Dealing with Emotional Pain: No Laughing Matter.

By Aiala

I don’t think I've ever met any normal human being that hasn't met, at least once in his life (or many times) with the “emotional pain” monster. That tremendous feeling of devastation stuck in our throats, chest or any other place in our body where he makes himself at home. We feel like crying and sometimes the helplessness is so great we can’t even shed a tear. This leads to even harder feelings of frustration and distress, to hopelessness and depression.

Emotional pain can be caused due to many different factors, each one independently or a mix of them: the ending of a relationship, loneliness, unemployment, the loss of a loved one, illness, feelings of emptiness or being unfulfilled, low self-esteem, and so on. And the truth is that you don’t need to justify your emotional pain: if it’s there, it’s real and it needs your attention and care.

What is Emotional Pain?

Psychological pain is an unpleasant feeling (a suffering) of a psychological, non-physical, origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It is mental suffering; mental torment."^[1] There is no shortage in the many ways psychological pain is referred to, and using a different word usually reflects an emphasis on a particular aspect of mind life. It may be called mental pain,^[2][3] emotional pain,^[4] psychic pain,^[5][6] social pain,^[7] spiritual or soul pain,^[8] or suffering.^[9][10] It is sometimes also called psychalgia.^[11] 

While these clearly are not equivalent terms, one systematic comparison of theories and models of psychological pain, psychic pain, emotional pain, and suffering concluded that each describe the same profoundly unpleasant feeling.^[12] Psychological pain is believed to be an inescapable aspect of human existence.^[13]

Emotional pain is a very serious matter and should be treated as it. The emotional or psychological pain we feel inside is real, and the physical pain we feel due to the emotional one is real as well. It’s not just a bad joke of our psyche; even so that many sources mention the fact that we use metaphors of physical pain to refer to psychological pain experiences, better known as a psychosomatic symptom.^[12][13]

 Somatization is defined as the tendency to experience psychological distress in the form of physical symptoms. Astoundingly, in one study of 1000 patients presenting over a 3-year period with 567 new complaints of 14 common symptoms (including chest pain, fatigue, dizziness, headache, edema, back pain, shortness of breath, insomnia, abdominal pain, numbness, impotence, weight loss, cough, and constipation) a physical cause was found only 16% of the time ( Alex Lickerman, M.D. in Happiness in this World).

The purpose of these symptoms is to occupy and distract the consciousness, to prevent it from discovering or dwelling upon repressed sensitive emotional issues. The subconscious mind perceives these issues to be a threat to the consciousness and self image of the individual and will do whatever it takes to conceal them (see defense mechanisms).

Physical pain and related symptoms are extremely effective ways to make sure the conscious mind stays focused on the physical body, which gives it no time or resources to probe into the depths of the hidden subconscious [14]. 

What makes it worse and harder to deal with this pain is the way we feel about it (shame, resentment, confusion) or not even understanding what is happening to us. This usually leads to different reactions:

Anger: When we are in emotional pain, it is very often – and maybe the most common primary reaction– to feel anger and resentment towards the one who caused that pain: it could be G-d, an ex or actual partner, a friend or even ourselves. Inside we believe that the aggravation was done TO us, in a personal way, and we feel resented, betrayed, sad and disappointed. According to Steven Stosny, Ph.D. in Anger in “the Age of Entitlement”, over time, the blame-anger response congeals into chronic resentment, which is a generalized, automatic defensive system geared to protect an ego made fragile by the perceived need of protection.

Denial:  denial is probably one of the best known defense mechanisms, used often to describe situations in which people seem unable to face reality or admit an obvious truth (i.e. "He's in denial."). Denial is an outright refusal to admit or recognize that something has occurred or is currently occurring. Basically, the pain is so deep we feel we can’t even affront it. So we busy up our lives, filling it with entertainment, work, sports or anything else that will help to cover the pain and make as if everything is just fine.  So it’s of no surprise that the same day of a major break-up with your long term partner, your friend might find you laughing out loud drunk in a bar, telling everyone that you've never felt so great before. For further reading on Denial Defense Mechanism, click here.

Social Isolation: due to the shame we feel inside as for feeling the way we do, we live in constant fear of rejection. We judge ourselves harshly, condemning our feelings as childish, immature, stupid, unreasonable and so on. We tend to believe that if someone would find out the way we feel inside, s/he would reject us, scoff us, or probably think we are exaggerating or that something is seriously wrong with us. We walk through life feeling misunderstood, lonely and different, leading us to draw away from close friends and/or family instead of seeking help and comfort from them. Finally, the emotional pain we were originally feeling worsens by the pain of loneliness and feelings of alienation making it mostly unbearable, darkening our inner view of the world and life.

Negative Compensation Behaviors:  The term compensation refers to a type of defense mechanism in which people overachieve in one area to compensate for failures in another. For example, individuals with poor family lives may direct their energy into excelling above and beyond what is required at work. In a positive way, compensation helps us achieve great success in areas where we feel stronger at (ex. Art making) as a compensation for our lack of aptitude on math. In a negative way, when referring to compensation behaviors due to emotional pain, it is most common to find people adopting compensation behaviors to “fill” the hole caused by their pain, instead of finding a way of healing it. these compensation behaviors differ strongly from each person. Still, the most common ones are: smoking (as for anxiety), eating (as for loneliness), compulsive shopping and any kind of addiction.

