According to the Hebrew Bible, after creating the world, God looked out over everything he had made and saw that it was very good. Most of us want to feel that this world is good, or at least basically good. But this desire runs up against a grim and complex reality, aptly characterized by Ernest Becker in his book Denial of Death:

What are we to make of a creation in which the routine activity is for organisms to be tearing others apart with teeth of all types—biting, grinding flesh, plant stalks, bones between molars, pushing the pulp greedily down the gullet with delight, incorporating its essence into one’s own organization, and then excreting with foul stench and gasses the residue? . . . Creation is a nightmare spectacular taking place on a planet that has been soaked for hundreds of millions of years in the blood of all its creatures. The soberest conclusion that we could make about what has actually been taking place on the planet for about three billion years is that it is being turned into a vast pit of fertilizer.

Becker’s question resonates: In this world, where life feeds on life, an individual sentient being, in itself, seems to be of no ultimate worth. (It has been said that nature values the idea of the individual, but not any particular individual.) How are we ever to find rest in such a world?

The unfortunate truth is that my experience is anything but restful. For the most part we spend our days drawing lines between the acceptable and the unacceptable, embracing what we will and rejecting the rest. We judge and choose, fret and worry. Yet despite centuries of humans laboring to remedy the psychological, sociological, and biological ills that make our existence a continuing struggle, the suffering persists. A suspicion arises that there may be, after all, some structural flaw at the center of things, some ugly defect that cannot be erased, repaired, or explained away. It can feel, in our darker moments, as if something is fundamentally wrong with us, and with this world, something that we cannot and should not accept, much less love. This suspicion, however, is too much to bear. So we avert our gaze and get on with our day-to-day lives.

According to the traditional story, Prince Gautama, the man who would later be known as the Buddha, could not avert his gaze. His encounter with aging, sickness, and death triggered a spiritual crisis, culminating in his insight under the Bodhi tree, which he later conveyed in the form of a medical diagnosis: Human beings, he declared, are ill, subject to a chronic malaise that infects everything we experience—even what we most desire, what passes for happiness. This is the first noble truth: Dis-ease (dukkha) is our disease.

To appreciate what is involved here, one must see how it’s possible to be ill without realizing it; the early signs of cancer can easily be written off as incidental aches and pains. Recognizing and acknowledging the symptoms of illness is the initial, indispensable step toward seeking a cure.

The most obvious manifestation of our dis-ease, according to the Buddhist analysis, is the anxiety bound up with physical and mental pain. The distinction between dis-ease—a spiritual affliction—and mundane, unavoidable pain is easiest to discern in our experience of physical discomfort. Here’s an example from my life:

Years ago, as a young college student, I worked as a waiter at a restaurant where the principal chef was a big, intimidating man who routinely bullied us all with the sheer force of his physical presence. One day while chopping shallots he nicked a finger. I happened to be picking up an order when the accident happened, and I saw him lift his hand and hold it there, staring with obvious distress at the cut. A tiny drop of blood beaded where the razor-sharp blade had grazed his finger. He examined it for a moment, his face paled and he dropped to the floor, unconscious.

There is the physical sensation of pain and there is our dis-ease about the pain—an existential distress that accompanies and can actually dwarf the physical sensation. Buddhist teachings suggest that this holds true for physical as well as psychological pain: a similar kind of agitation is present whenever our experience runs counter to our desires. When I don’t get what I want, I become restless, worried, fearful. That is to say, I’m not only unhappy; I am also anxious about my unhappiness.

Less obvious, but equally pervasive, is the dis-ease that emerges when what begins as pleasure merges imperceptibly into pain. Once again, here’s an example.

In my sophomore year at college I bought a sports car—a Triumph GT-6. A dark blue fastback with wire spoke wheels and a dashboard made of real, polished wood. The car rode so low to the ground that at a stoplight I could hang my arm over the open window and stub out a cigarette on the pavement. I had to work hard to make the monthly payments, but the pleasure I got out of driving this racy British machine made it worth the effort. Or so it seemed, for a while. This was the late 1960s. American cars were enormous. My little British roadster was hard to spot from the cockpit of a GTO or a Camaro—much less from the driver’s seat of a Buick Electra 225 like the one my father drove. Parking lots were particularly dangerous places. Several times I returned to my car to find a gash in the fender where someone had backed into it. Whenever this happened, I would take it to the body shop for repairs. One time, when the car was parked, a passing stranger wantonly snapped off the antenna, which I replaced—what’s the point of having the perfect car when its perfection is marred? All of this was expensive, of course. I was working at that same restaurant I mentioned above; the boss was a jerk, and the schedule so tight I didn’t have enough time to study for my classes. The pressure of keeping up with school and job was intense, but for months I stuck with it. Until one day I had an epiphany.

I was out for a drive, alone, listening to Simon & Garfunkel on the eight-track tape player. I had stopped at an intersection and just a few feet in front of where I sat with the engine idling two undergraduate girls were crossing the street. One of them tossed her hair back carelessly, blond curls flashing in the sunlight. She was laughing and, preoccupied with their discussion, clearly took no notice of me. But I noticed her. And I noticed that neither of them noticed me. And what’s more, I noticed that I cared. But why, I reflected, should they look at me? And why should I be upset if they don’t? And yet I was distressed. I wanted very much for those two girls to acknowledge me sitting there in my shiny British sports car. In fact, I needed them to look. When I realized all this, a curtain was momentarily drawn back, permitting me an insight into the role the car played in my life. It was supposed to be making me happy by enhancing an image of myself that I desperately wanted to project, but it had become instead the source of a great deal of anxiety. The cost of maintaining this self-image was suddenly crystal clear. I felt lonely and, in my loneliness, both sad and absurd.

