the teaching of the Headache

POSTCARD#354: Chiang Mai: Arrived here on a morning flight, Business class upgrade on Jiab’s air miles, and wheelchair at both ends because I’m not steady on my feet after the stroke last year. Physiotherapy sessions help me understand (body & mind) the impact of it and how exactly, the stroke knocked me off my balance and now, how to get back on my feet again.

A learning process and also I need to remind the physiotherapy staff of these headaches I suffer from, triggered by the smallest thing. So, to cut a long story short, I foolishly pushed myself too hard in physiotherapy exercises and strained something which affected whatever nerve group it is that led to this current gigantic headache (Post Herpetic Neuralgia, right occipital nerve).

So that was it, the last physiotherapy session had left me with a headache, that night, the next morning too. No time for Jiab to change the date of the Chiang Mai tickets so that I could stay at home and go to bed. Instead, I had to pack the Headache in my luggage and into the airport taxi.

A soft journey to Chiang Mai, thanks to the upgrade. In the apartment we had all the windows open, only the screens between our interior and the clear mountain air. It helped me to sleep for the rest of that afternoon and night, through till the morning and the Headache was now into its second day.

One thing that helps is that I’m familiar with being a prisoner of the Headache, at the mercy of monstrous thinking. Even though I daydreamed in awful dark wakefulness, I meditated and contemplated this discomfort all the way through until the Headache was nearly over. Next morning it was gone… “gone is gone,” words cannot express.

We got everything done that had to be done. Impossible to do much more, too long spent in that nether-world of sleep crowded with images I wanted to get rid of. I found a book I studied years ago: ‘Abhidhamma in Daily Life’ by Nina van Gorkom’, quite readable even though the exploration of the Buddhist network of cittas (realities) is vast. Interconnected mental factors that are useful to study in order to understand how the mind functions. It’s referred to as Buddhist psychology.

In this volume I was fortunate to find a few aspects of the Buddha’s teaching, that related very much to the experience (the teaching) of the Headache. For example the word ‘wholesome’ (kusala citta): conducive to or suggestive of good health and physical well-being. In the Buddhist dictionary, ‘kusala’ is explained as ‘kammically wholesome’, ‘salutary’, ‘morally good’, ‘skillful’ and ‘blamelessness’. Its opposite, ‘unwholesome’ (akusala citta) hence refers to the opposite – the ‘unwholesome’, ‘unskillful’, etc.

“Akusala citta is bound to arise more often than kusala citta because there have been countless akusala cittas in the past and thus the conditions for akusala have been accumulated. If there is no development of right understanding, akusala cannot be eradicated and we will continue to accumulate more akusala.”

There is that condition of mind where actions and thoughts take place as a result of automatic sensory responses. These states proliferate of their own accord, papanca. An opportunity arises here where I can escape from Akusala by seeing it for what it is, or I can be quite unaware of it…

Being unaware of it means unwholesome states arising from the Headache stimulate negative narratives (Akusala) and it becomes a story about ‘me’, attempting to assert myself; how am I to be seen in the eyes of my peers and others? Now it is so obviously Akusala imagery it’s easy to see there’s an opportunity here to leave it alone and let it all go.

Harder to see is the image of behaviour and speech seemingly agreeable and pleasant but what I really want to do is endear myself to others in the expectation of some gain or favour… multiple variations on this kind of thing; hard to see their realities – things are not always what they appear to be.

These are the kinds of images seen in the mind’s eye when extreme Akusala Citta is present, but I don’t have to have a three-day headache of course, to experience this, I can be quite conscious and wakeful whilst maintaining states of quiet anger or blaming.

So, how to escape from entanglements with Akusala? Mindfulness of the cittas as they arise, and through the development of insight the “escape” can be realized. Right understanding of realities eventually leads to freedom from all akusala, to the end of all sorrow.

The Buddha, when he was still a bodhisattva, considered the satisfaction in life, the misery and also the escape therefrom. We read in the Gradual Sayings (Book of the Threes, Chapter XI, par101, Before):

“Before my enlightenment, monks, this occurred to me: What, I wonder, is the satisfaction in the world, what is the misery in the world, what is the escape therefrom?

