If mindfulness is to be relevant and liberating in all areas of our life it needs to include discomfort. To be free only when we are comfortable is not the freedom that Buddhism advocates: real freedom is found when we have inner peace and equanimity in times of both comfort and discomfort.

One area of discomfort experienced on retreat is physical pain; sooner or later everyone who has a retreat practice will encounter pain in their body. While in daily life it may seem natural to make efforts to avoid it, experiencing pain during retreats can be an opportunity for practice on the path of liberation. Rather than viewing pain as a problem, the first strategy is to see it as deserving careful attention, as an opportunity for investigation and personal growth. Through the application of mindfulness, pain can lead to insight, peace, and inner freedom.

No retreat rule requires participants to endure pain. If changing one’s posture can alleviate pain, one is welcome to do so. However, when pain is seen as a practice opportunity it then becomes interesting to allow it to remain so it can become the focus of mindfulness. How long we remain with the pain depends on how long we see this as a worthwhile opportunity, which will be different for everyone. (People who have a condition that brings unremitting pain should discuss this issue with a retreat teacher at the beginning of a retreat).

One practical reason to investigate pain is to learn if there is a physical issue that needs addressing. In taking the time to feel and explore discomfort, we might learn what’s causing it. For example, we may discover that the pain comes from tension in a part of our body. Relaxing the tension may lessen the pain. Pain may also arise when our posture is out of alignment. Investigating the pain may reveal that a small adjustment in position not only alleviates the pain but also leads to a more balanced posture. In contrast, big changes to one’s posture at the first signs of discomfort may ease the pain by shifting to yet another unbalanced posture.

Taking the time to give careful attention to pain may help us recognize when it might signal the possibility of injury. Any time we suspect that injury might occur we should adjust what we’re doing. One warning sign is pain experienced in seated meditation that persists for five minutes or more after getting up and moving. To avoid injury in this case, we should find a different meditation posture that does not elicit the same pain.

When pain does not carry the risk of injury it can be useful to let the pain continue and to explore it. Particularly useful to investigate is pain coming from relaxing chronically tense muscles to which we have become insensitive or “numb.” With meditation these areas begin to soften and wake up, and sometimes the first sensations that return are the pains of chronic tension. Patiently allowing the pain to continue may allow the muscles to continue to relax. Tense muscles in the shoulders and shoulder blade area are the most common ones that may hurt as they relax, and occasionally those in the chest or belly.

Pain may also arise when the meditation posture fatigues weak muscles that are engaged for longer periods than they’re used to. For example, if we commonly sit hunched over, the back muscles required to sit straight may quickly tire out. When chronically tense muscles relax we may need to engage previously under-used muscles to hold our posture. While overusing fatigued muscles is not useful, it is also not useful to completely avoid the discomfort that comes with using weak muscles. It’s important to use them enough—perhaps intermittently—so they can gradually become stronger.

Our reactions and beliefs about pain are useful to explore through mindfulness. Rather than focusing on the pain, we can focus on our relationship to the discomfort. Are we impatient, aversive, angry, or afraid? Do we tense physically around the pain or contract mentally as we think about it? What beliefs do we have about the pain? Are there unnecessary beliefs that magnify the pain or our impatience? Is pain seen as a personal failure or shortcoming? Is it viewed as an obstacle? Sometimes these secondary reactions are more painful than the bare, physical pain itself. They  can also trigger tensing of muscles around the pain, thereby increasing it. By distinguishing the reactions from the primary physical sensations, we may find it much easier to be patient with pain and to decrease tension around it.

Over time we can learn to have a simpler and more easeful relationship with pain. We learn to experience it without creating stories about it, without self-pity or fear, and without resistance or contraction. Not only can we learn to be equanimous about pain, we can also experience profound peace—even while pain is present. We can allow pain to be just pain, nothing more and nothing less, simply present without being a problem.

Pain and the Four Foundations of Mindfulness 

To find a simple and easeful way of attending to pain we can use the lens of the four foundations of mindfulness (body, feelings, mental states, and mental activities) to guide our investigation and practice.