When the traffic light changed, I drove directly to the bank and asked what I owed them, went from there to a used car lot and sold the Triumph for exactly the amount I owed, then hitchhiked back to the bank and paid off the loan. I went from there to the insurance company and canceled my policy. All of this was accomplished within the space of a few hours, and the sense of relief was extraordinary. It was as if I’d been set free from prison. I’d been stressed out for months, but hadn’t been willing to admit it to myself—or even to see it. That night I had my shifts at work reduced by half.

This was a few years before I encountered Buddhism, but in that moment at the stoplight I glimpsed the lineaments of a principle with much broader application.

We can become so focused on the idea of pleasure that it takes a while to realize that whatever pleasure might originally have been there has long since morphed into pain, and we may not be able to pinpoint when the transformation occurred. Moreover, by the time we acknowledge the truth, chances are we have already turned our attention to some new fantasy of happiness. So the cycle continues, flourishing as it does on our near boundless capacity for denial.

Sigmund Freud saw denial as a basic coping mechanism, a strategy of the ego to protect itself from any perceived threat to its integrity. Sustained marital conflict, drug or alcohol addiction, compulsive behaviors surrounding money or food or professional status, the exercise of unearned social or economic privilege—anything that might make us feel vulnerable or guilty can in principle be denied. When confronted with a situation too uncomfortable or threatening to accept, the ego rejects the empirical facts, insisting that whatever it is could not be a problem despite the presence of prodigious evidence to the contrary.

Denial differs, however, from a straightforward refusal to accept what is seen to be true; for to be in denial means that I simply do not see the truth. It is to Freud’s credit that he illuminated how denial operates below the radar, where it allows us to live with what would otherwise be unbearable.

But how deep does our denial reach? How much of life is unbearable?

Which brings us to the subtlest level of our dis-ease, referred to in Pali as sankhara-dukkha.

According to Buddhist teachings, both unhappiness and happiness are infected by our dis-ease. As I discussed earlier, when we are unhappy, we are also anxious about our unhappiness. A similar principle holds true for happiness: We are anxious because our happiness is never all that we want it to be. At the very least, we are attached to our present happiness, and we want it to last, even though we know from experience that it won’t. (As Allen Ginsberg once observed, every marriage harbors an implicit question: Who will die first?) But we are seldom conscious of the residual anxiety caused by our attachment to happiness. In fact, what we take for happiness is so tenuous and fragile that it can only exist in a state of denial, an implicit commitment to not consciously acknowledge anything that might destroy the illusion and reveal the depth of anxiety just below the surface.

Sankhara-dukkha is an existential or, perhaps better, a spiritual dis-ease that permeates my identity as an individual person—which is to say, my entire psychological life. Merely to exist as an individual, to identify with a particular set of memories and traits, hopes and dreams, is to be dis-eased. This truth is hidden behind a cloud of denial, which periodically allows for the illusion of happiness. Certainly we learn to accept that life is far from perfect and that it brings times of sadness and even despair, but the first noble truth goes much deeper. We do not see—nor do we want to see—how everything about our experience, including our pleasure, is inherently dis-eased. Our denial, in this sense, is the groundwork of the personality, the bulwark of my sense of myself as one person set apart from others. We find it virtually impossible to admit—as Prince Gautama did when he left the palace—that our hard-won moments of happiness are a charade. It is simply too much to bear.

The difficulty of breaking through denial is in direct proportion to the significance of the truth that is buried. To see how the car I wanted so badly had become a source of anxiety took some time, but it was relatively easy. To see that my marriage is hopelessly dysfunctional—or that I’m an alcoholic, or that I hate a job I can’t afford to quit—is considerably more difficult, for it may demand that I reappraise my entire life from the ground up. But even that is a relatively simple task compared to what we’re dealing with at this third, and most subtle level of dis-ease. To see how I am, by my very constitution as a self-conscious individual, condemned to suffer places an inconceivable burden on the psyche. No wonder Buddhism teaches that this most subtle form of dis-ease is perceived only at a very advanced stage of the spiritual life when attachment to the self has already become so attenuated that one no longer resists such an insight.

The characteristic response of denial, when confronted with the truth, is anger. This can’t be what Buddhism teaches. It is simply too bitter a pill to swallow.

Denial always comes at a price, however, and the cost of not facing up to the truth of our dis-ease is high. The more I wriggle and squirm, scheme and strategize to get what I want, the more hopelessly dis-eased I become. But when the nature of my illness—the quiet desperation of the isolated, individual self, striving to be happy—is unearthed, brought into the light of awareness and clearly seen for what it is, then this very seeing becomes the cure. This is where the spiritual path began for Prince Gautama, which is no doubt why, as the Buddha, he made the pointing out of dis-ease the subject of his first noble truth.

What is seen is unending turmoil. What is not seen is the seeing itself, a limitless, empty space, always and everywhere at rest.

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