Mindfulness & ACT-based therapy: Questioning “I hurt; therefore, I suffer.”

Mindfulness & ACT-based Psychotherapy

Mindfulness & ACT-based approaches are becoming increasingly popular in treating depression, anxiety, & OCD and distinguish pain from suffering.

Mindfulness & ACT-based Approaches to Therapy

Mindfulness & Acceptance and Commitment Therapy (ACT)-based approaches to treatment might (Hayes, Strosahl, & Wilson, 2003) ask you to consider the truth of the following statement:

I hurt; therefore, I suffer.

Most of us would probably agree that suffering is usually borne out of hurt. But this doesn’t mean that pain, discomfort, or unwanted emotions necessarily lead to suffering.

In truth, many hurts do not lead to suffering.

Pain and suffering are distinct entities that exist on two entirely different planes. Pain is based on an experience, whereas suffering is based on how we perceive that experience. In many cases, we may not be able to sidestep pain or hurt; however, suffering may be a different matter.


Think about the last time you felt physical pain. Maybe you’re feeling it right now. You might consider the aches of tired joints, the familiar sting of chronic pain, the drawn-out burn after a workout, or even the experience of stubbing your toe. Consider what your pain feels like. Where is it located? Is it a sharp or dull pain? Constant or throbbing? Growing in intensity or fading?

Take a moment to really look at your pain. Examine it. Probe it.

Accept it as it is. Own it.

To do otherwise is to deny your own experience.

Acceptance of pain does not mean that you have to like it. It doesn’t mean that you hope for the pain to continue or to increase in intensity. It simply means that you’re not denying the reality of your current moment. If you’re experiencing pain, you’re experiencing pain.


What, then, is suffering? Suffering comes from an appraisal of pain, from an unwillingness to accept it. In many cases, suffering begins when we make certain types of statements or ask certain types of questions:

  • Why is this happening to me?
  • When will this end?
  • I can’t take this.

These types of statements lead to contradictions that cause suffering.

Think about it.

     Why is this happening to me?
     I don’t know why this is happening to me…but it is.

     When will this end?
     I don’t know when this will end…but it’s happening to me right now.

     I can’t take this.
     I feel I can’t take this…but yet, here I am.

These failures to accept your current experience cause suffering.

Pain may be a necessary prerequisite for suffering, but it is not sufficient to cause it. Suffering comes from how we think about our experiences.

Learning to conceptualize your pain in this way (be it physical or emotional) is fundamental to Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 2003), as well as other mindfulness-based treatment approaches. These approaches are gaining traction in the field of psychology, and there’s a growing body of research evidence supporting their effectiveness in reducing symptoms. Mindfulness and ACT are now being applied to the treatment of depression, OCD, panic, and other anxiety disorders.

When was the last time you sat quietly and observed your own pain without doubting it, questioning it, or disqualifying it? What did it look like?

Questions? Comments? Mindfulness or ACT-based strategies that have worked for you? Feel free to share below.

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