Here is a column that appeared in the March 5, 2006 Sunday Telegraph Human Pain and Human Vitality Nearly 30 years ago I had my first panic attack. A productive and reasonably successful young academic, I soon found myself struggling to give a lecture, to speak on the phone, or to ride in an elevator. From the outside I appeared calm – but on the inside I felt I was dying. Literally. Sitting still on a park bench my heart beat 165 times a minute as I fought a battle, not with a physical challenge requiring such blood flow, but with the word machine between my ears. Some of my experiences at the height of this struggle now seem so alien that it is only with difficulty that I can imagine the mindset that produced them. I’ll share one, knowing for many it may simply seem incomprehensible. An airline attendant stood at the front of a plane and described how to use the passenger seatbelts. I watched with a sense of amazement and incredulity, as one might gaze at an impossibly athletic feat during the Olympics. I remember thinking “how can she do that without being terrified?! She has to say all of those specific words, and they have to be right, and do it in front of a plane full of people!” Each of us compares our insides to others’ outsides, and our picture of the human condition is ever distorted as a result. That difference makes it believable that it is our birthright to be psychologically healthy, happy, and carefree – and that feeling good is the measure of a life well lived. Commercial interests are only too pleased to feed this vision, assuring us that we will approach it readily through the right car, home, or vacation. The pharmaceutical industry will provide the right pill; the media the latest “feel good” therapy; and the local bar both the ideal beer, and the setting to find the right romantic partner. It is seemingly only the abnormal person who suffers. The outsides of others provide superficial evidence of the validity of this vision. But what if everyone has a secret? And what if the joke is that we all have the same one? The fact is that almost all people are in pain somewhere in their lives much of the time. It is hard to be fully human. Almost all will struggle and suffer, and find that easy methods of feeling good bear little relationship to living a meaningful, valued, vital life. Anyone who reads the popular media, never mind the voluminous scientific literature on this topic, probably realizes that human problems are pervasive in the developed world. Few, however, seem to face the implications of such statistics considered as a whole. Over 30% of the population will have a psychiatric disorder sometime in their lives. Nearly 50% will struggle with thoughts of suicide for two weeks or more. Divorce rates reach similar levels; second marriages are no better; and the relationships that remain are often restricted or empty. If we add in the rates of emotional or physical abuse, sexual concerns, loneliness, burnout, problems with children, or 100 other such problems we need to consider the possibility that it is human pain is that is nearly universal. In effect it is abnormal to be “normal.” The treacle of modern “feel goodism” is simply false. That was my starting point, 25 years ago. Unable to control my anxiety, and sinking ever deeper into panic disorder as I tried to do so, I began to explore what it would be like to approach what I was struggling so mightily to avoid. I began to research whether it was the emotional and cognitive objects of my struggle that were my enemy, or struggle itself. We now know that one of the most pathological things a human being can do is to attempt to avoid their own thoughts and feelings, and to link their overt actions to this attempt. Researchers such as Frank Bond (University of London) have discovered that the psychological inflexibility that results from this effort produces bad outcomes almost everywhere you look. It predicts more anxiety, depression, worry, and trauma. It undermines your ability to learn new things, enjoy your job, be intimate with others, or rise to the challenges of physical disease. Lance McCracken (University of Bath) has shown that these processes predict far more disability due to chronic pain than the amount of pain or injury itself. Turned outward, the human mind is highly effective. We can predict the future and remember the past; we can evaluate outcomes based on imagined courses of action. It is these symbolic problem-solving abilities that have lead us to dominate the planet, despite being weak, slow, and vulnerable. But these same abilities also entangle us needlessly in a struggle with our own thoughts and feelings. If we don’t like dirt on the floor we can vacuum it up and the dirt will be gone. Conversely, if we don’t like a painful memory and try not to think it –we will make it more of a focus, more frequent, and more impactful. If we fear a future lack of food we can grow plants that will later nourish us. But if we fear the harm produced by future panic and thus try to avoid it, we will have brought that imagined harm into the present and amplified its role in our lives. The human mind has in effect been turned on its owner, merely by allowing it to do what it normally does, but in the wrong domains. It turns out that this is not necessary. We have developed methods to train people in a healthy alternative: accept feelings and be mindful of thoughts without arguing, coming instead into the present moment more consciously and fully, focusing on values and taking actions that move in their direction. For example, if the thought “I’m bad” is present, trying to change it only confirms that there is something unacceptable about you. In our approach we might instead say “bad” 100 times aloud, or sing the thought, or print it on a T-shirt and wear it, or say it in the voice of one’s least favored politician. Like the movie A Beautiful Mind, this defanged thought is then willingly brought along into valued actions, such as being a loving person, or contributing to others. Controlled research shows this these methods are helpful in areas as diverse as anxiety, burnout, diabetes management, smoking, pain, and depression among several others. I walk through these concepts and techniques in Get Out of Your Mind and Into Your Life (New Harbinger; 2005) which was the number one self-help book last week in the United States on Amazon. The basic and applied psychological science behind these methods will be presented for students, therapists, and researchers at a week-long “world conference” July 22-28 at the University of London (see www.contextualscience.org). For the first time in human history, we are trying to raise an entire generation on the message that feeling good equals living well. It is not true. It has never been true. And now we are seeing the sad results in our homes and on our streets. Our task as human beings is to learn how to carry pain without needlessly amplifying it into suffering, while creating a values-based life. Steven C. Hayes University of Nevada, Reno