Then, monks, this occurred to me: That condition in the world owing to which pleasure arises, owing to which arises happiness,—that is the satisfaction in the world. That impermanence, that suffering, that changeability in the world,—that is the misery in the world. That restraint, that riddance of desire and passion in the world,—that is the escape therefrom…

  • Excerpts from: ‘Abhidhamma in Daily Life’ by Nina van Gorkom

addendum

POSTCARD#352: Bangkok: This is the addendum. Additional material not included in the previous post will appear here. Some have said that the last post ended inconclusively, leaving more questions than answers,

So let’s rethink that, shall we?

Keep it simple.

You could associate the jolt of electric charge with all kinds of things, but the patient (me) had suffered a small stroke. Nobody I know knows what a small stroke means, the scale of it. A sudden bolt of energy in the chest sounds like that could be it.

My wife Jiab calls out as I’m carrying bags to the car… “Hey you can walk so well now, congratulations!”… and I can’t remember the context of what she is talking about. For the first time I begin to see the larger reality of being elderly and disabled; then the reality of my condition before all this came, unlikely to go away or become something else.

Post Herpetic Neuralgia – certain light and sound frequencies that are acceptable for most people but intolerable for me.

So when we decided to take the show on the road, so to speak, there were a few precautions; we had the tint colour of the car windows darkened quite a bit. Now it’s like a car wearing sunglasses, very cool and relaxing. For stepping out of the car, we were less prepared. I expected it to be a bit of a shock with all the arbitrary light frequencies entering through the eye and shrill sounds enter through the ear. But not the scale of the headache and the circumstances of its arrival. We have to accept these realities in our effort to slowly create a practical defense system against the invasion of light and sound, and the internal systems that are activated as best we can.

We broke the journey at Samut Sakarn after 4 hours hard driving. It had not been easy with all these road construction obstacles. Park the car get your things and suddenly, I’m out there, exposed in high resolution Photoshop enhancement. I’m really a nocturnal owl-like creature, sheltering behind a black umbrella, squinting in the daylight; a quiet presence behind sunglasses contemplating vibhava tanha, (Buddhist term for the desire to not exist)… I really don’t want to be here.

I feel Jiab’s small hand take mine and pull me towards the small Inthanin.com coffee shop in a wooden shack with window and overhang roof. Up the step and fold away the umbrella. Then into this dark environment with noisy AC, roaring ice crushing machine and suddenly I have to block out the sound by covering my ears with hand towels. People watching us come in must have been puzzled by what was going on. I try to be as inconspicuous as possible.

Jiab’s hand appears with an iced drink. It’s a smoothie but no ordinary smoothie. This was the first time I’d experienced the mango passion fruit smoothie. To start with, I made the same mistake I’d been making that nearly turned me off of smoothies; I opened the mouth and throat completely to take in a huge volume of the ice-cold liquid. After a moment the liquid begins to move down the gastrointestinal tract and here the headache is constant steady and intense.

No escape, no reversals, there’s just no getting away from it. I’m holding on also because of traces of the mango passion fruit flavor I can release into the pain arena as the drama of the event subsides. For quite a long time I’m hovering through pain and pleasure, long after the source of the ice-cream headache is gone. Then I’m in a smoothie heaven – all this of course with eyes closed, a small towel over the front of my head, gradually coming back into the world people normally inhabit.

This is how it happened, you could say this was episode three on the way to the beach at Hua Hin… or maybe that’s all done now.

the imaginary middle step

POSTCARD#350: Bangkok: Note: I started to write this post on 6th July because it was my birthday. Pretty soon it came to be too much of a revelatory thing to suit a simple chorus of Happy Birthday To You, but this is how it is, we live in strange times.

Seems to me, that Mind makes up a reason for things being the way they are, arbitrarily. It just comes out of nowhere. The mysterious and slightly sinister thing about this is that I (self) allowed it to get to be this way, knowing fully it would lead to lamentation, woe and bad destinations.

