“To perceive is to suffer.” – Aristotle, De Anima.

After examining Buddha’s metaphysics behind the Four Noble Truths, the Dalai Lama offers a more concrete description of suffering and a more practical means to free oneself. He exposes the specific types of suffering, their sources, and methods to make them cease.

He identifies three types of suffering: (1) out-and-out pain; (2) the suffering of change – that is reappearing needs such as hunger, or discontent from waning pleasures; and (3) pervasive conditioning – deeper afflictive or counterproductive emotions.  Examples for each are (1) a headache, (2) the eventual tiring of a new amusement, and (3) hatred, respectively. The Dalai Lama summarizes the human condition in this way: between the suffering of birth and of death are not only illness and aging, but also a series of discontents and disappointments. His immediate remedies are hope, positivity, and disciplined meditation.1

The sources of pain, he tells us, are twofold: afflictive emotions and ‘contaminated karmas.’ The former are negative or counterproductive feelings that contaminate karma. Some are better expressed such as fears from the past which diminish with recounting and confrontation. Other are better not expressed, that is, the counterproductive emotions such as jealousy, belligerence, or hatred. These increase in frequency and intensity with expression and are must be replaced by positive emotions such as love or satisfaction. The root of these is ignorance.  On the other hand, contaminated karmas are the consequences of former non-virtuous actions and can be life-altering karmas or can project into the next life as a “bad transmigration.”2

The Dalai Lama stresses the ultimate cause of most suffering of change and pervasive conditioning is the  ignorance of the true nature of persons and things, that is, their emptiness or selflessness – “the absence of a permanent, unitary, and independent self or, more subtly, the absence of inherent existence either in living beings or in other phenomena.”3 In steadfast meditation one becomes fully aware of the truth, and the power of one’s wisdom increases defeating the negative emotions rooted in ignorance.4

The Dalai Lama’s mixed psychological, ethical, and mystical approach to suffering is well-adapted to the Western mindset without disavowing Buddha’s metaphysics. In the final analysis, hopefulness, optimism, and deep reflection make an excellent triple therapy for non-physical suffering. Before we address the more refractory issue of sustained physical suffering, we will pause to look at Zen Buddhism and the  influence of the Buddhist concept of suffering on Western philosophy.


1The Dalai Lama, How To Practice. Atria Books, New York, 2002. ISBN 978-0-7434-5336-3, pages 31- 42.

2Ibid, pages 43-46.

3Ibid, page 142.

4Ibid, pages 57-58.


“This monks, is the Noble Truth of Suffering; birth is suffering; decay is suffering; illness is suffering; death is suffering; presence of objects we hate is suffering; separation from objects we love is suffering; not to obtain what we desire is suffering…” – Buddha.


Last time we saw how Buddha’s First Noble Truth that life is suffering is the critical premise of his philosophy. Today we will expand his doctrine, and next time we will look at the interpretations of a contemporary authority, the Dalai Lama.

First we need to review briefly Buddha’s three primary metaphysical principles. The first is anatta or impermanence, the non-sustainability of things in the world. Attachment to temporal things is the main cause of our suffering. The second is anicca or the ‘no-self’ by which he means the non-substantiality of the self. Contrary to common belief and the tenets of most philosophies, Buddha says there is no soul, nor even an inner self. Our material being is anatta and our concept of self is illusion.

The third principle is pattica samuppada or ‘dependent organization.’ Unlike Western philosophy which sees reality deterministically as a linear series of causes and effects, Buddha teaches that whatever is, depends on something else, and yet there is a mutual dependence of all things. In fact all things are mutually self-creating and thus there is neither God nor independent beings. Reality has the nature of process, and things (including space and time) are merely abstractions. There is no being, only becoming.1

From these doctrines is derived the bhavacakra or ‘Wheel of Becoming.’ Each of us is the sum of  continuous processes which include the cycle of birth, death, consciousness, perception, and so forth. The wheel’s segments demonstrate the cyclic dependence of causality with old age and death as symbols of dukkha or suffering. Ignorance is the root-process of suffering. Buddha does not maintain that non-existence is the way to non-suffering, rather the recognition that there is no self beyond these processes means that there is no subject to suffer as long as there is no attachment to the parts of the wheel.2

