Suffering and Illness as an Existential Crisis
Because illness has a profound existential dimension, a theology of suffering must have an existential perspective. This becomes critical as illness can have a devastating impact on one’s quest for meaning and purpose in life. Illness gives rise to important existential questions:
· Why me?
· Why now?
· What is to become of me?
· How will this illness impact on my future plans and the purpose for my life?
· Will I be able to handle constructively the loss of meaning in my life which this illness has inflicted on me?
· How will I cope with the loss of productivity in my life?
I believe that the church must practice the ministry of healing and encourage sick people to seek God’s healing intervention. But what if the ill person is not healed? What if the ill person is only partially healed? All healing practionners must engage with these questions and constructively draw the ill person into the place of deriving some meaning for life from the illness. In other words, pastoral care is involved with enabling ill people to move from the place of ‘Why this illness?’ to the place of ‘What purpose can this illness serve in my continued quest for meaning?’ In order to achieve this goal, we must understand the existential impact illness has on the psychosomatic, spiritual and psychological areas of a person’s life. Illness can be experienced as conflict on the following fronts:
The physical loss of quality of life
The loss of bodily movement due to an illness, such as severe arthritis or muscular dystrophy, limits a person’s mobility, not only in a physical sense, but also in a social context. This can result in a loss of regular physical contact with friends and family, exacerbating the feelings of isolation.
The loss of identity (self-image)
Illness can have a devastating effect on a person’s self-image. The uncertainty about the future and anxieties concerning the present illness can result in a loss of self-confidence. The illness can also lead to negativity. Hence the question: Who am I? Coetzer (2010a:48) argues that the tendency following a traumatic event, such as chronic illness is to feel shattered, perhaps worthless … but self-esteem can be developed, regardless of one’s history or circumstances.
A crisis of faith
The ill person’s faith functions can become impaired because God’s faithfulness is questioned. A once thriving faith becomes subjected to the existential questions: Where is God? Why has he allowed this sickness to have this negative impact on my life?
A loss of meaning and purpose
The fact that illness can have a negative impact on a person’s self-image, loss of productivity and his or her relationship with God, can lead to a loss of meaning and purpose in life.
The above discussion paves the way for an examination of the following existential dynamics that are at work in a sick person’s life.
Illness impacts our desire to live
The desire to live is what it means to be human. The desire to live is associated with a life that is full of meaning, purpose and vitality. In other words, I am significant and I am making a positive contribution towards significant others and in this world. However, the impact of illness can change this positive outlook to one of despair and meaninglessness. The future which once looked positive is now threatened by the possibility of a loss of personal activities and the imminence of death. The existential tension can be found in the will to live versus despair.
Illness, anxiety and fear of death
The inescapable fact about life is that people are prone to anxiety and fear of death. This is due to the transient nature of life, which is characterized by finitude and mortality. Illness intensifies the realization of this transient nature of life, reinforcing the reality that we will not live forever. This becomes particularly acute in the light of our quest for security in life through meaningful relationships and vocation. Hence to be ill is to be anxious.
It must be noted that anxiety during an illness could be a normal state due to the person’s life being threatened. It would be abnormal for the ill person not to experience any form of anxiety. However, if the anxiety experienced is not controlled through counselling and medication, and perhaps more importantly, through faith in God the ill person could plummet into the pit of despair.
Anxiety over your illness must also be understood in the context of fear of death or nonexistence. Louw (2005:120–121) states that: ‘Sickbed anxiety is a complex phenomenon and can assume various forms. In illness the dread of loneliness, the unknown, loss of social security (e.g. family and friends), loss of one’s own identity and self-control, regression (being dependent on others), and, profoundly, the fear of death, could cause disintegration of one’s total existence.’ Hence the existential tension can be found in the need for security versus anxiety.
Illness and guilt
Illness can have a debilitating effect on the person’s productivity. Not being able to do what they used to do can lead to feelings of guilt. In addition, guilt is experienced by the reality that what they set out to achieve may no longer be done. The future has become unknown.
People long for peace, wholeness and harmony. When this is disrupted by illness, the existential tension between peace, wholeness, harmony and guilt is experienced.
In the context of the God-human relationship, illness can give rise to the following question: Is God punishing me for my transgressions? This form of existential guilt must be taken seriously. Pastoral care is therefore involved in reconciling the person to Christ through repentance, confession and accepting Christ’s forgiveness so that guilt can be resolved.
In this paper we have discovered that chronic illness is not just a matter of being sick. Suffering and illness does have an existential perspective to it that pastoral care must take seriously. If pastoral care neglects to do this it will impede upon the ill person’s faith functions and their quest to continue to seek God for his healing intervention.
 Coetzer, W 2010a. Important guidelines for the counseling process. Student manual. Potchefstroom.
Louw, D J 2005. Mechanics of the human soul. About maturity and life-skills. Stellenbosch: Sun Press.