A Psychological Analysis of Physical and Mental Pain in Buddhism
A Psychological Analysis of Physical and Mental Pain in Buddhism
Ashin Sumanacara Mahidol University, Thailand.
Pain is a natural part of life and all of us. Ordinary people are inflicted with physical or mental pain. In this paper, firstly we will analyse the concept of physical and mental pain according to the Pali Nikāyas. Next we will discuss the causes of physical and mental pain, and investigate the unwholesome roots: greed (lobha), hatred (dosa) and delusion (moha), and their negative roles in causing physical and mental pain. Then we will highlight the Buddhist path to overcoming physical and
mental pain. Finally, we will discuss mindfulness and the therapeutic relationship. Mindfulness, as it is understood and applied in Buddhism, is a richer theory than thus far understood and applied in Western psychotherapy. Within Buddhism the development of mindfulness must be understood to be interrelated with the maturity of morality (sīla), concentration (samādhi) and wisdom (paññā).
Word about Buddhism
Buddhism, a spiritual movement, arose from the prevalent intellectual, political and cultural milieu of Indian society in the 6th century BCE and has been an influential cultural force in Asia for more than 2550 years. In recent decades, it has gained acceptance in the West, largely due to its solution of mental pain of human beings through mindfulness meditation.
The core teachings of the Buddha are contained in the Four Noble Truths, which are as follows:
(1) Dukkha: life is characterized by pain;
(2) Samudaya: the cause of pain which is craving (taṇhā);
(3) Nirodha: pain can be ended by the cessation of craving; and
(4) Magga: there is a way to achieve the cessation of pain, which is the Noble Eightfold Path (ariya-aṭṭhangika-magga).
These Four Noble Truths corresponds to four aspects in the practice of medicine:
(1) Diagnosis: determining if there is a disease.
If there is no disease, then there is no need for treatment, but in this case, there is a disease, called pain.
(2) Aetiology: the cause of the disease corresponds to the Second Noble Truth.
(3) Prognosis: a judgement about how the disease is likely to progress and that it can be cured. Again, if there is no cure, there is no need for treatment.
(4) Treatment: pain can be treated and cured by the prescription of the Fourth Noble Truth (i.e., the Noble Eightfold Path). The Four Noble Truths offer a theoretical method with practical implications for engaging with physical and mental pain and reorienting one’s life in order to achieve freedom from them.
In Buddhist psychology, mind has an important place. Buddhist psychology is regarded as a science of mind as it deals with mind – “All phenomena are preceded by the mind, mind is their chief, they are produced by mind (manopubbaṅgamā dhammā manoseṭṭhā manomayā )” (Dhp 1). With regard to mind, the commentary states: “All classes of arts in the world, specific or generic, are achieved by the
mind. And, owing to its capacity to produce a variety and diversity of effects in action, the mind, which achieves all these arts, is itself artistic like the arts themselves” (Maung Tin, Trans. 1976, 86). Buddhist psychology classifies mind as being either wholesome (kusala) or unwholesome (akusala), and tries to analyse the contents of mind from an ethical perspective. Hence, Nyanaponika Thera (1965) considers Buddhist psychology is primarily a practical way to know the mind, shape the mind, and free the mind.
Buddhist psychology analyses the person into five constituent aggregates (khandhas): matter or physical body (rūpa), feeling (vedanā), perception (saññā), volitional activities (saṅkhāras) and consciousness (viññāṇa). The first aggregate represents the material component of a person (rūpa) and remaining four represent mental components of a person or what we
call mind (nāma). Another key concept in Buddhist psychology is “dependent co-origination” (paticcasammuppāda), the concept of causality. It is regarded as one of the tools to analyse physical and mental pain. Consequently, Buddhist psychology explains that dukkha arises depending on the cause and condition.
Buddhist psychology states that because of evil conditions of mind, one commits evil deed and defiles one’s mind; and as a result, one becomes victim of his own deeds and loss health. Therefore, Buddhism emphasizes the importance of developing one’s [[own
mind]]. In Buddhism, mental development is of greatest importance because without it, it is impossible to gain complete health.
