What is the difference between pain and suffering? This is one of the most common questions I have been asked since the very beginning of my career. And even I have given answers to this in the past. But at the end of the day, it isn’t helpful to differentiate between pain and suffering. 

Pain is defined as: A localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and/or emotional distress. Suffering is defined as: To feel or endure pain or distress. As you can see, there is nothing in the definitions of the two concepts alone that make it meaningful to differentiate between them. To suffer is basically just to feel or endure pain. Never the less, many people now differentiate between the two. 

What distinction are people now making between them? They have decided to use the word pain to mean the initial physical or emotional sensation. So, pain would be the primary feeling. And they have decided to use the world suffering to mean what your mind does with that sensation. So, suffering would be the secondary response to that feeling of pain. When viewed through this lens, pain is what happens to you, while suffering is what you do to yourself through your thoughts about what is happening or about what happened. You will find that people tend to relate to suffering as being more intense and prolonged. But most importantly, people now relate to suffering as being different in origin, different in nature and especially different in terms of our capacity to control it. Which is where the idea of suffering being optional came from.    

Looking all the way back to Buddhist teachings, you will find the parable of the two arrows. The First Arrow (essentially unavoidable pain) represents the inevitable pain that is part of life. Illness, loss, or difficult events etc. The Second Arrow (essentially pain we have control over) represents our mental and emotional reaction to the first arrow, such as the thoughts which cause us to go into resistance to it, the meaning and interpretation we assign to it, all of which prolong or worsen the pain of the first arrow and the emotions that arise as a result of those thoughts. The lesson being that while you cannot always control the first arrow, you can learn to stop firing the second arrow through mindfulness practices.

In the late 19th century, scholars like Max Müller published the first major English translations of Buddhist texts. Key Western psychologists and Philosophers like Carl Jung, William James, Alan Watts and Eric Fromm studied these spiritual theories. Including the ones related to pain; and incorporated them. And then, in the 1970’s, there was a massive influx of Buddhist ideologies as Westerners traveled to Asia to study with teachers from the Eastern World and then brought those ideologies back home. They began backing them with scientific empirical frameworks and even stripping the concepts of their religious elements so as to integrate them into mainstream healthcare, neuroscience, and psychology. 

The idea that pain and suffering are distinct things deeply penetrated Alcoholics Anonymous and the twelve-step program. Most people don’t know it, but this is actually where the phrase “Pain is inevitable, suffering is optional” comes from. And it was used explicitly to teach recovery in this way: A person cannot control the pain of past trauma or life events, but they can control the suffering caused by obsessing over, resisting, or trying to numb those facts. This concept caught on like wild fire. It became a standard psychological, spiritual and self-help tool between the 197Os and 1980s. And it is now foundational to many therapies, for example DBT and ACT. It is also foundational to the teachings of many spiritual teachers and influencers, for example Jon Kabat-Zinn, Haruki Murakami and Eckhart Tolle. 

To give you a quick idea behind why people find it very beneficial to differentiate between pain and suffering is that it shifts a person from the mentality of being a helpless victim to being in a position of personal power. That it helps a person to see the “second arrow” so they can stop it and that it helps people to not fight against what is and instead take a mindful approach to what is. But allow me to explain why it isn’t helpful to differentiate between pain and suffering. 

