Managing pain in the real world.


When we’re in pain, our first job is to acknowledge that pain exists in our world right now, and needs to be managed. 

A lot of people lose a lot of momentum in managing their pain by going through a long period of denial, in which they try to pretend their pain doesn’t exist. 

The reason I want you to acknowledge your pain, rather than pretending it doesn’t exist, isn’t because I’m some sort of sadist. 

The reason is actually pretty simple: you can’t manage something you refuse to admit exists. 

Let me say that again: you can’t manage something you refuse to admit exists. 

This holds true for all sorts of pain: physical pain, depression, anxiety, grief. If you’re interested in managing it and not letting it control you, you’re going to have to look it in the eye. 

No way around it. 

Pain inconveniences and incapacitates us exactly as much as it does. No less, but no more— unless we tun the volume up on that pain by pretending it doesn’t exist. 

If we acknowledge our pain— its exact nature, its exact intensity, the exact ways in which it incapacitates us— we can start to formulate a realistic plan to work around it. 

If we acknowledge our pain, we can begin to consider useful, effective strategies to minimize and turn the volume down on that pain. 

Put another way: how do you expect to formulate a truly effective strategy to work around or work through something if you haven’t acknowledged and examined the EXACT parameters of that thing? 

Pain freaks us out. We don’t like it, obviously. 

But pain freaks us out on an even more basic level: when we experience pain, our evolutionarily-honed response is to escape that pain as soon as possible, because we don’t know when the hell we’re going to be out of that pain. 

The cave-people ancestors in our evolutionary history figured out that things that hurt you often end up killing you. So the instinct to escape pain as soon and as emphatically as possible has been hard-wired into our behavioral repertoire. 

It takes our more evolved cerebral cortexes— our bigger brains— to understand that if our first or only response to pain is to run the other way as fast as possible, we’re likely to just prolong that pain…or run headlong into situations that are more painful than the one we’re trying to escape. 

Productively acknowledging pain doesn’t mean we have to like it. 

It doesn’t mean we have to revel or languish in it, though some people do seem to have an interesting habit of jumping into painful situations and swimming around in them (whenever this is the case, I get curious about the greater pain they think they’re avoiding by doing this— or, conversely, how they’re somehow deriving pleasure or reinforcement from that behavior). 

Acknowledging and assessing pain is a simple, but not easy, skill. It requires us to get over our initial panic— to stop freaking out for a sec— and to learn to take a few steps back from ourselves…while, yes, still experiencing the pain. 

We can do that— observe ourselves while still remaining attached to our experience. We do it all the time, in fact. (It’s a trick we psychologists call developing your “observing ego”). 

When we experience pain, the first thing we need to do is throw our self-talk skillset into gear. 

If you’ve ever watched a professional boxing or mixed martial arts fight, you might have noticed the fighters’ respective cornermen shouting instructions and encouragement to the athletes, especially when they get into trouble. When we experience pain, we need to be our own “cornermen.” We need to learn to talk ourselves down from that reaction of fear and panic that accompanies pain. We need to be our own “coach” that helps us descend from that place of anxious desperation. 

Then, once we’ve put on our self “coach” hat, we need to put on our “scientist” or “researcher” hat when it comes to our pain. 

We need to ask questions of it. We need to assess it. We need to observe it. 

Yes, we need to do all of this WHILE we’re hurting. (I didn’t say this was an EASY skillset to develop.) 

The thing is, though? As we develop those two skillsets— our self-“coaching” skillset and our “researcher” skillset— we’re going to find our pain is ALREADY more manageable and managed than if we were simply denying that the pain exists. 

Learning to talk yourself through your pain and look at your pain through a “scientific” lens begins to put YOU back in charge of your experience. 

Denying and disowning pain only robs you of the ability to control your experience in any way. 

Pain isn’t easy to manage, and no one is saying it is. Moreover, no one knows what your pain, specifically, is like. I would never, ever be so arrogant as to tell you I know exactly what you need in order to handle your specific experience. 

I do know, however, that nobody— and I mean that, nobody— has wished or willed their pain away through the magic of denial. Nobody has ever effectively managed a problem, pain included, in the long term through denial. 

