Ruwan M Jayatunge M.D. PhD (in Progress) 

The Buddhist concept of Dukkha” describes the true nature of all existence. It has a profound philosophical meaning.  The term dukka has been commonly misunderstood and misused. The word dukkha means not suffering. Suffering can be found in the pathogenic paradigm. Suffering involves somatic, mental, social, and spiritual forms of distress and causing psychopathological alterations. Suffering is a subjective experience that can involve physical, emotional, or mental pain. These types of suffering can be mitigated via therapeutic or socio-economic interventions.

Dukkha is more than subjective suffering and a vast conscious experience and words cannot fully or accurately describe it. It goes beyond the pathogenic paradigm disintegrating the internal sense of coherence.

The Buddhist concept of dukkha is not suffering, despair, anguish, misery wretchedness, or disheartenment. It is not total pessimism either. Dukkha is a multidimensional concept and a complex construct that has no precise linguistic meaning. It is a vast universal experience connected to the universal consciousness based on the reality of human life. Dukkha exemplifies the true human condition.

The mundane understanding of suffering is related to the bearing of pain, inconvenience, and distress that is connected with hopelessness. According to the Buddha, the word suffering has a deep existential meaning. It is a universal explanation of the true human condition.  

Many Western Psychologists misinterpreted the word Dukkha” or universal suffering, and they viewed it as an agonizing human condition. This was due to the mistranslation done by the French Philosopher Anatole France in the late century. Anatole France translated the word Dukkha” into French as souffrance” and then into English as suffering. Ever since many Western scholars grasped the concept of Dukkha” incorrectly. Therefore, many thought Dukkha symbolized the dark side of human existence filled with pessimism and despair.

Dukkha narrates about the veracity and the accurate nature of existence. Existence has three major characteristics: impermanence, un-satisfactoriness aka dukka, and absence of a self. These are interconnected and interdependent.

Some view Impermanence as the philosophical problem of change. It is the absence of permanence and continuity. Impermanence denies the unchanging transmigrating human soul. The universe is incredibly vast and complex and constantly changing. It is not a permanent entity. The universe has normal matter, ‘dark matter’, and ‘dark energy’ which all constantly change. Nothing is permanent in an ever-changing universe. There is no physical or mental object which is permanent. The Greek Philosopher Heraclitus once stated: “No man ever steps in the same river twice.”   The world is constantly changing. Human change on the personal level as well as on the collective level.

The phenomenal world is transitory.  According to Buddhism matter is impermanent, feeling is impermanent perception is impermanent, determinants are impermanent consciousness is impermanent. When a person tries to resist the impermanent world without understanding its true nature, dukkha arises. He does not want things to be changed. But things around him change constantly. He can never go back to the same exact moment or experience again. The person is aging. He cannot stay forever young. It creates immense distress in the person. This distress is part of dukkha. The person wants an internal life for himself and his loved ones. But death is inevitable. No one cannot escape death. Fear of death and dying process is associated with dukka.

The world is filled with illusions. The person takes many imagined mental concepts as real.  The mental-physical ego-self is a mere deception.  Although we perceive the self as a distinct conscious entity there is an illusion of self. The brain creates self-identity with perceptual illusions via neural activations. The brain takes experiences, thoughts, and behaviors into a narrative to create a mythical sense of self. According to some Neurologists, the brain is a narrative-creating machine. The reality is a subjective experience. Self is not a single unified entity, but a bundle of sensations, perceptions, and thoughts lumped together. All physical and mental existence is not metaphysically real. There is no permanent mental-physical self. Self consists of the moment-to-moment flow of consciousness. When a person is trapped in this illusion dukkha arises.

The mundane understanding of dukka is suffering, related to bearing pain, inconvenience, and distress that is connected with hopelessness. Dukka is not mundane suffering or general unhappiness, uneasiness severe mental pain, or mental agony.  If Dukkha is suffering, then suffering is impermanent. It’s not everlasting or perpetual. Suffering is a subjective experience. The word dukkha has a deep spiritual, existential, and dialectical meaning. Dukkha does not symbolize the dark side of human existence filled with dread and misery. Instead, it highlights the authentic nature of all existence. Dukkha is associated with the impermanent nature of self.

Dukkha is not a pessimistic or nihilistic concept. Dukkha represents an array of emotions from happiness to despair. Dukkha refers to a state of existential confusion and fixation on deceptiveness and deviating from the reality of existence. Dukkha is an inability to understand the true nature of existence. It is the tension, conflict, friction, resistance, and change caused by circumstances of life. The illusion of self causes dukkha. It’s an existential and spiritual crisis that every man confronts, and some find the universe irrational and meaningless. Dukkha is the conflict between a rational man and an irrational universe. Dukka is a form of absurdism that men face. It is the struggle to find meaning in a meaningless world. Dukkha is about the universal un-satisfactoriness of life. Dukkha is intertwined with the whole existence.