Mindfulness is the essence of Buddhist psychology. Nyanaponika Thera calls this meditation as ‘the heart of Buddhist meditation’ or even ‘the heart of the entire doctrine’ (dhamma-hadaya) (1992, 7). Mindfulness is the core practice of Buddhist psychology, and the body of Buddhist psychology, including the Buddha’s original teachings and later writing of the
Abhidharma, may be considered the theoretical basis for mindfulness (Nyanaponika Thera 1998). Due to the importance of mindfulness for healing physical and mental pain, this meditation has been successfully implemented in the area of all Buddhist schools of psychotherapy as well as western psychotherapy.
The Analysis of Physical and Mental Pain
We generally translate the Pali term ‘dukkha’ as ‘pain’ or ‘suffering’, even though it has a wider philosophical meaning including un-satisfactoriness, unhappiness, distress, discomfort, dissatisfaction, sorrow, affliction, anxiety, anguish, and so on. Accordingly, dukkha can refer to various unpleasant experiences in varying degrees. Many Buddhist scholars have
offered explanations on dukkha. For example, Gombrich (1995, 62) says, “The word we translate ‘suffering’, lacks a close English equivalent. The meaning of the First Noble Truth is that life is unsatisfactory”. On the other hand, Harvey notes:
The word dukkha refers to all those things which are unpleasant, imperfect, and which we would like to be otherwise, “Rich in meaning and nuance … Literally ‘pain’ or ‘anguish,’ in its religious and philosophical contexts, dukkha is, however, suggestive of an underlying ‘unsatisfactoriness’ or ‘unease’ that must ultimately mar even our experience of happiness (Harvey 2009, 320).
Nevertheless, the common interpretation of the word dukkha to mean suffering, pain, or unsatisfactoriness does not convey its true meaning.
Now we will try to understand the true meaning of dukkha from the perspective of Four Noble Truths. In the first discourse of the Buddha mentions different forms of dukkha. The first sort of ‘dukkha’ conveys the meaning of birth (jāti), decay (jarā), disease (byādhi), and death (maraṇa). The next sort of ‘dukkha’ conveys the meaning of sorrow (soka),
lamentation (parideva), physical-and-mental pain (dukkha-domanassa), and despair (upāyāsā) – which extends the first sorts of ‘dukkha’. The next sort, that ‘dukkha’ is association with the disliked (appiyehi sampayogo), separation from the beloved (piyehi vippayogo), and not
getting what one desire is dukkha (yampicchaṁ na labhati tampi dukkhaṁ). The last row summarizes what dukkha is by referring to a group called “five aggregates of grasping” (pañcupādānakkhandhā): grasping or clinging to the five aggregates of (psycho-physical) existence is the whole mass of dukkha. Therefore, physical and mental pain are generally covered by the Pali terms
dukkha and domanassa. Among the different forms of pain, physical pain can be birth, aging, pain, disease and death. Mental pain can be grief, lamentation, distress. Also, people feel mental pain when they associate with an object or person they dislike or are separated from an object or person they like.
The Pali Nikāyas differentiate between dukkha born of physical contact and domanassa born of mental contact. For example, the Saccavibhaṅgasutta of the Majjhima Nikāya answers the question ‘what are dukkha and domanassa?’ with the following basic formula:
And what, friends, is dukkha? Physical pain, physical discomfort, painful, uncomfortable feeling born of physical contact – this is called dukkha” (M III.251). How is dukkha different from domanassa? Next, the Buddha describes domanassa, ‘mental pain’ in the following words: “And what, friends, is domanassa? Mental pain, mental discomfort, painful, uncomfortable feeling born of mental contact – this is called domanassa (M III, 251).
