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Layers of Pain

In therapy, we can think about our painful experiences as having two layers. Each layer of pain has a separate cause. The first and primary layer of pain is encountered when we have negative experiences with external factors. Perhaps our partner breaks up with us, we get let go from the job we love, or we suffer a loss of a loved one. This type of pain is often part of our life experience, and therapy can help someone going through this layer of pain by providing space for this pain to be felt and healed. Often this feels like having someone to walk along side of you, so you don’t feel as alone in your experience. Given the right conditions, this emotional wound will heal, bringing strength and resiliency as you reflect on the difficult circumstances you were able to navigate through.


The second layer of pain is brought on by internal factors connected with our reaction to the primary pain. For example, if our partner breaks up with us, the first layer of pain will be the grief over the loss of the relationship. However, a second layer of pain can be experienced in how we react to this grief. Some of us will tend to blame ourselves, anxiously reviewing our words and actions trying to determine what we did wrong. Others will be unable to sit with their grief and turn to unhealthy coping strategies such as drinking, gambling, or shopping. We might even jump directly into a new relationship in order to avoid experiencing the loss. This second layer of pain is often the target of therapy as it causes more problems (and more pain!) in someone’s life. In the example above, the person who turns to anxiety, addiction, or a new relationship because they are unable to fully grieve the loss of their relationship will suffer much greater than the person who is able to tend to and heal the emotional wound of grief.



Why would anyone add more pain onto an already painful experience? Well, we all try to avoid pain the best ways we know how. If we have not learned ways to be with our pain so that our emotional wound can properly heal, we end up causing more damage. Consider a child who did not learn to disinfect and put a band-aid on his cut, but instead picks at it, causing it to become infected. If we’re not sure how to help our emotional wounds heal, we will continue to rely on habitual ways of trying to avoid our pain which often makes it worse.


Using ISTDP, we explore areas of pain and determine if there are any secondary layers of pain that are preventing an emotional wound from healing. Therapists can’t prevent pain from occurring in the lives of those we work with, but we can help prevent any additional pain that is layered onto an already difficult experience. When we are unknowingly heaping on more difficulties to our already painful circumstances, things can go from bad to worse. However, when we determine what pain is caused by this secondary level, we can resolve the additional pain and start healing the primary pain. Moving forward, we will still experience the first layer of pain, but it will be much more tolerable because we are not adding a second layer of pain onto it.


If you think you might be adding onto your painful circumstances, reach out for a free consultation.

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