A primary cause of suffering is the fact that we have bodily form. According to the story of the Buddha’ s life, witnessing for the first time the four physical sources of suffering—birth, aging, sickness and death—deeply moved him. Almost no one remembers the trauma of birth, but it was a source of suffering. From the warm, comforting, floating existence of the womb we enter a world of bright lights, harsh sounds, sudden movements, hunger and thirst, and we are separated from our mothers. Birth is indeed a cause for suffering. However, the Buddhist concept of birth extends beyond the physical body. Every moment of existence comes into being and then vanishes. Thus, we experience birth and death every moment of our lives. The unavoidable fact of unenlightened existence is suffering.

The journey to death begins when we are conceived, and aging begins when we are born. We are not exempt from the fundamental principle that all dharmas come into being and pass away. The inevitability of death and our corresponding wish to live indefinitely undercuts our personal history. As one Western philosopher concludes, “a being is a being-unto-death.”23 Aging and death are not restricted to old people; it encompasses everything and everyone.

Suffering Caused by the Mind

Another cause of suffering is that in addition to bodily form, we have consciousness. Mental suffering comes from experiencing the cycles of the arising, abiding, changing, and perishing of dharmas. These include not getting what we want, having to tolerate what we do not like, and being separate from what we cherish. These three situations cover nearly all aspects of mental suffering.

Suffering Caused by the Five Skandhas