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Chronic Pain

Stretching Distress Tolerance

Just because something feels unpleasant doesn’t mean it has to go away.

Key points

  • The more you struggle with or avoid emotions/distress/physical sensations, the more intense they get.
  • Emotions and physical sensations, even unpleasant ones, are messengers. They can give you helpful information.
  • Stretching your distress tolerance allows you to respond to discomfort in helpful ways.
Source: Ryan McGuire / Pixabay
Source: Ryan McGuire / Pixabay

It is natural to want to avoid unpleasant or uncomfortable feelings and physical sensations, to think of them negatively, or to try to make them go away. For example, if I feel embarrassed, I might think, “I hate feeling this way.” Or, if I feel anxious or am in physical pain, I might think, “This feels awful. I need it to go away.”

Our level of tolerance toward discomfort is based upon how much unease we feel about it, how unbearable it seems, and how much we want to get rid of it. While it is true that we can problem-solve or get rid of some external factors and physical sensations—if I am cold, I can put on a sweater; if it is raining and I don’t want to get wet, I can use an umbrella—when we try to apply this same problem-solving/get-rid-of approach to our internal experience, it often makes things worse.

The more we struggle with or avoid our emotions/distress/physical sensations, the more intense they get. One way to end a game of tug-of-war with unpleasant experiences is to remember that emotions and physical sensations, even unpleasant ones, are messengers.

They are signals that provide us with information, including information about what we care about. Generally speaking, if we are upset about something, we care about it or something related to it. If we didn’t care, we wouldn’t feel upset. Also, emotions and physical sensations are not permanent. (At least not completely permanent; even those of us with chronic pain experience fluctuating levels of pain intensity.)

They are changing experiences that constantly vary and eventually pass. I have found that if I practice allowing my emotional and physical experience and let it be, let it “hang out,” it passes quicker than if I struggle against it. This is helpful to me for many reasons, including that it ultimately saves me emotional and physical energy because I am not using energy fighting what is.

Below are some additional suggestions for how you can practice tolerating emotional and physical discomfort.

  • Practice observing your experience. See if you can practice watching or observing your experience as if you can stand to the side of your body and mind and nonjudgmentally notice what is happening. It might be helpful to think of a documentary filmmaker who is holding a camera and filming what is in front of them. This person is not judging what is happening. They are simply filming it. It is important to remind yourself that regardless of what you are feeling, you are not your emotions or physical sensations. You are an observer of your experience.
  • Name your experience. It can be helpful to practice naming your experience in a curious and nonjudgmental way. You can practice this by completing the following sentences: “I am having the thought(s) that…” “I am feeling…” “I am having the physical sensation(s) of…” “I am having the urge to…”
  • Use imagery. Imagery can help to create mental space from unhelpful thoughts. For example, imagine your mind as the sky and your thoughts as clouds or birds that pass in the sky. Imagine your thoughts as credits that move up a movie screen at the end of a film, or imagine you’re sitting in a room with an open front and back door, and your thoughts simply pass through like guests. You can use these same images with emotions and physical sensations. Practicing letting them come and go.
  • Focus on the present moment. Once you have observed and named your experience, allowing it to come and go, practice focusing on the present moment. This could be focusing on a task that is in front of you or a sight, sound, smell, taste, or texture. Or, you may focus on your breath and the sensation of your breath moving in and out of your body.
  • Allow emotions and physical sensations to come back. Emotions and physical sensations come and go. They are not permanent, yet they tend to fluctuate in intensity and circle back around again like a suitcase on a luggage carousel that goes round and round many times (another image I like to use). This is okay. When this happens, go back to observing them and letting them come and go at their own pace.

You can use the above skills to help stretch your distress (discomfort) tolerance. In general, the larger your window of tolerance, the more ability you will have to respond to discomfort in helpful ways.

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