I want you to acknowledge your pain because I want you to both feel less pain and manage the pain you do feel well. 

And you can. 

I truly believe that. 


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The real-world, practical importance of goals.


You’re smart. I know you know the importance of goals. 

Without goals, it’s hard to get anywhere, at least anywhere you want to go. 

You might end up somewhere without goals, but it’ll likely be somewhere pretty random— or, more likely, you’ll end up somewhere chosen for you by someone else, in a place that serves their needs more than yours. 

Goals are tools we use to live our values. The link between our goals and our values is the big-picture importance of goals in our life. 

Goals have a more practical purpose in our lives as well, however. 

Goals help us establish what to put on our schedules every day in order to make sure our attention is getting funneled in the right direction. 

What we do with our time every day is enormously important. It can make the difference between feeling bored and engaged; between feeling empty and fulfilled; between feeling lazy and industrious. 

When it comes down to it, what we do with our time is really the biggest variable in whether we’re feeling happy or frustrated. 

How do we decide what do do every day? 

(Trust me on this: if you don’t have a plan for your day, someone else assuredly does. The world is FULL of people who are perfectly happy to tell us how to spend our days.)

We decide what to do with our time every day based on— you guessed it— your goals. 

I tell my patients that it’s enormously important to always be training for something, like an athlete does. 

Are athletes called upon to compete every day or every week? No, they’re usually not. 

But do athletes choose how to spend their time every day based on the steppingstones that lead to their “game day” goals? You betcha. 

Goals provide structure, down to the week, the day, even the hours. 

Human beings need structure. 

We need structure based on what we value and what we like. It’s really, really hard to live a life that you find fulfilling without structure that is erected around what you value and what you like. 

Many people hear the word “structure,” and they recoil. They think that “structure” is something that limits them.

(As if that would be a bad thing— when viewed in their proper perspective, limits are some of the most useful tools we have— but that’s a different subject.)

But ask yourself: if “structure” is so bad, what’s the alternative? Chaos? Randomness? 

Your self-esteem notices when you’re living a live of chaotic randomness. Self-esteem is hard to come by when you’re not living life on purpose, with mindfulness and intentionality. 

Pick some goals in your important life domains. 

We human beings have needs in various life domains— we need physical health, we need relationships, we need freedom, we need fun. Many of us have a need to feel connected to spirituality. All of these domains offer various opportunities for goal-setting. 

Pick some goals, then ask what the steppingstones or milestone goals on the way to those goals are. 

What are the steps? 

If a goal is going to take a year, what’s the six month goal en route to that goal? How about the three month goal? The one month goal? 

Get down to the week. Get down to the day. 

Ask yourself: if you were committed to this goal, and if these are the steppingstone goals or the milestones, what does that mean about how my day, today, needs to be structured? 

What do I have to do today, in other words? 

Goals are nice for their inspirational quality, that’s true. But for my money, goals are MOST useful because they answer the question of “how should I manage my time?” 

Time management is life management. 

This is your life. 

Ask good questions and manage it well. 


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But…but…but it feels SO DARN TRUE!!


One of the biggest emotional traps we can fall into is the “if it feels true, it is true” trap. 

This trap— which cognitive therapists call “emotional reasoning”— has an equally insidious sibling, the “if it doesn’t feel true, it must not be true” trap. 

Both of these traps have the potential to make us miserable and really screw up our decision making. And yet, they’re two of the easiest traps for people to fall into every single day. 

We have real problems in our culture discerning what is true. Our brains are notoriously persuadable to accept not-true things as fact, for a variety of reasons. 

For instance, research suggests that we are likely to believe things are true that are espoused by people we consider attractive or desirable. For example: if we think a celebrity is attractive or has a life we envy, we’re likely to consider their opinions to be more credible— regardless of the evidence. 

Research also suggests we are likely to believe things are true that are similar to things we already believe to be true. For example: if we think a certain “type” of person is terrible, we’re more likely to believe they did a terrible thing— regardless of the evidence. 

