Refocus Away from Pain
We who have pain are not to be passive and give up, and can continue to attempt
to lessen our suffering. The ultimate goal would be to become neutral in the
face of whatever outcome occurs, to not desperately strive for pain relief.
Most important, however, would be to refocus away from pain to dharma.
The Doctor's Dilemma
The guidance to seek detachment from outcomes would likewise apply to those
who treat patients. The dharma for a pain practitioner would be to be the best
practitioner possible, while accepting all outcomes. However, this wouldn't
suggest becoming indifferent to patients' suffering. Hindu traditions would
support still caring deeply for patients, but needing to recognize that physicians
aren't in control of outcomes, nor know what's the appropriate outcome from
the perspective of karma.
Mantras, Meditation & Yoga Can Help You Refocus
Specific tools for achieving detachment also include meditation and yoga. These
tools teach the understanding and control of one's mind, and seeing beyond one's
mind to God. As the focus of one's life should be on God, priority is given
to this inner journey, with less focus on the world. By becoming less attached
to one's circumstances, including being in pain, a person can focus his life
on God, not pain. Hindu traditions hold that all have a capacity to achieve
this. Spiritual assistance and support are also to be found in God. One way
to know God is through devotion, the way of 'bhakti', which implies that God
is accessible and knowable, in personal terms. A practice of some Hindus is
to pray to ask for support in facing problems, believing that their suffering
will be relieved and support will be provided.
When Religion Becomes a Hindrance
Although religion can be a positive resource for some, there are times when
religious coping can be ineffective. For Hindus, a first potential challenge
may be the feeling of passivity or fatalism that may arise because of karma.
A patient can feel hopeless or unable to change things because he feels that
things are fixed by karma. Hindu traditions counter this by saying that a person
can start in the present moment and go forward, living his life in a positive
way by following dharma. If a patient currently experiences pain, change can
occur by attending to present appropriate action.
Acceptance is Not Inaction
Acceptance can be misunderstood as passivity. Hindu traditions do advise a focus
on appropriate action, rather than outcome, but this doesn't mean inaction.
People with pain can be encouraged to actively manage their pain and continue
to seek improvement, but become detached from the outcome of these efforts.
However, the process of trying is important, rather than a focus on a final
goal of being detached. Patience with oneself is encouraged. Patients can also
try to learn as much as possible from their current situation, including their
apparent failures.
Medical Studies on Acceptance as a Coping Skill
Acceptance, from a nonreligious perspective, has been studied in pain research.
Although acceptance isn't unique to Hinduism, it's certainly central to the
religion, and includes at least two aspects. Hindu traditions view acceptance
as a logical attitude towards what one's life presents, including pain and suffering,
because all is seen as the just working of karma. The practice of acceptance
is also a means to a greater end, detachment. The process of accepting one's
life lessens one's desire for things to be different than they are. As desires
fall away, detachment is achieved. Related to pain, both painful and pain-free
states would be accepted equally. Detachment from this world, to be focused
on God, is a primary goal in Hinduism.
Acceptance Versus Control
As ways to cope with pain, acceptance-based strategies can be contrasted to
control-based strategies. In control-based strategies, the goal is to decrease
problematic thoughts, feelings, or experiences. It's believed that these need
to be reduced for improvement to occur. For example, relaxation treatment is
a control-based strategy for anxiety, in which relaxation exercises are used
to decrease the thoughts and feelings described as "anxiety." The
treatment goal would be a reduction or elimination of anxiety. In contrast,
acceptance approaches attempt to teach patients to feel emotions and bodily
sensations more fully and without avoidance.
Author's Note: How our pain experiences relate to our spirituality/religion is a special interest of mine. Spirituality was an important way of coping for me when I was suffering due to pain, and one of the most important ways I grew as a person because of the difficult time I had. Because of this special interest, I'm writing a series of journal articles on how different religious traditions view pain and suffering. The first paper in this series looks at Hinduism, and will be published in the 'Journal of Pain, 2007.'
