Category Archives: suffering

July 6, 2010 · 2:33 pm

Suffering and Divine Sovereignty?


What is similar and different counselors and beauty queens? Well, we both want to end human suffering and seek world peace BUT the counselor no longer talks as if it is possible in this life. We know that sitting in suffering is, in fact, an important act in this life.

So, for all you counselor types out there, I have a theology book for you. Currently, I am reading Suffering and the Goodness of God, edited by Christopher Morgan and Robert Peterson (Crossway, 2008).

Not all theology books are stuffy. Really. This one is very readable and helpful. Chapter one (Robert Yarbrough) lists 11 theses about suffering. I will not repeat them all here but each one is illustrated from Scripture and personal experience. Here is a taste:

1. Suffering is neither good nor completely explicable

2. Suffering in itself is no validation of religious truth

3. Accounting for suffering is forced upon us by our times

4. Suffering may be a stumbling block to Gospel reception

5. Suffering Creates teachable moments for Gospel reception (though this does not make suffering, in itself, good)

7. Suffering is the price of much fruitful ministry

10. Suffering unites us with other sinners we seek to serve

Lest you think this book takes a happy view of suffering, consider this quote:

It is certainly true that it is primarily God himself who in his redemptive activity has “caused us to be born again to a living hope through the resurrection of Jesus Christ from the dead” (1 Pet. 1:3). But this new birth does not take place in a vacuum. Rather it unfolds amidst earthly life, which is manifestly to some extent a vale of tears.

We sometimes wish to talk about “new birth” and redemption as if our suffering does not continue in this life.

The rest of the book addresses OT and NT interactions with suffering, the problem of evil and oppression and two chapters written by theologians about their own personal suffering. A good read if you realize you cannot ignore suffering or go back to some prior period of naiveté.

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May 6, 2010 · 11:28 am

What to say to suffering people: When truth isn’t helpful


Is the truth always helpful? Always the best option?

I think it is. But when we humans seek to convey truth, we never capture it all. As a result, what truth we do share may not be the truth that is most helpful. There are two things that have me thinking about this today:

1. On Monday night I shared with a class some of our experience with infertility. Some things said to us were downright stupid and wrong. Other things were true. In fact, God does have a wonderful plan for us. But it wasn’t helpful to tell us that when we were hurting. Scripture teaches us that when we sing songs of joy to the downcast it is like drinking vinegar or adding baking soda to it. Kaboom!

2. In recent weeks, CCEF has posted a couple of things on their website that need to be read together. This week they posted David Powlison and John Piper’s “Don’t Waste Your Cancer” to their homepage. This was written by both men when they were in the throes of Prostate cancer. I encourage you to read it from the perspective I am reading it. My wife has breast cancer. We hope to beat it. But we are in the throes of chemo right now. How does this sound to you. True? Helpful? Now, when you have read that, go read Ed Welch’s post: “What Not To Say To Suffering People.” He wrote a follow-up here.  How does this sound to you? True? Helpful?

Seems the first could be seriously misused and does not address all of what you say for comfort in the heat of the battle. Surely we need to be a bit careful about what the person needs to hear. Yes, we can “waste” the cancer in a “woe is me” mentality. But be careful not to go there too quickly! Know your audience and what they need NOW from you.

What do you think? I’d like your feedback.

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April 19, 2010 · 6:06 pm

How perspective changes everything


“Your wife has breast cancer…She’ll need chemotherapy.”

The first time you hear that, you only feel the blow of a seeming death sentence. You see your future as a widower flash before your eyes. Doesn’t everyone die who is diagnosed? No. But the anecdotes we carry would say so since we remember the awful stories and forget the great outcomes. You cry and ask God for a different story, a different outcome. Let the diagnosis be wrong.

It isn’t. And so you begin to accept the facts of breast cancer and learn what your story contains. You learn some people have wonderful post diagnosis stories and others have painful stories. You wait for confirmation. You talk with doctors, get the scans done and then talk some more.

After surgeries, scans, and appointments, you begin to accept the chemo path. But, you want a second opinion to be sure. Now, instead of praying for no cancer, you pray for the 2nd Doc to give you clear advice–either to confirm the first doc’s advice or to give something so clear that you know that one of the paths is so obviously right for you.

The second doc confirms every piece of advice the first doc recommends. You have consensus. Funny thing, when you hear that chemo is your best option, you are happy and relieved–not because chemo makes you happy but that it really does seem like the best option. Notice the much different response from the first mention of those words less than 2 months ago.

