Keeping Pain Clean

As a therapist, I blog somewhat hesitantly at the risk of adding to the bloated mountain of advice at our fingertips. 24 hours a day we are surrounded by media that overwhelms with unrealistic guidelines, “10-Things” lists, and other how-to instructions on everything from living the near-perfect, pain-free life to fixing aspects of ourselves we’ve labeled broken.  There is the assumption that the “experts” out there may hold just the right fixing, healing knowledge to serve as guides to a right way of living that brings ultimate happiness.

It’s never that simple, though.

The proliferation of self-improvement resources designed to help us better ourselves and our lives is a double-edged sword, generating moments of hope, while sending the message that we aren’t doing this life thing well enough on our own. Helpful tools are out there, potentially, but depending on how we respond to what we encounter, we can end up experiencing more disappointment and pain if we aren’t altered by what we’ve read, heard, or seen in the ways we had hoped.

In my very human experience, pain is not easily discarded, people aren’t just broken parts to be fixed, and happiness isn’t a guarantee–at least not happiness in the way it’s often touted (I call it Pleasantville Happiness…remember that movie?), as if a sense of complete, joyous contentment is available to us if only we were somehow different or better or a little more perfect. We strive for this type of happiness as a way of mitigating our pain, but in the process we are set up for suffering–the pain beyond pain–because so often we are disappointed to find the emotional struggles, the negative thinking, the body image issues, the relationship troubles, or the distressing moods have found us again.

Suffering…the pain beyond pain

Life is really, really hard sometimes, and pain, whether it be physical or emotional, is a universal part of what it means to be alive…to be fully human.  How much we suffer (“become worse because of being badly affected by something” Thank you,, however, is largely determined by how we respond to pain and the circumstances surrounding it, i.e., what we tell ourselves about it, what we feel about it, and other ways we behave in response to it.

Within Acceptance and Commitment Therapy, a model of practice I use in my work, the concept of pain is sometimes differentiated as “clean pain” (the pain of being human) and “dirty pain” (suffering: the pain beyond pain).

Clean pain vs dirty pain–what does this even mean? 

Here are a couple of scenarios we can probably all relate to…

When a relationship ends due to breakup or death, there is potentially grief and sadness as our brains and bodies work to adapt to a great loss. When we’re up for a job we really want and learn it has been given to someone else, disappointment or another emotion may be present. Both these experiences involving loss cause some degree of pain and discomfort. For the most part, this is clean pain unclouded by judgments, layers of other emotions, or any other stories we tell ourselves about the meaning of the pain and its circumstances. This is the type of pain that comes with being human.

Dirty pain comes into play when we use language to create stories about the pain and what it means in our lives. These meaning-filled stories are particularly problematic when they involve judgments about the experience, the pain, and how we’re responding to it. As part of this, dirty pain also comes in when we believe we have to get rid of the pain or avoid it through whatever means necessary, possibly leading us to engage in avoidance behaviors that ultimately aren’t healthy for us.

Now back to the scenarios from a dirty pain perspective..

After a breakup or death of a loved one, if we layer on judgmental thoughts or assumptions such as,  “I should be farther along by now.” or “I’m not grieving correctly,” we have clouded our clean pain. Instead of the pain of grief and sadness, now we also feel ashamed and defective because we’ve told ourselves we aren’t fitting some prescribed time frame or manner of grieving. If we’re denied a job we wanted, and we tell ourselves we didn’t get the job because we “never have been good enough” or the “interviewer had it in for me,”  we have clouded our clean pain. We already feel disappointed, and now we may feel worthless or resentful because of our framing of the experience.

In both scenarios, now we have the pain beyond pain, which leaves us with more hurt and vulnerability and more likely to engage in unhelpful habits in the attempt to rid ourselves of the pain and the suffering, only to find those things don’t ultimately do the trick either.

We receive abundant messages in blatant and subtle ways suggesting that if we could do things better, look a certain way, or be/feel somehow different, we won’t hurt. We are human and we will hurt. We’re all in this together. The good news is you and I have a great deal of power over how we respond to the hurt. If we can allow ourselves to feel the pain and let it move through us, while being aware of when we may be layering on unhelpful stories or emotions and then choosing not to engage with them, we can begin to reduce the amount of suffering we experience on a daily basis. Doing this isn’t easy and it takes practice. Sometimes the support of a therapist familiar with these concepts can help in navigating this process.

