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Best Therapist in Portland

my musings

A (not so) painful reality

This week I went to the dentist for a cleaning. (Hold your applause till the end.) 

First, a true confession. I have an unreasonable amount of fear, trepidation, and avoidance of dentists. I know, I know. It’s kind of my job to help others with these kinds of things, but well, therapists are humans too. And the truth is, some of us are afraid of things like dentists. And so my anxiety and worry spiraled around in my brain. Maybe you can relate? In between planning how I would get out of it (another snow storm would have been useful), I rehearsed my very old thought trains of how unfair it was that I should have to do this (no one else has to), and how terrible it was sure to be (probably deadly).

Now my logical brain knows this is silly. My grown up, reasonable brain knows a lot of things about dentists that my fight-or-flight brain refuses to acknowledge.  I have, and many other humans have, survived dental cleanings numerous times, and in fact I have zero personal evidence of even one cleaning that led to death.  But that’s how it goes with anxiety. Anxiety isn’t interested in reality. It’s only interested in spinning around in its own toxic fantasy of made up truths (kind of like some social media platforms I suspect). It’s a closed loop shunning outside information. It tells me I might die, and it lights up my brain to save my life (awww, thanks sweet brain! I love you too!).

During this particular trip to the dentist, I was thinking a lot about the idea of predictive pain versus actual pain. For a few days (let’s be honest, a month) I was experiencing predictive pain. This is a mental experience that is pure fantasy. Nothing is actually happening in my mouth, I’m not even in the dentist’s chair. But my brain is sending messages to my body to tense up and respond as if the pain is currently happening. Once I was in the chair, with the tools and the sounds and sensations, I was still experiencing a high level of predictive pain. Tensing up “for when the pain happens.” But when I turned my awareness toward the actual experience, I realized that no pain was occurring. 

Interesting. I observed some more. I paid close attention to what sensations were actually occurring, in real time, in my body. In a sense, I found myself there, in space and time. Not my fantasy self, but my actual self.  And what I found was pretty mind blowing. Sure, there was some discomfort, but nothing I would actually call pain. My body relaxed and I kind of melted. Huh. 

After a minute or two my thinking brain turned back to my fantasy of predictive pain and I tightened up. Bracing for impact. The stress in my body lighting up and a feeling of anxious doom passed over me. I gently turned my attention back to my actual experience and again…I found nothing. No pain. Sure, some discomfort, but it was fine. 

Over and over again I practiced. Moving back and forth between fantasy (body ready to flee) and reality (nothing actually happening that required running) When I moved into the actual moment, and looked closely at my discomfort, I found it very tolerable. Certainly nothing close to death. My fight-or-flight response went offline and relaxed. Magic. 

When we get down to it, predictive pain is so much a part of our lives and we have a hard time distinguishing it from the reality of what is actually happening. Predictive pain lives in its own little loop of horrors, feeds on it’s own propaganda and always ends in the worst case scenario. Real pain is rarely that bad, usually tolerable, and sometimes not there at all. And what’s even more interesting is that this predictive pain cycle is not just interested in physical pain. It is also consumed by predictive failure, loss, unfairness. Really, it’s worried about future discomfort of any kind. And the result is what we call anxiety or anticipation. 

My son is worried he’s going to fail a test and works himself into a melt down. Predictive pain. We are worried about giving speeches, being late, not being able to sleep, paying bills, being alone, not being alone, failing our friends, our friends failing us. Predictive pain.  We are worried about our children…oh man are we worried about them…and our parents, and our partners, and our jobs and…fill in the blank. We are worried. And while these problems surely exist (dentists are real and sometimes dental work is painful, truth), our rumination, worry and anxiety is usually based on predictive pain. It isn’t happening at this exact moment, and our fight-or-flight response is not useful in the least. 

Our sweet brains want to save us from death. All the time. Thank goodness for that. That predictive pain experience is always just a thought away and if we aren’t aware, some of us may spend a good portion of our lives in this fantasy and actually miss what’s actually happening. When we learn to differentiate between predictive pain and actual pain, we can start to practice awareness of what is actually happening and leave our closed loop mind traps for the much more manageable real experiences that are actually occurring. 

Moving from predictive pain into actual experience is a practice. And one that we can practice anytime, anywhere, over and over again. And the more we practice, the more we might become aware of the difference between our fantasy of discomfort and what our bodies are actually experiencing. The next time you find yourself worked up in anxiety and worry about something try this: 

Notice the predictive pain narrative. Name the pain thoughts out loud. (I’m going to fail my math test, and then fail 8th grade, and then not get into my high school of choice and then not go to college and then live at home forever.) Great. Now move your awareness to what your body is ACTUALLY experiencing right now. (My feet are on the floor, my cheeks are wet from crying, my breath is shallow.) Do you feel any pain? (No. I’m okay. Nothing is actually happening. The test is next week.) Notice how the body softens. 

It doesn’t mean the problem isn’t a problem. But once we get out of the predictive pain loop we can incorporate the true information that our worry doesn’t like to pay attention to. So then we can ask ourselves what the actual worst case scenario is. (If I fail, I can always make it up and nothing will really happen. I will be disappointed but lots of people fail tests and life goes on.) Great! Let’s go get a snack! 

Give it a try and let me know how it goes. I can’t wait to hear about your predictive pain awareness.


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