Facing Sufering

16 . See Robert Alter, Life Does Not Get Any Better Than This, Liguori (Missouri, USA): Triumph Books, 1996, pp. 48-49.

17 . José Luis Montes, El hombre que tuvo la fortuna de fracasar [The Man Who Had the Fortune to Fail], Barcelona: Plataforma Editorial, 2009.

18 . Interview with José Luis Montes, “Nos programan para ser infelices” [They Program Us to be Unhappy], El País, 9/13/09, p. 40.

19 . See William DeFoore, Anger: Deal with It, Heal with It, Stop It from Killing You (Health Communications, 1991).

20 . See Robin S. Sharma, The Monk Who Sold His Ferrari: A Fable About Fulfilling Your Dreams and Reaching your Destiny. New York: Harper Colins, 1999.

21 . Marcus Aurelius Antonius Augustus (121-180), was Roman Emperor from 161 until his death (180), and is considered to be one of the most important stoic philosophers.

22 . The Bible says, “Do not let the sun go down while you are still angry.” (Ephesians 4:26).

23 . For more about the subject, see Paul Tournier, Guilt and Grace, New York: Harper & Row, 1962.

24 . Also see Paul Tournier The Healing of Persons, New York: Harper & Row, 1983.

25 . Proverbs 17:22.

26 . See, for example, the case of Kyle Maynard or Nick Vujicic (see p. 161 of this book).

27 . Albert Schweitzer (1887-1965), was an Alsatian doctor, philosopher, musician, theologian, and protestant missionary. He received the Nobel Peace Prize 1952) for his life in service of the sick and disadvantaged. He spent most of his life, and died serving, in the hospital that he founded in Lambaréné, which is now in Gabon, Africa.

28 . Dr. Hans Hugo Bruno Selye (1907-1982), Austro-Hungarian physiologist, Director of the Institute of Experimental Medicine and Surgery at the University of Montreal (Canada), is famous for his studies on stress and anxiety.

29 . In particular, see Harold G. Koenig, David B. Larson and Michael E. McCullough, Handbook of Religion and Health, New York: Oxford University Press, 2001. This is a comprehensive book on the relationship between faith and health, resulting from the scientific analysis of over 1,700 different studies and research on the subject.

30 . Fitzgerald Helen, The Mourning Handbook, New York: Simon and Schuster, 1994.

31 . Barbara Wolf, Living With Pain, New York: Seabury, 1977.

32 . The Apostle Paul, in hard circumstances, found encouragement by thinking of divine promises: “For I consider that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us” (Romans 8:18). “Therefore we do not lose heart. Even though our outward man in perishing, yet the inward man is being renewed day by day. For our light affliction, which is but for a moment, is working for us a far more exceeding and eternal weight of glory, while we do not look at the things which are seen, but at the things which are not seen. For the things which are seen are temporary, but the things which are not seen are eternal” (2 Corinthians 4:16-18).

33 . Mary Craig, Blessings, London: Hodder & Stoughton, 1979 (2012), p. 77.

34 . From a spiritual perspective, Bridget Meehan, The Healing Power of Prayer, Ligouri: Ligouri Publications, 1988.

35 . Schwartz et al., “Altruistic Social Interest Behaviors are associated with Better Mental Health,” Psychosomatic Medicine (American Psychosomatic Society) 65:778-785, 2003.

4

A Hard Why

to Accept

“No one knows himself until he has suffered.”

Alfred de Musset

The test results left no room for doubt: lung cancer. Sara, a friend of ours, young and very pretty, has never smoked and neither have her parents. She’s a vegetarian and lives as healthy a lifestyle as anyone could ask. The terrible diagnosis not only moved us to express our pain; we also wanted to understand its causes. We asked ourselves: “Why is this happening?” “Why to her?” “Why so young?” It is paradoxical that suffering, being one of our most familiar realities, turns out to also be one of the most incomprehensible. Even for science, pain is still an enigma.

Useful pain?