For today, let’s stay aware of how we respond to our pain. Are we trying to do something with it-get it to stop, figure it out, read about it, judge it away? Let’s see if we can allow the pain to be present without doing these things. Maybe we can find something compassionate to tell ourselves such as, “Even with this pain, I am OK in this moment and I don’t have to fight it or myself. I don’t need to be fixed or any different than I am right now. I can feel what I need to feel.” Next we can practice self-soothing using our senses: take a bath, go for a walk, listen to a favorite song, eat a yummy meal, and really notice that experience. The pain may still be there. That’s OK. We’re still OK. It’s the clean pain of being human.  Let’s have compassion for the pain, for ourselves, and for all of us who are in the same place.

Today, I hope for genuine self-compassion for all of us.


It’s a lot. Be here.

“It’s a lot. Be here.”

This is a message I have needed to repeat to myself so much lately. When life is really busy, I find myself caught up in hurried thinking, planning, rehashing, judging, or dwelling instead of being rooted in the right now. My brain has been choosing my focus for me more than I’d like and it’s often a million miles away. Do you notice how often this happens to you—you’re here but you aren’t because you’ve become caught up in the internal whirl of physical sensations and past and future thoughts and emotions? I like to call this getting lost in “The Noise.”

I think of The Noise as a zany bunch of internal friends and family. We’re all on pretty good terms these days, but sometimes they get a little more rowdy and distracting than is helpful. You might find another name for your whirl of internal stuff and make friends with it, too. Don’t get me wrong, some of what they are nagging about is true and/or important, but often the brain would have us believe all of it is truth and it’s all urgently important and needs figuring out right this very moment. When it feels like our brains have taken over in this way, it is difficult to hop off the merry-go-round of mental experiencing.

This happens to all of us, and although our brain may not stay in hamster-wheel mode all the time, sometimes it can begin to feel like the norm. When it does, we miss out on what is happening here and now–the important experiences the present moment has for us. We are here, yet absent. Another byproduct of getting swept up in The Noise (or whatever you’d like to call your over-zealous brain hamster)–we may react to ourselves and others with less compassion or thoughtfulness.

Can you relate to this?

Let’s try something.

Just for a bit I want you to stop reading this…well wait, maybe finish this last paragraph. Please stop doing anything and take a handful of minutes to sit comfortably and breathe. That’s it. Wherever you are—the bed, the couch, a chair, just place your attention on what it’s like to sit and breathe in this moment. You can close your eyes if you want. Try to hang in there for 5 minutes. Most importantly, I’d like you to do this without judging what it’s like or how easy it is to sit and notice. If your brain gets judgmental, that’s OK, too. Just notice it. That’s all you need to do. I’ll do it with you.

(ommmmmmmm….ding) (Are you really doing it? Please try…)

Welcome back! I’m wondering how easy that was.  Even though we’re human “beings,” we live in a culture of constant “doing” and we have trouble slowing down sometimes. If you’re like me, it’s also likely your mind was all over the place, moving into past and/or future thinking and feeling and pretty far away from noticing your breathing lungs and perching bum.

How about a judgey voice?  Did you find yourself criticizing the experience, i.e., “This is weird. Ugh, this is too hard and it’s a waste of time.”? If you didn’t, that’s nice to hear. If you did, you’re so very normal and it’s OK.  We make judgments frequently about pretty much everything…what we think, how we feel, what we’ve done, and what other people think, feel, and have done. Depending on context, sometimes judgments help keep us safe. Often, however, judgments contain a great deal of shame and criticism for ourselves and others and they aren’t really helpful to us.

Our brains are busy. 24 hours a day they are working to take care of us. They analyze, judge, assess for danger, solve problems, plan, react, figure things out, rehash things, while at the same time telling us when we’re in pain, breathing for us, sending blood to our organs, and keeping us alive! With all of that going on, our brains don’t settle easily and I’m not sure they accept something new very easily, either, once beliefs and habits are in place.

