Facing Sufering

Moreover, as demonstrated by Dr. Sylvie Galland, there are many patients who repeat models of painful relationships that they experienced in childhood, which would often be inevitable. For example, the child of an alcoholic tends, more easily than someone else, to take on a painful role similar to the one her mother suffered because of her father’s problems, subconsciously predisposing her to put up with the behavior of a husband…preferably alcoholic! “Perhaps our competitive society has something to do with this. Honors and gratification belong only to those who succeed. But affection, compassion and general favor naturally go to those who suffer. As it is much easier to fail in life than to succeed and to be unhappy than to be happy, the tendency for some is to prefer the easy way.”19

To make matters worse, there are conditions that, for some patients, have a captivating, almost heroic aspect, whose intensity they would never find in the routine of their mediocre lives. An emergency physician friend told me about a homeless man who “had accidents” on a regular basis, to the point where the medical team believed that he did it on purpose, because he missed the excellent care that he received in the hospital each time that he was admitted for his recovery period. Obviously, this is an extreme case, but even to lesser degrees the nostalgia of suffering is not unusual. Some patients confine themselves to their problems as if they did not wish to leave a jail cell to which they had grown accustomed.

These kinds of patients have, in a way, resolved their situation in life. Regaining their health would mean rethinking work, personal, or family issues that they don’t have the courage to face. Their healing—or that of a disabled child, etc.—would obligate them to look for work, or allow their spouse to finally file for a divorce that the spouse does not dare file under the present circumstances. Nothing can cure an illness that the patient benefits from….

In these cases that are close to pathology, in order to begin to regain freedom, the patient would have to get to the point of being willing to give up certain present “benefits” and recognize that they are prolonging in some way a situation that they could overcome. The patient would have to ask themself seriously what would happen if the problems they suffered suddenly disappeared: How would I deal with this new situation? How would my loved ones react? Etc. But to reach that point of ideal clarity and liberating awareness, something more than maturity and intelligence is needed. Human nature is very complex. Taking on the responsibilities of one’s autonomy is never easy and even less so for the patient. In general, people who get stuck in these types of problems need a lot of understanding and professional help to overcome them.

1 . The World Health Organization (WHO), in its 1946 Constitution, defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

2 . See http://www.iasp-pain.org (updated 22 May 2012).

3 . See for example, K. J. S. Anand, D. Craig and D. Kenneth, “New perspectives on the definition of pain”. in Pain, Vol 67 (1), Sep 1996, 3-6. Cf. Jan Frans van Dijkhuizen, Pain and Compassion in Early Modern English Literature and Culture (Boydell & Brewer Publishers). 2012.

4 . Phillip Moffit, Dancing with Life: Finding Meaning and Joy in the Face of Suffering, New York: Rodale, 2008, p. 86, 91.

5 . Cicely Saunders began a revolutionary movement in 1967 in favor of care for the dying, in St. Christopher’s Hospice, located South London, England. Today the movement has transformed the treatment of the terminally ill in hundreds of hospitals around the world, based on the principle of integral care, meeting the patient’s physical, social, emotional, and spiritual needs. Their motto is: “You matter because you are you. You matter to the last moment of your life.” (See Cicely Saunders, “The Care of the Patient and His Family,” in Documentation in Medical Ethics, n° 5 (London Medical Group, 1975).

6 . David B. Morris, The Culture of Pain. Berkeley: University of California Press, 1991. Cf. by the same author, Illness and Culture in the Postmodern Age, Berkeley: University of California Press, 1998.

7 . Cf. W. J. Roberts, “A hypothesis on the physiological basis for pain”, Pain, nº 24 (1986), pp. 297-311.

8 . See Stanley Hauerwas, God, Medicine and Suffering, Grand Rapids: Eerdmans, 1990.

9 . Janice M. Morse and Barbara Carter, “The Essence of Enduring and Expression of Suffering: The Reformulation of Self,” in RTNP vol. 10/1 (1998), pp. 43-60. See further Joseph A. Amato, Victims and Values: A History and a Theory of Suffering, New York: Praeger, 1990.