Trying to understand the cause of our ailments in order to cure them is the most logical thing in the world. Much of our suffering comes from trauma to the body: blows, wounds, infections. Our immediate reaction to them is to reject them. The feeling of injury caused by pain generates a sudden sympathetic reflex from our whole being, reacting to the injury, mobilizing our resources for the restoration of harmony. Various kinds of discomfort intervene to protect life. An intricate system of nerve endings sends out uncomfortable sensations, like alarm signals warning of danger (a burn, a sting, etc.), implementing the mechanisms responsible for avoiding greater harm. In that sense, pain first has a protective role, which is very positive. In a large number of cases, pain is the main reason why the wounded or sick individual decides to go to the doctor.

Healthy babies are born with a complex sensory system, perfectly equipped for detecting pain in its many forms. This system will protect them from countless problems throughout their life. Those who suffer from some form of congenital analgesia, i.e. the inability to feel pain, run more serious risks than those who are susceptible to suffering. A larynx that doesn’t have cough reflexes allows pneumonia to develop easily. Joints that don’t hurt (and that don’t require a change in position) run the risk of becoming dislocated. The victims of rare diseases that decrease their sensitivity to pain tend to die young due to wounds that never hurt. Many of the deformities affecting those with leprosy result from the fact that leprosy destroys their ability to perceive pain and their bodies become mutilated due to this lack of sensitivity.

In this basic preventative role, pain is not our enemy, but a faithful guardian that warns us of danger. But pain is a resource that we value very little. Our rebellious nature, prone to hedonism and convinced that technology should fix everything, perceives any discomfort, even the most benign, as an assault. If pain reliever X takes away the pain from the onset, so much the better. And we run the risk of being left without an alarm system.

Dr. Paul Brand advises: “First, listen to your pain. It is your own body talking to you. I, too, may take an aspirin to relieve a tension headache, but only after pausing to ask what brought on the nervous tension that provoked the headache. I have taken antacid for stomach pain, but not before considering what I might have eaten to give me such pain. Did I eat too much? Too fast? Pain is no invading enemy, but a loyal messenger dispatched by my own body to alert me to some danger.”1

Natural suffering

There are many kinds of pain or suffering that have a functional cause we all know and understand: unmet physical needs such as hunger or thirst, tiredness after hard work, strain from the effort an athlete puts into exercise, the discomfort caused by heat or cold, the pain that comes with childbirth as a physiological function necessary for giving life, etc. These kinds of suffering are relatively easy to cope with. We are all willing to suffer to a certain extent when we understand why or we hope to gain something better in return: to earn an income, keep in shape, have a family…. Each day millions of men and women do difficult things because of their work, braving inclement weather, difficult work schedules, harsh working conditions, or social injustices. For all of us—though, of course, for some more than others—suffering is an integral part of daily life.

Most privileged people suffer, too, but often for different reasons. Apart from having to face the inevitable ups and downs of life we all experience, many affluent individuals inflict additional tortures on themselves, investing their considerable resources and effort in cosmetic treatments, gym workouts, fad diets…or in plastic surgery to correct the shape of their noses, change the size of their breasts, implant hair in bald spots, or inject Botox into their wrinkles. Why? Because even when we are enjoying great privileges, we cope poorly with the limitations of life, our physical imperfections bother us, and we are willing tosuffer a little in exchange for other benefits. This type of voluntary suffering is accepted, since it is a way of fighting the ups and downs of our human condition with the hope of relief, however fleeting.

Avoidable suffering

Besides these kinds of assumed suffering, there are numerous sorrows that are totally avoidable. They are the result of our own behavior, the fruit of the misuse of our freedom. From the moment that we have the power to choose for ourselves, we must reap the consequences. Our unhappiness is not only a technical problem: it is also, and perhaps mainly, the result of us taking the wrong path.