Thus, in the case of the binomial words dukkha-domanassa, the term dukkha (‘du’ = bad or painful + ‘kha’ = empty, space) has to be understood as physical pain and the term domanassa (‘du’ = bad or painful + ‘manas’ = mind) has to be understood as mental pain (cetasikaṃ dukkhaṃ domanassaṃ paṭisaṃvedeti) (cf. Nyanatiloka 1970, 189; Bodhi Ed. 1993, 36, 115-116). Contrary to the term dukkha
which denotes physical pain (kāyika dukkha) when defined as an indriya, domanassa, as seen above, refers to mental pain (cetasika dukkha) (See Bodhi Ed. 1993, 36). Thus, Buddhism distinguishes two forms of dukkha: physical (kāyika dukkha) and mental (cetasika dukkha). In other words, the Pali terms dukkha and domanassa signify the painful feeling of body (kāyika dukkha vedanā) and painful feeling of mind (cetasika dukkha vedanā).
Now we will discuss the Pali term domanassa from the Abhidhamma point of view. Abhidhammatthasaṅgaha states that “domanassa is associated with aversion (paṭigha) and accompanied by unhappiness, and therefore unwholesome (akusala)” (Abhidh-s 1). The term domanassa is explained in the Abhidhammatthavibhāvinī-ṭīkā:
‘Unhappy mind’ (dummano) means an irritated mind or someone who has that; that is, the consciousness [itself] or the person with that consciousness. The state of that [[[consciousness]] or person] is unhappiness (domanassa). It is a term for unpleasant mental feeling. Accompanied by this is being accompanied by unhappiness. Striking against the object is aversion or hate; because of its violent nature it occurs as if striking against an object (Abhidh-s-ṭ 61; Wijeratna & Gethin, Trans. 2007, 16)
Now we will discuss the terms kāyika dukkha and cetasika dukkha. With regard to the physical pain (kāyika dukkha) and mental pain (cetasika dukkha), in the Sammohavinodanī, the commentator explains:
The meaning of the pain of bodily pain should be understood and the meaning of pain of mental pain should be understood; but here they
are called pain because both of these are themselves pain and because they are the basis for bodily and mental pain (VibhA 105; Ñāṇamoli, Trans. 1996, 125).
The commentator further explains: This pain of body that afflicts produces further pain of mind as well, and that accordingly is why this specially is known as pain (VibhA 105; Ñāṇamoli, Trans. 1996: 126). This means all the conditioned states of life are pain.
Mental pain arises from various sources such as stress, interpersonal conflict, depression, confusion, anger, greed, behaviour problems, separation from the beloved one, etc. According to Buddhist psychology, mental pain or mental illness occurs in individuals when the mind is upset (khitta-citta) or a psychotic (ummatta-citta). The Pali English Dictionary
defines ‘khitta-citta’ as “one whose mind is thrown over, upset and unhinged” and ‘ummatta-citta’ is defined as “out of one’s mind, mad” (Rhys Davids & Stede, Eds. 1921, 373, 550). The Pali Nikāyas mention that when one is touched either by bodily painful feeling (sārīrikaṁ dukkhaṁ vedanaṁ) or by mental painful feeling (cetasikaṁ dukkhaṁ vedanaṁ), one would go mad, go out of one’s mind (ummādam-pi pāpuṇissati cittakkhepaṁ) (M I.237).
A passage in the Pali Nikāyas mention ummattikā khittacittā with reference to a woman who went mad and lost her mind, owing to her mother’s death (M II.108-109). The Buddha compares khitta-citta with a fluttering fish that is drawn from its watery abode and thrown upon the land (vārijo va thale khitto okamokata ubbhato, pariphadat’idaṃ cittaṃ māradheyyaṃ pahātave) (Dhp. v.34; Ud v.31.2). The Pali Nikāyas also mention two compounds ‘vikkhitta-citta’ and ‘byāpannacitta’ with reference to mental disturbance. The Pali-
English Dictionary defines ‘vikkhitta-citta’ as “upset, perplexed, mentally upset, and confused mind” and ‘byāpannacitta’ is defined as “malevolent intention or corrupted mind” (Rhys Davids & Stede, Eds. 1118, 1375, 1469). The Pali Nikāyas mention distracted mind (vikkhitta-citta) mostly with regard to mindfulness meditation (See M I.59; D II.300) and ‘byāpanna-citta’ with reference to the monks who experience a state of unhealthy fear and terror, as an impact of a corrupted mind, bad thinking, and defiled intention (byāpannacitta paduṭṭhamana saṅkappasandosahetu) (M I.18).
