What is Mindfulness of Breath When You Can't Breathe?

Warning – I describe in some graphic detail the recuperation from a surgery.

I wake up slowly in the recovery room, blood beginning to drain from my nose.  The next 36 hours will become an intriguing study of mindfulness, compassion, self-pity, and watching mind’s neurotic habits.  First thing I notice – I’m not blind.  They said there was 5% chance of blindness from this operation.  That did not seem like a small and comforting number to me.

It started about six months ago – I noticed that my lower left sinus cavity was beginning to feel blocked.  Three different courses of antibiotics over three months didn’t help.  The CAT scan showed that there was no space left in my left sinuses.  There were many nights where I became completely congested and couldn’t breathe, or could only with very strenuous pulling.  Doing mindfulness of breath meditation when one can’t breathe gives a new appreciation for it. 

I often liken mindfulness of breath meditation to working out with very heavy weights.  If you want to build muscle quickly, you do as many repetitions as you can with the heaviest weight you can.  Mindfulness of breath is like the heavy weight, precisely because it is boring as hell.  The breath is with us so constantly and effortlessly that it is very difficult to maintain attention on it.  This makes it easy to drop, and once dropped, easier to notice that we’ve lost focus.  This is why we don’t call watching television “meditating” – it takes no effort. 

When simple breathing takes effort, however, then meditating on it gets much easier.  It stops being boring when you feel like your lungs will never get the oxygen they need.  It stops being boring when you can’t sleep because you can’t breathe.

The surgery was supposed to fix all this.  Unfortunately, by 5 hours after the operation the packing they had inserted into my sinuses has filled with blood completely closing off all air.  This makes swallowing impossible, as the suction needed to swallow creates tremendous pressure and pain in my sinus cavity.  I stop eating and drinking.  It hurts too much and I seem to be immune to the high-powered pain medicine they gave me.

I arrange the easy chair to try to sleep while allowing draining.  The problem is that although I can breathe a little from one nostril when awake, as soon as I fall asleep and relax the soft palate at the back of the throat, it closes down what little air passage I have and I wake up because I can’t breathe.  This means that I sleep in one-second intervals all night.  I do a lot of meditating on the breath, or lack thereof.

What is more annoying, however, is watching what my mind does.  Rather than simply note what is, it pays attention to every little change that seems worse and makes me worry.  Any time things ease up, it ignores that.  I have been told that I should take my narcotics before getting the packing removed the next day because the process is so painful.  Thinking of that keeps me awake.  I keep changing the blood-soaked bandages under my nose, not being particularly grateful that one side is clearly getting better.  By 4 am I am draining so little that I believe I can transfer from the chair to a bed.  I’ve never been able to sleep sitting up, so I am hopeful that I will finally get some of the sleep I desperately need.  Unfortunately, I still can’t breathe at all once I relax control over my throat.  I am not good at mouth breathing, and that seems especially unpleasant given that I had a tube stuck down my throat for the three-hour surgery.  So I continue to drift between daydreaming, resting, and focusing on every tiny change, generously remembering to wake myself up with regular thoughts of not only how much the packing hurts now, but how much it will hurt to remove.  Doing tonglen does little to settle me.  Feeling grateful that I am privileged to have medical care of this quality helps more.

By the afternoon of the next day, I am getting seriously dehydrated because I still can’t swallow.  The pain is reduced but I’m pretty shaky.  Having the packing removed hurts less than I expect.  Nonetheless, the nurse kindly wipes the tears off of my cheek with gauze.  After all the cleaning out is complete, I can feel so much air going through my sinuses that it almost hurts.  I haven’t breathed like this in months.

Unfortunately, within minutes (really, only minutes!) I am already ignoring the breath.  Once it has become easy again, it disappeared.  No more am I aware that I am breathing in long, or short, or laboriously.  Mind is a fickle a**hole.  It is already off wondering whether the lab tests will come back next week showing cancer.

Image sources: HERE and HERE - This was first posted on the Interdependence Project blog.

Our Endless Cycle of Hope and Fear - The Second Noble Truth

In the last post, we discussed how we tend to have a pervasive feeling that things are unsatisfactory, stressful, or just not quite enough, and that even getting what we want often ironically increases this feeling.  Why do we have this feeling (dukkha)?

The Dhammacakkappavattana Sutta states that the origin of stress and suffering is "craving."  The Pali word used here is tanha, which can be also defined as a demanding desire or thirst.  This is distinct from chanda, a desire to do, which can be beneficial.  This statement that craving/thirst/desire is the root of suffering is known in Buddhism as the Second Noble Truth.

This seems to make intuitive sense.  If we truly don't worry about something, it doesn't cause much suffering.  But what does craving mean?  The Buddha said there are three types of craving.

