Accepting “clean pain” and letting go of “dirty pain”

A few winters ago, I broke my toe when I rammed it into the corner of my couch. I knew I had injured it, but promptly went into denial. I ignored it for a few days, walking on it, exercising, jamming my feet into snow boots (gotta love Chicago winters), till the swelling and pain became so excruciating that I could hardly walk. I got it checked out and was given one of those open-toed orthopedic shoes to wear. Turned out, I had probably started off with a small fracture but made it worse by continuing to bear weight, jump, run, kick, etc.

I was PISSED. I would stew on how pissed I was as I hobbled down the street, furious and impatient with myself for taking twenty minutes to walk a mere two blocks. I griped about having to “waste” money on cabs and bus fare for distances I normally could walk. I cried with frustration about not getting to exercise or do yoga, and I felt SUPER antsy. I cursed my body for failing me and cursed myself for being such a klutz. I went back over the scene of crime dozens of times, each time agonizing over how I “should have” been more cautious, should be more coordinated, should be smarter. The thoughts in my brain made me feel like a total idiot for messing up the simple act of walking across a room. I have a tendency to be pretty harsh towards myself.  After all, in the scheme of things, it was just a few weeks of my life where I was inconvenienced while healing an injury.

Reflecting on that incident, I can see just how silly and irrational all of those nasty thoughts were at the time. But that didn’t stop my brain from giving me all of that BS.  If you’re a fellow human, you can probably relate to the feeling of RAGING against yourself when you make a mistake or get hurt. Maybe you can relate to raging against your body for experiencing pain at an “inconvenient” time. Have you ever been upset that you got sick right before a big event and had to miss it? Or run outside to catch the bus, only to see it pulling away, then started cursing everyone and everything for your bad luck? Or guilted yourself for getting upset at something that “isn’t a big deal?” We’ve all been there.

In Acceptance and Commitment Therapy (ACT), this is explained by the concepts of “Clean Pain” and “Dirty Pain.”  Clean pain is natural.  Pain is a part of being human.  We fall and scrape a knee, and it hurts. We get broken up with, and the rejection hurts. A pet or a loved one passes away, and it hurts. The fact that these experiences naturally create pain is not BAD or WRONG. It’s just an inevitable part of life. Clean pain is any pain that arises from the experiences we have as humans moving through the world.

So to recap: we experience pain, and there’s nothing we can do to change this fact. However, us humans like to be TOTALLY IN CONTROL of everything, everywhere, all of the time. So we get upset when pain happens because it reminds us that there are things we can’t control. We naturally fight against our pain, either by getting caught up in thoughts about how it’s NOT FAIR that we are dealing with pain, or looking for someone or something to blame for it happening. We get stuck in beliefs about how it is BAD or WRONG that the pain happened. We beat ourselves up for being human (e.g., when that bully in your brain starts saying stuff like “I’m so stupid! I’m such a failure. I’m never gonna get it right. I’m overreacting. Other people have it much worse than me. This is really not a big deal at all. It’s ridiculous that I’m upset by this”). Or we blame others for causing us pain, and we stew on feelings of resentment or even hatred (“How could he do this?  Who does she think she is? He only cares about himself. Why do they keep screwing me over? I hope he gets his heart broken”). We get sucked into feelings of anger, frustration, shame, impatience, sadness, and hopelessness. We look for ways to “solve” the pain, by numbing out through drinking or drugs, making efforts to control our bodies and minds through self-harm, restricting, binge-eating, purging, and exercising, ignoring or distorting reality, or trying to avoid any situation we think might cause us more pain. Does any of this sound familiar to you?

When pain happens, we try to comfort ourselves by looking for ways to prevent future pain. We try to regain that false sense of being “totally in control” of everything. Our brains don’t think we “should” experience pain, so we treat it as something “wrong” with us or consider ourselves “weak” (especially if the pain comes in the form of a difficult emotion that we were taught we should not have).  These responses to “clean pain” are examples of what’s called “dirty pain.” Dirty pain is any reaction to clean pain that we inadvertently create, like beating ourselves up mentally for being so clumsy, ignoring an injury and making it worse, or self-sabotaging in our next relationship out of fear of getting hurt again.

