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Cognitive Behavioral Therapy
How CBT Can Help Us Make Sense of Suffering
The way we perceive situations shapes how we respond to them.
Posted June 3, 2021 Reviewed by Devon Frye
Her name is Jeanne, and she is 33 years old. She comes to our office and states, “I don’t know what’s wrong with me. Everybody hates me. Nothing I do works out, or it ends up working against me. I cannot do anything right. I cannot even succeed at killing myself. What’s wrong with me? I hate myself!”
However startling her words may sound, this patient is more typical than not. We see patients like this in both mental health and general medical settings. Jeanne's words are also representative of a decent percentage of the general population [1]. You likely know someone who hates him- or herself or who frequently asks, “What’s wrong with me?”
The question is why. Why do people hate themselves? Why do people believe that they have nothing to offer, either to themselves or to anyone around them? Why do people feel that nothing works or that whatever they do works against them?
We have encountered, time and time again, numerous patients and clients who speak this way about themselves. And we hear about more when discussing patient care with our own supervisees or mentees. In other words, we are being confronted with an epidemic of sorts—an epidemic of self-hatred and emotional suffering.
It's estimated that 800,000 people die by suicide every single year [2], or about one person every 40 seconds. All of this is despite the fact that humans have created advanced technology—from smartphones to computers—and are endlessly creative and imaginative. Yet so many people like Jeanne—more often than not and more days than not—find themselves wondering what is wrong with them, why they are hated, and wondering why nothing they do works out. In the cases where suicide doesn't occur, they may wonder why they cannot even "succeed" at killing themselves.
This is a vast amount of suffering to exist in the world. But why? Why is there so much suffering when we as humans have made great strides in many areas?
What Is Suffering?
In science, the first step in knowledge is the ability to name things. We can, for example, name "suffering," which Jeanne and many others undoubtedly experience. The second step after having named things is defining or operationalizing them. For example, what is suffering? What does the word "suffering" mean?
A quick, easy, and common definition of suffering is “the state of undergoing pain, distress, or hardship.” [3] Etymologically, the word “suffering” comes from two Latin words: “sub,” which means "from below,” and “ferre” which means “to bear.” [4] In other words, looking at "suffering" from its roots means "to bear from below."
What does it mean "to bear from below"?
If we combine the basic definition of suffering with its etymological definition, it becomes: "being in a state of undergoing pain, distress, or hardship—but doing all this from below." What does it mean to say "from below?" In our view, it means that you are at the mercy of that which is causing your suffering. "From below" means you are the victim of whatever the suffering is associated with. "From below" means there is nothing you can do about it, and this is exactly what leads to suffering.
Suffering and Cognitive Behavioral Therapy
If you're confused, stay with us—it will all become clear shortly.
First, let's start with a key tenet of cognitive behavior therapy, or CBT. Anyone who's familiar enough with CBT knows that our perception of a situation—and not the situation itself—determines the behaviors and feelings that follow. This means that though anyone could be in a state of pain, stress, or hardship, not everyone goes about experiencing it the same way. Not everyone will experience a specific situation as suffering and, as such, not everyone has the same perception of that situation.
What is perception? It's defined as "the state of being or the process of becoming aware of something through the senses." [5] Thus, suffering is a state. Perception is a state. One state matches the other.
This is a very important aspect of suffering—as well as a very important aspect in ending suffering. Why? If my perception of a situation determines the behaviors and feelings that follow, then my behaviors and feelings tell me what kind of perception I'm having. And if those behaviors and feelings are experienced as suffering, then I know that my feelings and behaviors offer feedback about my perception of the situation.
Our perceptions derive from our attitude, and our attitude derives from our beliefs. That means that our beliefs are driving the show, even when we are not consciously aware of them. That is the root of suffering—that is, "from below."
What does it take to end the suffering that currently exists in the world? Our upcoming articles will attempt to answer this question.
References
[1] Mann M, Hosman CM, Schaalma HP, de Vries NK. Self-esteem in a broad-spectrum approach for mental health promotion. Health Educ Res. 2004;19(4):357–372.
[2] “Suicide.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/suicide.
[3] “SUFFERING: Definition of SUFFERING by Oxford Dictionary on Lexico.com Also Meaning of SUFFERING.” Lexico Dictionaries | English, Lexico Dictionaries, www.lexico.com/en/definition/suffering.
[4] “Definition of Ferre.” Definition.org, Gnu Collaboartive International Dictionary of English: Licensed under The Code Project Open License (CPOL), definition.org/define/ferre/#:~:text=Definition%20of%20%22ferre%22%20%5Bfer%E2%80%A2re%5D&text=%22Suffering%20is%20derived%20from%20the,off'%3B%20or%20from%20the%22.
[5] “PERCEPTION: Definition of PERCEPTION by Oxford Dictionary on Lexico.com Also Meaning of PERCEPTION.” Lexico Dictionaries | English, Lexico Dictionaries, www.lexico.com/en/definition/perception.