Now we will look at abnormal behaviour that appears most in the Buddhist stories. An analysis of Buddhist stories shows a clear picture of different types of abnormally or mentally sick persons. The famous examples of psychopaths of violent type are Devadatta, Ajātasattu and Aṅgulimāla; and Patācāra and Kisāgotamī are the example of psychoses. In the Jātaka stories, we find different types of
abnormal behaviour. Harischnadra notes “the Bodhisatta, is told that in this world there are eight categories of “ummada” meaning psychiatric disorders, namely: [[sexual} dysfunction]] (kama-ummadaya), mania (krodha-ummadaya), hallucination (darshana-ummadaya), mental retardation (moha-ummadaya), possession disorder (yaksha-ummadaya), melancholia (pitta-ummadaya), alcohol dependence (sura-ummadaya), and depression (vyasana-ummadaya)” (Harischnadra 1998, 65-66). The Jātaka stories also mention of pretended madness. For example, Sujāta faked madness in order to relieve his father’s grief over the death of his grandfather (See Ja III.352).
In the Buddhist Jātakas stories, many cases of abnormal behaviour are said to be caused by sensual desires (kāmataṅhā). For example, the Asātamanta Jātaka (Ja I.61) tells how a blind and aged woman fell in love with a pupil of her son and planed to kill her
own son in order to have unhindered sex. Furthermore, Kaṇavera Jātaka (Ja I.318), Darīmukha Jātaka (Ja I.378), Kuṇāla Jātaka (Ja II.536) and some other Jātakas indicate various psychiatric disorders which are caused by sexual madness. In the Milindapañha, Bhikkhu Nāgasena illustrates a hermit’s madness at the sight of the princess {[Caṇḍāvati]] and gives a clear explanation of insanity.
Just, O king, as a madman, when out of his senses will step into a fiery furnace and take hold of an infuriated venomous snake, and go up to a rogue elephant, and plunge forward into great waters, the further shore of which he cannot see and trample through dirty pools and muddy places, and rush into thorny brakes and fall down precipices, and feed himself on filth, and go naked through the streets, and do many other improper things (Miln II.16ff.).
This passage shows some of the characteristics of a mad person. In the Milindapañha, Bhikkhu Nāgasena explains to the King Milinda that the cause of abnormal behaviour is due to circumstances – ‘at the very sight Caṇḍāvati, the princess, the hermit went out of his mind and lost command of himself through love’ (Miln II.16ff.). Thus according to the Pali sources, some persons would suffer from a mental illness and physical illness due to the unusual or excessive sexual desires.
Buddhist psychology considers physical pain (kāyika dukkha) and mental pain (cetasika dukkha) as illness (or disease) (roga):disease of the body (kāyika roga) and disease of the mind (cetasika roga). With regard to disease, in the Rogasutta of the Aṅguttara Nikāya, the Buddha says:
Monks, there are two kinds of disease. What are the two? Disease of the body and disease of the mind. Monks,
there are to be seen beings who can claim to be physically healthy (free from bodily disease) for a year…two years … three years … four years … five years…ten years … twenty years…thirty years … forty years and fifty years … who can claim to be healthy for a hundred years. But monks, hard to find are those beings who can claim to be mentally healthy for even a moment except for those [[[Arahats]]] whose mental cankers are destroyed (A IV.157).
According to this passage, we can say that only the Buddha and the Arahat (the Enlightened One) has a perfectly healthy mind, as they have destroyed all fetters. Besides the Buddha and the Arahat, as worldlings we are all afflicted with mental pain.
