There is physical pain we cannot avoid and then there is mental suffering/pain. The Buddha taught that there are certain situations each sentient being will meet in life: birth, old age, sickness and death. These four situations reveal two truths about reality; pain is unavoidable and everything changes. In this context, pain refers to the unavoidable physical pain that often accompanies birth, old age, sickness and death. The physical pain experienced during these four situations is real physical pain that is inevitable to experience at some point in your life. When we recognize that some pain is unavoidable, we can stop struggling against it and begin to work with the experience more directly. In most cases, ignoring the reality of physical pain may cause more harm to ourselves. That pain may tell us something important like, “Go to the doctor, don’t ignore this.”
Denial or Acceptance, it’s your Choice
Accompanying the truth of physical pain is also the truth of change, or impermanence. The four situations of birth, old age, sickness and death mark periods of tremendous change in our physical realities. Denying the reality of what is happening to the body causes us more suffering. We stop relating to what is actually happening and get caught in a mental wish that things would be different. Acceptance of the pain allows us to respond directly to the situation. This may look like: going to the doctor if you are sick or talking about fears about giving birth. When we accept what is happening we are no longer caught in a struggle of ignoring or trying to force the situation to change. We faced with circumstances we cannot control we have a choice to look directly at it and work with it or pretend it’s not really happening. When someone is dying, it is advised to be honest and not pretend things will get “back to normal.” The news of death while difficult to accept is much harder to work with if everyone is pretending is all going to go away. Releasing the struggle through acceptance can allow some space into the situation. This spaciousness can allow for some deep connection and even relaxation into the situation. When we feel connected, the pain will often become more workable. Workability means we accept what we cannot change and look for ways be more at ease within the pain.
We cling to what is Pleasurable
Physical pain isn’t always the culprit of our suffering. Sometimes our suffering is really about not being able to control the situation. There are three types of suffering that the Buddha identified in this category: coming across what is undesirable, not 
being able to hold onto what is pleasurable, and not getting what you want. For the most part, these are pretty self-explanatory. Things happen in our life that just stink and we have no control over whether it happens or not. We may lose our job, the plumbing may back up, it rains on our wedding day, we get a flat tire on the way to work…Murphy’s Law, if it can happen, it will. Humor and a relaxed attitude is a skill set utilized best during these moments. Not being able to hold onto what is pleasurable is a painful reminder to us about how attached we are to things being pleasurable or comfortable. For anyone who has unrequited love, experienced the end of romantic relationship, or gotten to the end of the best homemade pie ever; this is what not being able to hold onto pleasure is all about. We may repeatedly try to recreate the enjoyable experience only to find frustration and disappointment. Finally, another aspect of suffering is that we may find ourselves searching for a peak experience or ideal situation which is never found. Every time we think “this is it”, it turns out not to be what we thought it would be like. For others, we may not know what we’re searching for but only that we still haven’t found “it.” The bottom line is we have difficulty with change. There are ways that we can relate to change that either cause us to suffer more or suffer less.
Here are some suggestions for working with Change.
- Recognize that change is occurring
- Notice how you are relating to change
- Accept what you don’t have control over
- Identify your choices
- Try to relax and respond genuinely
- Connect to some appreciation for either yourself or another person
