The Difference Between Pain and Suffering

To get the most from your performance, you have to accept the unpleasant — and keep pushing

This month, during the final few miles of the 122nd running of the Boston Marathon, if all goes to plan, elite U.S. marathoner Des Linden will be in a world of pain.

Pain is, after all, necessary for Linden — or any athlete — to get the most out of herself. But, Linden says, “I won’t spend time negotiating with myself about ways to relieve it.” Instead, when the pain arrives, Linden will check in with her body, relax her arms and jaw, and dial in her breathing pattern. “When I’m hurting, I check in with the physical sensations of my body,” she says. “But I also remind myself that this is what I signed up for.”

Linden doesn’t fight the pain. She embraces it. And in her trade, the ability to do so is one of the fundamental elements of success. A 2012 meta-analysis published in the journal Pain found that athletes possess a higher pain tolerance — that is, they can endure more of it until they reach their breaking point — compared with the general population.

Pain can be a bit of a catch-22: often the more you try to wish it away, the worse it becomes. According to modern psychology (not to mention ancient Buddhism), therein lies the difference between pain and suffering. Pain is pain, and it’s bad enough. Suffering — which features distress and misery layered on top — occurs only when you try to fight that pain.

Pain can be a bit of a catch-22: often the more you try to wish it away, the worse it becomes.

Consider the work of Steven Hayes, a well-known clinical psychologist and professor of psychology at the University of Reno, Nevada. He’s shown that the more you resist or try to avoid unpleasant thoughts, feelings, and sensations, the stronger and more frequent they become. “If you cannot open up to discomfort without suppression,” he writes, “it becomes impossible to face difficult problems in a healthy way.”

Hayes’s work is based on acceptance and commitment. When you’re in pain, be it physical or emotional, you need not make it worse by resisting it. It’s better to accept the pain and commit to accomplishing your goals, and often that means carrying the pain with you.

In the midst of pain, “thoughts like ‘This is killing me,’ ‘I can’t stand it any longer,’ or ‘How long will this go on’ may all move through your mind at one point or another,” explains Jon Kabat Zinn in his seminal work, Full Catastrophe Living. “You may find such thoughts coming and going constantly. A lot of them are fear-based, anticipatory thoughts about how bad the future may be. It is good to notice that none of them is pain itself.”

Zinn, who is a professor emeritus at the University of Massachusetts Medical School and a world-renowned meditation teacher, has helped everyone from cancer patients to elite athletes deal with discomfort. “It’s not always the pain per se, but the way you see it and react to it that determines the degree of suffering you will experience,” he writes.

Much like Hayes, Zinn recommends that instead of fighting pain you should acknowledge it and hold it in your awareness — even curiously explore and warmly embrace it. Treating pain in this manner, he’s found, almost always makes it easier to bear.

If you cannot open up to discomfort without suppression, it becomes impossible to face difficult problems in a healthy way.

Embracing pain may sound nice conceptually, but that doesn’t make it easy to do in the heat of the moment. One way to build this facility is through meditation. Studies show that individuals who meditate regularly feel the same amount of pain as those who don’t, but they respond much differently. Instead of reacting to the pain with a massive stress response (i.e., suffering) they accept the pain, sit with it, and then move on. In the words of Zinn, instead of fusing with the pain they are able to “cradle it in their awareness,” which in turn dampens its effect.

Another way to prevent pain from turning into full-blown suffering is to have what my close friend and collaborator Steve Magness calls a calm conversation. Magness, who is a running coach at the University of Houston and also works with many top pros, says that the conversation, which should be deployed when workouts or races start to get really tough, goes something like: “This is starting to hurt now. It should. I’m running hard. But I am separate from this pain. It is going to be OK.”

Similar to regular meditation, Magness’s calm conversation gets athletes in the habit of creating space between the physical sensation of pain and their reaction to it. Obviously, the calm conversation can be applied outside of sport, too.

“If you fight the pain, or freak out at its onset, that’s when you really suffer and tend to crumble,” he says. “But if you learn how to somewhat dispassionately observe your pain, you increase your chances of working through it.”

Want more tips on health and peak performance? Follow me on Twitter @Bstulberg where I share tips daily.

Note: This story was first published with Outside Magazine, where Brad writes the “Do It Better” column. Sign up for Outside’s Bodywork newsletter to get the latest on fitness, nutrition news, and training plans sent directly to you twice a week.