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.

The “Inner Detective” inside of each woman

The other morning, I decided to cut through a nearby park on my way home from a workout. As I was strolling along, a man approached, clearly staring me up and down. When we crossed paths, he said to me, “You’ve got the face of an angel!” I smiled politely and he continued on, “Do you know that you’ve been kissed by God?” I responded with another smile and kept walking. I felt myself exhale as I saw that he continued walking in the opposite direction. It wasn’t until the interaction ended that I even realized that my subconscious had been hard at work for the duration of the 15-second exchange, evaluating threats and calculating the most “appropriate” ways to react. I took in his appearance, body language, tone of voice, and physical size.  There was an automatic analysis of his likely intention (to hit on me? to be friendly? to give me his input on my identity as an angel?) and my wisest response (to laugh? to nod? to ignore him?) and never once did I consider what I felt like doing because the focus was on keeping him non-threatening and getting on with my day.

Someone recently shared with me a piece in the Huffington Post by Gretchen Kelly, titled “The Thing All Women Do That You Don’t Know About.” She points out the various ways that women de-escalate and shrink our everyday experiences to avoid confrontation. As soon as I read it, I felt validated and shared it with several of my female friends, colleagues, and clients. It resonated with each of them. I realize as I write this that I conveniently “didn’t think about” sending it to any men. Perhaps on some level, I assumed they wouldn’t be interested, or wouldn’t find it as powerful as I did (which would feel invalidating and make me question whether my reaction was “right”). As social creatures, we naturally look to others for external validation, and when we don’t get it, we naturally question whether our perceptions were accurate. That’s why groupthink is a thing. We like to “belong,” to feel like people agree with us and believe that what we bring to the table is important.  So I guess I played it safe by sharing the article with people I could count on for validation– fellow women.

I share Kelly’s worries when it comes to discussing women’s issues. I worry that I’ll be accused of exaggerating or overreacting, or being “sensitive.” In another part of my brain, though, there’s a voice that says “It doesn’t matter. I’m a person, and dammit, all human experience is valid!” It’s a newer voice, probably fueled by my training as a psychologist, but I sure am grateful it chimed in. The fact that this voice is not the most familiar message my brain gives me tells me that as human beings, we need to talk about what’s happening, so that we can stop invalidating each other and start connecting more authentically.

As a woman, I’ve been programmed to do the type of split-second assessment I did at the park the other morning everywhere. It’s something that happens as automatically as blinking. Nobody ever sat me down and taught me to dissect the environmental, social, physical, and emotional elements of my daily interactions with men, but I still learned how to do it. I learned the necessity of de-escalating, as Kelly calls it, to keep myself functioning in the world.

I know that regardless of gender, anyone can commit or become a victim of sexual assault and other forms of violating interpersonal behavior. I also know from experience that when we feel attacked or accused of something that feels “icky,” we become defensive. You could ask me about the race of the man who approached me in the park, and argue that had something to do with my fear. I can already feel my defenses gearing up to “prove” that my fear response was not based on the man’s race, because “Oh my gosh, what if I seem racist?” You could tell me I should have been flattered by his compliment, and I feel myself start to question down another self-doubting road, “Oh my gosh, what if I’m overreacting to something harmless and he was just being friendly?” Those reactions are there because there’s some truth underneath.

Here’s the thing, though. As I mentioned in my post last Thanksgiving, I know that I have biases. I make implicit associations based on race, gender, age, appearance. We all do.  We can’t possibly know about all of them, but when we discover them, we can try our best to acknowledge and own them instead of denying them. It’s an uncomfortable process that nobody is ever truly “done” figuring out. But here’s the other thing. I don’t think it helps anyone to pin this womanly “detective work” on racial or any other type of bias. I have had this feeling in response to looks, gestures, and comments from a diverse range of men. Maybe race plays a role, maybe age plays a role, maybe my mood that day plays a role in how I perceive someone… but these are not even close to being the only factors at play. I learned to assess and respond to men to keep myself safe, to prevent a scoff and a muttering of “bitch” under a stranger’s breath, to avoid angering or provoking.

