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3/2/2021 Season of Discontent

Human beings, unlike animals, seem capable of suffering amid abundance. If animals are given food, warmth, shelter, and care, they seem perfectly content. People of contemporary society, on the other hand, with far greater luxuries, often seem discontent.

Citizens of Sweden enjoy one of the highest standards of living and best working environments in the world. Everyone is fully covered by free and high-quality health care. Education, including university study, is free and open to all. Citizens enjoy more vacation time, a shorter work week, greater number of holidays and longer paid maternity leave than anywhere else on earth.

At the same time, Sweden has more workers on sick leave and work-related disability due to chronic pain and stress-related disorders than anywhere else in the world. Sweden also has one of the world’s highest rates of suicide.

This paradox is reflected in how we view pain. Pain is an inevitable part of living. Humans have dealt with pain in living circumstances which were much harsher in the past. When pain was unavoidable, we tolerated it. When pain became avoidable, it became intolerable.

For too long we have been dreaming a dream from which we need to awaken. This dream is that if we just improve the socioeconomic situation of people, everything will be okay, people will become happy. The truth is that as the struggle for survival has subsided, the question has emerged: survival for what? Ever more people today have the means to live, but no meaning to live for.

As we deal with difficult circumstances or people, we need to remember there is meaning in the struggle. There is something to be learned from the pain. Courage to be shown. Resiliency developed.

Our Behavioral Health intervention is based on ACT. This acronym stands for acceptance and commitment therapy. The power of ACT is how it connects change to our values. It begins with the basic premise that while pain hurts, it is the struggle with pain that causes suffering. In this understanding, most of the suffering in chronic pain is self-created and unnecessary. And I am speaking not just of physical pain, but especially emotional hurting.

ACT utilizes mindfulness to establish a sense of self that is greater than our thoughts and emotions. You separate and preserve that self from painful experiences. The thoughts and memories are unavoidable. So, you don’t try. You notice it the way a cat watches a mouse hole. Like watching cars go by outside the windows. They are real. They are about you. Try not to pass judgments on your feelings. Just knowledge them. But notice who it is that is doing the noticing. Because these feelings are not you. You are the same person who showed up on the first day of Kindergarten.

Simply said, you do not lose yourself to the pain. You can observe your pain without becoming your pain.

ACT requires we identify personal values that direct our life compass. We should not allow anyone else to chart that course. It is when we live consistent with our deeply held values that we will find purpose and contentment. Affluence cannot do that for you.

This is why I think it is important.

My body has changed in the 70 years of its existence. It doesn’t work as well as it used to.

I was not always this handsome. But I am not my body. There is a me that remembers being a small boy with dreams. I will not lose that person to a failing body.

Feelings, regardless of how strong they feel, will change. You have had strong feelings about someone or some issue awhile back that you hardly feel anything about today. Feelings are in constant movement. Notice who is noticing the feelings. Remember that it is you who give feelings power.

Similarly, your mind has great analytic ability to solve problems. Your thoughts are in constant change. Knowledge is increased. But YOU have remained the same.

You are not just your body, not just your feelings, not just your pain, and not just your thoughts. They are about you. But however, things turn out, you will remain you. Be kind to that person.

When we connect with our values, we can find the vitality of natural positive reinforcement in the activities we have chosen. Work or educational requirements, exercise, nutritious eating, weight loss, spiritual focus, caregiving, can shift from passive tasks we do because we have been told to – to an active choice which coincide with our own values.

I don’t know if any of this makes sense. A Bob Dylan lyric states: “People don’t live or die, people just float.” Too often that is true. Life’s current of chance determining our course. And there is a bunch of kids on the side of the water throwing rocks. It doesn’t have to be that way.

My dream is that we can share purpose and discover meaning together at Evergreen. Covid, politics, economic challenges, difficult personalities, or any other manner of friction should not deter that. We chart our own course by our organization’s values. It will require that we 1) are willing to experience pain and 2) engage in our mission consistent with our values even in the face of pain.

Pain is inevitable. Suffering is optional.

Tim Powell MD

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