1. The actual definition of these words (pain and suffering) being what they are, using the word suffering to represent the second arrow dynamic of pain, is something that really does not benefit people. It is far better to come up with a totally different word to describe it. This will make more sense as we continue.
2. Differentiating between the two, especially when you say that suffering is a choice, often makes people go into further resistance to pain in general. The exact opposite of one of the main intentions they had for differentiating between them. Pain is a response. Human biology does not neatly separate the physical from the psychological. And no clear line actually exists between the pain that is part of the initial physical or emotional sensation and the pain that is being caused by the secondary mental response to the initial pain. It’s all just pain for people. Also, who defines this? One expert would say that the pain that arises as a result of finding your partner in bed with someone else, is just the initial pain. Another expert would say that that pained reaction in and of itself is actually suffering because it is the byproduct of thoughts that are within your control. Basically, your mind has instantly made it mean something and so you feel pain. Another person from a different culture may not have that same personal interpretation and so, they wouldn’t even feel pain. Because the what is and isn’t initial pain vs. what is and isn’t just my own self causing me to feel pain is so blurry and is a HUGE philosophical debate, people are lost in the weeds. We are forcing people to try to intellectually separate the raw data of pain from the emotional response happening as a result of what they think in response to that pain. This is not an effective way to help people to process their distress. And it is a delineation that the greatest minds don’t even agree upon. As a result, over and over I watch people relating to pain in general as if experiencing it at all means they are doing something wrong and as if it is a personal failure. As if they would not feel any pain if they were conscious enough or positive enough. Even worse, because people associate suffering as being intense and prolonged pain, anytime the pain they are feeling is intense or prolonged, they automatically label it as suffering and therefore link it to “not ok, not necessary, my fault”. This will put you into resistance to your own pain real quick.   
3. Differentiating between the two, especially when you say that suffering is a choice, is not automatically empowering. Instead, it is deeply invalidating, as well as psychologically and emotionally harmful. When someone is in the middle of something extremely painful, something that no one would ever choose, they do not need to come into contact with any notion that they are choosing to feel that pain and could just as easily not be feeling it. It adds a layer of shame to the person experiencing pain, so they end up in double pain. It also leaves them alone with their pain. The implication of suffering being something you do to yourself and therefore, something that is optional, means that if you’re in pain, it’s your own fault. And if you’re doing it to yourself, no one feels sorry for you and no one will help you. You almost deserve it if you’re going to do it to yourself. If someone’s pain involved being harmed by someone else, this ideology is victim blaming. The "suffering is a choice" narrative forces an individual to fix themselves. This completely ignores the biological fact that we are a social species that thrives in co-regulation. 
   When a person cannot simply "choose" to stop feeling pain or stop feeling devastated by tragedy, they internalize their pain as a sense of personal failure. They are now dealing with the original trauma plus the crushing guilt and shame of being affected by it. And it is to say that the painful situation isn't the problem; your inability to accept reality or hold a different perspective about it is the problem. If you would like to learn more about this, you can watch my video titled: People Are Not Attached To Their Pain.  
   This ideology surrounding this differentiation between pain and suffering is deeply ignorant to physiology and neurobiology. To tell someone facing serious pain, whether that be a physical condition or a trauma or a crisis or a compromised nervous system or chemical imbalance or gut microbiome issue or mold toxicity that they are choosing to suffer is as cruel and inaccurate as telling someone with a broken leg that they are choosing not to walk. The mentality that has come from the differentiation between pain and suffering patronizes the person who is in pain, erases reality and trivializes the often brutal complexity of their lived reality.    
4. It is a minimization tool. When you differentiate between pain and suffering, you are literally shrinking the size of a tragedy by dividing it into two pieces, and then throwing the biggest piece away as illegitimate. If the pain you are experiencing is reduced to a "self-created narrative," it minimizes the actual size of the real pain. And this is not how it is experienced. So, it is a gaslight. When someone is experiencing pain, telling them to separate pain from suffering minimizes their experience. It implies that the event itself is only a minor, temporary pain, and that their ongoing pain is just suffering that they are generating themselves. This downplays the pain of the situation and reframes an entirely normal human response to pain as an exaggerated emotional failure. On top of this, when the pain involves a trauma, this mentality reduces the very real neurological and biological crisis that is occurring to an attitude problem. When the situation is far more complex. This minimization takes the focus off of the painful situation itself and puts the focus on whether or not you are thinking positively enough, meditating correctly, practicing acceptance well enough, or are being too dramatic. It minimizes the objective pain of the event by turning the entire thing you are going through into a test of your own personal emotional and mental maturity. Which is cruel.     
5. Differentiating between pain and suffering promotes bypassing and suppression of key elements of distress that need to be processed. It is all too easy to decide that pain is just suffering and is therefore unnecessary. This can cause a person to suppress, deny and disown emotions as well as the painful personal truths contained within those emotions. For example, people may suppress genuine and important grief, anger, or fear by labeling it as "unnecessary suffering". This idea really tends to be one of those intellectual concepts that gets used to avoid all things negative, which is why it is so wholeheartedly embraced by people who cope with toxic positivity. Promoting the suffering is a choice mindset onto people creates an environment where negative emotions are banned. It demands that people maintain a facade of positivity. This prevents people from voicing legitimate complaints, being truthful, revealing vulnerabilities and acknowledging and expressing emotion because any sign of deep distress is dismissed as a personal spiritual defect. 
   This differentiation can cause you to bypass the reality of how you feel because you’ve already made it not real and unnecessary. Constantly trying to categorize feelings into "clean pain" versus "dirty suffering" has the tendency to seriously prevent a person from fully processing and moving through their emotions. 