A great deal of both research and common sense suggests that we tend to believe things are true when we have a vested interest in believing they are true. For example: if election results are accompanied by controversy, we are far more likely to believe the electoral result that is consistent with electing the candidate that we strongly feel “should” in the election. 

Human beings simply aren’t all that great at sniffing out the truth. We’re very, very subject to influence. 

Appearances, unconscious biases, cultural biases, peer pressure, faulty or insufficient information…these are just a few of the factors that contribute to the reality that, left to our own devices, we’re notoriously unreliable truth-seekers. 

Feelings are a particularly tricky factor when it comes to our ability to ferret out the truth, because, well, sometimes things just feel SO DARN TRUE. 

There have definitely been times when many of us have felt helpless and hopeless— and have become frustrated with others’ attempts to point out to us that we were not, in fact, helpless, and there was, in fact, hope, because, well, those feelings of helplessness and hopelessness just felt SO DARN TRUE. 

There are many times when we have felt unloved or unappreciated— and have been surprised to find out that we were mistaken, that there were in fact people who loved us and appreciated us a great deal, because, well, in our own heads, those feelings of being unloved and unappreciated felt SO DARN TRUE. 

Conversely, there have been times we’ve felt confident and certain— and have been unpleasantly surprised to find that we were not as prepared for what lay ahead as we thought we were, because, well, those feelings of confidence and certainty just felt SO. DARN. TRUE. 

For many of us, it’s a rude awakening that our FEELINGS are not infallible guides to what is or isn’t true in the world outside our heads. Our feeling states may be our emotional reality— and, don’t get me wrong, our feelings should be acknowledged and respected as our emotional reality— but they may or may not bear any particular resemblance to the actual, objective world that occurs outside the boundaries of our bodies and minds. 

“Are you saying my feelings are WRONG?” some may angrily ask when I tell hem their feelings are NOT an infallible guide to the reality of the world. 

Well…yes and no. 

FEELINGS, in and of themselves, are what they are. You didn’t ask for your feelings; in many ways you’re the passive recipient or observer of your emotional life. Feelings aren’t “wrong”— you feel what you feel. 

Most of the time, for that matter, feelings, whatever relationship they may bear to the real world, have valuable information for us. We should pay attention to our feelings. Our feelings are valuable barometers of our perceptions and needs. Most of the time our feelings are valuable, functional tools. 

But is that to say our feelings should be relied upon as accurate barometers of the actual situation on the ground out there, in the “real world?” 


Sometimes they are. But sometimes they’re not. To assume that everything you’re FEELING is true is to assume everything that pops up on a map is an accurate reflection of the territory. 

To quote a truism in Neuro-Linguistic Programming: the map is NOT the territory. 

Pay attention to your feelings. Ask questions of your feelings. Ask where they come from; what they mean; what they’re trying to tell you. Honor your feelings and work the information they provide into your life plan. 

But remember: feelings are one tool. One tool that have been shown to be very manipulable by people organizations who understand how feelings work and have invested lots of money in manipulating them. 

Feelings are not facts. 

Do not confuse the two. 


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Want to accomplish your goals? Get out of your head and do this one thing.


Check in.

Checking in with someone who is outside your head improves your ability to accomplish your goals DRASTICALLY. 

Overwhelmingly. Stupendously. Ridiculously. 

I’m not just talking about checking in regarding the accomplishment of your big goals, either. I’m talking about informing someone else of your daily schedule and to-do list; then informing them of the progress you made on that to-do list. 

I’m talking about checking in with someone regarding the little, steppingstone goals and tasks that comprise your day to day grind.

It’s THOSE goals and tasks that run the biggest risk of not getting done if we stay up inside our own heads, without any outside accountability. 

That said: a lot of people resist the need to check in with others. 

They feel like checking in with others is akin to being “babysat” or “supervised.” It feels as if they’re being patronized or infantilized. 

Some people don’t like checking in with others because they feel they “shouldn’t have to.” 

They feel those little, daily tasks and goals are small enough that they “should” be able to accomplish them on their own, without the involvement of anyone outside their own heads. 

It may be the case that we can accomplish many things on our own initiative, only accountable to ourselves. When I emphasize the importance of checking in with someone else, I’m not in any way denying the importance and desirability of independence and self-regulation. 

