I’m currently in the midst of teaching a three week series about yoga and chronic pain. The purpose of the series is not any attempt to “cure” anything, but to give people additional tools for life with chronic pain through yoga. Each session includes some discussion, meditation, pranayama, and asana. The first week, the discussion focused on the roots of chronic pain and the physiological/psychological effects of it, as well as the benefits of yoga for the pain and the effects. The second week, we spent some time talking about the emotional impact of chronic pain, from the perspective of the kleśās.
From a Indian yogic perspective, much of the cause of human suffering is related to the five kleśās, or poisons, that all humans experience. According to Patañjali’s Yogasūtra, thekleśās are:
- avidyā – ignorance of the way things really are
- asmitā – egoism, the construction of a self around which we organize understandings of everything
- rāga – attachment to things or to how we believe life should be
- dveṣa – aversion to things/situations we see as bad or wrong
- abhiniveśa – fear of death or of endings
As I worked on my class in the months leading up to the series, I was drawn to consider how the kleśās related to the suffering we experience as a result of chronic pain, and I found it particularly useful for my thinking about my own responses to having an ongoing medical condition. I would like to share some of my thoughts here. I would note that, when I speak of “we,” I’m invoking a generality of being (based particularly in Westernized thought); it’s certainly not the case that everyone thinks in these ways. I’m using it here as a discursive shorthand and to suggest that I have also had (and have) these experiences, so I am not meaning this as a negative judgment of others who do.
First, avidyā – For many of us, we operate under an assumption that the body should work efficiently, in a particular way, and that our own particular bodies won’t “break down.” When we are then diagnosed with a chronic condition, we feel betrayed and surprised. In reality, the human body is, from the start, slowly wearing out. It is only natural and reasonable that parts will begin to change, and statistically speaking, virtually all of us will experience bodily problems over time. These changes aren’t even really breakdowns, as they are a normal part of the varying lifecycle of a human body.
Which relates to asmitā – Oh, asmitā! In our lives, we build up this whole image of who we are. We construct elaborate life stories around that image, that contain beliefs about what we can and cannot do, how we think, what our beliefs are, etc. When a chronic illness comes along, this story of me can be shaken to the core. We begin to feel unmoored, not knowing exactly who we are if we aren’t that person. We have trouble envisioning how we can still be “self” in a different way.
Part of this view of self is rāga, our understandings and attachments to the way things should be. We have a whole set of beliefs about what “should” happen in our lives, what we “should” be able to do and/or be responsible for, what our future “should” look like, and so on. Suddenly, chronic pain may begin to intrude upon that. The belief that a “good mother should,” or that “men should always” butts up against the physical reality of the body and, because it is so hard to let go of those attachments to what should be, we feel sorrow, guilt, and shame over what we now perceive as failings.
And this is connected to dveṣa. Along with those beliefs about what should be, we have a constellation of dislikes. We don’t like illness or “weakness.” We don’t want to be seen as disabled or incapable. We are averse to pain. We see illness in the young as something that it wrong, sad, a pity. And the list goes on. When we get a diagnosis of a chronic illness, or we experience sensations of pain, we want to fight against it, to reject it.
At the root of it all, is abhiniveśa, our fear of endings, of change, of death. Chronic illness and pain are a vivid reminder that everything ends, including our abilities to do X, Y, and Z, and eventually our mortal lives. Most of us are uncomfortable thinking about or talking about that reality. We know that we won’t live forever, but we don’t really want to address it, even in our own minds, and we find it very difficult to accept it.
Thinking about these kleśās, it becomes so easy to see the many ways that chronic pain impacts us that have nothing to do with the pain’s physiological effects, and everything to do with our mental and emotional responses to it. Though the kleśās are a normal part of the human experience, and pretty hard to avoid, through practices such as meditation and yoga, perhaps we can get enough distance from our own responses that we can see them, and maybe that awareness gives us some room away from the pain.