Audio recorded at Buddha House Adelaide. Transcript auto-generated and AI-corrected; may contain errors.
About this talk. Most physical pain, Khensur Rinpoche argues in this 46-minute workshop session, is true pain plus the meaning we assign it — and that meaning can be worked with. The session opens with a guided four-powers purification practice using visualization of white light flowing from Śākyamūni Buddha, then turns fully to end-of-life pain management. Drawing on Ian Gawler’s methods, practical training techniques are outlined: a bulldog clip placed on the hand, sitting on rocks during meditation, and learning to sit calmly before a garden sprinkler — building tolerance before serious illness arrives. An open discussion with hospice workers and nurses follows, gathering first-hand accounts of what actually helps: touch, a caring voice, patient acknowledgment, and giving dying people control over their own analgesia. The session ends with a guided imagery exercise for working directly with pain.
File metadata (for organising)
File: 08 A of D 1993 08 07.mp3
UUID: 2c415306-91b8-4fb6-94e8-29a5a9d9f782
Teacher: Khensur Rinpoche
Collection: Art of Dying Workshop (Khensur Rinpoche)
Date: 1993-08-07
Recorded at: Buddha House Adelaide
Duration: 45.9 minutes
Words: ~3,700
And to recommit yourself not to harming that person, but to caring for them, to recommit yourself to having develop some kind of compassion, wishing them happiness, wishing them well-being, wishing that they’re not suffering. Then thirdly, determine as best you can, even if it’s only for the next hour, not to repeat that action again and being mindful and making effort not to not to fall into that same habitual pattern of way of relating. And then fourthly, we’ll do we’ll apply the the, force of antidote And imagine, whatever figure is meaningful for you, in this case, if you wish, Śākyamūni Buddha. Then will, while reciting the mantra, a shaft of white light comes from the heart of Śākyamūni Buddha down to the crown of our head. And along this shaft of brilliant white light flows white nectars.
And a body fills from the bottom upward with radiant white lights and nectars completely eliminating, you know, all of our negativity, the darkness, all the heaviness, all our feelings of guilt, completely purifying our body and mind. Our body and mind become crystal clear like pure. And and allowing yourself to to let go into that sense of innocence and that sense of lightness, of purity. You know, it’s finished. Okay.
I made a mistake. It’s over. And believing. Having a sense that you’ve actually done something significant to eliminate that heaviness that was there before any type of feeling of guilt or wrongdoing, even if it’s not acknowledged, that it’s finished. And allowing yourself to dwell in a sense of purity, in a sense of innocence, a lightness.
And then finally, Śākyamūni Buddha will come down, or whomever it will be, will come down to the crown of our head and dissolve into ourselves. And then we ourselves can begin to imagine, you know, that we have we can identify momentarily with the goal of our spiritual path, the goal of what it means to be an ordinary human being, however you may conceive of that, whatever is our model of sanity, our conception of the evolutionary possibilities of humankind. And we begin to dissolve from the bottom downward and from the bottom, from the top downward, from the bottom upward until there’s just clear infinite space and peace. So this is very brief and not a particularly elaborate, but I think it’s useful means of purifying our negativity. So should we try this if you’d like to take a comfortable firm posture?
And beginning with a minute of mindfulness of breathing. Focusing among the bringing the mind to the in and out flow of the natural breath. We are going to begin the purification method with first the power of regret. You can recollect any specific negativities that you may have created. You develop a sincere sense of regret, a sense of acknowledging your mistakes and wishing wishing that you hadn’t acted that way.
Then the power of reliance In case of having harmed others, generating a sense of love and compassion for them, recommitting yourself to helping others rather than harming them. And the power of reversal, the time determining in a realistic and honest fashion not to repeat this action again. And the power of antidote, visualizing at the level of your eyes, approximately a meter and a half in front of you or the size of your hand, whatever you hold us to be worthy with, some sort of presence, something of great value, that which you hold us most high, that which you revere. It could be Śākyamūni, Buddha, Christ, but some presence which you which you admire and respect. If you can’t see anything, doesn’t matter.