We are all more or less guilty of losing some points from the “driver’s license” of our lives.2 Imprudent choices, risky behaviors, bad habits, irresponsible acts, infidelities…an endless list of mistakes reminds us that many decisions come with painful consequences, mostly avoidable ones. Nevertheless, we often risk suffering, and even death, because we don’t resign ourselves to respect certain limits. Unless we make better choices, we can all continue to suffer needlessly and reap painful and unnecessary consequences. In this regard, there is a way for everyone to prevent some pain. And the laws of life have their own, often unforgiving, logic. We are limited by time and space. Some of our actions have irreversible consequences that eventually will reveal either the benefits of our good decisions or the seriousness of our mistakes. We can avoid behaviors that expose us (and others) to unnecessary suffering. An unhealthy lifestyle causes countless problems.

That’s reality, and it doesn’t make sense to claim a right to not suffer from it. What would make sense would be to claim the right to abstain from deliberately harming ourselves and others, and at the same time explore our possibilities for reducing discomforts from other sources. For this we would have to assume that we do not have the right to inflict pain on our fellow man under any circumstances, except to protect him from worse harm. We can take inspiration from medical ethics, which requires us to combat pain by all means, knowing that sometimes it is necessary to do some small harm so that a greater good can come of it.3

Can we claim the right to be absolutely free from pain? The affirmative answer is based on the fact that, if it were possible, it would be cruel not to try to achieve that goal. In an ideal situation, all human beings would be able to access palliative care services and be able to count on appropriate analgesic treatments to meet the needs of each individual. But it doesn’t happen like that. The distribution of resources remains unequal and unjust. And we still complain that much of human suffering continues to be, ultimately, avoidable.

Destructive suffering

But not all instances of suffering are avoidable. And they cannot be compared to one another. The hunger pangs a person feels who knows she is going to eat soon are not nearly of the same caliber as the desperate, ravenous hunger someone feels who knows he will not be satiated in any way because he cannot obtain food. In this case, hunger pangs lose their functional purpose and become an added torture. Rather than leading us to a solution, our suffering is compounded by the powerlessness of experiencing to what extent we are vulnerable, to what extreme our own bodies are capable of turning against us.

So, much of our suffering, far from being natural or “deserved,” is terribly unjust. Our friend Sara took good care of her health and still developed cancer. Our wonderful neighbors’ son, a very careful young policeman, died in a senseless traffic accident. Among my work colleagues are some excellent parents who gave their children the best education and yet have not been able to prevent them from falling into the clutches of drug addiction. And to these examples we could add many, many more.

So we can say that in some cases we are alive thanks to pain’s protective function, but in others we succumb due to its destructive consequences.44 When we reach certain limits, and we face situations without solutions, we must abandon the idea of positive suffering. All too often, pain becomes a sinister addition that destroys us without giving anything in return. If a “healthy” suffering exists, warning us to live better, then there are also destructive torments that defy reason. These we suffer from without any benefit in return, and they make us worse or even lead to death.

Chance and tragedy

Those of us who live in democratic societies, accustomed to expecting responsibility from everything, tend to think—without grounds—that behind every misfortune there must be someone responsible. But this is not always true. It is correct that if we all did our part, and if we were able to make use of all the means at our disposal, we would avoid many misfortunes. But may be not all. Social injustices and economic inequalities cause a lot of gratuitous harm, but random chance also exists, and catastrophes—natural or man-made—will continue to be a reality. A tsunami affects thousands of people, but we cannot pinpoint its direct cause. Even so, parents will blame themselves for letting their children go to the beach that day, victims’ family members will blame the weather service for not issuing a warning in time, and the survivors will feel guilty for being alive.

That culpability is not real. There are things for which no one is directly responsible. But the feeling of guilt is one of the most stubborn blights of humanity, the cause of many of its problems. The feeling of guilt is both the lucid flash and the bitter dregs of the human conscience.5

Traditional approaches

Clearly, “natural” explanations of suffering are only satisfying to a point. From time immemorial, man has tried to understand the mystery of pain, resorting to explanations that go beyond the realm of our existence. All religions offer metaphysical answers to the question of evil. Some explain it as a result of a violation of the natural order (see the notion of taboo in animistic societies); others, as divine punishment for the sins of humanity (theistic religions); and still others, as a privileged means for progressing, purifying oneself, or purging faults (Eastern traditions).

