Paper: "Chronic Suffering, Deeper Meaning"
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Choose Life Project--Paper #8
CHRONIC SUFFERING, DEEPER MEANING
This paper in the Choose Life Project series does not deal with
the reduction or alleviation of suffering, as do the others. This one
presupposes a situation where a person has chronic suffering, and has
concluded that the pain is irreversible. The purpose here is the
explore avenues for making the best of it where suffering seems
unlikely to go away. It is for those who have tried every treatment,
and none has worked.
Based on extrapolations from survey data, we might estimate that
less than five percent of the population in the USA are chronic
sufferers, suffering week after week, year after year. This figure
could even be as low a one percent of the population, depending on how
one defines the nature of chronic suffering.
Coping with continual suffering, and coming to grips with a
likelihood of its persistence, is not an impossible task. The world is
full of people who are making the best of it with chronic suffering,
and there are such people in each of our communities. Sometimes the
word morbid is misapplied to those chronic sufferers. Indeed, the
average person finds it very discomforting to witness or even to think
about someone who suffers constantly. But if you are the person living
with chronic suffering, you cannot turn your back to it. Morbidity
becomes an afterthought. Most likely, heroic fortitude is the better
term for the dilemma, rather than morbid.
Most people who face terminal illnesses arrive at some
conclusions that enable them to live out their lives. Thousands of
people with terrible illnesses, such as ALS (Lou Gehrig's Disease) or
Huntington's Disease, find answers necessary for perseverance. The key
point in this discussion emerges quickly:
If living is not inherently enjoyable, or one faces a life of
suffering, then there must be some reason to accept the struggle.
Hence, one must find meaning to the suffering.
Or find meaning despite the suffering. In this situation, some
sense or purpose within the borders of the pain must be realized,
enabling acceptance of the affliction, and enough resilience to
continue engagement with living. And from there, life goes on.
This is no easy matter. But so many suffering people do find
answers and purpose, find such meaning during suffering. And it is a
much deeper and tested meaning--one that has withstood the storms and
the furies.
---------------------------
On the following pages are two outlines for finding meaning
during suffering, one outline based on spiritually-oriented reasons,
the other on existential-secular reasons. The remainder of this paper
will be devoted to explaining and discussing these sorts of methods
for finding meaning during suffering.
FINDING MEANING WHILE SUFFERING--
AN EXISTENTIAL-BASED FRAMEWORK
This outline below pieces together ideas from Camus, Sartre,
Frankl, and Yalom. It represents an existential or secular approach
to finding meaning to suffering.
----------------------------
Four Responses to Irreversible Suffering:
1. Gain full stature as a person by standing up against absurdity and
meaninglessness.
2. Add something to the fund of human dignity by persevering.
3. Climb the full mountain of human experience and contribute to the
solidarity of humankind by making the best of things during times of
anguish.
4. Fight the world's indifference by striving to do something good
despite suffering.
FINDING MEANING IN SUFFERING--
A SPIRITUALLY-BASED FRAMEWORK
The outline below is derived from elements of the various
religions of the world. It is a way for finding meaning to suffering
using ideas from spirituality.
-------------------------------------
Four Responses to Irreversible Suffering:
1. Atonement. To offer up suffering as a realization of justice for
any wrongdoing one has done.
2. Redemption. To offer up suffering for the relief of others who
suffer.
3. Spiritual Growth. Recognize that one's spiritual self may grow as
one accepts suffering, even perhaps to the point of a sort of
spiritual nobility, as in heroic fortitude.
4. Affirming God's Plan. By accepting suffering and offering it up,
assert that God's ultimate plan of providence will be further
strengthened and promoted.
--Paramount Mission
One powerful way for finding meaning despite suffering can be
through having a sense of paramount mission. This would mean having a
mission that is viewed by the sufferer as being quite important, a
mission such as a compelling goal or responsibility. This sense of
paramount mission would be even more highly valued by sufferer if he
or she concluded that it was a unique contribution, one that could
only be contributed by the sufferer, or one that could best be
accomplished by him or her. The paramount mission, then, becomes a
reason to live that outweighs the suffering.
An example of a paramount mission would be the manic-depressive
mother who continues living in order to provide care for her children.
Or the multiple sclerosis patient whose primary meaning in life comes
from leading a self-help group for those with the illness. Or even
the chronic alcoholic who is determined not to end his life so as not
to darken his younger relatives' view on living.
The story of Viktor Frankl provides an impressive picture of the
power of a paramount mission. Viktor Frankl was a Viennese
psychiatrist who after World War II became famous for writing Man's
Search for Meaning, a book that has sold millions of copies. The
significance of Frankl's viewpoint, though, comes from the fact that
he was a Holocaust survivor, having been a Jewish inmate in the
Auschwitz death camp during the war.
When Frankl entered Auschwitz he carried with him a manuscript on
his new thinking on psychotherapy, a book ready to be published. But
the manuscript was confiscated at the gates of the concentration camp,
and destroyed. Frankl was forced into the painful and degrading
existence of the slave labor section of Auschwitz. The question for
him and others became: is this a life worth living?
For many, the thought of death appeared appealing in the midst of
the cruelty and squalor of the death camp. Each person was faced with
the task of finding some reason to continue living. Many gave up and
perished. But thousands persisted on and lived to see the liberation
of the camp by the allied troops.
Frankl in his discussions with his fellow inmates at the camp
often alluded to two quotes from the philosopher Nietzsche: "He who
has a why to live for can bear almost any how." And: "That which does
not kill me, makes me stronger." Frankl also quoted a German poet:
"What you have experienced, no power on earth can take away from
you." The idea he expressed was that even through the suffering, some
kernel of value would emerge.
While in Auschwitz, Frankl quickly arrived at a reason to
continue living. He wanted to rewrite the book that had been taken
from him at the doors of the death camp. He had some original ideas in
the book that had never been expressed before. If he died at
Auschwitz, those ideas might die with him. In a real sense, Frankl
found a paramount mission for coping with his suffering.
And as the story goes, Frankl was liberated from the
concentration camp along with the other emaciated survivors. He went
on to rewrite his book, it was published, and his ideas became the
basis of a new form of psychotherapy--one based on finding meaning in
all aspect of life.
--The Work of Viktor Frankl. This is as good a place as any to
explore the ideas presented by Viktor Frankl. He called his
contribution to psychological treatment "logotherapy," from the Greek
word logos, translation = "word" or "meaning." Frankl said that his
was the third school of Viennese psychiatry, one based on the will to
meaning. The first two schools were Sigmund Freud's, based on the
will to pleasure; and Alfred Adler's, based on the will to power.
Frankl believed that people found happiness from meaningful
activities in life, and that happiness was a byproduct of engaging in
these ventures. He felt that people find meaning as they strive for
some goal that is worthy of them. This may involve some tension or
struggling, but meaning and happiness are the unconscious outcomes of
the effort. Thus, according to Frankl, we would do well not to brood
over ourselves, and to really transcend the Self as we strive towards
some valued goal.
In Frankl's view, everyone had some goal awaiting their
attention. "One should not search for an abstract meaning of life.
Everyone has his own specific vocation or mission in life; everyone
must carry out a concrete assignment that demands fulfillment."[i]
Irvin Yalom asserts that Frankl felt "there is a God who has ordained
a meaning for each of us to discover and fulfill."[ii] Yalom calls
this a "unique life project."
Aside from the empirical doubts that some may have on this sort
of thinking, one can easily see how a person could have an enhanced
sense of meaning and purpose if one believed there was a Divinely
ordained task awaiting him. One of the objectives of logotherapy was
to help the perplexed to find that unique meaning in life, his or her
life project.
In general, there were three ways a person could find meaning,
according to Frankl: 1) by doing a deed; 2) by experiencing a value;
and 3) by suffering. Yalom paraphrases these concepts in a more
understandable fashion: Meaning comes from "1) what one accomplishes
or gives to the world in terms of one's creations; 2) what one takes
from the world in terms of encounters and experiences; and 3) one's
stand towards suffering, towards fate that one cannot change."[iii]
Yalom calls these three elements of meaning the creative,
experiential, and attitudinal. Perhaps we could even more easily see
life's meaning by these four categories: meaning comes from 1) work,
2) relationships, 3) valued experiences, and 4) one's response to
suffering.
Of course, it is the notion of meaning in suffering that one
finds the hardest to fathom. Nevertheless, Frankl stated more than
once that it is in suffering that one can find the deepest meaning.
[iv] He believed that suffering could be ennobling rather than
degrading.[v] In Auschwitz, Frankl quoted Dostoevski--"There is only
one thing I dread: not to be worthy of my suffering." And in Frankl's
own suffering, he found possible solutions that matched the profundity
of his anguish. His is a noble story.
To quote Frankl:
"Suffering is an eradicable part of life, even as fate and
death. Without suffering and death human life cannot be complete.
"The way in which man accepts his fate and all the suffering it
entails, the way in which he takes up his cross, gives him ample
opportunity--even under the most difficult circumstances--to add
deeper meaning to his life. He may remain brave, dignified and
unselfish. Or in the bitter fight for self-preservation he may forget
his human dignity and become no more than an animal. Here lies the
chance for a man either to make use of or to forego the opportunities
of attaining the values that a difficult situation can afford him.
And this decides whether he is worthy of his suffering."
