As I mentioned in the previous post I just finished reading the book ‘Everything is F*cked: A book about hope‘ which was quite intriguing, by Mark Manson. You can check out some of my thoughts on the concept of an antifragile system and chronic pain in that post. But he also talks about the nature of suffering and I have heard of this before. Likely you have come across this before. Hell, I have seen memes on it before ‘Pain is inevitable, suffering is a choice’ sort of thing. Which I find true in some senses and debatable in another sense.

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” 

—Viktor Frankl
Chronic pain and suffering


So in his book Mark Manson is right when he talks about suffering. Or at least, I share that theory, in part.

“The Buddha said that suffering is like being shot by two arrows. The first arrow is the physical pain- it’s the metal piercing the skin, the force colliding with the body. The second arrow is the mental pain, the meaning and emotion we attach to being struck… in many cases, it lasts far longer.” (pg186) “That while pain is inevitable, suffering is always a choice. That there is always a separation between what we experience and how we interpret that experience.”

I believe that pain is a physical sensation and that suffering is the mental and emotional attachment to it. But there has been research to show that neurologically they are linked. That you feel the sensation to pain and it sends a signal for the brain. There are linked. We have a reaction because the brain needs an interpretation. So linked, yes, a Choice, no.

However, I do believe we do and we can do things to dampen that mental and emotional reaction to pain. Hell, we do it All the freaking time. We know, for example, focusing on our pain makes it more intense, while distracting from it helps us Not focus on it. We know ruminating on it creates problems because it creates Meaning and then more Meaning and MORE MEANING that was never there before and that can be extremely depressing. I should know… I was awesome at this. I called it the slippery slope into despair and happened frequently with unmanaged high pain at night.

So we know many ways to deal with the emotional and mental consequences of pain from meditation to Cognitive Behavioral Therapy… Art therapy to a gratitude journal… and we pick and chose the best for us to manage these normal responses to pain that we get a damn constant influx of because we have an abnormal amount of pain. We know that also some days are just Bad Days. And we just have to get through them.

So the above quote where the belief is that suffering is a choice, not so much. The idea that without suffering we wouldn’t be human, I can get on board with. An infragile system Gains from stressors and pressure... not avoids them or nullifies them. Gaining strength from it. That suggests that we engage with suffering on a level. Just like we engage with pain. Because they are a linked system.

I’m just saying you can’t get rid of pain, no matter who you are, and certainly not when we have chronic pain. And we cannot get rid of the emotional and mental consequences of pain, no matter who we are, unless we are a Buddhist monk that spent a lifetime doing so, but we can dampen it a bit with all the tricks we pick up to cope with pain.

Relentless pain

The main problem is that chronic pain is so relentless. The physical Pain Itself. It can not be effectively treated. Often it is not effectively treated these days. That then makes it severely limiting as well.


I can deal with temporary pain at an exceptional level because I know it is going to end.


This is never going to end. It is relentless. There is no break. No pause button. No volume control. Maybe I am resilient as F*ck. Maybe I am more antifragile than I otherwise ever would be. Maybe I deal with setbacks way better than I used to.


It literally doesn’t matter. Because it never ends. I will get angry. I will get sad. I will get frustrated. I will have exceptionally bad days. And be in a hell of a mood about it. I will have some crappy thoughts about my pain. I will sometimes cope horribly. Becuase I am bloody well human… no matter how well I cope 91.2% of the time, let’s say, there still will be sometimes I really am having a damn hard time.


I know we adapt to chronic pain. I know we do even when we think we do not cope well we have learned compared to when we started. That is for sure. We definitely do gain perseverance, endurance and resiliency. Yay us.

But we can’t make sense of this. Our brain wants to making meaning from our pain experience and it can’t. It is meaningless constant pain. And any meaning we Make tends to be a crappy belief system that makes us feel worse but we are not even consciously aware of. Like I used to think it made me ‘useless’ and ‘worthless’ and a’failure’. So thanks for the ‘input’, brain. I felt Great with that rolling around my head.

And we are human AND with brains desired to have an emotional response to physical pain so an emotional toll is inevitable and normal. We learn how to direct it and dampen it but sometimes it is just going to get to us. And Sometimes it is just something we need to let out.

