Dealing with anxiety in times of uncertainty – Part 1: pain and suffering

I think it is safe to say that everyone has been swept out of their comfort zone to some extent, lately. COVID-19 confronts us in a painful manner with the aspects of human existence that we’re particularly not fond of: mortality, vulnerability, dependence and uncertainty.

Within two months, this virus has spread all over the world. It shows us how intensely connected and interdependent we are. The amount of time you stay at home and avoid contact with people, will play a role in the spread of this disease and the saving of lives. Suddenly we become aware that every action of ours counts, in every aspect of life.     

Governments and experts have been giving us strict guidelines and rules for staying safe, healthy, and at distance from each other. Our personal freedom is considerably limited now. In the meantime, you may find yourself in the situation where you have to work from home, while at the same time trying to home school and entertain your kids. You also might have no work anymore at all, wandering how to make ends meet for the next couple of months. Or you might be working double shifts in an essential profession, approaching a possible emotional breakdown.

Either situation can give rise to stress and anxiety, on top of the concerns for your health, the health of your loved ones and the general wellbeing of your country or the world. How do you cope with all that?

Suffering is different from pain

The bad news is, life will keep on throwing setbacks at us, this will never change. Sooner or later in your life, you will experience adversity on a personal level or on a collective level, right now. This results in pain. The good news is, we have a choice to which extend we suffer from this pain. Now you might think, pain and suffering, aren’t they two words for the same thing?

There is a Buddhist saying that says when you get hurt by an arrow, this results in pain. But, there is a second arrow that hits you as well:  your reaction to the arrow. You get angry or sad, maybe you want revenge. In Buddhism, pain and suffering are treated as two different things. Acceptance and Commitment Therapy (ACT), the therapeutic model I work with, also says that pain and suffering are different concepts:

Pain is direct, in the present moment, caused by outer circumstances and incontrollable. Examples of pain are disease, physical pain, death of loved ones, divorce, problems at work, etc.

Suffering is how you relate to the experience of pain, often in the form of resistance. Examples of suffering are worrying about the past or future, fear of things that might or might not happen. Suffering is indirect, and caused by the mind: memory in combination with thoughts and language.

Let’s look at this with an example. In this new corona infected world, let’s say you are business owner who just started out, and you just saw all your assigned jobs evaporate. Your partner works as nurse and you have two young children, who you suddenly have to take care for around the clock. Your parents are old and have diabetes, so they are a risk category. These facts of life are your pain. You cannot control them.

At the same time, your situation makes you restless, stressed and anxious. You can’t get to sleep at night. During the day, you’re tired and lacking concentration. Being sleep deprived, your emotions become more intense and negative, you get irritated easily, you snap to your partner and kids, you have the feeling that you cannot think straight anymore. You worry about the future and cannot stop thinking about all kinds of worst-case scenarios that could happen to you. These bodily sensations, thoughts and feelings are your suffering. And there is an alternative for suffering.

Your mind as the cause for suffering

I’ve mentioned that suffering is caused by the mind. But why, and maybe you also want to know: how? Let’s look at this from two different perspectives, those of a baby and a toddler.

An infant has needs: warmth, touch, milk, etcetera. When the baby experiences a deficiency of these needs, this is experienced on the physical level, and expressed via physical sensations called ‘affects’. The baby expresses this affect by crying. Since the baby has not yet developed a sense of self that’s separate from the rest of the world, there is no ‘I’ yet that has become conscious of the deficiency. Consequently, the baby is able to express anger, but he is not yet conscious of being angry or sad as a person, thinking “I am hungry, and angry because mommy won’t feed me”.

Whenever the mother is available to feed her child again, the baby’s biological impulses are satisfied and the anger disappears immediately. The angry affects are instantly replaced by the bodily sensation of satisfaction, without any conscious memory of the previous distress. (Please note: very distressful situations can of course cause trauma in babies. These traumatic experiences are stored in the subconscious and can cause sensations of fear later on, without having any conscious memory of the previous experience)

In contrary to a baby, a toddler has a conscious mind: a developed sense of self. This means a toddler – let’s call her Susan – has quite a different experience. She has short- and long-term memory, and developed language to think and communicate. When she wants to have an ice cream and her parents don’t give it to her, she can become angry. On top of having the affect of anger, she also is conscious now of having the emotion of anger. Susan is able to verbally express anger to her parents, shouting: “I want ice cream!”. She can also think for herself “I am angry because mommy and daddy won’t give me ice cream”.

An important consequence of this cognitive ability is, that when after a while the parents do give Susan her ice cream, she can still consciously remember her previous moment of distress, and experience the emotions she felt back then. The same goes for possible future moments of distress. Let’s say that Susan has been bitten once by a dog. There is a chance that she will fear any future dog she encounters, even though this dog didn’t bite her and probably won’t bite at all. [1]  

This is where suffering starts. Although there is no direct threat for Susan when she meets a dog, she can still experience distress, derived from earlier memories when the situation was different. She can think relationally: connect an event in the past to her feelings in the present moment, and project them on a future event.

Memory, thoughts and language are all aspects of the mind. They are great cognitive abilities for learning, reflecting, planning, organizing and so much more. But the downside of the mind is that it allows you to experience distress about situations that happened in the past, situations yet to come, or even imagined situations that will never happen at all. In all occasions, you can experience the imagined distress as if it was happening right now, in the present moment. At worst, this type of distress can cause trauma (directed at the past) and anxiety disorders (directed at the future).

Willingness and acceptance

Our new pandemic life situation is a given fact, and clearly not something we can control. But what we cán control, is how much we suffer from this situation. ACT offers an alternative to suffering, called willingness.