Buddha’s lesson is powerful but challenging. Most of us recognize the impermanence of all things, but  nonetheless remain attached to them – loved ones, material goods, modern pleasures, society, and life itself. Detachment sounds easy, but turns out being extremely difficult. The illusion of self is still harder to fathom; our own self seems the most certain reality we know. Letting go of that foundation seems unthinkable. The interdependence of all things is easily accepted, but the wheel itself is unfamiliar especially in the West where reincarnation is not generally accepted. However, if we consider human history or even the many vicissitudes of an individual’s life given modern longevity, the cyclic nature of reality becomes more recognizable.

Perhaps we can  learn from a less didactic presentation on the place of suffering in Buddhism and a more practical approach to deal with it. Next time we will explore that possibility through the wisdom of the Dalai Lama.

1Koller, John M., Oriental Philosophies, Charles Scribner’s Sons, New York, 1970. ISBN 684-13668-6, pages 126-127.

2 Ibid. pages 128-129.


“It is by our power to suffer, above all, that we are of more value than the sparrows.” – Edith Hamilton, The Greek Way.






After the modern analytical consideration of suffering as opposite of happiness we go back in time to one of the greatest spiritual masters in history, the Buddha. We learn from Asvaghosha’s Buddha-Karita that Buddha was the son of a King, prophesied to “embrace transcendental happiness.”1 His father wishing him to succeed him as monarch rather than become a holy man “turned him to sensual pleasures” and tried to protect him from any “inauspicious sight which could disturb his mind.”2

But one day, the future Buddha saw an old man, a diseased man, and a dead man, and recognized that life involves suffering and so resolved himself to the ascetic life and the search for Nirvana or enlightenment. He left the palace and spent six years in meditation and bodily withdrawal sometimes living on little more than grass and dung with other hermits. His enlightenment came when he decided to sit facing east under a Bo-tree until he “attained the supreme and absolute wisdom.”3

What did Buddha ultimately discover? He identified three main doctrines, the Middle Way, the Four Noble Truths and the Noble Eightfold Path.4  The Four Noble Truths are:

1.   There is suffering (Dukkha).

2.   Suffering is due to thirst or desire (Samudaya).

3.   To eliminate suffering, eliminate desire (Nirdoha) through Nirvana.

4.  To achieve Nirvana, follow the Eightfold Path.

The Eightfold Path consists of: Right Views (Buddha’s teachings), Right Thoughts (aspiration to purity and charity), Right Speech, Right Conduct, Right Livelihood, Right Effort (avoid lapses and frailty), Right Mindfulness (awareness of the truth of the doctrine), and Right Concentration (spiritual exercises leading to awakening).

Here we find a beautiful and surprisingly comprehensive path to a meaningful life and the Greek notion of eudaimonia. For our purposes however, the first Noble Truth is the focal point. Next time we will explore its expanded form, followed by a commentary by a current Eastern authority, after which we will look at the impact of Buddha’s teachings, particularly that life is suffering, on Western thinkers.


1Stryk, Lucien (editor), World of the Buddha. Grove Press, New York, 1968. ISBN 0-8021-3095X, page 24.


3Ibid, pages 36-37.

4Ibid, page xxxviii.


“You can hold back from the suffering of the world, you have free permission to do so and it is in accordance with your nature, but perhaps this very holding back is the one suffering that you could have avoided.” – Franz Kafka.


Last time we ended on the scientific approaches to suffering touching briefly on psychology as the means to reduce mental suffering. Of course psychology has been migrating away from the mere treatment of mental disorders to the search for a positive science of mental well-being. Today we will look at one thesis in this area, that of understanding happiness by identifying its opposite and their relationship.

