When Suffering Arrives

Perhaps it was providential that I met with so many of my clients who have chronic health illnesses this week when I was formulating this article. This has become a bit of a sub-specialty of mine, in part because having a trauma specialty means that your client group experiences more chronic health problems than the general population. It's also been a part of my own therapeutic work because of a couple of (now) well managed chronic health conditions which still pop up every so often.

I start with these observations because today's topic is quite difficult, particularly if you are currently in a period of suffering. It might be your own health issue, the death of a loved one, or the unwanted end of a relationship. And writings such as this can be experienced as somewhere between ineffective, shaming, or plain mean by those who are in the suffering right now.

All too often people want the person who is suffering to just feel better, and a host of well-intentioned but tone-deaf comments can come with that. I cannot promise this won't feel like more of the same, but I can say that this is coming from a place of some experience.

I Don't Want to Feel This Way

Suffering “arrives” whether we want it to or not.

Particularly for those who are in a season of suffering, the return of an illness or the next problem to arise can ignite a storm of emotion along with it. There can also be panic, including the rush of the spine-numbing adrenaline of a panic attack. Then the thoughts may start to swirl as you try to reason your way out of it or head into problem-solving mode. For some, you may be on your way to a favorite numbing strategy before you even realize what you're doing.

If either the swirling thoughts or the numbing speaks to you, I invite you to try something in this moment. Place one of your hands on your chest. Take a deep breath in, and then out. And then tell yourself, "Of course I do that. I'm trying my best to manage the pain."

Really sit there and see if you can feel a sense of compassion for yourself. It may be a deeply unfamiliar feeling or it may feel wrong to do. There is always room for growth and change, but the effective starting point for change is compassion, not condemnation. We do many maladaptive things as a species to get ourselves out of suffering, but I have yet to see shaming someone for their coping as an effective way of helping a person do better.

Experiential Acceptance

In ACT terms, the stance we're looking for is experiential acceptance. "Experiential" refers to anything we are feeling internally, including emotions, bodily sensations, urges, desires, memories, and thoughts. Note, it's not acceptance of external circumstances - that's a different skill for a later time. It's a willingness to listen to what we are hearing from inside ourselves, whatever reaction we are having.

That willingness is the acceptance. "Acceptance" doesn't say "I like this" or "I'm going to give up and just put up with this." Acceptance says "I won't waste energy fighting myself or reality. It says "I am ready to hold this with curiosity and openness."

But to talk about holding suffering with openness and curiosity is generally enough to make people run for the exits.

Experiencing Doesn't Mean Ignoring Your Needs

The good news is that we're not called to suffer needlessly. This is a little more tricky with psychological things, so I'll start with a physical example. Let's say you have a headache. Having a headache is not pleasant. Doing something to get rid of the headache is a perfectly reasonable response.

But it might be important to look at the experience (the headache) with a momentary sense of curiosity. Perhaps it is useful information about how much you drank the night before. Or about the quality of a relationship in your life. It could just be the weather (or hello fall allergies!) The point is that it is useful to take a moment to observe and acknowledge what we experience as a potential important communication from ourselves to ourselves.

The same it true with feelings, urges, desires, memories, and thoughts. There are often important reasons these experiences occur. The urge to eat a whole cake probably isn't one to follow through on, but might it tell you something about hunger or boredom or loneliness which should be addressed?

Experiencing is Different than Getting Entangled

Taking time to sit with internal experiences in a healthy way is also different than getting swept away by them. With thoughts, we used the term cognitive fusion to describe paying too much attention to those. A similar process can happen if we dwell on feelings, memories, urges, or desires - engaging them in an unhealthy way or to an unhelpful degree.

Take anger as an example. You might notice your heart racing or brow furrowing. You might notice your jaw clench and your body start to tense. Anger can be unpleasant to feel, but other times we might want to hang onto anger. It can feel empowering. It might help us justify our decisions or keep us feeling superior. It might help drive action - maybe standing up for oneself...or slashing someone's tires.

Note how in this example we moved from the experience of an emotion down a trail of additional feelings, as well as thoughts and actions? The "behavior" moved from noticing the internal experience to other things which could be useful or helpful or not. There was a line between noticing the initial feelings and choosing a next step - be it feeling or thinking or doing - where more got added to the experience.

Experiencing is Being in the Present Moment

For now, we're not going to focus on the right or wrong or good or bad of any of those additional things. (Although let's agree that car-tire-slashing is a 'no'?)

Where I want to focus us is staying with the initial experiences of the emotion, and only the experiences of the emotion. Neither seeking to push away or dive more into. Just allowing the experience to be as it is. This is very difficult for most people. And the more strongly you feel your feelings, the more likely you are to engage with them by moving from feeling to thinking or feeling to action or feeling to feeling something different.

If this is working for you, by all means keep doing what you're doing. If you aren't sure whether it's working, I would encourage you to keep experimenting with the skill of noting. If you're not sure what it would look like if your way of engaging with your emotions wasn't working, you might consider the following:

1. Do you notice anxiety or unease at times and you're not sure why?

2. Is it hard to sit still when there's nothing for you to work on?

3. Is it uncomfortable to have down time or time off?

4. Do you find yourself binge eating?

5. Do you often spend too much time scrolling on your phone?

6. Do you like how quiet your mind gets when you drink?

7. Do you find yourself getting frustrated or snapping at people and you're not sure why?

8. Do you feel like you don't feel a lot of emotions - including good ones?

9. Is it hard for you to label the emotion you're feeling?

10. Is it hard for you to say 'no' to doing something or do you prefer to be busy?

11. Do you answer the question "how are you" with "fine" or "okay" even when the person is really asking about how you're doing?

12. Do you respond to conflict with people by going away by yourself till it blows over?

13. Does it make you uncomfortable to not be able to fix a conflict right away?

If any of these apply to you, consider taking time each night this week to check in with yourself. Look at the post on noting, and try a little mental review each night. There is a chance it might not feel comfortable, so give yourself compassion and patience as you try. And we'll get deeper into the skills next week.