Frankl further says:
"When a man finds that it is his destiny to suffer, he will have
to accept his suffering as his task; his single and unique task. He
will have to acknowledge the fact that even in suffering he is unique
and alone in the universe. No one can relieve him of his suffering or
suffer in his place. His unique opportunity lies in the way in which
he bears his burden."[vi]
This is reminiscent of John Powell's audiotape entitled
"Suffering: It Can Make You Bitter or Better." In Frankl's view,
suffering becomes less potent once one finds some meaning in it. Says
Yalom's analysis: "Suffering can have a meaning if it changes one for
the better." Yalom states:
"When all other meaning seems obscured by present tragedy and
suffering, Frankl stresses that one may still find meaning in assuming
a heroic stance towards one's fate. One's attitude may serve as an
inspiring model for others--children, relatives, friends, students, or
even other patients on the ward. One's acceptance of inevitable
suffering may be seen as an embracement of God from whom the suffering
emanated. Or, finally, one's heroic attitude towards one's fate is
meaningful in itself in much the same way that Camus regarded
`prideful rebellion' as a human being's final response to
absurdity."[vii]
Frankl believed in the permanence of the past. "Accomplishments
and experiences are stored away forever." The wonderful things about
one's past cannot be blotted out. So yesterday is full of meaning as
well. And as one suffers, an heroic stance plus an endearment of fond
memories can help one say that life was worthwhile.
A "paramount mission" and a "unique life project" have conceptual
similarities, though the former has a more imperative tone to it. And
this may make a difference when chronic suffering is involved.
One may have a profound mission on behalf of a person, a group of
people, an idea, an organization, a movement, one's country, a future
hope, or even persist in living so as not to allow absurdity to have
the final word.
When chronic suffering takes away the most accessible forms of
meaning, a paramount mission can create meaning in a life that might
seem pointless to others. And one might struggle to create meaning
through acts of kindness, perhaps realizing that often when one does
the right thing, things get better.
---------------------------
--Secular-Existential Responses to Chronic Suffering
According to survey research, about 90 percent of Americans
believe in God. Most of these have a spiritual worldview that enables
them to see some meaning in their suffering. It might even be
something as simple as affirming their continued loyalty to God and
his ultimate providential plan, as in those who say "Thy will be done"
during periods of hardship and adversity.
The remaining 10 percent of Americans who have no spiritual
beliefs have a tougher time finding meaning in their suffering. There
are examples though where such meaning does emerge--as in the agnostic
soldiers in World War II who willingly accepted the privations of the
infantry life, or even put their lives in danger, in order to stop
Hitler's mad vision.
But more often than not, those without spiritual beliefs look to
find meaning during suffering, but not necessarily in suffering
itself. Some compelling meaning must surface during irreversible
suffering in order for the secular-oriented person to continue on
living. It is here that the Existential viewpoint is crucial.
--The Existentialist Perspective. In his Existential Psychotherapy,
Irvin Yalom of Stanford University gives a very eloquent overview of
how those with a secular-existential perspective can find meaning in
life. And he does see the role of meaning to be of utmost importance
in the human story. Much of this section on Existential thinking is
based on Yalom's analysis, though the application here is how to find
meaning during suffering, whereas his discussion is on seeking meaning
in life in general.
Yalom early on makes the point that key Existentialists, such as
Camus and Sartre, argue strongly for the necessity in finding meaning
in life, even during pressing circumstances. This is the case even
though Existentialists are often seen as shouting that life and the
world are inherently meaningless. Camus and Sartre (the latter in
his fiction) tell a different story.
Albert Camus in his essays sought to find meaning sturdy enough
to support life, a life that could witness the poverty of North Africa
and the scourges of World War II in France. He argued that we could
learn to cherish our nights of despair, for they gave us a chance to
gain full stature with human dignity by living caringly in the face
of absurdity. In a way, it was a revolt against the absurd in the
name of the solidarity of humankind.
Camus lived out this thinking while working against the Nazis in
the French Underground. He found something worth struggling for while
in the shadow of the human nihilism that the Third Reich represented.
In his life as in his writing, Camus did not give in to the absurd. In
his fiction, a heroic character in the form of a physician during a
plague (a symbol of intense suffering) conducts himself with courage,
vitality, love, fraternal passion, and secular saintliness. These are
values that can reign supreme in the midst of a plague (or in a life
riddled with suffering). Camus went on to win a Nobel Prize in
literature for giving us insights as valuable as this. And he gave us
the memorable quote: "In the depth of Winter I finally learned there
was within me an invincible Spring."
Jean-Paul Sartre, the other great French Existentialist, is best
known for branding life as meaningless, an idea expressed strongly in
Sartre's non-fiction. Yalom makes an important point though in
focusing on Sartre's works of fiction, where characters do find
"something to live for and something to live by." Yalom pays close
attention to Sartre's play The Flies, based on the Greek mythological
characters Orestes and Electra.
In the play, Orestes seeks to find values to base his life on,
despite personal tragedy. His answer, a very personal one, is to leap
into engagement with life. Orestes resolves to soothe "all those
people quaking with fear in their dark rooms..." He pronounces that
"It is right to restore them their sense of human dignity." Although
he himself walks with the burden of tragedy, Orestes is determined to
move on this new path, and he sees that it is much better than to
wander through life pointlessly. He utters a now famous line: "Human
life begins on the far side of despair."
Orestes invites his sister Electra to be part of his mission.
What mission? He says: "Beyond the river and mountains is an Orestes
and an Electra waiting for us, and we must make our patient way
towards them." Thus, they seek to reach out to others. So even from
the pen of the most severe of Existentialists, meaning and worth are
found in life. And Sartre resurrects a tragic character of Greek
drama, and gives him a zest and passion for living.
There is no cosmic meaning to life presented by Camus and Sartre.
Yalom points out that they contend that each person must invent one's
own meaning. And to make it, the secular person must believe in that
meaning. Even if, as psychologist Gordon Allport says, one is half-
sure but whole-hearted. Yalom alludes to Thomas Mann's pragmatic
dictum: "Whether that be so or not, it would be well for man to behave
as if it were so."
Yalom makes another interesting statement-- "On this one point
most Western theological and atheistic existential systems agree: it
is good and right to immerse oneself in the stream of life." Through
seeking and striving, one might find enough meaning to make even a
life of suffering a worth-while venture.
--Yalom's Categories. Speaking from an Existential perspective, Irvin
Yalom outlines six types of secular activities that give human beings
a sense of purpose, a sense of meaning: altruism, dedication to a
cause, creativity, hedonism, self-actualization, and self-
transcendence. According to Yalom:
"These activities are supported by the same arguments that Sartre
advanced for Orestes: they seem right; they seem good; they are
intrinsically satisfying and need not be justified on the basis of any
other motivation."
For those secular-oriented folks who agree with this assessment
from Yalom, the world can be ripe with meaning. There are hundreds of
opportunities in the world for anyone to engage in these activities.
Let's summarize below Yalom's six categories of activities.
Altruism can involve helping others, participation in charity
(what Yalom calls the greatest virtue of all), or striving to make the
world a better place to live in. One expert calls parenthood forty
year's worth of altruism. Yalom notes that altruistic people seem to
face adversity more easily, and quotes Jung: "Meaning makes a great
many things endurable--perhaps everything."
Dedication to a cause can in Will Durant's words: "give life
meaning, lift the individual out of himself, and make him a
cooperating part of a vaster scheme." Yalom quotes Durant to the
effect that a dedication to a cause can give a person a sense of being
involved in something bigger than himself, and the satisfaction of
being part of something that will not be shattered by his death. The
person working for a good cause can have a sense that he is part of a
force for good and betterment.
Creativity is for Yalom a work that "justifies itself, is its own
excuse for being. Creativity defies the question: What for?" Witness
that most large cities have art museums, and local communities have
cultural councils, libraries, theater groups, and community
orchestras. About everyone has a music genre they like best. And even
if one's span of interests doesn't extend much beyond sitcoms on
television, there too creative people are at work via actors and
screenwriters. Creativity involves bringing something new into the
world, and a sense of purpose can come from creating beauty or forming
jarring but insightful prose.
Hedonism does not have to stir up images of the Roman bacchanals,
Turkish baths, or Viking feasts. It can be something as simple as
enjoying the delights and beauty of the world. One might just decide
to live fully, and savor the very nice things that life has to offer.
A person might find wonderful pleasure in going to a botanical garden
and smelling all the flowers, and seeing all the varieties of orchids
there are. (In the author's area, there exists such a botanical
garden, and it is absolutely free to visit.) Finding things to enjoy
can make a day seem worthwhile, even when one is under difficult
circumstances.
Self-actualization involves engaging at something that uses one's
highest talents. Here one applies his or her full potential. Maslow
talked about one becoming a fuller and fuller person, as one presses
towards good values such as kindness, courage, honesty, love, and
unselfishness. From this perspective, what do we live for? To become
a full person, as full as we can be. What do we live by? These kinds
of good values mentioned above. And this can involve a whole life's
worth of activities, and absorb one almost completely. Searching for a
sense of meaning can become a thing of the past.
Self-transcendence takes us beyond ourselves. Martin Buber was an
Existentialist who had a great interest in Jewish religious
traditions. He asks the most basic question of life's meaning: "What
for? What am I to find my particular way for? Not for my own sake."
