The following excerpt was adapted from Vidyamala Burch’s upcoming course “Freeing the Mind When the Body Hurts.” Learn more about the course and enroll here

When living with pain or illness, it’s important to be aware of our breathing. Breathing is a very powerful practice. Mindfulness of the breath can help us move from tight, constricted breathing to more wholesome breathing. When we breathe with the whole body, we begin to open, release, and settle. We can cultivate calm energy and positivity, even happiness. I have lived with a spinal injury for the past forty-five years, which I can break down into four very distinct phases: denial, bargaining, acceptance, and flourishing. And each of these stages connected back to my breath. I’m sharing my story in the hope that you may recognize your own experience in it and it may give you some encouragement.

The first stage of my journey with pain was denial. I injured my spine when I was 16, had two major surgeries when I was 17, and then went into a period of denial. I’m quite a stubborn sort of character, and I kept up this denial for about ten years. I’d been very sporty and active, and then I lost that identity quite suddenly over a period of months. I was no longer that girl. I became a girl who was living with a disability and living with pain. I could not come to terms with what had happened, so I went into denial and kept on trying to do the things that I used to do. And then, of course, I got exhausted. The pain would flare up. I would get heartbroken, upset, and distressed, and my health would get worse. I kept trying to shoehorn myself back into my old life when, actually, my life had changed. 

When I think back to my breathing during those years, it was very high in the body. It was tense, shallow, and tight because I was tense, shallow, and tight. That became my default setting, my nature of being. 

Five years after my operation, I fractured another part of my spine in a car accident, which made my pain much worse. And still, I went back to, “It didn’t happen.” My breathing was narrow and inhibited, and my mind was uptight and fearful. I can look back on that time now with good humor, compassion, and understanding, but it was extremely unpleasant. And I was probably quite difficult to be around because I was aloof to myself and to others. 


The next phase, bargaining, began when I was 25. In 1995, I reached a point of severe crisis with my health, particularly with my back, because of all the denial and strain of trying to do too many things. After some treatments had gone wrong, I ended up bedridden for a number of months, and eventually, I had to be hospitalized. There was one night in particular in the intensive care ward where I had an incredible existential dilemma because I was asked to do something that I couldn’t do. I’d had a particular treatment that required me to sit up for twenty-four hours afterward. I hadn’t sat up for months. So in the middle of the night, my mind got into a tussle between two sides. My logical, rational mind thought, I cannot do this, I will go mad. And another part of my mind said, But you have to

I can’t! But you have to. I can’t. But you have to. 

During all this back-and-forth, I grew obsessed with the morning, because that was when I would be able to lie down again. 

I can’t get through this until the morning. Yes, you can. No, I can’t. Yes, you can. 

Eventually, a third voice came in very clearly and said, You don’t have to get straight to the morning. You just have to live this moment, and this one, and this one, and this one. Something in me relaxed. I wouldn’t say it was a pleasant experience. I was still tormented, but my mind had changed. And I think that was partly because I knew in every cell of my being that it was true. I knew that the absolute truth of things is that we only live life one moment at a time. That realization of that truth awoke within me an enormous curiosity.

What does it mean to be present? What does it mean to live life one moment at a time? It doesn’t mean that there isn’t a past or a future. Of course there is, we’ve got memories and we plan. But the only time that we actually live is now. The future arises out of now, and the now, to some extent, is a consequence of the past. The only moment that we can experience directly is now. So I will be glad to get through till the morning. Ever since that night, I have been driven to understand that experience of knowing. How can I really embed that in my awareness? How can I live from that place? 

Another realization I had while in the hospital was that I needed to take responsibility for myself. Until that point, I wanted someone else to take the blame so I could pretend that nothing had ever happened. But I realized that how my life unfolds, to a large degree, will depend on me. Because there weren’t any medical solutions to my difficulties, the medics advised me to learn how to adapt my life to this new reality. So I gave that a go. I didn’t return to my career in film—where I was constantly pushing, shoving, and striving. Instead, I started meditating. 

One day a chaplain came to see me at the hospital and guided me through an awareness practice. Within ten minutes, he helped me take my mind to a memory when I’d been happy. I took my mind to the Southern Alps of New Zealand, where I’ve been ecstatically happy before. When he brought the meditation to a close, I felt significantly different. In reality, the only change was my awareness when I filled my mind with beauty and happiness. The possibility that I could choose made me feel happier and much more positive. So I started doing things that were good for me. Along with meditating, I started rehab swimming, yoga, and taking my nutrition seriously.