James Pawelski of the Positive Psychology Center at the University of Pennsylvania provides a scholarly account.1 First he points out that there are three types of opposites: (1) binary contradictory – such as male and female (one or the other), (2) continuum contradictory – such as light and dark (gradations of more of one and less of the other), and (3) subcontrary –such as pleasant and unpleasant (non-exclusive or concurrent, e.g. bittersweet)

He then points out how the prefix un- indicates opposites linguistically – for example affordable and unaffordable. Thus logically unhappiness is the presumptive opposite of happiness. This pairing has some features of a continuum contrary and some of subcontraries. It is our experience that the removal of unhappiness does not lead to joy but rather a neutral state, and psychologists find that there is at best a weak correlation between the increase in positive emotions and a reduction in negative emotions. Barbara Fredrickson has found it takes three positive emotions to overcome one negative emotion. Corey Keyes proposes that a complete state model of human mental health includes independent salutogenic and pathogenic scales. Pawleski concludes that subjective well-being requires a composite of high positive affect, low negative affect, and high life satisfaction. The implication is evident: two processes will lead to happiness –  an increase in positive states and conditions and a reduction in negative states and conditions.1

Pawelski also considers several philosophical approaches to the pursuit of happiness: Stoic, Epicurean, and the teaching of Epictetus and Boethius. The reader can review the last two posts for my discussion on such approaches. However, my immediate interest in Pawelski’s discussion is to consider whether the true opposite of happiness is not unhappiness, but suffering.  If joy, meaning, and flourishing make up eudaimonia, then dysdaimonia is misery, alienation, and languishing –something more than the bland feeling of dissatisfaction or unhappiness, much more akin to suffering. But like unhappiness the relationship of happiness and suffering is as subcontraries. Indeed suffering while regrettable is inevitable and can serve as a stimulus for happiness, growth, and meaning. Next time we will look at Buddhism where this opposite of happiness is the starting point for enlightenment.

1Pawelski, James O., Happiness and Its Opposites, in David, Susan A. et. al., The Oxford Handbook of Happiness. Oxford University Press, Oxford, U.K., 2014. ISBN 978-0-19-871462-0, pages 326-336.


Last time we looked at the Hindu, Stoic, Epicurean, and Christian interpretations of and responses to suffering. Next we consider Existentialism which offers still another interpretation of suffering. In this philosophy where man defines himself, suffering is seen as one impediment to self-actualization. Friedrich Nietzsche criticizes the traditional responses to misery, guilt, and the fear of death as cultural deceptions and considers the Christian suggestion that suffering is the means to a sacred future as completely fraudulent. In its place he asserts “existence is considered sacred enough to justify even a tremendous amount of suffering…”2  By affirming even the harshest suffering, man achieves strength and deification in the only life he is allotted.

Karl Jaspers, who is an existentialist and theist, agrees to a large extent with Nietzsche. He views the inevitability of suffering, struggle, and death as ‘ultimate situations,’ and “Along with wonder and doubt, awareness of these ultimate situations is the most profound source of philosophy.”3 He rejects Stoicism which offers no consolation or opportunity for inner transformation and fulfillment. He also doubts the truth of redemption offered by Christianity and other religions. Instead he recommends the philosophical life of  (1) solitary meditation focused on self-reflection, transcendence, and selection of life tasks and (2) communication with men of mutual understanding. In this way the individual can find authenticity and participate in meaning.4

The last major approach to human suffering is the scientific. Physical suffering such as pain, illness, disease, and death are viewed objectively and fully understandable with an eye to identifying physical means to alleviate them through diagnosis and treatment with medications, therapeutic procedures, and compassion. Science also offers tremendous opportunities to relieve suffering of want such as hunger through technology. It is worth emphasizing that in the modern realm, the first effort must always be to ease all physical suffering possible before pursuing philosophical remedies.

Science however is less amenable to other forms of suffering especially the external and situational forms. Psychology, one of our younger sciences, seeks to alleviate internal suffering and has made some progress. Medications may lessen some mental health disorders such as anxiety, depression, and psychotic disorders. Psychotherapy and counseling have value in particular cases, but on the whole cannot cure grief, guilt, feelings of failure, alienation, loneliness, or rejection, and are especially limited with situational distress such as exposure to war, crime, disasters, and so on. We conclude that science and psychology are simply unable to eliminate all human suffering even as modernity adds new miseries for man.

We will dive a little deeper next time as we investigate one psychological construction of suffering as the opposite of happiness.


