Suffering, both mental and physical, is thought to be part of the unfolding of karma and is the consequence of past inappropriate action (mental, verbal, or physical) that occurred in either one’s current life or in a past life.
It is not seen as punishment but as a natural consequence of the moral laws of the universe in response to past negative behavior. Hindu traditions promote coping with suffering by accepting it as a just consequence and understanding that suffering is not random. If a Hindu were to ask “why me?” or feel his/ her circumstances were “not fair,” a response would be that his/her current situation is the exactly correct situation for him/her to be in, given her soul’s previous action.
Experiencing current suffering also satisfies the debt incurred for past negative behavior. Suffering is seen as a part of living until finally reaching moksha. Until reaching this state, suffering is always present on life’s path. Hindu tradition holds that as we are in human form on earth, we are bound by the laws of our world and will experience physical pain. Pain is truly felt in our current physical bodies; it is not illusory in the sense of not really being felt .But while the body may be in pain, the Self or soul is not affected or harmed. Arjuna, a seeker of wisdom in The Bhagavad-Gita, is told:
“The self embodied in the body of every being is indestructible”, and “Weapons do not cut it, fire does not burn it, waters do not wet it, wind does not wither it. It cannot be cut or burned; it cannot be wet or withered; it is enduring, all-pervasive, fixed, immovable, and timeless”.
As the Self is not affected, there need be no concern over temporary suffering. Patients may gain comfort by viewing the pain as only a temporary condition and one that does not affect their inner Self. Pain and suffering are not seen as solely bad but as experiences that need to be viewed from multiple perspectives.
Hindu traditions hold that all things are manifestations of God/The Ultimate, so nothing is only good or bad; God/The Ultimate encompasses everything. Everything, including pain and suffering, is given by God/ The Ultimate. To view suffering as bad is to see only one side of it. Suffering can be positive if it leads to progress on a spiritual path.
Some even embrace suffering as a way to progress on his spiritual path, to be tested and learn from a difficult experience. Attachment and detachment are concepts that in Hindu traditions relate to one’s level of involvement in this world and to the power this world holds over one’s state of mind. Attachment signifies overinvolvement in this world, having desires for things that one does not have and clinging to things one has.
Detachment is a positive state of objectivity toward this world, where relationships, objects, and circumstances hold no power over one’s state of mind. Attachment is a primary stumbling block to achieving moksha, complete release. Attachment perpetuates the “terrible bondage” that keeps a person in the cycles of samsara, rebirth. Only through recognition that the Self is not bound to this world of suffering can release be achieved. Perfect detachment creates an “. . . even disposition in the face of either happiness or sorrow . . .”.
When one achieves perfect detachment, no problem or circumstance, including pain, can cause one to suffer. “Contacts with matter make us feel heat and cold, pleasure and pain. Arjuna, you must learn to endure fleeting things—they come and go! When these cannot torment a man, When suffering and joy are equal for him and he has courage, he is fit for immortality”.
What suggestions are made for achieving this detachment? It cannot be simply an intellectual understanding that the Self is part of God/The Ultimate. It is not escapist, pretending that suffering does not exist. One part of achieving detachment is to follow dharma, appropriate action, but to be unconcerned with the outcomes of these actions.
Arjuna is told: “Be intent on action, not on the fruits of action; avoid attraction to the fruits and attachment to inaction! Perform actions, firm in discipline, relinquishing attachment; be impartial to failure and successthis equanimity is called discipline”.
Patients in pain are not to be passive and give up and can continue to attempt to lessen 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 guidance to seek detachment from outcomes would likewise apply to pain medicine practitioners, though this may challenge the outcome orientation of Western medicine. Lack of immediate success in treating patients can be frustrating; however, an approach based in Hindu traditions would suggest continuing to try one’s utmost to heal patients but not becoming upset by failure. The dharma for a pain practitioner would be to be the best practitioner possible, while accepting all outcomes.
To be clear, this is not to suggest becoming indifferent to our patients’ suffering. Hindu traditions would support still caring deeply for our patients but needing to recognize that we are not in control of outcomes, nor do we know what is the appropriate outcome from the perspective of karma.
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/The Ultimate. As the focus of one’s life should be on God/The Ultimate, 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/The Ultimate, not pain. Hindu traditions hold that all have a capacity to achieve this.