The Girimānandasutta of the Aṅguttara Nikāya (A V.108) gives a list of forty eight types of diseases: eye-disease (cakkhu-rogo), ear-disease (sota-rogo), nose-disease (ghān a-rogo), tongue disease (jivhā-rogo), body-disease (kāya-rogo), head-disease or headache
(sīsa-rogo), ear disease (or mumps) (kan n a-rogo), mouth-disease (mukharogo), teeth-disease (or tooth-ache) (danta-rogo), coughs (kāso), asthma (sāso), colds (pināso), burning sensation (of body or heart) (dāha), fever (jaro), abdominal disease (or stomach-ache) (kucchi-rogo), fainting (mucchā), bloody-flux (or dysentery) (pakkhandikā), piercing pain (or gripes)
(sūlā), cholera (visūcikā), leprosy (kuttham ), boils (gando), dry pustules (or plague) (kilāso), Phthisis (soso), epilepsy (apamāro), herpes (daddu), itching (kandū), ringworm (kacchu), small-pox (rakhasa), scabies (vitacchikā), blood-bile (or pustule) (lohita-pittam), diabetes (madhumeho), piles (amsā), cancer (pilakā), ulcer (or fistula) (bhagandalā); and afflictions due to bile (pitta-samut t hānā ābādhā), due to phlegm (semhasamut t hānā ābādhā), due to wind (vāta-samut t hānā ābādhā), consisting in conflict of the
humors (sannipātikā ābādhā), produced by change of climate (utuparin āmajā ābādhā), by unaccustomed activity (or careless behavior) (visamaparihārajā ābādhā), by violence or assault (opakkamikā), by ripeness of one’s kamma (kamma-vipākajā ābādhā); and cold (sītam ), heat (un ham ), hunger (jigacchā), thirst (pipāsā), excrement (uccāro), and urine (passāvo). These forty-eight types of diseases are described in the Girimānandasutta according to location, type, cause and nature of diseases (See A V.108).
The Causes of Diseases
In the Pali Nikāyas, diseases (rogas) are considered to be caused by bile, phlegm, wind, bodily humors, and changes of climate, careless behaviour, assault, and kamma (A V.108). Here, I will briefly discuss the last four causes of diseases.
1. A change of climate (utu-parin āmajā ābādhā): It refers to the alteration in a previously supporting climate or environment. It may also refer to the unhealthy environmental that could aggravate disease i.e., unhealthy and dangerous working or living condition, socio-economic factors, etc.
2. Careless behaviour (visama-parihārajā ābādhā): It means when a person fails to care his own mind-and-body and ignores his mental-and-physical well-being. As a result, his health can get worse and he may become vulnerable to disease. Some of the careless behaviours are: lack of proper nutrition, lack of physical exercise, alcohol and drug abuse, grief, anger, etc.
3. Violence or assault (opakkamikā): Violence or assault includes punishment, animal bites, assault by the enemies or robbers, self inflicted injury, accident, etc.
4. Ripeness of one’s karma (kamma-vipākajā ābādhā): The karmic effect of disease and health are spelled out in the Culakammavibhaṅgasutta (the shorter discourse of action) of the Majjhima Nikāya. According to this sutta, one who caused injuries or pain to beings in the present life, then wherever he is reborn he is sickly, subject to diseases – as a result of such bad karma (See M III.203). A solid example is Cunda, the pork butcher. In his whole life he slaughtered many animals. Due to this bad karma he became mad, crawled in his house for seven days, grunting and squealing like a pig and finally died (See Dhp v.15).
Three Root Causes: Greed, Hatred, and Delusion
Buddhism explains that everything in this world, including pain of human beings, takes place in accordance with casual law. The origin of everything is dependent, conditional and relative. Buddhist psychology describes three “root causes”– greed (lobha), hatred (dosa), and delusion (moha) – that give rise to pain. For example, the Majjhima Nikāya states: “Greed (lobha) is a root of the unwholesome; hated (dosa) is the root of the unwholesome; delusion (moha) is the root of the unwholesome. This is called the root of the unwholesome” (M I.47).