The awesome thing is that our brains learn pretty well, and it is possible for us to help our brains develop healthy ways to settle and focus and become more accepting through something called mindfulness.

Some of you may have heard the term. Mindfulness has become increasingly more popular in Western culture, so much so, that it runs the risk of becoming a buzzword. This can dull the power of a very important concept and practice. So what is it, for those of you who haven’t heard the term? I like this definition from, “Mindfulness is the gentle effort to be continuously present with experience.” A little more elaborate is the definition by Jon Kabat-Zinn, creator of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Healthcare, and Society at the University of Massachusetts Medical School: “Mindfulness means paying attention in a particular way…on purpose, in the present moment, and nonjudgmentally.”

The practice of mindfulness can occur during quiet reflection and meditation, and it is also a way of experiencing the day-to-day world. Let’s practice some more and expand on the sitting/breathing mediation we did earlier. This will give you some direct experience with mindfulness.

I’d like for you to stop reading again and sit comfortably. This time gently attempt to focus your attention on the sensation of your breathing or possibly the soles of your bare feet planted on the floor. For some people with anxiety, focusing on the sensation of breathing, particularly the rising and falling of the belly, can create more anxiety, so feel free to focus away from the belly breathing. You can also focus on the sensation of air entering and leaving your nose. As you sit, notice the experience and anything that comes up. When you become drawn to the past or future or caught up in a lot of emotion or even distracted by something outside of you, recognize what has happened without being hard on yourself or analyzing what’s there (don’t get on the train). Then thoughtfully bring your attention back to your breath or the soles of your feet. Try to hang in there for 5 or 10 minutes if you can. If you can’t, that’s just fine.

Welcome back again! Interesting, huh? You’ve just done a sitting mindfulness of the breath meditation. As I mentioned previously, this isn’t the only way you can practice. The process of nonjudgmentally bringing your awareness back to your present experience can be done throughout the day, while working, driving, or spending time with loved ones. There really are no limits to when and where you can do this.

Here’s an example of something that might happen in daily life and how mindfulness can help. Perhaps we are with a friend and become lost in thought and feelings of regret about a conversation with someone else we had earlier in the day that didn’t go as we had planned. That past conversation is over, but we are still caught there and not actively engaging with our friend. Mindfulness allows us to notice we are pulled away and to make the choice to shift from the past experience back to the present moment connection.

When practicing, remember that external and internal events will distract you. This is normal. When you find yourself distracted, bring you mind back to your breath, soles of your feet, or to the present moment activity. This repeated distraction and refocusing is the mindfulness practice, and it doesn’t mean you’re doing something wrong if you notice you are caught up in external or internal experiencing.

By cultivating mindfulness in our lives, we have the opportunity to observe thoughts, emotions, and other experiences without becoming overwhelmed by them, lost in them, or judging them, ourselves, or others. When we choose not to “dive in” to something the brain is presenting, we can also make the choice to shift away from it, not in avoidance or denial, but in our decision to stay present with what is happening now and not where our brain would have us in that moment. Perhaps later we may choose to come back to the thought or emotion if it still needs our attention. Your brain will let you know.

There is a growing body of research evaluating the effectiveness of mindfulness combined with psychotherapy to mitigate symptoms of mood disorders, such as major depression disorders, anxiety disorders, and other mental health diagnoses. Potentially, this is a powerful practice for people coping with experiences that often feel consuming.

If you’re interested in learning more about mindfulness and mindfulness research, I’ve included a few links I have found helpful both personally and professionally:

I  encourage you to read a little about mindfulness and practice a lot. That is where the power lies.

It’s a lot. Be here.

Wishing you peace,


What do you think about beginnings?


The willingness to consider possibility requires a tolerance of uncertainty. –Rachel Naomi Remen

My good friend Google tells me to “begin” is to “undergo the first part of (an action or activity).” That makes it sound fairly easy, right? It’s a nice and straightforward clinical definition that leaves out the often-intense emotional experiences of beginnings. Starting something new is many things but it’s rarely easy.

A few days ago I was thinking about the many beginnings I’ve faced. Presently, I’m a little ways down the road of another starting point in my professional life, as April 2015 marks the beginning of my new counseling/psychotherapy practice. This isn’t my first professional beginning. Over the years I’ve changed areas of social work practice, new clients come and go, and each day brings a new therapeutic issue or concept to delve into and understand. As beginnings go, though, this practice is a big one for me.

