Clean Pain vs. Dirty Pain: Can You Tell the Difference?

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Nobody likes pain. It makes sense that we make every attempt to avoid it or make it go away. That’s just part of being human. But why do some humans seem to have less of it than others? There are two types of pain: clean pain and dirty pain. We don’t have a whole lot of choice about our clean pain. But we can create dreadful amounts of dirty pain throughout our lives in reaction to the clean pain.

We start to experience clean pain on the very first day of our lives as we enter a bright, loud, cold, and unfamiliar world. As we develop, our experience of pain expands from physical pain to emotional pain. And as we continue to grow and learn, our minds become very creative in developing various ways to avoid pain. Sometimes our minds try to protect us by creating stories or defenses that tend to provide a temporary solution. But these solutions don’t last and eventually, that pain will recur and our minds will recall what has worked in the past, and following the path of least resistance, our minds employ old familiar strategies again and again, creating more and more dirty pain.

This is normal. Our minds are not our enemies. They are not our friends either. Our minds are designed to function a certain way and sometimes it serves us well, and other times it creates more problems. For example, a client told me that he was experiencing terrible, worrisome thoughts that something tragic might happen to his dear mother. I’ll call him Vincent. Vincent would imagine scenes of her being shot in the head, or driving over a bridge that had just collapsed, or of getting hit by a drunk driver while walking home from the store. When he began thinking these exaggerated, worrisome thoughts, he found it impossible to stop and he would spend lengthy periods of time ruminating and turning over all of these terrible thoughts and images in his mind. When I asked Vincent what might happen if these thoughts were to cease, he froze for a moment and then chuckled. He warned me that what he was about to say was going to sound ridiculous. He told me that as long as he is thinking these thoughts, which he admitted were very unlikely, he knew that his mother was still alive. Telepathic life support!

In this example, Vincent’s thoughts served a function. The hyperbolic nature of the mental scenarios his mind was creating served to protect him from the very likely thought that his mother, approaching her twilight years and suffering a serious heart condition, may actually die in the near future. His mind’s creativity showcased an astonishing and morbid defense against his clean pain. It’s normal to feel pain when you think about your mother’s eventual death. But when we try to avoid clean pain, we end up intensifying it or creating even more problems.

I failed to mention that Vincent was suffering from depression. He wasn’t depressed because of the clean pain of anticipating his mother’s death, because his mind was dutifully and instinctively taking him to this new, weird place. When he was perseverating on the exaggerated thoughts, he could not escape them in time for him to get dressed and go to work, so he had to call in sick. This happened almost every day for several weeks and he consequently lost his job. He also refused to call his mother for fear that she would not answer, assuming she would be dead. So his lack of contact with his mother created disconnection and increased his guilt. It is through dirty pain that we develop emotional problems or mental illness.

Good news!

By developing acceptance toward his clean pain, acknowledging his mother’s poor health, feeling genuine sadness, and exploring his values about being a good son, the morbid thinking dissipated on its own, and Vincent rekindled his relationship with his mother, who he now visits every Sunday to make her breakfast. She will die. Vincent will feel sad. But life is a spectrum and if we aren’t present for all of it, we’re not really alive. Right now, which is the only time that really counts, he is closer to his mother than he can remember. Had he continued to grovel in his dirty pain, he would have never experienced such joy.

Also posted here: http://www.goodtherapy.org/blog/disruption-of-unhealthy-pain/