1. Greed (lobha): It is what is greedy (lubbhatī ti lobho). It has the characteristic of sticking to the object or wanting an object (Abhidh-s-ṭ 83). According to the Buddhist psychology, the first unwholesome root, greed (lobha), covers all levels of desire or thirst (taṇhā) and clinging (upādāna). It overlaps the inclination for sensual lust (kāmarāga) and attachment to existence (bhavarāga). The related wholesome basic tendency is non-greed (alobha).
2. Hatred (dosa): It is what does harm (dussatī ti doso). It has the characteristic of anger like a poisonous snake when struck (Abhidh-s-ṭ 83). It covers aversion (paṭigha) and ill-will (vyāpāda); and always accompanied by mental painful feeling (domanassa vedanā). It also includes a variety of negative emotions namely, denying, grudging, disappointment, dejection, anxiety, despair, etc. The root of hatred is likening to latent tendency of aversion (paṭighānusaya) which is the basis for craving for non-existence (vibhava-taṅhā). The related wholesome basic tendency is non-hatred (adosa).
3. Delusion (moha): It is that which is deluded about the objects; it is misunderstanding (ārammaṇe muyhatī ti moho, añāṇaṃ). It has the characteristic of concealing the nature of the object, for although occurring by way of taking hold of the object (Abhidh-s-ṭ 82). It covers the latent tendency of ignorance (avijjānusaya), blindness to certain facets of reality, such as the three characteristics: impermanence (anicca), pain (dukkha), and non-self (anatta). At the cognitive
level, it accesses our perceptions, thoughts, and views. The related wholesome basic tendency is nondelusion (amoha). These three roots are said to be clouded our perception and lead to unhealthy mentalities. From these three roots arise states of pain, unhappiness, aversion, anger, doubt, upset, etc. It is our own reinforcement of those negative emotions that makes them so much worse.
Buddhist Path to Overcoming Physical and Mental Pain
In Buddhism, freedom from physical and mental pain is described in eight elements known as the Noble Eightfold Path namely, Right Understanding, Right Purpose, Right Speech, Right Action, Right Livelihood, Right Effort, Right Mindfulness, and Right Concentration. This Path consists of the practice of morality (sīla), the practice of concentration (samādhi), and the
development of wisdom (paññā). The moral aspects of the Eightfold Path, consists of Right Speech, Right Action and Right Livelihood represents the ethical foundation of the Buddhist path. Here, the word “right” concerns taking responsibility for one’s speech, actions, livelihood and mental attitudes so that one gains a sense of inner happiness.
As long as physical and mental pain is considered, we can use Buddhist ethical teaching as a primary approach to mental healing. Some of these ethical teaching include controlling of unwanted thoughts by distraction, training in social skill, observing precept, offering gifts, etc. Ethical guidelines, which have to do with the person’s interactions with other beings, help the person to avoid actions that lead to mental pain i.e., guilt, shame, remorse and other unpleasant mental states.
In the context of ethics, the Buddha counsels people to reflect on the consequences of their actions before proceeding and to abstain from unwholesome actions that are not conducive to happiness for one’s self and others (M I.55). In Buddhism, there are two terms related to ethical arguments: wholesome (kusala) and unwholesome (akusala). These two terms can be called action (kamma). Kamma as “action” is defined by the word cetanā: “Bhikkhus, volition (cetanā), I say, is kamma.
Having willed, we create kamma, through body, speech, and mind” (A III.415). Buddhism points out that one must be careful in carrying out one’s action. According to Buddhism, there are ten unwholesome actions (dasa- kusala-kamma) and ten wholesome actions (dasa-akusala-kamma). The ten unwholesome actions are: killing living beings (pānātipātā), taking what is not given (adinnādānā), sensual misconduct (kamesumicchācārā), lying speech (musāvādā), divisive speech (pisunavācā), harsh
speech (pharusavācā), idle speech (samphappalāpa), covetousness (abhijjhā), ill-will (vyāpāda), and holding wrong view (micchādiṭṭhi). Briefly put, the ten wholesome actions are the opposite of the ten unwholesome actions. Such actions are called unwholesome as they yielding pain, ripening in pain. Thus, freedom from physical and mental pain consists primarily of progressive stages of mental culture culminating in the attainment of emancipation of the mind from all unwholesome states that defile it and produce unending misery for the person.