Perspective sure changes how you hear words. Now, instead of a death sentence, it is a way to work towards a cure. Odd, don’t you think. Yes, but also an answer to prayer.

I suspect many of us have a story like this. Initially we can’t believe what we are hearing. Later, we hear it completely differently based on the things we learn, the options we see before us, and a whole lot of prayer.

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January 4, 2010 · 12:39 pm

Psychopathology Monday


Happy New Year all. Our semester begins today with the first session of Psychopathology for the first year students. Before launching into the various forms of mental illness and emotional maladies, we consider the larger concept of suffering. Without a careful understanding of (a) the nature, causes, and theology of suffering, (b) the meanings of suffering, and (c) our beliefs and responses to suffering, we counselors become a dangerous lot. We fall prey to simplistic understandings and responses–and fall prey to false hope and false despair.

Sound like a great way to start of the New Year? It does to me because we now have an opportunity to look at ourselves and our world with more realistic eyes than we may have during the stress of the holidays.

Coincidentally, we had a Sunday School class yesterday on the topic of suffering. Our church has buried 10 people who died before their time (so it seems to us!) in the past 5 years. Not only have we had these tragedies, we’ve also splanted a church and been in a transitional malaise for maybe 7 years? The class allowed individuals to talk about suffering and heartache. Good class. We heard those who felt that what was going on was a message from the Lord, from those who just felt confused and in pain, from those who felt the nearness of the Lord during these normal ups and downs of life in a fallen world.

What was said in multiple ways was that one’s perspective or expectations about suffering really impact how one feels about the struggle of life. If you expect life to always be healthy then repeated sicknesses and death will set you back. Someone said there that if you lived in a dirt hut that moving into a trailer would seem wonderful but if you lived in a palace, the trailer would seem a terrible thing.

So, what should we think about suffering and the seeming explosion of death and heartache?

  1. God is saying something AND yet He may not be sending some special message to us
  2. Our actions may cause some of our own suffering but living more righteous lives does not prevent suffering
  3. Suffering is to be expected in this world AND yet it is NOT THE WAY IT IS SUPPOSED TO BE
  4. Isolation and failure to connect to others in suffering ALWAYS makes that suffering worse
  5. Even those who only observe those in suffering suffer as well and need to connect with others in order to avoid despair
  6. Good may come out of suffering, but suffering itself is not good
  7. God, through the cross, bears our suffering and yet it still hurts
  8. It will not last forever

Finally, how do you respond to suffering? Turn away? Become numb? Angry? Probably all the above, right? Take a moment to consider how you respond to suffering right in front of you and watch yourself for those trite statements that can hurt those who are already in pain.

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December 1, 2009 · 12:04 pm

Chronic pain and the Christian faith


Last night’s Counseling & Physiology class covered the topic of chronic pain. There are a number of syndromes and disorders that cluster around pain as the presenting problem: Chronic Fatigue, Fibromyalgia, Irritable Bowel Syndrome, Rheumatoid Arthritis, Osteoarthritis, back pain, etc. Depending on which research study you read, some 9-17% of the population struggles with some form of chronic pain.

While these various forms of pain are quite different, there are some commonalities. Chronic and diffuse pain sufferers frequently experience some form of inflammation, fatigue, sleep disruption, negative mood, and poor memory (its hard to pay attention to new information when you are weighed down by pain). We don’t really know what causes what but we do know that these symptoms form a vicious cycle. If you don’t get restorative sleep, you experience more fatigue, you are more prone to negative thought patterns, your pain levels go up, memory goes down…and thus you don’t sleep well the next night, and so on. Researchers describe this vicious cycle in terms of “allostatic load”–the deleterious effects of chronic stress hormones without restorative sleep.

Because of the diffuse nature of pain (vs. focal) and the lack of obvious objective evidence of that pain (a big red spot, a swollen limb, etc.), chronic pain sufferers and their families struggle to understand whether or not the pain is real and what they are truly capable of doing. How do you measure pain levels? It’s pretty subjective! Thus, it encourages more “I should be able to…” thinking in all parties. Those not suffering chronic pain do more damage by implying that the person is just looking for attention, is just being lazy. Those suffering pain who either deny the pain and try to do too much or refuse to engage the world and withdraw from it do damage to themselves–real physical damage.

