As a mental health psychotherapist, I encounter pain all the time. Physical and emotional, psychic and existential, people come to therapy because they are in pain. Because I am not a medical doctor and have no particular skill in addressing actual bodily pain issues, I am left to address pain of all sorts therapeutically. Fortunately, there are many approaches to take, and some experts to guide the way.

Tara Brach wrote a book ages ago (2004) that was my first official introduction to acceptance as a way to think about pain. In Radical Acceptance: Embracing Your Life With the Heart of a Buddha, she provides many guided meditations that are extremely beneficial. You can also listen on her website. But we’re getting ahead of ourselves; first, we must consider pain from a new perspective that might seem counterintuitive at first.

Most folks are inclined, at least initially, to consider pain as a bodily experience based on actual illness or injury. In the Life School podcast, Brooke Castillo discusses how to view pain as an interpretation we make rather than a literal body dysfunction. When I first heard this, I was thrilled to have such a concise and accessible reference for clients to get a basic understanding of the brain based happenings when they are injured, physically or emotionally.

It is helpful to understand a wee bit of the brain here. The anterior cingulate cortex is the part of the brain that connects the emotional (limbic) system to the cognitive (prefrontal cortex) system. This is where thinking and feeling come together! So, if we can understand how the two interact, it is easier to understand how pain could be an experience determined by thinking as well as feeling. This is also not an area of expertise for me (see above re: my non-doctor status), however, I understand just enough to know this is important stuff! While not a brain expert, I do understand how thoughts and feelings work quite well. Being able to observe both, with curiosity and objectivity, is of considerable import.

Observing your thoughts when it comes to pain is a game changer. Get to know what judgments and assumptions you make without even realizing. Often people are telling themselves that “this pain is awful,” “it won’t ever go away, I”ll feel like this forever,” or, “I can’t handle this.” All of these messages create a version of that painful reality on top of whatever pain is there initially. You are compounding your own discomfort. The way out is through acceptance.  

In the linked podcast, Castillo reflects on how to change the experience of pain by changing how we think about it. Specifically, she recommends addressing how we talk about pain to our Self. Make non-judgmental statements about the current situation: I feel pain in my foot, there is something uncomfortable in my shoulder, or my back is tight or achy. These phrases are much less charged than the earlier list where an atmosphere of hopelessness and suffering are being instilled and reinforced.

While physical pain is made worse by how we are thinking, emotional pain is actually created by thoughts. The meaning and interpretation we give to experiences that are painful are often at the root of suffering. Of course, I am not suggesting that emotional pain is entirely avoidable, nor should that even be a goal. Rather, I encourage people to explore how they are framing the experiences in life that cause the emotional distress. If you experience a breakup, do you believe yourself to be unloveable? That will cause significant more upset than if you believe that person was not a great match after all. Is your conclusion after a bad grade that you are a failure rather than you perhaps needed to study more or get direct guidance from the instructor? You will suffer more in life if so.

If pain can be accepted, it allows a rethinking that enables us to actually feel less pain. Easier said than done, right? Maybe not entirely… Regular use of thought challenging, as described above, helps to shift the automatic thoughts that make pain worse. Practice acceptance by sitting with open and upturned hands as a signal that you are ready and willing to accept whatever reality is current. Know that acceptance is not the same as approval or complacency; it is not an invitation to lay in bed and resign yourself to never feeling better. Explore Tara Brach’s work and website, along with any guided meditations you can find on YouTube, Insight Timer, or Headspace. These are all good resources for meditations on specific topics. (LINKS)

When reality is not accepted, we are led directly to suffering. If you cannot solve your problem, change how you feel, or radically accept, the default other choice is to stay miserable. Some pain cannot be entirely bypassed: breakups suck, death is painful, cruelty is the worst. This is all part of the human experience. If we block it, though, and say to ourselves that we can’t handle it, it’s too much and I won’t accept it, then we are opting in to suffer. Refusal of reality creates more pain. Carl Rogers (20th century humanistic psychologist) said, “The curious paradox is that when I accept myself just as I am, then I can change.” How do you practice acceptance or otherwise manage your pain?

Leave a Reply