Furthermore, it is believed that that various types of disease can be cured or minimised through the seven factors of awakening (satta-bojjhaṅgas): mindfulness (sati), investigation of the dharma (dhamma-vicaya), energy (vīriya), joy (pīti), calm or tranquility (passaddhi), concentration (samādhi), and equanimity (upekkhā) (S V.63-64). For example, the Buddha states,
“Kassapa, these seven awakening factors are well expounded by me, cultivated and much developed by me and when cultivated and much developed, they conduce to full realization, to wisdom, to Nibbāna” (S V.79). Receiving and accepting the full teaching of the seven factors of enlightenment Kassapa there and then recovered from that sickness. He regained his physical and mental health. Therefore, these seven factors of enlightenment can also be used to heal physical and mental pain.
Apart from these seven awakening factors, loving-kindness (mettā) meditation is helpful in reducing pain i.e., negative emotions and feelings such as anger, jealousy and hatred and to strengthen positive relationships and self-esteem in people. It also gives security mentally and physically to a person to minimize his pain. In addition to lovingkindness (mettā), there are three other wholesome mental qualities namely, compassion (karuṇā), appreciative joy (muditā), and
equanimity (upekkhā). The Buddha describes these four wholesome mental qualities as the four sublime states (brahma-vihāra) and immeasurable minds (appamāṇa). They are fundamental functions in developing all the other types of wholesome qualities, such as generosity and honesty. Therefore, these four minds can be practiced by people inflicted with physical and mental pain.
Mindfulness and the Therapeutic Relationship
The Pali term for ‘mindfulness’ is ‘sati’, which is related to the verb ‘sarati’, to remember. Etymologically ‘sati’ is derived from the Sanskrit ‘smṛti’, which means memory, recognition, mindfulness, alertness, remembrance, attentiveness etc. (See Sumanacara 2010, for discussion).
Mindfulness has been described for psychotherapy includes being aware, intentionally, being acceptance and compassion in which each thought, feeling, or sensation that arises is acknowledged and accepted as it is. It is a paying attention to the arising and disappearing of thoughts, feelings, and perceptions within all human beings. Thich Nhat Hanh, a meditation guru and peacemaker, describes the essence of mindfulness in a radio interview:
Mindfulness is a part of living. When you are mindful, you are fully alive, you are fully present. You can get in touch with the wonders of life that can nourish you and heal you. And you are stronger; you are more solid in order to handle the suffering inside you and around you. When you are mindful, you can recognize, embrace and handle the pain, the sorrow in you and around you to bring you relief. And if you continue with concentration and insight, you’ll be able to transfer the suffering inside and help transform the suffering around you.
Elsewhere Thich Nhat Hanh defines mindfulness as “remembering to come back to the present moment” (Hanh 1998, 59). Nyanaponika Thera describes mindfulness as “the clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception” (Nyanaponika Thera 1972, 5). Jon Kabat-Zinn, a founding director of the Stress Reduction Clinic and the Center for
Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical schoold, emphasizes the present moment awareness and the nonjudgemental aspect of mindfulness: “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment to moment”
(Kabat-Zinn, 2003, 145). It is present moment awareness because with mindfulness one reflects only what is presently happening and in exactly the way it is happening. Larry Rosenberg (1998, 15), a meditation trainer, compares mindfulness to a mirror simply reflecting what is there. Thus, Mindfulness is about cultivating, sustaining, and integrating a way of paying attention to the ebb and flow of emotions, thoughts, and perceptions within all human beings. The qualities of Mindfulness are:
1. Present-centered: Mindfulness is always in the present moment. It engages continually observing the objects of meditation, moment-by-moment.
2. Choice less awareness: Mindfulness is a choice less conscious effort as meditation object at the present moment can be one any one of these four: body, feelings, thoughts, and mental objects.
