When I first encountered the Buddha's teaching on dukkha, instead of feeling disheartened, I felt relieved. At last, here was an honest and straightforward description of how I felt at some point every single day of my life! In addition to feeling relieved, I immediately felt a profound connection to others. The circumstances of our lives may lead to slightly different experiences of this noble truth, but beneath the surface, we know what others' dukkha feels like because we experience it ourselves.

Dukkha is often translated into English as "suffering." Suffering is an aspect of dukkha, but it's inadequate to explain this central of Buddhist concepts. Some Buddhist scholars say we should stop trying to translate dukkha and just let this complex word enter, as is, into the cultural stream in the West.

I like to describe dukkha as dissatisfaction with the circumstances of our lives. For me, that encompasses the many words used to describe it: suffering, stress, unease, anguish. Aren't you dissatisfied with your life in some ways? Your dissatisfaction may be unease over the "big questions" (Does my life have meaning? What does climate change mean for the future of the planet?). It may be tied to the stresses of everyday life (tension in a relationship, difficulty on the job). It may be due to mundane discomforts and irritations (the dog barking next door, the lost sock in the dryer). Reflect on your day-to-day life. Notice how there is an ongoing effort (subtle or intense) to adjust its circumstances to be more to your liking.

There's a tendency to deny the presence of this dissatisfaction with what I think of as an "if only" mentality: "If only I had the latest smart phone, I'd never want another electronic device"; "If only my friend would call, I'll never want anything from her again"; "If only I weren't sick, I'll never complain again."

Who am I kidding? If all my "if only's" came to pass, I'd soon find they didn't bring lasting satisfaction. A smart phone is no fun without all those cool apps. I doubt one phone call from my friend would lead me to give up all expectations about her! And, although I'd be glad not to be sick, my life would still have its share of dukkha.

The good news from the Buddha is that we can work with our minds to alleviate dukkha—this dissatisfaction with the circumstances of our lives. Notice I said "work with our minds." We were born into bodies and they get injured, sick, and old. The Buddha endured great bodily pain at times, but he did so without suffering in the mind. I think of the Buddha as a scientist of the mind. Indeed, the Dalai Lama called the Buddha a great psychologist, saying that he had a keen understanding of how the mind works.

The first step in alleviating dukkha is to understand its source. In the second noble truth, the Buddha said that its source is our self-focused desire to get our way, whether it be (1) to get something—a material thing (that smart phone), a particular sensory experience (the taste of ice cream), an identity (acclaimed author); or (2) to get rid of something—this illness, the outside temperature being too hot, the politician we don't like. The Buddha didn't mince words when he told his monks: "Dukkha is not getting what you want and getting what you don't want."

The second step in alleviating dukkha—our dissatisfaction—is to bring it and its source—our desire to have life conform to our liking—-into conscious awareness (called "mindfulness" in Buddhist practice). This gives us the opportunity to make a choice. One choice is to persist in our fruitless desire to change those circumstances in our life over which we have little or no control (the inability to afford those smart phone apps, the behavior of a friend, the state of our health). The result of making this choice is an intensification of dukkha.

The second choice is to acknowledge, without judgment or blame, that this desire intensifies our dukkha, and to let that desire go. To let go of desire, we mindfully observe that it has arisen, but we don't feed it with our thoughts, speech, or actions. We watch it arise and we watch it pass. With practice, we come to see that if we don't make that desire stronger with our thoughts, speech, and action, it will, like all phenomena, pass away on its own.

There's a tendency to fool ourselves into thinking we have our desires under control, but they're often present without our even realizing it. Many years ago, I was at a daylong retreat with the Buddhist teacher, Ruth Denison. Everyone brought a dish to share for lunch. When the time came to eat, we lined up at the front of two long tables that were filled with food.

Then Ms. Denison took us by surprise. She said, "Before you take a dish and start serving yourselves, everyone is to walk slowly by the tables—twice—and notice your desire for the food." If you'd ask me when I lined-up if I was being "ruled" by desire, I'd have said "no!" But as I walked passed the food, I could feel that I was nothing but desire! As I walked passed the food the second time, I gradually realized that I could just watch the desire, acknowledging its presence without acting on it. It was a powerful exercise. When I walked down the line the third time, I filled my plate slowly and mindfully, and felt tremendous gratitude toward those who had taken the time to fix such scrumptious food to share.

Every day, I work on bringing into awareness the self-focused desire that underlies each feeling of dissatisfaction in my life. Then I try to make the conscious choice to let go of what I cannot change and to accept my life as it is. I'm inspired in this practice by a quotation from the Buddha in which he said that the mind is as soft and pliant as a balsam tree. This means that change is possible—in this context, changing our knee-jerk response to desire.

Don't confuse letting go of self-focused desire and accepting life as it is with indifference or resignation. I haven't given up looking for treatments that might improve my health. But I have stopped the relentless craving for my life to be different than it is. When I open my heart and mind to how my life is right now, sickness included, I feel content and at peace with my life. It's a taste of freedom (a taste of the freedom that some call awakening or enlightenment).

I still sometimes hold tightly to the thought, "If only I weren't sick, I'd never complain again." After all, I'm a work in progress, not an enlightened being. But at least I know the drill.

© 2011 Toni Bernhard

I'm the author of the How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and their Caregivers, winner of the 2011 Gold Nautilus Book Award in Self-Help/Psychology and named one of the best books of 2010 by Spirituality and Practice.

I can be found online at www.howtobesick.com