Pain is Inevitable.
As a Licensed Psychologist and therapist, I know all too well that life involves pain and still believe that suffering is optional. Whether a breakup, hurtful conversation with a family member, heartbreak, loneliness, a twisted ankle or yet another microaggression, shit happens. Life happens.
Pain is most commonly recognized in its physical form, whether a stinging burn from the stove, a migraine, or a chronic backache. But discomfort and hurt also show up in our emotions, and pain can include grief, loss, and social exclusion. We all know longing hurts. In fact, when we experience rejection, the very same brain pathways that react to physical injury light up. Social Pain Overlap Theory describes how physical wounds and emotional wounds set off the same alarms in the brain that tell us we’re in pain.
Although pain is inevitable, most of us were never taught the best ways to respond to it. That applies especially to emotional pain. Some folks grew up in households where, if we cried too long or too loudly, we faced anger, stoicism, or silencing. Encouraged to suppress our pain, we didn’t learn how to self-regulate, receive emotional support, or respond to our own feelings with compassion.
We were left to try to regulate ourselves.
Depending on gender and other identities, for some of us, socialization in our home meant focusing on the positive, earning worth through service, shrinking ourselves, hiding, masking, or putting everyone else’s needs ahead of our own. Later on, for all of us, tragedy, loss, rejection, and oppression don’t get easier–the issues just ripple outward. Our upbringings, intergenerational trauma, and the white supremacy myth itself often discourage us from mindfully approaching our pain. As a result, we often suffer more and we miss out on the support and healing we need.
At times we are downright encouraged to suppress our feelings. Emotional suppression can be brought about through personal, familial, religious, cultural, or social avenues. It can sound like this: IF YOU KEEP CRYING I’ll… It’s wrong to feel jealous. Don’t sit like that. Real men don’t… You disrespect your family by not being appreciative. Your lust is immoral. Your feelings for someone are sinful.
When we suppress or try to ignore our emotions, we are pitting ourselves against our pain. A growing body of research supports the idea that resisting our pain only generates more suffering on top of the original pain. It can be tempting to resist our emotions by numbing, trying to bring about an opposite emotion, pretending our feelings aren’t there, or wishing for our pain to go away. But when we resist our emotions, we actually make our feelings stronger and we bring about suffering in the process. Suppressing our emotions creates physical stress in the body. Emotion suppression is also linked to heart health and cancer mortality. Therapy is about learning to step outside the learned tendencies that may have once been our essential survival strategies.
As the wisdom goes, Pain x Resistance = Suffering.
This has particular implications for those who have been historically and systemically oppressed. These folks face the pain of marginalization in emotional and physical forms. Pain is a disproportionate burden of racial and ethnic minorities, yet these folks are more likely to be under-treated for their acute pain, cancer pain, and chronic pain compared with white folks.
The growing field of research on pain and resistance illuminates how pain gets compounded. It also offers the promise of therapeutic methods that can help minimize suffering through leaning into our emotions, seeking a compassionate audience, and developing an attitude of acceptance.
How can therapy help us better approach our pain?
As a psychologist who works with LGBTQ+ clients, Mixed race folks, and people of culture in need of help across the country, I know that coping with and managing pain isn’t easy to do, especially when we’re alone. Thankfully, therapy offers numerous opportunities, frameworks, and strategies for better coping with pain, moving beyond resistance, and reducing suffering. Let’s take a look at three therapy approaches that inform counseling at Panorama Therapy. I’ll share what these therapies have to say about how suffering is optional.
1. Suffering is Optional, using emotions as a guide: Emotion-focused therapy (EFT)
One of the main barriers to treating emotional pain is the resistance that often accompanies it. For instance, people who are prone to anxiety might have learned habits of emotional resistance early on in life. In the present, they might find it more difficult to learn proactive strategies for coping with their symptoms. In contrast, in counseling informed by emotion-focused therapy (EFT), clients are guided to use their emotions as valuable sources of information instead of terrible states to be resisted.
Emotion-focused therapy promotes a therapy space where your vulnerability can be met with warmth and welcoming. EFT is based on a foundation of relentless empathy, which helps clients become aware of their experience of pain while deconstructing unhelpful beliefs about the self and others.
Emotion-focused treatment for emotional pain takes place over three major phases. The first phase involves building emotional awareness while you get to know your therapist. Next, you’re guided to explore unhelpful emotional responses that might be promoting your suffering. The transformation phase involves exploring underlying or alternative emotions and reflecting on the root, core emotions to learn insights and create new meaning. If you’ve worked with me in therapy, you know I am all about this emotion-focused work.