And Buber says: "You have done wrong? Then counteract it by doing
good." Yalom continues that we start out thinking of ourselves, but
then it is important to forget oneself and become immersed with the
world. Yalom points out that even Maslow felt that self-actualized
persons dedicate themselves to self-transcendent goals.
Irvin Yalom's answer for the issue of human meaningfulness was
simply engagement--to be fully engaged with the world and applying
oneself as completely as possible. After a certain point it is
important to stop the philosophizing and get down to work, love, and
enjoyment. Indeed the philosophizing can "drain the vitality from
life." We can decide to make a difference in things, and "when things
matter, they don't need meaning to matter!" For Yalom, a secular
person needs to not get bogged down in the hefty questions, but rather
"leap into commitment and action." Again Yalom:
"Engagement is the therapeutic answer to meaninglessness
regardless of the latter's source. Wholehearted engagement in any of
the infinite array of life's activities not only disarms the
[negative] galactic view but enhances the possibility of one's
completing the patterning of the events of one's life in some coherent
fashion. To find a home, to care about other individuals, about ideas
and projects, to search, to create, to build--these, and all other
forms of engagement, are twice rewarding: they are intrinsically
enriching, and they alleviate the dysphoria that stems from being
bombarded with the unassembled brute data of existence."[viii]
And this is a secular conclusion presented from an Existential
perspective. Frankl, who considered himself an Existentialist, saw
meaning as a "situation which implies a question and calls for an
answer." The recovery adage "Find a need and meet it" comes to mind.
Within our own cities or towns, there are literally thousands of
opportunities for finding meaning. There are thousands of situations
that could be made better from our effort. And each one of us can be
a mover in one of these situations, and be the beneficiary of a sense
of purpose.
Yalom concludes his section on Meaningfulness by saying this:
"The question of meaning in life is, as the Buddha taught, not
edifying. One must immerse oneself in the river of life and let the
question drift away."
--The Purpose in Life Test. Are there data that support the
conclusions above? Certainly there are many case studies that would
bear them out. Social scientists often call these anecdotal evidence.
Yalom does report some broad empirical evidence from studies done on
the Purpose to Life Test.
Created in 1964, the Purpose of Life Test is a psychological test
based on twenty questions intended to measure a person's sense of
purpose and meaning. Each question has an ordinal scale from 1 to 7,
with 4 being neutral. For example the first question reads: "I am
usually: 1) bored; 7) exuberant, enthusiastic." One then chooses a
value between 1 (bored) and 7 (enthusiastic) to denote their level of
general enthusiasm. Some of the other questions are:
* In life I have: 1) no goals or aims at all; 7) very clear goals
and aims.
* If I could choose, I would: 1) prefer never to have been born; 7)
like nine more lives just like this one.
* Facing my daily tasks is: 1) a painful and boring experience; 7) a
source of pleasure and satisfaction.
Well, there are twenty questions along these lines, and from the
responses, the psychologist can derive a numerical score depicting
one's sense of purpose in life. The higher the score, the more life's
meaning the person is purported to have, and one's score can be
compared with other person's or groups.
This Purpose in Life Test has been administered to many thousands
of people, and statistical analysis with various population subgroups
has been measured, with interesting results vis-a-vis our present
discussion.
For instance, high scores on the Purpose in Life Test (PIL)
correlate with high involvement in organized groups (whether they be
ethnic, political, or community service oriented). High PIL scores
correlate with having a sense of idealism, having a positive world
view, with goal orientation, and having self-transcendent goals. High
PIL scores even correlate with having hobbies. College students who
had made vocational choices had significantly higher PIL scores than
those who hadn't.
Another point to consider, high PIL scores correlate with those
who have strong religious beliefs that play a central role in one's
life. And high PIL scores correlate with involvement in religious
organizations. This foreshadows the discussion in the next section
on the role of spiritually-oriented responses to suffering.
This summary of the ideas of Camus, Sartre, and Yalom veers
towards finding meaning in life in general. Our focal question of
finding meaning during suffering isn't as directly addressed by these
authors, though Camus' life experience and Sartre's fictional
character Orestes certainly underwent stress and anguish.
If one comes to the point of chronic suffering with a secular-
existential conviction, then a combination of the four items in the
above table of Existential responses to suffering, along with Yalom's
six categories of meaningful activities, plus Frankl's ideas on the
meaning to suffering could very well help one cope better with his or
her affliction. And this is the hope.
--Spiritually-oriented Responses to Chronic Suffering
In the Western world, when one considers the role of spirituality
in suffering, there are usually four kinds of questions involved:
1. Will God protect me or others from suffering?
2. Why has God allowed me or others to suffer?
3. Will God relieve my suffering? Or the suffering of others?
4. And if the answers to the above questions are not encouraging--
Will God somehow bring meaning out of my suffering? Or the suffering
of others?
There are numerous religious traditions in the West, and some
emphasize one or two of these questions, but not others. Most
Western religious traditions transform one or more of these four
questions into prayer, as in supplication. And these sorts of prayers
have held firm over the centuries. Mankind has suffered for over 4,000
years of human history, and in recent centuries has been introduced to
strong religious doubt. But still we have compelling data on
spirituality, such as the survey results reporting that 90 percent of
American still believe in God.
Those who have Faith face suffering, even to the point of death
in this world. Judeo-Christian traditions produced the Book of Job in
order to emotionally cope with the realities of such suffering.
Modern-day writers have penned books such as "When Bad Things Happen
to Good People" and "Where is God When it Hurts?" to bring these
eternal concerns to readers of the present.
Chronic sufferers sometimes reject the faith of their early
years, while others embrace their faith all the more strongly, and
find a sense of solace amidst the troubles. Chronic sufferers with
Faith often cling firmly to some very basic Answers, hold them close
to their hearts, and are able to live out their days. It is no
surprise that suicide rates are lower for those with Faith.
This section of the paper will not be as detailed, because most
chronic sufferers with Faith have found some Answers on their
suffering, and more words aren't needed. For those still seeking
answers, a few precepts from the world's religions are offered here in
their most elementary forms.
A theological debate is not the purpose. Just an offering from
the world's Wisdom Traditions which might be helpful to a person or
few. Indeed someone with Faith would likely benefit better by
discussing their suffering with a member of their own clergy, such as
a pastor or rabbi. However, some who are unsettled on spiritual
matters might find the following helpful. As always, take whatever
might be useful, and disregard the rest.
--Atonement. A dictionary definition of atonement is to make amends
or reparation for wrongdoing. Before presenting this paper's notion of
atonement, it's best to lay out what is not being expressed.
There is no attempt here to convey the idea of a punishment from
God, or that anyone deserves to be punished. There is no call for
penance. In the Middle Ages, groups of people in Europe called
Flagellants travelled from town to town whipping themselves over their
perceived wickedness or the perceived wickedness of the world. This is
a very extreme form of exactly what is not being expressed here. For
a chronic sufferer, life is hard enough without any mental
whippings.
There is a certain danger in thinking that one deserves to
suffer. This is especially true when someone has scrupulosity, and
begins to see wrongs where there are none. A well-developed and mature
conscience is needed to assess one's mistakes or miscues.
But still, there is wrongdoing in the world. One need only read
the crime reports in the local newspaper to be convinced. On a much
smaller scale, people hurt each other by words said, by stepping on
someone else's sensitivities.
Herein, the notion of atonement is conditional. So often one has
already suffered far more than any wrong afflicted on others. Still,
one could simply offer up in prayer his or her humble atonement while
remembering a person or persons one has hurt in the past. The
conditional part is that the sufferer could then in prayer ask that if
atonement is not needed, that God use the suffering for some good in
some other way.
When thinking along these lines, one might do well to remember
that the sacred texts such as those of Christianity, Judaism, and
Islam state the merciful nature of God. The acceptance of suffering
in humble atonement could open doors of mercy in ways unexpected.
Good things could arise in an infinite number of expressions when a
merciful God moves into action. Humble atonement and acceptance could
represent a wish for benevolence. And the wish could come true.
--Redemption. The notion of redemptive suffering for others does not
show up in all the world's religions and denominations. Some folks
may feel uncomfortable with this concept, and may wish to move on. For
those who are open to the idea, by offering up suffering for others
in prayer, the prayer taken the form of another wish for benevolence.
And wouldn't it be wonderful if the kind wishes became real. And
realizing at the same time that one does not suffer in vain.
--Spiritual Growth. The acceptance of irreversible suffering can
produce a sense of heroic virtue, in the form of fortitude. Growth in
the spirit in unseen ways may be the outcome. Perhaps at some future
mountaintop, one might be very pleased with oneself for having made it
through an ordeal in life. And even as the body deteriorates, the
spirit can grow.
--Affirming God's Plan. During prayer while suffering, one can state
his or her continued loyalty to God, and offer an affirmation of God's
plan for future goodness. This stands in contrast to revolt while
suffering. The prayerful affirmation becomes a stronghold of Faith.
--Breaking Down the Deepest Despair
The main portion of the Choose Life Project can likely bring life
affirming feelings for 90 percent of folks, about 90 percent of the
time. But what of those who don't fall within these parameters?
Chronic suffering can wear a person down, bring on despair, and
lead one to cast a tired eye on life. Perhaps the deepest despair with
chronic suffering comes from the dual thoughts that things are not
going to get better and that there is no meaning to the struggle.