If you’re familiar with my whole philosophy on human experience, you know that I talk a lot about how we can’t control what thoughts or feelings arise in us.  So you might be wondering, “If we can’t control what we think about or how we feel, how can we ‘stop’ our unhelpful reactions to pain?” That’s a fair question, and a good point. We can’t stop the thoughts or feelings from popping up, but we CAN start seeing them for what they truly are: unhelpful reactions (often in the form of commentary from that “bully” voice inside our brains). That bully or inner critic has a field day every time something unwanted happens to us.

The key to dealing with those dirty pain reactions is to practice acceptance. Acceptance doesn’t mean you like, want, enjoy, or welcome something. After all, who WANTS to feel grief and sadness when they suffer a loss? Acceptance just means we are allowing something to be a part of our current reality.  It means we are willing to tolerate something uncomfortable, painful, or unpleasant for the sake of getting to be alive. Accepting clean pain helps us to disengage from the dirty pain, and as a result, the clean pain naturally feels a little less “painful.” It becomes a little less intense and overpowering. The key though is that you have to stop trying to make the clean pain go away in order for this to work, which can be tricky.

In numerous research studies, when folks with chronic pain learn to practice mindfulness and acceptance, they become more functional and they experience their pain as subjectively less distressing and less intense than it was before they accepted it. The SAME pain felt LESS painful because they changed their relationship to the pain. Cool, right? (Click here to check out a randomized controlled trial on ACT with pediatric pain, and click here or here for some correlational studies).

When I work with people on clean/ dirty pain, we talk about all of the ways they’ve tried to control or avoid certain internal experiences (thoughts, feelings, memories, sensations, or physiological pain) and how each strategy has worked for them.  Often, people realize that they’ve spent so much energy trying to make pain go away or trying to make sure they never experience a certain type of pain (like rejection or embarrassment) that it’s taken over their lives and has become a central focus. Learning to let go of efforts to control or prevent pain can be challenging (it means you have to FEEL the pain, which can be pretty intense or uncomfortable), but the trade-off is that you gain freedom. When you accept that “it is what it is,” you allow yourself to invest your energy into things that will actually have a payoff. It takes practice, but through mindfulness and acceptance, you learn to have a different type of relationship with pain.

That winter with my broken toe, what helped me let go of the “dirty pain” was gratitude. I realized how much I took for granted the fact that I had ten functional toes that supported me every day, and allowed me to balance and move my body with ease. I realized how lucky I was to only be inconvenienced for a couple of months, when plenty of people have injuries far more debilitating and permanent.  I tried to challenge my restlessness by finding moments of joy in stillness, and exploring other forms of meditation instead of my preferred physical activities.  I challenged thoughts from my inner bully that were urging me to ignore hunger cues or change my eating behaviors to “compensate” for being more sedentary than usual.  I listened to my body’s cues and forgave myself for being human. None of these responses were my natural, instinctive reactions, but I got there eventually.

Nobody is perfect, and even the most mindful and self-aware people will struggle at times to let go of their “dirty pain.” Be patient with yourself and with others.  Remember that I am always here to help you strengthen that mindfulness muscle and would be honored to join you in your journey towards acceptance.

Want to enjoy your life more? Think about death.

I recently saw an exhibit at the Field Museum called “Evolving Planet” that completely blew my mind. The display takes the visitor through four billion years of life on Earth, starting with single-celled organisms and moving all the way up through the evolution of every species till present-day humans. I knew from biology classes over the years that a ton of species have gone extinct over the course of Earth’s history, but it was still surreal to see it all laid out in a timeline (#nerdalert).

