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When It Comes to Painful Emotions, Don’t Think — Just Feel


Five words was all it took to break through the blockade that surrounded my heart, freeing it to feel legitimate pain and eventually inspiring it to let go:

Some things are just sad.

A wise friend said this to me over dinner six months after I, at age 33, had suffered two unexpected and rare heart attacks in one week. The sadness he was referring to was not only the malaise that surrounded my subsequent loss of health, heart function, and confidence about life as I had known it. It was also a cloud that settled after I heard the added news that I should never get pregnant, thanks to the condition that caused my heart attacks—spontaneous coronary arterial dissection (SCAD)—in the first place.

Benevolent honesty is a way to be gentle with ourselves (and others) as we (or they) absorb painful realities.

SCADs are the leading cause of heart attacks in women under 50, and they often occur in “perfectly healthy” women (like I was) who are pregnant or postpartum (which I wasn’t). That my body wanted to do this twice when I wasn’t pregnant, the doctors said, would make the chance of it happening again if I was pregnant “astronomically high,” and the impact would almost certainly be “life changing or life ending.”

My friend’s head shifted slightly as he spoke the words. His voice was soft but steady, and his gaze kind yet intentional. There was no mincing of words, psychospiritual fanfare, upbeat suggestions of alternative scenarios, or positive spin. He was simply engaging in what I’ve come to call “benevolent honesty” — a kind of mindful, clear-eyed, no-exaggeration way of handling challenge or loss. He offered his with a present-focused, embodied kindness and compassion. Benevolent honesty is a way to be gentle with ourselves (and others) as we (or they) absorb painful realities.

As a therapist, clinical ethicist, and trauma researcher, I know well that absorbing painful realities is not something we humans easily do; we tend to avoid being in our bodies unless it feels good. After two heart attacks at an uncommonly young age, for no identifiable reason, being in my body felt pretty scary and uncomfortable. That it would also be denied the chance to bear a child only compounded that discomfort.

Whether we do it out of instinct or at the advice of therapists, often our first-line strategies for dealing with sadness, grief, or trauma are “neck up” — meaning thought- or mind-based. For instance, until that dinner with my friend, I had been processing all “sad news” by trying to leverage aspects of my psychotherapy training, namely restructuring my thoughts about the situation in the hopes of helping me move forward. “What doesn’t kill you makes you stronger,” I often reminded myself, as if trying to squeeze drops of resilience from my soul’s dry sponge. I reached for “there’s always adoption or surrogacy,” echoing well-intended friends and family.

“Knowing that pregnancy can cause these heart attacks is a blessing,” I affirmed bleakly on one especially dark night, “because it may have saved my life.” For months, I relentlessly kept trying to conjure rational reasons to explain away the painful emotions that were gripping me from somewhere beneath my shoulders. But the temporary dopamine shot of “feel better” (I never quite made it to “feel good”) that this mind strategy occasionally provided did little to reconcile the lingering body and soul feelings of sadness and grief.

Cognitive elusion and the science of distress

Benevolent honesty is an alternative to what I call “cognitive elusion,” the tendency to escape into our head as a way to avoid painful emotions, concerns, and anxieties and/or heal old traumas by doggedly trying to rationalize or explain them away. Cognitive elusion is a “discomfort detour” that often results in a “resilience roadblock” for one simple reason: Distress affects much more than our thoughts.

Distress of any sort is systemic, meaning it prompts an embodied response. It reaches beyond the prefrontal cortex area of our brain, where rational, higher-order cognitive functioning lies, and penetrates our whole being — not the least of which is our nervous system. Distress causes an immediate drop in “feel-good” chemicals, such as oxytocin, serotonin, and dopamine, and a rise in stress chemicals, like adrenaline, cortisol, and norepinephrine.

Separation from or the death of something meaningful… hurts, quite literally.

This rise in stress chemicals leads to a host of physical, emotional, and mental symptoms. Our heart rate and blood pressure rise, readying our bodies for self-protection. Our breathing quickens or becomes shallow. Our muscles tighten, creating a general sense of tension or unease. And all nonessential functions, like digestion, become dormant — often contributing to feelings of nausea, loss of appetite, dizziness, and difficulty concentrating. Being able to articulate and appropriately express our feelings or desires also becomes difficult or exhausting. When stress chemicals reach a fever pitch, we often shut down as one final act of self-preservation, filling us with numbness and the sense of being isolated, alienated, or disconnected.

In addition to the prefrontal cortex area going offline, the limbic system gets involved. The limbic system oversees personal recall, emotion and memory integration, attention, and our ability to connect with others. Perceiving grief or loss as a threat, the amygdala portion of this system commands our body to resist grief, which is one reason we often have powerful, instinctual responses to stimuli that remind us of what we’ve lost.

Contemporary findings from individual fMRIs also show that sadness and grief may be linked to physical pain. Interestingly, these are the same areas that are responsible for the anxiety infants experience when separated from a parent or caregiver and are yearning for reconnection. Separation from or the death of something meaningful — something that is very dear to us, like a person, dream, or relationship, an expectation or opportunity, or our health, security, or faith — hurts, quite literally.

While there are certainly some situations that benefit from a cognitive approach, it doesn’t universally work, not only because intense emotions, such as sadness, grief, and loss, affect our ability to think and process information effectively, but also because some emotions simply need to be felt in order to be dealt with. Simply put, emotions cannot be deciphered or described at a level equal to their intensity. Clobbering emotions and feelings that emerge with rational analyses or artificial meaning serves only to delegitimize them, and this ensures that they never fully metabolize. Without that metabolization, we can’t fully heal. Sometimes the best way to help the heart and mind recover in the face of sadness, grief, or loss is to get into the body.

I didn’t simply hear and process those words—I felt them viscerally, deeply, wholly. A twinge in my jaw. A hollowness in my belly. A stone upon my chest. A full body existential sigh.

Practicing benevolent honesty: How to be with distress

Benevolent honesty is listening gently with our body to a harsh truth or a painful reality — to all of the tactile sensations that flicker and shift, affecting how we feel and what we think. While these sensations and emotions don’t necessarily feel good, they aren’t anything to fear. They are simply messengers with something important to tell us.

The key to truly understanding the messages (and the key to optimal emotional care in general) lies in regulating how much “flow” (or stimulation) we allow into our internal system. It’s kind of like adjusting the handles on a faucet: too much and we get splattered or soaked; too little and we can’t wash. Finding the right amount of stimulation keeps us regulated and within our window of tolerance, which allows us to do that full-body listening — to recognize what we are sensing in a moment, discern its meaning and purpose for that given situation, and choose whether to hold onto it or let it go.

It can be incredibly helpful to learn how to titrate experience and regulate emotions with breathing exercises so that you’re able to listen with benevolent honesty when distress arises.

Listen to the body

The mind is not a place to escape to when trying to heal from a painful experience. If every time we feel an intense emotion, we try to explain it away or bend it into a form that fits inside a nice, neat “rational” box, we will become like Sisyphus — eternally pushing the immense boulder of distress up a very high hill. The body is the container for all our sensations and feelings, so we must learn to dwell there.

Cognitive elusion may seem like a good strategy when we’re distressed, because it convinces us that we can avoid feeling pain, which is particularly compelling because many of us lean so heavily on thinking. But all it really does is prolong suffering. Benevolent honesty helps us to gently accept that some difficult truth or harsh reality does exist, feel the effect of those realities, metabolize necessary emotions, and, eventually, move forward.

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