🧘 How should I deal with pain in the practice?

It can be very challenging to work with painful and uncomfortable sensations in our body during meditation. With practice, our capacity to just be with unpleasant experiences gets stronger, and we learn how to navigate them wisely and skillfully. Joseph Goldstein talks more about dealing with discomfort in the video for Session 6 of The Basics course (“Challenges in Meditation”). You can also search in the app for guided meditations related to working with pain.

When we encounter painful sensations in our meditation, we have a couple of options for how to work with them. One is to turn towards the sensations and open to the discomfort with a gentle allowing for it to be part of our field of awareness without reactivity. If our mind is stable enough, we can investigate the uncomfortable sensations with some curiosity, beginning to examine our pain with some interest and exploring where the sensations might be less solid and fixed than we think. So rather than noting a blanket "pain," we might use more specific words that point to the direct physical experience such as "tightness," "pressure," "burning," and so on. We can start to notice that there may be areas within the part of our body where discomfort is happening that actually feel neutral or even pleasant and that the uncomfortable sensations that seem very fixed are often changing and shifting when we look at them more closely.

If, however, staying with the pain is undermining our ability to stay mindful of it, then as an alternative, we can also consciously turn our attention away from the pain to areas of the body that might feel subtly neutral or pleasant—where there is no discomfort—and we can intentionally concentrate our attention in these areas. It’s also perfectly acceptable, and sometimes wise, to shift positions when we determine that it is not healthy or safe for our body to be in its current position or that the sensations are getting too much for our capacity to be with them. In this case, the key is to shift positions mindfully and with awareness, rather than doing it automatically or reactively.

Another option is to take a much wider field of awareness of the whole body, and even outside the bounds of the body, so that while we are still aware of the uncomfortable sensations, they occupy a much smaller portion of our awareness, and we are also able to notice other things happening in our environment, such as sounds. You might think of this approach kind of like if we were to put a handful of salt into a small container of water it would have a significant effect on the taste of the water, but if we put the same amount of salt into a huge lake it would have no perceptible impact. Like this, we can be aware of the uncomfortable sensations occurring but hold them within a much larger field of awareness that is also aware of other experiences. And we can use our awareness to move in and out of the uncomfortable sensations as we feel able to meet them, using the techniques described above.

When there are strong unpleasant sensations in the body, it can also be useful to bring attention to what else is happening in the mind, especially to our attitude towards the experience and the likely proliferation of negative thoughts and feelings that we might create in response to the uncomfortable sensations. One of the challenges we can face in meditation is the common tendency to “eternalize” unpleasant experiences. For example, we may think: “Because I’m feeling pain right now, the whole rest of my life is going to be that way.” This can create a lot of added stress and suffering on top of an already unpleasant experience. Often the most difficult part of working with physical pain is actually the fear, anxiety, or sadness that may arise when we focus on our projections into the future and imagine how it will always be this way or face the anxiety that comes with the uncertainty of how we will feel going forward. These are all valid concerns and experiences but they can quickly get us lost in projecting into the future rather than staying present with what is actually happening for us right now, which, at its most basic, is just the bare experience of sensations, albeit unpleasant ones.

Finally, during periods of very intense pain, it often helps to bring in a lot of compassion for ourselves as this may be a strong experience of suffering. Drawing upon loving-kindness meditation — as taught in Sharon Salzberg's course, 10% Nicer — we can bring gentle kindness and care for ourselves, even placing a hand on our heart and holding our experience in kind awareness, recognizing the wish for ourselves to be free of pain and suffering, and using that sincere wish to soften our hearts with compassion. Self-compassion meditation can also be very supportive during difficult times; you might like to check out some of these offerings on the app: