Category: Avoidance

The Three Characteristics/Marks/Seals of Existence: A Practice

Post author By Steve Wasserman
Post date September 3, 2019

I’ve been thinking recently about a buddhist notion that all beings (including us), and in fact all phenomena, are marked by three characteristics. These are sometimes called the three marks of existence, or three seals: suffering (or some kind of “shortfall”), impermanence, and contingency.

Here’s an acronym to remember them by: SIC!

I’ve deliberately chosen SIC as it sounds a bit like “sick” when said aloud (as in debilitated, disordered, down in body and mind), but it’s also the word we use in a text to indicate a phrase or quote that looks dodgy but is in fact is exactly what was printed or said. As in when The Donald comments on Boris becoming PM:

“Good man. He’s tough and he’s smart. They’re saying ‘Britain Trump’ (sic). They call him ‘Britain Trump,’ (sic) and there’s people saying that’s a good thing.”

The idea, as with all buddhist ideas, is that if we can really explore and understand on an experiential level these three characteristics, learn how to recognise them as they arise in our moment to moment perceptions rather than just as conceptual symbols on a screen or in a book, this exploration can greatly help us to live our lives in a more unencumbered way, with more peace and grace. So are you willing to do a bit of exploring?

If so, here’s a quick overview of the three characteristics and then the simple, no-fuss practice.

SUFFERING

Dukkha, the pali word for this concept, is often translated as “suffering” or “discomfort”, but I’ve always liked the notion that its etymology can be traced back to something like “a painful, bumpy ride due to a poorly-fitting axle hole in the centre of a wagon wheel”. This is the buddhist version of “life’s a bitch…”.

Perhaps a better translation might be something along the lines of shortfall or insufficiency: that unsatisfactory or peevish disgruntlement we experience, whenever anything in our experience falls short of our expectations. Once you start noticing the extent to which there is a shortfall between what we expect or desire, and what we actually get, you start to see this phenomenon everywhere, and in everything, a true mark of existence.

It pops up even in ostensibly good times. Let’s say I’m on a beautiful country walk, as I was yesterday alongside my trusty doggy companion Max, and for the most part having a great time. Yet even woven into that walk there were countless example of dukkha. Here are just a few:

On my way to my destination, I find a quiet part of the train carriage to sit in so that I can read. At the next stop, a noisy family gets on the train, sits next to me and yaps away for the next 40 minutes.
The weather app forecasts clear skies, no rain. So I don’t take any rain gear with me. For the five hours I’m out, it’s overcast for three quarters of the time, and rains off-and-on for an hour.
I find a mobile phone in the middle of a forest which someone appears to have dropped. Even though the screen is locked, I manage to text a friend of the phone’s owner, and then agree to walk back to a pub I’d passed earlier, to return the phone. Twenty minutes later, the phone’s owner thanks me in brief, somewhat tepid fashion, the kind of thank you you might expect if you’d just told someone their shoelaces were untied. Effulgent, enthusiastic appreciation was what I’d expected for my do-goodery, thinking how I’d feel if someone reunited me with the expensive handheld computer on which all my unbacked-up photos, as well as the rest of my life was stored. A damp squib thank you was not what I’d planned for, but it’s what I got. My mind of course immediately stepped in to tell me that next time I should just leave the bloody phone in the forest, and let them find it themselves.
I stop halfway through my walk to feast on a few handfuls of delicious wild blackberries, picked straight from the bush. Half an hour later, my stomach is distended and tight, and for the rest of the walk, I feel queasy and uncomfortable. Either the rain (see point 2) didn’t sufficiently wash off the bugs and bacteria, or maybe the high levels of salicylate in the fruit are causing me a few hours of stomach cramps. Either way, dukkha!
After 12 miles of walking, I get into the station at Cowden, only to find that the 8 o’clock train has been cancelled, and the next train into London is an hour away. The stomach cramps are just starting to abate and I am feeling hungry. At this rate, I will now have to wait until 10:30 for dinner.

And on it goes. These are not huge traumatic forms of suffering, just the usual, everyday-dukkha, the niggles, the jolts, the stuff that might easily be generated if you just stop reading this sentence and sit quietly for a moment.

Try it. It won’t take long before your mind points out some kind of shortfall, some kind of gap between how you’d like things to be, and how they are, whether it’s in relation to your mood, or body, or relationships, or surroundings, or the tasks you’ve taken on today. Non-stop dukkha is how it goes, I’m afraid. But keep on reading for some suggestions of what to do with that.