I’m also not suggesting that what most of us need is “accountability” in the sense of someone else approving of us or punishing us based on what we do or don’t accomplish in a day. That’s not what accountability— checking in— is all about. 

What accountability is really all about is getting out of our own heads. 

See, as long as our to-do list and daily schedule stays in our own heads, it remains very, very easy for us to alter on a whim. 

As long as our to-do list and daily schedule stays in our now heads, it remains somewhat ephemeral, unreal. 

Actually writing down a to-do list, and then sharing that to-do list with someone else makes it more real, more concrete— and overwhelmingly more likely to be acted upon in the real world. 

What are the things that most people struggle to do in the real world, with their actual time? 

That’s right: the little, daily, steppingstone goals that aren’t terribly interesting, not terribly stimulating, that don’t SEEM terribly important. 

The little goals and tasks, in other words, that are easy to put off in the first place— especially if we’ve only committed to do them in our heads. If we’ve only committed to do something in our heads, it’s exponentially easier to just put them off when we decide or realize they’re not going to be very much fun to do…and we human beings are excellent at doing the easier thing rather than the harder thing. 

Checking in doesn’t need to be complex. It doesn’t need to be overwhelming, it doesn’t need to be embarrassing, it needn’t require a huge commitment of time or attention from either party involved. 

Just make a to-do list for the day, then share that to-do list with someone.

Tell them what’s up. Say, “I’m trying out this new technique that this super smart psychologist on the Internet recommended— just bear with me here. This is my agenda for the day.” 

Then, at the end of the day, update that person on what got done and what didn’t. 

Notice: you’re not asking for any feedback, positive or negative. You’re just looking for acknowledgment from another human being that you had a plan, and you acted upon that plan. 

There are multiple cognitive and psychological reasons this technique works. The biggest concept involved is called “cognitive dissonance,” which means that we humans will work awfully hard to be consistent with who we’ve said we are and what we’ve said we’ll do. It’s why salespeople pressure customers to buy up front— they know that for customers to back out later will spike their cognitive dissonance, and that most people will go to fairly great lengths to behave consistently what what they’ve said they will or won’t do previously. 

Ever wonder why the 12-step tradition works when it does? It’s largely the result of the check-in/accountability function that is built in by those meetings. People who are familiar with AA and its associated traditions know that 12-step meetings aren’t places of judgment or scorn— they’re mostly just a place to check in with people, where you can draw your commitment to sobriety out into the real world, outside of your head. 

Getting something out of your head, and engaging a supportive other person, makes you more likely to follow through. It’s as simple as that. 

Don’t take my word for it. Try it. 

Pick someone to be your accountability buddy. 

Check in with them morning and night for a week. Just try it out. 

You’ll be surprised at how much more willing to do the little, stupid stuff in your day when you know you’re going to have to report in to someone. 

The trick is getting out of that head of yours. 


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When “pride” gets complicated.


“Pride” is a concept that seems to get misunderstood a lot in our culture. 

“Pride” has historically been considered a “sin”— in fone of the “Seven Deadly Sins,” in fact, along with laziness, greed, and gluttony.

We’ve been told “pride goeth before a fall.” 

And yet, there are positive connotations we have with the concept of “pride” as well. 

We tell our loved ones who accomplish difficult things that we’re “proud” of them. 

We celebrate holidays that are focused on “ethnic pride.” 

Civil rights movements have sought to restore the collective “pride” of groups who have historically suffered from institutional oppression and cultural discrimination. 

So what is “pride,” a Deadly Sin or a useful emotional tool? 

As with so many concepts that speak to how humans relate to our presence and accomplishments in the world, it can be both— depending on how we understand and relate to the concept of “pride.” 

I can’t tell you what “pride” should mean to you spiritually, i.e., if it’s a Deadly Sin that should be avoided at all costs. That’s between you and your deity and your spiritual mentors. 

It’s my understanding that the religious condemnation of pride is likely rooted in many religious traditions’ wariness about humans becoming so enamored of their own accomplishments and success that they neglect to give God proper attention, credit, and respect.  

