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I have a client who sometimes starts a session saying “I don’t want to talk about Rwanda”.  What he means is he wants to be able to talk about his pain and suffering, and the unfairness of life, without having to think about people who have it worse.

The extremes of human suffering can serve to discount one’s own more mundane complaints. In their severity, they can be used to delegitimize even significant hardship and trauma in our lives.  I remember a great scene in “Sex, Lies and Video Tape” when Andie MacDowell’s morbidly depressed character uses her time in therapy to talk about “the starving children in Africa”.

It is actually quite a common occurrence in therapy; clients encoding their distress in a story about societal, historical or political happenings. Or explaining to the therapist that their suffering is irrelevant as it can only be viewed in contrast to the worst atrocities human kind has faced. My client is trying to avoid the invalidation of his trauma by reducing the field of comparison.

The trick, or rather the place of most grounded health, requires a balanced, fluid perspective.

It is true that if compared to the human suffering of the holocaust, atrocities in Rwanda, or the experience of victims of abduction and long term torture, most of us could hardly want to trade our lot. But that does not mean that our suffering isn’t relevant. The realities of our hurts, and traumas, and disappointments need our attention.

We wouldn’t expect someone to ignore a bleeding gash on their arm just because the injury hadn’t torn off their arm. But of course we also would find it difficult to tolerate someone treating their gash like a lost limb.

What we know about physical injury could actually help us attend to our injuries in context. For instance, paper cuts do really hurt. A tiny bit. Enough to say ouch out loud. Enough to suck on our hurt finger. And that is about it. Unless it gets infected. Then we have to attend to it a tiny bit more. Still not much, but to ignore it would not work well.

And a gash? A gash likely needs some medical attention. Not necessarily an ambulance, but maybe some stitches, and maybe some bandages. And if ignored, may indeed pose a real problem for us. Many of our childhood injuries are like this. They may have been left unattended and festered untreated, making them more tender than the time of the injury.

Context and perspective are so key to understanding our suffering, that sometimes even a lost limb requires us to note what remains. Honoring our losses always demands that we also note what we have.

Gratitude for the abundance of our lives doesn’t have to negate our pain in loss. It just contextualizes it. Multiple things can be true at one time. We can have suffered terrible injustice and unfairness in our childhood homes, like my client who had parents that vilified him, and left him with the deep shame and rage of a Cinderella who never had her day of triumph.That suffering must be felt, acknowledged, validated and ultimately mourned.

To do so opens one up to the abundance of blessings.


Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on your needs and issues as well as your and own therapists’ personalities and styles. All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing.

Author Karen L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.

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