A worldly person experiences two types of suffering; one is mundane suffering due to low socio-economic deplorable living conditions and health-related issues. These types of suffering can be fixed through worldly interventions. The second kind of suffering which is called Dukkha suffering is more than mundane day-to-day suffering. It cannot be fixed via worldly interventions.  

Is human life being full of unbearable suffering? I have spoken with the former Gulag prisoners of the Soviet Union, Holocaust survivors, and the POWs who underwent unbearable and tortuous suffering. However, most of them concurred that despite their suffering there were happy and content moments in their lives while under bondage. Despite their suffering, they had moments of inner contentment. This may be an innate survival mechanism that humans achieve through evolution.

Mr. Smaith lived a productive life of 84 years. He had a happy childhood, a good education, and a fruitful adult life with a respectable profession. He was happily married. He was a delighted man for most of the time. He disregarded some of the life stresses, negativity, and disappointment and had a positive outlook on his life. He died at the age of 84 in his sleep without any old age suffering. Although Mr. Smith is a fictitious character, we know many people who had similar lives as Mr. Smith.  Did they ever complain life is full of suffering?

Suffering can be external. A chronically depressed person might suffer due to his erroneous worldview, his negative life philosophy, and his detrimental perceptions. A person from a war-torn region might suffer due to geo-political reasons. The internal suffering could be due to disruption of brain chemistry. Think about a person suffering from drug-resistant depression with altered brain chemistry.  He is experiencing prolonged suffering.   

Some people are not aware of their suffering. For instance, patients with Alzheimer’s disease are in an intriguing condition, yet these patients are not aware of their worldly suffering.

In the past people suffered as a result of various diseases such as smallpox, polio, measles, mumps, and rubella. With the progress of medical science, this suffering has been eradicated. Therefore, we don’t see suffering due to these infectious diseases. However cellular aging (the cell biology of aging) is a universal factor that is associated with pain and discomfort. There is a suffering from the consequences of old age.  due to bodily decline and physical/mental deterioration, there is suffering.

Suffering is a personal matter as well as a collective matter.  Universal suffering covers a wide range of human experiences, and it has physical, psychological, social, and existential dimensions. These universal characteristics are common to every human. As a result, these universal characteristics bring a conscious awareness of the self’s vulnerability. They feel that life no longer makes sense. This awareness is Dukkha.

Dukkha is not clinical depression, mundane suffering, alienation, or tiredness of life that is associated with suicidal intentions. These conditions can be treated with anti-depressants and psychotherapy. But Dukkha cannot be treated with anti-depressants. Dukkha is a profound and strong awareness of life’s universal maladies.

Some Buddhist texts state that birth is suffering. Here it does not refer to normal childbirth. Childbirth is often a happy occasion for parents. In the Buddhist context, birth refers to the birth of the ego. The birth of ego and fixation leads to universal suffering. Following ego fixation, the person is mentally preoccupied with fixed belief. He has grasped a false sense of self. When his beliefs are changed or challenged, his false sense of self is compromised, and he is experiencing discomfort and anxiety. This leads to dukkha.

Aging is suffering. However, modern scientific technology especially gene therapy decelerates the aging process. Sometimes within the next 100 to 200 years, medical science will develop anti-aging treatments and humans will be able to live 250 to 300 years. Even that will not resolve Dukkha. Because aging and demise are inevitable and finally people would experience universal suffering.

Sickness is suffering. But the medical science has found treatment for many diseases. Perhaps within another 200- 300 years’ time, humankind might eradicate 95% of infectious and non-communicable diseases including cancer. Then sickness wouldn’t be viewed as a factor that brings human suffering.  

Indeed, death is suffering. The medical science can prolong the human life span. Bio-printing technology can replace skin and other internal organs and rejuvenate the human body. Although these measures would give a long life death is unavoidable. Therefore, death will be a part of human existence. Dukkha is associated with death anxiety.

A lack of meaning in life can result in dukkha. Although people have every comfort and many materialistic things, often they are hit by meaninglessness in life. They do not have a clear sense of purpose. According to Viktor Frankl, without meaning, people fill the void with hedonistic pleasures, power, materialism, hatred, boredom, or neurotic obsessions and compulsions. A lack of meaning in life would bring dukkha.

Dukkha is not about pessimism or cynicism. Dukkha is connected with true human nature. Dukkha is not an enigma without an answer. The Buddha described the comprehensive nature of Dukka and its cessation.