yoga for chronic pain

Chronic Pain

We have a hard time relating to pain, humans. Everything tells us we should be happy and pain free.  We are sold 'cures'.  Medicinals are hawked at our symptoms, which tells us symptoms should be gotten rid of as best as possible.

Yet if we're human - and I'll just suppose for the moment that we are - there will come a time when pain levels us and can't be avoided.

Since we're practicing, we're becoming more sensitive to pain, not less.  We're becoming more attuned not only to floated, inspirational moments where we feel so alive but also to the nagging voices, the days we creak, and the murky underlying issues in our hearts.

Practicing, we're more sensate not only to our own inner pain, but the pain of others.  Compassion and empathy are noble and valuable things.  We want to be kind.  The science shows that these practices draw us open in that direction, along with healing our anxieties and soothing our depressions.  This is great. This is true.  But the advertising of mindfulness doesn't quite touch the bone truth of the matter: tenderness and compassion sing with ache; this stuff literally hurts.  Months ago, around a death of a student's parent, two children unknown to myself, and a rash of American violence in the headlines, I said sitting with our pain opens us to humanity.  Ours.  Other's.

I don't know if I also said 'it hurts like hell'.  Maybe I did.

Practice makes us aware of how we react to the pain of others.  Good intentions aside, we're rarely compassionate.  Generally speaking, other people's pain is usually worse than our own.  You'd think this would elicit gratitude or sympathy. It makes us angry.  The pain of strangers elicits judgement. The pain of loved ones moves us to fix, advise, or in some way 'handle' the situation.

Relating to pain is hard.  The heart is tender.  It bruises so easily.

Relating to the pain of other human beings generally proves we need to change the story we've been telling ourselves. A mawed heart rearranges us.

Pain forces a visceral knowing of vulnerability.  I mean actual viscera.  I mean the fact of dying, on top of the frailty of relationships, money, day to day grind.  All out of the blue, we are totaled.  The car is wrecked.  The delicate balance of finances has to be rearranged and the day to day is out the window.  It's gone, like a flit of paper napkin out a car window, hundreds of miles deep into a highway.  Such things will never be touched by a hand again.

*

I am alone in the house.  It is January.  January with it's big swallowed chestedness about how I will act in the coming year.  This year, I've promised myself I will write about yoga, which has historically been hard for me to do.  Something of a fear of being incredible, lacking authority; something too of exasperation - how does one write things that are beyond language?; and something, too, of the self doubt and perfectionism that spoil most everyone's resolutions.

With gusto, with jazz and trumpeting, with a sense of relief and finality, I dedicated the year to writing a book.

Then I got sick.

The sunlight in my house is spectacular, mid winter.  It is the idea of white, the only warmth winter has.  My living room is a sundial and the light pours in the old windows, floods room after room like water bursting a dam.  I love this light, this clarion solitude.  It's a place of sun washed skin, and paper.   The insides can come all out, haloed.  All, out. Hallowed ink haloed.

Today I lay in it, not writing, sprawled gingerly, hardly breathing.  I am wrapt with disgust. This is not what I meant when I said I love the light.  This is not what I wanted.

*

The Sallatha Sutra has a teaching on pain.  It says a practicer relates to, rather than reacts. The story explains how this still hurts.

The story is called the two darts.

One who hasn't learned these practices feels pain, and then seeks soothing.  Through the mouth, sweets and cigarettes.  Or though the mind, blame and indignation.  This reaction is like a second dart, a second wounding, infecting the first. It tends to feed the first pain, hang around in it's own right, and become the only sensation left.  Sugar balm.  Nicotine stain.  Resentment like a crude oil on the whites of our eyes.

The practioner ("noble, well trained") feels the pain.  Knows the rising, passing.  Knows reality.  "Is not fettered by suffering".

But the story doesn't ever say "be happy and painfree!  You'll never have to feel that way again."  It just doesn't.

*

A girlfriend - not a yogi or a buddhist - asks me sweet heartedly how I am.  I cite aches and pains.  Mounds of kleenex.  The inefficacy of medicine.  The thing under my back rib that feels like a rusted blade.  I explain how I try very hard not to touch this when breathing.  How hard my shoulders and neck and jaw and eyes are with the effort.

She asks, all sweetheartedly, how I am doing emotionally.  I gave more physical details.

I'm sorry, she says.  That sounds anxious and fearful and angry.  A little resignation, sadness, and uncertainty.