But as discussed herein, there are secular and spiritual beliefs
available that enable one to see meaning during suffering. Indeed
there might be something of a "paradox of suffering." It could be
worded like this: As one's suffering becomes acute or chronic, he or
she could find the deepest meaning in life. Great mountains can be
climbed during hardship and adversity.
At the same time, absent in this paper has been the fact that
symptom relief sometimes does come to chronic sufferers. Religious
folks talk about miraculous cures, and the scientific community refers
to the phenomena as spontaneous remission of symptoms.
And sometimes new medical treatments come almost out of nowhere.
A case in point relates to the illness of schizophrenia. In 1948,
millions of people with schizophrenia were inpatients in government
asylums around the world, with little hope of ever being released.
Then around 1952, antipsychotic medications were introduced, and
people with schizophrenia experienced major symptom reduction, to the
point where most were able to be released from the asylums in the
following two decades. Then in the early 1990s, a new type of
antipsychotic medication was introduced, with even further symptom
relief for those with schizophrenia. In 1948 and again in 1988, these
breakthroughs were unanticipated by patients with schizophrenia. The
new treatments simply reduced the level of chronic suffering. This
can happen.
A light pierces the darkness of despair when relief or meaning
are grasped and form something of value from the mosaic of suffering.
And this formation of inner qualities may well endure beyond the
reaches of pain, to where expressions of sorrow are no longer heard.
S.A. Choose Life Project
List of Influential Readings (Partial)
The following sources had some impact on the thinking involved in
the eight papers of the Choose Life Project. A book's inclusion does
not mean that the writer agrees with every idea contained in the book
or other books by that author.
Benson, Herbert, M.D. The Relaxation Response. New York: Avon
Books, 1975.
_________. Beyond the Relaxation Response. New York: Berkley Books,
1984.
Borysenko, Joan, Ph.D. Minding the Body, Mending the Mind. New
York: Bantam, 1988.
Bradshaw, John. Healing the Shame that Binds You. Deerfield,
Florida: Health Communications, Inc., 1988.
___________. Bradshaw on: The Family. Deerfield, Florida:
Health Communications, Inc., 1988.
___________. Homecoming. New York: Bantam, 1990.
___________. Creating Love. New York: Bantam, 1992.
Brothers, Joyce, Ph.D. Positive Plus--The Practical Plan for Liking
Yourself Better. New York: Putnam, 1994.
Burns, David, M.D. Feeling Good. New York: Signet, 1980.
Buscaglia, Leo, Ph.D. Living, Loving, and Learning. New York:
Fawcett Columbine, 1982.
Campbell, Joseph (as interviewed by Bill Moyers). The Power of
Myth. New York: Doubleday, 1988.
Camus, Albert. The Myth of Sisyphus and Other Essays. New York:
Vintage Books, 1955.
Ciszek, Walter, S.J. He Leadeth Me. Garden City, NY: Doubleday Image
Books, 1973.
Cousins, Norman. The Anatomy of an Illness. New York: Norton & Co.,
1979.
Dalai Lama and Howard Cutler, M.D. The Art of Happiness. New York:
Riverhead Books, 1998.
Day, Dorothy. The Long Loneliness. New York: Harper and Bros.,
1952.
Dosick, Rabbi Wayne. When Life Hurts: A Book of Hope. San
Francisco: Harper Collins, 1998.
Durant, Will. The Story of Philosophy. New York: Simon &
Schuster, 1926.
Ellis, Albert. A New Guide to Rational Living. North Hollywood,
Calif.: Wilkshire Book Co., 1975.
Fisher, Roger and William Ury. Getting to Yes. New York: Penguin
Books, 1981.
Frankl, Viktor, M.D. Man's Search for Meaning. New York: Pocket
Books, 1963.
Fromm, Erich. The Art of Loving. New York: Perennial Library,
1956.
Green, Thomas, S.J. Opening to God. Notre Dame, Ind.: Ave Maria
Press, 1977.
_________________. Weeds Among the Wheat. Notre Dame, Ind.: Ave
Maria Press, 1984.
Govig, Rev. Stewart. Souls are Made of Endurance. Louisville:
Westminster John Knox Press, 1994.
Ignatius Loyola. The Spiritual Exercises. (Puhl translation) Chicago:
Loyola University Press, 1951.
Jampolski, Gerald, M.D. Love is Letting Go of Fear. New York:
Bantam, 1979.
John Paul II. Crossing the Threshold of Hope. New York: Random
House, 1994.
Kabat-Zinn, Jon, Ph.D. Full Catastrophe Living: Using the Wisdom
of Your Body and Mind to Face Stress, Pain, and Illness. New York:
Delta, 1990.
Kane, Thomas (ed.). Happiness. Whitinsville, Mass.: Affirmation
Books, 1982.
Kassof, Maureen. Exploring the Concept of Hope in Patients with
Schizophrenia. Master's Thesis, School of Nursing; Wayne State
University; Detroit, Michigan; 1986.
Kubler-Ross, Elizabeth, M.D. On Death and Dying. New York: Collier
Books, 1969.
Kushner, Rabbi Harold. When Bad Things Happen to Good People.
New York: Avon Books, 1981.
LeShan, Lawrence. How to Meditate. New York: Little, Brown & Co.,
1974.
Martin, Garry and Joseph Pear. Behavior Modification. Englewood
Cliffs, N.J.: Prentice Hall, 1983.
Merton, Thomas. The Sign of Jonas. New York: Harcourt and Brace,
1953.
Moore, Thomas, Ph.D. Care of the Soul. New York: Harper
Perennial, 1992.
Moyers, Bill. Healing and the Mind. New York: Doubleday, 1993.
Myers, David, Ph.D. The Pursuit of Happiness. New York: Avon
Books, 1992.
Myers, Isabel Briggs. Gifts Differing. Palo Alto, Calif.:
Consulting Psychologist Press, 1980.
New Harbinger Workbooks. Anxiety and Panic Attacks and Relaxation and
Stress Reduction. Oakland, California: New Harbinger Press.
Ornstein, Robert, Ph.D. and David Sobel, M.D. Healthy Pleasures.
Reading, Mass: Addison-Wesley Publishing, 1989.
Peale, Norman Vincent. The Power of Positive Thinking. New York:
Fawcett Crest, 1956.
Peck, Scott, M.D. The Road Less Traveled. New York: Touchstone
Books, 1978.
___________. Further Along the Road Less Traveled. New York:
Touchstone Books, 1993.
Pennington, Basil, O.C.S.O. Centering Prayer. New York:
Doubleday Image Books, 1982.
Powell, John. Happiness is an Inside Job. Allen, Texas: Tabor,
1989.
__________. Why Am I Afraid to Tell You Who I Am? Allen, Texas:
Argus: 1969.
__________. A Reason to Live! A Reason to Die! Allen, Texas:
Argus, 1972.
__________. Fully Human, Fully Alive. Allen, Texas: Tabor, 1976.
__________. Suffering--It Can Make You Bitter or Better.
(audiotape).
Russell, Bertrand. A History of Western Philosphy. New York:
Simon & Schuster, 1945.
Seligman, Martin, Ph.D. Learned Optimism. New York: Pocket Books,
1990.
Selye, Hans. The Stress of Life. New York: McGraw-Hill, 1956.
__________. Stress Without Distress. New York: Dutton, 1974.
Smith, Huston. The World's Religions. San Francisco: Harper Collins,
1991.
Smith, Manuel, Ph.D. Popular books on assertiveness training.
Solzhenitsyn, Alexander. One Day in the Life of Ivan Denisovich. New
York: Alfred Knopf, 1962.
Thich Nhat Hanh. Peace is Every Step. New York: Bantam Books,
1991.
Veninga, Robert, Ph.D. A Gift of Hope. New York: Ballantine
Books, 1985.
Walpola Rahula. What the Buddha Taught. New York: Grove Press,
1959.
Wholey, Dennis. Are You Happy? New York: Houghton Mifflin, 1986.
Yalom, Irvin, M.D. Existential Psychotherapy. New York: Basic
Books, 1980.
Yancey, Philip. Where is God When it Hurts? Grand Rapids, Mich:
Zondervan, 1990.
Also A.A. and 12-step literature; articles on happiness found in
recent editions of Psychology Today; and essays on life-affirmation by
Larry A. of S.A.
------------------------------------------------
ENDNOTES
--------------------------------------------------------------------------------
[i]... Viktor Frankl, Man's Search for Meaning. (New York: Pocket
Books, 1963), p. 172.
---------------------------------------
[ii]... Irvin Yalom, Existential Psychotherapy. (New York: Basic
Books, 1980), p. 463. Yalom has an extensive section on Frankl, and
much of this discussion is patterned after Yalom's analysis.
--------------------------------------------
[iii]... Ibid, p. 445.
-------------------------------------------------------
[iv]... See pages 107 and 178 of Man's Search for Meaning for
Frankl's statement that one can find the deepest meaning through
suffering.
------------------------
[v]... Ibid, p. 181.
--------------------------------------------------
[vi]... The quotes are from Frankl's Man's Search for Meaning, pages
106 and 123.
-------------------------------
[vii]... From Yalom (1980), pages 476 and 446.
-------------------------------------------
[viii]... Yalom (1980), p. 482.