I remember it was at the time I started writing things down on scraps of paper because of the hellish stabbing headaches I’d get when typing text on a digital device and the infernal twinkle of blasted light frequencies going off like a flash of lightning in an electric storm… a deep stab in the eye, exactly in the optic nerve. No warning. And that whole thing against a backdrop of a 24 hour managed ‘headache’ held together with a tight regime of powerful meds dealing with neuropathic pain.

So I went back to writing on ordinary paper with dull pencil. I had to learn to write properly after decades of scribbling reference numbers and OTP, one time passwords and that’s all. Then, as the non-digital me, keying it all in with plain black text on a white background, and up into WordPress formatting then hit Publish… but more about that some other time.

What I’m trying to write about here has to do with the arbitrary decision to take a particular action, regardless of the obvious danger that may result. It all went wrong when I found one of these scraps of paper and on it was written something like, say less than one sentence; a note to self.

“the standard walking pattern suggests another step between left and right… left foot (step) right foot.”

Like a magic formula, as soon as I read it I remembered, the image of the middle step. Walking was more like a bumpy three-legged rolling unicycle wheel. Reckless is not the word – wildly irresponsible, when you think of Bangkok traffic going at maximum speed just inches away from the pedestrian zone. We are all expected to take responsibility whether driving car, truck, motorbike or walking, and that’s just the way it works.

Somehow I bypassed these cautionary warning signs and set out to boldly go and try my balance all over the place, while learning how to best cope with this new middle leg I’d integrated. Then there were these spectacular falls in public places. Spectacular because I’d more or less worked out a recovery that included the same ‘middle step’. Note to self: This recovery was imaginary although nearly always there was a reasonable recovery. So it all seemed like a dance, no serious injury at all… then there was the ‘big one’ and that brought everything to a standstill.

For nearly a year I forgot completely about the middle step, and I couldn’t understand why I wasn’t able to walk properly. It was that middle step that was causing balance problems and at the time I had no idea. The only safe place for me to walk was on the grass at public parks or airports where there is space all around. But I was bumping into people, besides it was not a ‘walk’ as we normally perceive ‘walking’. This was more like an imaginary Fred Astaire dance with the furniture than an attempt at walking. So someone suggested I get a wheelchair at airports and walk with a companion in ordinary environments.

Jiab says there is such a thing as occupational therapy where perhaps I can relearn those missing skills, so I will look into that. The biggest mystery is ‘the imaginary middle step’ and I’m referring to it now as something known, concrete, impossible. If I approach it obliquely I’m likely to wander off and fall in front of the traffic. Since finding that scrap of paper I notice anything to do with walking triggers the imaginary middle step.

 

painlessness & the twitch

POSTCARD#345: Bangkok: The continuing story of relief from the pain-in-the-head (H = headache) that’s been with me these last 3 years. Yes a time for celebration, but considering my threshold being as low as it is, therefore affected in a big way when even the smallest easing of pain arises, it’s more like being thankful for small mercies. I’m in a world of tiny calibrations these days, the vast Roller Coaster Ride of self medication is over.

Sunday 24th : I didn’t need to take the magic pill until afternoon because there was no serious H – another example of the state of painlessness is that I forgot to take the usual Neurontin dose in the afternoon because there really was no headache. So I’m still walking-on-air, in this pain-free zone I’ve been travelling through for a while.

25 March : This morning, 8 am, there was the usual dose of Neurontin, the H was still there so I waited to see how bad it was and at 10am, take the magic pill. By 11 am I had forgotten all about it – the headache was gone. 12.30pm: no sign of H. I take the usual dose of Neurontin and wait to see if the H will appear. No, nothing ‘till late afternoon, I take the magic pill and H is gone.

Tuesday 26th, I feel so good and empowered, I walk to the Skytrain station, approximately 1 kilometre and got the train downtown to Central Chidlom Food Hall, got all kinds of food items and back in a taxi with all the shopping.

27 March, 10 am: Felt liberated and free, same as the other days except in the late morning when the H started to arise and I had to take the old meds instead of the magic pill (at the Neurologist’s request). The H disappeared, but then came back again pretty quick in the afternoon. This does not bode well, I thought… waited to see how bad it was then took another dose of the old meds. Reasonably effective pain killer but not the same.