IMPERMANENCE

I’ve written more fully about impermanence here, but let’s stay with that walk and notice a few marks of impermanence along the way:

My energy levels wax and wane, as do my levels of bodily discomfort throughout the walk. There is not a single emotion, or sensation held within my body or mind that endures for the length of this 5-hour ramble. The majority of my perceptions lasts for seconds at a time, some like the blackberry-reaction endure for over an hour. But even there, the amount of physical discomfort and the ways in which it manifests (queasiness, stomach cramps, trapped wind) shifts every few seconds from noticeably uncomfortable, to background “noise”.
The walk itself is impermanent, as is everything I come into contact with on the walk. While I am on it, I am fully engaged with the totality of the experience flooding into my senses: sights, sounds, interoceptive responses. But writing about it a day later, it may well have been a dream. Apart from a handful of memories, I cannot bring anything of the walk back with me into this moment. None of it lasts, neither good nor bad.
My disgruntlement at the phone-person lasts, but only due to the words above re-awakening and re-minding me of the gap in what I expected and what I got. But in a few days time, I will have forgotten this incident too. And at some point, there’s a good chance that it will entirely disappear from my memory.

CONTINGENCY

In buddhist literature, this is sometimes referred to as no-self, or non-self, but my understanding of this is that although we see ourselves as separate, self-determined entitites, our experience of the world is inextricably, at every moment of the day, shaped and circumscribed by our environment and life-context, as well as our life course up to this point, the weather, the people who populate our existence, and a million other factors that are not even a conscious part of our awareness.

If you start to think about yourself in this contingent way, you soon realise that the story-of-me that we tell ourselves (here I am, going on a walk, on a Saturday afternoon, learning a poem, listening to an audiobook, enjoying the sights, sounds, and smells around “me”) is actually something much more mysterious and shaped-by-everything-that-is-not-me, which is to say shaped by my circumstances and surroundings rather than emerging directly out of my body and mind.

Perceptually, a good analogy for this might be something like the Escheresque Rubin’s vase, where figure and ground get muddled the more we pay attention to the image: are the faces made possible by the vase, or the vase by the faces?

Of course each shapes the other. Our environment impacts us in ways that we are often hardly aware of. After walking in drizzle and overcast weather for a while, when the rain abates and the sun comes out, I become a different person: lighter, more joyful, if only for a few paces before Impermanence sets in again, and I shift into another way of being.

And this doesn’t just happen for us. Yesterday, I noticed that even the birds are “moved” or shaped by something as simple as sunlight. A moment before the sun came out, all was quiet. But as soon as sunshine broke through the clouds, rapturous birdsong rang out of the forest that I’d just passed through, sonically matching the uplift in mood that I’d been feeling, and who is to say we didn’t all feel a very similar buoyancy. Maybe even the trees, grass, and insects therein. For a few seconds, bathed in sunlight, we all became slightly different entities.

—

WORKING WITH ALL OF THIS: A NOTING PRACTICE

So if you’re broadly speaking in agreement with this theory that all existence can be usefully understood as marked by three interlinked characteristics or seals, which we can either fight against or try to work with as best we can, how to make this happen?

Here’s the practice, a very simple one that I’ve been trying out recently. Every time you notice some form of psychological or physical suffering, see if you can “seal it” with one of the above characteristics of existence: SUFFERING (aka distress/deficiency/disappointment), IMPERMANENCE, and CONTINGENCY. Often, all three are present, in which case you can designate what you’re experiencing with the SIC triple whammy. “Yeah, that’s some serious SIC there, dude” (or however you choose to acknowledge the presence of SIC).

Whichever of the three you notice, just label it, using one of three characteristics, and then see if that allows you to live more in accord with your environment and circumstance or not.

The three characteristics of existence in the order I’ve presented them also perhaps adhere to the most frequent ways in which the mind becomes aware of them in consciousness.

Some form of distress or unsatisfactoriness is usually picked up very quickly by the problem-finding/problem-solving mind as a form of SUFFERING (irritation, disappointment, deficiency), or SHORTFALL: whether it’s having to stand in a long queue at Sainsbury’s, or not getting the response we might feel we need from a loved one.

We notice this first characteristic right away, because that’s usually the part that hurts. And it hurts for a good reason: our minds are saying “Pay attention to this. This is not in sync with your wishes or needs. Maybe we can make it better or easier for you in some way?”