10 . T. S. Eliot, “The Burial of the Dead”, in The Waste Land, I (1922).

11 . “Pain is personal, more private than thought (you can share thought but not your pain), and so not one of the billions in the world’s cauldron of disease and death ever suffered more than what each one, individually, could.” Clifford Goldstein, Life Without Limits, Hagerstown: Review & Herald, 2007, pp. 106-107.

12 . The International Association for the Study of Pain (IASP) defines the pain tolerance level as the maximum intensity of a pain-producing stimulus that a subject is willing to accept in a given situation. “As with pain threshold, the pain tolerance level is the subjective experience of the individual. The stimuli which are normally measured in relation to its production are the pain tolerance level stimuli and not the level itself ” (H. Meskey, “Pain terms: A list with definitions and notes on usage recommended by the IASP subcommittee on taxonomy”, Pain 1979; 6:249-252).

13 . Quote attributed to Herbert George Wells (better known as H.G. Wells, 1866-1946), author of The War of the Worlds.

14 . Lawrence W. Wilson, Why Me? Straight Talk about Suffering, Kansas City: Beacon Hill Press, 2005, p. 19.

15 . Viktor E. Frankl, Man’s Search for Meaning, New York: Washington Square Press, 1963, p. 166.

16 . Doug Manning, Don’t Take My Grief Away, San Francisco: Harper, 1979.

17 . Unless what he wants is to pull out the tooth as soon as possible to get a reward from his family members! (Cf. Sylvie Galland and Jacques Salomé, If Only I’d Listen to Myself! Resolving the Conflicts that Sabotage our Lives, Element Books, 1997).

18 . To say nothing of the “sick tyrant,” who doesn’t ask for anything, but never ceases to brag about it!

19 . S. Galland, “L’attachement à la souffrance”, ” [Attachment to suffering], Optima, nº 217, February 1992, pp. 27-28.

2

Expressing Our Pain

“Give sorrow words.”

Shakespeare1

–I can’t find the words to express the sorrow I feel…

Many of the sympathy cards that we send or receive begin with words like these. Whether it is the unexpected loss of an unborn child or any other misfortune, even if it was anticipated, it seems like we are left speechless when confronted with pain. It is not easy to express what we feel when we find out that a friend has been diagnosed with cancer, or when a senseless accident leaves a young neighbor maimed, or when an acquaintance has been the victim of an assault…. An inner need compels us to express our feelings of sorrow, so difficult to shape out of a mixture of emotions, confused with feelings of anger or helplessness.

If enduring pain is difficult, it seems even more difficult to bear it silently. It seems that we have a basic need to express it, although we don’t know how. Upon arrival into this world, the first thing a newborn does is cry in protest, from separation, from fear, perhaps. He who suffers, no matter his age or cultural situation, usually speaks up, whether by complaining or crying about his pain.

Recounting your sorrows, writing them down to feel heard, talking about your illnesses and surgeries, is part of a real therapy. Who hasn’t ever noted the expressions of satisfaction or relief on older women’s faces when share stories with others about their surgeries, childbirths, or illnesses?

But many of us have been taught to reject the best channels for releasing pain. Someone didn’t know how to tell us that at the right time tears are an undeniable relief. And there are countless people who go through life without even venturing to share their sorrows with those with whom they should share them. Because of their personality, because of their upbringing, they think that sharing their problems with someone else is a weakness. Or, because of the nature of their problems, they are ashamed to share them. They ignore the fact that sharing what they feel with someone they trust could help them to see more clearly and release negative emotions, especially if that person is a professional who can provide solutions for their personal situation.

Just being listened to and finding our suffering reflected in the stories of others, such as in support groups, helps us to feel less isolated and to better understand our situation. Upon realizing that others share our problems, and even suffer and struggle as much or more than we do, it is easier for us to gain perspective on our own pain and cope with it. In reality, “people who do not find a way to express their suffering run the risk of being destroyed by it […]. Without the possibility of communicating with others, change is not possible. Remaining silent, shutting oneself off from relating to others, is death.”2

The courage to cry

When emotions overcome us, sometimes we cannot hold back the tears. Although tradition reminds us in many parts that “big boys don’t cry,” all human beings, including men, feel the imperative need to cry at some time or another. We are designed to cry: crying is natural.

