pain

Practicing Acceptance: Acceptance and Commitment Therapy Series

Tell me if you’ve had a day like this one: you’re in your car on the way to work.  The sky is blue, the sun is shining, and the road is clear…until you hit the freeway and traffic comes to a standstill.  You’re slightly annoyed, as you don’t want to be late for your meeting at the beginning of the workday.  Suddenly, a car whips in front of you, nearly hitting your front bumper.  Your anger skyrockets.  You might yell some curse words or make a rude gesture at the driver.  By the time you arrive at work 15 minutes late for your meeting, your day is ruined.  You may think to yourself, “why do I always do this?  There’s no reason to get this worked up about traffic.”

We began this Acceptance and Commitment Therapy series with an overview of ACT’s purpose: to approach all situations and circumstances with an eye toward personal values and committed actions in alignment with those values.  The first concept discussed was contact with the present moment, which requires staying in tune with your sensations, thoughts, and emotions in any given part of your day.  But what happens when those internal experiences are frustrating or overwhelming?

Acceptance

The next concept of ACT is so crucial to this theory that it makes its way into the name: acceptance.  As humans, we often attempt to avoid or control our pain. In so doing, our creativity and perspective become narrowed, and we are disconnected from what is important to us.  Our interpretation of events magnifies our pain and disrupts our daily life. 

When we resist acknowledging the painful realities that exist in our internal world and our external experiences (circumstances, other people, relationships, etc), we create tension that interferes with taking action and causes us to feel stuck.  In his book Acceptance and Commitment Therapy, the creator of ACT called this experiential avoidance, defining it as “efforts to control or avoid private experiences (eg. sensations, emotions, thoughts, memories, urges) when doing so is ineffective, unnecessary, or contrary to living a meaningful life.” 

Why We Need Acceptance

It makes sense that we would act in ways that attempt to protect us from pain.  But often the end results of our self-protection are consequences and disconnection from our values.  And trying to force our internal world to change doesn’t always work.  We can’t force ourselves to feel a certain way, we can’t suppress our urges for very long, and our thoughts arise automatically.

In the same vein, it is impossible to control things that are outside of ourselves, as much as we may try.  We cannot force someone to love us, change others’ thoughts or experiences, or control how bad traffic is on any given day.

In addiction recovery, addicts often find that trying to suppress their urges to act out or use their drug of choice end up backfiring.  Similarly, denial of the reality of harm done by their addiction in relationships can lead to the dissolution of those relationships and more severe consequences than if reality was accepted and acknowledged in the first place.

What Acceptance Is…and Isn’t

We need to practice acceptance in order to thrive and create the life we want.  But what does acceptance look like on a daily basis?  It requires taking the role of an observer of both your internal world and external circumstances to see things as they are without judgment, removing any labels like “good” or “bad.”

But acceptance is not the same thing as settling or resigning yourself to your fate.  Settling is a passive response: putting up with their circumstance without any hope of taking action.  Often, those who feel they have settled carry some degree of anger or resentment, even if it is buried beneath the surface. They feel stuck in a situation they don’t want, and it seems impossible to change.

We think acceptance means a barren life, but the opposite is actually true.  Acceptance is not a resignation or giving up, and it doesn’t require you to like the situation in which you find yourself.  In fact, acceptance leads the way to change.  In order to change what isn’t working, we must first accept the reality of what is.

Principles

Suffering is universal and unavoidable.

None of us can go through life without pain.  Pain will be there whether we accept it or not.  Many of our efforts to avoid or control pain end up creating more harm for ourselves or others, in such forms as addiction or relational disengagement.  Accepting the reality that we will experience pain can help us prepare for it and be conscious of it when it happens, rather than being taken by surprise, believing that we should always be happy, or expecting that we will think positive thoughts all the time.

Observe negative thoughts or painful emotions without attempts to change them.

One recent study showed that repeating positive self-statements did not have a positive effect on those with low self-esteem, but rather left them feeling worse.  Attempts to avoid pain by forcing positive thoughts actually had a negative effect on those individuals.

According to ACT theory, attempts to change negative thoughts or painful emotions only exacerbate the pain and don’t allow for acceptance.  This principle exists in contrast to more traditional cognitive theories, like cognitive-behavioral therapy, that encourage reframing or changing thought patterns.  ACT also contrasts the cultural message that if you’re struggling with negative thoughts or painful feelings, you must not be trying hard enough to get better.