And yes, sometimes this problem-finding/problem-solving stance of the mind is genuinely helpful. Maybe I can find a quieter carriage of the train to read in, maybe I can find shelter under a tree when it begins to rain. But what to do when that suffering or shortfall cannot be eradicated, or avoided, or controlled in some way? What to do when your stomach is cramping and you’ve still got 6 miles to walk before you reach the train station – other than acknowledge what’s going on, and that there is clearly a gap between what we want or were expecting, and what we actually get. Just acknowledge that, no more, no less, maybe with a simple word like “suffering” or “unsatisfactory” or “shortfall” – whatever works for you.

I quite like using the pali word dukkha, just because it’s short and a tad brutal: the DU might as well be doo-doo, the KHA a stone in your shoe, or something worse (a scorpion?). Every time I say that word, it’s like acknowledging that life is often this way: you’re tramping along, just trying to get by, or get on with your environment or other people, and suddenly you step in a pile of shit that also harbours a scorpion’s nest. Welcome to the human condition.

Often, the recognition of SUFFERING, requires an accompanying recognition of the other three marks of existence, which are usually to be found somewhere in the mix. At times IMPERMANENCE is what we perceive first, either with or without DUKKHA. When my stomach gripes finally abated, I noted the impermanence even of that painful phenomenon, and this was accompanied by the opposite of DUKKHA: SUKKHA (happiness, pleasure, ease)! Which of course only lasted for a few seconds before my mind went on to find fault with something else in my surroundings.

Simply noting all of this and trying not to take it all so personally (CONTINGENCY noting helps a lot with this) can ease things a bit, or even substantially. Why not give it a go – you’ve got nothing to lose – and tell me what you think if you give this a try.

Acceptance Acceptance and Commitment Therapy Anxiety Avoidance Control Coping strategies DBT Emotion Regulation Feel Better Living A Valued Life Strategies and tools Thought Suppression Transcendence Worry

The Stoic Fork

Post author By Steve Wasserman
Post date March 3, 2019

At the moment, I wake up to jackhammers and drills.

Not just the usual jackhammers and drills of my own thought curves and mental convolutions, supplied by that sometimes-not-so-kind, maybe even Totally Loopy Word Machine we call the mind. But also “real” noise, and lots of it, from the builders next door who are probably going to be around for the next couple of months (!!), completely refurbishing and extending 109 Ruskin Gardens.

I’d been warned, I knew it was coming, and have got the owner of 109, Mr Patel to graciously agree to keep the work relatively quiet when I’m seeing clients. But at all other times, the gloves (or in this case, the jackhammers, drills, power-saws, etc) are off. Which is to say “on”. All the time.

Already I can feel the effect of all that banging and the drilling on my nervous system, and partly in response to this, am trying to re-engage with a mindfulness practice: mindfulness being all about working on our willingness to “be with” upsetting thoughts, memories, body sensations, and external irritants. Especially those we have limited or no control over.

I’ve also been finding a great deal of solace in a fork. A conceptual fork. Though in sessions, I’ll occasionally rush into the kitchen to grab a real fork in order to explain the concept to someone else.

This conceptual fork, sometimes called The Stoic Fork, is designed to get us to reflect on control, as well as the relinquishing of it. If you’re anything like me, control is important to you. It helps you to feel like you have agency, and choice, and most importantly “a say” in what happens in your life. And yes, control is important. One understanding of depression is that it proceeds from a misperception that we have no control over our lives whatsoever, that whatever we’re struggling with is so difficult and burdensome and entrenched, that we will never, ever, ever get a handle on it. Understandably that can be something of a buzzkill (to say the least).

This fork that I’m going to excitedly wave in front of your face says that we do have control, we do have agency, and the ability to make choices that are value-driven and meaningful to us. It says that we do have control over choices that will impact on how we live our lives right now in the present, as well as choices moving us forwards into the kind of lives and people we want to be in the future.

But.

We need to skilfully differentiate between what is in our power and what is not. And that very differentiation happens to be the first thing we read about in a book of collected discourses issuing from the lips and the mind of a crippled, Roman slave named Epictetus who lived 2000 years ago. I like to imagine him as a slightly more philosophical and Latin-spouting version of Tim Renkow’s lovably, cheeky character in his new sitcom Jerk (if you haven’t seen it, do!).

Here’s a little experiment for you to try out before I explain the fork.

Think of something that’s getting you down at the moment. It could be anything: a physical ailment, a relationship issue, a problem at work, a crass comment someone made recently in your presence, something unsettling you’ve seen or read, or even six dudes banging and hammering and drilling all day long right next to where you’re sitting trying to capture the evergreen wisdom of Epictetus 😉

Make a mental or actual note of this thing, this thing that’s irking you. Now imagine me whipping out my IKEA fork (see drawing below) and asking you, as Epictetus might have done to another slave as they laboured from dusk to dawn on a Roman building site: “How much control do you have over this person/thing/situation/noise that’s upsetting or worrying you?”

