The first two of the four noble truths in Buddhist philosophy are that: 1. Everyone wants to be happy, and 2. Everyone suffers. That is what connects us to each other. Even when there are no solutions to erase another person’s pain, we can bring a compassionate presence. We can bear witnesses to our shared human experience. For addiction and mental illness, stigma and isolation turn pain into suffering. We can help to mitigate that. Pain is unavoidable in life, but suffering can be managed and reduced by connection to others. It is painful when someone we love leaves us, but it creates suffering when we believe that loss means we are un-lovable or doomed to be lonely forever. Suffering is how we describe the meaning of pain in a way that diminishes us. Pain wounds us, but suffering prevents the wound from healing. We can’t create a life free of painful experiences, but we can learn to reduce the degree of our suffering.
As I’ve been in this profession over the course of four decades, it has become clear to me that our painful, challenging experiences are the foundation for developing compassion. Certainly, not everyone finds the path through crisis that leads to a greater capacity for caring and compassion. Pain, however, can be a terrific teacher. It shatters illusions and opens doors to connection with others who have suffered. I believe that some problems, like addiction, often begin as a solution to avoiding pain. Many people who develop an addiction have a history of trauma or abuse. Over time, however, the “solution” becomes the problem and people suffer from both the history of trauma and the myriad problems associated with addiction. Ultimately, no matter where you go, there you are. As the Randy Newman song, “Guilty” goes, “…it takes a whole lot of medicine for me pretend that I’m somebody else”.
I’m always aware of the importance of being present for my patients and not diverting their attention to my experiences. It’s a cardinal rule, and rightly so, that the person in the “big chair” doesn’t take center stage. Therapy is not about the therapist; the patient’s needs are always the focus. There are those instances, however, when we can say “I know how it feels to be scared…to be rejected…to be lonely…to feel hopeless…to feel lost”. Empathy is compassion in action. I know from my experience in the “little chair” when I’ve sought help, just how healing it can be to have someone who is willing to be with me in my pain. Being in the presence of a compassionate person – someone who can bear witness – is a powerful experience. To feel that we are not alone, that someone cares about our well-being. That is how suffering is subdued. That’s the work we’ve chosen to do as therapists. I appreciate all the techniques and innovative approaches that we have developed over the years to help people. I have seen quite a few approaches to therapy and different methodologies come and go (anyone today practicing “Primal Scream Therapy”?). I’ve certainly tried many different strategies to be of help to my patients, from EMDR to mindfulness training. My experience, however, is that there is nothing more effective than focusing on our shared human condition.
It’s my hope that when we sit in the big chair, we don’t forget our connection to the joys and sorrows of our own experience. Without that awareness and appreciation of our happiness and suffering, how do we connect in a meaningful way to those experiences in others? I believe that an important goal of psychotherapy is to help us cope with pain in a manner that doesn’t increase our suffering. Through acknowledging our own painful experiences and how we have learned to cope, we share hope and reduce stigma.