Through my work with Acceptance and Commitment Therapy (ACT), I have always found having the discussion regarding primary pain versus secondary suffering not only useful, but usually eye opening for many clients (as it also was for me when I was first introduced to the concept).

As symptoms and uncomfortable thoughts and feelings arise, it is almost second nature for us to try and palliate or rid ourselves of these symptoms as soon as possible!  A problem usually arises, though, if there isn’t a simple and easy fix to our unpleasant situation.

When someone has been dealing with symptoms on a chronic basis and they find they feel stuck in their suffering or that their suffering is getting worse, it can be important to begin to decipher the difference between their primary pain and their secondary suffering.  So let’s start with that:

Primary Pain:  This is the root of the problem.  These are the actual unpleasant feelings you would experience inside your body, whether it be feelings of chronic pain, depression, anxiety, etc.

Secondary Suffering:  This can be looked at as the havoc/problems the primary pain can cause in your life.  This is the additional pain that arises when you resist and react to your primary pain.  For example, if your primary pain is anxiety and you cope by avoidance (i.e. not spending time with friends, avoiding your regular gym class, avoiding family events), your secondary suffering would be the loss you experience by not spending time doing these things that bring fulfillment to your life.

Because we live in a quick-fix culture, and things like chronic pain, depression and anxiety may not always be helped by a quick fix, ACT’s approach is to help to reduce and eliminate the secondary suffering.  One may not be able to quickly or efficiently reduce their primary pain, but many have found that by reducing secondary suffering by working on completing daily behaviours that bring them closer to the life they want (i.e. still going to spend quality time with friends or attend your favourite group gym class), the volume of the primary pain may eventually turn down, and the even bigger bonus is that doing so guarantees a decrease in their secondary suffering!

This may sound easier than it looks – and that is true – it takes an individual’s commitment and acceptance every day to make choices that bring them closer to the life they want.  Strategies like mindfulness can help keep you grounded and accepting of each moment.  Continued reflection of your daily choices and committed actions will also help with keeping you on track.  Use patience and perseverance to work through making committed actions daily because the reduction in secondary suffering will definitely be worth it!



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