"God is most glorified in us, when we are most satisfied in Him" -Piper

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Forming an Understanding of Suffering in the Context of the Christian Faith

Part 1: Suffering and Chronic Illness

Suffering on a Physiological and Biological Level

Suffering is inevitable. To be human is to suffer. Suffering has a physiological/biological-sociological-psychological-political and spiritual dimension to it. I want to propose the following questions and answer them over the course of the next few weeks. How are we to understand suffering from a Christian perspective? How can the sufferer best work with his/her condition of suffering? What role does faith play for the Christian caught in the grip of suffering? Is suffering just a mystery that must be treated as such, or can Scripture provide us with answers and solutions to the human predicament to suffering?

An Introduction to the Series

In these series we will discuss the following topics:

·         Pastoral care for the sufferer.

·         Illness and suffering as an existential crisis.

·         Illness and suffering from a theological perspective.

·         Finding meaning and value in suffering.

·         Managing suffering and chronic pain.

·         Personal growth through suffering.

·         A pastoral model of care for the suffering.

·         An ancient paradigm for understanding illness, suffering and healing.

·         The psychological perspective on suffering.

Chronic Illness and Suffering

To kick off these essays on suffering we will examine chronic illness and suffering. To begin with let me point you to two quotes by Sendrail and Larchet. Both of these views may come across as very morbid, however, it is a daily reality of being human.  

Sendrail (in Larchet 2002:9) writes: Life, it has been said, ‘is by its very nature a temporary staying of death. Every one of our cells is preserved at the cost of ongoing struggle with forces that tend to destroy us … From birth, human cells contain the seed of their own destruction … Sickness marks the whole of our fleshly life … Medical professionals constantly observe the fact that physical processes leading to morbidity are combined with the most basic life-functions.’ Larchet (2002:9) writes: ‘Even when we believe we are in good health, illness is potentially there within us, and it merely requires the weakening of one of our systems of defense for it will appear in one form or another. And at times, before we are even aware of it, it has done considerable damage.’[1]

The reality is that perfect health of the body can never be attained in this life. Human beings face finitude and the reality of death. This point cannot be muted. While we do face finitude and the reality of death as Christians these two points of reality do not define us. We are not defined by death but by eternal life and resurrection life!

Suffering on the physiological and biological level does have certain repercussions for the sufferer. What are they?

Abram (1972:661–662) notes that there are several psychological defenses which sick people use to deal with the anxiety and conflicts associated with chronic illness.

 

·                     Regression. The patient regresses in reaction to the threat of his or her illness.

·              Denial. The person avoids the threats that the illness imposes on their physical, psychological and social   function by employing denial.

·                     Intellectualization. The patient uses an overt intellectual approach to his illness to conquer anxiety.

·           Depression. Feelings of helplessness, sadness and bleakness in one’s outlook on life and the future are common in the chronically ill person.

·                     Overdependency. The illness becomes an excuse to relinquish many responsibilities.

·            Non-adherence to regimen. The patient refuses to take his or her medication or cooperate with treatment protocols.[2]

 LeMaistre (1988) has noted the ongoing emotional trauma of chronic physical illness as a process of stages, which she identifies as:

 ·                     Crisis.

·                     Isolation.

·                     Anger.

·                     Reconstruction.

·                     Intermittent depression.

·                     Renewal.[3]

 Chronically ill persons suffering from chronic pain are continually tempted to withdraw from society to try to protect themselves from the intolerance of others. However, chronically ill persons need the community for support, love and care.

As already stated chronic illness and pain are interrelated. Gatchel, Peng, Peters, Fuchs and Turk (2007:581-624) argue that pain which persists for three months are more, is generally regarded as being chronic. Chronic pain persists for months or years, either constantly, or intermittently is most often associated with disease or unresolved injury. Pain like illness is experienced on the biosphychosocial levels. Gatchel, et al (2007:581–624) argue that although pain is a subjective experience it is nevertheless created by the interaction between biological, psychological and social factors, rather than defining pain as purely a physiological phenomena.[4]

According to Harris, Morely and Barton (2003:363–370) chronic pain frequently interrupts cognition and behavior which may lead to poor performance or non-completion of tasks, or non-participation in events. They explain that chronic pain patients tend to experience a decline in interpersonal interaction and work-involvement, which is in turn associated with an increased experience of negative affect. Emotional distress and interference are the two most important predictors of the use of medical services; emotional distress in the form of anxiety, catastrophising and depression, are significant prognostic indicators for chronic pain duration.[5] The emotional distress of chronic illness leads to catastrophising which Coetzer (2010a:29) argues can lead to patients making things much worse than they actually are.[6]

Coetzer (2010a:29) says that catastrophising takes the form of assuming that something is so horrible, dreadful, disastrous, or awful that we can’t stand it. Or in exaggerating the badness of the situation, we also magnify our arousal and create a feeling of hopelessness.

The danger of catastrophising argues Coetzer is that it keeps the person in a place of distraction from what can resolutely be done to maximize the possibility of a good outcome. Coetzer (2010a:30) therefore proposes that the following rebuttals must be put in place of this pervasive distortion:

 ·                         Ask, ‘How likely is this to do me in?” Will this really be the end for me if it should happen?

·                         Think, ‘It’s not so bad. This is inconvenient not a catastrophe.’

·                         Think, ‘Okay let’s assume the worst is really happening or will happen. What will I do then?’

Coetzer (2010a:30) wisely says that there is something calming about fully facing the worst, accepting that it could happen or is happening.

In summary, chronic illness and chronic pain must be treated together on the physiological, psychological, social and spiritual levels.

Conclusion

The discussion has revealed that illness involves pain, which in turn produces suffering on a physiological/biological and psychological level. Later on these series we will deal with the spiritual impact suffering has upon a person suffering from chronic illness.

 

 

 

 

 


[1]Larchet, J C 2002. The theology of illness. Translated by John and Michael Breck. New York: St Vladimir’s Seminary Press.

[2]Abram, S H 1972. ‘The psychology of chronic illness,’ Journal of chronic disease 25 (1972).

[3]LeMaistre, J 1988. Beyond rage: The emotional impact of chronic physical illness. Oak Park, III: Alpine Guild.

[4]Gatchel, R J, Peng, Y B, Peters, M L, Fuchs, P N, & Turk, D C 2007. The biopsychosocial approach to chronic pain; scientific advances and future directions. Psychological Bulletin, 133(4), 581–624.

[5]Harris, S, Morley, S & Barton, S B. 2003. Role loss and emotional adjustment in chronic pain. Pain, 105, 363–370.

[6]Coetzer, W 2010a. Important guidelines for the counseling process. Student manual. Potchefstroom.

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This particular point sounds very morbid, however, it is a daily reality of being human. Sendrail (in Larchet 2002:9) writes: Life, it has been said, ‘is by its very nature a temporary staying of death. Every one of our cells is preserved at the cost of ongoing struggle with forces that tend to destroy us … From birth, human cells contain the seed of their own destruction … Sickness marks the whole of our fleshly life … Medical professionals constantly observe the fact that physical processes leading to morbidity are combined with the most basic life-functions.’

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Larchet (2002:9) writes: ‘Even when we believe we are in good health, illness is potentially there within us, and it merely requires the weakening of one of our systems of defense for it will appear in one form or another. And at times, before we are even aware of it, it has done considerable damage.’

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