Suffering, both mental and physical, is thought to be part of the unfolding of karma.Suffering is seen as the consequence of past inappropriate action (mental, verbal, or physical) that occurred in either one's current life or in a past life. It isn't seen as punishment but as a natural consequence of the moral laws of the universe in response to past negative behaviour.

Suffering Isn't Random

Hindu traditions promote coping with suffering by accepting it as a just consequence and understanding that suffering isn't random. If a Hindu were to ask "why me?" or feel her/his circumstances weren't "fair," a response would be that her/his current situation is the exactly correct situation for her/his to be in, given her/his soul's previous action. Experiencing current suffering also satisfies the debt incurred for past behaviour.

Pain is a Reality

Suffering is seen as a part of living until finally reaching 'moksha'or the complete release from the cycle of rebirths. 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're bound by the laws of our world and will experience physical pain. Pain is truly felt in our current physical bodies; it isn't illusory in the sense of not really being felt.

The Soul is Blissful

While the body may be in pain, the Self or soul isn't affected or harmed. Arjuna, the warrior and seeker of wisdom in the Bhagavad-Gita, is told that "The self embodied in the body of every being is indestructible..."

"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 isn't affected, there need be no concern over temporary suffering. Those of us in pain may gain comfort by viewing pain as only a temporary condition and one that doesn't affect our inner Selves.

Pain is Not Purely Bad

Pain and suffering aren't 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 or Brahman, so nothing is only good or bad; Brahman encompasses everything. Everything, including pain and suffering, is given by Brahman. 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

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 over-involvement 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.

Perfect Detachment Leads to Moksha

Attachment is a primary stumbling block to achieving Moksha (complete release from this world). 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 a sense of equanimity or an even disposition in the face of either happiness or sorrow. When someone achieves perfect detachment, no problem or circumstance, including pain, can cause that person to suffer. From the Bhagavad-Gita:

"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."

How to Achieve Detachment

It can't be simply an intellectual understanding that the Self is part of God. It isn't escapist, pretending that suffering doesn't exist. One part of achieving detachment is to follow dharma (appropriate action), but to be unconcerned with the outcomes of these actions. In the Bhagavad-Gita, a seeker of wisdom 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 success - this equanimity is called discipline."

Refocus Away from Pain

We who have pain are not to be passive and give up, and can continue to attempt to lessen our 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 Doctor's Dilemma

The guidance to seek detachment from outcomes would likewise apply to those who treat patients. The dharma for a pain practitioner would be to be the best practitioner possible, while accepting all outcomes. However, this wouldn't suggest becoming indifferent to patients' suffering. Hindu traditions would support still caring deeply for patients, but needing to recognize that physicians aren't in control of outcomes, nor know what's the appropriate outcome from the perspective of karma.

Mantras, Meditation & Yoga Can Help to Refocus

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. As the focus of one's life should be on God, 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, not pain. Hindu traditions hold that all have a capacity to achieve this. Spiritual assistance and support are also to be found in God. One way to know God is through devotion, the way of 'bhakti', which implies that God is accessible and knowable, in personal terms. A practice of some Hindus is to pray to ask for support in facing problems, believing that their suffering will be relieved and support will be provided.

When Religion Becomes a Hindrance

Although religion can be a positive resource for some, there are times when religious coping can be ineffective. For Hindus, a first potential challenge may be the feeling of passivity or fatalism that may arise because of karma. A patient can feel hopeless or unable to change things because he feels that things are fixed by karma. Hindu traditions counter this by saying that a person can start in the present moment and go forward, living his life in a positive way by following dharma. If a patient currently experiences pain, change can occur by attending to present appropriate action.

Acceptance is Not Inaction

Acceptance can be misunderstood as passivity. Hindu traditions do advise a focus on appropriate action, rather than outcome, but this doesn't mean inaction. People with pain can be encouraged to actively manage their pain and continue to seek improvement, but become detached from the outcome of these efforts. However, the process of trying is important, rather than a focus on a final goal of being detached. Patience with oneself is encouraged. Patients can also try to learn as much as possible from their current situation, including their apparent failures.

Medical Studies on Acceptance as a Coping Skill Acceptance, from a nonreligious perspective, has been studied in pain research. Although acceptance isn't unique to Hinduism, it's certainly central to the religion, and includes at least two aspects. Hindu traditions view acceptance as a logical attitude towards what one's life presents, including pain and suffering, because all is seen as the just working of karma. The practice of acceptance is also a means to a greater end, detachment. The process of accepting one's life lessens one's desire for things to be different than they are. As desires fall away, detachment is achieved. Related to pain, both painful and pain-free states would be accepted equally. Detachment from this world, to be focused on God, is a primary goal in Hinduism.