I’ve worked with many clients who struggle to heal from trauma. What I find hardest about treating people who have been abused, assaulted, and raped is that there is this larger-scale minimizing that works against them. We can sit together and validate like there’s no tomorrow, but it often feels like just a drop in the bucket. We still live in a world where de-escalation is the norm. At the society level, we are denying, distorting, and invalidating people’s experiences. I get it; this type of stuff isn’t exactly fun to acknowledge. It’s much easier to say to someone (or to yourself) that “he was just joking around” than to say to someone (or to yourself) that what he just said was inappropriate. It’s much easier to blame the recipient of unwanted advancements (“if you don’t want to get hit on, don’t dress in a tight shirt”) than to turn inward and acknowledge that we said or did something that made someone uncomfortable. Plus, these exchanges often happen so automatically that it isn’t always possible to recognize them before they’re over.

Peel back one more layer of the onion and it’s clear that many of us choose not to bother speaking up, often until things “cross the line” and get dangerous. The shaming/ blaming/ dismissing responses that tend to come from calling out inappropriate and intrusive behavior makes it easier sometimes to just shame/ blame/ dismiss it within ourselves before even acknowledging that something bothered us. We’ve done it a billion times. It often ends up being seen as “overreacting” if we say that someone’s behavior felt scary, creepy, or hurtful. And who wants to be labeled as “dramatic” or “blowing things out of proportion” or “playing the victim?”

Here’s my challenge to all of us: speak up, let yourself speak up, and let others speak up without dismissing.  If you’re a woman, admit that something didn’t feel okay to you and let yourself get pissed off. Teach your children that their experiences are always valid, and that if something feels threatening, they aren’t overreacting. If you’re a man, let yourself consider that what I’m saying might be accurate. Notice if you become defensive and think, “it’s not fair to blame us for your reactions,” or, “I’m a nice guy/ social worker/ philanthropist/ feminist/ mensch, don’t try to make me feel guilty about this stuff,” or “men can be victimized, too.” Then, see if you can get to something else, below your automatic reaction. I’m not saying men can’t be victimized, and I’m not saying all men have done this type of thing. I’m just asking for everyone to listen and take it seriously.

I’m not pointing fingers at anyone; this isn’t about casting certain people as villains based on their gender or any other demographics. It’s about getting one another to start listening openly and without defenses. Asking yourself if you’ve invalidated someone is not an easy thing to do. I hate having to admit when I have minimized someone else’s experience, because I feel guilty and ashamed, but I also know it’s the only way to change things. And I know from the number of people I see, day in and day out, who bravely share the pain of their experiences, that we need to make this change.

New Year, Same Fear (Part 1)

It’s 2016! When did this even happen? Time seems to pass at weird rates.

How often have you asked someone about their day at work, and they replied, “Ugh, it was so LONG” or have you been asked about a trip and you responded, “it went by so FAST”?   The passing of time can feel excruciatingly slow or dizzyingly fast, depending on a million other internal and external factors.

Not to go all Literal Lucy here, but time actually moves at the same rate, no matter what. A minute is always sixty seconds. The reality is that this is 100% our perception and experience of time.

If we can recognize that the passing of time is only quickened or slowed down by our perceptions of it, we become better equipped for living fully in each moment. Time doesn’t have to be this slippery, elusive element that never seems to do what we want it to; time simply passes, and we can watch it, ignore it, lament what could have been, anticipate what is to come, or, trickiest of all, simply live in it.

What makes us wish time slowed down (or stopped) during the joyful moments is the same thing that makes us wish it sped up when our day feels sucky. It’s the phenomenon referred to in Acceptance and Commitment Therapy (ACT) as experiential avoidance or control, which is the attempt to control or alter the form, frequency, or situational sensitivity of internal experiences, such as thoughts, feelings, sensations, or memories, even when doing so causes us behavioral harm (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996).