Just feel that that presence is there, looking compassionately upon you without judgment. And as we recite the mantra, imagine that from the heart of this presence, a shaft of brilliant white light extends from your heart to the crown of your head and along this shaft brilliant white nectars begin to flow, completely filling your body from the bottom upward with the brilliant white lights and nectars, completely eliminating any darkness, any feeling of heaviness, guilt, negativity, unworthiness. Your body and mind become crystal clear, pure. As you recite the mantra, try to imagine this visualization accompanied with these feelings of purification, of innocence, of overcoming negativity. All the negativity is completely purified.
All the heaviness is gone. The guilt is gone. Try to feel a sense of innocence, a sense of lightness and purity, and let yourself go beyond logic, beyond irrational mind, into that sense of purity and innocence. And then the figure before us, Śākyamūni Buddha, whoever you imagine, comes to the crown of our head and dissolves into ourselves. And you completely identify with the goal of your spiritual path, however you may conceive of it.
You are that. And then slowly, from the top downward and the bottom upward, they begin to dissolve, to disappear. Until finally there’s only clear vacuity, empty space, infinite, clear space, and a deep sense of peace. And bring your mind back to the breath, the gentle, easy, in and out flow of the breath. Becoming aware of your body.
And slowly, in your own good time, becoming aware of your surroundings. That many people have found very useful for dealing with pain. So it’s really like a meditation. My main source of information about pain is Ian Gawler. His book has a very good section on pain, where he talks about two types of pain emotional and psychological pain and physical pain.
And what most pain is usually is, in my interpretation, is true pain plus the meaning. So it’s usually the meaning and how we feel about the pain that actually is the problem that really creates the problem. When I used to have a few niggles in my liver area, I used to immediately panic, feeling like, well, it’s growing bigger and that means I’m going to die’ and all of these sort of things. Usually, is really mainly the whole emotional thing. In our society, there’s a great deal that we’re conditioned to be frightened of pain.
And Ian talks about one of his oldest child growing up where his parents didn’t ever react if she fell over. So she used to just get up and get on with things and not really react to the pain until she used to go to her grandmother’s. And she went to her grandmother’s and said, oh, no, Rosemary, are you all right?’ and made a big fuss of her. She used to try it on when she got home too, making a big fuss of her crying and saying, oh, it hurts so much.’ And they used to just ignore it because she never really reacted to it anymore. But when we’re looking at the pain that comes through serious illness, it’s another very big thing to be dealing with.
And when you’re looking at people who have had a lifetime of conditioning, of pain being frightening, and you yourself have also had that conditioning, then what to do? Obviously, the use of analgesics is a really vital part of helping the dying and is a totally legitimate way of dealing with it. There’s training that one can do. One of the things Ian talks about is actually training ourselves to actually know how to deal with pain. And what we all acquired on the course was a bulldog clip, which we were told to put in the most uncomfortable place possible on your hand or whatever.
This actually isn’t very tight, so it’s not very it doesn’t hurt very much. The ones that I got over there were very tight and really hurt. And what he recommends is that you actually practice learning how to deal with pain. And he talks about how he trained himself to deal with pain to the point where he would be able to go to the dentist and have all sorts of serious root canal work done and all sorts of things without feeling a thing, because he trained himself to deal with pain through using these clips and then through sitting on rocks when he was meditating. He also talks about sitting in front of a sprinkler, one of those ones that goes like that, and being able to just not react to that.
So he talks about just that it’s a really important thing to do, because when pain comes in our lives, it blows us away. It sweeps us away. And it means that we’re not able at all to concentrate on, to be mindful. And the essence in the context of this workshop is that if we can train ourselves to deal with pain, we can help those that we’re working with to deal with pain, then they can have more control of their mind and of the process of dying, which is the essence of the whole Tibetan Buddhist approach to dying. So we can look at physical training, and then we can look at meditation, the use of imagery, which we’ll do after we’ve had a discussion about this.
And then also thinking of, when we have pain, to actually think about it in terms of what it means about how others suffer. For instance, I slipped on our driveway because it was very wet and slippery the other day. I landed very heavily on my elbow and it really hurt. But it did immediately make me think about all those old people who fall over all the time and how awful it must be to be so fragile and so easily falling over and all of those sort of things. Whilst it may not immediately remove the pain, it does actually have some set.
And in a sense, you can visualise yourself taking on the suffering of all of those people who have fallen over and really hurt themselves. And it can help to put one’s mind in a good direction. So if we could just What I guess I’d like to know, and which I think is very relevant for us, is to know what are the experiences that those of you who have had as hospice workers and nurses and people in your own lives of helping people to deal with pain that have worked, that have been valuable? Or, yes, your experiences of working with pain. So, for those of you who are working with the dying, what are the ways that you have you found any ways that are helpful?