Still, I had pain and a broken spine. 

The bargaining phase is quite tricky in the sense that it’s not as deluded as denial, but it’s still delusional, painful, and confusing. If I’m doing all the right things, why am I not getting my desired outcome? Well, the issue is that the desired outcome is the thing that’s at fault, not the practices themselves. You do the right things, but you do them with a false agenda. My fantasy was that if I did these things, all my back pain would go away and somehow, miraculously, I would be cured. I know that sounds ludicrous, but I think many of us want to believe this kind of fantasy. Well, I’m sorry to disappoint you, but that’s very unlikely. What you can do is heal your attitude to what you’re experiencing. There’s an interesting distinction between prioritizing healing and searching for a cure. While we might not be able to cure ourselves of our illness or our pain, we can take steps toward healing our attitude. I recognize this is difficult.

During the denial phase, my breathing was constricted, as I struggled to continue with things that were not working for me. In the bargaining phase, there was a prevailing inability to truly be with what is. Even when I tried more intensive meditation and yoga, my breathing was tight and strained. So the phases are not completely discrete. Although bargaining is wiser than denial, it reveals an inability to be with the self fully. During those years, I did a lot of work on myself and a lot of grieving. Even then, I was still caught by this unrealistic fantasy of what the outcome would be if I was a good meditator, good practitioner, or a good person—whatever that means.


Eventually, I started moving into a much deeper phase of acceptance. This was a much more realistic, wise, and kind phase in life, which came out of another crisis. When I was 37, my back and mobility deteriorated significantly. My bones and bladder became paralyzed. This period was quite bleak. I would think to myself, I’ve been doing these practices for ten years. What is it that I’ve missed? What memo did I not read from the universe to help me make peace with my situation? 

I realized two things, the first being that I was using my spiritual practice to escape my illness rather than coming closer to my experience. I definitely grew and developed, but I was still caught up in that impossible dream of a perfect life, and I disliked the life that I had. So I realized that I needed to profoundly change my attitude and energies. As I moved toward acceptance, I relied on my practice, awareness, kindness, and Buddhist wisdom to help me land in this life, just as it is. Let me love this life as best as I can. And let me let go of all these layers and layers of tightness and contraction, grasping and confusion. I also developed my ability to take my practice into all the moments of my life, not just when I was meditating.

Let me love this life as best as I can.

In the acceptance phase, my breathing began to change. My voice dropped and became more resonant, and my breathing was reaching much deeper into my body. My breath went down into my belly, my pelvis, and then to my lower back, where all the trauma and pain lived. I had previously been using my practice to avoid that pain, but as my acceptance grew, my breathing was able to gradually open and drop down into that part of my body. I was able to come into relationship with my lower back with an attitude of healing rather than fantasizing about a cure. It has been an exquisitely tender and beautiful healing. 


I always thought that acceptance would be the goal, the end of the line. If I could be more accepting and live this life with a little more grace, that would be a wonderful thing. The final stages of grief, as taught by various people, often end with acceptance of something that has happened. But what has surprised and delighted me is that out of acceptance grows a new phase, which I call flourishing. When you let go of the battle, let go of fighting with your spirit, then more energy will rise up. You will gain the energy to grow and move into new possibilities. In this flourishing phase, my whole body was breathing. I was breathing in the belly and the back and the chest, because all of myself could be brought into this flourishing phase. 

When I talk to people about living with pain and illness, I tell them that, yes, it’s important that we come to terms with it and accept our situation as best we can. But out of that acceptance, we can also gain a new lease on life, a new way of being that’s more open, abundant, positive, and openhearted. 

And although I’ve described four separate phases, I also experience movement between the phases. I do believe that I’m in a flourishing phase now, but I still have really low days when I go back to bargaining. It’s not like you move out of one phase and then it’s complete. It’s more about the general trend of your life and going in and out of these phases depending on your circumstances. That’s inevitable and very human. I think if I’d heard someone’s story like this forty years ago, I would have felt like that person was talking to me directly. I hope you find this encouraging.

So those are the four stages of denial, bargaining, acceptance, and flourishing. And who knows what will come next? Who knows?