Dealing with Emotional Pain and Solutions

As a therapist that has seen hundreds of clients, I recognize one of the most common issues clients come to me with is their difficulty coping with emotional pain, be it struggling with anxiety, depression, obsessions and compulsions, or substance use. It seems that there are many misconceptions out there about what to do with these difficulties. Ask yourself, what would you do if you have a life-altering decision to make, or if you are awake at 2:43 am ruminating on what happened and what’s going to come? Many try to rationalize, plan to the finest details, or compartmentalize and avoid the suffering. Truth is, sometimes folks come to therapy hoping for quick tools, which can be very helpful if used correctly, to fix these feelings. Since so many are asking, I think an article breaking this topic down to reframe our relationship with pain may be helpful to those in need.

Why do we experience pain?

Physical and emotional pain alike, a pain is your body’s signal to you that something requires your attention. Pain is adaptive in our survival. Consider an accidental burn on a hot pan while cooking. The pain signals to us that our body is hurt, and we must remove our hand from that burning surface to protect ourselves. If we do not experience pain, we cannot know when to take action or if an action is even needed. Emotional pain is quite similar. It informs us that we have been harmed or will be harmed if no measures are taken. In this sense, pain is our ally. It’s nothing but a signal, here to help us. So first, welcome it with open arms, hear it with an open mind. Let it speak to you about your needs and your damage to guide our next actions.

What Do We Do With Pain?

Depending on the theoretical orientation of a therapist, different measures are taken to address emotional pain. I’ll outline what I might suggest depending on which framework is guiding my work with a particular client.

Dialectical Behavior Therapy (DBT)

I love DBT for clients who struggle with overwhelming emotions. It’s packed with worksheets and regulation skills, helping clients take action and adjust their behaviors, not just cognitions. If I were to use DBT, I ask the client to consider these four dimensions: distress tolerance, mindfulness, emotional regulation, and interpersonal effectiveness. In DBT, pain is meant to be tolerated, sat with, while helping the body relax. We settle in first, relax, observe the situation, and only then take action. Decisions that come out of this process respond to pain’s helpful message and are more likely to be helpful to our situations. Radical acceptance is a life-changing mindset. Accept the situations and feelings that come our way, because resistance is where pain actually worsens.

Cognitive Behavioral Therapy (CBT)

CBT focuses on the interaction between cognition, behavior, and emotion: the CBT triangle. In this situation, a client may decide to tackle any one of the three to change the entire chain reaction. We want to take the pain’s message, adjust the phrasing, and take corrective actions. For instance, a teen feels anxious to go to school due to a heavy workload. They may think, “If I go to school, I’ll definitely have a bad day.” I will then label the cognitive distortion, in this case fortune-telling. We can never fully know if anything will “definitely” happen. We then reframe the thought, “If I go to school, I might have a bad day.” The client will then be more open-minded to the school day, try to go to school, and very well may have a different feeling about the experience. 

Exposure and response prevention (ERP)

ERP is all about desensitization to the same pain triggers, aiming to reduce suffering by confronting pain head-on. Pain is, in this case, likely not proportionate to the severity of the situation. The goal is to not shy away from exposing ourselves to discomfort, say touching a public door handle and risking getting our hands dirty, but to progressively desensitize ourselves to the anxiety that comes from the same action/circumstance. When a client makes an exposure list, there will be a subject rating of distress scale (SUDS) to describe discomfort next to every item. We progressively work our way up, lowest to highest, to gradually reduce distress. We aim to prevent responses that are “quick fixes,” such as washing hands very quickly after every exposure, as these responses are typically maladaptive and may reinforce future repetitions.

Let’s speak human to sum things up

I use many other approaches that I did not list above, but if there’s anything universal I can say from years of clinical work and evidence-based training, pain is not something that requires a panic fix. It can be informative, manageable, and tremendously motivating for real changes in our lives if we make space for it and truly listen. In Living Untethered: Beyond the Human Predicament, Michael Singer drives home the idea that it’s not the triggers that intrinsically cause suffering. It’s our reactions and meaning-making that would create pain. It’s interesting, he is speaking of Buddhist mindfulness, but I found it very scientific. I encourage the readers of this article to reconsider their relationship with pain and befriend it, as it is here to help us in the end.

Individual Support

Pain makes life seem more difficult, but it could also be the beginning of tremendous growth. In the end, we always grow from pain, not from pleasure. 

If you’re seeking therapy in Thousand Oaks, I invite you to reach out. Let’s work together to help you evolve and grow into your most grounded, confident self!