Willingness is allowing and actively inviting painful and uncontrollable events in your life. Your goal is not to feel better, but to feel better. Respond actively to your feelings, also the unwelcome ones, by feeling them as much as possible. If you’re willing to feel and accept your fear or pain, you will suffer less. Consequently, you can direct your energy elsewhere, and live a more complete life in the direction to what you value as important.[2]

Maybe this concept of pain, suffering, willingness and acceptance resonates with you, or maybe it doesn’t. I remember that it did make sense for me theoretically for a long time already, but that didn’t mean I could apply it to my own life successfully straight away. Understanding something on a cognitive level, doesn’t mean that it is easy to change your life accordingly. Everyone knows smoking severely damages your health, but that still doesn’t make it easy to quit.

It was only after a certain event happened in my personal life, that I truly experienced the difference between pain and suffering. During that process, I realized my mind was making the experience so much worse for me then it actually was. Since this experience was so transformative, I want to share it with you.

A story about my own pain and suffering

About two years ago, someone who is very dear to me unexpectedly disconnected all communication with me, without any reason, warning or explanation. The effect that had upon me, was beyond everything I could have imagined.

The loss of a loved one leaves a deep impression on us, it can feel like a stab in your soul. This was my pain. But that was not everything. I also felt confused, angry, rejected, treated unjust, heartbroken, dehumanized, indignant. At times even desperate, craving for an explanation. So, all these thoughts and feelings I had about the situation, they made everything twice as bad. This was my suffering on top of the pain.

Fortunately – and thanks to a great deal of previous coaching and guidance – I already was aware of the fact that emotions always come and go. They can be overwhelming, but  will always become less intense with time. I knew I was not going to be stuck in this situation forever and that I had to give space to everything I felt: the more I accepted my emotions, the easier I could process them. Avoiding them was pointless.

So instead of trying to get rid of my emotions, I welcomed them wholeheartedly. I cried a lot, I allowed myself to be as sad as I was. By doing that, I was being compassionate to myself. This is how I dealt with my pain and suffering: grieving, and doing my time. Simply waiting until it hurt less.

Somewhere halfway the process of grieving and living through my emotions, I started to realize something. How was it possible, that my state of being completely depended on the rejection of this one person? Why did I make him responsible for my emotional wellbeing? Isn’t that a little ridiculous? That’s when I realized that the only person responsible for the emotions I felt, was me. My friend’s actions were not the cause for everything I was going to, they were only the trigger. A trigger for an open childhood core wound, though.

As it goes with open wounds, they are quite vulnerable. They are sensitive for inflammation and need care and attention. When you don’t take care of your wound, it will start to ulcerate, and possibly effect other parts of your body. So, I started to take care of my wound. By only paying attention to what was really going here, by acknowledging my childhood experiences and consciously living through this, I gave rise to the process of healing. If you don’t heal your wounds, the outside world will keep on causing inflammations.

It is only after your wound has turned into scar tissue, that is has become protected against influences from outside. Finally, you are able to see a person or situation that triggers your emotions, for what it is: a recurrent representation of earlier (childhood) pain that has nothing to do with the present event.

Transformative lessons

After a while, I could clearly distinguish the two situations: The pain I experienced as a child, was now causing extra suffering on top the pain I experienced as an adult. The powerful thing about this process was that I didn’t just realize this on a cognitive level, I felt it in every vessel of my body. My suffering as an adult was caused by an old pain that had nothing to do with the person I am now.

An exercise that was really helpful in this process, is the following. Every day I sat down for a couple of minutes with closed eyes. I took a couple of good breaths and directed my attention away from my thoughts, into the present moment. I asked myself: at this very moment, am I doing OK? If I’m not entangled in my thoughts about the past and the future, am I in pain right now? Or am I safe, comfortable and in peace between the four walls of my living room? Do I have caring people around me, values and purposes to live for?

Every time I did this exercise, the answer to the question if I was in pain right now, was always ‘no’. Without thoughts and memories, I was in fact doing perfectly fine and I became aware of a deep and solid sense of strength inside of me. I learned that the only thing responsible for my emotional misery, was my mind: thinking about the past or the future. My suffering was debunked.

This incident and the way I learned to deal with it, radically changed my attitude towards life. Distinguishing pain from suffering is something I can now apply to every problem I encounter. Whenever someone or some incident triggers me, I notice it is happening. By doing inner work, I can connect this incident to a situation from my past, and give space to my old pain. When I manage to heal the wound, the trigger suddenly isn’t a trigger anymore.

Overall, this has been such an incredible liberating journey for me. By disconnecting from me, my friend has given me a truly precious gift. Looking back, I’m forever grateful that I had to go through it. At some point, I wholeheartedly accepted the situation as it was, and totally came to peace with it. I was not only liberated from suffering, I was even done grieving.

And exactly at that moment, my friend decided he wanted to restore our relationship. And because I had completely lived through my pain, I didn’t feel the need any more to let him do penance. So, I decided to open up my heart again for him, without any caveat. I now know that (temporary) separation can be great way to learn a from each other and contribute to each other’s development.

Following my own experiences, I have made a follow up piece on this post and a flowchart to help you practice willingness and grow resilience times of adversity and uncertainty.

[1] Nelleke Nicolai (2016) Emotieregulatie als basis van het menselijk bestaan Diagnosis Uitgevers, Leusden

[2] S.C. Hayes, S. Smith (2005) Get Out of Your Mind & Into Your Life: The New Acceptance & Commitment Therapy. Oakland: New Harbinger Publications

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