In other words, many religious traditions heavily emphasize placing worship of their “true God” above all else, and warnings against human “pride” are more than anything about keeping God in proper perspective. The sin of “pride” is thus more about NOT giving God his due, rather than giving humans their due. 

Moreover, the “pride” that we’ve been warned “goes before a fall” seems more akin to the concept of “arrogance” or “hubris” than anything else. 

It seems that this saying— “pride goeth before a fall”— often refers to the lack of humility and attention that can happen when humans become overconfident in there abilities or accomplishments. When we get too comfortable or confident in what we can do or what we can accomplish, we can sometimes get lured into not paying as close attention as we should. 

So what is the basic problem with “pride,” then? Or what can be the basic problem with pride? 

Pride becomes a problem when it takes away from our central priorities. 

Pride becomes a problem when it blinds us. 

Pride becomes a problem when we become more enthusiastic about or interested in it than our actual goals and values. 

In the end “pride” is just a label that we humans have attached to many things— recognition of progress, celebration of history, confirmation of dignity. Part of the very problem inherent in the concept of “pride” is how many people use it to mean so many different things. 

But let’s be real: ANYTHING is a problem when it blinds us. 

Intelligence, desire, money, sexuality, success, poverty— anything that makes us less focused on our goals and values, including “pride,” can be said to “goeth before a fall.” 

You can celebrate your identity your progress, your accomplishments, and your history without becoming blinded. It takes effort, though. 

It takes the willingness to go through every day with eyes wide open— even to the challenges, even to the disappointments, even to the hurt, even to the bad stuff. 

Sometimes we want to close our eyes to the bad stuff. We WANT to be blinded. 

Self-esteem can’t be built with your eyes closed tight. 

Celebrate who you are. You don’t need a special month or day or parade for that. Be aware of and celebrate your identity, celebrate how far you’ve come, celebrate the extent to which you’ve chosen to be honest with yourself and others about who you are. 

Lights aren’t meant to be hid under bushels, and we human beings can be dazzling lights indeed. 

But remember that your feelings about yourself— your “pride” in various aspects of who you are— do not remove from you the necessity to stay humble and realistic and vigilant about what you need to do, day to day, to move toward your goals and values. 

Pride doesn’t have to goeth before a fall. 

But it’s on us to manage it.


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“Whatever it takes?” Like…whatever.


Sometimes we hear we should do “whatever it takes” to achieve our goals. 

That has always struck me as somewhat curious advice. 

I tell my patients we have two components to our internal guidance systems: our goals and our values. We get feedback from both of these components via our feelings. 

Our goals are the stuff we want. They represent the people, places, and things that send surges of the neurotransmitter dopamine through our brains, which in turn spurs us into action. 

Goals represent the stuff we want to move toward, day by day. 

Our values represent things we find important. Most often values are described in terms of concepts or ideas or principles. We can value truth, balance, achievement, justice, kindness. 

Values represent the limits by which we choose to live, so we can sleep at night. 

We need to be committed to both our goals and our values. Insufficient commitment to either is a recipe for low self-esteem and lack of fulfillment. 

When it’s said we should do “whatever it takes” in order to achieve goals, however, this neglects the “values” side of the equation. 

Attention to BOTH goals and values is essential if we’re trying to create happiness that endures and expands. 

The pursuit of goals that is not guided and bounded by values is a recipe not just for difficulty sleeping at night…it probably won’t lead to the satisfying achievement of those goals, either. 

Our culture really, really likes talking about goals. I really, really like talking about goals, too. 

Goals are fun to think about. There’s a reason why imagining the stuff we want lights up our central nervous system like a Christmas tree. We’ve been evolutionarily programmed to seek out shiny objects that enhance our happiness and survival. 

There’s not a thing in the world wrong with wanting stuff and going after it. 

Our culture is less hot about talking about values. 

Well, that’s not entirely true. Much of the discussion on social media these days does seem to be about values, at least superficially. We love to post and react to posts about who is and isn’t a good person, and whether the things people think, say, and do fall in line with values we agree with. 

The thing is, those discussions seem to revolve mainly around the limits we’d prefer placed on other people— not us. 

