) have for people who experience physical pain (caused by an illness and treated by a doctor)? Or for the people (friends, family, even nurses) of such people?

That (physical pain) is what the word "suffering" implies or means to most people.

Is "see the doctor, get better analgesics" the best or only real answer? What if analgesics have an effect on the mind -- e.g. opioids -- is that 'bad'? What if analgesics don't work, e.g. neuropathic pain, or if the medicines are not available?

Sorry for asking. This isn't a "real problem" for me at the moment, so it may be an example of unnecessary worry -- but I'm able to ask now, and in case this problem happens to me or someone else in the future, I want to have prepared/studied some appropriate advice in advance.

And/or what advice do you have for people now, before they experience pain, to prepare.


I agree that 'pain' is meant to send some kind of warning message, so temporary/new pain and a trip to the doctor might be the first thing.

For the sake of this question, please assume that the underlying problem has already been medically diagnosed: that it is chronic pain, from an illness like diabetic neuropathy or terminal cancer, or something like that.

  • Commenting since this isn't wort a full answer. Shinzen Young is a very experienced meditation teacher, and has a lot to say about pain. In particular he has sympathy with your point, ChrisW, That although your pain might not be an issue right now, it could become one, and so better to learn how to manage it now while you have the chance! Here's a starting point: shinzen.org/Articles/artPain.pdf – tkp Oct 13 '14 at 19:46
  • One other comment-not-worth-an-answer: opiate pain killers are probably second only to terrorism in that they needlessly scare the bejeezus out of too many people. The vast majority of people use them properly, don't end up with addiction issues, and could learn meditation and meditation-related pain control synergistically with (careful) opiate use. In that respect, they are no more "bad" (nor good) than chocolate. – tkp Oct 13 '14 at 19:49
  • @tkp Thank you for the reference etc. It is a good answer and needn't be 'merely' a comment. – ChrisW Oct 13 '14 at 19:53
  • I would recommend watching this discourse by Yuttadhammo Bhikkhu on Pain : youtube.com/watch?v=BldDclolLCg – Monk Oct 15 '14 at 15:58
  • @Monk I would not: its subject is, what you can learn from the pain of getting stiff legs during meditation. It would be IMO a desperately inappropriate/cruel set of messages to give to someone who is seriously ill and in pain, unless perhaps they have already bought into (internalized) the philosophy: in summary in says, "the universe doesn't care about your pain; suffering is part of life; the fire of attachment is suffering, happiness doesn't come from clinging to impermanent things; it's not a big deal it's not going to kill me; whatever you do isn't going to solve the problem so give up". – ChrisW Oct 15 '14 at 16:29
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According to my teacher, the enlightened attitude is to see pain is information. (For comparison, the non-enlightened attitude is to block/avoid/suppress pain by all means.) Because pain is information, we should evaluate it, see what message it carries and what it means for us, and then act.

Some physical pain is a symptom of a deeper-lying problem, and instead of suppressing the symptom a wiser approach would be to take care of the causes (often, bad lifestyle habits).

Some physical pain accompanies exercises that help one get stronger physically and emotionally. The right attitude to such pain is to accept the physical component and by accepting it eliminate the emotional component that comes from resistance and self-pity (so called "pain of pain").

Obviously, some physical pain is a sign of damage being done to the body right now, like the pain that accompanies tearing of ligaments. There is also residual pain that accompanies recovery process etc. -- these fall in the realm of regular medicine.

So the rule of thumb is to not worry about the pain itself, but the message behind it.

However, if pain is so overwhelmingly strong that it obscures the mind, I would imagine the Buddhist approach would not disagree with using anesthetics temporarily.

  • I assume, perhaps unskillfully, that accepting medicine is part of the Middle Way. I read that medicine is permitted to monks. – ChrisW Oct 13 '14 at 17:08
  • I'm sorry i can't see a relationship between my answer and your comment. I see you edited your question now. You're asking about techniques for dealing with pain. Yes, the technique is to see pain directly as energy or information. Then it is no longer painful. – Andrei Volkov Oct 13 '14 at 18:31
  • Your last sentence "would imagine the Buddhist approach would not disagree with anesthetics": I tried to confirm that. – ChrisW Oct 13 '14 at 18:36
  • Are you equating anesthesia with medicine? Cuz for me these are two different things. One treats causes and the other suppresses symptoms. – Andrei Volkov Oct 13 '14 at 18:36
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    Yeah, i have some experience of watching strong throbbing pain for days. With time it becomes a 3D scene. Plus, my current mentor has us do pain tolerance exercises every week. Once you switch, pain feels more like heat, not like pain pain. (It's not a damaging pain, just static muscle exercise) – Andrei Volkov Oct 13 '14 at 18:59
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This is not a proper answer about the ethics but my personal experience.

