Working with Chronic Pain as a Path to Liberation - Nalandabodhi International
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Zen master Thich Nhat Hanh has said that our fear of suffering keeps us stuck in suffering, and that acknowledging and embracing the presence of suffering is the key to our liberation from suffering. With this teaching in mind, I have been pondering how to embrace and work with suffering when my chronic pain flares up and literally and figuratively brings me to my knees.

The Four Noble Truths taught by the Buddha immediately come to mind as a framework for working with the suffering that accompanies my physical pain. The First Noble Truth recognizes the existence of suffering, but if we don’t even acknowledge suffering’s existence, then there’s no way to enter the path toward liberation from suffering (which is the Third Noble Truth), let alone experience the cessation of suffering (the Fourth Noble Truth). As my teacher Ponlop Rinpoche has said, “You have to let it come to let it go.”

My knee-jerk reaction, when my pain flares up, is self-pity. Working mindfully with the Second Noble Truth — the cause of suffering being ego-clinging — has helped me tremendously over the years to let go of self-pity and know that we all experience pain and suffering. When I remember this, there is an immediate sense of relief and spaciousness around my pain, as well as compassion for myself and all others.


Working directly with the energy of physical pain has become my path out of the suffering that accompanies my pain. Here is an exercise I’ve created for working directly with physical pain:

  1. Focus on the pain and breathe into it
  2. Explore the pain with a sense of curiosity:
    • Where is the pain located?
    • How big is it?
    • What is its shape?
    • If it had a color, what color would it be?
    • Is it hot or cold?
    • Is it static or does it move or vibrate?
  3. As you explore the pain in this way, notice how it shifts and moves. This is a good reminder that everything is impermanent. 
  4. Remember that we all experience pain during our journey on the Four Rivers of Life – birth, old age, sickness and death. 

Suffering is optional

When I work with my pain directly in this way, I am fully in the present moment. My thoughts, judgments and resistance are gone, and so is the suffering that I’ve added to the pain with those thoughts, judgments and resistance. In that present moment, I experience the cessation of suffering, the Fourth Noble Truth.  As the old adage goes, “Pain is inevitable; suffering is optional.”

Beth Patterson
Beth Patterson

Beth Patterson is a psychotherapist specializing in grief, loss and life transitions. In her work, Beth relies on Buddhist psychology, mindfulness based cognitive therapy and body-centered therapies. Her articles and ebook are available at Beth is a longtime Buddhist practitioner and a student of Dzogchen Ponlop Rinpoche.

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