Sitting with Pain

Zen Buddhism is about the end of suffering.  But meditation is physically painful for many people. Zen proponents are telling people who trust them to do meditation, but the sitting is painful. On the one hand Zen says it helps with suffering, and on the other people who sit zazen experience pain when sitting.

Sitting in pain is a problem in Zen practice that needs to be acknowledged.  On it's face Zen proponents are on thin ice ethically.  Many smart people can rationalize,  and equivocate in an attempt to dismiss this contradiction.  My concept of Buddhism, and Zen in particular is to simply and squarely face reality and simply say "I am fully responsible for this".

Does sitting cause pain?  Or is it just that we finally settle down and, lacking distraction, see the underling pain in in our life?  Is it actually just a physical manifestation of our emotional turmoil?  Is pain different than suffering?  Is pain with sitting some kind of hazing ritual?  Is it an essential part of the maturation of a Zen student?  Is the pain just a manifestation of our clinging and aversions?  Or is there really no pain at all, just a label that we choose to slap on sensations that we decide we don't like?

I refuse to get involved.  I tire quickly of intellectual gymnastics.  Indeed, I am quite dull and prefer to rely on simple stories from my youth:

My first visit to Tassajara Zen Monastery was for 2 weeks in the middle of the summer as a guest student.  It was hot.  The next year I decided to stay the entire summer and got there just as the winter/spring practice period ended.  I rode my Yamaha two stroke twin over the mountain bringing everything I thought I would need strapped on the back.  "It's the summer." I told myself.  "It will be hot and I won't really need much clothing."  The next day, (actually the middle of the night), the wakeup bell went running by my bed.  I got up, wrapped a hand-me-down black robe around my scrawny 6'4" 150lb frame and went off to the zendo.  I fucking froze my ass off.  After morning sitting I immediately went to the "Goodwill" for something - anything - warm to wear.  I was not surprised to find another shivering guest student there with the same goal.  What was surprising was that he had just put on a bright pink puffy one piece jump suit which made him look like a giant infant or freakish easter bunny.  It looked profoundly undignified, incredibly hideous.  Of course, I shared my thoughts with him.  My fellow guest student turned to me, looked me dead in the eye and in two words, gave me a profound lesson.   He said simply "Fuck Suffering".

One aim of the Yoga of Zen must be to help people sit with less pain.  Those who recommend zazen should be well versed and recommend adjuvant practices that are likely to help people sit with less pain.  It is a simple act of compassion for more senior students to be familiar with the causes of pain while sitting and to make sure everyone is offered every possible assistance.

So lets look for something that might help with the pain.  But where should we look?   Drugs are out.  Tiger balm is smelly.  We've all tried squirming constantly: not so fun.    How about instead of sitting cross legged maybe  try sitting on a seiza bench?   Or maybe a chair?  Sometimes using these allows people to sit in less pain.  Why is this?  I think the only explanation is:  how you use yourself is important.

This may seem like a trivial statement but it actually says a lot:  pain is not simply a physical manifestation of psychic issues.  It also means we are not victims of circumstances: we can make changes to how we use ourselves that makes sitting less painful.  Also, it means that sitting without pain may not be exclusively available only to those with years of experience.

But how do we know if a change will be helpful or not?  In the meditation hall there are lots of cushions, pads and supports that can be used in countless variations and permutations.  Do we have to experiment over a period of years?  Is it hit a miss?  Doesn't sound like much fun, huh?  I did this for 30 years.  For me, it wasn't the fun part of sitting...

It might be useful here to introduce two ideas: 'manner of use' and 'conditions of use'.  Conditions of use refers to what your body is physically capable of doing.  Your Average Joe (who just set aside the remote and is getting off the recliner to try zazen for the first time) has limited external rotation of the hip which will make sitting in full lotus, ah, difficult.  That is the condition of use.  'Manner of Use' is much different.  Ones 'manner of use' is defined by how a Zen student wants to use herself, what she thinks is possible, what her personality suggests, what her beliefs are, what feels right.  She sits the way she does because that is who she thinks she is - plain and simple, not very considered.

Now, if our use contributes to the pain we feel, is the pain from the 'conditions of use' or the 'manner of use'?  Raise your hands if you think it is the 'condition of use'.  Just as I thought - you all believe it the 'conditions of use'.  I thought so because if you google 'yoga' and 'zen' you get endless sites that claim the two complement each other wonderfully.  Tassajara has many summer programs on yoga and zen taught by wonderful smart people.  That's proof.  Or listen to the Rolfers and chiropractors and massage practitioners who adjust your body manually - who change your 'conditions of use': your strength, flexibility and coordination.  They will change your conditions and you will change how you sit and you will sit comfortably.   Right?

If pain while sitting is caused by the 'condition of use' then changing your 'manner of use' will not help at all.  Our Zen student can decide to change her manner of use but as she actually tries she will bump into the limits of what her conditions dictate is possible for her.  Clearly, changing the manner of use should have little effect on pain while sitting if the 'conditions of use' are important.

I beg of my kind reader just a few moments to consider something different.  Something so different that it has the potential to radically change how zazen is taught.

Let's take a step back and ask if there is are any professionals out there that can help us with our 'manner of use' - who might help us to use ourselves better?  Alexander Technique teachers claim they can help us to do just this.  And that is all they claim.  It is the only educational technique that specifically claims to improve how we use ourselves - our 'manner of use'.

Might pain with sitting be no different than common (non malignant) back pain?  Pain, for many of us, does not stop once we leave the meditation hall.  In fact most of us are achy quite a bit of the time.    The most common type of pain we have is back pain.  Its the 6th most costly diagnosis in US managed care.  There have been a fair number of scientific studies hoping to find some way to alleviate this pain.  The science suggests that therapies such as massage, acupuncture, rest, exercise, and chiropractic care can be helpful in the short run, but have very little proven benefit in the long term: improving the 'conditions of use' have not been found to reliably help with back pain in the long term.   Recently there was a very important study on back pain published in the British Medical Journal, one of the most respected medical journals in the world.  It was impressive because of the quality, long term follow up and the magnitude of the outcome.  You can read it here: http://www.bmj.com/content/337/bmj.a884.full  The study is a high quality, prospective, randomized study involving 579 people with quite significant back pain.  People were randomized to a exercise, massage or lessons in the Alexander Technique.  Bottom line: those with lessons had a 84% reduction in days in pain compared with the control group.  The control group reported three weeks in pain in the past month while the Alexander Technique group only had three days.   And this follow up was done a full year later which suggests that the AT group were given tools that provided life long relief from back pain.  Of course, this was only one study, but given the quality of the study and other studies - which uniformly find benefit with the AT - we can safely say that the AT helps with back pain.   And it help by improving the 'manner of use' NOT the 'conditions of use'.

To sit with much less pain one only needs from 6 to 24 lessons in the Alexander Technique to improve the 'manner of use'.   Trying to improve the 'condition of use' will only marginally help and there are other problems with these therapies and practices as well.  Improvement in 'conditions of use' does not help much with sitting because the 'conditions of use' are not what is really limiting us.  

All students and Zen teachers must understand the difference between the 'condition of use' and the 'manner of use'.  Pain while sitting can not be substantively addressed by trying to change the 'condition of use'.  Since the AT is the only technique to improve the 'manner of use' it should at least be recommended to all zen student who are troubled by pain while sitting.  If we care about our Sangha we must talk about the problem of sitting with pain, consider it's causes, and recommend the AT which is proven to be effective.