It is true that, in some societies, those gentlemen who cannot hold back their tears in the face of sorrow are still treated as weak and unmanly. But attitudes are changing, and today we see more and more men who have the courage to cry in public, something that would have been unthinkable only a few years ago. There are some men who look too brave and masculine to cry, like when the volunteer firemen in Haiti rescued a boy from the rubble of the earthquake in 2010, when the soccer player Iker Casillas won the World Cup in South Africa that same year, or when tennis player Roger Federer lost the Australian Open in 2009. From pain, sorrow, or joy, we all need to cry sometimes.3 Some hold it in, others cannot. Crying is natural, and it is part of our body language to express our extreme emotions. Our reaction to the need to cry is cultural and depends largely on our education.

The language of pain

The language of pain is complex and ambiguous. If pain compels us to complain, there is the paradox that, when we try to explain our suffering, few of us know how, including those who suffer most. Our response to pain is, for the most part, learned. It depends mostly on personal context and culture. So, the great tennis player Rafael Nadal, after an epic game against the equally famous Novak Djokovic, claimed to have “enjoyed suffering.”

For millennia the language of pain was tinged with religious and philosophical connotations. But with the advent of scientific medicine, our modern societies refer to disease with more and more secular terminology. When facing illness, pain, and death, a growing number of our contemporaries no longer rely on spirituality; instead, they turn almost exclusively to science and public services in which they have placed their remaining faith. In place of the undeniable benefit of meditation or prayer, they prefer immediate, technical solutions. So the management of these quite personal realities is passing from the existential to healthcare, as if they fell to the social healthcare system in the first place.

In other times periods or latitudes everyone has had to live with the elderly, the sick, and the dying. In our environment the attention to those who suffer has become so socialized and technical that the majority of our citizens have almost no contact with the final stages of life until it affects them directly. Hospitals and mortuaries keep the sick and the dead separated from the healthy and the living. One of the most immediate consequences is that today very few of our contemporaries are emotionally prepared for a personal encounter with suffering, and even fewer still have adequate words to express their pain or to communicate with those who are suffering. We don’t know what to say in painful situations, for the simple reason that we have never faced them and we haven’t learned from family tradition what to do in these cases.

Not even medical terminology has found a way to adequately express the level of pain we experience. We don’t know how to describe our own suffering, and when we try we often find that we cannot go beyond a superficial communication, because we are unfamiliar with the language that pertains to it. Hardly anyone speaks of those things in a society that maintains the illusion that it is entitled to avoid every inconvenience. This amplifies the feeling of a lack of understanding of those who are suffering, including with those people they trust.

At the doctor’s office, the physician uses scientific medical terminology that leaves the patients unsatisfied because they do not understand it, but it protects the professional from uncomfortable questions from the patient and family, in case they begin to ask profound existential questions to which the physician often does not have an answer.

Our growing confidence in science is accompanied by a growing fear of the effects of disease and of the power of health professionals. So pain not only grips us with a sense of helplessness, but often it also leaves us without words. And this silence adds the weight of loneliness to our suffering.

The right to be happy

The situation becomes more complicated in our societies because the media have convinced us that we should all be happy. Although no one guarantees us the right to happiness, we are frequently bombarded with advertising that says happiness is within everyone’s reach, immediate and with minimal effort. But it’s one thing to have the right to pursue happiness and it is another to try to get it, no less, by buying a car, a house, or an insurance policy. Reality does not always conform to our wishes, and making our happiness dependent upon the things we have or the people who surround us is a sad illusion. As much as this and that can contribute to our moods, in the case of subjective experiences, the roots of happiness are planted in our attitudes, in our inner being.

