Psychologist, Tara Brach approaches therapy using mindfulness as the foundation to healing; she does this through a blend of westernized therapy and eastern buddhist practices. Her website www.tarabrach.com, has hundreds of free recorded talks, videos, and articles where she investigates different facets of the human experience; pain being one of them. In the video The Dance with Pain that I attached below, Dr. Brach explores the relationship between emotional and physical sensations when dealing with acute and/or chronic pain and discomfort. Dr. Brach reminds us when humans feel pain - they tend to contract against the pain, they judge the pain, and blame themselves, others, and/or the pain. However, this fight and resistance tends to create more physical and emotional pain/discomfort. Dr. Brach then goes on to clearly teach us ways in which we can mindfully inhabit our bodies and learn how to listen and respond to the pain with awareness and compassion.
Pain is Distressing….But Distress Can Be Tolerated!
Through Distress Tolerance we learn how to get through difficult moments until they pass.
Through distress tolerance we move to do something that will help us ride through a difficult, but transient, time.
Distress tolerance is about willingness and acceptance…being willing to accept your current situation and then to do something about it.
The purpose and goal of distress tolerance coping skills are to cope with and get through particularly difficult moments until they pass and one is in a better moment.
Thus, these skills are to be used when one is in significant physical and/or emotional pain or distress. Through the use of these skills, we do not fight with our pain. Instead, we accept the pain and the difficult moment, but we empower ourselves to manage the moment.
The trick is to use distress tolerance strategically and deliberately…so you know what to do and you are in control during the most difficult times.
Distract: Through distraction we focus our attention away from our pain and onto something else.
Sensory Distraction: In this process we activate the part of our brain that is more involved with our senses (sight, touch, sound, taste, smell). In doing so, we de-activate the part of our brain involved in physical pain and emotional distress. It will not make the pain go away, but it will quite literally turn down the volume of the pain.
Examples of Sensory Distraction: exercise, holding ice and feeling it melt in our hands, listening to music, tapping our leg with our hand, smelling something strong/odorous, eating something with a powerful taste.
Cognitive Distraction: Here we activate the part of our brain focused on logical and rationale thinking, reflection and imagination. In doing so, again we de-activate the part of our brain involved in physical pain and emotional distress. Our mind can only focus attention on one thing at a time, although our attention can shift quite rapidly and frequently. However, by sustaining our attention on something that is interesting or mentally stimulating, our focus is taken off of our pain and distress.
Examples of Cognitive Distraction: Reading a book, playing a musical instrument, watching a movie, crafts and projects, puzzles, anything that requires or activates focus and attention.
Self-Soothe: This is similar to distraction, but in a soothing, enjoyable and comforting way. Use your senses (vision, touch, hearing, smell and taste) to soothe and bring comfort to yourself. The same activation and de-activation process in distraction occurs, although self-soothing requires a willingness to be soothed.
Examples of Self-Soothing: Watch a sunset, pet a pet, take a hot bubble bath, get a massage, listen to your favorite soothing music, watch a funny movie, listen to the birds, watch children play, eat and savor a favorite food, anything that brings enjoyment and comfort.
Improve the Moment: The idea with Improve the Moment is that you are going to be in pain anyways, so you might as well do something productive. Otherwise, all you have to show for your time is pain and distress. So, tell yourself “I am going to make the best of this difficult time and do something to make my life a little bit better.”
Examples of Improve the Moment: Pay the bills, exercise, do some chores, respond to emails, call a friend, work on your resume, look for job opportunities, wash your car, play with you kids or pets, you get the idea.
It too Shall Pass: This is more of an attitude and an outlook versus an active coping strategy, nonetheless, it can be quite effective. Keep in mind that life is always changing and distressing moments pass. Every moment leads to another, and we know from life experience that the next moment can bring something else and something better.
Use this as a mantra for It Too Shall Pass:
Moments pass, that is the nature of moments. Don’t get stuck in a bad moment - wait for a good moment to come. Remember, a good moment is just around the corner waiting for the bad moment to pass.
Vacation: Take a small vacation from your life and the stress that comes along with it. A weekend, a day, or even an hour away from what you usually do can revive and redirect energy. Vacations recharge and restore us to balance. Be specific and plan it out, or specifically plan not to plan. Treat yourself to something out of the ordinary, something special, something fun. Remember, a good vacation takes some thought and planning.
Try these techniques when you are feeling overwhelmed by your pain (or any upsetting situation). While we can't always make our pain go away we can make riding it out less distressing.
For more information on distress tolerance see this great website: titled DBT Self-help.
Krista Jordan, Ph.D., ABPP