Okay, I’ll chill on the psych jargon and give it to you straight. Basically, we use all kinds of conscious and unconscious strategies to try to avoid, suppress, or ignore the things that we don’t enjoy (the long line at the supermarket, the obnoxious sound your partner makes when he chews his cereal, the throbbing pain of a sinus headache, the painful memories of a traumatic experience, the feeling of grief when we lose a loved one, the feeling of rejection when we get dumped). When we perceive something as crappy, we want to make it STOP or GO AWAY. On the other hand, we do the opposite and try to cling to, prolong, or drag out the things that give us pleasure (vacations, eating cake, having an orgasm, getting a good night’s sleep, feeling important or special when we get a promotion at work, feeling loved when our children climb into our laps with a book).

For example, try to recall a time you have felt a positive feeling (such as pleasure or delight) and an experience that went along with it. For me, an easy example is when I’m eating a delicious ice cream sundae on a hot summer afternoon. With my first decadent bite, I can count on a slew of enjoyable feelings and internal experiences to pop up. I’ll think the thought, “this is delicious!” accompanied by my mouth watering when I taste the refreshing sensation of cold, creamy sweetness. Then… the moment I have these enjoyable experiences, my body and brain automatically go into experiential control efforts. No more than a few bites in, I may start to think, “I wish this bowl was bigger.” I start trying to eat very slowly and make it last longer, or I think about what else I can get to satisfy my insatiable sweet tooth after I finish. Sometimes I feel guilty over my indulgence, or I feel annoyed that it’s melting faster than I want to eat it. All at once, my experience of pleasure becomes tainted by my own reactions, my “control agenda” and the effort to hold onto ice-cream-induced pleasure forever and ever.

The same goes for avoidance efforts. Addiction often develops because of experiential avoidance. For example, a 35-year-old man feels self-conscious when socializing in groups, but he works in an office culture where the expectation is to attend work-related social functions. He finds that after a few drinks, his nerves are calmed and his anxiety is dulled. He starts to rely on this strategy more and more, to take the edge off. Over time, this behavior gets reinforced. He learns that when he drinks, the unpleasant feelings go away. His body builds tolerance to alcohol, and he must drink more and more to get the same effects. When he sobers up, he feels guilty and ashamed, on top of the anxiety he already was feeling. He starts drinking before work in the mornings, trying to prevent the unpleasant feelings before they overwhelm him. It’s easy to see how the man’s efforts to control his feelings lead to his feelings controlling him, as his daily life becomes focused on “not feeling anxious.”

As Brene Brown mentions in her popular Ted Talk, The Power of Vulnerability, we cannot selectively numb. We can’t choose to not feel anxiety ever, because anxiety is part of life. On a related note, we cannot selectively cling. We can’t choose to only feel joy all the time. Knowing this, it’s futile to tell someone (or to tell yourself) to “just stop thinking about it” or “perk up!” If you’ve ever been on the receiving end of these well-intentioned pieces of advice, you know how unhelpful they can feel. We don’t get to choose WHAT our thoughts, feelings, and internal experiences are. What we can choose is HOW WE RELATE to those experiences. We have a choice in how much attention we give to the thoughts, emotions, memories, and sensations that we experience, and how much we allow them to dictate our behaviors and control our daily lives.

Next time you feel like time is slipping through your fingers, or find yourself impatiently watching the clock, see if you can turn inward and tune into what else you’re feeling, not just what’s driving a sense of urgency.  And then, see if you can let go of the urgency and connect to the experience itself.  If you’re not sure how to do this, you’re not alone. It’s much easier said than done.

Stay tuned for a sequel to this post in the next few days, and as always, feel free to contact me for help or support.

 

Wishing everyone a warm and healthy new year!