There is nothing I think that is weak about normal human nature and a normal human response to pain. Do I think adaptation to suffering and coping with suffering is good? Yeah. I think we have to in some ways. I think that is also human nature. We endure so much more than we ever think we can. But damn, there are times… there are times when it is so very hard to do.

Physical pain has distinct biological and psychological components that effectively represent stimulus and response. The biology of pain is the signal transmitted through the central nervous system that “something is wrong.” The psychology of pain is the interpretation or meaning we give to that pain signal—the internal self-talk and beliefs about it which then drive our emotional reactions. Suffering results from mental and emotional responses to pain. The biological and psychological facets of chronic pain combine to become like a smoke detector that goes on and stays on, continuously sounding a harrowing alarm at high volume.

Psychology today

There is this idea that we can have control over our reactions. Control over how we react to pain in our lives so we can then not suffer. I’d like to see that after a few decades of chronic pain. I really, really would. I really think someone would not be ambivalent about their pain experience at that point. Yes, we dampen it. Again, we work our asses off dampening a Constant signal. And that includes working on self talk and beliefs.

Suffering is both a cause and an effect of the catastrophic cognitions and distressing emotions associated with chronic pain: anxiety, irritability, anger, fear, depression, frustration, guilt, shame, loneliness, hopelessness, and helplessness. Negative thinking only makes situations we believe to be “bad,” worse. Many people, including those who do not suffer from chronic pain, can ruminate on something by continuously and unproductively replaying it in their minds or magnifying the negative aspects of it. Our thoughts have the capacity to make us miserable, and negative thinking can be especially insidious, feeding on itself, with the potential to become a self-fulfilling and self-defeating prophecy. For people with chronic pain, there is a direct correlation between negative thinking and the level of pain they experience. It’s a vicious circle wherein pain triggers negative thoughts and self-talk which translate to feelings that coincide with suffering, and increases muscle tension and stress. That, in turn, amplifies pain signals, triggering more of them.

Psychology today

I do not disagree with the above quote. I certainly spent my fair share of time ruminating, with negative self-talk, and, yeah, it focuses you keenly on pain and suffering. Not that I blame myself. It is really hard to cope when pain isn’t managed and you are trying to hold onto a full-time career and exceeding your pain limits. Life magnified that suffering. Let’s just say that, shall we?

What I disagree with is when we have super duper resiliency, acceptance and worked on our self-talk and cope quite well… we still deal with a level of suffering. The signal of pain never ends. Coping with suffering, therefore, never ends. We are in a never-ending push-pull cycle between pain signals and the suffering it causes. And sometimes we suffer more than other times. We do not Choose to. It is just really hard to consistently, constantly maintain this balance and control over pain and our reaction and response to pain. We can do way better than we used to. Sure. But we are still going to have some really cruddy days. Weeks. Months. Because sometimes it just SUCKS. And we want to acknowledge that. And then go back to trying to dampen and manage our suffering in any way humanly possible.

Now then IS life Suffering according to Buddhism?

That is another story altogether. Because although it is used in this book with a very sharp example it is often a misunderstood concept. I don’t study Buddhism but I do like some of the ideas behind it.

Life is suffering – this link helps describe what is meant by ‘suffering’ and it is a lot more than we put into the word because the ORIGINAL word in the notion is Not ‘suffering’ at all but ‘Dukkha’. It means a lot more than ‘suffering’.

I know you have problems that cause pain. You’re hurt and it’s not feeling nice. The good news is that nothing is wrong with having problems. It’s part of life, life will never be perfect for us to enjoy only when it is perfect, and every single living being, I promise you, has them. However, when we resist the situation, the fact that there is pain and we fill our mind with agitation, anger and aversion about the pain (situation) we are adding another pain. So really, what we are doing, is burden our already painful state with some more pain.

Acceptance, on the other hand, is not (I repeat – is NOT) equal to allowance & agreement. It’s not to say we like the situation that causes our pain.

Acceptance is when we, wholeheartedly, say:

I’m in pain. I don’t like this. But let me stay with this for a short while. What is it that hurts me? And what is it showing me about me and my life lessons? What can I learn? And what can I change? Why and how do I change this?