Be warned! This is a trick-question. If you’re anything like me, you might say this in response: “Well not much, not as much as I’d like, but….”

Or.

“Don’t lecture me on control. Control has got nothing to do with this. Or if it does, it’s because that person/thing/situation is out of control and they’re driving me craaaaaaazy.”

To which I imagine Epictetus using his walking stick to draw a line in the sand showing the following “fork”.

As you can see, on the right he’s written the kind of things we sometimes believe or think (maybe not always consciously) that we can control, especially with regard to other people: what other people think what they say, how they act around us. But equally this works with any phenomenon in the outside world, or the inside world (our thoughts, feelings, body sensations, urges, memories). I have no control over whether my stomach might decide to translate my anxieties and worries into an unpleasant, nauseous sensation, or if my head might suddenly begin to ache, or feel tired and woozy.

Epictetus believed that the only thing we have any control over are thoughts/feeling, and our actions. As you can see in the picture above, I’ve gone and crossed out THOUGHTS & FEELINGS because although he was an incredibly wise man, and although many of his thoughts and theories have formed the bedrock of our modern psychotherapy and psychology practices, we also know now, that thoughts and feelings, just like body sensations, memories, and urges cannot be controlled!

I can no longer control what thought is going to flit into my mind in the next minute than I can control what tweet Donald Trump is going to send out to his 60 million followers in the next hour. In fact, modern psychology has shown that the more we try and control our thoughts, feelings, urges, and memories, the more persistently they surface to assail us. It’s a bit like a government trying to ban a “naughty” or “insiduous” book or film (Lady Chatterley’s anyone, A Clockwork Orange?): as soon as people catch wind that now they’re not “allowed” to read that book, or watch that film, that’s the only thing you then want to do. Our minds seem to work according to similar dynamics.

If this is so, then we need to keep on reminding ourselves in some way, that the one and only thing we have any control over whatsoever, is our behaviour: our actions, our words, the things we write and say, and do. That’s it. That’s all we have. And that’s a lot!

Want to feel more in control? Control, in a healthy-ish, skillful-ish way your actions. As we know, there are lots of unhealthy ways to control our actions: starving ourselves (eating disorders) or overeating; exerting or harming our bodies so as to distract or focus our attention away from our pain; limiting our interactions with people we might enjoy being with in order to keep ourselves safe. So as with anything, a mindful approach is best when it comes to our actions. But always with the notion that, apart from what we say and do and write, we’re not in the driver’s seat of any shared inter-action (with another person or the world), and never will be.

How does one then apply this wisdom? I find it helpful to use the fork as a kind of reminder or mantra when I find myself getting irked by someone else’s behaviour. Let’s say a friend or a loved one does or says something that triggers me in some way, so that my knee-jerk response is one of the following:

“I wish they hadn’t said/done that!”
“Why couldn’t they have responded to me with X, rather than Y”
“I bet they’re now thinking this about me!” etc. etc.

This list might stretch to infinity, as infinite are the ways in which our minds proliferate suffering on the back of a perceived threat or hurt. At this point, if I’m quick enough to catch the panicky or angry thought, I might inwardly try and shrug my shoulders, call to my mind the image of that stoic fork and go:

“Can’t control her/him/it. Let it go.”

“ I have no control over this person/situation/thing. Let it go.”

“Not my circus, not my monkeys!” (or if you prefer the original Polish version of this expression “nie mój cyrk, nie moje małpy” [pronunciation here])

I might follow this with an attempt at a kind of rueful smile here, which can also sometimes help, particularly if it replaces the expression on my face at that moment which is likely to be a glowering or grimacing one.

It’s a simple practice, but I find it quite a powerful, especially when used in the midst of interacting with other human beings who are invariably going to be saying or doing things we wish we could control, but acknowledge we can’t. And even it allows us to be a little bit more flexible and kind with ourselves as well as with each other, we’re onto a winner.

Acceptance and Commitment Therapy Avoidance Feel Better Living A Valued Life Pain Suffering

Tell me about your despair, yours, and I will tell you mine.

Post author By Steve Wasserman
Post date January 9, 2019

There’s a wonderful poem by Mary Oliver where she talks about pain, suffering, and our relation to it.