Every 50 meters or so, throughout the exhibit, a sign would indicate that at that point in the timeline, there was a “mass extinction,” where a bunch of species were killed off and only those most well-adapted survived to the next era. To refresh your memory if it’s been awhile since your last science class, that’s what happened when the dinosaurs were killed off—only the birds survived. Earth has had five mass extinctions in its history, and apparently we are on track for a sixth. (As a side note, did anyone else forget that birds were descendants of dinosaurs? Crazy, right? I definitely forgot that. Apologies to my fifth-grade teacher.)

Based on my rudimentary understanding of evolution, I realize that since humans have only been around since the most recent mass extinction, we aren’t destined for long-term greatness on this planet. It seems likely we will be killed off in the next mass extinction and/or we will evolve into some even more advanced species. So when you think about it, our lives are really not that big of a deal at all.

I walked out of that exhibit feeling surprisingly peaceful, thinking about how the years representing my birth till my death probably wouldn’t occupy more than a few millimeters of space on the timeline in that museum. As someone who is not naturally very “chill,” I was reminded that all of the time I’ve ever spent worrying, over-analyzing, and over-planning was a completely unnecessary use of energy, and I could let it go. My significant other walked out with the same awareness that his tiny human life is little more than a blip on the radar of this planet’s existence. But he didn’t share my sense of peace; in fact, he felt more anxious and a nagging sense of meaninglessness.

So why does the awareness of our inevitable mortality (which researchers call “mortality salience”) upset some of us, and relieve others? It depends on how you understand and define your life. It depends what you’ve been through, your spiritual beliefs, and perhaps where you see yourself on the timeline of your dreams, goals, and lifespan development. It also depends on how frequently you think about your mortality and how mindfully you live.

If you react like my partner, with panic, you’re in good company. After all, according to Terror Management Theory (developed in 1986 by Greenberg, Pyszczynski, & Solomon), all human behavior is motivated by the fear of our impending deaths. Often, human awareness of our unavoidable demise “generates a state of anxiety that triggers a defense mechanism for the control of thinking” (according to Gordillo & colleagues).

In several recent studies published in the European Journal of Psychology, researchers have explored whether people evaluated an individual’s personality differently or felt more positively or negatively about a person based on whether the person was dead or alive. It turns out that we think more highly of people when they’re dead. We are more positive in our appraisals of a person when they are dead, and rate our impressions of them more favorably even when we didn’t like them very much while they were alive.

This gets me thinking about how it’s socially taboo to “speak ill of the dead.” We can see from heartfelt eulogies that we often focus on a person’s positive qualities quite easily (and forgive their negative ones) once they’re dead. But wouldn’t it be nice if we could harness that same perspective while we (and the people around us) are still alive?

All of this comes right back to the freedom and peace I felt walking out of the Field Museum that day. While it may be a tough sell to some people, I believe it can be profoundly beneficial to think about death. It can take awhile to develop the willingness to sit with that fear and not let it drive the bus (and this is where mindfulness skills come in handy). Despite the discomfort that may arise, though, thinking of death can actually enhance your overall satisfaction with life and enrich your feelings towards loved ones, friends, enemies, and even strangers.

Personally, here’s how I’ve found it helpful:

~Remembering that I will die one day reminds me that there’s no need to strive for perfection. In the grand scheme of things, the way you look, your grades, your salary, and your accolades will literally mean nothing. Isn’t that great? There’s no pressure to do everything “right” all of the time! Given this information, the only reason to strive for an accomplishment or work hard to pursue a goal is out of genuine care for that thing. You don’t have to work hard for stuff that’s on someone else’s agenda (including any culturally-prescribed expectations that don’t resonate for you). This is why it helps to get clear about what matters to you in life, so that you can focus on those values and priorities.