1Edwards, Paul (editor), The Encyclopedia of Philosophy. Macmillan Publishing Co., Inc. & The Free Press, 1972.   Volume 34, page 326.

2Kaufmann, Walter (editor), The Portable Neitzsche. Penguin Books, New York, NY, 1976. ISBN 978-0-14-0150629, page 459.

3Jaspers, Karl, Way to Wisdom. Yale University Press, New Haven, 1954. ISBN 0-300-00134-7, page 20.

4Ibid. pages 120-131.


“To suffer and endure is the lot of humanity.” – Pope Pius XI, Quadragesimo Anno






As one reads the great philosophers, particularly the ancients, one is amazed at the varying interpretations and responses offered to suffering that emerge from their work. Most do not construct philosophy from a foundation of thinking about suffering like Buddha, but rather apply their method to the universal experience of it. Let’s consider some of the major systems in chronological order.

The earliest major philosophy to address suffering directly is Hinduism. Suffering in this system is seen as parceled out based on karma, a kind of providential justice ensuing to actions in this life and former incarnations. Current suffering then is unavoidable as it is the consequence of prior actions, but can be minimized in the future by virtuous behavior going forward. Briefly then, suffering is relieved by virtue even if delayed. There appears to be some variation in what action are virtuous in Hinduism, but include (1) doing one’s duty (Bhagavad Gita), (2) piety and contemplation of Self as reality (Śankara) and (3) suspension of all activity and injury to other life (Jainism).1   Buddhism also arose out of this tradition, but will be discussed separately in a future blog.

Later, there appear in ancient Greece competing “schools” of philosophy that offer different views on the place of suffering in human life. First the Stoics identify suffering as one aspect of fate and best managed by the acceptance of Providence, suspension of wants, and denial of bodily desires. Meanwhile the Epicureans, whose philosophy is based on pure materialism, see suffering as mostly preventable through the conscious decision to avoid discomfort and worry with the ultimate goal of a state of untroubledness or ataraxia. Unlike hedonism, Epicureanism endorses the pursuit of basic needs (e.g. food, water, and shelter) and limited pleasure rather than risk the unease of continuous pleasure-seeking or fear of material loss. The prize is tranquility not ecstasy.

By the third century of the Common Era, Christianity adopts modified versions of the Stoic concepts of fate, and Providence is recast as God’s will. Suffering in our world is explained as the price for original sin and God’s gift of free will for humans and fallen angels. But unlike the Stoics, the acceptance of suffering is not mere countenance, rather it serves as a test of faith and more importantly the path to sacred existence. This structure of beliefs leads to the martyrdom, asceticism, and self-flagellation seen in Roman and medieval Christianity.

(continued next post)


“In life, you must choose between boredom and suffering.” – Madame De Staël.



After distinguishing suffering from evil and placing it in philosophical context, we are ready to examine its many forms. The purpose of this exercise is simply to remind the reader of the many types of suffering and thereby confirm its unavoidability and inevitability. From this effort, we will see that Buddha’s first noble truth is in fact credible and that suffering must be mastered for happiness and meaning to be achieved.

Suffering generally involves a deficiency or excess of necessities or pleasures or the presence or inexorability of discomforts. There are four broad categories of suffering: (1) Physical, (2) Internal, (3) External, and (4) Situational. Physical suffering includes for example pain, temperature extremes, physical and mental illness, disability, hunger, and thirst. Internal suffering includes fear, anxiety, despondency, feelings of disappointment and failure, guilt and shame, indecisiveness, and meaninglessness. Externally based suffering includes grief, loss, bondage, and oppression. Situational suffering includes isolation, loneliness, rejection, alienation, and subjection to environmental horrors such as natural disasters and war.

It appears that to expect to be free of suffering we need to be perfect so that we are never disappointed in work or love, never fail, and never err in social situations. We must never have any medical conditions, physical wants, fears, anxieties, emotional problems, material losses or loss of loved ones.  We must not be subjected to or be affected by any social, national, international, or natural disturbances. Such a Garden of Eden or Utopia may appear to eliminate suffering, but as Madame De Staël observes, boredom would be the inevitable outcome, itself a form of suffering.

