This Is Going To Hurt

By Jeff Levy

this is going to hurt therapy blogNo one wants to feel pain.  At least that’s true for most of us.  In fact, a good number of us make the decision to enter psychotherapy to alleviate pain.  As a therapist, I’ve also been in the position of wanting to support my clients in easing the pain they are feeling.  I’m still not so sure that’s an unrealistic goal.  What I have learned, however, is that the way to assuage one kind of pain often requires that we feel another.  No one necessarily signs up for this.


Trading One Pain For Another

This was the case for Daniel, a 45 year old formerly Catholic man who had spent the last five years coming out as gay, telling his wife and two children, divorcing, and leaving his very strict religious community.

Daniel came to see me because he could no longer bear the burden of keeping his identity secret.  He couldn’t sleep.  He couldn’t function at work.  And he said he couldn’t function as a father and husband.  He felt intense shame about letting down those he loved and also intense shame about his identity as a gay man.

“I have to tell my family,” he said one day, “because the secrecy and pressure is killing me.”

On the surface, it seemed like the solution to Daniel’s dilemma was to relieve himself of the burden he was carrying by telling those close to him about his sexual orientation.  That is where we started our work together; thinking about who he wanted to tell first, what he wanted to say, and his hopes for each disclosure.  Through our conversations, it became clear Daniel expected to feel a great deal of relief in coming out.  And in so doing, he expected he would feel better.

What Daniel didn’t fully acknowledge was that in addition to relief, he might experience pain and rejection; that it was possible he might even continue to feel shame based on people’s reactions.  He knew the course of action he wanted to take, but before he began telling people, we spent time considering how any course of action he would take—staying silent about his sexual orientation or disclosing it—-would most likely result in some kind of pain.

Feeling Pain In Order to Grieve

Lance’s reason for coming to therapy was different, yet the inevitability of experiencing pain as part of his process was similar.  At the encouragement of his wife, Lance came to therapy to address his relationship with alcohol.  In his first session he talked about a long history of drug and alcohol use, some periods of brief abstinence, but a more recent increase in use paired with blackouts.

During the first few months of therapy, Lance shared growing up in a home where he witnessed verbal and physical conflict between his parents.  He talked about his father’s alcohol use, which eventually resulted in his death due to driving while intoxicated when Lance was 16.

Despite his father’s belligerence when drunk, Lance felt close to him and remembered going with him to baseball games and on camping trips.  Because his death was alcohol related, Lance’s anger hijacked his sense of loss.  He spent several sessions talking about his father’s alcohol use as a betrayal, but didn’t make a connection between his own use of alcohol and his father’s.

As these discussions continued, Lance came to a session clearly under the influence.  We’d had a discussion about the importance of coming to sessions sober, so my instinct was to follow our agreement and send him on his way (on foot, of course).  Still, there was something about his mood and his sadness that caused me to have him stay.

It was in that session, that I saw Lance cry for the first time about his father’s death.  And it was in subsequent sessions that we began to explore the way alcohol also helped him manage pain and loss.

While Lance came to therapy to change his relationship with alcohol, it became clear that he would continue to face pain if he continued to drink, and he would face pain if he stopped.  He began to ask himself which pain felt more bearable.  While his path was not linear, he made the choice to become sober and feel the pain of loss.

The Pain of Acceptance

Not everyone’s decision about pain is as clear as it was for both Daniel and Lance.  Eric is a 70-year-old gay man working as an accountant.  He had been in several long-term relationships, but had been single for the five years leading up to his decision to enter therapy.  He expressed hopelessness about ever being in an intimate relationship again, and jealousy of his friends who seemed to have an easier time finding and maintaining partners.

For Eric, finding a partner became his second full-time job.  He placed profiles on every dating app he learned about and spent almost all of his free time either meeting people for coffee or going back and forth via instant messenger with potential dates.  He often came to sessions either extremely excited about an upcoming date or extremely depressed and disillusioned following one.

“The men I am interested in aren’t interested in me, and the men who are interested in me I’m not interested in.  Why do I keep picking the men I do?” he lamented during a recent session.  “I don’t know why I keep trying.  This shouldn’t be so hard!”

Eric’s sadness was contagious.  I found myself feeling sad and hopeless for him.  In retrospect, I think because of my own discomfort with sadness, I flipped into “cheerleading.”  I tried to point out all of Eric’s positive qualities.  I was encouraging about his continued dating efforts and tried to brainstorm other ways he could meet available men.

The more encouraging I became, the more entrenched in hopelessness Eric became.  I started to believe he was continuing to date more to please me than anything else.  And his history of pleasing others at his own expense had been a lifelong theme.

Eventually, I asked him what it might be like to stop trying so hard to meet someone.  Because this was so different than how I had been approaching things with Eric, he looked at me incredulously.

“Are you saying I’ll never find someone?  So you finally think it’s as hopeless as I do?”

It was at that point that I invited Eric’s pain more explicitly into our work.  We began to explore the energy he had been putting into avoiding pain and loneliness—and even how that energy actually magnified his pain rather than diminished it.  He seemed almost relieved for us to be having this conversation.

As Eric considered either being alone or seeking a relationship our work shifted from avoiding pain to understanding the inevitability of some degree of pain.  While we continued our work, Eric made the decision to remove his profile from all dating apps.  He even went so far as to remove his data from sites that were more about sex and hook-ups than they were about dating.

“I think I need to find a way to accept that I might not have another long term relationship,” he volunteered in a recent session.  I realized my cheerleading wasn’t a useful strategy toward this acceptance, so I asked Eric how he might also accept the sadness that might come with this decision.  He concluded that accepting the possibility of some pain was actually liberating, since he had spent so much of his time and energy scrambling to avoid it.

Pain is Inevitable

I don’t know where we would be without pain.  Sometimes pain is a signal to move away from something because of potential danger.  Other times pain is a reminder of an old injury that requires sensitivity and acknowledgment as we move forward.  There is also the pain that is a necessary part of healing. Lance, for example, needed to feel the pain of losing his father in order to grieve.

While it may initially feel counterintuitive to be a psychotherapist who sees the value in pain, I’ve come to believe that we can only be effective in our work when we invite pain into the room and accept it as an inevitable part of our humanity, our grace, and our path toward healing.

My own journey with pain has been a complicated one.  Both my father and his mother suffered from depression that was pervasive and situationally aggravated.  Very early in my life I tried desperately to help them feel happy.  In part, I’m sure that my experience in my family is what fueled my decision to become a psychotherapist.  I am also sure this history makes it harder for me to be with another’s pain without becoming a cheerleader as I did with Eric.

It’s no surprise that it remains a challenge to accept the painful parts of my own life.  I have learned that I am really not a very effective cheerleader for myself.  And despite the knowledge I have about the value of being with pain, my family history shows up with surprising clarity as I unconsciously evoke the cheerleader in my partner when he sees me in pain.

And then I almost always chuckle internally when I hear myself say to him:  “Can you please just let me be sad?”

“There is no coming to consciousness without pain.”
Carl Jung

Written by Jeff Levy, LCSW, Co-Founder and Former CEO
Psychotherapist and Senior Advisor, Live Oak, Inc.

Published on February 13, 2018