As I sit writing this, I am in a moderate amount of pain. Like millions of people around the world, I suffer from chronic musculoskeletal (back and hip) problems, so most days come with either a small or large dose of pain, depending on how well I am looking after myself, how stressed I am, how much sitting I do that day, plus various other factors.
Having been in some degree of daily pain for almost two years now, I have learned a few things about the relationship between physical pain and mental suffering:
- It’s important to distinguish between ‘primary’ and ‘secondary’ pain. I learned this from Vidyamala Burch, founder of the excellent Breathworks. This organisation provides the Mindfulness-based Pain Management programme, which has a strong research base behind it and helps many people in the UK deal with chronic pain and illness.
- Burch also co-wrote Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing with Danny Penman. In this superb book the authors explain that primary pain is the actual raw data caused by, say, a gash in your leg. Intriguingly, the majority of the pain you end up experiencing is secondary – the pain created by your brain as it amplifies that raw data, depending on the way you think about and respond to your primary pain.
- This only became clear to me recently, when I visited my osteopath, feeling down and hopeless about resolving my problems. He reminded me that the pain was significantly better now than when I first came to see him; and that it was crucial to remain as positive as possible, because my negative thoughts (‘I will never get over this’; ‘Nothing will help’; ‘I can’t stand the pain any more’) were undoubtedly making the pain worse (this is essentially what the Buddha taught – that human life inevitably involves pain, but we create suffering by our response to that pain. But that’s a topic for another day).
Managing the pain
I think it’s important to note here just how hard it is to maintain a positive, optimistic mood in the face of chronic pain or illness. As anyone with a long-term condition knows, it grinds you down, especially when it flares up or your symptoms get worse for whatever reason. Please don’t think I underestimate the impact of physical ailments on your mood – it is a struggle and gets everyone down from time to time, as well as causing stress and worry/anxiety about the future. I couldn’t understand that vicious cycle any better. But, once you understand the relationship between pain in the body and the way that your brain either amplifies or minimises those physical sensations, it seems crucial to me that you do all you can to use your brain/mind to help your body.
When I first hurt my back and was really struggling, Vidyamala Burch’s guided meditations really helped pull me through. Here is a great one, available for free, if you would like to try it. And if you are dealing with chronic pain or illness, my thoughts and well wishes go out to you – I hope you get the medical help you need and manage to overcome your problem soon.
Humans are born wired for connection – it’s in our DNA, as strong a need as food, water and warmth. And if you look at a newborn baby, that makes sense. Unless babies successfully attach to their mother, they won’t be able to survive – human infants are born completely helpless, so we are entirely reliant on our caregivers. A loving, secure relationship is literally a matter of life and death for babies.
So in our brains is an ‘attachment system’, which gives us a magnetic attraction to others – (usually) first mum, then dad, siblings, grandparents, aunts and uncles, school friends, teachers, adult friends, colleagues, mentors and later romantic partners and our own family, when the whole cycle starts over again. Jeffrey Young, the founder of schema therapy, understood this need for attachment – that’s why it is one of the core developmental needs he identified in all children (along with the need for safety and protection; to be able to express our feelings and emotions; spontaneity and play; and boundaries/being taught right from wrong).
Another psychotherapy pioneer to understand this fundamental need was psychoanalyst John Bowlby, often called the ‘father’ of attachment theory. Bowlby realised that all children (and adults) need a secure attachment to their caregivers, especially mum. If we are lucky enough to develop this secure attachment in infancy, this ‘attachment style’ will remain constant throughout our lifetime and help us form strong, stable, loving relationships with friends, romantic partners and then our own children.
Strengthening your connections
Most of the people I see for schema therapy were not so lucky. For various reasons, their attachments were not secure as children, so they have all sorts of problems in relationships now. Perhaps they struggle to commit, or dive in too quickly and deeply (especially if they are a Highly Sensitive Person – read about them here). They may avoid relationships altogether, because they are just too painful. But, as I always tell my clients, although these patterns are firmly established in our brains, they are not set or fixed in any way. Our brains are always changing, throughout our lifetime (because of neuroplasticity). This remarkable discovery means that we can learn to attach more securely and so learn to love, to trust, to allow others into our lives.