The conclusion of our examination is that suffering is unavoidable both empirically and logically. It is ontologic or existential for man and most likely for any sentient being. If there is a God, even He must experience some suffering due his observations of the failures of his creatures, and the harm that occurs to them from their errors and from natural disasters. The hope for us to be free of any form of suffering then is unreasonable. However, obviously we want to limit suffering as much as possible. Those who experience extreme suffering may hope for help from the more fortunate, but require a philosophical approach to their suffering as part of their search for meaning. That is the subject of the next post.


“Life is tragedy and the tragedy is perpetual struggle, without victory of hope of victory, life is contradiction.”- Unamuno, The Tragic Sense of Life..



The first task in thinking about suffering is to distinguish it from similar concepts and place it in a philosophical context. First we must differentiate suffering from evil. I have previously defined evil as the opposite or negation of good itself defined “as that which contributes to the happiness, well-being, longevity, pleasure, or knowledge of oneself and others or at least does not diminish these for others; or which promotes existing non-human reality in the universe.”1

Suffering can be defined as the condition of experiencing pain, distress or anything unpleasant, or sustaining injury, disadvantage or loss.2 Suffering then may appear to be the subjective experience of evil, but there are exceptions. For instance one suffers the unpleasantness of chemotherapy for the good of cure of cancer. Meanwhile some evil causes no overt human suffering, for example the extinction of an unknown species. We see that while most suffering is evil and much evil causes suffering, they are not equivalents.

On the other hand, pain is merely a form or subset of suffering as there is much suffering that does not involve physical pain, as for example loneliness, poverty, and grief. Moreover pain’s opposite, pleasure, can involve suffering as for example the elation obtained from drugs in addiction or the ecstasy of inappropriate or dysfunctional sexual relationships. In fact, the avoidance of pain and the pursuit of pleasure can be both evil and occasions of suffering.

Suffering has a central place in philosophy. In all likelihood, philosophy began as a means of understanding and comfort in the face of man’s troubles and struggles. Human suffering has historically been the greatest argument against belief in an omnipotent, omniscient, and omnibenevolent deity. Traditionally suffering is seen as one of the greatest detriments in the quest for happiness or eudaimonia, and yet paradoxically is used by sages and spiritualists as a tool for purification, discipline, and conquest. Personal suffering and the response to it are vital components of the search for human meaning and apotheosis.

Next time we will look at the categories of the common forms of suffering that make up the human condition.

1See post titled Good and Evil, dated 1/16/19 on this site.

2This definition is a compilation of the first five definitions listed in the Unabridged Webster’s dictionary, p. 1901.


“Life is suffering.” – Buddha.

The quest for a meaningful life has led us down a path past the subjects of (1) good and evil, (2) God, (3) body and soul, (4) death and immortality (5) free will, fate, and destiny, and (6) teleology. We might think ourselves done with our preparatory work until we consider the disruptive force of suffering. It may appear hopeless to postulate a meaningful life for someone with a chronic illness or continuous privation, but some readers may face that very prospect, and all of us will face some degree of suffering during our lifetimes. It is now time to address this obstacle to eudaimonia.

First, as a physician, I want to be particularly sensitive to others’ misfortunes and respect the difference in their situation versus my own and likely that of the majority of the readers. None of what follows is intended to diminish the magnitude of your hurt and anguish. Still Buddha’s observation seems irrefutable – suffering simply is an existential reality for all men even if its intensity varies among individuals and over time for each individual. Perhaps the shared human experience of suffering can lessen, however slightly, your tragedies.

As in other sections, I will break our discussion of suffering within a meaningful life into parts:

1)    Introduction

2)   Distinction from evil and location within philosophy

3)   Categories of suffering

4)   Interpretations and responses

5)   The opposite of happiness

6)   The First Noble Truth

7)   Viktor Frankl’s  Man’s Search for Meaning

8)   Asceticism

9)  Conclusions

We will begin by distinguishing suffering from similar concepts such as pain and evil. Then we will explore the types and forms of suffering experienced by man and the philosophical and theological interpretations and responses to suffering. After a pause to reflect on suffering considered as the opposite of happiness, we will move on to Buddha’s insight on universal suffering as the springboard to enlightenment. Next we will examine personal suffering of grief, pain, and illness through the lens of Viktor Frankl’s masterpiece of philosophy derived from his experience of intense suffering in a concentration camp.  Last we will look at the privation of asceticism as a tool by which one may attain contentment and ultimate meaning.