27 March, 7pm : A very bad pain started inside the left eye, a huge kind of rolling pain, occupying the whole interior of my head. Four or five rolls, the whole thing lasting around 1 minute from start to finish, tapering off at the end but feeling it was not really gone. I was glad it happened at home because I fell on to the bed and covered my head with pillows and moaning like an animal. Wow! I hadn’t had it that bad before. So I take the magic pill and after a few hours a second dose. The H is gone and, sorry Dr. Ms. Neurologist, that’s the end of your experiment.

28 March, 10 am : Walking to the Skytrain aware there’s pain in the head, stepping out carefully, gliding along as smooth as can be, trying to stay calm and see how it feels. I don’t want to stop and take a pill with swig of bottled water I keep in my bag because of the broad daylight, big wide pavement and so many well-dressed office staff coming and going. What to do? There’s a coffee shop up in the Skytrain station I can get something there and take the magic pill.

I go up the escalators until I’m 3 floors above street level, and the traffic noise, amplified by concrete and steel is incredible, hard to believe. Push open a green glass door with a small whoosh of cool air. Step inside, the door gently closes behind me… traffic noise is suddenly gone. Nearly all the seats are taken, Thai students studying for exams, grouped together at small tables. I feel I shouldn’t be there, the only foreigner in the place… ah well, maybe that’s cool.

I find a seat and order cinnamon tea. Open my bag, get the meds – fast hand-to-mouth movement followed by a quick gulp of water. That’s it done, Relief Coming Soon. Now, one last thing I haven’t mentioned yet, is ‘the twitch’, and I don’t mean the rock band named Nervous Twitch or the Gamers’ Twitch at twitch dot com, I mean ‘twitch’ as a neurological issue, caused by either the neuralgia I suffer from or the meds to treat the neuralgia.

Not a big deal, just a short, small, unexpected jerk in the arms usually or in the upper body, not the face thankfully. Maybe it’s becoming more noticeable, not sure. I’ve just gotten used to it now – but not used to having to cope with it in public. And I think you can guess what happens next; cinnamon tea arrives, elegant cup I lift carefully to the mouth, head inclines towards it, lips protrude slightly to receive the hot liquid… and just at that moment, there’s a really bad twitch. The cup is jerked out of its graceful passage, and cinnamon tea is splashed over the front of my shirt.

Wow, okay so I have deal with that now, hot wetness, dab-dab dabbing with folded tissue paper, here and there and all over the place, acting like it never happened. But after a while the shirt starts to dry out and you could hardly see the stain. So that’s what happened. I got up from that chair, no evidence of cinnamon tea stain, out into the traffic noise, and back into the state of painlessness.


 

wise discernment

If you find a good companion,

of integrity and wisdom,

you will overcome all dangers

in joyous and caring company

v.328

The mind, like water, takes on the shape of the vessel in which it is contained. The Teacher is encouraging us to be mindful of the company we keep. The Discourse on Great Blessings says, “Avoid the company of the foolish and associate yourself with the wise.” As we apply skilful discrimination, we need to exercise care that we don’t confuse prejudice with wise discernment. Wise discernment is compassionate and kind and is interested in protecting all beings from harm. [Dhammapada Reflections, Ajahn Munindo, p12]

This verse and commentary are meaningful to me because of having to place the word ‘discernment’ in the unusual setting of friends and friendship. In fact, discernment is a very Buddhist word. I think for a minute about the meaning of discernment and use that meaning of the word to investigate ‘discernment’ further; discerning on and on, deeper through the layers.

Wise discernment can also be applied to ongoing qualities of pain – my 24/7 headache caused by Post Herpetic Neuralgia (PHN) situated in the right occipital nerve. There are times when I know how to cope with it, and times when I don’t; and it’s here these words from the Buddhist realm reach me one way or another.

I’ve had it for 3 years and only recently able to shake off the depression;  I am the ‘headachee’ – the bell that is struck, the drum that beats. The neurologist got me round to seeing the sudden ‘spike’ headaches in terms of Severity, Frequency and Duration, units of measurement, instead of feeling sorry for myself; victimhood, a passive sufferer of constant headache. Now I keep notes, monitor the meds and put into words qualities of pain in my head… or is it discernment beyond words? Pursuing this to the end seems to make sense, besides there’s not much else that I can focus on these days.

