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The Simple Concept of Clean Pain vs. Dirty Pain and How It Can Help You Keep It Together During COVI

One of the concepts of a type of therapy called ACT (Acceptance and Commitment Therapy) that I have always found helpful is clean pain vs. dirty pain. Think of clean pain as the pain that is an unavoidable part of difficult experiences. The sadness that a relationship has ended, or the grief felt after the loss of a loved one. Clean pain can also be physical—the ache in your chest when you hear bad news, or a headache. Dirty pain is essentially all the pain we experience as a way to avoid the clean pain. Examples of this would include avoiding relationships so you don’t end up hurt, declining invitations so you don’t end up too tired or in too much pain (this is a common one I hear from my clients who struggle with chronic pain), telling a loved one she “should have” done something different (either out loud or in your own mind). The basic distinction is that clean pain is actually going through something; dirty pain is going around it.

Dirty pain will always last longer and cause more suffering in the end than clean pain. It prolongs the discomfort.

I’ve found these concepts to be a particularly helpful way to talk about how we handle our emotions during the COVID-19 pandemic. Clean pain would be acknowledging how scary it can be to feel uncertain about our future or to name the sadness and grief that come with so many changes in our lives. Dirty pain would be obsessively reading every news alert or social media post about the virus, picking a fight with a loved one who is following different safety guidelines than you are, refusing to wear a mask or making fun of a stranger who wears a mask. It gives you the illusion that you’re dealing with your pain, but what it actually does is distract you from the clean pain. In each of the above examples, the person is probably feeling (as we all are) fear and uncertainty. Pretending you can learn enough to take that uncertainty away, or pretending that you are strong enough not to need to follow safety guidelines is a form of dirty pain.

One way to know for sure is to check in your body. Clean pain will feel open (probably in your chest) and vulnerable and maybe a little shaky. Dirty pain will feel tense or tight (probably in your chest), closed off or shut down and often feels like it’s moving very quickly (like when you’re angry and it feels like the words fly out of your mouth before you’ve thought them through, or when you instinctively avoid engaging out of fear).

When you spot yourself in a moment of dirty pain, here are a few tips to go through with yourself:

  1. Take a breath

  2. Ask yourself: what’s really going on here?

  3. Don’t take any action that you’re going to have to clean up later. (Yelling at a friend, blaming your partner for an innocuous mistake). Instead, take another deep breath and just notice what you’re feeling. Check for the sensations in the body I described above. Are any of them there? Are others present?

  4. Say out loud what emotion you’re having. It may sound overly simplified, but just saying the words can help make the feeling manageable (name it to tame it!). So for example, I am feeling scared. I am feeling sad. I am feeling frustrated.

  5. Take another breath

  6. Offer yourself some compassion. For example, This is hard. This is scary. These are normal emotions given the circumstances.

  7. Choose the activity that sounds the most appealing for supporting your system next:

  • Talking about your pain to a therapist or friend

  • Journaling about the emotion your are feeling (the emotion that’s behind the clean pain)

  • Going for a walk outside

There is so much uncertainty in regular, everyday life. Throw in a pandemic and things can really start to get tough. I wish you luck in navigating the clean pain and supporting your system through this experience.

And as always, for residents of Texas, I am offering tele-health sessions and would be happy to discuss options for therapy with you. You can contact me here.

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