-------------------------------------
--------------------------------------------------------------------------------
Choose Life Project--Paper #8
CHRONIC SUFFERING, DEEPER MEANING
This paper in the Choose Life Project series does not deal with
the reduction or alleviation of suffering, as do the others. This one
presupposes a situation where a person has chronic suffering, and has
concluded that the pain is irreversible. The purpose here is the
explore avenues for making the best of it where suffering seems
unlikely to go away. It is for those who have tried every treatment,
and none has worked.
Based on extrapolations from survey data, we might estimate that
less than five percent of the population in the USA are chronic
sufferers, suffering week after week, year after year. This figure
could even be as low a one percent of the population, depending on how
one defines the nature of chronic suffering.
Coping with continual suffering, and coming to grips with a
likelihood of its persistence, is not an impossible task. The world is
full of people who are making the best of it with chronic suffering,
and there are such people in each of our communities. Sometimes the
word morbid is misapplied to those chronic sufferers. Indeed, the
average person finds it very discomforting to witness or even to think
about someone who suffers constantly. But if you are the person living
with chronic suffering, you cannot turn your back to it. Morbidity
becomes an afterthought. Most likely, heroic fortitude is the better
term for the dilemma, rather than morbid.
Most people who face terminal illnesses arrive at some
conclusions that enable them to live out their lives. Thousands of
people with terrible illnesses, such as ALS (Lou Gehrig's Disease) or
Huntington's Disease, find answers necessary for perseverance. The key
point in this discussion emerges quickly:
If living is not inherently enjoyable, or one faces a life of
suffering, then there must be some reason to accept the struggle.
Hence, one must find meaning to the suffering.
Or find meaning despite the suffering. In this situation, some
sense or purpose within the borders of the pain must be realized,
enabling acceptance of the affliction, and enough resilience to
continue engagement with living. And from there, life goes on.
This is no easy matter. But so many suffering people do find
answers and purpose, find such meaning during suffering. And it is a
much deeper and tested meaning--one that has withstood the storms and
the furies.
---------------------------
On the following pages are two outlines for finding meaning
during suffering, one outline based on spiritually-oriented reasons,
the other on existential-secular reasons. The remainder of this paper
will be devoted to explaining and discussing these sorts of methods
for finding meaning during suffering.
FINDING MEANING WHILE SUFFERING--
AN EXISTENTIAL-BASED FRAMEWORK
This outline below pieces together ideas from Camus, Sartre,
Frankl, and Yalom. It represents an existential or secular approach
to finding meaning to suffering.
----------------------------
Four Responses to Irreversible Suffering:
1. Gain full stature as a person by standing up against absurdity and
meaninglessness.
2. Add something to the fund of human dignity by persevering.
3. Climb the full mountain of human experience and contribute to the
solidarity of humankind by making the best of things during times of
anguish.
4. Fight the world's indifference by striving to do something good
despite suffering.
FINDING MEANING IN SUFFERING--
A SPIRITUALLY-BASED FRAMEWORK
The outline below is derived from elements of the various
religions of the world. It is a way for finding meaning to suffering
using ideas from spirituality.
-------------------------------------
Four Responses to Irreversible Suffering:
1. Atonement. To offer up suffering as a realization of justice for
any wrongdoing one has done.
2. Redemption. To offer up suffering for the relief of others who
suffer.
3. Spiritual Growth. Recognize that one's spiritual self may grow as
one accepts suffering, even perhaps to the point of a sort of
spiritual nobility, as in heroic fortitude.
4. Affirming God's Plan. By accepting suffering and offering it up,
assert that God's ultimate plan of providence will be further
strengthened and promoted.
--Paramount Mission
One powerful way for finding meaning despite suffering can be
through having a sense of paramount mission. This would mean having a
mission that is viewed by the sufferer as being quite important, a
mission such as a compelling goal or responsibility. This sense of
paramount mission would be even more highly valued by sufferer if he
or she concluded that it was a unique contribution, one that could
only be contributed by the sufferer, or one that could best be
accomplished by him or her. The paramount mission, then, becomes a
reason to live that outweighs the suffering.
An example of a paramount mission would be the manic-depressive
mother who continues living in order to provide care for her children.
Or the multiple sclerosis patient whose primary meaning in life comes
from leading a self-help group for those with the illness. Or even
the chronic alcoholic who is determined not to end his life so as not
to darken his younger relatives' view on living.
The story of Viktor Frankl provides an impressive picture of the
power of a paramount mission. Viktor Frankl was a Viennese
psychiatrist who after World War II became famous for writing Man's
Search for Meaning, a book that has sold millions of copies. The
significance of Frankl's viewpoint, though, comes from the fact that
he was a Holocaust survivor, having been a Jewish inmate in the
Auschwitz death camp during the war.
When Frankl entered Auschwitz he carried with him a manuscript on
his new thinking on psychotherapy, a book ready to be published. But
the manuscript was confiscated at the gates of the concentration camp,
and destroyed. Frankl was forced into the painful and degrading
existence of the slave labor section of Auschwitz. The question for
him and others became: is this a life worth living?
For many, the thought of death appeared appealing in the midst of
the cruelty and squalor of the death camp. Each person was faced with
the task of finding some reason to continue living. Many gave up and
perished. But thousands persisted on and lived to see the liberation
of the camp by the allied troops.
Frankl in his discussions with his fellow inmates at the camp
often alluded to two quotes from the philosopher Nietzsche: "He who
has a why to live for can bear almost any how." And: "That which does
not kill me, makes me stronger." Frankl also quoted a German poet:
"What you have experienced, no power on earth can take away from
you." The idea he expressed was that even through the suffering, some
kernel of value would emerge.
While in Auschwitz, Frankl quickly arrived at a reason to
continue living. He wanted to rewrite the book that had been taken
from him at the doors of the death camp. He had some original ideas in
the book that had never been expressed before. If he died at
Auschwitz, those ideas might die with him. In a real sense, Frankl
found a paramount mission for coping with his suffering.
And as the story goes, Frankl was liberated from the
concentration camp along with the other emaciated survivors. He went
on to rewrite his book, it was published, and his ideas became the
basis of a new form of psychotherapy--one based on finding meaning in
all aspect of life.
--The Work of Viktor Frankl. This is as good a place as any to
explore the ideas presented by Viktor Frankl. He called his
contribution to psychological treatment "logotherapy," from the Greek
word logos, translation = "word" or "meaning." Frankl said that his
was the third school of Viennese psychiatry, one based on the will to
meaning. The first two schools were Sigmund Freud's, based on the
will to pleasure; and Alfred Adler's, based on the will to power.
Frankl believed that people found happiness from meaningful
activities in life, and that happiness was a byproduct of engaging in
these ventures. He felt that people find meaning as they strive for
some goal that is worthy of them. This may involve some tension or
struggling, but meaning and happiness are the unconscious outcomes of
the effort. Thus, according to Frankl, we would do well not to brood
over ourselves, and to really transcend the Self as we strive towards
some valued goal.
In Frankl's view, everyone had some goal awaiting their
attention. "One should not search for an abstract meaning of life.
Everyone has his own specific vocation or mission in life; everyone
must carry out a concrete assignment that demands fulfillment."[i]
Irvin Yalom asserts that Frankl felt "there is a God who has ordained
a meaning for each of us to discover and fulfill."[ii] Yalom calls
this a "unique life project."
Aside from the empirical doubts that some may have on this sort
of thinking, one can easily see how a person could have an enhanced
sense of meaning and purpose if one believed there was a Divinely
ordained task awaiting him. One of the objectives of logotherapy was
to help the perplexed to find that unique meaning in life, his or her
life project.
In general, there were three ways a person could find meaning,
according to Frankl: 1) by doing a deed; 2) by experiencing a value;
and 3) by suffering. Yalom paraphrases these concepts in a more
understandable fashion: Meaning comes from "1) what one accomplishes
or gives to the world in terms of one's creations; 2) what one takes
from the world in terms of encounters and experiences; and 3) one's
stand towards suffering, towards fate that one cannot change."[iii]
Yalom calls these three elements of meaning the creative,
experiential, and attitudinal. Perhaps we could even more easily see
life's meaning by these four categories: meaning comes from 1) work,
2) relationships, 3) valued experiences, and 4) one's response to
suffering.
Of course, it is the notion of meaning in suffering that one
finds the hardest to fathom. Nevertheless, Frankl stated more than
once that it is in suffering that one can find the deepest meaning.
[iv] He believed that suffering could be ennobling rather than
degrading.[v] In Auschwitz, Frankl quoted Dostoevski--"There is only
one thing I dread: not to be worthy of my suffering." And in Frankl's
own suffering, he found possible solutions that matched the profundity
of his anguish. His is a noble story.
To quote Frankl:
"Suffering is an eradicable part of life, even as fate and
death. Without suffering and death human life cannot be complete.
"The way in which man accepts his fate and all the suffering it
entails, the way in which he takes up his cross, gives him ample
opportunity--even under the most difficult circumstances--to add
deeper meaning to his life. He may remain brave, dignified and
unselfish. Or in the bitter fight for self-preservation he may forget
his human dignity and become no more than an animal. Here lies the
chance for a man either to make use of or to forego the opportunities
of attaining the values that a difficult situation can afford him.
And this decides whether he is worthy of his suffering."
