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At first, my conscious life was all pain. Acknowledging the pain and its power eventually allowed me to explore my body fully and find there actually were experiences in my body besides the pain—here is pain, here is bending, here is breath, here is movement, here is sun warming, here is unbearable fire, here is tightness—something different wherever I looked.

My life began to be filled with sensation. Not just pain but sensation of all kinds: children’s voices outside my window; subtle changes in the shadows on the wall as the day passed; feeling my entire body when I turned over in bed; noticing the temperature differences in the various parts of my body, those inside and outside the covers; the contours of a familiar face. Rather than shrinking, my world was as intricate as ever, just on a much more subtle level. Because I was no longer goal-directed, sensation and feeling filled my consciousness. I kept telling myself this must be the world of babies and animals. Everything is fresh and fascinating.

Valuing these subtle experiences is very unconventional thinking; it is extraordinary to be willing to be involved with ordinary things, to be willing to live in the mundane. We don’t have a lot of role models for this kind of attention in our society. Thus, we are very deeply touched when they appear to us. It is so moving when it does happen that it can inspire us for years. When I was first very sick, lying in bed, I happened to hear a recording of Mississippi Fred MacDowell’s Delta blues music. He strums a guitar and sings in a rough voice. He plucks each string of his guitar as if it were his own heartstring he’s vibrating to express his pain. When I heard him, I felt that if he could manage to touch a guitar string that way, I could try to live as sincerely as possible.

If you are in great pain much of the time, it becomes absolutely necessary that you create a life for yourself that you can not only tolerate but love and enjoy. I am probably in more pain than most of the people I know, yet I see my life as one of the most pleasant ways of living currently available to human beings. I believe my life is enjoyable and satisfying because I take my pleasure as seriously as my pain. And what I take most seriously is living each moment of my life, to the extent that I am able to pay that much attention.

Another way to put this is that I try to do each thing for its own sake, to experience every motion, every endeavor, every contact, for what it is. Washing the dishes is not just about getting the dishes clean; it’s about feeling the warm, soapy water soothing my arthritic fingers and noticing the brief discomfort in my elbow joints when I lift a clean dish into the dish drainer. Folding the laundry is an opportunity for smelling its cleanness and luxuriating in the simple movements as a counterpoint to my complex life. There need be no better reason than that I am alive and doing these activities. This is engagement that arises out of a commitment to live as thoroughly as a human can.

When we concern ourselves with the problem of chronic pain, whether psychological or physical, we also need to talk about pleasure. If we are in great pain, often the first step is simply noticing that we have any pleasure at all in the midst of terrible suffering. Then we need to learn how to notice that pleasure is actually present in the experience of pain. Not that pleasure distracts us from the pain or chases it away but that it is able to send little tendrils of relief or comfort into the pain, in the same way that darkness interpenetrates light, that death interpenetrates life.

I think that if you are overwhelmed by emotional stress or physical pain, it is advisable to think about cultivating the ability to recognize pleasure wherever the potential for its existence may lie. I say this not because I am a thrill-seeking hedonist but because somebody has to say it. Not so many Zen lecturers or stress reduction teachers or arthritis doctors do, so I have to fill the breach.

It would be useful to first explore the relationship between pleasure and pain. Like a lot of pairs—light/dark, life/death, love/hate, sickness/health—pleasure and pain are interdependent. That is, they have meaning only in relation to each other. Our ability to perceive each of them is totally dependent on our understanding of the other. Their existence is so commingled in our consciousness that if we decide to concentrate our attention on one of them, the other comes into our consciousness eventually, whether we intend it or not.

Sickness and health are an example I use often, because I work with people who have chronic physical problems. When I began to recuperate from the worst ravages of rheumatoid arthritis, and spent more and more time out of bed, I climbed onto the ever-turning wheel of the sickness-health dichotomy. Every morning when I awoke, I’d think, “Am I better or worse today?” Because I was emotionally involved with the answer—I was repelled by my sickness and clinging to any signs of good health—I was either cast down and disappointed, or raised up and elated, depending on whether I was feeling better or worse.

So the problem with pain is aversion, and the problem with pleasure is clinging. The solution is to just live your life without getting tripped up by all these fixations, but “just” means living your whole life. It’s being alive for all the details of your life and not picking out the moments that you’re going to attend to and those you’re going to ignore. You can take care of your body simply because it yearns to be taken care of and you are alive, listening to its yearnings, flowing in and out of its intelligence, not making it into a separate being apart from yourself. You can attend to your relationships with friends and mates with a heart open to all their various characteristics, those you enjoy and those you find annoying.

There is an absence of struggle when you pay attention this way. What is really going on is that you are doing what needs to be done for your body and for your relationships; it’s not you against sickness or pain or your friends’ personalities.

When you do prefer one state of mind over another, whether it’s pleasure or pain, you lose your capacity to be present in the moment. When you’re making love, you’re taking time out to think, “Can we do this again before morning?” Instead of tasting every morsel in your mouth during the birthday dinner lovingly prepared by your friends, you’re thinking, “What’s the next course?” You’re constantly living somewhere else, in the past or the future.

If you do see your cycle of craving and aversion, and regard it with some humor or detachment, bemused at the fact that you’re always running after something or away from something, you can begin to practice the disinterested pursuit of pleasure. This is pleasure recognized and fostered rather than frantically and compulsively grasped at. You can cultivate pleasure in the same way that you eat sensibly or put on your jacket when it’s cold. This is just something you do for your and others’ wellbeing.

Why should you cultivate pleasure in this disinterested way? Recent research indicates that pleasure is good for you. Pleasure is biochemically better for your health than pain is; it produces a different blood chemistry than pain does. Pleasurable experiences make you breathe deeper, and some of them make your immune system function better. Pleasure relaxes your body, so that your muscles are more flexible and responsive. They can gently pull your joints apart as you move, keeping you from getting arthritis or easing the arthritis you already have.

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