Right. So he reinterpreted the meaning of pain. Right. Well, that’s wonderful. That’s wonderful.
Yes. Yes. So that literally meant so that what he was saying was that your love, makes my pain go away. Yes. But that’s very so that you can see that the power of that that can take away physical pain, the power of touch.
Thank you, Natalie. As much as possible. Yes. Sure. So that you’ve noticed that, and you do that as much as possible, and you notice that that really that that does make a difference.
Yes. Yes. Yes. It’s it comes back to love in the end, doesn’t it? Yes.
Peter? Yeah. And just working in an acute care setting like in a hospital, I remember. Can’t I just fear about that sometimes. Yes.
The times that I do, I find it really helps just to be able to not necessarily even do anything, like we’ve all said, just to just to be with someone. Yes. Yes. But because you’re really there’s just not time, then you have to resort to analgesics and How, with analgesia, it’s very important to respect and listen to the pain causes their pain because you can’t see it or you can experience it yourself. Sure.
Where is it? How that is a sort of that person has been in control of you describing it, and never stayed there. Sometimes it’s helping helping somebody explore their pain just to not even verbally, but just for themselves to to go inwards and just look at her expression and just explore it in in terms of what sort of pain is it, how bad is it. Just it sometimes helps. Describing it.
Describing it. And to recognise that as though you are aware of the person that you understand. Acknowledge it. Yeah. Can you talk about, what happens if you don’t listen to?
I suppose, like, when any person, substance use, I suppose, to the system and to the staff, and you’re there as a condition as much as anything else. And that’s very frustrating. And we just compound that whole thing even worse to make a fairly often disillusioning, and tricky experience just that much worse, and thereby acknowledging and recognising that that person is in discomfort, it just is more empowering for that person. Yes. So you’re actually saying that beyond anything that you do, even touching or whatever, you actually have to listen to the person and hear what they say about their pain.
Could you tell us any stories? Oh, just standard patience if they’ve had a hip replacement or something, and they’re obviously gonna be very sore. And you do have people who, like, Joy just said, there’s a pain protocol, you’re meant to do this for hourly and if someone at times just doesn’t cover it. And you as a nurse are restricted by the fact that you can’t prescribe analgesia. So it’s getting your doctors in there and making them listen and telling them it’s not effective and just being a real advocate, which nurses are really do try and do.
And it’s kind of like, I haven’t been there since very long, but they say it’s improved. It’s just being important. That is fair. Young who don’t have enough pain relief in hospice is excellent. They have been really well covered, that’s the real focus.
Whereas hospice patience who aren’t in hospice, they’re on a big surgical ward or medical ward. The doctors and the nurses are as in tune to that sort of type of condition and pain, and they’re a lot more interested in getting that person better. But obviously that’s not reason that person’s in hospital. They’re there to die So it’s just a different approach. Yes.
Because I know it’s a dot. So you’re saying that the context really affects the context that the person is in really affects then how their pain is dealt with. Yeah, and perceived. Perceived and dealt with. Yeah, and perception is a good thing.
And it’s just that you have to respect other people’s differences, I suppose. Whilst trying to meet the needs of the patient. Great. It helps all of us. I don’t know how it helps her.
Well, I guess, in a sense, that’s the very best that she can possibly do. Because if, in fact, she has a sense that she can be open about her pain or that is openly acknowledged, then that can actually probably support the rest of you in that group. Because as we talked about before, it’s often it’s the people around the dying person who is suffering. As Angela said, I think people around who will suffer a great deal, so that you’re paying attention to the context of that person’s working life in a really positive way. So that’s very important.
It’s very easy to just to hide, not to talk about things. I mean, guess the natural instinct of everybody is to not say anything about her pain because it makes them feel too uncomfortable. But you’re actually stepping outside that and acknowledging and being open about it. And so therefore, it’s manageable. And he’d be typical of most people, wouldn’t he?
So that if you think about that, then, you know, as professionals working with with clients, then then it’s logical that you you wouldn’t see very much of that person. So it’d be very hard to really listen and know what what that person is really feeling. Yes. Yes. Because they may not say so.
About sinusitis pain? They’re not telling anyone. I know. Don’t wanna you. Yeah.