~Remembering that everyone around us will also die one day reminds us that there’s no point in holding grudges or harboring resentment. After all, the person you’re pissed at has an expiration date, too. This applies to all living creatures. I feel boundless love and gratitude for my dog when I remember that one day, he will no longer be with me. I find it much easier to forgive him when he snaps food off my plate or destroys the sofa. I’ve heard from people who have young children that thinking about their limited time on this planet helps soften towards them for throwing a temper tantrum or breaking a mug. Mortality salience can also make it easier to get over the guy who cuts you off in traffic or the rude grocery store clerk.

~Similarly, recognizing loved ones’ mortality helps us to forgive them for honest mistakes, accept their flaws, and deepen our appreciation for our relationships. It makes confronting them when we are hurt a little less scary. It becomes more worthwhile to work through conflicts so that we can make the most of our time together and spend it loving and enjoying one another. It also makes it easier to let go of a relationship when it becomes clear that it isn’t serving you to keep investing, since as the cliché goes, “life is too short” to waste on that BS.

~Since the only thing that’s certain in this life is that we will die one day, we can accept that most of what happens in the universe is completely out of our control. This can be freeing. We are literally only responsible for our own individual actions, and therefore might as well invest what little time we have on this planet to making our actions meaningful and worthwhile.

Way back in the day, the Stoics believed that maintaining awareness of mortality was important and allowed them to experience more gratitude. Recent research has shown these positive effects in modern times, too. When people are reminded of mortality, either consciously (by being asked to think about death) or unconsciously (like walking past a cemetery), they behave more kindly and compassionately towards others and make positive changes in their lives. Their actions are more authentic and more in alignment with their personal values and priorities. When something is time-limited, it becomes more valuable. And when it’s more valuable, we appreciate it more and we focus more on making it worthwhile.

I’m not saying it’s always fun to be aware of your own or others’ expiration dates. Like anything, accepting our inevitable demise can involve a curly, non-linear grieving process. It can mean going through those classic “stages of grief,” sometimes living in a state of denial about it, and other times feeling angry, depressed, or trying to “bargain” away mortality (many wellness companies capitalize on our death anxiety by promising long lives if we use their product or take their supplement). And don’t even get me started on our cultural emphasis on “youth” and “anti-aging,” which could be an entirely separate blog post. Essentially, we find it tempting to ignore, dismiss, or fight against the fact that we all inevitably age and expire.

However, if we can resist the pull to drown in panic or anguish over our lack of importance, and resist going down the rabbit hole of “why even bother trying if none of it matters?” we can use this awareness to deepen our appreciation for life and shift our focus to the things that truly matter to each of us.

Do you agree, disagree, feel ambivalent, or feel totally indifferent? Does all of this “death talk” bring up fear, gratitude, mixed emotions? Whatever your reactions, I’d love to hear from you!

Get REAL This Thanksgiving

Warning: this post may seem harsh. “Thanksgiving” is a sly and misleading name for the part of American history it commemorates. It has a dark side, but it’s so hidden by turkey and stuffing and family drama and football that most of us can easily forget it’s even there. With Thanksgiving, Americans have created a holiday that connotes all things wonderful, gratitude and family and patriotism and perseverance, but Thanksgiving is also a holiday commemorating our exploitation of the land, resources, and people who were here before us. As explorers, intruders, colonizers, Americans came to a land that was already populated, and made up and imposed rules on this country. The people and culture who were exploited continue to experience oppression and marginalization to this day. Like anything with a dark side, we came up with reasons for why this was necessary, even helpful, rather than recognizing such oppression. Celebrating Thanksgiving as purely positive, without mentioning the genocide that ensued, is a whole lot of ignorance and denial.

Go ahead, call me cynical or a downer. React however you’re going to react. At the end of the day, I’m giving voice to something real.

