Your Questions About Practice

How do you stay in the present moment when it’s physically painful (not a posture issue)?

Andrea Fella responds: One reason it’s hard to stay in the present moment when there is physical pain is that we are reactive to the pain.  We react with fear, confusion, aversion, the feeling of being out of control. The reactivity is what tends to keep us from staying present.

So we need to start by distinguishing the reactivity to pain from the actual physical pain itself, and then explore whether we can be present for the reactivity.  One of my teachers, Sayadaw U Tejaniya, suggests if you are reactive to pain, it’s not helpful to try to pay attention to the pain itself, because it is being experienced through a lens of reactivity, which usually exacerbates the pain. So, instead of trying to be with it, turn towards the relationship you have with the pain, the emotional reactivity: what does it feel like to be fearful, confused, angry, out of control?

Sometimes when physical pain is quite strong, even if we are trying to turn towards the reactivity, the pain pulls the attention, almost with a magnetic force. It’s as if the attention narrows down and pain becomes the entire universe of our experience.  In that kind of situation, I have found it helpful to consciously try to expand the field of attention to include the many other things that are happening at the same time: this can be a simple recognition: “yes, there is physical pain” and then consciously acknowledging “…and seeing is happening, and hearing is happening, and other body sensations are happening.”  There are so many things happening in the present moment; if we can expand our field of attention, that helps the mind recognize that pain is not all there is in the world!  This can help the mind to relax around the pain, and stay present.  
And then sometimes it’s helpful to turn the attention to something else entirely. Attending to pain for long periods of time can weary the mind. So, we can explore it for a little while, perhaps in the ways that I’ve suggested, but at some point it may be helpful to redirect the attention to give the mind a break from the pain, if that is possible.  For example, take a walk in nature and let the attention take in a whole different perspective.  Or turn the attention to an area of experience where there is no pain: perhaps the sensations of the hands, the feet contacting the floor, or the experience of hearing.