Maybe you’re in a similar place with something new or perhaps a change is on the horizon. Professionally or personally, it seems we’re always beginning, in a sense. It is a large part of what it means to be alive, whether it’s waking up and facing a new day, beginning a new medical treatment, picking up a new hobby, starting a new relationship, seeing a new client, beginning a new program of study in school, starting therapy, or starting a new job or business. Depending on who we are, our history, and the specifics of the road we’re setting out on, we can generally expect some degree of stress about what’s to come.

When I’m orienting myself to a new experience, I find comfort in the collective wisdom of friends, and so I asked some of mine to answer the question, “What do you think about beginnings?” The varied responses came quickly. Some suggested we’ll never feel fully ready for our particular beginning, and so we must go ahead and do it anyway, moving forward through fear, uncertainty, and perfect imperfection. For others the concept of a beginning is too stressful and often arbitrarily defined as such–what feels like a beginning in some aspects of life is really not that at all, as what is happening was set in motion long before through earlier effort.

For some, focusing on beginnings feels like too much pressure. It’s like if you miss a beginning, you’ve missed out. Instead, middles are the ideal places, offering up more opportunities for a new start. Attention was given to the newness and naiveté that can surround beginnings–recognition that the brain desires novelty and may be more motivated by an exciting beginning and somewhat blind to the possible difficulties ahead. Others pointed out how our brains can analyze every potential worst-case scenario along the map, almost paralyzing us from moving forward at all. Another shared that beginnings are easier when you break them down into manageable parts and get started one part at a time.

For me, beginnings are intense. With every one, depending on the magnitude of what is happening, I’m called to be present with the internal experience of anticipation (which sometimes includes excitement), fear, and uncertainty. At the same time, I am learning to recognizing a deeper knowledge that I will be OK even when I’m not completely sure how. It’s like standing blindfolded with a parachute on the precipice of where I’ve been and having no idea how close I am to where I’m going. My next footstep will hit land or sky, but either way, I know I’ll keep walking or I’ll fly. It may not be fast and it may not be pretty all the time and I may have to climb back up again to start over, but I’ll keep moving.

Now, I pose the question to you, “What do you think about beginnings?”

If you’re beginning something, there may be anticipation and excitement or fear and apprehension. Depending on the nature of your particular road, perhaps there’s some of all of it. Whatever it is, no matter what is being asked of you or what you’re asking of yourself, it is so important for you to take good care of yourself. Please don’t let genuine self-care become a cliché. Here are some ideas that have been working for me…

  • Be patient with yourself and how you’re responding emotionally and physically. It takes time to accept something new or feel competent in it and sometimes that process has to happen over and over.
  • Remember to go heavy on the self-compassion and pull the reins in on self-shaming. Try not to be hard on yourself when you stumble or struggle.
  • Spend time thinking about things other than what is beginning. Mental and physical breaks are important. You don’t have to force yourself not to think about what’s going on (that generally backfires); just try to direct your attention elsewhere. It’s OK if you shift back into beginning thinking, but make sure several times a day to reorient yourself to the other things and people in your life and spend some time there, too.
  • Exercise–Even gentle movements, such as yoga, help your brain and body handle stress.
  • Take care of your physical body and emotional health by soothing using your senses. Pamper yourself-take a warm bath, get massages, go on and get that pedicure you’ve been putting off. Eat a delicious meal. Listen to new or familiar music you love. Smell coffee beans (insert favorite smell). Sit outside and feel the breeze, the heat of the sun on your skin, or stare at the stars. Hug someone.
  • Read books that inspire or allow you to delve into your imagination. If you feel like you don’t have time for books, find articles or even quotes that speak to you about what you’re experiencing or take you somewhere else for a short while.
  • Reach out to the collective wisdom for support. Finding trusted others to talk with along the way to encourage and guide you. Support is crucial. No one expects you to do this alone.

That’s enough for now. Just remember… Start where you need to start. Take breaks. Start again when you’re ready. Be patient. Most of all, be good to yourself. Abbie