Confession time: I did not know anyone who identified as Native American while I was growing up. I generally consider myself to be a pretty flexible, open-minded, accepting person, and I appreciate diversity in all aspects of the word. But as I’ve mentioned before, I started this blog as a challenge to myself to practice what I preach. To uncover blind spots and biases, to bring them into awareness, and to move through them in the most honest ways that I could. So while I am embarrassed to say this, I’ll put it out there and deal with my consequences: I used to love Pocahantas. Okay, I said it. I even dressed as her for Halloween once. I have lived in multiple cities with sports team mascots derived from Native American symbols and that portray Native peoples (think Redskins, Blackhawks, Braves, Chiefs) in completely racist and dehumanizing ways, and I often did not notice.

When I was 26, I moved to Minneapolis for a year to complete my pre-doctoral training at a chemical dependency treatment center. Minnesota has a much larger Native community than anywhere else I’d ever lived, and I began working with colleagues and clients who were Native. If I’m being honest (which, let’s face it, I’ve kind of signed myself up for Honesty Boot Camp here, being both a writer and a psychologist) it was almost as if Native Americans weren’t real to me until I met people who were Native American. The ignorance I had muddled through for much of my life began to dissipate as the Native American story slowly became more real and alive to me. I struggled with feelings of sadness, shame, and the residual “white guilt.”

Oftentimes, when we (humans) realize we were racist, ignorant, or naive in some way, we feel such overwhelming shame that we get defensive. We react to those uncomfortable feelings by denying that we were ever so off-base, or making up excuses for why we had a right to do what we did and think what we thought. I’d be full of shit if I didn’t admit that I was tempted to do that, too. The thing is, once you learn something, it really does more harm to un-learn it than to incorporate it into awareness. I have developed more empathy related to what Native American people have experienced. Recognizing that I had this unconscious bias, working through my initial guilt and defensiveness, and then allowing myself to become a more respectful and compassionate person has been uncomfortable, but guess what? It’s been fine. I didn’t spontaneously combust. I know I’m not going to rewrite history, so denying it is pretty useless. The systematically-induced shaming and ignoring of Native Americans in this country has been happening for centuries and it blows my mind that before I went to Minnesota, I was never exposed to it. It was glossed over in my textbooks.  All that I can do today is give the history some validation here.

While I understand how offensive and insensitive it is to dress in costumes of another culture for amusement, or to turn other human beings into mascots, I also know that it’s unproductive for me to get stuck feeling shameful, guilty, and pissed off at myself for being so ignorant. I truly did not know any better, and now I do, and so I’m choosing to change my attitudes. Simple… but not easy.

We all can relate to and connect with others, however different we may appear on the surface, and I think we need to get better at recognizing that. I was ignorant, and in many ways, I still am ignorant and don’t even know it (which is kind of the definition of “ignorance,” right? It’s not conscious). When I realized that I had been unwittingly, blindly, albeit innocently following traditions and practices that dehumanized Native American people, I felt horrible. I also realized that I have a choice, and I choose to own up to it, apologize for it, and become a more accepting and compassionate person.

Confession, Part 2: despite my awareness, I still celebrate Thanksgiving. I think there are many wonderful things about Thanksgiving, as it can be a lovely opportunity to connect with loved ones and enjoy a meal together. As a big fan of mindfulness, I also really like the idea of taking some time to be thankful, to intentionally recognize what we appreciate in life. However, it’s necessary to paint the whole picture for ourselves. We can make space for both the dark and light sides of history.

I encourage you to take a look inward, and recognize whether you, too, have been unwittingly, innocently following along with views that are unbalanced or ignorant of other human beings. Try to resist the urge to disown your experiences and instead, let yourself feel uncomfortable for a minute. Nobody is built completely bias-less, but everybody seems to want everybody else to think we are. Let’s get real.

I believe that through continuing to be vulnerable at different levels, we can learn to strike a balance between accepting ourselves, accepting others, and feeling accepted by others. This Thanksgiving, and every day, I think we owe it to ourselves as human beings to let ourselves get called out on our biases, and instead of reacting with defensiveness and denial, instead of trivializing or sinking into shame, respond with clarity and acceptance.

I wish everyone a safe, healthy, and meaningful holiday.