CSEAS Fridays at Noon Lecture Series. On anti-mindfulness versus wound-as-guide: competing figures of lay and ascetic coping with chronic pain in Thailand

In the last ten years, there has been a worldwide surge in mindfulness as an approach to coping with chronic pain, fueled partly by a turn away from opiates for palliation and toward more functionality-based models that require pain sufferers to incorporate their pain into daily life. In this talk, I use fieldwork with chronic pain patients in Thailand to question the core assumptions of this mindfulness movement, as well some core assumptions in contemporary scholarship on Buddhism, with dramatic stakes for individuals navigating lives full of pain. Chronic pain patients in Thailand have almost universally concluded that mindfulness as a practice worsens their pain, and have thus turned instead to various forms of "anti-mindful" but deeply Buddhist practice, combining various chimeras of Buddhist teachings on loving-kindness, karma and non-self instead to help them manage their pain. I compare the experiences of these practitioners to ascetic monks also suffering from chronic pain, who have begun to use their pain to unsettle the assumed relationship between suffering and enlightenment, pointing to the brutal reality of liberation as an all-or-nothing state of being. I include a in-depth analysis of one monk, who uses his own tumor with a dramatic wound as a teaching tool to demonstrate this paradox about enlightenment. The result of this analysis is a new way of viewing "Buddhisms" as multiple overlapping and contingent ways of viewing the world that practitioners -- lay and monastic alike -- constantly reconfigure to deal with the ever-changing reality of their pain. As a practicing physician, I conclude with the stakes of this debate both for my own care for chronic pain patients in clinics in Thailand and the U.S., and for the global quest to find non-pharmacological technologies to guide the way through painful lives.