6. It creates obsessive self-monitoring and self-policing. Attempting to police one's own thoughts to prevent suffering often creates a secondary layer of anxiety. People become hyper-vigilant, constantly checking in on their internal monologue: "Am I creating my own suffering right now? Am I making this worse? Am I doing this to myself?" This obsessive self-analysis increases stress rather than reduces it.   
7. This philosophy can very easily cause a person to slip into the idea that external conditions do not matter. People LOVE this idea. People HATE powerlessness. It makes them feel empowered to be able to be unaffected. It’s why they adore books like Man’s Search for Meaning. But as profound as these insights on human perception are, we need to seriously ask ourselves “should the goal for us as people be to be unaffected?” What are the shadows inherent in this? What are the dangers of this? I can assure you, there are many. And external conditions DO matter. Telling someone who is hurting because of these conditions that their suffering is just a “poor mental attitude” is gaslighting and pushes them to put up with things they should not be putting up with. It can force a person to focus on their internal thought patterns rather than addressing the actual, ongoing source of harm. It also makes us complacent to things that need to be changed. It should really scare you how far this can go because this differentiation between pain and suffering, where suffering is purely an individual, internal choice can easily go in the direction of society having no obligation to help those who are struggling. It can absolve governments, communities, institutions and each other of our responsibility to help where we can, to fix broken systems, to alleviate poverty, or to provide social safety nets and the list goes on. It has the tendency to shift the entire burden of systemic and structural failures onto the shoulders of the individual. Which none of us should think is ok. Worse still, the "pain vs. suffering" rule changes the math of accountability. This is especially important when it comes to abuse. Because it makes the person who was harmed accountable for the pain they are experiencing, rather than the person causing harm. 
8. We shouldn’t define it this way, but let’s pretend to go along with everyone and define suffering as the secondary response to that initial feeling of pain. What you do to yourself through your thoughts about what is happening or what happened. What people who need to make the world simple and cut and dry do not get is that when something happens, the reaction you will have to this is instantaneous. The subconscious mind literally floods forward. And it does this so incredibly fast that there is no way for a person to tell what’s what and what is causing what. This secondary response, which is in fact immediate, is usually an absolute multilayered mess. It isn’t like frosting being added to cake. It’s like an Indian curry or better yet, aunt Mildred’s failed lasagna that devolved into a soupy mess. For example, let’s say that a you get into a car accident. That second, you could be flooded with the pain of traumatic physical injuries and somatic shock. Just seconds after the impact, the experience may give rise to the immediate thought: "I am trapped." This thought is both an accurate assessment of the present moment and the birth of a long-term driving phobia. The brain welds them together instantly because the brain is designed to learn from danger instantly so it can keep you alive next time. And it works the same way with pains/threats of an emotional/psychological nature.  All of a sudden, you start to panic about finances and feel the financial pressure crushing in on you. You fear losing your job. You feel the hit of pain of thinking about having to depend on other people, traumatic memories about being treated like a burden, fearful images about a relationship falling apart due to them having to take on extra pressure, including caring for you. All the horrible associations you have with police officers. That dark humor trope you picked up from doing a first aid course… Bystander: "He broke his leg!" Paramedic: "Stand back! Let me drop this heavy stretcher on his other leg so they match." And the accompanying terror that the first responders are going to make it worse rather than better. You feel an overwhelming need to just be held by someone familiar. All the while, your brain is already forming permanent, subconscious associations. It binds the sensory data (the smell of burning rubber, the sound of breaking glass) to intense terror.  Human distress behaves like a rapid, compounding feedback loop. One response instantly causes the next, erasing any clear boundaries between pain and suffering. When we are experiencing intense pain, especially if part of this pain is the perception of danger, you lose the cognitive ability to step back, look at your emotions objectively, and sort them into neat categories. Everything just feels like a massive, blurry, abstract, ambient, all-consuming wave of pain.
   Weeding through this mess to isolate out and resolve the layer that people are calling “suffering” (essentially what a person is adding to a situation, what they are making a situation mean and their interpretation of what is) has a very important place and time in the process of healing. But there has to be a huge level of attunement to when that place and time is right. And it isn’t as simple as “it’s just stuff I am adding to it, and so it’s suffering and so, I now choose not to suffer”. I’ll give you just one example of what I mean. Let’s say that you experience something painful and that causes a core belief to come up and that core belief is making you suffer more. Just because you can identify that this core belief is something you are adding to the experience, doesn’t mean you can just decide to not have it. A whole process is needed just to uproot that one belief. Whole different experiences are needed to no longer have traumatic associations. And when it comes to complex traumas, there are often layers upon layers upon layers upon layers. Years and years worth of layers. Everyone would love to just be able to “choose not to suffer” the minute they see one of these layers. But this is not how this layer people are calling suffering works.   
   When someone is in pain, they really may not benefit by a semantics lesson on pain vs. suffering. Nor do they need a highly intellectual lesson on the difference between a primary and secondary emotion. Nor do they need to feel the cognitive burden and heat of being responsible for objectively observing their pain and philosophically differentiating between pain and suffering. They certainly don’t need the pressure of “you should be able to make yourself feel better” on top of the pain they are feeling.        

For all of these reasons, it isn’t helpful to differentiate between pain and suffering. What we need to do is to respond to pain as valid and important period the end, no matter what is causing it. We do this by seeing it, feeling it, listening to it, and deeply understanding it as well as what is causing it. And with that information, we figure out consciously how to best respond to that pain so that the conditions are no longer there to cause the alarm (which is what pain is) to go off.