Pain Versus Suffering

Pain Versus Suffering is part 2 in the series, When You or Your Loved One is in Pain. We will be taking a look at the emotional and psychological aspects of pain…as well as the concept of suffering. Are pain and suffering the same thing?

But, before we begin, let’s review part 1 of this series where we explored the perception of physical pain, that is, how pain is experienced in our bodies. How do we sense pain? We know that pain is real. It impacts our lives in many ways. One of the best lines of defense we have to deal with any problem, such as pain, is to understand more about it. When we understand something…the what, why, and how of something…we are more capable of planning our response to it. For a review of part 1 of this series, I invite you to click on this link: How Do We Sense Pain?

And now, returning to our initial question: Are pain and suffering the same thing? Jade Wu, PhD (Quick and Dirty Tips) relates “Pain and suffering don’t have to go in hand. While pain is unavoidable in life, suffering is optional.”

A Discussion About Pain

Definitions Of Pain

Because pain is primarily a subjective experience, we find that there is not just one definition for it. You may define it one way, I may define it another way. In part 1 of our series, pain was defined very simply by a famous cartoon character:

“Pain is when it hurts.”

Charlie Brown

We also defined it in a more medically precise way:

Pain is “a more or less localized sensation of discomfort, distress or agony, resulting from the stimulation of specialized nerve endings.”

Dorland’s Medical Dictionary

Whether defined by a cartoon sage or a group of esteemed physicians, we can all pretty much agree that pain “hurts.” It can cause “discomfort, distress, or agony.” How would you define pain?

Emotional Responses To Persistent Pain

In part 1 of this series we identified several different types of pain (see How Do We Sense Pain? for a list and definitions of these various types of pain). One of the most debilitating types of pain is chronic pain.

Chronic pain can be caused by “ongoing tissue damage, such as in osteoarthritis. However, in some cases no physical cause for the pain can be found or pain persists long after the injury has healed.”

myDr

These Feelings Are Real

In my career as a Clinical Social Worker, I often worked with clients who had significant pain issues and were experiencing feelings such as those listed above. Many times I had to make the decision as to whether or not I would self-disclose my own challenges with physical pain. In some cases I did not disclose, in others I did. In those instances I don’t remember ever disclosing my entire pain story…as I did not believe clinically it was in the best interest of the client. I feel certain that other mental health professionals have had to make those decisions in their work as well.

Now that I am retired, and no longer see clients in a clinical setting, I am more free to self-disclose. I won’t go into the details of my pain story, but I will acknowledge that I have experienced persistent pain for many years. My pain is due in part to issues with osteoarthritis, fibromyalgia, and two rather complicated knee replacement surgeries. What I can attest to is that the emotions that are associated with chronic pain are real.

Clinicians and Loved Ones: It’s important to understand the possible emotional responses when someone is in pain.

A Discussion About Suffering

Definitions Of Suffering

“Suffering is the struggle, denial, worry, regret, indignation, complaining, and self-pity wrapped around pain.”

Jade Wu, PhD (Quick and Dirty Tips)

“Suffering is not a mere sensation, like pain. Neither is it an emotion, like sadness or fear. It’s a state that encompasses our whole mind, that is made not just of negative emotions but also of thoughts, beliefs and the quality of our consciousness itself. Suffering, like its opposite, happiness, is a state of being.”

Speaking of Research

Suffering can be associated with pain, but it can also, as cited above, be a “state of being.” Suffering is more of a negative mindset. When in pain, suffering is almost like wearing blue-colored lenses in your glasses. You can see, but everything looks “blue” (please excuse the pun). Let’s look at what suffering can look like in action (courtesy of Jade Wu, PhD):

• “Why is this fibromyalgia happening to me? What did I do to deserve this?”
• “I always have the worst luck. This couldn’t be worse timing for breaking my arm!”
• “I hate this cramping so much. When will it ever end?”
• “These migraines are never going to go away. I can’t take it.”
• “How come I ended up with arthritis but my partner didn’t? It’s not fair”
• “I’m young and healthy – I shouldn’t have back pain!”

“Suffering cannot sit still. It wrestles with the pain, trying to deny it or bargain with it, judging it, condemning it, blaming it on someone, projecting it into the future, regretting it from the past.”

Pain Versus Suffering

A Story

Several years ago I was involved in certification training for Interactive Guided Imagery(sm) at the Academy for Guided Imagery. My mentor, Dr. David E. Bresler, told a story that highlighted the concept of Pain Versus Suffering. Although I cannot recall the story word for word, please allow me to paraphrase (sorry Dr. Bresler!).

Dr. Bresler told the group about two clients that he treated in his psychology practice, both who experienced chronic pain issues. He said that the first client came to see him, in much distress. She was complaining of severe pain and suffering, holding up her hands to show him the arthritis in her fingers. She was very distraught because she would no longer be able to play the piano as she once had. This was devastating to her.

Dr. Bresler then described his second pain client, stating that she came into his office with a smile on her face…and with a serene demeanor. He asked her how she was doing and she related that she was doing well and having a good day. She did not appear to be in any distress, although Dr. Bresler knew that she, too, was experiencing significant pain. The difference between his first and second client, however, was that this smiling client came into his office in a wheelchair and she was severely disabled.

In this story, it’s quite obvious that there is indeed a significant difference between pain and suffering. Dr. Bresler’s first client had little pain (confined only to her fingers) and suffered greatly. His second client had significant, debilitating pain and suffered little.

But how can this happen?

Pain Versus Suffering. We all will experience physical pain in our lives. How we respond to that pain is a choice. I’m not implying that this choice is an easy one. You sprain your ankle and end up in the Emergency Department for tests, only to be told that your ankle is indeed broken and will require a cast…and you’ll have to walk with crutches. You hear this news as you are in incredible pain and *POOF* you choose not to suffer. It doesn’t work that way. But…we do have choice over our thoughts.

Dan Mager, MSW (Psychology Today) writes: “Our thoughts have the capacity to make us miserable, and negative thinking can be especially insidious, feeding on itself, with the potential to become a self-fulfilling and self-defeating prophecy.”

He goes on to state: “For people with chronic pain, there is a direct correlation between negative thinking and the level of pain they experience. It’s a vicious circle wherein pain triggers negative thoughts and self-talk which translate to feelings that coincide with suffering, and increases muscle tension and stress. That, in turn, amplifies pain signals, triggering more of them.”

How Do We Break This Vicious Circle?

Is it possible to break this vicious circle? Dan Mager, MSW (Psychology Today) puts it this way: “Is this easy? Of course not. However, it is absolutely possible. By adjusting our thinking, and how we think about our thinking, we can change our emotional responses, the extent to which we suffer (or not), our level of tension and stress, and in turn, our experience of pain.”

And, In The End…

I have been privileged to work with many clients as they bravely faced their pain and resulting emotional issues. And, I have continued on my personal journey to find ways to deal with my own pain concerns. Pain is real. The struggle is real. And the good news is that there is help and hope out there!

Stay tuned for part 3 in our series, When You or Your Loved One is in Pain. It will include a variety of mental health tools, tips, techniques, and resources for pain management, as well as our emotional responses to pain.

As always, your feedback is appreciated!

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