Self-destructive behaviors: Self-destructive behavior is often a form of self-punishment in response to a personal failure, which may be real or perceived. Self-destructive behaviors may be used as a coping mechanism, when things get to be 'too much' to handle, and especially when we are passing through an emotional pain period in our lives, and we blame ourselves for it.

It manifest itself in different ways: as an active attempt to drive away other people. For example, they may fear that they will "mess up" a relationship. Rather than deal with this fear, socially self destructive individuals engage in annoying or alienating behavior, so that others will reject them first.

More obvious forms of self-destruction are eating disorders, alcohol abuse, drug addictions, sex addiction, self-injury, and suicide attempts.

An important aspect of self-destructive behavior is the inability to handle the stress stemming from an individual's lack of self-confidence- for example in a relationship, whether the other person is truly faithful ("how can they love someone like me?"); at work or school, whether the realization of assignments and deadlines is possible ("there is no way I can complete all my work on time"). Self destructive people usually lack healthier coping mechanisms, like asserting personal boundaries. As a result, they tend to feel that showing they are incompetent is the only way to untangle themselves from demands.

Successful individuals may self-destructively sabotage their own achievements; this may stem from a feeling of anxiety, unworthiness, or from an impulsive desire to repeat the "climb to the top."

Self-destructive behavior is often considered to be synonymous with self-harm, but this is not accurate. Self-harm is an extreme form of self-destructive behavior, but it may appear in many other guises. Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions. The most common form of self-harm is skin-cutting but self-harm also covers a wide range of behaviors including, but not limited to, burning, scratching, banging or hitting body parts, interfering with wound healing (dermatillomania), hair-pulling (trichotillomania) and the ingestion of toxic substances or objects [15, 16, 17].

IMPORTANT: if you are dealing right now with emotional pain, and you are hurting yourself in any way described above or in any different way, or the pain has prolonged for more than 6 weeks affecting your daily tasks (waking up, sleeping and eating patterns, not going to work), personal relationships, mood,etc., please seek professional help asap. Call a friend, a relative or anyone you trust and know you are safe with. Do not feel ashamed of what you are going through. Know that you are not alone, and usually people close to you will be happy to lend a hand, support you and be there for you. Getting help will help you feel much better, and hopefully the pain will pass. 

If you are a therapist, and your patient is hurting himself or suffers from any symptoms described above, make sure you get the right supervision on the case, and maybe a psychiatric consultation is recommended as well. 

Click here to learn how Art Therapy can help you heal your pain!

References:

1.     Shneidman ES. The Suicidal Mind. Oxford University Press; 1996. Appendix A Psychological Pain Survey. p. 173.

2.      Weiss E. Bodily pain and mental pain. The International Journal of Psychoanalysis,. 1934;15:1-13.

3.      Orbach I, Mikulincer M, Gilboa-Schechtman E, Sirota P. Mental pain and its relationship to suicidality and life meaning. Suicide and Life-Threatening Behavior,. 2003;33(3):231-41.doi:10.1521/suli.33.3.231.23213.

4.      Bolger EA. Grounded theory analysis of emotional pain. Psychotherapy Research,. 1999;9(3):342-62. doi:10.1080/10503309912331332801.

5.     Joffe WG, Sandler J. On the concept of pain, with special reference to depression and psychogenic pain. Journal of Psychosomatic Research. 1967;11(1):69-75.

6.     Shattell MM. Why does "pain management" exclude psychic pain?. Issues in Mental Health Nursing. 2009;30(5):344. doi:10.1080/01612840902844890.

7.      Macdonald G, Leary MR.. Why does social exclusion hurt? The relationship between social and physical pain. Psychological Bulletin. 2005;131(2):202-23. doi:10.1037/0033-2909.131.2.202. PMID 15740417.

8.     Spiritual pain: 60,000 Google results. Soul pain: 237,000 Google results.

9.      Rehnsfeldt A, Eriksson K. The progression of suffering implies alleviated suffering. Scandinavian Journal of Caring Sciences. 2004;18(3):264-72. doi:10.1111/j.1471-6712.2004.00281.x.

10.     Psychalgia: mental distress. Merriam-Webster's Medical Dictionary. But see also psychalgia in the sense of psychogenic pain.

11.     Meerwijk EL, Weiss SJ. Toward a unifying definition of psychological pain. Journal of Loss & Trauma. 2011;16(5):402-12. doi:10.1080/15325024.2011.572044.

12.    Wille RSG.. On the capacity to endure psychic pain. The Scandinavian Psychoanalytic Review. 2011;34:23-30.

13.   Flaskerud JH.. Heartbreak and physical pain linked in brain. Issues in Mental Health Nursing. 2011;32:789-91. doi:10.3109/01612840.2011.583714

14.   http://www.cure-back-pain.org/psychosomatic-allergies.html

15.   Klonsky, E. D. (2007), "The functions of deliberate self-injury: A review of the evidence",Clinical Psychology Review 27 (2): 226–239, doi:10.1016/j.cpr.2006.08.002,PMID 17014942

16.   Skegg, K. (2005), "Self-harm", Lancet 336: 1471

17.    Truth Hurts Report, Mental Health Foundation, 2006, ISBN 978-1-903645-81-9, retrieved 2008-06-11