Relatively rarely do we see deep discussion about how values limit what WE should think, do, and say. 

We see lots and lots and lots of content posted about how we wish other people would be limited by our values…but I can’t remember the last time someone posted something about how they were personally wrestling with the limits their values place on their pursuit of goals. 

It’s almost as if many people want to have their cake and eat it, too. 

They want to be able to pursue the things they want, and not be limited by the things they value. 

All of which isn’t exactly my point here. My point here is that you should not, in fact, do “whatever it takes” to achieve your goals. 

My point is that you should do those things to achieve your goals that are consistent with your values system. 

My point is also that you should do everything you can, within that values system, to achieve your goals. 

Goals and values are important because they are the building blocks of who we are and how we impact the world. They define our very existence. “Who are you” is a question that fundamentally asks what you want and what you value. 

Successful living requires a great deal of thought about both goals and values. 

Don’t fall into the trap of believing we can sacrifice either one in the service of the other. 


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It’s not about magic. It’s about choices.


When I tell my patients to focus on solutions rather than problems, it’s not because I think there’s anything magical about positive thinking. In fact, quite the opposite. 

I don’t think there’s magic in “thinking” at all. I think there’s magic in doing. I’m a believer in works, not just faith. 

No, my admonition to focus on solutions rather than problems is a very practical consideration: we only have so much energy. 

We only have so much focus. 

Lord knows we only have so much time. (Time is probably the most finite, but most important, resource that we have, that most people don’t take seriously as a resource.) 

Simply put, time we spend worrying or focused on how much things such is time we’re never getting back. It’s not time that is productive, and— most importantly— it’s time that is literally taken away from the time (and the focus, and the energy) we have to spend on solutions. 

I do not think that just by imagining and hoping and wishing for solutions, they will appear. 

I do think, however, that focusing on solutions makes us far more aware of various options than we would otherwise be. 

I do think that focusing on solutions orients us in a direction that is entirely more productive than focusing on problems. 

I do think that focusing on solutions reinforces a set of beliefs about the world that is more productive than focusing on problems— notably, that problems in fact HAVE solutions, and those solutions are within our grasp. 

It’s not about magic. 

It’s not about the “law of attraction.” 

It’s a simple matter of prioritizing how we’re going to invest our resources intelligently. 

Our ability to design a life, achieve goals, live our values, and create our identities depends largely on our ability and willingness to make choices and set priorities. 

Even in our darkest, most vulnerable moments, we STILL have the opportunity— and the obligation— to make choices and set priorities, most importantly about how we’re going to nurture and use the resources we have available to us. 

When we’re down and out, we often forget that we have resources. 

When we’re broke, we tend to think that since we lack financial resources, our other resources don’t “count.” 

When we’re in pain, our resources of attention and energy are limited; and we thus have a tendency to assume that our other resources don’t “count.” 

Nothing could be further from the truth. It’s when we’re short on resources that how we prioritize and invest our remaining resources becomes of the utmost importance. 

No matter how tired you are, you still have to decide where to put your attention. 

No matter how crunched for time you are, you still have to decide how to spend the time you DO have available. 

No matter how broke you are, you still have to decide how to spend the money you DO have. 

What’s more: no matter how scarce your resources are, you’re STILL capable of making conscious, intelligent, value-driven decisions about your resources. 

I love when some people maintain that other people who are down on their luck are somehow incapable of making good decisions about their remaining resources. How incredibly patronizing is that? 

You may not be able to afford the food that would constitute a perfect diet; however, you’re quite capable of making intelligent decisions with the money and food you DO have. 

You may not be able to read entire books at a time; however, your’e quite capable of making intelligent decisions about what you DO put into your head. 

Don’t let anyone try to talk down to you by suggesting you’re incapable of making conscious, intelligent, values-driven decisions. Anyone who suggests this to you is probably trying to get you’re consent to surrender your decision-making ability to them, “for your own good.” 

For the sake of your self-esteem, I strongly suggest you deny them that consent. 

Successfully creating a life or improving the life you have is never about the “magic” of positive thinking. 

It’s about choices. 

You can make those choices…even if some people in your life have tried very hard to convince you otherwise. 


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