Affect Tolerance: What Can I Do About All These Darned Feelings?

“Our wounds are often the openings into the best and most beautiful parts of us.” —David Richo, PhD, MFT

“Everyone is down on pain, because they forgot something important about it: Pain is for the living. Only the dead don’t feel it.” —Jim Butcher, author

“The sweetest pleasures are those which are hardest to be won.” —Giacomo Casanova, adventurer and author

According to Sigmund Freud, we’re all pleasure seekers; it’s our fundamental nature. He said maturity is the ability to postpone desire for comfort and pleasure in order to deal with reality. Despite ongoing controversy about some of his more unusual concepts, I think he was right about this one. Humans have come up with an astounding variety of ways to change pain into pleasure. Here is a partial list of things I’ve heard people talking about just in the last week or so:

• Marijuana (this one’s popular these days!)
• Alcohol
• Vacation
• Overeating
• Undereating
• Running
• Netflix
• Medication
• Organizing one’s closets
• Knitting
• “Zoning out”
• Caffeine
• Chocolate
• Gaming
• Music
• Overworking
• Avoiding work
• Sex

As always, these things aren’t inherently bad; many are wonderful. Like anything in life, it’s all in how these things are used, especially over time. Are we using them to avoid difficult emotions? Or are we using them to create something in our best interest?

When it comes to dealing with pain, though, there’s another approach. In meditation and 12-step recovery circles, we are often told to “just sit with it.” What does this mean?

In psychology, affect tolerance basically means this: how much of your emotion can you tolerate? Sit with? Feel? That is, without needing to take action to shut them off.

In psychology, affect tolerance basically means this: how much of your emotion can you tolerate? Sit with? Feel? That is, without needing to take action to shut them off. There is no way to precisely measure emotion or someone’s tolerance of it. However, it’s useful as one indicator of mental and emotional health.

Why would anyone want to hang out with their lousy feelings? This is a valid question, and having a clear answer in mind is pretty much a prerequisite for doing the work. Drawing on my clinical (and personal) experience, here is why I believe feeling one’s difficult feelings (and increasing one’s affect tolerance in the process) is useful:

• Because feeling our difficult feelings is what makes them go away. And I mean truly go away, not just lurk around, waiting to pop up on a rainy day. Now, there are a few caveats: The feelings have to be within the person’s window of tolerance. That is, the intensity must be somewhere in between avoiding and flooding—that “sweet spot” where the body can metabolize the feelings. In the case of complex trauma, this may take a while (and therapeutic assistance is important). The worse the trauma, the longer it may take, but the vast majority of people are capable of positive change if they put their minds to it and have a competent guide. Sitting with difficult feelings is a skill best learned from another, more experienced human being (parent, mentor, sponsor, therapist, etc.).
• Because we can’t shut down pain without also shutting down a lot of our pleasure. And I think it’s our birthright to feel the joy of just being alive. Our bodies are made to feel good in simply existing, when things are going well. Dissociation is like novocaine: it might take away the pain, but you’re not going to perceive much pleasure, either. Especially not the deeply felt, embodied pleasure and liveliness that constitute peak experiences.
• Because our experience of “bad” feelings shifts over time as we get the hang of it. “Parting is such sweet sorrow,” Shakespeare wrote. Believe it or not, there is usually a positive aspect to unpleasant feelings. But it’s like the post-workout high: you have to be “in shape” in order to start experiencing it. It may feel lousy at first.
• Because it feels fantastic when the old feelings are cleared. Many people who have habitually avoided their emotions find it difficult to feel their bodies’ signals. There’s good reason for this: our bodies are where the trauma lives. In somatic therapy circles, we call this “being disembodied” to some degree. 
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• Because emotional repression creates chronic stress, which lowers immune response and makes us vulnerable to physical illness. Dr. Gabor Maté explores this connection at length in his book When The Body Says No. This book is a synthesis of theory, his own clinical vignettes, and a lot of medical research. In the chapter titled “Stress, Hormones, Repression, and Cancer,” Dr. Maté explains the interactions between stress-responsive endocrine glands, the brain, and the immune system. “In short, for cancer causation it is not enough that DNA damage occur; also necessary are the failure of DNA repair and/or an impairment of regulated cell death. Stress and the repression of emotion can negatively affect both of those processes” (p. 92). On page 97, he continues, “Under conditions of chronic stress, the immune system may become either too confused to recognize the mutated cell clones that form the cancer or too debilitated to mount an effective attack against them.” Of course, psychotherapy can not treat medical problems and is not a substitute for medical care. In a more general way, the body of work called psychoneuroimmunology promotes the idea of well-being by increasing self-regulation, particularly downregulation, or coming out of the stress response.

In some cases, it may take a while to get to where you want to be emotionally. The cultivation of affect tolerance and a rich inner life is, I believe, a lifetime practice. But, really, is there anything more important in life than feeling truly healthy, good, and at the top of your game? Wouldn’t you rather look back five years from now and be glad you started the work then? What do you have to lose?

References:

1. Azar, B. (2001). A new take on psychoneuroimmunology. Monitor On Psychology: American Psychological Association. Retrieved from http://www.apa.org/monitor/dec01/anewtake.aspx
2. Maté, G. (2003). When the body says no: Exploring the stress-disease connection. New Jersey: Wiley and Sons.

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