Yes, I said, internally wondering how she is not the buddhist and why I, the yoga teacher, slipped into complaint and didn't catch all that she just summed up in 10 odd seconds. I suppose anyone who relates, who is compassionate, is buddhist and yogi.  She fingered at my bruise.  She prodded, true.  She related to my pain while I was shooting daggers at it.

Yes.  How can I be a yoga teacher, I said, how can I possibly run a studio if I am dealing with a dumb and inexplicable and uncontrollable thing called 'chronic pain'?

My disgust is not with plegm, ache, or the muddy thinking; I am disgusted with uncertainty.  I am afraid.  I am disgusted by the uncontrollablity of pain.

* Nyanaponika Thera's translation of the Salltha Sutra says:

"An untaught worldling, O monks, experiences pleasant feelings, he experiences painful feelings and he experiences neutral feelings. A well-taught noble disciple likewise experiences pleasant, painful and neutral feelings. Now what is the distinction, the diversity, the difference that exists herein between a well-taught noble disciple and an untaught worldling?

"When an untaught worldling is touched by a painful (bodily) feeling, he worries and grieves, he laments, beats his breast, weeps and is distraught. He thus experiences two kinds of feelings, a bodily and a mental feeling. It is as if a man were pierced by a dart and, following the first piercing, he is hit by a second dart. So that person will experience feelings caused by two darts. It is similar with an untaught worldling: when touched by a painful (bodily) feeling, he worries and grieves, he laments, beats his breast, weeps and is distraught. So he experiences two kinds of feeling: a bodily and a mental feeling.

"Having been touched by that painful feeling, he resists (and resents) it. Then in him who so resists (and resents) that painful feeling, an underlying tendency of resistance against that painful feeling comes to underlie (his mind). Under the impact of that painful feeling he then proceeds to enjoy sensual happiness. And why does he do so? An untaught worldling, O monks, does not know of any other escape from painful feelings except the enjoyment of sensual happiness. Then in him who enjoys sensual happiness, an underlying tendency to lust for pleasant feelings comes to underlie (his mind). He does not know, according to facts, the arising and ending of these feelings, nor the gratification, the danger and the escape, connected with these feelings. In him who lacks that knowledge, an underlying tendency to ignorance as to neutral feelings comes to underlie (his mind). When he experiences a pleasant feeling, a painful feeling or a neutral feeling, he feels it as one fettered by it. Such a one, O monks, is called an untaught worldling who is fettered by birth, by old age, by death, by sorrow, lamentation, pain, grief and despair. He is fettered by suffering, this I declare.

"But in the case of a well-taught noble disciple, O monks, when he is touched by a painful feeling, he will not worry nor grieve and lament, he will not beat his breast and weep, nor will he be distraught. It is one kind of feeling he experiences, a bodily one, but not a mental feeling. It is as if a man were pierced by a dart, but was not hit by a second dart following the first one. So this person experiences feelings caused by a single dart only. It is similar with a well-taught noble disciple: when touched by a painful feeling, he will no worry nor grieve and lament, he will not beat his breast and weep, nor will he be distraught. He experiences one single feeling, a bodily one.

"Having been touched by that painful feeling, he does not resist (and resent) it. Hence, in him no underlying tendency of resistance against that painful feeling comes to underlie (his mind). Under the impact of that painful feeling he does not proceed to enjoy sensual happiness. And why not? As a well-taught noble disciple he knows of an escape from painful feelings other than by enjoying sensual happiness. Then in him who does not proceed to enjoy sensual happiness, no underlying tendency to lust for pleasant feelings comes to underlie (his mind). He knows, according to facts, the arising and ending of those feelings, and the gratification, the danger and the escape connected with these feelings. In him who knows thus, no underlying tendency to ignorance as to neutral feelings comes to underlie (his mind). When he experiences a pleasant feeling, a painful feeling or a neutral feeling, he feels it as one who is not fettered by it. Such a one, O monks, is called a well-taught noble disciple who is not fettered by birth, by old age, by death, by sorrow, lamentation, pain, grief and despair. He is not fettered to suffering, this I declare.

*

A few days ago, someone brought me tulips.  Their milky, fleshy white is exactly the texture of the light from the south facing windows.  As I have been laid up, I move them with me, room to room.  I place them on the bedside table while I sleep.  In the morning I chew toast and watch them breathing.  In the evening, they are with me when I soak in the tub.

I realize this is silly.

