The Buddha said that physical pain can be likened to being hit by one arrow and the emotional distress that results from it is like being hit by a second arrow. Although it may not be possible to totally eradicate the physical pain we experience as a result of organic damage, it may be possible to eliminate the emotional distress resulting from these sensations. In other words, Buddhism teaches that it is possible to live with pain without suffering.
Indeed, obsessively bringing attention to the source of pain as a consequence of fear will create a self-reinforcing feedback loop increases its intensity. Instead, bringing attention to the pain in a way that affirms and accepts its reality is how its emotional hold is broken.
“Nerve fibers carry pain signals up the spine to a key branching point in the brain called the thalamus. From there, pain signals travel along one pathway to the somatosensory cortex, a brain region that contains a map of the human body. It records the sensory aspects of pain, and tells us whereit hurts. Another pain pathway from the thalamus leads to the cingulate cortex. This region specializes in the unpleasantness of pain — telling us thatit hurts.
Amazingly, people with damage to the cingulate cortex often report that pain doesn’t hurt. That is, if they choose to pay attention, they can identify sensations in the body that correspond to pain. But to them, pain lacks the urgent quality that demands attention. “They used to do limbic leucotomies for pain, which is basically zapping the anterior cingulate,” Alice Flaherty, a neurologist at Massachusetts General Hospital, told me. “People would say, ‘I don’t care about the pain anymore. I still feel it, but it’s not so obnoxious.’”
The cingulate — the word is derived from the Latin for “belt” — is a complex region with a number of different functions, but brain scans and anatomical studies indicate that one of its functions is to act as a neural alarm. It’s activated by physical pain, but also, as shown by the research of UCLA psychologist Naomi Eisenberger, by emotional distress like the sting of social rejection. The aversive component of both physical and emotional pain is perhaps best captured by the word suffering.
Our response to fear and our response to pain overlap in a subregion of the cingulate. This area prepares the body to flee. When alarmed, we tense our muscles so we can get away quickly. But as Ronald Siegel warns, if our muscles stay tense for a long time, this can lead to additional pain.”