I spend a lot of time with suffering.
To provide psychotherapy is to sit with people who are often in the midst of a great deal of suffering, joining them in the space of their pain, helping them hold it, make meaning from it, and take action on that meaning. Thousands of hours of witnessing and sharing in the pain of others has brought to light some truths about what it is to be human, specifically around the universality of suffering. I have found myself turning to Buddhist ideologies, as well as philosophical theories and even the world of endurance athletics, to try to find the words to express more accurately how suffering has presented itself in my work and my own humanness.
One of the core pieces of Buddhism which speaks deeply to our humanity is the concept of dukkha. Dukkha is often loosely translated as “suffering” or “unpleasant.” However, dukkha refers to suffering beyond the physical or even mental pain we tend to consider. It also encompasses disappointment with the loss that comes with change, the dissatisfaction inherent in the impermanence of the things that bring us joy, and suffering from the existential realities of aging, illness, and death. Dukkha sits at the heart of Buddhism’s four noble truths, with the truths presenting a path toward understanding dukkha, its causes, movement away from its causes, and then effort toward an enlightened state. (For more, check out this article). For our purposes, I emphasize here its recognition as a universal element of humanness. No person lives a life devoid of suffering, whether it is physical, mental, or existential. When we enter the world in our physical bodies, they come already equipped with dukkha as a guaranteed aspect of our existence. To live is to suffer.
Universal suffering as a concept can sit heavy. It is unpleasant to suffer, and as a result, we often become preoccupied with not feeling our own pain. We all develop protective parts of us whose sole purpose is to numb, mute, or distract us from discomfort. You may notice internal managers who step in during times of possible stress, such as a tightly wound perfectionistic part of you looking to avoid suffering from making mistakes or disappointing others, or a part who keeps you tense and self-conscious in social situations to try to avoid suffering from judgment or rejection. You may also notice internal firefighters who douse the flames of suffering with alcohol or drugs, distract with compulsive behaviors or a short attention span, or even the ultimate escapist firefighters with thoughts of self-harm. These parts of us can become so strong that we are consumed with avoiding pain, at the cost of living a life that is present, grounded, and open to fully experience our humanness. In fact, living a life oriented to avoid our innate dukkha is to also place limits on our ability to experience the depths of joy, beauty, and connection.
How do we move forward toward fulfilling lives while also enduring human suffering? Things here quickly become complex and deeply personal. Those who practice Buddhism strive to rid themselves of attachments, understanding fully the impermanence, transience, and unreal-ness of all existing things, so that there is no room for suffering when there are no attachments. Fully achieving this state of understanding is enlightenment, or self-actualization. Those who practice other religions also often use those belief systems to hold their suffering with humility and meaning. Personal values can also inform how we understand our innate suffering; values provide direction and purpose, which can offset our struggles and maintain guardrails on our individual paths.
Endurance athletics introduces a scientific lens of how we suffer, and what we do with that suffering. A fascinating line of research has shown that endurance athletes feel less pain than the average person. A key study had participants hold their hands in ice water for as long as possible, and it was found that ultra-endurance runners experienced pain significantly less than non-endurance athlete participants. Non-athletes averaged 96 seconds in the water and rated their pain at the top of the scale; however, the endurance athletes withstood the ice water all the way up until the three-minute safety cutoff, and they rated their pain at an average of just six out of ten. How is it, then, that endurance athletes don't seem to feel pain like others do? The article plays with some different theories, with most of them pointing to psychological adaptation to the experience of pain and suffering. The theory that strikes me the most is that endurance athletes practice suffering as part of their daily training. Through repetition of feeling pain and moving through that pain, they recalibrate their psychological understanding not only of pain, but also of the limits of what they can tolerate. It is a common experience with exercise that our minds tell us that we can handle far less than what our bodies truly can handle. Through frequent exposure to suffering, these athletes have a sharpened understanding of their own grit and the limits of their tolerance.
Let's imagine that we can build up our own grit to handle more general forms of human suffering, or dukkha. While we won't necessarily build grit that through running ultra-marathons or climbing mountains, perhaps we can in other ways. Rather than indulging in the parts of us that want to avoid suffering, what would happen if we were able to sit in our pain, welcoming it as part of our humanness? What if we gently asked our protective internal managers and firefighters to take a step back and give us a chance to actually feel our sorrow, disappointment, pain, and loss, to recalibrate our sense of what we can truly handle? Perhaps increasing our tolerance for suffering would help us not turn so readily to these parts that distract, make us anxious, or encourage us towards substances or risky behaviors; rather, we could have more permission to be our most authentic selves as we move through our lives, open to and accepting of the full range of the human experience. These shifts in coping techniques, however, should not be done without a system of support around us.
Bolstering our sense of connection through sharing our pain with others gives us the foundation from which we can begin to hold our suffering with an open heart. The universality of suffering does mean that we will all experience our own individual pain; however, this universality also gives us a common thread among all people, as well as a common language we all speak. Sharing our pain with trusted family, friends, support groups, therapists, and others reminds us that we don’t have to endure suffering in solitude - in fact, our burdens often feel lighter when we aren’t carrying them alone. Working towards comfort with the vulnerability inherent in sharing, and on the receiver’s side, working on listening without judgment, abstaining from jumping to advice-giving, and showing empathy and compassion, can yield great comfort in the midst of human suffering. We can find this connection in any human relationship with people we trust, and it is the bread and butter of effective therapy. Healing doesn’t happen without connection and empathy as the foundation of the therapeutic relationship.
I am working to embrace my ongoing relationship with suffering - in my personal life, the lives of my loved ones, and of course, the lives of my clients. Witnessing the bravery of people willing to sit in their pain and allow me to hold it with them is an incredible honor. It is these moments where I feel most human - when the universal language of pain is laid bare and felt together.
Dr. Bethany Detwiler is a psychologist practicing in Allentown, PA. She specializes in mood and relationship struggles. She also is an adjunct professor of counseling at Lehigh University.