Little School of Buddhism

This is what the author of the book Mark Manson refers to as engaging with our pain rather than avoiding it. With chronic pain we can have acceptance and that doesn’t mean we do not stop trying to improve our situation, it just means we accept the situation as it is, live life as it is, engage with the pain as it is and limit suffering as best we can. Resisting the situation does cause a lot of mental anguish. Causing a lot of rumination and thoughts that just bring us a great deal of suffering. The fact we cannot change the pain itself is a fact itself that causes us suffering actually. So again we are trapped in a cycle of pain signal, suffering, trying to dampen that response to suffering. Acceptance is just when we are acknowledging this cycle and how we best cope with it.

The quote ‘Pain is inevitable, suffering is a choice’ is not exactly accurate. It is just sort of a succinct way of saying what was actually said. As it says more precisely in the book I read, and specifically in Buddhism:

“When touched with a feeling of pain, the uninstructed run-of-the-mill person sorrows, grieves, & laments, beats his breast, becomes distraught. So he feels two pains, physical & mental. Just as if they were to shoot a man with an arrow and, right afterward, were to shoot him with another one, so that he would feel the pains of two arrows; in the same way, when touched with a feeling of pain, the uninstructed run-of-the-mill person sorrows, grieves, & laments, beats his breast, becomes distraught. So he feels two pains, physical & mental.”

Fake Buddha quotes

And with chronic pain we have to be acutely aware of this. That pain is tangled up with mental and emotional suffering, whether we like it or not. It brings with it a mental and emotional reaction and experience and thoughts and beliefs. We have to figure out, in our own way, on our own paths, how to find balance with that. Complicated by the biological impacts of pain. Complicated by the comorbids of our illness which include mental illnesses like depression and anxiety. Knowing suffering is something we always have to cope with because pain never ever turns off.

Is it any surprise that we Suffer? That we falter? That we need rest? That we deal with intense feelings and thoughts. That we cope really well and very poorly... year to year, decade to decade? If the Pain in your life Never Stopped how well could you Control your Reaction to it… your suffering? The first day? The tenth day? A year later? Five years later? A decade later? Two decades later? Oh, you would struggle. It might break you. It might make you and break you. And then you might find acceptance and balance… for a bit. But then rage against it again. And then later… back to acceptance. Yeah, you would struggle with Choosing how you React every single day of your life this Pain continued on and on and on.

Just saying we have a keen understanding of pain. And a keen understanding and relationship with suffering and how we cope with it. You can choose how you react to it for 100 days and then… it just gets to you… but then you choose how you react to it 100 more… but then it Gets to you again. Push. Pull. That is the nature of chronic pain.

See more about chronic pain

Our Chronic pain story: Plot
Our Chronic pain story: The Theme
Our Chronic pain story: The Author

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22 thoughts on “Chronic pain and Suffering

      1. Yes: There have been people basically wanting me to “man up”, but with no idea what I really go through.
        (And, in certain cases, I wonder if they could handle a week, of what I’ve had for 33 years.)

        Liked by 1 person

  1. I was at the UMass chronic pain center when Jon Cabot Zinn’s was head and researching his book: ‘Full Catastrophe Living’. Actually offers some helpful practices without blame or denial.

    Liked by 1 person

  2. Just because we don’t whine and cry about something does not mean we are not suffering. It also has no meaning as to our strength or indeed anything else. Each person is different, each person deserves to tell their own story and not be generalized into oblivion.
    Over the weekend, out of nowhere, my joints started aching terribly. I stopped climbing the stairs to everyone’s consternation. The pain changes, moves around, does its own thing. I’m not going to explain my pain. I don’t think anyone (outside of hubby) is interested.
    The complexity and amount of medication is ridiculous and expensive! I’m begging to get off of a few of these meds, but not if I feel more pain!
    Pain is, and a pain free person has no dog in the fight and therefor cannot explain pain at all! Nikki, you do a better explanation than anyone I have ever met / read.

    Liked by 2 people

  3. Sometimes I think people who believe suffering is a choice have never had to permanently physically suffer. I have a decent life and I really would be perfectly fine if I hadn’t spent the last 10 year being crippled by pain. I love your post, it definitely made me think about all this in a different way.