1. Craving for sense pleasures
• Have you noticed how easily you can become bored with something, even something you really like?  Each of our six senses (sight, smell, touch, taste, hearing, and thinking) seems to like novelty.  We are attracted to things we haven't seen before, or are different from what is currently happening.
• Consider the sense of anxiety that many of us have that makes us check our email or text messages constantly, needing something new to see, hear, etc.
• The funny thing about this is that we believe that by following this desire for the next sense pleasure we will attain happiness, but it never works for long and the pattern never ends (this is one defining characteristic of samsara, the wheel of suffering).  But if you aren't grateful for and content with what you already have, what makes you think that having more will somehow change that?
2. Craving for existence - craving to be
• We have a desire to be stable, solid, permanent, and ongoing - we want to feel like we matter
• We want to believe that we have a past and a future
• We have a desire to compete, prevail, and ultimately dominate
3. Craving for non-existence
• We often spend a lot of time wishing (craving) for bad feelings, annoying people, and difficult situations to go away
• We want to be separate from painful experiences
• We don't want to experience the world in all of its rawness

Summing these up, it seems to me that we basically get stuck in an endless cycle of hope and fear.

One way of considering this cycle of hope and fear is the idea of the Eight Worldly Concerns, also called the Eight Worldly Dharmas or Eight Worldy Winds (Yes, Buddhists LOVE to make numbered lists of things!).  The idea is that we are constantly engaged in seeking something and avoiding something in this group of four pairs:

• Pleasure or pain
  
• Loss or gain
• Disgrace or fame
• Praise or blame

We clearly prefer one of these and not the other on our treadmill of hope and fear, constantly running from one of each pair and toward the other.  The problem is that no matter which of these 8 concerns arises, it is temporary and usually not particularly important in the course of our lives, so why do we make such a big deal to ourselves about them?  (To read what Buddha said about these and the difference between ordinary and enlightened approaches to them, read the Lokavipatti Sutta.)

But this is only part of the issue.  Although it is fairly easy to notice in ourselves how most of our planning and rumination about what just happened to us is linked to one of these eight concerns, these only focus on our personal motivations:  What we believe is happening to ME.  But we are actually concerned about far more than ourselves.  We care about what happens to others.  We care about what happens to our things.  We care about what happens to the planet.  We are not solely focused on these 8 worldly concerns - these are an outgrowth of a more basic human tendency called the Three Poisons (I told you Buddhists love lists).

The Three Poisons are how we almost automatically and immediately have one of three possible reactions to any and everything that arises in our experience - we are either attracted to it, repelled by it, or don't care about it.  This is true about people, situations, our sensations, and even our own feelings and thoughts.  In the Titthiya Sutta, Buddha describes the reasons why these occur.  The three are translated into different English words by different translators, so I have given a couple below to give a more complete sense of their flavor.

The Three Poisons

1. Attachment or passion
• Buddha notes that the cause of attachment/passion is the "theme of the attractive," and that it "carries little blame and is slow to fade."  That is, when we are attracted to something or someone, when we want it, we see only its good qualities.  We become unbalanced. The object of our passion carries little blame - we can't see the bad qualities.  We also believe ourselves to be be blameless in the pursuit of our beloved object, believing that the ends of getting our goal justify our means.  Because it is slow to fade, we will work very hard to achieve our goal of getting what we want.
2. Aversion or aggression
   
• Buddha notes that the cause of aversion/aggression is the "theme of irritation," and that it "carries great blame and is quick to fade."  That is, when we get irritated or annoyed by something or someone, we see only the bad qualities.  We again become unbalanced.  The person we are annoyed with carries great blame - we only see the bad qualities and the damage that they allegedly did.  We do not see how we were part of the problem, and we strike out in anger or frustration.  Once we have decided that the other is to blame, or once we have retaliated, we often feel somewhat satisfied, and the aggression fades until it is prompted again.
3. Ignorance or delusion
• Buddha notes that the cause of ignorance/delusion is "inappropriate attention," and that it "carries great blame and is slow to fade."  That is, when we think something is uninteresting, boring, or we honestly just don't know or care about it, it is because we really haven't yet tried to understand it.  The Greek roots of "ignorance" mean very literally "to not know."  We ignore the people and objects that don't seem immediately important to us, which can cause us to fail to act appropriately to get the most benefit out of the situation.  We ourselves are solely to blame for not paying sufficient attention, and we are slow to realize that we should take more care.

It is a good exercise when meditating to notice that almost every arising thought and feeling has one of the three poisons attached to it.  When planning something, we're grasping after trying to control something in the future - we are attached to the idea of trying to achieve some outcome.  When remembering some annoyance, we bring up feelings of aggression or we think about how we can work to avoid the person/situation in the future, or what unkind thing we "should" have said.  When we think of something that we don't really have a feeling about, we could approach it with a feeling of curiosity to try to understand it better, but we usually don't.  We even attach these feelings to our emotions, trying to avoid emotions we dislike and seek ones we like better.

Ultimately, in the Buddhist perspective, this grasping after certain outcomes, wishing to avoid others, and ignoring other possibilities is what causes our suffering and stress.  This is good news.  Knowing why we feel such discomfort in our own lives gives us something to work with to reduce it.  And we can reduce it - we can break out of this endless cycle of hope and fear (knowing this is the Third Noble Truth, which we'll discuss next).