Presence In Pain

It’s not uncommon, but I’ve recently had more clients try to push me away from their pain. As we start to touch on a sad memory, a painful relationship, or even the main reason they’ve come for therapy, I get hit with a, “I’m not going to talk about that today. It’s just a waste of time to feel that sad”. I’m not the type to directly push on that comment. I let my clients guide, but I often return to those statements and check in about why they feel that way.

Emotional pain, of all types, is obviously what I deal with on a daily basis. It’s sort of why folks come into my office. I’ve been reflecting more on pain, both physical and emotional and how presence seems to take on a different, less welcome role with pain.

When I was in eighth grade, I broke my elbow at basketball practice. My foot got caught on someone when I jumped up. They walked out from under me, my legs went out with them, and my elbow broke my fall. I remember losing my breath, not from hitting my back on the ground, but from the eruption of pain that ran through my arm. I remember the taunting throbbing through my arm with each beat of my heart. I remember the sharp screaming pain shooting in every direction as a doctor tried moving it in the ER. It didn’t just hurt, it absolutely overwhelmed me. You probably have an experience like this. It’s like nothing else exists. It’s a presence you just want to get away from.

Pain is an acute form of presence that we often try to get distance from and yet its very nature tends to keep us trapped in the present moment of misery that the pain creates. I remember thinking over the next several months after having surgery, enduring excruciating pain in therapy, and losing my breath over and over again at the slightest of brushes against it, how nice it would be just to not feel pain. I longed for my OT to be able to straighten my arm without gritting my teeth or to move my arm seamlessly again without a shot up my shoulder. What bliss to break my elbow and just let it heal without the pain? It seemed ideal.

Many years later, in grad school, I learned about a rare genetic condition that prevents a person’s body from being able to sense pain. Wow, I thought. I can’t believe that actually exists. But instead of living blissful lives without pain, those folk tend to live short lives. Why? They don’t know when something is wrong. I thought back to my elbow. If it didn’t hurt, I wouldn’t have known that it was broken, at least not until I had done more serious damage to it. I would have stayed in practice, tried to use it, probably gotten frustrated when it didn’t work properly, and then thrown it around more forcibly. After surgery, how would I have avoided further injury if it didn’t hurt? I would have reinjured it without ever giving it the chance to heal.

Pain is necessary for our survival. It tells us something is wrong so that we can protect ourselves and slowly fix it. If we never felt pain or completely avoided it, the injury either won’t heal properly, gets worse, or likely both.

I think of this level of physical pain when I’m working with clients trying to avoid their emotional pain. It’s a keen reminder of why they want to get away from it. It’s what we often do when we feel hurt. Distract yourself. Act like it doesn’t exist. Try to shove it way down so you can pretend it went away. Even in the act of doing this, most people get that pushing the pain away won’t help in the long-term. We just don’t know what else to do. So we let it build up until it comes out at another time, often in an explosive and overwhelming manner.

Although the pain can be overwhelming and even debilitating for some, emotional pain, like its physical counterpart, is trying to tell you something. Emotionally, it’s an acute reminder that something is wrong; that something that matters to you isn’t being fulfilled; that something is hurting you and needs to be helped. Like physical pain, that can’t be ignored or it doesn’t heal and lingers sometimes for a lifetime if left unattended.

Emotional pain is not something to avoid, ignore, or even necessarily something to “fix”, but is rather something to sit with, pay attention to, and allow to be your guide to what is important in your life. That’s where allowing yourself to be present in the pain becomes so important; so you can understand what the pain is, why you’re experiencing it, and then what to do with it. Being present with it can be extremely overwhelming, but it is also the path to understanding why it’s there.

This isn’t to say you should sit in the presence of pain permanently until it’s “fixed”. Sometimes we need the distractions to take us out of the pain temporarily. Sometimes we need medication to weaken the intensity of the pain. Sometimes we just need to spend time with friends and talk about something else. It’s not that you have to only sit and dwell in it. Just being present in the pain, without support, guidance, or any course action, can actually make things worse.

I know. I just told you how vital it is to be present in your pain, but also that can make it worse. The reality is this: like most things in life, navigating pain is a very delicate balance of being present in order to understand the pain and then taking the steps to protect yourself from it in order to slowly heal. You can’t learn to heal if you’re constantly in pain but you also can’t begin to heal until you understand the root of it. Eventually we have to return to it, sit in it, and understand it in order to work through it.

That’s why the therapeutic space is so important for people. It gives them a place to explore these pain points, begin to understand them, and then begin to figure out what to do. Therapy is a safe space to confront pain, but it isn’t the only place to do that. It doesn’t have to be therapy to be therapeutic. Sometimes confronting pain is confiding in a close friend, having healthy conflict with a spouse, getting in a good workout while you process, or listening to music that connects to what you’re feeling. The important thing is that you find a safe space to process the pain and not just hold onto it. As you’re able to acknowledge your emotional pain points, try to find your safe space to deal with them. Treat your mental health like your physical health and give it a chance to heal properly.