1.Mindfulness of the Body 
The Buddha’s instruction for the first foundation is to observe the body solely in terms of the body. Thus we focus on the pain simply as physical sensations independent of our emotional reactions or thoughts about those sensations. As if seeing the pain through a magnifying lens we can direct attention to the specific area in the body where the pain occurs. As we bring mindfulness closer and closer to the primary experience of pain it will sometimes transform into a kaleidoscopic dance of very particular sensations that arise and pass quickly. Occasionally the sense of pain will disappear, as all we are aware of are these rapidly changing sensations.

Because the word pain is an abstract concept, viewing it only through the lens of this word  actually removes us somewhat from the actual pain. It can quickly get us entangled in thoughts, memories, and expectations associated with pain. Dropping the concept pain can make it easier to identify the physical sensations that make up the pain. Possible sensations include pulling, stabbing, tightening, burning, or aching. Some sensations, such as vibration and tingling, may be more neutral than unpleasant. The basic sensations may be easier to experience than the mental associations about the pain.

2.Mindfulness of Feeling Tones
The second foundation of mindfulness is a step deeper into our subjective experience than simple physical experience. Here we become aware of the feeling tone of the pain—i.e., the simple evaluation of its being either pleasant, unpleasant, or neutral. While pain is usually unpleasant to experience, it is not always so. When the shoulders are mildly painful from being tense, this pain can be pleasant and welcome if it is a sign that the shoulders are beginning to relax. Another similarly mild ache may be felt as very unpleasant if we believe it is the harbinger of a serious illness. This may change to a neutral response if the ache proves to have a benign and temporary cause.

Becoming aware of the feeling tone of the pain, it may be possible to distinguish the feeling tone from any reactions and stories that might arise. It may be easier to maintain a relaxed awareness of the simple experience of unpleasantness without further complications such as negative interpretations or states of mind that strengthen the overall sense of unpleasantness. The mind has the ability to remain peaceful in the face of mild pain, and with mindfulness practice this peace may be possible with even stronger pain.

3.Mindfulness of Mind States
The third foundation of mindfulness takes us deeper into our subjective experience by focusing attention on our general state of mind or mood, often a more intimate and personal aspect of life than either our physical experience or the feeling tone of experience. Perhaps the simplest approach to the third foundation is to be aware of whether our state of mind is tense or relaxed, contracted or expansive. This can include recognizing if the overall state of our mind is happy or sad, hostile or kind, dissatisfied or content. Mind states often last longer than physical pain; therefore, when the pain has disappeared, the associated mood may persist.

If we react to pain with negative mind states we may further react to the unpleasantness of the mind state itself, so that it becomes the strongest and most debilitating part of our experience of pain.

When physical sensations of pain, feeling tones, and mind states are all undifferentiated it may be quite difficult to recognize the details of the experience. The whole experience may seem dense and impenetrable. Distinguishing these three component parts can make it easier to be mindful of the mental activities that are considered part of the fourth foundation.

4.Mindfulness of Mental Processes
The fourth foundation is the most intimate aspect of our experience.  It focuses on the mental activities that bring us toward either more suffering or happiness, to either entanglement or freedom. This foundation is the heart of Dharma practice.

The simplest way of practicing this foundation is to recognize whether or not we are clinging to or resisting anything. When there is pain, do we meet it with craving or hostility, with resistance or worry or confusion? The fourth foundation includes discovering how mental suffering around pain comes from compulsively wanting things to be other than they are. It is also recognizing the corollary, which is that mental freedom and peace come from letting go of this wanting.

Ideally, practicing with pain on retreat is done with compassionate concern for ourselves. Being mindful of pain does not require stoicism, resignation, or duty. Rather it is meant to be a way to care for ourselves through the growth of wisdom and the reduction of the inner roots of our suffering.

Because persistent pain on retreat can be tiring, it is important to avoid spending too much time practicing with it. If possible, spend some periods of meditation in a posture that is pain-free to refresh your mind and body. Pace yourself with pain so you don’t become grim or feel overwhelmed by it.

Retreats can be seen as microcosms of how we react or respond in daily life. By studying our reactions to pain on retreat we can become more knowledgeable and wiser about how we respond to challenges when we’re not on retreat. We can learn how not to get hooked into our reactions to pain and use these lessons in the rest of our life.

Pain is a normal part of life. Becoming wise about it is one of the benefits of retreat practice.