The things I do when no one is looking are out and out absurd.  I do them, anyway, out of a weird and desperate honesty with myself.  These little ceremonies are what I am, mostly.  The best things I know of being alive.

I think of a passage May Sarton wrote in one of her journals.  "When I am alone the flowers are really seen; I can pay attention to them.  They are felt as presences.  Without them I would die.  Why do I say that?  Partly because they change before my eyes.  They live and die in a few days; they keep me closely in touch with process, with growth, and also with dying.  I am floated on their moments."

*

We are hardwired to resist and avoid pain.  This is aversion, or dvesha.  As this translation of 'the two darts' shows, dvesha run deep enough becomes resentment.  Other people's pain pisses us off.  Ours is an unfairness and elicits self-pity.  We alternate between selfishness and self-loathing.

Dvesha, aversion and avoidance, blossoms to avidya, not seeing.  Not seeing.  Not knowing.  Not feeling.  Not able to be with life.  Not able to be emotionally present even to ourselves.

Blind and stunted, we can't know reality - the beginnings and endings of things, their gratification or cessation, their escape.  We don't know pain's healing.

Aversion becomes so deep, so under and habitual, it becomes the only thing we know.  It becomes substratum, the underlying, the 'truth' through which we filter every grit of detail and arising experience.  Every sensation is the heavy lidded one of our own unseeing.

I am a sundial

A photo posted by Karin (@coalfury) on

*

Most of the time, I am well.  I was diagnosed a long time ago.  Pain was constant, if alternating between 'grim' and 'mildly incapacitating'.  But it's changed.  I mean, over years and years.  I became what is loosely called a yogi.  Over time, I became a person who eats vegetables.  I am organic and damned near vegan, most of the time.  Over the course of many years, my relationship to stress, sleep, money, time management, and other human beings has changed subtly and profoundly.  It's now mostly balanced, honest, felt.  Therefore, I am mostly well.

I believe this:  yogic movement and meditation change the way the body works so wholly the very conditions of the body change; I believe what we eat has everything to do with wellness and disease, happiness and lightness or lethargy and malise; I believe the practices of a spiritual life radically rearrange us into graceful modes of being.

I believe yoga has changed my pain.

So it is hard for me to face the fact that in spite of my yoga asana, in spite of my diet, in spite of mindful effort and good intention and new years resolutions, there will be days I will be flattened to the floor and incapable of thinking through a clear sentence.  I simply don't know how to relate to this.

*

Talking with a woman, recently, about chronic medical conditions and yoga, she suggested I focus my teaching there.  'Chronic pain' could be my schtick.  I could advertise it.

But how, I wondered.

If we know anything about chronic conditions, it's the fact that everyone's is different.  Symptoms are different; pain itself and prognoses are different.  No two people experience fibromylgia (or MS, or IBS, or PTSD) the same way.

There is no 'teaching' or 'sequence' or 'pose' I could offer for fibromylagia.  Just as there is no teaching that could answer to every knee, heart condition, or fear.  If I were to 'market' my expertise to chronic pain, what happens to the students who don't have chronic pain?  There are two dozen people around me who have 'knee pain', arthritis pain, grief pain, stress pain.  The pain of loneliness, boredom, stupid meaningless life pain.  Sometimes, normal people are totaled, all out of the blue.

Symptoms shouldn't be mitigated.  The arising and passing should be explored.  The arising and passing, of both pleasure and pain, are life.

It takes humility to be so intimate with your own life.

Intimacy with blooming and wilting flowers makes them sweet and wholly naked.  Intimacy with suffering makes suffering less personal.  Pain isn't personal.  It's chronic.

The petals yawn, fully flushed, going yellow.  They mark my hand with a shadow.  I am close.

*

Relating to pain hurts.  It asks me to not advise, not palliate, not fix or condone or judge, but to open.  Openness is ruthless and will not end.  Openness tends to demand much more of me.

Staying close to process is the only way for me to know where I am in the process; what to do, how deep it goes, what feels.  Tulips keep me, my writing, my teaching, from the foolishness of black and white, hyperbole, all or nothing.

Pema Chodon says there is a longing, a yearning, a need to honor our own wounds while opening our hearts to the wounds of others.  She says this is the way the heart wakes up.

*

I take the flowers with me, room to room.  And a box of kleenex.  And a blanket.

I cancel classes.

The tulips are four days old now.  They are limp.

Most of the time, I am well.  Today I write half a poem.  It begins, "I love the light..."

