The Two Arrows of Suffering: 3 Strategies to Reduce Yours

by | Feb 19, 2021 | COVID-19, Physician Resilience

Have you heard the phrase “pain is inevitable yet suffering is optional?”

This is a phrase can generate a lot of confusion, yet the concept is critically important if you want to be resilient to the challenges you face. Let’s look at this more deeply and see how it can be helpful to you, now, during the pandemic.

What we’re talking about here is what’s often called the two arrows of pain and suffering:

The first arrow is the actual event, challenge, or difficulty. 

The second arrow is where your mind goes with it.

Let’s look at an example:

You wake up with a sore throat. No other major symptoms but you become worried. You start thinking:

What if this is Covid?

What if I get really sick?

Oh no, what if I have to be hospitalized?

How will I care for my family and manage my other responsibilities?

What if I get Covid and then I spread it to my family?

Sound familiar?

Well, there are two arrows here.

The first arrow is the sore throat. That is the actual event. Simply waking up with a sore throat.

The second arrow is the series of fears, worries, and thoughts that your mind goes to. Well beyond a simple sore throat, your mind may be off and running with all sorts of ideas about a future that may never ever be real.

Another example relates to an internist I was coaching who brought up a struggle she was having with her 17-year-old daughter. Her daughter was smart but didn’t seem to be applying herself to her studies. A prior A student, now she was getting largely Bs. Two years earlier, the client had gotten divorced and they had moved to a neighboring town.

Of course, my client was worried about the impact this would have on college applications.  She found herself having these thoughts:

What if she can’t get into a good college?

Maybe I don’t have her in the right school.

Maybe I made a big mistake moving to this neighborhood.

Maybe we never should have gotten divorced. 

Maybe we should have gotten divorced years ago.

I think I’ve really screwed things up.

She told me that her mind was caught up in all these thoughts and worries, her mind playing them over and over. She found herself up at night replaying all the worries and then so depleted during the day that it was impacting her patience with her daughter. 

What are the two arrows here?

The first arrow is having a daughter who previously did well at school, now not.  This is something that most parents would find difficult.

You can likely spot the second arrows: the thoughts, fears, worries that the client experienced. The places her mind went that actually made her less able to work effectively with her daughter.

Now, I want to be clear that having second arrows is perfectly normal. We all do this!

But it’s also something we can work with and gain greater agency over. 

Learning Resilience From Our Pets

I was thinking about this yesterday when I was out walking my dog, Miss Sydney. Like most dogs, she’s incredibly friendly, loves every human and canine she encounters. But we ran into a dog walker with two dogs, one of whom got excited and jumped up on my dog. There ensued a bit of a kerfuffle, with my dog’s hackles raised and some intense growling. This lasted 30 seconds at the very most, and then Miss Sydney’s body relaxed and she resumed her happy and contented countenance.

But what happens to me when I  have a similar challenging interaction or situation? I know that I tend to hang onto “the kerfuffle” a lot longer. I might think to myself:

What was that person doing?

I can’t believe they said what they said to me! 

Didn’t they realize how hurtful that was?“ 

This is horrible! How could anybody be expected to tolerate this!?

If you’re anything like me, your mind goes round and round, escalating whatever the initial event was. Sometimes I might even spend half my day ruminating about something that was really quite small.

I would definitely like to be more like my dog!

Resilience Involves Focusing On What We Can Control

There are many forms of suffering we can’t control. The pandemic. Difficult bosses. Ways that other people act.  Unrealistic demands in our jobs. Accidents. Illnesses. 

The examples are legion. 

Suffering and difficulty are a part of life, for all of us. Whether in small or large ways, no one gets through life without struggle and strife. 

Resilience is not so much about the challenges we face and more about how we face the challenges.

The concept of the two arrows helps us focus on the aspects of suffering that we can control, not the ones we can’t. It also helps us work with our minds to be the most resourceful we can be in facing the difficulties we encounter. 

Work With Your Arrows

Is it easy to shift out of the second arrows? No, it is challenging! Our minds are used to certain patterns and creating second arrows is one that most of us have done for years and even decades. It’s part of the negativity bias we hear so much about.