3. Nonjudgemental: Mindfulness is paying attention nonjudgementally to what goes on in the present moment – in our body and mind, and our surroundings. When one is mindful, the attention is focused on the present so judgment cannot be placed.
4. Acceptance: From the mindfulness perspective, acceptance refers to welcoming every feelings or experiences as they arise – without regarding the pleasant or unpleasant qualities of the object.
5. Letting go: Mindfulness is letting go – the natural consequence of a willingness to accept things as they are, as they appear to be.
6. Clear comprehension: Mindfulness is seeing the object of meditation thoroughly and all its aspects.
7. Investigative: Mindfulness awareness is always investigating subtler levels of feeling and perception.
8. Liberating: Mindfulness is liberating as every moment of mindful awareness provides insights and freedom from the causes of pain.
These qualities can be found in most discussion of mindfulness in both the psychotherapy and the Buddhist literature. They occur simultaneously in each moment of mindfulness. Mindfulness meditation includes mindfulness of body (kāya), feelings (vedanā), consciousness (citta), and mental objects (dhamma). However, traditionally it is often stated with concentration on the breath (ānāpānasati).
Mindfulness-based interventions suggest that the therapists who teach the meditation should practice mindfulness themselves. Mindfulness helps to a therapist’s skill to accomplish a sense of the client’s inner understanding; communicate awareness of that felt sense; and give words to their feelings and sensations. In a mindfulness condition, therapists are better able to observe thoughts, feelings, and sensations without emotion and attachment. This calm state of self-experience may enable therapists to react to situations more deliberately. In addition, therapist manners should be characterised by kindness, acceptance,
support, and genuineness. Thomas Bien notes that “Mindful therapy is therapy in which the therapist produces true presence and deep listening. It is not technique drive” (2006, 217). This shows the role of mindfulness in cultivating presence and listening within the client-therapist relationship.
For the most effective treatment, cultivating an awareness of and a compassionate response to the suffering of others is central to the teachings of Thich Nhat Hanh. He notes: “When we are mindful, touching deeply the present moment, we can see and listen deeply, and the fruits are always understanding, acceptance, love, and the desire to relieve suffering and bring joy”
(Hanh 1995, 14). Active listening is another important tool for effective therapy as listening voice is the primary form of care. Thus, within the clienttherapist relationship, mindfulness is a way of paying attention with compassion, attendance, and attentive listening that can be developed, maintained, and integrated into our work as therapists during the ongoing discipline of meditation practice.
Conclusion
The aim of Buddhism is to end the pain of the human beings. Buddhism teaches that mind should be purified in order to get rid of pain. In this paper, we have analysed the concept of physical and mental pain according to the Pali Nikāyas. We have highlighted how three evil roots (greed, hatred, and delusion) cause disturbances on physical and mental life. We have suggested that Buddhist ethical teachings and mindfulness meditation can be helpful to overcome mental and physical pain.
Mindfulness lies at the heart of Buddhist psychology. We have highlighted that mindfulness is a comprehensive approach that promotes wholesome mental states in an individual’s life, and helps one to overcome physical and mental pain. Though we have described mindfulness by using a number of terms, the experience of mindfulness cannot be captured in words. Hence it cannot be precisely described using words or language. Most of all, mindfulness actually must be experience to be understood.
In conclusion, freedom from pain is the result of following the spiritual path, practicing the Noble Eightfold Path, living a virtuous and ethical life, developing the four immeasurable minds (brahmavihāra) and mindfulness. Each of these trainings and practices help us to know and let go of unwholesome roots from the mind. The pain ceases when one has eradicated all defilements (kilesas) by means of the three trainings:
ethical behaviour (sīla), concentration (samādhi) and wisdom (paññā).
Abbreviations:
Abhidh-s Abhidhammatthasaṅgaha
Abhidh-s-ṭ Abhidhammatthavibhāvinī-ṭīkā
Dhp Dhammapada
Miln Milindapañha
VibhA Vibhaṅga Aṭṭhakathā (Sammohavinodanī)
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