This is one of the most moving and beautiful aspects of therapy – seeing people learn to deepen and strengthen their connections, first with me, then family, friends and later a romantic partner, even if this seems like an Everest-sized obstacle at the beginning of our work! However daunting it seems, remember that you are never too old and it is never too late to let love blossom. We are born ready to love – it’s just the painful experiences we have when young that throw us off the path toward fulfilling relationships. All you have to do – with help, guidance and support – is step back on to the path…
If you want to understand how we are meant to feel emotions, look at a small child. When kids feel their emotions they really feel them! If they are angry, they will shout and scream and have a tantrum. If they are sad, they will cry. If they’re scared, they will run away, or hide behind their mum’s legs until the threat has passed. Now, I’m not saying that as adults we should indulge ourselves in tantrums, but neither should we repress or swallow our feelings.
Sadly, as we grow older we tend to stiffen up. We learn that (for men) it’s not OK to cry when we are sad, or to tell our friends if we’re going through a rough time. Or (for women) that being angry or assertive is unacceptable. We start to feel bad for feeling bad. We learn to hide our feelings, sometimes even from ourselves. Or we use a substance (alcohol/weed/cocaine/food/cigarettes) or an activity (gambling/hours spent on Facebook/gaming/shopping/sex) to numb or avoid uncomfortable feelings like anxiety, sadness, loneliness, anger or hurt. And the message we are giving ourselves is that emotions are somehow bad, wrong or even threatening.
Let’s go back to the kids. Watch a child getting angry: they feel the anger, intensely. Then they release it, verbally and physically. Then they seek a trusted person to soothe and comfort them. And then… the anger is gone. They see a butterfly and chase after it, utterly delighted and distracted, with no trace of the anger left in their body or mind. This is how we are supposed to feel, process and seek solace when we experience strong emotion. I have started summing it up for my schema therapy clients with a simple formula:
1. Feel it. If you’re sad, be sad. If you are angry, let yourself be angry. It’s just an emotion and can’t do you any harm – in fact, the only harm we can do is if we try to avoid the emotion (leading to problems like addiction or anxiety disorders such as OCD).
2. Release it. If you are sad, and alone, have a cry. If you’re angry, write a (never-to-be-sent) letter to the person you’re angry with, then burn or tear it into tiny pieces. Vent the emotion and let it go.
3. Get soothed (by yourself or a trusted person). Just as children need soothing when they are upset, so do adults – we’re just not very good at doing it for ourselves or seeking it from those we love and trust.
Learning to detach
One of the unconscious ways we learn to suppress or avoid our feelings is by detaching, which involves a psychological process called ‘dissociation’. This is something we all do, to a greater or lesser extent, but will have learned to do a great deal if we suffered trauma, abuse or neglect as a child. Dissociation is an unconscious process in which the brain shuts down to protect us from overwhelming stress. It’s a bit like a fuse blowing on a circuit board when there is a power surge, to stop electrical devices getting fried.
If we dissociate a lot as a child, it becomes an automatic process that we over-use, shutting down when we feel any kind of difficult emotion. This leads to us developing a ‘mode’ called the Detached Protector – one of the most common modes in my clients. We may feel numb, empty or spacey when this mode is triggered. We might also feel disconnected from other people, even experiencing strange sensations such as feeling far away, seeing the other person as very small, or feeling like there is a glass wall between us and the world. These are all common symptoms of dissociation.
None of this is bad or wrong – it’s just what we learn to do to protect ourselves from overwhelming pain or stress. Part of my job is helping people unlearn this unhelpful coping strategy, feel their emotions as described above, and learn to build up their ’emotional muscles’, so they feel stronger, more resilient, and can live a rich and fulfilling life. After all, emotions – the full range, both those we like and the ones we would rather not feel – are what make us human.
Originally published at www.danroberts.com