How do you deal with it? Because that is a pervasive problem, isn’t it? I mean, people don’t wanna bother people about it. I mean, it’s It’s up with the words. I mean, you ask the patient if they’ve got pain, I’ll say no.
You can say, oh, you’re Oh, right. Well, so being authentic, being real yourself is what it’s about, isn’t it? I just spent three weeks in hospital with a lot of pain, with cancer and operation. And what I do remember most is not the pain. It’s was the loving empathy in the voices of the nurses.
I know they didn’t have much time to spend with me, but every everything they ever said, any question or any greeting was always with this loving sound in their voices. So sometimes if they haven’t got time to touch and hold, just that voice contact, that loving sound really stays inside the patient. I’m just letting you know that really works for me, that caring sound in the voice. And that’s what I remember most from the pain. That’s great.
Was there anything else, Valerie, that actually really helped you with the pain? Morphine. Yes. I guess it’s the issue of control, isn’t it? That mostly a lot of people in pain feel like they have no control.
And that’s a really frightening thing. When that control is given over to the person who has the feeling of that pain, they generally use less of the medication. They generally experience less pain. Yes, so that if they’re given responsibility for dealing with their own pain, then it’s actually a lot better. Obviously you can’t do that with somebody who has that problem.
What about you, Sue? Did you really have that? No, I didn’t. Did you? No, I didn’t.
I virtually was symptom free. I mean, apart from feeling really wiped out and things, I’d somehow managed to contain it and and and wasn’t anywhere else in the body. And my liver my liver function tests were always normal. So it was really weird. But I didn’t I had niggles, you know, sort of uncomfortable feelings and things, but I didn’t have any pain.
So I really have no experience of pain. Rex? I find I can help with lesser pains, like, sort of a severe headache or something. That is to pain. Right.
And to describe the shape of it, the color of it. Good. Yes. And keep out of it. Yes.
It will change its color. It will change its shape, sometimes it will disappear. Right. And, also, I find that it’s not so much pain when you breathe in. It’ll almost disappear, and the pain will be there when when you breathe out.
I’m sort of experimenting with that. Oh, that’s interesting. Yes. Well, we’ll we’ll do this imagery exercise in in two ticks, that follows those sort of ideas. And I think it’s actually very useful because what seems to really work is actually really focusing on the pain.
I’ve certainly found that if I actually just I’d really hurt my finger a little while ago. When I’ve focused entirely on that, you know, in a very physically relaxed state as possible, it actually was it didn’t it wasn’t nearly as bother to me as it had been. Do you understand anything, Barbara? That pain? A lot of pain is very, very isolating and you tend to draw into yourself.
That’s why people wonder why touch helps. It helps because it takes you out of yourself. There is always a physical pain, but there are emotional components and psychological components to it that worsen it. The touch I’ve always found tends to address those components of it and ease them. Then the pain itself eases and becomes what it actually is, which is a lot less than what you’re experiencing.
The imagery for me was something that really worked going into the pain and looking at it and trying to define it and work out what it was and what it did or didn’t do. That really eased it. I was also very lucky that when I was a small child the dentist that I went to, he used to experiment in dental hedonists but he didn’t tell you that. The water that he’d use to rinse your mouth out would have that in a spray bottle. And he told me from a child, well this was chicken juice, and that he’d spray it in my mouth and I’d never feel any pain.
And I never did. The fascinating part was he’d pull teeth out, fill teeth, and I never felt any pain. I really trusted him. And I had no problem at the dentist. And then I sort of grew up and I started questioning what was going on.
And it was really funny because I never actually experienced pain. I had quite a bit of root canal work and I had it all done without any injections whatsoever. At some level I just accepted it, even when I realised that what he was telling me was a lie. At some level I accepted it. So when you start looking into the power of the mind and what the mind can do, how it can change it.
There are documented cases of people who have undergone quite radical surgery under hedonists with no other pain control. They have done it, a very simple way of explaining it. One lady that I know just went to the Flinders Ranges. She could actually remove herself so she could step away from what was happening with her body, dissociate herself and take her mind somewhere else and contain it in that way. Okay.
Really comfortable position, maybe even lying on the floor. Otherwise, you can just stay seated. So just get yourself I just need to go to the loo. In your lie in your comfortable position, and close your eyes. Relaxes.