Frankl further says:
"When a man finds that it is his destiny to suffer, he will have
to accept his suffering as his task; his single and unique task. He
will have to acknowledge the fact that even in suffering he is unique
and alone in the universe. No one can relieve him of his suffering or
suffer in his place. His unique opportunity lies in the way in which
he bears his burden."[vi]
This is reminiscent of John Powell's audiotape entitled
"Suffering: It Can Make You Bitter or Better." In Frankl's view,
suffering becomes less potent once one finds some meaning in it. Says
Yalom's analysis: "Suffering can have a meaning if it changes one for
the better." Yalom states:
"When all other meaning seems obscured by present tragedy and
suffering, Frankl stresses that one may still find meaning in assuming
a heroic stance towards one's fate. One's attitude may serve as an
inspiring model for others--children, relatives, friends, students, or
even other patients on the ward. One's acceptance of inevitable
suffering may be seen as an embracement of God from whom the suffering
emanated. Or, finally, one's heroic attitude towards one's fate is
meaningful in itself in much the same way that Camus regarded
`prideful rebellion' as a human being's final response to
absurdity."[vii]
Frankl believed in the permanence of the past. "Accomplishments
and experiences are stored away forever." The wonderful things about
one's past cannot be blotted out. So yesterday is full of meaning as
well. And as one suffers, an heroic stance plus an endearment of fond
memories can help one say that life was worthwhile.
A "paramount mission" and a "unique life project" have conceptual
similarities, though the former has a more imperative tone to it. And
this may make a difference when chronic suffering is involved.
One may have a profound mission on behalf of a person, a group of
people, an idea, an organization, a movement, one's country, a future
hope, or even persist in living so as not to allow absurdity to have
the final word.
When chronic suffering takes away the most accessible forms of
meaning, a paramount mission can create meaning in a life that might
seem pointless to others. And one might struggle to create meaning
through acts of kindness, perhaps realizing that often when one does
the right thing, things get better.
---------------------------
--Secular-Existential Responses to Chronic Suffering
According to survey research, about 90 percent of Americans
believe in God. Most of these have a spiritual worldview that enables
them to see some meaning in their suffering. It might even be
something as simple as affirming their continued loyalty to God and
his ultimate providential plan, as in those who say "Thy will be done"
during periods of hardship and adversity.
The remaining 10 percent of Americans who have no spiritual
beliefs have a tougher time finding meaning in their suffering. There
are examples though where such meaning does emerge--as in the agnostic
soldiers in World War II who willingly accepted the privations of the
infantry life, or even put their lives in danger, in order to stop
Hitler's mad vision.
But more often than not, those without spiritual beliefs look to
find meaning during suffering, but not necessarily in suffering
itself. Some compelling meaning must surface during irreversible
suffering in order for the secular-oriented person to continue on
living. It is here that the Existential viewpoint is crucial.
--The Existentialist Perspective. In his Existential Psychotherapy,
Irvin Yalom of Stanford University gives a very eloquent overview of
how those with a secular-existential perspective can find meaning in
life. And he does see the role of meaning to be of utmost importance
in the human story. Much of this section on Existential thinking is
based on Yalom's analysis, though the application here is how to find
meaning during suffering, whereas his discussion is on seeking meaning
in life in general.
Yalom early on makes the point that key Existentialists, such as
Camus and Sartre, argue strongly for the necessity in finding meaning
in life, even during pressing circumstances. This is the case even
though Existentialists are often seen as shouting that life and the
world are inherently meaningless. Camus and Sartre (the latter in
his fiction) tell a different story.
Albert Camus in his essays sought to find meaning sturdy enough
to support life, a life that could witness the poverty of North Africa
and the scourges of World War II in France. He argued that we could
learn to cherish our nights of despair, for they gave us a chance to
gain full stature with human dignity by living caringly in the face
of absurdity. In a way, it was a revolt against the absurd in the
name of the solidarity of humankind.
Camus lived out this thinking while working against the Nazis in
the French Underground. He found something worth struggling for while
in the shadow of the human nihilism that the Third Reich represented.
In his life as in his writing, Camus did not give in to the absurd. In
his fiction, a heroic character in the form of a physician during a
plague (a symbol of intense suffering) conducts himself with courage,
vitality, love, fraternal passion, and secular saintliness. These are
values that can reign supreme in the midst of a plague (or in a life
riddled with suffering). Camus went on to win a Nobel Prize in
literature for giving us insights as valuable as this. And he gave us
the memorable quote: "In the depth of Winter I finally learned there
was within me an invincible Spring."
Jean-Paul Sartre, the other great French Existentialist, is best
known for branding life as meaningless, an idea expressed strongly in
Sartre's non-fiction. Yalom makes an important point though in
focusing on Sartre's works of fiction, where characters do find
"something to live for and something to live by." Yalom pays close
attention to Sartre's play The Flies, based on the Greek mythological
characters Orestes and Electra.
In the play, Orestes seeks to find values to base his life on,
despite personal tragedy. His answer, a very personal one, is to leap
into engagement with life. Orestes resolves to soothe "all those
people quaking with fear in their dark rooms..." He pronounces that
"It is right to restore them their sense of human dignity." Although
he himself walks with the burden of tragedy, Orestes is determined to
move on this new path, and he sees that it is much better than to
wander through life pointlessly. He utters a now famous line: "Human
life begins on the far side of despair."
Orestes invites his sister Electra to be part of his mission.
What mission? He says: "Beyond the river and mountains is an Orestes
and an Electra waiting for us, and we must make our patient way
towards them." Thus, they seek to reach out to others. So even from
the pen of the most severe of Existentialists, meaning and worth are
found in life. And Sartre resurrects a tragic character of Greek
drama, and gives him a zest and passion for living.
There is no cosmic meaning to life presented by Camus and Sartre.
Yalom points out that they contend that each person must invent one's
own meaning. And to make it, the secular person must believe in that
meaning. Even if, as psychologist Gordon Allport says, one is half-
sure but whole-hearted. Yalom alludes to Thomas Mann's pragmatic
dictum: "Whether that be so or not, it would be well for man to behave
as if it were so."
Yalom makes another interesting statement-- "On this one point
most Western theological and atheistic existential systems agree: it
is good and right to immerse oneself in the stream of life." Through
seeking and striving, one might find enough meaning to make even a
life of suffering a worth-while venture.
--Yalom's Categories. Speaking from an Existential perspective, Irvin
Yalom outlines six types of secular activities that give human beings
a sense of purpose, a sense of meaning: altruism, dedication to a
cause, creativity, hedonism, self-actualization, and self-
transcendence. According to Yalom:
"These activities are supported by the same arguments that Sartre
advanced for Orestes: they seem right; they seem good; they are
intrinsically satisfying and need not be justified on the basis of any
other motivation."
For those secular-oriented folks who agree with this assessment
from Yalom, the world can be ripe with meaning. There are hundreds of
opportunities in the world for anyone to engage in these activities.
Let's summarize below Yalom's six categories of activities.
Altruism can involve helping others, participation in charity
(what Yalom calls the greatest virtue of all), or striving to make the
world a better place to live in. One expert calls parenthood forty
year's worth of altruism. Yalom notes that altruistic people seem to
face adversity more easily, and quotes Jung: "Meaning makes a great
many things endurable--perhaps everything."
Dedication to a cause can in Will Durant's words: "give life
meaning, lift the individual out of himself, and make him a
cooperating part of a vaster scheme." Yalom quotes Durant to the
effect that a dedication to a cause can give a person a sense of being
involved in something bigger than himself, and the satisfaction of
being part of something that will not be shattered by his death. The
person working for a good cause can have a sense that he is part of a
force for good and betterment.
Creativity is for Yalom a work that "justifies itself, is its own
excuse for being. Creativity defies the question: What for?" Witness
that most large cities have art museums, and local communities have
cultural councils, libraries, theater groups, and community
orchestras. About everyone has a music genre they like best. And even
if one's span of interests doesn't extend much beyond sitcoms on
television, there too creative people are at work via actors and
screenwriters. Creativity involves bringing something new into the
world, and a sense of purpose can come from creating beauty or forming
jarring but insightful prose.
Hedonism does not have to stir up images of the Roman bacchanals,
Turkish baths, or Viking feasts. It can be something as simple as
enjoying the delights and beauty of the world. One might just decide
to live fully, and savor the very nice things that life has to offer.
A person might find wonderful pleasure in going to a botanical garden
and smelling all the flowers, and seeing all the varieties of orchids
there are. (In the author's area, there exists such a botanical
garden, and it is absolutely free to visit.) Finding things to enjoy
can make a day seem worthwhile, even when one is under difficult
circumstances.
Self-actualization involves engaging at something that uses one's
highest talents. Here one applies his or her full potential. Maslow
talked about one becoming a fuller and fuller person, as one presses
towards good values such as kindness, courage, honesty, love, and
unselfishness. From this perspective, what do we live for? To become
a full person, as full as we can be. What do we live by? These kinds
of good values mentioned above. And this can involve a whole life's
worth of activities, and absorb one almost completely. Searching for a
sense of meaning can become a thing of the past.
Self-transcendence takes us beyond ourselves. Martin Buber was an
Existentialist who had a great interest in Jewish religious
traditions. He asks the most basic question of life's meaning: "What
for? What am I to find my particular way for? Not for my own sake."