Often in acknowledging these thoughts and emotions and letting go of the need to change them, you can experience a greater peace as you become an observer rather than a controller of your experience.

Open up to what shows up. 

Acceptance is characterized by a mindset of openness, both to circumstances outside of yourself and your internal response to those circumstances.  It involves a willingness to engage and receive whatever comes, whether it is painful or joyful.  We choose to engage with the feelings and circumstances that we would rather avoid, moving closer to them in an attempt to grow toward thriving in a meaningful life.

Foster creative hopelessness.

As you’ve made attempts to cope with painful emotions and circumstances, you’ve probably noticed that your coping strategies have varied levels of impact.  However, one thing you’ll likely see is that none of your coping strategies eliminate pain forever.  Even if it is a temporary fix, the pain will come back at some point.

Creative hopelessness comes when we recognize that none of the things we do to try to change our internal or external worlds actually eliminates pain.  Many of our attempts to do so are futile in the long term, even if they provide temporary relief.  Acknowledging this reality means that we can begin to explore more creative strategies about how to live out our values. 

Practices

Observe your thoughts, feelings, and urges intentionally.

Sit in a comfortable position and set a timer for five minutes.  During that time, observe any thoughts, feelings, sensations, memories, or urges that float through your mind and body.  As you’re doing this, recognize that there is no need to change them, but simply to observe them.  Notice how long they take to work their way through your system or if they repeat or resurface.  Notice any impulses you have to suppress or push them away.

The purpose of this observation time is not to clear your mind, but instead to watch your mind and body and catch what comes through you.  There is no judgment of these thoughts as “good” or “bad,” but rather an impartial awareness. 

List experiences you are avoiding.

Make a list of any experiences, both internal and external, from which you are trying to stay away.   Maybe it’s an emotion, like anger, that comes with an urge toward violence or lashing out verbally.  Perhaps it’s a belief you have about yourself like, “There must be something wrong with me.  I’m so stupid.”  Maybe it’s an uncomfortable social situation where you tend to feel shame or embarrassment.  Usually, these avoided experiences are those that create some form of pain in your life, whether due to an internal cause or a circumstance outside of yourself.

Identify attempts to control, avoid, or influence painful experiences.

Make a list of behaviors you do to try to control or influence your circumstances, reduce discomfort, and/or avoid pain.  More obvious behaviors are external, such as going for a walk or binge-watching TV.  But also include those behaviors that are internal, such as suppressing thoughts or overanalyzing your emotions.  This list can include both self-destructive or harmful behaviors as well as supportive coping behaviors.

Now ask yourself: do any of these internal or external coping behaviors eliminate pain completely?  Do they make it so that pain will never come back?  Or do they provide only temporary relief within the larger context of life?  Chances are, you’ll find that no behavior can completely erase the experience of pain.

Dig deeper into your behaviors.

Look back at the list you just created and notice patterns of behaviors that help you avoid or control pain.  Ask yourself: what would happen if I did not carry out these behaviors?  What thoughts, feelings, urges, memories, or sensations would be left?  What, in essence, am I avoiding?

Similarly, you might ask yourself what function the behaviors serve.  How do they work for you, and why do you keep going back to them? 

Evaluate the function of your avoidant behaviors.

It is important to acknowledge and validate your process of avoidance so that you don’t begin to shame yourself for your behavioral response.  We will never fully eliminate the urge to control pain with these behaviors, so seek to understand and accept your coping behaviors with kindness and compassion.

One way to recognize a behavior’s function over time is to track the ways in which you avoid pain in the upcoming week. Notice how that goes.  Recognize how different behaviors work or don’t work for you, and notice where avoidance gets in the way of value-based living.

Slow down and acknowledge.

Practice slowing down to acknowledge a painful internal experience.  Use the prompts in the first observation practice to connect to your body and mind as you consider a painful moment.  Can you survive the temporary feeling of pain?  Often we think we can’t handle or survive a painful emotion or experience, but reality tells a different story. 

Then imagine holding that internal experience in your awareness while also doing something that is important to you.  Is it possible to be acting in a way that is in accordance with your values while also feeling pain?  Can you feel a certain way, have a memory resurface, or think a painful thought and still show up how you want in life?  Can you exist and thrive with these thoughts, feelings, urges, sensations, and memories still being present?  Imagine yourself doing so and see what comes up.

