First, there is the suffering of suffering. This level of suffering is easy to recognize and relatively easy to find solutions for. It includes physical and mental pain. Even animals can understand this level of suffering.   

Second, there is the suffering of change. With awareness, or mindfulness, one observes that suffering comes when things change. At first, some objects and events appear desirable – they do look as if they will bring happiness, and for a time they do. However, when time passes and circumstances change, the same desirable objects and events can turn into something undesirable, something one wants to avoid. Because of changing circumstances, our view of objects or events also changes. 

In reality, everything is impermanent. The reason that change brings suffering is because we want things to remain as they are. 

To get an insight into how this happens, we need an understanding of the gross levels of impermanence, how things come into being, remain, then cease, by the power of others. They arise by the power of others, while they remain they are still under the power of others and their cessation depends on the power of others. Nothing happens independently. If we really understand that very gross level of impermanence and how we have so little freedom, it will help us understand the more subtle levels of impermanence. 

This process of change has the nature to produce some kind of suffering. We all know things change, but we need to know this at more than an intellectual level; it must be at the heart level. Things are changing, and these changing processes (whether human emotions or actions are involved or not) have the potential to bring unhappiness. 

We are not saying the nature of change itself is suffering. There is a big difference. The change from autumn to winter itself is not suffering but it has the nature to bring some kind of suffering because we cling on to what is there and do not want to lose it.

There is nothing wrong with enjoyment, but when we are attracted to something we have to bear in mind that it will change. If we are not really aware of that changing nature, then when this change comes, as it must, it will be a big shock. Through constant effort, we can avoid falling prey to strong emotions which lead to strong suffering.

Third, there is pervasive suffering. At the end of the Buddha’s teaching on the Four Noble Truths, he stated: “In brief, attachment to the five aggregates is suffering.” 

Now, our existence is essentially these five aggregates. Therefore, our existence itself is suffering! And so, pervasive suffering means that this suffering pervades our whole existence.  The five aggregates are as follows:

Form	All the physical aspects of the body
Feeling	All things providing our day-to-day (1) pleasure, (2) displeasure, (3) neutral sensations in connection with sensory or mental consciousness
Perception(discrimination)	Through contact, we get some kind of feeling which we interpret as “nice”, “not nice”, “right”, or “wrong”. This is perception or discrimination.
Mental formulations(compositional factors)	This includes the many different types of mental process such as doubt, desire, determination, conceit, etc. Particularly important is volition (or karma).
Consciousness	Includes the five sensory consciousnesses, and the sixth consciousness, the mental consciousness.

This third level is there wherever we are born in cyclic existence. We cannot avoid it. Because it is very deep rooted in terms of its causes and conditions, it is very difficult for us ordinary people to even acknowledge we have this kind of suffering. 

Only when we do acknowledge it, can we start to understand how to abandon it. Because the result itself is very sophisticated, and the causes are those origins which are so deep rooted in our everyday consciousness, to get rid of this pervasive suffering needs a lot of effort. 

In his book, The Four Noble Truths, the Dalai Lama states: “Finally we come to the third type of suffering, the suffering of conditioning. This addresses the main question: Why is this the nature of things? The answer is, because everything that happens in samsara is due to ignorance. . . . Here the third level of suffering therefore refers to the bare fact of our unenlightened existence.” 

Perhaps the best way to understand pervasive suffering is to understand impermanence. In What the Buddha Taught, Rahula states: “It is duhkha not because there is suffering in the ordinary sense of the word, but because whatever is impermanent is duhkha.” We suffer because we are impermanent. In other words, it is duhkha because it is impermanent.

In sum, pervasive suffering refers to that unsatisfactory state which pervades our entire unenlightened existence. We will not be free of it until we are free from samsara, until we are a Buddha. 

Source: Adapted from Geshe Tashi Tsering, The Four Noble Truths: The Foundation of Buddhist Thought, Vol. 1, with a foreword by Lama Zopa Rinpoche, ed. Gordon McDougall (Somerville, MA: Wisdom Publications, 2005), 33-38.