And Buber says: "You have done wrong? Then counteract it by doing
good." Yalom continues that we start out thinking of ourselves, but
then it is important to forget oneself and become immersed with the
world. Yalom points out that even Maslow felt that self-actualized
persons dedicate themselves to self-transcendent goals.
Irvin Yalom's answer for the issue of human meaningfulness was
simply engagement--to be fully engaged with the world and applying
oneself as completely as possible. After a certain point it is
important to stop the philosophizing and get down to work, love, and
enjoyment. Indeed the philosophizing can "drain the vitality from
life." We can decide to make a difference in things, and "when things
matter, they don't need meaning to matter!" For Yalom, a secular
person needs to not get bogged down in the hefty questions, but rather
"leap into commitment and action." Again Yalom:
"Engagement is the therapeutic answer to meaninglessness
regardless of the latter's source. Wholehearted engagement in any of
the infinite array of life's activities not only disarms the
[negative] galactic view but enhances the possibility of one's
completing the patterning of the events of one's life in some coherent
fashion. To find a home, to care about other individuals, about ideas
and projects, to search, to create, to build--these, and all other
forms of engagement, are twice rewarding: they are intrinsically
enriching, and they alleviate the dysphoria that stems from being
bombarded with the unassembled brute data of existence."[viii]
And this is a secular conclusion presented from an Existential
perspective. Frankl, who considered himself an Existentialist, saw
meaning as a "situation which implies a question and calls for an
answer." The recovery adage "Find a need and meet it" comes to mind.
Within our own cities or towns, there are literally thousands of
opportunities for finding meaning. There are thousands of situations
that could be made better from our effort. And each one of us can be
a mover in one of these situations, and be the beneficiary of a sense
of purpose.
Yalom concludes his section on Meaningfulness by saying this:
"The question of meaning in life is, as the Buddha taught, not
edifying. One must immerse oneself in the river of life and let the
question drift away."
--The Purpose in Life Test. Are there data that support the
conclusions above? Certainly there are many case studies that would
bear them out. Social scientists often call these anecdotal evidence.
Yalom does report some broad empirical evidence from studies done on
the Purpose to Life Test.
Created in 1964, the Purpose of Life Test is a psychological test
based on twenty questions intended to measure a person's sense of
purpose and meaning. Each question has an ordinal scale from 1 to 7,
with 4 being neutral. For example the first question reads: "I am
usually: 1) bored; 7) exuberant, enthusiastic." One then chooses a
value between 1 (bored) and 7 (enthusiastic) to denote their level of
general enthusiasm. Some of the other questions are:
* In life I have: 1) no goals or aims at all; 7) very clear goals
and aims.
* If I could choose, I would: 1) prefer never to have been born; 7)
like nine more lives just like this one.
* Facing my daily tasks is: 1) a painful and boring experience; 7) a
source of pleasure and satisfaction.
Well, there are twenty questions along these lines, and from the
responses, the psychologist can derive a numerical score depicting
one's sense of purpose in life. The higher the score, the more life's
meaning the person is purported to have, and one's score can be
compared with other person's or groups.
This Purpose in Life Test has been administered to many thousands
of people, and statistical analysis with various population subgroups
has been measured, with interesting results vis-a-vis our present
discussion.
For instance, high scores on the Purpose in Life Test (PIL)
correlate with high involvement in organized groups (whether they be
ethnic, political, or community service oriented). High PIL scores
correlate with having a sense of idealism, having a positive world
view, with goal orientation, and having self-transcendent goals. High
PIL scores even correlate with having hobbies. College students who
had made vocational choices had significantly higher PIL scores than
those who hadn't.
Another point to consider, high PIL scores correlate with those
who have strong religious beliefs that play a central role in one's
life. And high PIL scores correlate with involvement in religious
organizations. This foreshadows the discussion in the next section
on the role of spiritually-oriented responses to suffering.
This summary of the ideas of Camus, Sartre, and Yalom veers
towards finding meaning in life in general. Our focal question of
finding meaning during suffering isn't as directly addressed by these
authors, though Camus' life experience and Sartre's fictional
character Orestes certainly underwent stress and anguish.
If one comes to the point of chronic suffering with a secular-
existential conviction, then a combination of the four items in the
above table of Existential responses to suffering, along with Yalom's
six categories of meaningful activities, plus Frankl's ideas on the
meaning to suffering could very well help one cope better with his or
her affliction. And this is the hope.
--Spiritually-oriented Responses to Chronic Suffering
In the Western world, when one considers the role of spirituality
in suffering, there are usually four kinds of questions involved:
1. Will God protect me or others from suffering?
2. Why has God allowed me or others to suffer?
3. Will God relieve my suffering? Or the suffering of others?
4. And if the answers to the above questions are not encouraging--
Will God somehow bring meaning out of my suffering? Or the suffering
of others?
There are numerous religious traditions in the West, and some
emphasize one or two of these questions, but not others. Most
Western religious traditions transform one or more of these four
questions into prayer, as in supplication. And these sorts of prayers
have held firm over the centuries. Mankind has suffered for over 4,000
years of human history, and in recent centuries has been introduced to
strong religious doubt. But still we have compelling data on
spirituality, such as the survey results reporting that 90 percent of
American still believe in God.
Those who have Faith face suffering, even to the point of death
in this world. Judeo-Christian traditions produced the Book of Job in
order to emotionally cope with the realities of such suffering.
Modern-day writers have penned books such as "When Bad Things Happen
to Good People" and "Where is God When it Hurts?" to bring these
eternal concerns to readers of the present.
Chronic sufferers sometimes reject the faith of their early
years, while others embrace their faith all the more strongly, and
find a sense of solace amidst the troubles. Chronic sufferers with
Faith often cling firmly to some very basic Answers, hold them close
to their hearts, and are able to live out their days. It is no
surprise that suicide rates are lower for those with Faith.
This section of the paper will not be as detailed, because most
chronic sufferers with Faith have found some Answers on their
suffering, and more words aren't needed. For those still seeking
answers, a few precepts from the world's religions are offered here in
their most elementary forms.
A theological debate is not the purpose. Just an offering from
the world's Wisdom Traditions which might be helpful to a person or
few. Indeed someone with Faith would likely benefit better by
discussing their suffering with a member of their own clergy, such as
a pastor or rabbi. However, some who are unsettled on spiritual
matters might find the following helpful. As always, take whatever
might be useful, and disregard the rest.
--Atonement. A dictionary definition of atonement is to make amends
or reparation for wrongdoing. Before presenting this paper's notion of
atonement, it's best to lay out what is not being expressed.
There is no attempt here to convey the idea of a punishment from
God, or that anyone deserves to be punished. There is no call for
penance. In the Middle Ages, groups of people in Europe called
Flagellants travelled from town to town whipping themselves over their
perceived wickedness or the perceived wickedness of the world. This is
a very extreme form of exactly what is not being expressed here. For
a chronic sufferer, life is hard enough without any mental
whippings.
There is a certain danger in thinking that one deserves to
suffer. This is especially true when someone has scrupulosity, and
begins to see wrongs where there are none. A well-developed and mature
conscience is needed to assess one's mistakes or miscues.
But still, there is wrongdoing in the world. One need only read
the crime reports in the local newspaper to be convinced. On a much
smaller scale, people hurt each other by words said, by stepping on
someone else's sensitivities.
Herein, the notion of atonement is conditional. So often one has
already suffered far more than any wrong afflicted on others. Still,
one could simply offer up in prayer his or her humble atonement while
remembering a person or persons one has hurt in the past. The
conditional part is that the sufferer could then in prayer ask that if
atonement is not needed, that God use the suffering for some good in
some other way.
When thinking along these lines, one might do well to remember
that the sacred texts such as those of Christianity, Judaism, and
Islam state the merciful nature of God. The acceptance of suffering
in humble atonement could open doors of mercy in ways unexpected.
Good things could arise in an infinite number of expressions when a
merciful God moves into action. Humble atonement and acceptance could
represent a wish for benevolence. And the wish could come true.
--Redemption. The notion of redemptive suffering for others does not
show up in all the world's religions and denominations. Some folks
may feel uncomfortable with this concept, and may wish to move on. For
those who are open to the idea, by offering up suffering for others
in prayer, the prayer taken the form of another wish for benevolence.
And wouldn't it be wonderful if the kind wishes became real. And
realizing at the same time that one does not suffer in vain.
--Spiritual Growth. The acceptance of irreversible suffering can
produce a sense of heroic virtue, in the form of fortitude. Growth in
the spirit in unseen ways may be the outcome. Perhaps at some future
mountaintop, one might be very pleased with oneself for having made it
through an ordeal in life. And even as the body deteriorates, the
spirit can grow.
--Affirming God's Plan. During prayer while suffering, one can state
his or her continued loyalty to God, and offer an affirmation of God's
plan for future goodness. This stands in contrast to revolt while
suffering. The prayerful affirmation becomes a stronghold of Faith.
--Breaking Down the Deepest Despair
The main portion of the Choose Life Project can likely bring life
affirming feelings for 90 percent of folks, about 90 percent of the
time. But what of those who don't fall within these parameters?
Chronic suffering can wear a person down, bring on despair, and
lead one to cast a tired eye on life. Perhaps the deepest despair with
chronic suffering comes from the dual thoughts that things are not
going to get better and that there is no meaning to the struggle.
