Why on Earth Would I Want to Accept My Pain?
Pain is inevitable; suffering is optional; and psychological flexibility might be the difference. Whether through our bumpy arrival into the world, our first pangs of hunger, or the cumulative aches and pains of a body well-lived, we will encounter physical pain. Of course, such pain can occur to varying degrees of intensity, frequency, and debilitation depending upon a myriad of factors, including one’s life circumstances and lifestyle behaviors. If your best friend is training to compete for the boxing heavyweight championship of the world, and you’ve generously offered to serve as a punching bag, well – you’ll likely experience more than most individuals. Special circumstances aside, after addressing any underlying biophysiological processes that may be perpetuating pain in our bodies (via fitness, ergonomics, nutrition, surgery, etc.), it’s our response to the stimulus of pain that appears to be a more significant determinant of our suffering.
Our minds are programmed to perceive pain as a threat when detected. If our earliest ancestors ignored the pain of a life-threatening injury or severe dehydration, they didn’t live very long; and thus, you and I wouldn’t exist. Instead, their attention would narrow onto the threat, and resources would be mobilized to eliminate the threat (e.g., treat wound, drink water) so that they could live to fight, flee or (insert other “f” word here) another day. This threat-mobilization system works quite well for acute conditions, though in the case of chronic pain, it can stay chronically activated, creating an amplifying loop: we perceive pain, view it as a problem to be solved, do what we can to solve it, and when we’re still left with (some) pain, we continue to view it as a threat, yet one that can’t be eliminated, which sets up a struggle within us. This psychological struggle (or inflexibility) can show up in the form of rumination (e.g., “why did…”, “should have…”), catastrophizing (creating worst-case future scenarios), or resistance (e.g., “wish I didn’t have…”). Yet, this intuitive desire to rid ourselves of pain bears paradoxical costs, namely increased pain intensity (Talaei-Khoei, et al. 2017) and lower quality of life (Feinstein, et al. 2011) - ugh! And, if we experience reinforcement for our pain (e.g., attention, affection, escape from responsibilities), we may end up identifying with it (e.g., “I am my pain”), which creates another self-amplifying loop of suffering.
So, where does that leave us – hopeless? Well, that’s not necessarily a bad place to start – at least with respect to the aforementioned cycles of suffering. Letting go of that agenda makes room for a new way of relating to our pain – one that is more accepting, compassionate, and effective over the long run. We can start with pausing to make contact with pain – in the moment – as it is - noticing its physical features with an attitude of receptive curiosity. When the mind (naturally) jumps in to judge, resist, ruminate or catastrophize, we can gently recognize that as a normal product of conditioning, albeit one that’s not very workable, and then reorient our attention to curiously exploring and bravely being with the pain. We can breathe into the sensation, creating space around it, which allows any nearby muscles to loosen their grip (you may have noticed how muscles surrounding an injury often tense up to protect it from further damage). Finally, we can practice holding (i.e., perceiving) our pain within a larger context – expanding our awareness to include the rest of our body, and then extending our sense of self into the valued domains of our life and into common humanity. For example, while gradually extending our conscious attention, we may say to ourselves, “There’s this pain, there’s the rest of my body, and there’s who/what is important to me in my life. This pain is simply one part of me, not the whole of me. There’s much more to me than that. And, I’m not alone in this pain; there are many others in the world experiencing pain right now.” This psychologically flexible way of responding can build our capacity to skillfully navigate pain, disrupt the amplifying loops of suffering, and free us up to focus our time and efforts on what matters most to us.
Talaei‐Khoei, M., Fischerauer, S. F., Lee, S. G., Ring, D., & Vranceanu, A. M. (2017). Pain catastrophizing mediates the effect of psychological inflexibility on pain intensity and upper extremity physical function in patients with upper extremity illness. Pain Practice, 17(1), 129-140.
Feinstein, A. B., Forman, E. M., Masuda, A., Cohen, L. L., Herbert, J. D., Moorthy, L. N., & Goldsmith, D. P. (2011). Pain intensity, psychological inflexibility, and acceptance of pain as predictors of functioning in adolescents with juvenile idiopathic arthritis: A preliminary investigation. Journal of clinical psychology in medical settings, 18(3), 291-298.