You do not have to be good.
You do not have to walk on your knees
For a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about your despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting —
over and over announcing your place
in the family of things.

The key shift in the poem begins with that line Meanwhile the world goes on. It is a move out of the teeth-gritting effort of being alive and struggling as we often do with this, into that more transcendent, open, peaceful place, a place we sense other animals inhabit more readily, as well as the rest of the unthinking, non-language-using natural world. And we want to live there, not here, where it sometimes feels like we’re walking on our knees for hundreds of miles weighed down by our being-humanness. We want instead to be there, high in the clean blue air. And sometimes we experience that feeling of being there: maybe whilst meditating, or doing yoga, or walking in the countryside, or listening to a podcast that intrigues us, or after vaping some cannabis or three glasses of wine. We know what it means to crawl, and we have all had experiences of flying. Don’t we long, like those wild geese to have wings and take flight, again and again?

It may even seem unfair that we’re slithering along on our bellies, like slugs, when others seem to be soaring. At least according to social media updates and what we see in the social realm when out and and about. Soaring! If we’ve been struggling for some time, we’ve maybe plagued ourselves with different forms of the “why?” question: “Why can’t I just get over it?” “Why can’t I feel better?” “Why is life so hard?” “Why hasn’t therapy worked?” “Why can’t I be a normal person?” “Why can’t I be happy?” We may feel victimized somehow by questions that seem not to have any ready answers. Cornered by your own emotional pain and our struggle with it, we may feel as if your life is narrowing in around us.

If you’ve been fighting a war inside your head, what would it be like if instead of trying to win that war, you knew a way to step out of it? This doesn’t mean that the war would stop; it may continue. Rather, it means that you would no longer try to live inside a war zone, with your psychological survival seemingly dependent on the outcome of the war. What if that were possible?

The different modes of therapy that I use (ACT, DBT, Schema Therapy and IFS) invite you to examine your perspective not only on what psychological pain is and how it operates, but on the very nature of your consciousness, even your identity, that is, who you take yourself to be. No issue is too “basic” if it seems necessary to address it. And for that reason, these concepts and methods may shake you up a bit. Initially, some may be hard to swallow and may even fly in the face of what you’ve been taught are the “solutions” to your problems.

Concepts like:

Psychological pain is normal, it is important, and everyone has it.
You cannot deliberately get rid of your psychological pain, although you can take steps to avoid increasing it artificially.
Pain and suffering are two different states of being.
You don’t have to identify with your suffering.
Accepting your pain is a step toward ridding yourself of your suffering.
You can live a life you value, beginning right now, but to do that you will have to learn how to get out of your mind and into your life.

Often many people we meet in our daily lives seem to have it all. They seem happy. They look satisfied with their lives. You’ve probably had the experience of walking down the street when you’re having a particularly bad day, and you’ve looked around and thought, “Why can’t I just be happy like everyone around me? They don’t suffer from chronic panic (or depression, or a substance abuse problem). They don’t feel as if a dark cloud is always looming over their heads. They don’t suffer the way I suffer. Why can’t I be like them?”

Here’s the secret: They/I do suffer, and you/we are like them in many ways. Although I also believe, and Elaine Aron’s research into high-sensitivity has shown this, that about a quarter of us do feel things a tad more strongly than others. And that matters too. We all have pain. All human beings, if they live long enough, have felt or will feel the devastation of losing someone they love. Every single person has felt or will feel physical pain. Everybody has felt sadness, shame, anxiety, fear, and loss. We all have memories that are embarrassing, humiliating, or shameful. We all carry painful hidden secrets. We tend to put on shiny, happy faces, pretending that everything is okay, and that life is “all good.” But it isn’t and it can’t be. To be human is to feel pain in ways that are orders of magnitude more pervasive than what the other creatures on planet Earth feel.

SO WHY DO WE FIND OURSELVES IN THE POSITION WE DO?

If you kick a dog, it will yelp and run away. If you kick it regularly, any sign of your arrival eventually will produce fear and avoidance behavior in the dog by means of the process called “conditioning.” But so long as you are out of the picture and are not likely to arrive, the dog is unlikely to feel or show significant anxiety. People are quite different. As young as sixteen months or even earlier, human infants learn that if an object has a name, the name refers to the object. So what, you might say?

This capacity for language puts human beings in a special position. Simply saying a word invokes the object that is named. Try it out: “Umbrella.” What did you think of when you read that word? Alright, that one’s pretty harmless. But consider what this means if the named object was fearful: anything that reminded the person of its name would evoke fear. It would be as if all the dog needs to feel fear is not an actual kick, but the thought of being kicked.