The goals of this section are to demonstrate that life can be meaningful despite the inevitability of suffering, and to offer an approach for suffering persons to find meaning within their lot. Join me next time as we fine tune our understanding of the concept of suffering..


African Philosophy –Myth and Reality  _ ANALYSES

“When philosophy is regarded in the light of a series of abstract systems, it can be said to concern itself with two fundamental questions: first, the question ‘what there is’; and second, the question how ‘what there is’ may be explained.”– Kwame Nkrumah, Consciencism.

After the introduction and his arguments regarding authentic African philosophy, Hountondji analyzes two African-born philosophers. The first is Anton-Wilhelm Amo an 18th century Ghanian who went to Europe at age four likely to be trained as a preacher. He ended up a master of philosophy in 1730 and taught for at least ten years and wrote at least four philosophical treatises. He eventually moved back to Ghana where the last record of him was a meeting in 1753 with David Henri Gallandet, a Dutch physicist and ship’s doctor, who found him living as a hermit with the reputation as a soothsayer.

Hountondji critiques Amo’s Dissertatio de humanae mentis apatheia (On the Impassivity of the Human Mind) where Amo argues the mind is neither the seat of sensation or the faculty of sensation (a passive function) consistent with the human mind as active, insensible, and free of passion, like the divine mind. But the human mind turns sensation into ideas which are only the mediative knowledge of things, representations, or reactivated sensations. This leads to an ironic difference in kind, not simply degree, from divine spirit whose impassivity is a perfection, whose thinking is creation, whose understanding of reality is direct. Non-passivity of spirit becomes a ‘transvaluation’ on passage from God to man.

But when Hountondji asks what in this work is African, his answer is nothing. Written in Latin for Europeans with no African audience or partners, Amo is the victim of the painful isolation of his historical situation. In the end, his works are instructive as demonstrating the need to “put an end once and for all to the monstrous extraversion of our [African] theoretical discourse…”1

Hountondji’s second example is Kwame Nkrumah, a contemporary American-trained philosopher, who became the political leader of Ghana. His works are mainly political philosophy focused on anti-colonialism and pan-Africanism. In his youth he embraced the non-violent approach of Ghandi and the politics of socialism, arguing that traditionally Africa society had the form of egalitarian communalism; therefore the movement to socialism would be smooth and without class struggle. Over time he came to see overturning neocolonialism, imperialism, and class inequality required armed resistance.

In his most famous work, Consciencism, Nkrumah sees philosophy as the instrument of ideology. He espouses a materialist metaphysic – the priority of matter which generates mind through a ‘categorical conversion’- defined as a process through which a given reality generates a reality of higher category. God, if he exists, is then a higher form of matter. From this metaphysic, he develops an egalitarian and humanistic ethic strongly influenced by Kant, and a political ideology of self-determination and socialism – all of which are closely interlocked and form a collective philosophy for all of Africa.

Hountondji criticizes this so-called Nkrumaism at several levels. First the metaphysic itself seems implausible. Second political justifications need to be political and economic rather than metaphysical. Third Hountondji denies the possibility of a collective African philosophy – rather sees a pluralistic debate and dialogue in conjunction with science as the best course for African philosophy.

Hountondji closes his amazing book with a reiteration of his key points: African philosophy must be based on (1) true internal pluralism, not a supposed primitive unanimity or an acculturation, (2) free dialogue,  (3) living rather than studying African culture, and (4) placement in the terrain of science. I suspect he would agree that in fact these principles apply to philosophy everywhere even if it took the experience of Africans to demonstrate them to the rest of us.


1Hountondji, Paulin J., African Philosophy – Myth and Reality. Indiana University Press, Bloomington, Indiana, 1996. ISBN 0-253-33229-X, page 130.