This explains why, even if we are able to avoid many problems, we continue to feel unhappy. Not suffering does not mean being happy. Our inevitable clashes with reality poison our existence, laying waste to the small patches of happiness—passing and ephemeral—that are within our reach. All too often events are not responsible for our discomfort, but the interpretation and the attitude that we take toward them.4

To prevent a lot of avoidable unhappiness we would have to learn to accept things as they come to us, and the rest as they are.5 Acceptance does not mean resigning ourselves to reality, rather, recognizing its existence and reacting intelligently and positively in the face of it. Living is not an easy matter. So, instead of fearing that our happiness is running out, it is easier to fear that it never begins. Someone once said, with a bit of humor, that “looking on the bright side of life won’t damage your eyesight.” Therefore, considering the large amount of pain that already exists in the world, our best option is to look more on the bright side, to try to help and even smile—if possible—even though we are hurting. Because every minute wasted on negative thoughts is a minute of life that we cannot get back.

Constructive suffering?

That doesn’t mean unhappiness is inherently good. It means that we can deal with it in ways that are more positive and intelligent than others. Stefan Zweig was certainly very adamant when he said that we owe everything to pain: “All science comes from pain. Suffering always looks for the cause of things, while well-being encourages passiveness and does not look back.”6 Without going that far, we must acknowledge that at least an essential part of universal literature arises from the need to express human drama or overcome it. The Debate between a man and his soul (Egypt, 2000 A.C.) reads: “To whom can I unburden myself today? Anguish chokes me. Not even the silence wants to listen to me. Perhaps my only confidant is death…”

The most beautiful poems are often the most desperate. The strength of Greek tragedy lies precisely in having given expression to the drama that battles in each human being faced with an inevitable, mortal destiny against which he rebels and of which he feels simultaneously victim and culprit. In their conflicts, tears, and anguish, love and suffering intersect at the same time like cause and effect. A large number of literary works express man’s fight against adversity and his ceaseless efforts to communicate pain, understand its meaning or overcome it somehow.

Biblical literature, deeply rooted in our culture, continues to provide comfort in suffering because it contains some of the strongest testimonies to pain. As Pascal said, “Solomon and Job knew and expressed human misery better than anyone: one in prosperity (see Ecclesiastes) and one in adversity. One experienced the vanity of the pleasures and the other experienced the reality of suffering.”7 The book of Psalms contains 150 prayers, including many inspiring psalms of “orientation” and some appalling psalms of “disorientation,”8 that is to say, of complaint, lament, and protest over the injustice in life. Meditation or prayer with those prayers is good for us because it helps us to put our hurt into words, through the experiences of those who felt heard and received comfort in their suffering.

In the art world, works of art that are downright cheerful are scarce. Comic art and laughter often mask grimaces of pain. For example, of Don Quixote it is very aptly said that “when you finish laughing, you should cry.” It has been said that the great artists are beings “cursed by suffering” and that someone who has not suffered has nothing to say.

In fact, many artists have appointed themselves as a spokesperson for suffering, lending a catalyzing aspect to their artistic creations. Some of the greatest works of art are inspired by pain.

Sensitivity—an essential trait in an artist—either makes you suffer more than other people or it enables you to express your pain with more emotion.

Although it may seem exaggerated, the truth is that if we take a list of the greatest artists in history, and we go through it almost at random, starting with musicians, this thesis seems to be confirmed. Johann Sebastian Bach was orphaned at the age of 10. Mozart died of illness and misery at 35. Beethoven, grandchild of a madwoman, son of an alcoholic and a maid, was deaf as an adult, and still wrote the sublime Pastoral. Debussy, who had such refined taste, grew up in a very poor neighborhood with a mother who had, among her other faults, a heavy hand and a fondness for using the whip.