At the end of last year, I was working with low doses of meds (Gabapentin,  Pregabalin and Norytriptaline ), in order to see the effects in a minimalist kind of self-research. Also to get stable after two years on a reckless maximum consumption drive, existing in a vague, pain-free haze every day. The following are some diary entries at the time [H: the headache]

  1. I learned so much from the pain now, anyone who’s gone through long term recovery from an injury will know what I’m saying about balancing the meds. My injury is very long term, a lifetime, plenty time to understand the process of recovery.
  2. The day I came to Outpatients for the appointment with ENT removing wax from the ears. After tolerating the pain and sound of the suction over and over and again, the self fragmented and got sucked away. What was left was empty space, no one to whom this was happening.
  3. However the terrible shrill noise had activated H; a massive steel grip tightening on the back of the skull bones. I couldn’t interrupt the doc as she had said I have to sit still. I was somehow transfixed. Suddenly there was this growling sound like an animal, and I was wondering where it was coming from. Then I realized it was me! The ENT Doc stopped the machine.
  4. I apologized for the animal noises and explained to the lady I have this massive headache every time she starts the machine. So she listened to me and we took a break then did another session that didn’t last long because of the involuntary growling again. The doc said it was enough, okay now, the eardrum was clear and that was that, end of the ENT sessions. I think she was glad to see me off.

 

 

beyond victory and defeat

Victory leads to hatred,

for the defeated suffer.

The peaceful live happily,

Beyond victory and defeat.

  1. v. 201

 

Those who live beyond victory and defeat are called ‘the peaceful’, but not because they are devoid of feelings. They are not ‘beyond’ because they have escaped the confidence trick of self. Self is like a rainbow. From a distance it appears real and substantial; as you get closer it appears less solid. If we hold too tightly to our sense of self, we get lost in views about what makes us happy. We believe that winning is all that matters, not seeing that in the process we cause suffering to others. If we hold too loosely to our sense of self we get lost, this time from a lack of boundaries, becoming overly sensitive and lacking in confidence. Self-respect and self-confidence are the natural consequences of a life lived with integrity and understanding. [Ajahn Munindo, Verse 201, A Dhammapada For Contemplation (2nd edition), Aruna Publications 2006]

There’s something about this one that takes me to a place where everything becomes clear. It’s like making space for it all so I can see what’s helpful and what’s not. I’m busy with treating my pain – a 24/7 headache situated in the right occipital nerve. There’s not much else that gets my attention these days.

The following are diary entries at the end of last year when I was working with low doses of meds (Gabapentin and Pregabalin), in order to see the differences and the qualities of each, if possible. Also to try to adjust from two years on a reckless maximum consumption drive, existing in a vague, pain-free haze every day. [H: the headache]

Self in itself is not anything of substance, but it activates all kinds of mind stuff, triggers all kinds of feelings of possessions; ‘me’ and ‘mine’. Basic instincts; catch, hold, kill, eat.

So, for me, it’s necessary to retract the claws that cling to things because it only makes the pain worse. It’s not ‘my’ pain, it’s just pain. Pain is pain no difference between your pain or mine. Pain is a non-countable noun; there is only one pain in the world, in the same way as there is water; there is only one body of water in the world.

Another thing, the negativity surrounding pain; I have pain, therefore I am a bad person. I must have done something bad to deserve this pain. That’s a ‘self’ concocted thing, let go of self and allow that to fall away