That is exactly the situation we are in. That is exactly the situation all humans are in with language.

Here is an example: Take a moment now to think of the most shameful thing you have ever done. Take a moment to actually do this.

What did you just feel? It’s very likely that as soon as you read the sentence, you felt some sense of either fear or resistance. You may have tried to dismiss the request and quickly read on. However, if you paused and actually tried to do what we asked, you probably began to feel a sense of shame while you remembered a scene from your past and your actions in it. Yet all that happened here was that you were looking at patterns of ink on paper. Nothing else is in front of you but that. Because relations that verbal humans learn in one direction, they derive in two, they have the capacity to treat anything as a symbol for something else. The etymology of “symbol” means “to throw back as the same,” and because you are reacting to the ink on this paper symbolically, the words you just read evoked a reaction from you; perhaps they even reminded you of a shameful event from your past.

Where could you go so that this kind of relation could not take place? The dog knows how to avoid pain: avoid you and your foot. But how can a person avoid pain if anytime, anywhere, pain can be brought to mind by anything related to that pain?

The situation is actually worse than that. Not only can we not avoid pain by avoiding painful situations (the dog’s method), pleasurable situations also might evoke pain. Suppose someone very dear to you recently died, and today you see one of the most beautiful sunsets you have ever seen. What will you think?

For human beings, avoiding situational cues for psychological pain is unlikely to succeed in eliminating difficult feelings because all that is needed to bring them to mind is an arbitrary cue that evokes the right verbal relations. This example of a sunset demonstrates the process. A sunset can evoke a verbal history. It is “beautiful” and beautiful things are things you want to share with others. You cannot share this sunset with your dear friend, and there you are, feeling sad at the very moment you see something beautiful.

The problem is that the cues that evoke verbal relations can be almost anything: the ink on paper that made up the word “shame,” or a sunset that reminded you of your recent loss. In desperation, humans try to take a very logical action: they start trying to avoid pain itself.

Unfortunately, a number of the methods we have of avoiding pain are incredibly unhelpful in and of themselves. For example, not getting out of bed when we feel down, or drinking a bottle of Malbec may temporarily reduce pain, but it will come back stronger than ever and further damage will be caused. Denial and learned numbness will reduce pain, but they will soon cause far more pain than they take away.

The constant possibility of psychological pain is a challenging burden that we all need to face. It is like the elephant in the living room that no one ever mentions.

The approaches we will explore in our sessions are suggested by the word “suffering.” The primary root of suffer is the Latin ferre, which means “to bear or carry” (the English word “ferry” comes from the same root). The prefix “suf” is a version of “sub” and, in this usage, means “from below, up (hence) away.” In other words, suffering doesn’t just involve having something to carry; it also involves moving away. The word “suffer” connotes the idea that there is a burden you are unwilling or unable to carry, perhaps because it seems “too heavy,” “too unfair,” or it just seems “beyond you.” That connotation refers to more than pain alone; in fact, it provides a different way to address the problem of pain.

EXERCISE: Your Suffering Inventory

If you like, why not write down or say aloud a list of all of the issues that are currently psychologically difficult for you. This is something we’d probably talk about in our consultation session, but you can do that here too if we haven’t looked at this together.

When compiling your Suffering Inventory, do not write about purely external or situational events, independent of your reactions to them. What I’m most interested in is how you react to these situations and events. For example, “my boss” would not be a good example of a difficult issue you experience; but “getting frustrated with my boss” or “feeling put down by my boss” might be. This is because, not everyone is triggered in the way you are by the personality type of your boss. S/he may even be universally loathed, but you probably realise that not everyone gets as upset or angry about, say, your boss as you do. And this is key when working with our issues.

You may also want to make a note of any of your thoughts, feelings, memories, urges, bodily sensations, habits, or behavioural predispositions that may distress you, either alone or in combination with external events. Don’t overthink it. Just write down what plagues you and causes you pain. Be honest and thorough when creating your “suffering inventory”. It may take some time, but it will be time well worth spent.

After you’ve completed your list, go back and think about how long these issues have been a problem for you. Write that down as well.

Now I’m going to ask you to organize this list. First, go back and rank these items in terms of the impact that they have on your life. Then, in the space provided below, write down the same items, but rank them in order. The order should range from those items that cause you the most pain and difficulty in your life to those that cause you the least trouble. We will use this list as a guide throughout our sessions, referring back to this list as your touchstone for the events and issues that cause you pain.