Edgar Allan Poe, who lost his mother at the age of 3, wrote: “I could not love except where Death / Was mingling his with Beauty’s breath.” R. M. Rilke, in his Letters to a Young Poet (written when he was only 27 years old and the recipient, 20), wrote that “the creator must be a world for himself and must find everything in himself. […] I learn it every day of my life, learn it with pain I am grateful for […]. The quieter we are, the more patient and open we are in our sadness, the more deeply and serenely the new presence can enter us […]. Why do you want to shut out of your life any uneasiness, any misery, any depression, since after all you don’t know what work these conditions are doing inside you?” Later he would add, “Give every man his own death,” a statement that turns out to be almost prophetic for someone who died young as a result of a wound caused by a rose thorn….9

Vincent Van Gogh, the afflicted painter, ended up losing his mind after fighting desperately against madness. After painting day and night, up to one painting a day without any success or recognition, he experienced self-mutilation, hospitalization, and finally suicide at age 37, without having ever sold a single painting. In 1888, two years before his death, he wrote from Arles to his brother, Theo, who sent him funds so that he could continue painting, “Sometimes I feel too weak in the face of the given circumstances, and I’d have to be wiser and richer and younger to win the fight. Fortunately for me, I no longer count at all on any victory, and in painting I look for nothing more than the means of getting by in life.”10

Edvard Munch, the great Norwegian painter of anguish, wrote the following: “Disease, Insanity and Death were the angels which attended my cradle, and since then have followed me throughout life. […

] I learned early about the misery and dangers of life. […] When [my father] punished us, he could be almost insane in his violence. […] In my childhood, I was always treated in an unjust way, without a mother, sick, and the threat of punishment in Hell hung over my head.”11

The great genius of dance, Vaslav Nijinsky, was forced at 16 to give in to the sexual demands of the great Diaghilev, director of the famous Russian ballets, in order to study and further his career. All his short life, which ended in insanity, was consumed with the fear of misery. Towards the end of his life he wrote in is his Diary: “I live, so I suffer. But my face has rarely seen tears: my soul has had to swallow all them.”

Anguish and worry may indeed be conducive to artistic creation because the artists, being more sensitive that the average person, express their pain in their works. Their art, like therapy, helps them overcome especially difficult circumstances. A creative personality finds new means of expression even for pain. Moreover, artists suffer the chasm between the imperfect reality in which they live and the marvelous art that they long to create. Through their art, they build bridges between those two worlds. In the face of the horrors of pain and their admirable struggle to not allow themselves to be destroyed by it, it isn’t surprising that artists feel an overwhelming need to create beauty. But there is no doubt that their masterpieces emerge more from their genius talent than from their misfortunes.

1 . “Give sorrow words: the grief that does not speak / Whispers the o’er-fraught hear, and bids it break.” (Shakespeare, Macbeth).

2 . Dorothee Sölle, Suffering, Philadelphia: Fortress Press, 1975, p. 76.

3 . Former US president George H. W. Bush, after the death of two of his crew in a plain crash, wrote the following: “I’m afraid I was pretty much a sissy about it, cause I sat in my raft and sobbed for a while. It bothered me very much. I did tell them, and when I bailed out I felt that they must have gone, and yet now I feel so terribly responsible for their fate, oh, so much right now...” (All the Best: My Life in Letters and Other Writings, New York: Touchstone, 1999, p. 51).

4 . See Eduard Punset, The Happiness Trip: A Scientific Journey, White River Junction: Chelsea Green Publishing Company, 2007.

5 . “Each player must accept the cards life deals him or her: but once they are in hand, he or she alone must decide how to play the cards in order to win the game” (Voltaire).

6 . Stefan Zweig was an Austrian writer who lived from 1881 to 1942, author of Decisive Moments in History: Twelve Historical Miniatures, Ariadne Press, 1999 (1927/1940).

7 . Pascal, Pensées [Thoughts], § XV.

8 . W. Brueggerman, The Message of the Psalms, Minneapolis: Augsburg Fortress, 1984, pp. 51-52.

9 . See Paul Tournier, Creative Suffering, Harper & Row, 1983.

10 . See The Letters of Vincent Van Gogh, (Selected and edited by Ronald de Leeuw, translated by Arnold Pomerans), London: Penguin Classics, 1997.

11 . Reine Caulet, « Je crée danc je souffre, » dossier Douleur, pp. 35-36.

3

Heeding the