Pain, Joy, and Longing: What The Giver Can Teach Us About Desire

What comes to your mind when you think about the word desire?  Is desire a familiar friend to you?  Or something that you run from as soon as you feel even a hint of it? We all carry different desires in our lives: desire for food, desire for another person, desire for a promotion at work, desire for a house (or a bigger house, or more stuff for your house).  Or perhaps your desire is more abstract: desire for more peace and calm in your life, desire to be loved, desire to achieve a mission or purpose in life.

Merriam-Webster's Dictionary defines the verb desire as “to long or hope for;” “to express a wish for” or “to feel the loss of.”  Notice how desire is so closely tied to disappointment or anticipation: we’re looking forward to something, but we haven’t yet attained it.  Or on the flip side, the final definition intertwines desire with loss or grief, as when we desire something we once had but lost.

What are some of the desires you identify most strongly in your life?

A short time before the movie release a few years ago, I read the children’s book The Giver by Lois Lowry.  In this novel, the characters live in a dystopian future where everything exists in shades of gray.  The lack of visible color extends as a metaphor to the citizens’ emotions and longings.  The inhabitants of this community take a pill each day that suppresses desire and emotion.  The plot of the book begins when the main character, Jonas, is assigned to the role of Receiver of Memory.  This assignment requires him to receive all the painful memories that the society has wiped from its memory. 

I listened to a podcast discussing some of these themes in greater detail after reading the book.   This theme discussed in the podcast struck me: because the characters in the book do not experience emotion and have no memories, they don’t experience feelings of pain.

Wouldn’t we all like that?  Our world is full of pain: we have only to open up a newspaper, turn on the TV, or take a walk on the city streets to see suffering in our world.  We grieve the deaths of those we love, we feel pain at broken relationships, we are shocked by the violence around the world, and we weep at images of children who are starving.

As Jonas begins his process of receiving the memories the society chose to erase, he is wrecked by the intensity of the emotions he feels, ranging from joy to sadness.  In the process, something starts to change in him.  He begins to see in color.  He stops taking his pills and begins to experience desire, sadness, and joy in his daily life.  Emotions he didn’t even know existed are now rising to the surface.

Another theme that surprised me in this novel was the assertion that medicating pain through erasing memories doesn't just strip these people of suffering.  Because pain and longing do not exist, there is no opportunity for joy.

There are a multitude of ways that I attempt to make myself happy to feel a fragment of that joy in my day-to-day life.  I’ll obsess over how many Facebook likes I get on that photo, spend hours playing mindless games on my phone when work feels overwhelming, or stop and get my favorite fast food when I’ve had a bad day.   But it doesn’t take long for me to realize that these are all ways I’m simply medicating my pain and deadening my feelings through this false sense of happiness, while denying the deeper desire that bubbles just beneath the surface. 

We all have ways that we choose to escape from our pain and longings. These typically involve us numbing that pain or desire, driving it far away so we don't have to deal with it or feel it.  We can run to shopping, drugs or alcohol, sex, the approval of others, perfection, power…any number of things that quiet the voices inside of us that want something more.

How do you avoid pain and deaden your heart to your desires?

Pain is uncomfortable, that's true.  Longing typically leads to pain, because our longings likely won’t be perfectly fulfilled in this life.  But if I kill my desire and shove my pain into a deep dark corner of my heart where it will never be acknowledged, my life will be flat.  Maybe I won’t feel sadness or longing, but I also am robbed of my ability to experience joy.

I love that joy and pain are juxtaposed so clearly together.  They are two strong and seemingly opposing emotions, but you have to be able to experience one to find another.  As a Christian, I am grateful for the pain God has brought me through, because the deeply rooted joy I can now experience is so clearly an outflow of that.  I can rejoice and be thankful in God.

How can you choose to acknowledge your desire, knowing that it will be painful?

I need to choose to embrace desire every day.  (And to be honest, I’m not always successful.)  It is easy to find ways to medicate pain in our world, because we as a people don’t like to feel these difficult emotions.  But I must choose to sit in pain or sadness when I feel it, rather than running away from it.  I must choose to become alive to my desires, although that often hurts.  And in so doing, I’m opening myself up to experiencing joy and compassion toward others.