Pain vs. Suffering: The Hidden Mechanism That Keeps It Going

Before long, we’re no longer dealing only with what happened. We’re dealing with everything the mind has built around it since.

Are you suffering with something?

I don’t mean simply having a problem, because everybody has problems. I mean something that’s moved into your inner life and started taking up too much room, something you return to when you’re alone, when you wake in the night, when you’re driving, or when things become quiet enough for your mind to wander back to whatever’s been troubling you. It may be grief, betrayal, a relationship that ended badly, a frightening health problem, regret over something you did years ago, or something somebody did to you that still feels unfinished. It may even be something that hasn’t happened at all, but which you’ve rehearsed so many times that part of you is already living through it.

The Difference Between Pain and Suffering

I think there’s an important difference between pain and suffering, even though the two are often tangled together. Pain can come straight from life. Someone dies. A marriage ends. We lose our health, our security, a friendship, a business, or a dream we’d been carrying for years. Sometimes there’s nothing to reinterpret because the thing itself is genuinely painful, and I’ve never liked the habit of trying to turn every bad experience into a lesson about growth or resilience. Some things hurt because they matter. Grief after the loss of someone you love isn’t a sign that you need to improve your thinking. It’s part of loving someone who’s no longer there.

Suffering gets more complicated because the mind can take that original pain and extend it, sometimes far beyond the event itself. We replay what happened and imagine how it might have gone differently. We decide what it says about us. We wonder what’s going to happen next and start filling in the blanks with increasingly unpleasant possibilities. We have arguments with people who aren’t in the room, imagine explanations we’ll probably never give, and revisit moments that are already over as though one more inspection might somehow alter them.

Before long, we’re no longer dealing only with what happened. We’re dealing with everything the mind has built around it since.

When Mental Rehearsal Turns Against Us

We’re very good at mental rehearsal, and most people understand how useful that can be. An athlete runs through a performance before competing. A musician hears a difficult passage internally before playing it. Someone preparing to speak in public imagines standing up, finding the right words and getting through it well. We usually think of mental rehearsal as preparation for success, but the same ability can just as easily be turned against us.

You can rehearse being abandoned before anyone leaves. You can rehearse a terrible diagnosis before you’ve been given one, picture the argument before it starts, imagine the humiliation before you make the mistake, or spend hours living through the consequences of a financial disaster that hasn’t happened.

None of this is pretend in the ordinary sense, because the feelings produced by it can be very real. You can be sitting safely in a chair with a racing heart, tight muscles and a churning stomach because of something that exists entirely in your imagination.

That’s one reason fear can become so persuasive. Once the body joins in, it’s easy to mistake the strength of the feeling for proof that the prediction must be accurate. We feel terrible, so we assume something terrible must be happening, or must be about to happen. Sometimes that’s true. At other times the feeling tells us more about what we’ve been repeatedly imagining than it tells us about the future.

One Person’s Pain, Another Person’s Catastrophe

Frames matter here because experience never arrives in the mind completely untouched. We place events in context, compare them with other things that have happened, decide whether they’re temporary or permanent, and draw conclusions about what they say about us and where our lives are going. Much of this happens automatically, which helps explain why two people can go through remarkably similar experiences and come out of them in very different states.

Imagine two people who both lose their jobs. One is frightened, angry and uncertain, but thinks, “I have no idea what I’m going to do next.” The other concludes that this is the beginning of the end, that nobody will want to employ them again, that they’ve failed, and that everything is now sliding downhill. The event is painful for both, but the second person is carrying far more than the event itself.

This is what I mean when I say one person’s pain can become another person’s catastrophe without remedy. From the inside, that catastrophe feels completely real. Telling someone to cheer up, be positive, count their blessings or look on the bright side usually doesn’t help very much, because it doesn’t touch the structure of the experience. If someone has come to believe that what happened is permanent, all-encompassing and hopeless, encouragement alone probably won’t reorganize it.

Taking Apart the Mechanism

It can be much more useful to get curious about how the suffering is being maintained, not in a blaming way, but almost as though you were taking apart a mechanism to see how it works. What actually happened? What did you conclude because of it? What are you predicting now? What scenes do you keep replaying? Which parts belong to reality as it stands today, and which parts have been added by fear, memory, imagination or expectation?

There’s a considerable difference between not knowing how you’re going to get through something and deciding that you never will. There’s a difference between wishing something hadn’t happened and treating it as proof that your whole life has been spoiled. There’s also a difference between knowing that something hurts now and assuming it will always hurt in exactly the same way.

Those distinctions can look small on paper, but they can change the whole experience.

None of this means we should be trying to think our way out of every difficult emotion. Some losses can’t be repaired, and some things leave a mark. If we try too hard to make pain disappear simply because we don’t like feeling it, we can add another struggle on top of the first one. A person may be grieving, frightened or angry for perfectly understandable reasons, and the useful question isn’t always how to get rid of the feeling. Sometimes it’s whether we’re allowing the pain that belongs there without continually feeding it with dreadful predictions and endless rehearsal.

Working With How an Experience Is Held

This is one of the reasons hypnosis belongs in the conversation.

Hypnosis doesn’t alter history, and it doesn’t require anyone to pretend that something painful didn’t happen. What it can do is help us work with the way an experience is being held in the mind. Attention can shift, mental pictures can change, expectations can change, and memories can sometimes be experienced differently. A person who’s learned, without realizing it, to respond automatically to certain thoughts, sensations or images may be able to learn another response.

There’s real research behind this, particularly in the treatment of pain. Hypnosis has been studied in medical procedures, surgery and chronic pain, and many studies have found that it can reduce pain or help people cope with it more effectively. It doesn’t help everyone in the same way, and I’d be deeply suspicious of anybody selling it as a miracle cure, but there’s enough good work behind it to take it seriously.

That makes sense when you think about the nature of pain itself. What’s happening in the body matters, of course, but so does what the person expects, fears, remembers and imagines, along with what they believe the pain means. Hypnosis gives us a practical way of working with some of those processes, and changing them can sometimes change the experience more than people expect.

None of this means hypnosis is a magic eraser for grief, trauma, physical pain or the ordinary difficulties of being human, and I wouldn’t trust anybody who presented it that way. What it does suggest is something much more interesting: our experience of pain is shaped not only by what’s happening, but also by the way we attend to it, what we expect to happen next, what we imagine, what we remember, and the meaning we’ve attached to the whole experience. If some of those things change, the experience itself may change with them.

If there’s something you’re suffering with at the moment, it may be worth looking at it from this angle. There may be a real problem that needs action, a loss that needs grieving, or a situation that simply has to be endured for a while. But there may also be part of the suffering that’s being kept alive by the way your mind keeps returning to it, rehearsing it, predicting what comes next and giving the original event fresh emotional energy every time around.

You may not be able to change what happened, and in some cases you may not be able to change what’s happening now. But if part of the suffering lies in how the experience is being carried, remembered and anticipated, then there’s something there you can work with.

Hypnosis can sometimes help with that very thing.

- Mike Mandel