Four years ago I was diagnosed with Stage 4 cancer of the jaw and was given two months to live. I prepared my final plans, said goodbye to my family and gave up everything to my wife (who's a MD so truly understood the score). While I've almost died more than a few times (USCG MK on a 44' MLB in the North Atlantic) this sucked because I had children. Even with surgery it was unlikely they would get everything. I was most likely going to die.

After aggressive, life altering surgery (12 hours on the table and three days in a coma but with clean margins), major chemo and 39 radiation sessions to the head in an eight month span that nearly killed me the cancer was gone. As I healed I slowly and systematically in a six month span weaned myself off of a >200mg daily dose of oxycodone. I'd like to say it was tough but it wasn't. Uncomfortable? Yes but I knew that the discomfort was not of being sick but of healing so I welcomed it. For three months after that I went with no pain medications, prescription, OTC or other.

What was left was major neuropathic pain around the surgical site where facial injuries are very sensitive and right leg where the bone graft [implanted in my jaw] was taken. My MDs have no problem having me on opiates until I die but to me that was a death. For me any opiates were not acceptable. So what did I do? My state has a medical cannabis law and I got a caretaker that in many ways is a true bodhisattva. Is it worse than alcohol and opiates? IMO and those of my MDs: no. My IM MD (a medical school professor and addiction specialist) of >15y is happy with my choice. With tinnitus from the chemo I can't even take a NSAID. Medical cannabis has made a difference in my life. It's not perfect but it is IMO relatively benign and my best choice.

So IMO in the end it has to be your choice. If you need medications then take them. If you don't then don't. Also IMO the fact that you're even asking the question clearly shows you understand this and would embrace it. You're "ahead of the curve" on this one.

I hope you find an answer that works for you.

Today I find myself as the personal secretary to a Vietnamese-American Dharma master (her master was the "Mother Teresa of Vietnam" and only in a handful of Dharma heirs from her) and abbess of the local nunnery who is the most compassionate person I will ever meet. She truly understands the lesson of Avalokiteśvara and lives that life to the betterment of our sangha. To sit at the same desk with a such a person is humbling.

Life does go on.

Nam mô A Di Đà Phật.

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There are multiple "pain clearing" techniques, that have a meditative and Buddhist foundation.

First, I'll summarize a few high points (see (1) thru (3) below), then I'll give abbreviated steps for the technique I most often use (see (a) thru (i) below). For whatever understanding is worth (sometimes understanding is the booby prize ;) here's the few high points:

  1. Play with the point of view, that pain and suffering are distinct, and that suffering is all about resistance. (You can see the Buddhist roots of this.) So... for this: EMBRACE your right-now experience (if you have resistance, embrace that too), the "suffering" aspect decreases... and as you continue to embrace, not only can the suffering decrease... you can even see the pain disappear.
  2. Pain may initially be a natural response, but very quickly (seconds), you can end up experiencing the memory of a pain, as much or more than the actual right-now sensations. So, for this: BE PRESENT. For example be aware, and then notice who is the one being aware.

    (Afternote: also, suffering can be our emotional recoil from the pain... which the "welcoming" steps below will help with.)

  3. Also helpful: bring something that is "present energy" for you, to the pain. Examples: spaciousness, love, presence, relatedness.

Ok, an example of using the technique below: the day after I learned the below Sedona Method's pain-clearing technique (from a group phone conference, facilitated by Hale Dwoskin)... I slammed my fingers, while closing a window using one hand... so hard, that I had to drop what I had in my free hand, so I could pound the window, to get it open. Long story short: about 5-10 minutes later, I still had bloody fingers, but no pain... using that technique.

The technique: (a) experience the right-now sensations (not just the pain -- ALL sensations); (b) experience the spaciousness, that surrounds and inter-penetrates that; (c) go back to the right-now sensations; (d) spaciousness again; (e) back and forth -- sensations, spaciousness... maybe 10 times... (f) ask yourself: would I be open to seeing this experience as a memory?; (g) COULD I let that memory go?; (h) WOULD i let that memory go?; (i) and When? Repeat (a) - (i) above if helpful.

Note the Buddhist elements: the now, the non-resistance, and the spaciousness.

I've taken probably 10 people thru that technique, and consistently had them report pain decrease... sometimes complete disappearance.


Another modality with a good pain-clearing meditation is Brandon Bays' modality "The Journey"... but while a lot she does includes a Buddhist flavor, her pain-clearing technique is more NLP / visualization.