Working with the second arrows requires practice. 

And yet, that’s what resilience is about, building these skills, each and every day. 

Here are the steps you can take: today. They all involve mindfulness and self-compassion. Will they work? Yes, this is what I have seen over and over, with my clients and with myself.

  1. Bring mindful awareness to your own mental patterns around the two arrows
  2. Don’t beat yourself up for having second arrows! Try to be your ally, not your adversary
  3. Take purposeful pauses to help your mind let go of the second arrow

I hope this reduces your suffering as you go through your days. I’d love to hear how it goes.

  1. Embrace uncertainty

When you stop and think about it, uncertainty and change are the only things that are certain. Impermanence is one of the basic laws of our world.

After all, everything changes. Our relationships change. Our kids grow up and change. Our bodies age and change. Our environments change. Our planet changes.

All too often, however, we forget this basic truth. We somehow expect things to be predictable and stable.

The problem is that this expectation sets us up for difficulty. It leaves us struggling unnecessarily when something shifts. It adds a layer of suffering above and beyond that caused by all the VUCA around us.

What I’m getting at is that we have a choice. We can meet uncertainty with reactivity or we can meet it with mindful understanding.

More than meditating on a remote mountainside, mindfulness helps us have the calm, steadiness, and clarity we need to work constructively with all the change and uncertainty.

At the same time, while we can find ourselves resisting change, we can remind ourselves that it does not have to mean something bad! Just take a moment right now to think of all the difficulties you have faced in your life and work that are now resolved and far behind you. This can help you see how change has actually been quite the positive.

  1. Respond to complexity with compassion

Even knowing that change is the only thing that is certain, it can still be difficult to weather. Living in such a VUCA time is difficult. You deserve compassion for managing all the challenges.

With mindful awareness, we can bring ourselves compassion for what we’re going through. There is increasing evidence that self-compassion is a powerful antidote to stress and even burnout. From where I sit, I think that it is actually one of the most powerful medicinals available to us.

  1. Take purposeful pauses

With mindfulness, we are aware of what is going on within and around us. We tune in and pay attention to our experience. We learn to utilize our breath to take us out of the fears, worries, stories, and preoccupations our minds are so good at generating about what might come next, and bring us back to the present moment. Here in the present, we leave that overly activated limbic state and can experience a sense of calm.

A pause also serves to allow our prefrontal cortex to come online. It creates a critically important space between our emotional response and conscious, intentional action.

Once we have paused, we can then see more clearly that fear had taken hold. 

With a pause, we become the witness of our experience as opposed to the one trapped by it.

  1. View VUCA as opportunity

I don’t know about you, but I can find myself reacting to the VUCA environment with something of a fixed mindset. With a fixed mindset, I am telling myself things like ‘it shouldn’t be this way’ and ‘why is this happening?’

When I can utilize mindful awareness, I can see that I’ve boxed myself in with a fixed mindset. I can challenge myself to grow. By grow, I mean challenging myself to see whatever difficulty I’m experiencing as an opportunity to learn.

Here again, mindfulness again throws us a lifeline. Mindful awareness involves leaning into curiosity.

I can flip the script and ask myself:

What can I learn from this experience?

How can I use this to be a better version of myself?

How can I help others cope in this VUCA environment?

What do I want to look back and see about how I acted?

In summary, while VUCA is definitely the order of the day in healthcare and beyond, you don’t have to succumb. You don’t have to live in fear. There are constructive actions you can take to help you cope with uncertainty, build calm in chaos, and even thrive in chaos and VUCA. While we can’t control much that is contributing to the VUCA time, with mindfulness we can control how we respond to it.

I hope you’ll try out these 4 mindfulness strategies as I have seen them help countless people. I’d love to hear how it goes.


To learn more about how mindfulness coaching can help you cope with this VUCA time, please reach out for a complimentary consult.

6 Free Resources To Help You During COVID19 And Beyond.

  1. 14-day meditation series 
  2. Imposter No More PDF
  3. Resilience Book Chapter
  4. Leading In Crisis PDF
  5. Balance To Burnout PDF
  6. 30-minute consult

Take advantage of one or more of these valuable resources created for clinicians and non-clinicians.