Research shows that EFT also has solid applications for folks receiving gender-affirming care. In one case example shared in this recent article, a young transfeminine client was guided in EFT to access her emotions, move out of hopelessness, and deepen in her self-compassion and support while setting more boundaries in unhealthy relationships.
Essentially, the goal of EFT is to help people to reclaim rather than become desensitized to painful feelings and memories. We always have the opportunity to create or reclaim new beliefs about ourselves, our relationships, and the world. Emotion-focused therapy offers the chance to turn feeling your feelings into your superpower.
2. Suffering is optional if you accept your pain: Dialectical behavioral therapy (DBT)
The central goal of dialectical behavioral therapy is to encourage acceptance while helping develop ways to cope with pain, regulate emotions, and improve relationships with others. The premise of DBT is this “dialectic:” acceptance AND change. No way AND yes-huh.
Studies have found that the more accepting we are of ourselves, the more likely we are to be happy. This is because acceptance helps us buffer against reacting and exacerbating our negative mental experiences when something bad happens. Simply, if you can accept your painful emotions without criticizing or judging them, you’re less likely to be stressed. Makes sense, right? Over time, you’re less unhappy, you feel healthier, and you experience a higher quality of life.
DBT effectively targets structural and internalized stigma, as in studies with gender and sexual minorities. DBT does so by directly and explicitly addressing the impact of social- and self-invalidation. Depending on your specific experiences of stigma, varying applications of DBT can help, including mindfulness, emotion regulation, distress tolerance, and interpersonal skills. I’m like, win, win, win.
3. And it’s all better when you can get psychologically flexible: Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy combines mindfulness and self-acceptance to promote psychological flexibility. This is the ability to interact with painful content in a way that’s adaptable. The Association for Contextual Behavioral Science founded ACT (said like the word “act”) on the concept that suffering is a natural and inevitable condition for us all. Bleak, right?
On the contrary, ACT has the unique goal of helping clients build a rich and fulfilling life alongside the existence of pain and suffering. It’s more than possible for them to coexist. In fact, it’s the only way we can get through a life that, yes, can be hard! #2020 #theyearthatwontend
The ACT model proposes that it is the preoccupation with and struggle against our pain that hurts us (irritates the scab) the most, rather than the presence of pain alone. For example, in a study of how anxiety gets worse, researchers demonstrated the costs of fighting against anxiety. This fighting can mean avoiding meaningful activities and not pursuing one’s career or relationship ambitions. Fighting it isn’t the only way, though. In the study, ACT therapists were able to teach their clients new ways of being with anxiety, such as:
- Simply noticing and experiencing anxiety for what it is,
- Letting go of efforts to avoid experiencing anxiety, and
- Learning to re-engage in personally valued activities
- Even in the presence of unwanted anxiety. See this cute video about this ACT principle.
The result is that this focus on pursuing your values and changing your relationship to pain, from resistance to acceptance, has the paradoxical effect of reducing the discomfort and pain. If it sounds like magic, it kind of is.
These ACT interventions don’t just focus on symptom change. Rather, meta-analytic research has shown that symptom reduction is a by-product of re-engaging in life in meaningful ways and increasing acceptance of painful internal experiences. So embracing life and pain comes first and lessened pain comes later. Try it out. Ask us for help.
Suffering is Optional, Especially with Help & Connection
Pain is inevitable, but suffering is optional, as the saying goes. It can seem like the hardest thing in the world to lean in to your pain, but you don’t have to do it alone. With the help of therapy informed by these three frameworks, we can move into greater emotional awareness and acceptance together.
It’s important to note that to accept does not mean to give up or surrender. Rather, it means you no longer spend your energy resisting pain and bringing on additional emotional hardship. I hope this thought piece helped you find more understanding and acceptance of any pain you might be facing right now. These three therapies and more inform how we show up as affirming therapists for LGBTQ folks, BIPOC, multiracial and Mixed folks, and everyone in between. The strategies you learn in therapy will help to see you through your present challenges, soften resistance, and find peace.
Before you go, here’s a brief acceptance exercise for you to stick in your back pocket. Whenever you find yourself stuck in resistance, I invite you to come back to this exercise.
Go ahead, talk back.
What resonated with you here? What do you want to know more about? What’s a goal you might set for yourself around the pain you’re facing? Share your thoughts in the comments below.