The attempt to explain suffering within a philosophical or religious concept of the world is marked by various ideologies. Depending on the notion that one has of life, one explanation or another will be given for the question of pain and it will be spoken of with a specific language.

Fatalism

The Homeric texts, like many other expressions of the ancient pagan cultures, raise the question of the meaning of suffering, but they don’t really answer it. The heroes of the Iliad and the Odyssey live in an environment of fatalistic pessimism, enveloped in a permanent feeling of sadness. They believe that they will wander this earth for only a short time, and that later they will be taken to Hades, where an uncertain and gloomy fate awaits them. Their lives have no meaning. Not even the gods can alter the misfortunes of fate or chance. For the ancient Greeks, fate was a force greater than that of the gods themselves. Its power was especially feared, because it was believed to affect the human condition in an inexorable way. Both Greek mythology and literature taught the futility of trying to change the course of things, since destiny is predetermined before the birth of each individual, so that it can even be foretold by oracles and omens. This belief pervades Greco-Latin mentality to such an extent that Greek tragedy consists of describing how anyone who dares to defy his destiny or social order is punished with madness or death.

Denial of Pain

With the idea that it is useless to fight against fate, some philosophers tried to fight pain by developing a doctrine focused on the sufferer’s attitude. Their big question was: What can we do so that what happens to us causes us less harm? The famous Stoic response said: “If I voluntarily accept my fate (which I cannot change) nothing bad can happen to me. That is to say, I am free, because I have accepted from the beginning that I will take whatever happens to me.” Stoicism looked for a way out of the problem of suffering through the path of denial, the repression or lack of expression of pain. So, Epictetus taught his disciples to fight pain by repeating the following sentence: “Pain, you are nothing but a word.”6 But his own followers soon discovered that the theory of apathy (impassibility) proposed by the master of Stoicism doesn’t tend to work in practice. Harsh reality imposes itself on this philosophy and at times pain is so violent that not even the most stoic individuals can accept it. The only course left to them is suicide, a final act of the assertion of freedom and the suppression of pain.

A similar response is found in various Eastern traditions, with practices that tend to fight suffering through the elimination of desire. Buddha says: “This is, my brothers, the truth about suffering: Birth is dukkha, aging is dukkha, death is dukkha; sorrow, lamentation, pain, grief and despair are dukkha; association with the unbeloved is dukkha; separation from the loved is dukkha; not getting what is wanted is dukkha...”7 In a word, the origin of suffering is the desire for happiness, the desire for existence. With the premise that suffering comes from frustration, the proposed solution is the renunciation of individual will, the annulment of self, and the struggle for the abandonment of all desire.

There is a lot that is positive about some self-control techniques. However, while some serenity practices can relieve certain kinds of pain, mostly physical pain, it doesn’t always work for emotional suffering, others’ or our own. Denying its existence does not eliminate it. Some practices of “diversion of attention” remind me of the case of a smoker that a doctor friend of mine told me about: He was so terrified about what he had read in a newspaper article about the harmful effects of tobacco, that from that day on he stopped reading the newspaper…. And one asks oneself if, long-term, it is beneficial for the human being to become insensitive, particularly to the suffering of others.

Resignation to Fate

Various traditions teach their followers not to rebel against misfortune. They believe that it is always a result of personal faults or divine will. As an example, they often use individuals affected by sexually transmitted diseases due to lifestyle choices. For them, suffering is a direct result of specific transgressions, although the guilty person may not be aware of them. In a way, it is the fatalistic idea of Insha’Allah, which in many cultures is rooted in a religious education of blame. If a child falls trying to reach a jar of jam in the kitchen cupboard, there are parents who will say: “It is God’s punishment. You have disobeyed your mother and that is your punishment. You deserve it.” And so the child ends up believing that every form of suffering comes from direct—and divine—sanction of their faults.

Rebellion

But the idea that human suffering is due to divine punishment makes us rebel. As a neighbor of mine once said: “They say that God makes those who He loves the most suffer, but I’d rather He left me alone. What could I have done to Him so that He would give me such a difficult daughter?”

