Avoiding pain is a primary motivation for all humans—therapists included
One needn’t read Freud or Darwin (both of whom have a lot to say on the subject) to understand that avoiding pain is a primary motivation for all human beings. Pavlov can suffice: I touch the hot stove, it hurts, and so, I avoid touching the stove again.
It is understandable, then, for therapists to align themselves against discomfort. Being in a good deal of pain is a common condition for those who seek therapy and therefore, the more decent of us who provide therapy want very much to provide this comfort. However, while we can integrate difficult feelings and experiences without necessarily feeling bad, big changes and adjustments usually come with discomfort.
Feeling better and creating lasting, meaningful change require more than quick fixes
People understandably look to therapy as a tool to feel better. It’s appealing to a therapist’s sense of kindness and caring to offer that. Likewise, insurance companies (and the employers that pay them) want to pay less for healthcare. Feeling better is fairly quick in contrast to the slower process of making meaning. Because of this, therapists and therapy training programs have increasingly aligned themselves with these quicker fixes.
Vagal nerve stimulation, motivational interviewing, EMDR, and, of course, countless psychotropic medications often do help people feel better. But feeling better and creating lasting change, finding meaning in life (including loss and suffering), and self-understanding require something more from both patients and therapists.
Being close to patients’ pain is emotionally quite difficult for therapists. Robert Frost tells us, “The only way out is through.” However, to accompany people in pain on a journey through that pain means feeling it, witnessing it, and tolerating patients’ dislike of it (and even receiving their anger in the process). Skilled therapists with good teaching and supervision can gain help in understanding this and learning how to invite willing patients to tolerate feeling bad while seeing the value in something more rigorous (just as kale will always be a tougher sell than potato chips, but plenty of people enjoy and find benefit in kale).
There is a difference between being in pain and working through pain
We often remain in unhelpful pain by virtue of being stuck in it, avoiding it, or directing it away from its cause. Stuck pain gets stuck because it can’t be properly worked through at the time. Working through pain means understanding it, interpreting it, and connecting it to history. It’s quite similar to seeing a physician. The doctor says, “Tell me where it hurts,” and then, asks questions about the particular nature of the pain, which, alongside other methods of observation, gives an understanding of what is wrong.
There is a crucial difference between being in pain and working through pain that is at the heart of the art of therapy. Pain is a secondary product of suffering. For instance, being in a bad relationship that causes suffering is wholly different than the pain of looking at the reality of that relationship and confronting the frightening parts of what needs to be taken on to change the relationship or leave it. So too with the agony of having been raised by an alcoholic parent, avoiding feelings and the close relationships that could cause hurt in a similar way, and connecting with those old feelings of fear from childhood.
Feeling bad is a natural part of working through and goes along with integration. In therapy, as with removing a knot from a muscle, sometimes we need to disturb the tissue so that it can settle in.