    Liked by 1 person

    1. Yes chronic pain makes that whole choice aspect rather out the window. Even the concept we choose how to respond… because I’d like to see someone choose to respond Well to pain every Single day for a decade. Because that would be pretty impressive. I can’t every day for sure!


  4. Hi Nikki. A thought provoking and well written post about pain. I agree with Shelley’s comment. People who think suffering is a choice likely haven’t had to suffer physically on a permanent level. I haven’t read his books. I’m curious to know if he lives with physical chronic pain or if he’s just writing about pain in general. I enjoy Toni Bernard’s series on a Buddhist perspective of living with pain greatly. Her Turning Straw into Gold column on Psychology today Today is terrific.

    Liked by 1 person

    1. He is writing about pain and suffering generally since his book is a sort of different perspective on the nature of hope. But it got me thinking because chronic pain is just never really something anyone considers with pain and suffering… and we are the ones that really really explore the depths of it


  5. November 2nd 2020 was my 18th anniversary of the worst pain I have ever known although I had lived with the bearable chronic pain of FIbromyalgia as well for 30 years. Now 2nd 2002 is etched on my brain as the day something “went” in my spine leaving me bedridden for 9 months with a doctor who didn’t believe me and said I was just hysterical. He wouldn’t even give me paracetamol and left me screaming with pain and in shock. Slowly over those months the shock turned to determination to find a way to live again and with the help of Bowen Therapy I managed to get back on my feet again- literally; changed GP, got admitted to hospital and put on strong opiates which at least made me able to function but still in pain. I have tried every alternative therapy that exists and often ended up teaching the therapists how to cope. I can’t walk my dog; I can’t stand for more than 3 minutes, I rarely see friends any more and most have drifted away but I can function. I can write, I can paint, I can garden if I sit down, I can be successful. Lockdown has meant nothing because I’ve spent 18 years locked down .. But despite the disbelief of other people including my husband I have become used to the pain and accepting that it will be there forever but it will change. Not all days are as bad or as good. i make the most of the good ones and a while back I wrote this.
    It won’t beat me

    When every day is filled with pain;
    When you wake with the lark and think “Oh not again;”
    When every small task is just too much;
    When you try and fail to just dust and such;
    When your friends drift away because you have to say
    “I really don’t think I can get there today.”
    When just getting dressed is really too hard
    And every movement puts you on your guard;
    When a trip to the shops gets put off to tomorrow
    And your life seems full of nothing but sorrow
    Then look at your pain, through different eyes
    The pain you feel now won’t respond to your sighs
    What you’re feeling right now will be gone in a trice
    And that pain can’t come back, you won’t feel it twice
    What you feel the next moment is something quite new
    It may not be as bad, could bring peace to you.
    Take each minute and relish it, don’t let pain win
    Pack it up, throw it out, put it into the bin.
    Make the most of each moment and sit up and say
    “This thing won’t control me.
    It won’t go away
    But I will decide what I can do today.
    I’ll be in charge not this thing they call pain.
    I’ve beaten it once. I can do it again.”

    Liked by 2 people

    1. No matter what we find a way to fit a life in there. Although it is very difficult to do and harder for others to fathom, we have to in some way endure and have things we can do.


  6. Nikki

    I love your blog! I’m so sorry your suffering with Vertigo. Can you recommend some books you have read about chronic pain?

    Chronic pain sucks. That’s it. We Warriors have to fight everyday. God help us all


    1. There are a lot of books I have read that have helped in many ways:

      Resilience: Powerful Practices for Bouncing Back from Disappointment, Difficulty, and Even Disaster by Linda Graham

      The Pain Companion by Sarah Anne Shockey

      And for overall health The Whole Health Life by Shannon Harvey which was a great read with just th right balance of research to back everything- and that I rather like a lot.


  7. On chronic pain, I recomend ,” Nikki’s blog”. Truly inspirational. I have followed you over the years and I can say you helped me understand my Lupus issues more than my doctor’s b/c you explained where it make’s much sense. Thank you for the years of inspiration and understanding whether the conscious mind or the unconscious mind.

    Liked by 1 person

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