In my pastoral ministry, I have heard many reactions to painful situations:

“How can God allow my baby to suffer?”

“What wrong have I done to have cancer? I’ve always attended church…. I don’t think I’m any worse than my friends, but everything is going well for them.”

“Why does God allow children to die in wars?”

“How am I going to have an operation to remove this tumor if maybe God sent it to me?”

In secular societies, loss of faith, trust in medicine as the solution for everything, and the utopian dream of a world in which science one day eradicates pain, have led many people to stop looking for answers in philosophy and religion to the problem of suffering. Most end up ignoring the enigmatic dimension of the issue and look elsewhere.

Emotional Suffering

From the point of view of bioethics, pain is usually distinguished—with reason—from suffering. If pain can be fought at all costs, suffering does not have the same possibilities for therapeutic treatment because the circumstances that produce it cannot be modified with concrete formulas. The doctor may not know the suffering that a given situation causes for a particular patient and may limit the treatments to merely symptomatic ones. And the patient may make incorrect personal decisions that counter the effects of any therapy.

Given the complexity of the task, medicine continues to seek out new resources for fighting or relieving different kinds of pain. Among other things, it has been found that a number of physical ailments proceed, at least in part, from unhealthy attitudes about life and, in particular, from unresolved emotional problems. Unlike physical pain, mental suffering does not come from accidents or disease states. It arises, most of the time, from the conflict between our desires and reality: the death of a loved one; the loss of a job; reduced faculties due to an illness, accident or decrepitude; emotional wounds due to a divorce or a breakup; etc. This kind of suffering is caused by our physical limitations (we find ourselves deformed, diminished, or elderly), our social disadvantages (we feel excluded because of our gender, race, nationality, marital status…

), our financial difficulties (debts or troubles), our emotional problems (a betrayal or rejection), and so on.

This anxiety grows when we are faced with barriers, sometimes insurmountable, that are between us and our hopes and dreams. As John Lennon used to sing in Beautiful Boy, “life is what happens to you while you’re busy making other plans.” Emotional suffering emerges from painful situations for which we cannot find a solution: guilt from wrongs that cannot be righted; unrequited love; feeling hopeless because it is too late to change a fault; feeling powerless at the death of a loved one; feeling despair at the proximity of one’s own death; etc.

Emotional suffering is inevitable in an unjust world. And deeply human. We could almost say that it is sane and positive to feel it, because it comes from some of the best abilities of a person: sensitivity and compassion. It is part of our humanity. It would be inhuman to remain insensitive to injustices or misfortunes, whether they are others’ or ours own.

Anxiety, stress, and depression

A classic example of how difficult it is to separate pain from suffering is provided by anxiety, stress, and depression. According to statistical estimates, in the year 2000, there were already hundreds of millions of individuals suffering from depression, two times the number in 1950, mostly in the West. In 2009, between 7% and 10% of the world’s population suffered from some form of depression, mostly in the countries with a Western lifestyle.8 The causes behind this growing problem are very complex, as its physiological components are difficult to separate from its psychological factors, and include genetic predisposition, lifestyle, the impact of environment, family tensions, and personal problems.

According to experts, stress and loneliness are two of the main causal factors of depression. Stress comes from fear and hurry, from emotional overload at work, from worry about personal problems, from pressure to do more without ever knowing how much more. Loneliness, meanwhile, hurts us by a lack of emotional support, a lack of affection, a lack of communication with others, the inability to count on someone with who can provide us with a less subjective frame of reference than our own on the reality in which we live. And it also comes from the assumption that all of the above makes us feel alone, even when we are not alone in reality. Every day there are more people who have unmet emotional needs or a weakening self-esteem. Many depressed individuals suffer from a lack of recognition or appreciation. They don’t need fame, fortune, or medals to be happy. They just need someone to recognize their achievements, help them accept their reality, soothe their concerns about their burdens, and help them find inner peace. Stress and loneliness alter personality, affect self-perception, and disrupt serenity in the face of reality, creating unnecessary anxiety and distress.9