Do you have to suffer when you have pain?


I’ve read many many reports documenting the experiences of people who have pain.  From medical to physiotherapy to occupational therapy to nursing, without distinction the phrase that leaps from the page is ‘The patient suffered a [insert pain problem here]’.  Sigh.

My question is, does suffering inevitably accompany pain?  Really? What about the pain that accompanies winning a marathon?  The pain that accompanies birth? That blissful pain that goes along with a really vigorous massage?

If you go into Wikipedia, you’ll find this definition:

Suffering, or pain,[1] is an individual’s basic affective experience of unpleasantness and aversion associated with harm or threat of harm… 

The word suffering is sometimes used in the narrow sense of physical pain, but more often it refers to mental or emotional pain, or more often yet to pain in the broad sense, i.e. to any unpleasant feeling, emotion or sensation.

Now I’m not the only one who has pondered this.  Far wiser and more experienced philosophers and pain researchers have mulled over the conflation of the terms ‘pain’ and ‘suffering’ – for one of the best summaries, you can’t beat Turk and Wilson’s editorial in the June Clinical Journal of Pain.

From my Judeo-Christian background I had aligned the ‘acceptance’ of suffering as ‘good for the soul’ as something to do with the religion of my birth.  BUT  a quote from Hindu scripts provides just as strong an indication that many religions encourage forbearance in the face of negative things:

Worthless are those who injure others vengefully,
While those who stoically endure are like stored gold.

The gratification of the vengeful lasts only for a day,
But the glory of the forbearing lasts until the end of time.

Though unjustly aggrieved, it is best to suffer the suffering
And refrain from unrighteous retaliation.
– Tirukkural 16: 155-157

I wonder whether some of the blurring between ‘pain’ and ‘suffering’ exists because of an underlying belief that suffering is somehow good for the soul.

Anyway, back to pain and suffering – from my own experiences with chronic pain, the negative emotional impact varies from day to day.  There are days when pain is simply an experience, there are other days when I’m fed up with and frustrated by my pain.  Then there are other days when I can deliberately and thoughtfully put my ‘judgements’ to one side and simply experience the sensation of pain.  This is where mindfulness practices pays off for me.

Turk and Wilson suggest ‘If our analysis is correct, a treatment may reduce suffering but not necessarily alleviate pain. The converse is also likely to be true. There are a number of treatment outcome studies confirming that reduction in pain may occur without being accompanied by improvements in physical, emotional, and social functioning. There are studies demonstrating that patients may be satisfied with the treatment they receive for their pain without demonstrating any concomitant reduction in pain severity.

Conversely, there are studies demonstrating that patients may be satisfied with the treatment they receive for their pain without demonstrating any concomitant reduction in pain severity…
On the basis of the points raised above, perhaps it is time to stop assuming that pain and suffering are isomorphic, and unless there is specific knowledge that a patient with pain is suffering (some formal assessment), it may be time to stop referring to patients with pain as if they are suffering from a painful condition rather than that they simply have a painful condition.’

They end with a quote attributed to the Dalai Lama: “Pain is inevitable, suffering is optional.’’ I don’t think anyone can put it better than this really.

Turk, D., Wilson, H. (2009). Pain, Suffering, Pain-related Suffering—Are These Constructs Inextricably Linked?. Clinical Journal of Pain (25)5, pp 353-355.

6 comments

  1. I quite agree, for me pain and “suffering” are two separate things not always experienced at the same time. To an extent it is related to whether I am able, desipite pain, to do what I want to do. And to an extent it is whether I am accepting my current condition and limitations at that moment or chaffing at it.
    While the pain doesn’t seem to be able to be completely removed, suffering can be aliviated. Actually, sometimes joy or sweetness of a moment can seem even greater when it co-exhists with pain.

    1. Thanks so much for putting your perspective across kmom. I appreciate your perspective as someone who has persistent pain. I really do believe that the ‘suffering’ part is something I can determine to a certain extent – it’s so much about acceptance, and also about, as you say, that bitter-sweet recognition of good times.

  2. I know that suffering and pain can be different when I experience physical pain. I have met people through my work in hospice who answer no to whether they are in pain and yet I can see or hear that they are in pain. Are they suffering because of some sort of pain? Or are they suffering in spite of pain? Because of my observations and knowing that my own chronic pain was masked by depression, I would hope that health care workers would persist in using a multi-focused approach in assessing pain.

    In hospice, we look at that Venn diagram to assess for social, physical, emotional, financial, spiritual pain. I believe in using social workers on health care teams just for this purpose – but there are many additional reasons to use social workers.

    1. I agree egrace, its so important to listen beyond the words, and to take the time to find out what the person is really saying. You’re correct in saying that social workers can help identify these factors, among other health care professionals. The systems approach that social workers bring can be especially helpful when finances and family are involved.
      Thanks for taking the time to comment, it’s great to have your opinions on here!

  3. The use of the word ‘sufferer’ haunts me all the time, and also ‘victim’ too. I really hate that these words are used as descriptive blanket terms. In my wee support network, we like to refer to ourselves as survivors🙂

    You certainly don’t have to suffer while you are in pain, you can enjoy things just as much as the rest of the world, sometimes much more so. Its when you lose the ability to enjoy things that you start suffering and I dont think its pain=suffering, its pain+ something =loss of coping mechanisms =suffering. Thats probably pretty simplistic but I guess kinda explains what I’m trying to say.

    Also they cant be the best thing for patients to hear as descriptive terms right? sufferer/victim sounds like you should be entitled to pity and compensation or something, survivor sounds like you should be proud of your achievements and conquer the world!

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