Finally, in the area to the right of this list, draw arrows between every item on the list that is related to another item. You will know that two items are related if changes in one might alter another. For example, suppose one of your items is “self-criticism” and another is “depression.” If you think the two are related (that is, the more self-critical you are, the more likely you are to feel depressed, or vice versa), draw a two-headed arrow between self-criticism and depression. You may find that this area becomes cluttered with arrows. That’s fine. There is no right or wrong way to do this. If everything is related, it’s important to know that. If some items relate to only a few others, that is useful information too. The higher on your list the items are and the more other items they connect to, the more important they become. This may suggest a reranking of your problems and you may find that you now want to combine some items or to divide them into smaller units. If that is so, you can create your final working list below, ranked from highest to lowest in order of impact on your life.

Finally, you may also want to think about all the things you’ve attempted to do to “sort out” or “get rid of” or “fix” in some way these issues you’ve been struggling with. Let’s join the D-O-T-S on those! Our most common strategies for dealing with pain are:

D- Distraction: I (Steve) often try to distract myself from painful thoughts and feelings (eg Netflix, surfing the web, downloading music or books etc)? How about you?

O – Opting out: I (Steve) often opt out (quit, avoid, or withdraw from) people, places, activities, and situations when I don’t like the thoughts and feelings they bring up for me. How about you?

T -Thinking: I (Steve) have more often than not tried to think my way out of pain? (e.g. blaming others, worrying, rehashing the past, fantasizing, positive thinking, problem-solving, planning, self-criticism, ‘What if?’, ‘If only …’, ‘Why me?’, ‘Not fair!’, analyzing, trying to make sense of it, debating with myself, denial, beating myself up, etc.) How about you?

S – Substances, Self-harm, other Strategies: I have often tried putting substances into my body (including food and prescription medication) to replace the pain. These can become quite extreme in terms of self-harming activities (overeating/undereating is also a form of self-harm), as well as suicide attempts or reckless risk-taking. These are not the only way we try and avoid our pain. There are hundreds of strategies, e.g. excessive sleeping, or being on our phones (Twitter, Instagram, Bumble etc.)? Do you do this too?

Have any of these strategies helped? Many might have helped in the short term, and quite often they’re good things to do in and of themselves (going on a meditation retreat always makes me feel great), but what about the long-term? Perhaps this is part of your frustration. It’s certainly part of my frustration. Surely there has to be something out there to sort all this suffering out?!?

You can also do this exercise for what’s going on for you right at this moment by looking at this worksheet.

If we were working together, once you had created your Suffering Inventory, we would begin looking at each problem and thinking about the ways in which our interaction with that problem (on the whole) might, despite our best intentions, may only have made matters worse (so frustrating, isn’t it?).

Here’s a flavour of the way in which we’d dissect this together: Worksheet Link.

This would then give us a clearer understanding of the particular shape that human suffering has taken in your life, and we can start to think about what to do with all this pain.

THE PROBLEM WITH PAIN

Psychological pain hurts, by definition. But it does more than that. Often pain holds you back from living the kind of life you want to live. There is no question that a person with a panic disorder would rather not experience the feeling of extreme fear, because it is so unpleasant. But that discomfort is compounded by the fact that the panic seemingly gets in the way of living itself.

If you have a panic disorder, you may have begun feeling too afraid to engage in the activities you normally would because of your fear that you might panic. It may be that you no longer go to the supermarket because you are afraid you might have a panic attack there. Perhaps you are uncomfortable in social situations, because you don’t want anyone to see you panic. You cultivate friends with whom you feel safe, but then you are dependent on their schedules and availability. You start to live your life in ways to accommodate your problem, and, as a result, your life becomes narrower and narrower, less and less flexible.

It is worth noting how much of the pain we feel is a focus of attention because it seems to interfere with other activities. One way to get at this core issue is to imagine how your life would be different if your pain went away. Imagine that someone has waved a magic wand over you, and your pain has vanished. Imagine that you wake up one morning and suddenly, for no reason at all, the chronic depression you’ve suffered from all these years (or the anxiety, or worry, or whatever your core struggles may be) is gone. The cloud has lifted and the pain is over. What would you do? This question isn’t a rhetorical one, we mean it literally: What would you do? What would you want your life to be about? How has your current psychological struggle interfered with your goals and aspirations? Let’s explore that in the exercise below.

EXERCISE: The Pain is Gone, Now What?

Take an item from your suffering inventory. It could be any item, but it might be best to start with an item high on your list and connected to other items. This is probably an issue that greatly inhibits your life. Now go ahead and fill in your problem, but don’t fill in what you would do if it were gone.