 

 

 

mysterious bodies

Body is a hard thing to understand.  We can name and label things.  We do.   But the questions of body - why?  Why am I healthy, when my brother is ill?  Why does this food do this?  What is aging?  what am I capable of?  Why does illness hit, or miss? - stay stuck in mystery. Kicked into the bucket of sometimes bad things happen to good people and don't take what you've got for granted. Except that we do.

I, do.

A few days ago a woman showed me two pictures.  The first was a bag of pills - big as a person's chest, pounds heavy - that she no longer takes.  This doesn't include the supplements and the over the counter stuff, she said.  The second picture was of a year old German Shepard, whom she has adopted and goes running with.  She couldn't walk very well when she started yoga, due to various and medically unexplained neuropathies.  Was one of those who said 'I probably won't be able to do most of this, but I'll do what I can". She was shocked when things she took as fact started changing.

Yoga does this.  Makes us take nothing, nothing for granted.

We've all heard similar stories.  Yet I don't want yoga to come across as a miracle cure, nor myself as a healer.

Yoga doesn't miraculously cure.  It only teaches us to approach our own experience as open to change.  It doesn't change disease, all the time.  Or even some of the time.  Or at all predictably.  It does, however, change our experience of being alive.  It changes us.

I have fibromyalgia.  It is flaring.  I keep forgetting what I'm doing. I stop talking midsentence because I've forgotten words, and I trip because my back or knee or ankle gives.  I think my insides are lined with cut glass. Breathing hurts.  This makes me not breathe very much.  Not breathing much has now thrown my neck out and a headache in and a shake into my arms.  For four days now I haven't been able to sleep, think, or stand without hurting.  My clothes hurt.  The bed hurts.  If you've noticed that I'm tongue tied and stupid, and forget things like yoga pants so I teach in jeans, or that I kinda hobble around like I'm seventy nine and arthritic, my apologies.  I promise it'll pass.

But here's the thing: I can still do yoga.

Mincingly, true.  Very, very slowly and cautiously, true.  But I can.  Yesterday, it amounted to one very ginger child's pose and half an hour crawling my way around blankets and bolsters trying to get under certain muscles and float the joints so they don't touch anything.  I spent the rest of the day laying in various positions on the bathroom and kitchen floor, rubbing ointments and oils and herbs in, popping ibuprofen, alternating hot and cold.  I was miserable and teary.  But I had child's pose, and one archingly tender backbend.

It seems, over the years, that yoga has given me enough knowledge and sensitivity  to move without making the pain worse.  Which is something.

I know of nothing else that asks me to move so slowly, so attentively.  Tender, but in the sweet sense of the word.

I think of all the ailments people have cited to me.  Progressive and chronic diseases.  Grief.  Anxieties.  I don't have answers.  I don't know why one person falls ill, another is hit by a car, a third seems to be 'blessed' but is miserable.  I know others with fibromyalgia who can no longer work, who are so debilitated by pain and pain medications that they have lost, significantly, the joy of being alive.

I don't know why I am mostly well.

Bodies are mysterious.  But then again, so is everything.

Every question burns down to an unknowing: We don't know right from wrong, who deserves what, why we have this body or that problem, what happens when we die or how we ought to be living.  There is no guidebook and there are no rules.  You can find rules, sure; but you can also find ten other rules offering contradictory advice.  Accepting rules and handed down wisdom gives some comfort, surely; a good enough map.  But at some point, medicine is not going to be able to answer the more human questions of our mortality.  And self help is going to fall stupidly short when it becomes a moral imperative for us to act justly, let go of our own prejudices, or help us care for our elderly.

Everything is mysterious.  We are mysterious.

Does god exist? What do I believe and what does that mean?   Am I in love?  How do I live with cancer? with grief?  None of these questions can be answered.

Right answers don't, ultimately, exist.  I don't have anything ameliorative to say about this.  Except that I know this yoga, and this yoga asks us to move slowly, attentively, with acceptance and humility and willingness, toward what is most achingly tender.  To live in the delicate and vulnerable space of questions and uncertainty.  To take up the responsibility the questions ask of us.

Each time we do, a connection is made.  Something is sounded.  I mean, like when you sound out the depth of ocean.  Not 'understood'.  Not 'proven'.  But infinitely more resonate and felt than what was there, before.

This doesn't cure.  It isn't a miracle.  It's simply a way of living that takes nothing for granted.  A tender way of attending.  A way of moving without causing pain.

Which is something.