Another example that is very Buddhist is from a tape (I think it was "The Art of Happiness") that I heard, by Ken Keyes Jr., who wrote "The Handbook to Higher Consciousness" (again, some very Buddhist roots), and who himself was a Polio victim confined to a wheelchair. He had an entire group raise their hands if they had chronic pain (it sounded like some did), then TRACE IN THE AIR an outline of their pain, going around and around the outline, constantly updating it as he continued to lecture... then at his next break in his train of thought, he asked them to share if their pain had decreased... and for some, their chronic pain had actually disappeared. Again, notice the Buddhist elements: being present, staying where we are, welcoming what's here... or simply "being with" it in a way that has us get related to how it really is, right now.

Of course, it also helps to have someone else take us thru steps like this, especially the first time we're doing it... but I disappeared that window-slam pain facilitating myself.

Hope that helps.

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My own approach toward pain is to meditate. If I have pain sitting up I lay down. If I fall asleep I must need sleep. What is meditation? "a state of consciousness in which the observer detaches from several qualities of the mind." One of these qualities is pain. http://en.wikipedia.org/wiki/Dhy%C4%81na_in_Buddhism

Dhyāna (Sanskrit; Devanagari: ध्यान) or Jhāna (झान) (Pāli) means meditation in Hinduism, Buddhism and Jainism. It refers to various states of samadhi,[1] a state of consciousness in which the observer detaches from several qualities of the mind.[2] In this state one has become firm and stable and everything that is appearing is noticed but not identified to.[3]

Dhyana is the awareness of the observer (witness) yet inclusive of mind, body, senses and surroundings, however not identified with it, deepening of which leads to samadhi. The Sutta Pitaka describes four levels of dhyana, called jhana, each of increasing depth. The Jhanas are described many times in the Pāli canon, and a great deal of the post-canonical Theravāda Buddhist and Mahayana literature have been devoted to its elucidation.

Rather than tell you how to meditate (follow the breath, concentrate, have compassion for all people, and other Buddhist meditation techniques) let me just say expand your meditation practice or add new elements to it. Of course this is not a recommendation to opt out of medical treatment if you feel that is your path, but it is to say that relief can be found, or at least a distancing and non-identification with the body sensations. Of course if you are bleeding, stop the bleeding, then meditate. Do all you can like accupressure, yoga or whatever gives you relief, then meditate. Start your day with meditation and end it with meditation. Distance yourself from the pain as you count the breaths. The pain may not disappear but the identification with the pain may disappear. This is the Buddhist concept of cessation. A pain is still a pain, but it is no longer my pain. It is a merely an electrical impulse in the aggregates that form the body.

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I think that for pain one ought to take pain medication if the pain is enough to interfere with normal functioning. Even if it has an effect on the mind I think it is a legitimate reason. For example, in the Vinaya Pitika the Buddha went so far as to recommend the use of marijuana placed in boiling water as pain relief for arthritis, and the mind altering effects of marijuana is more than that of opiate pain meds taken at a proper dose, so pain meds should be fine.

In terms of other ways to have pain relief I have found in my own experience that practicing mindfulness of the body is an effective method. Even if it can't get rid of the pain mindfulness of the body can greatly reduce the mental reaction to the physical pain making it quite bearable. I wouldn't try to use it in place of medication, but using it along side it should help.

For information on practicing mindfulness of the body I recommend reading the Kayagatasati Sutta particularly the instructions on discerning the body in terms of the four properties.

  • The "proper dose" of opiate pain meds can become high: in some situations/countries a doctor may eventually become willing to prescribe a dose that's high enough to have a sedative effect: in this Buddhist perspectives article, see e.g. "the need for alertness in the dying Buddhist" to avoid having too much, conversely "cognitive impairment (e.g. delirium)" about having too little. – ChrisW Oct 13 '14 at 15:29
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There's a guided meditation on that subject here: Using Meditation to Deal with Pain, Illness & Death

The author (Thanissaro Bikkhu) says that he used it to "help get me through the worst bouts of pain and disorientation" when he had malaria, suggests that it's useful to practice before it's "too late to get fully prepared", and recommends it for care-givers as well as for the patients who are in pain.

It's "breath meditation" without 'so-called' Buddhist doctrine: apparently it's a speech he gave to people at an AIDS conference; so it could be useful also for people with non-Buddhist relatives or friends.

It begins,

Close your eyes and say to yourself, 'May I be truly happy and free from suffering.' [etc.]

It continues,

You should be very clear on one point: The purpose of meditation is to find happiness and well-being within the mind, independent of the body or other things going on outside. Your aim is to find something solid within that you can depend on no matter what happens to the body.

Some specific techniques or ideas begin with the paragraph which starts with,

So now I would like to focus on how to use meditation to face these things and transcend them. First, pain. When it happens, you first have to accept that it's there.

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I have tried this myself when i was sick and this is not my personal opinion,This was advised by lord Buddha to the monks (Theravada).It is a meditation called "Vidarshana".It focus on the temporariness of what we feel and can numb mild pains within minutes.This is one of the two meditations mentioned in Theravada Buddhism to unlock enlightenment.

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