But as discussed herein, there are secular and spiritual beliefs
available that enable one to see meaning during suffering. Indeed
there might be something of a "paradox of suffering." It could be
worded like this: As one's suffering becomes acute or chronic, he or
she could find the deepest meaning in life. Great mountains can be
climbed during hardship and adversity.
At the same time, absent in this paper has been the fact that
symptom relief sometimes does come to chronic sufferers. Religious
folks talk about miraculous cures, and the scientific community refers
to the phenomena as spontaneous remission of symptoms.
And sometimes new medical treatments come almost out of nowhere.
A case in point relates to the illness of schizophrenia. In 1948,
millions of people with schizophrenia were inpatients in government
asylums around the world, with little hope of ever being released.
Then around 1952, antipsychotic medications were introduced, and
people with schizophrenia experienced major symptom reduction, to the
point where most were able to be released from the asylums in the
following two decades. Then in the early 1990s, a new type of
antipsychotic medication was introduced, with even further symptom
relief for those with schizophrenia. In 1948 and again in 1988, these
breakthroughs were unanticipated by patients with schizophrenia. The
new treatments simply reduced the level of chronic suffering. This
can happen.
A light pierces the darkness of despair when relief or meaning
are grasped and form something of value from the mosaic of suffering.
And this formation of inner qualities may well endure beyond the
reaches of pain, to where expressions of sorrow are no longer heard.
S.A. Choose Life Project
List of Influential Readings (Partial)
The following sources had some impact on the thinking involved in
the eight papers of the Choose Life Project. A book's inclusion does
not mean that the writer agrees with every idea contained in the book
or other books by that author.
Benson, Herbert, M.D. The Relaxation Response. New York: Avon
Books, 1975.
_________. Beyond the Relaxation Response. New York: Berkley Books,
1984.
Borysenko, Joan, Ph.D. Minding the Body, Mending the Mind. New
York: Bantam, 1988.
Bradshaw, John. Healing the Shame that Binds You. Deerfield,
Florida: Health Communications, Inc., 1988.
___________. Bradshaw on: The Family. Deerfield, Florida:
Health Communications, Inc., 1988.
___________. Homecoming. New York: Bantam, 1990.
___________. Creating Love. New York: Bantam, 1992.
Brothers, Joyce, Ph.D. Positive Plus--The Practical Plan for Liking
Yourself Better. New York: Putnam, 1994.
Burns, David, M.D. Feeling Good. New York: Signet, 1980.
Buscaglia, Leo, Ph.D. Living, Loving, and Learning. New York:
Fawcett Columbine, 1982.
Campbell, Joseph (as interviewed by Bill Moyers). The Power of
Myth. New York: Doubleday, 1988.
Camus, Albert. The Myth of Sisyphus and Other Essays. New York:
Vintage Books, 1955.
Ciszek, Walter, S.J. He Leadeth Me. Garden City, NY: Doubleday Image
Books, 1973.
Cousins, Norman. The Anatomy of an Illness. New York: Norton & Co.,
1979.
Dalai Lama and Howard Cutler, M.D. The Art of Happiness. New York:
Riverhead Books, 1998.
Day, Dorothy. The Long Loneliness. New York: Harper and Bros.,
1952.
Dosick, Rabbi Wayne. When Life Hurts: A Book of Hope. San
Francisco: Harper Collins, 1998.
Durant, Will. The Story of Philosophy. New York: Simon &
Schuster, 1926.
Ellis, Albert. A New Guide to Rational Living. North Hollywood,
Calif.: Wilkshire Book Co., 1975.
Fisher, Roger and William Ury. Getting to Yes. New York: Penguin
Books, 1981.
Frankl, Viktor, M.D. Man's Search for Meaning. New York: Pocket
Books, 1963.
Fromm, Erich. The Art of Loving. New York: Perennial Library,
1956.
Green, Thomas, S.J. Opening to God. Notre Dame, Ind.: Ave Maria
Press, 1977.
_________________. Weeds Among the Wheat. Notre Dame, Ind.: Ave
Maria Press, 1984.
Govig, Rev. Stewart. Souls are Made of Endurance. Louisville:
Westminster John Knox Press, 1994.
Ignatius Loyola. The Spiritual Exercises. (Puhl translation) Chicago:
Loyola University Press, 1951.
Jampolski, Gerald, M.D. Love is Letting Go of Fear. New York:
Bantam, 1979.
John Paul II. Crossing the Threshold of Hope. New York: Random
House, 1994.
Kabat-Zinn, Jon, Ph.D. Full Catastrophe Living: Using the Wisdom
of Your Body and Mind to Face Stress, Pain, and Illness. New York:
Delta, 1990.
Kane, Thomas (ed.). Happiness. Whitinsville, Mass.: Affirmation
Books, 1982.
Kassof, Maureen. Exploring the Concept of Hope in Patients with
Schizophrenia. Master's Thesis, School of Nursing; Wayne State
University; Detroit, Michigan; 1986.
Kubler-Ross, Elizabeth, M.D. On Death and Dying. New York: Collier
Books, 1969.
Kushner, Rabbi Harold. When Bad Things Happen to Good People.
New York: Avon Books, 1981.
LeShan, Lawrence. How to Meditate. New York: Little, Brown & Co.,
1974.
Martin, Garry and Joseph Pear. Behavior Modification. Englewood
Cliffs, N.J.: Prentice Hall, 1983.
Merton, Thomas. The Sign of Jonas. New York: Harcourt and Brace,
1953.
Moore, Thomas, Ph.D. Care of the Soul. New York: Harper
Perennial, 1992.
Moyers, Bill. Healing and the Mind. New York: Doubleday, 1993.
Myers, David, Ph.D. The Pursuit of Happiness. New York: Avon
Books, 1992.
Myers, Isabel Briggs. Gifts Differing. Palo Alto, Calif.:
Consulting Psychologist Press, 1980.
New Harbinger Workbooks. Anxiety and Panic Attacks and Relaxation and
Stress Reduction. Oakland, California: New Harbinger Press.
Ornstein, Robert, Ph.D. and David Sobel, M.D. Healthy Pleasures.
Reading, Mass: Addison-Wesley Publishing, 1989.
Peale, Norman Vincent. The Power of Positive Thinking. New York:
Fawcett Crest, 1956.
Peck, Scott, M.D. The Road Less Traveled. New York: Touchstone
Books, 1978.
___________. Further Along the Road Less Traveled. New York:
Touchstone Books, 1993.
Pennington, Basil, O.C.S.O. Centering Prayer. New York:
Doubleday Image Books, 1982.
Powell, John. Happiness is an Inside Job. Allen, Texas: Tabor,
1989.
__________. Why Am I Afraid to Tell You Who I Am? Allen, Texas:
Argus: 1969.
__________. A Reason to Live! A Reason to Die! Allen, Texas:
Argus, 1972.
__________. Fully Human, Fully Alive. Allen, Texas: Tabor, 1976.
__________. Suffering--It Can Make You Bitter or Better.
(audiotape).
Russell, Bertrand. A History of Western Philosphy. New York:
Simon & Schuster, 1945.
Seligman, Martin, Ph.D. Learned Optimism. New York: Pocket Books,
1990.
Selye, Hans. The Stress of Life. New York: McGraw-Hill, 1956.
__________. Stress Without Distress. New York: Dutton, 1974.
Smith, Huston. The World's Religions. San Francisco: Harper Collins,
1991.
Smith, Manuel, Ph.D. Popular books on assertiveness training.
Solzhenitsyn, Alexander. One Day in the Life of Ivan Denisovich. New
York: Alfred Knopf, 1962.
Thich Nhat Hanh. Peace is Every Step. New York: Bantam Books,
1991.
Veninga, Robert, Ph.D. A Gift of Hope. New York: Ballantine
Books, 1985.
Walpola Rahula. What the Buddha Taught. New York: Grove Press,
1959.
Wholey, Dennis. Are You Happy? New York: Houghton Mifflin, 1986.
Yalom, Irvin, M.D. Existential Psychotherapy. New York: Basic
Books, 1980.
Yancey, Philip. Where is God When it Hurts? Grand Rapids, Mich:
Zondervan, 1990.
Also A.A. and 12-step literature; articles on happiness found in
recent editions of Psychology Today; and essays on life-affirmation by
Larry A. of S.A.
------------------------------------------------
ENDNOTES
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[i]... Viktor Frankl, Man's Search for Meaning. (New York: Pocket
Books, 1963), p. 172.
---------------------------------------
[ii]... Irvin Yalom, Existential Psychotherapy. (New York: Basic
Books, 1980), p. 463. Yalom has an extensive section on Frankl, and
much of this discussion is patterned after Yalom's analysis.
--------------------------------------------
[iii]... Ibid, p. 445.
-------------------------------------------------------
[iv]... See pages 107 and 178 of Man's Search for Meaning for
Frankl's statement that one can find the deepest meaning through
suffering.
------------------------
[v]... Ibid, p. 181.
--------------------------------------------------
[vi]... The quotes are from Frankl's Man's Search for Meaning, pages
106 and 123.
-------------------------------
[vii]... From Yalom (1980), pages 476 and 446.
-------------------------------------------
[viii]... Yalom (1980), p. 482.
-------------------------------------
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