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.

 

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