If …weren’t such a problem for me, I would….

If I didn’t have … , I would….

Now, think about what you would do if that pain were suddenly lifted. The point of this exercise is not to think about what you might like to do on a given day if your problems weren’t plaguing you. The idea isn’t to celebrate by saying, “My depression is gone, I’m going to Disneyland!” The point is to think more broadly about how your life course would change if your constant struggle with emotional pain was no longer an issue. Don’t worry if you think that you don’t have a good grip on this yet. Just go with your gut instinct. Somewhere within yourself you have some idea about the things that really matter to you. Concentrate on those.

Here are three examples to give you an idea of what I mean:

If anger weren’t such a problem for me, I would have more intimate relationships.

If I didn’t have so much stress, I would work harder at my career, and I would try to find the job I always dreamed of having.

If I wasn’t so anxious, I would travel and participate more fully in life.

Now, go back and fill in the blank lines about what you would do if your pain disappeared. Be honest with yourself and think about what you really want. Think about what has value to you. Think about what gives your life meaning.

Now, let’s do that again but this time, let’s use a different area of suffering (although it certainly wouldn’t hurt to do this exercise with all of the items on your Suffering Inventory). This time, choose an item that appears to affect a different area of your life than the first one you chose. (Although after thinking about them you may find that they are not as different as they seem to be.)

If …weren’t such a problem for me, I would….

If I didn’t have … , I would….

THE PROBLEM WITH PAIN: REVISITED

You’ve just discovered that all of your problems provide you with two sources of pain. It is not just your anxiety or depression or worry that creates pain. Your pain is also holding you back from living the life you want to lead. There are activities you would be engaged in if it weren’t for your pain and the role it has played in your life.

The problem you wrote down in the exercises above refers to the pain of presence (issues that are present that you would prefer to go away). Social anxiety might be an example of the pain of presence. The anxiety you feel on social occasions is real and present in the moment you feel it. You may wish it would go away. Nonetheless, it persists in the face of your best efforts to defeat it. This is the pain of presence.

Those activities you would engage in if matters changed, represent a different kind of pain: they are called the pain of absence. As an example, consider the same socially phobic person above. Perhaps this person truly values engaging with other people but their fear keeps them from doing so in ways that are meaningful. The connection with others that is so yearned for is not there. This is the pain of absence. You have pain on top of pain, suffering on top of suffering. Not only must you deal with the immediate pain of your thoughts, feelings, and physical ailments, you also must deal with the pain caused by the fact that your pain prevents you from living the kind of life you want to live.

Now see if this next sentence is true for you: Generally, the more you live your life trying to ward off the pain of presence, the more pain you get, particularly in the form of the pain of absence.

Remember, I asked for honesty and openness about your own experience. Even if it doesn’t seem logical that this should be so, look and see if it isn’t true. While you’ve focused more on getting rid of the pain of presence, you’ve been feeling more of the pain of absence. If that’s what’s been happening for you, it may feel as though life is closing in around you. It may feel as though you’re in some kind of trap. If you’ve been experiencing those kinds of feelings, then a therapeutic modality like ACT is about finding a way out. There’s an alternative to living as though you’ve been trapped.

LIVING A VALUED LIFE: AN ALTERNATIVE

Often, we attach ourselves to our pain, and we start to judge our lives based on how we feel and not on what we do. In a way, we become our pain. The answers you’ve filled in as your responses to the four sentences in the two exercises above contain the seeds of another kind of life: a life in which what you do is connected not to your pain, or to the avoidance of your pain, but to the kind of life you truly want to live.

The therapeutic modalities I offer are not about solving your problems in a traditional way so much as it is about changing the direction of your life, so that your life is more about what you value. Moreover, the unnecessary amplification of pain stops. When that happens, the issues you’ve been struggling with will begin to diminish. Your life will begin to open up and become more wide-ranging, more flexible, and more meaningful.

These ways of thinking about our pain ask us to allow the possibility of living a life you value to be our guide. They aren’t asking us to go out and lead a different life right this minute. There is a lot of work to do first. None of this will be easy because the traps our minds set for us will continue to be laid.

In a therapeutic mode like Acceptance and Commitment Therapy (ACT) we’ll have a set of processes that do seem to empower the people who work with these processes to improve their lives and to dismantle troublesome traps and dead ends. Gradually, step by step, I can walk you through those processes in the service of living a vital, valued, meaningful life.

If you are willing, let’s talk more.