  1. One thing I’ve noticed about these pain meds is that they reduce the pain of course, but they also work on how the patient feels about the pain. There’s a distance between me and the pain. This is quite extraordinary sometimes when the pain feels like it’s here, but I can’t feel it because it’s behind a wall, or something. Or it’s in the next apartment, where a noisy party is going on… so I don’t have to pay attention to any of that any more.
  2. Sometimes it feels like a self takes shape and considers the situation… the pain is here but there’s no ‘me’ to whom it is directed. Self dissolves again. Another self comes into being with the question: To whom is this pain directed? “It is happening to me, myself!” Now I have full exposure to the pain! And I learn how to quickly let go of self when it’s not being helpful.
  3. Another self arises and says, “I’m going to suffer this Headache for the rest of my life!” So many times I’ve pondered this – how do I feel about this truth today? (compared with how I felt about it yesterday). Give it the attention it’s due then sidestep the awful self that wants to make a big thing out of it: “This is happening to me!” What are we going to do about it? And other unhelpful things.
  4. Next morning, wake up and no headache! At 9 am I take 900 mg Neurontin although there is still no headache, only small indications. It was like this all day.
  5. 1 pm, second dose of 900 mg Neurontin only small stabs of pain but not the huge deep stabs I’ve had in the past.
  6. 5pm: 900 mg Neurontin, so what’s going on here? I’m taking this medicine as a preventative measure? Let me think for a bit about this… how could it be? Anyway still no noticeable H and the day is over!
  7. Next day, H is back again but the pain not so bad, I’m able to get involved in small activities. Note: If I’m not able to forget the H, things become quickly unbearable, and I’m subject to the needs and requirements of the H. Things quickly get out of hand. This careless self-medicating takes up the whole afternoon, all in a dizzying spin. I’m grateful when 8pm comes around and the night meds send me off to sleep almost immediately.
  8. With these new meds, pain is masked off, forgotten about, for long periods of time… it’s like I forget about it. I forget also, other things I’d normally remember – is it this ‘forgetting’ that seals off pain from the mind? Is it the sense of ‘self’ that gets forgotten? There’s no ‘me’ to whom this is happening?
  9. And for quite a long time, things in the room I’m in are so fluid there’s only the forms I meet from time to time, forming, transforming… quite extraordinary…

knowing knows knowing

IMG_2910bPOSTCARD #205: DELHI: … like suddenly waking from a dream, an unfinished story and something just happened – so fast that everything is out of sync, skips a beat. It’s because I’ve been unknowingly holding this pain in my head that’s now breaking through and the holding is not as important as the getting away from it… this is not happening to me! With that recognition, suddenly there’s no ‘me’ to whom this pain is happening just the velocity of it, like a wind storm and I’m lying flat in the grass as it passes over.

Some time after that, having taken my meds and the pain is now walled off in a corner of the head, I’m sitting in a straight-backed chair, just to see how that feels. Breath enters the body like a wind gusting in, withdraws, comes back, blows through everything then it’s not there again. Focus shifts to a great emptiness opening up – opening and opening… I might easily believe this will never end, but moving along with it to see what the next thing is. The purpose of my life is the on-going experiential response to the impact of sensory contact – what else could it be about? Skin, muscle, flesh, and these mysterious organs held by ligaments bonded into a skeletal structure. It’s as if there’s an electrical charge in there, sparks flying out. I am the context for the outer content. The whole investigation is one that is open to following where the knowing of it leads, see where it’s going, how it reacts. Conscious awareness of how the mind is able to concentrate and to what extent – passageways of insight open in an instant and a great flood of things to think about pours in.

Thought sequences and memories become apparent when they reach the point of “being”… before that they’re in the uncreated state – arbitrary, disassociated. Things don’t exist at all, until I observe them. There’s the Observer Effect in quantum physics, the experiment showing that when one is observing the movement of electrons it changes their behavior. In Buddhist thought, the ‘observer’ is not the ‘self’ but the self-construct arising from responses to sensory input via the Five Khandas. Received data is formed according to the mechanisms of the human sensory process – including cognition, which is a sense like all the others, and the great dome of sky above. Mindfulness is a returning to that place where I see how things change through my engagement with them…

‘All we know of a thought is the experience of thinking, all we know of a sensation is the experience of sensing, all we know of a sight is the experiencing of seeing, all we know of a sound is the experience of hearing…. And all that is known of thinking, sensing, seeing, hearing, touching, tasting and smelling is the knowing of them. And what is it that knows this knowing? Only something that itself has the capacity to know could know anything. So it is knowing that knows knowing.’ [Rupert Spira]

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Note: excerpts from an earlier post titled: ‘it’. Photo: Buddha rupa on the my working desk and the view of the garden