Now we turn to what we are referring to when we talk about “suffering,” beginning in this post with what the Buddhists call dukkha, the subject of the first noble truth.
Francis Story lists many words used in English to translate dukkha.
Disturbance, irritation, dejection, worry, despair, fear, dread, anguish, anxiety; vulnerability, injury, inability, inferiority; sickness, aging, decay of body and faculties, senility; pain/pleasure; excitement/boredom; deprivation/excess; desire/frustration, suppression; longing/aimlessness; hope/hopelessness; effort, activity, striving/repression; loss, want, insufficiency/satiety; love/lovelessness, friendlessness; dislike, aversion/attraction; parenthood/childlessness; submission/rebellion; decision/indecisiveness, vacillation, uncertainty.” (Francis Story quoted in Bullitt.)
As long as it is, Story’s list does not include “suffering” or even “stress,” the word preferred by the scholar and translator Thanissaro Bhikkhu. Other commonly used English words missing from the list are affliction, uneasiness, unsatisfactoriness, discontent, unhappiness, sorrow, dissatisfaction, discomfort, and misery.
When I was in my 40s, I started playing racquetball. After a while I started having intense pains in my knee. X-rays could find nothing wrong with either knee, but the orthopedist noticed that one leg had less range of motion than the other. X-rays showed that my right hip joint had lost a lot of cartilage and had developed many bones spurs and other “junk.” Over the next 10 years, my hip continued to deteriorate to the point that I was in constant pain because the head of my femur was grinding, bone-on-bone, into the hip socket. That is why the etymology of dukkha and its antonym, sukha, speak to me.
The word kha … was originally the word for “hole,” particularly an axle hole …. Thus sukha … meant, originally, “having a good axle hole,” while duhkha meant “having a poor axle hole,” leading to discomfort. (Sargeant et. al., 303 fn.)
I can just picture that axle wobbling and grinding into the hole, which was itself grinding into the axle, when I think of dukkha. To suffer means to work against the work itself, to change by turning each subsequent change against change. At the danger of causing confusion by mixing metaphors, as well as etymologies, I do think that it is relevant that “agony” comes from the same Greek root as “antagonistic.” The axle and the hole are in a contest, a struggle, which is the root word in Greek, agōn.
Sergeant’s etymology comes from his translation of the Hindu Bhagavad Gita. Buddhaghosa gives a different derivation in the Buddhist classic, The Path of Purification. There he says that dukkha comes from the words for bad or vile and empty. “So it is called dukkham (‘badness’ = suffering, pain) because of vileness and emptiness.” (Buddhaghosa 501) This discrepancy reminds me that etymology does not prove anything about meaning. (Speaking of etymology and the relation between work and pain, we will return shortly to ponos (work) as another Greek word for pain, as well as to work as pain, pain as work, and working with pain.)
There are two common reactions to disease or injury that help explicate the axle-hole metaphor.
The first reaction is to tell oneself that the damage is a catastrophe. “Pain catastrophizing,” as it’s called when this activity is turned into a noun, arouses bad feelings and keeps them aroused, gets in the way of responses to pain that help the sufferer to adapt to the situation, and can actually alter “neural processes related to attention and responses to pain.” Lumley et al. (953)
The other reaction that helps turn pain into suffering is just that—fear. When we globalize the pain and its consequences, initiate the cognitive and bodily patterns of fear, and work at escaping or avoiding pain, we can not only feel worse, we can make matters worse. (Lumley et al. use the term “pain-related anxiety,” but their list of its components and their examples all involve fear.).
Buddhaghosa’s translator prefers “ease” or “pleasure” for sukha, “though the latter does not at all necessarily imply any hedonism construed with sensual pleasure ….” (fn. 8, p. 823)
You may have noticed that there were a number of positive words in Francis Story’s list of meanings for dukkha: pleasure, excitement, desire, hope, effort, striving, activity, love, parenthood, decision. Why would he include these activities in the same category as fear, dread, and anxiety? They are aspects of the movement of dukkha that we usually don’t think about when talk about pain and suffering. They allude to movements that change the axle hole to set off the cycle and that continue to dig the axle into the hole with each revolution. In less metaphorical terms, these movements constitute the suffering of change, the suffering that arises when we try to hold on to what we want, when we fixate on not getting what we want, or even don’t know what we want.
As helpful as the axle metaphor can be, we are not talking about motion that is so primitively mechanical. One danger of the axle metaphor is that we tend to think of suffering as something inherent in whatever object hurts us, whereas suffering also arises from how we look at what is going on and how we interact with others about what is going on. (Morrison 33)
Nor are we talking about isolated movement. Another danger of just looking at the axle is that we think that pain belongs to an isolated individual. In this regard, Dorothee Soelle (1975, 13) adds a dimension that was missing from, or at least not explicit in, the dimensions of pain in the McGill questionnaire: the social dimension. I’ve mentioned before that the more recent medical literature also goes beyond Melzack to consider pain as a “biopsychosocial” event.