There’s a concept I use a lot in therapy called clean pain vs dirty pain. People come to therapy because they’re in some kind of pain—or as we therapists like to call it, psychological suffering. Sometimes that pain is obvious: grief, anxiety, heartbreak, burnout. But often, there’s a second layer of pain making everything worse. That’s where this concept comes in.
What is Clean Pain?
Clean pain is the pain of being human. It’s the kind of pain that comes with living a full life—loving people, losing people, taking risks, failing, growing. Clean pain is what you feel when something hard happens: a breakup, a tough conversation, getting laid off, or your kid having a meltdown in Target.
It’s raw and real, but it’s not something to pathologize or fix. Clean pain is part of being alive. It’s grief after loss. Sadness when things don’t go the way you hoped. Nervousness before something big. Clean pain shows up the moment we’re born and stays with us because… life is hard sometimes.
What is Dirty Pain?
Dirty pain is what happens when we pile on to the clean pain. It’s like taking a glass of water (the clean pain) and dumping in a bunch of dirt, then swirling it around. It gets murky. Heavier. Harder to sit with.
Dirty pain shows up as self-judgment, blame, shame, resistance, and harsh inner commentary. It’s the story we tell ourselves about the pain that often creates more suffering than the original experience.
Let’s look at a few examples:
- Clean pain: I didn’t sleep well last night. I feel exhausted and foggy.
Dirty pain: What’s wrong with me that I can’t sleep? I’m going to ruin everything tomorrow. Why can’t I get it together? - Clean pain: I didn’t have enough time to finish everything today.
Dirty pain: I’m such a failure. Everyone else seems to manage. Why am I always behind? I’m a terrible mom/partner/employee. - Clean pain: I feel anxious before a first date.
Dirty pain: Ugh, not this again. I shouldn’t feel this way. If I’m anxious, I’m going to ruin everything.
Can you see how clean pain is something we can sit with, move through, or even share with someone—and dirty pain feels more like a spiral?
Pain x Resistance = Suffering
In mindfulness-based therapy, there’s a powerful little equation:
Pain x Resistance = Suffering
Here’s what that means: pain is inevitable. But when we resist the pain—try to avoid it, fix it, outrun it, criticize ourselves for feeling it—we amplify it. We turn up the volume.
The more we fight the pain, the more we suffer.
Examples of resistance:
- Trying to numb or distract with food, alcohol, screens
- Isolating from others
- Overthinking or obsessively analyzing
- Replaying past events or predicting worst-case scenarios
- Avoiding situations that might bring up hard emotions
Sometimes those things bring temporary relief, but they often leave us feeling worse in the long run—especially when the original clean pain is still there waiting for us, now tangled up with guilt or frustration.
Breaking Free From Dirty Pain
So how do we stop making our pain dirtier?
The first step is noticing. Becoming aware of when clean pain shifts into dirty pain. You can start by asking yourself:
- What am I feeling right now?
- Am I adding any judgment or self-criticism on top of this feeling?
- What if this feeling is valid and doesn’t need to be fixed?
Here are a few more strategies that help:
- Name it to tame it: Say to yourself, “This is clean pain” when you’re feeling sadness, grief, or disappointment. Labeling helps create space between you and the story your mind wants to tell.
- Drop the story: When your thoughts start spiraling—“Why me? This isn’t fair. I’m such a mess.”—gently bring yourself back to the feeling in your body. “Oh, I’m feeling tight in my chest right now. I’m hurting.” That’s clean. That’s allowed.
- Practice self-compassion: Talk to yourself the way you’d talk to a friend. Instead of “What’s wrong with me?” try “This is really hard right now. I’m doing the best I can.”
- Let go of “shoulds”: Dirty pain often hides behind “shoulds.” I should be more productive. I shouldn’t feel anxious. I should have handled that better. Try replacing “should” with “it’s okay that…” or “it makes sense that…”
- Give yourself permission to feel: We don’t need to justify pain for it to be valid. You get to feel sad just because you’re human. You don’t need a big dramatic reason.
If you take one thing away from this post, let it be this: Clean pain is hard, but it’s not bad. Dirty pain is what happens when we tell ourselves that being human is wrong.
You don’t have to add suffering on top of your pain. You can meet yourself with kindness instead.
And that, in itself, is healing.
Kathryn Tipton, MA, LPC, PMH-C, is a licensed therapist and co-founder of The Houston Center for Valued Living. She specializes in reproductive mental health, insomnia, and anxiety treatment, helping clients navigate life’s hardest moments with clarity, compassion, and evidence-based tools.