As with all physiological problems, one’s mood, one’s perceptions, one’s focus, one’s stress levels impact severity of the problem. While chronic pain is not just in one’s head, how one responds to chronic pain may help alleviate or elevate the pain sensations. Ironically, many pain sufferers resist counseling because they fear that others will believe that their symptoms are all in their head. Those who refuse to acknowledge the psychological factors in pain sensation and management miss out on important means to cope with the pain and to lower pain perceptions.

Chronic pain sufferers must accept the need to adjust their lifestyle to accommodate more rest. They must fight to get the best restorative sleep possible. These are probably their primary practical responses–even above medical treatments (and I’m not knocking medical treatments nor saying that just getting sleep will solve the problem).

One of the biggest challenges for pain sufferers is the matter of hope and faith. When we suffer problems, we often hope they will go away. And when they do not, or only get marginally better, it is easy to slide into despair. Despair usually is the result of things not going the way we hoped or expected they would. Part of dealing with chronic pain is grieving what is lost in order to accept–even enjoy–what strength and health we do have. Without hope, we lose what self-efficacy we once had, thus not doing the basic care-taking activities within our grasp. Interestingly, one of the clearest signs of this struggle is the massive dropouts in pain management research. Frequently, dropouts number about 50% in these studies. This means that before a study gets too far along many are dropping out because they assume the new treatment isn’t going work.

Faith is not that things will go my way right now but that God is in control, cares/protects me, and is working for my ultimate redemption–even when the opposite seems to be true. Faith is acting in a manner consistent with said assumptions even while grieving over real losses. Such faith enables us to be mindful of our thoughts so that we do not practice into beliefs counter to what we have come to know as true.

The chronic pain sufferer who grieves well (asks God for relief, stays in community with others, seeks relief through human means yet has an attitude of waiting on the Lord, and yet still willing to explore and confront hidden sin in self) begins to see that in the midst of the pain, God is there and providing momentary help. Such a person need not act as if the pain were nothing but will look for and rejoice in 5% improvement, 10% more comfort, etc, rather than demanding complete healing as the determinant as to whether God is present with them in their distress.

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Filed under biblical counseling, christian counseling, christian psychology, Christianity, counseling, counseling science, Despair, Mindfulness, suffering

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November 6, 2009 · 9:59 am

Orbinski on humanitarianism, dignity, and hope


 

Two days ago I had the privilege of meeting and hearing Dr. James Orbinski at the 2009 Frobese Day, an educational conference held at Abington Memorial Hospital each year. Dr. Orbinski is the former head of Medicins Sans Frontiers (Drs without Borders), current head of Dignitas, professor at U. of Toronto, author of An Imperfect Offering, and central figure in the documentary, Triage. Of interest to me was his work in Rwanda during the genocide.

On a personal note, I found him very engaging. When I was introduced to him, he didn’t do the usual handshake and move on. He really engaged me about Rwanda and what work we did and plan to do there and gave a number of encouraging comments that went above and beyond the call of duty. I guess that is one of the characteristics you need if you are a person who goes into distressed areas. You need to connect to the people, figure out what they need and what can be done, and then do it.

First, an assortment of observations presented:

  • There are about 6.8 billion people in the world. Some 3.8 billion, or about half, subsist on less than 2 dollars a day
  • 1.1 billion go to bed hungry each night. This number grows by about 100 million each year
  • Nearly all famines are the function of political conflict rather than acts of nature
  • There has been a 24% increase in food prices in impoverished areas. One of the key causes is the increase of developing biofuel. Food is more valuable if it can be made into fuel.
  • The World Food Bank is begging for about 23 billion dollars to feed this number of poor. It can’t get it. But, 13 TRILLION dollars has been recently expended to prop up a collapsing international economy.
  • In 2000, it cost 15,000 (a year, I think) to provide an individual in Africa the antiretroviral meds needed to survive. Today, with political pressure, it costs 99 dollars
  • The drug companies say that it costs 1.6 billion dollars to bring a drug from a new chemical to market (through research & Development). While they do not reveal how it costs this much, it is clear that part of the costs they factor in is the income they expect to make on the drug. So, if you expect to make 10% on your investment, can you really consider that a cost to develop a drug. Apparently, they do
  • A recent nonprofit just released three new drugs dealing with neglected diseases in Africa. The costs to bring these drugs to the market was 100 to 300 million dollars. And, the companies selling them are indeed making a profit

A couple of his key ideas:

  • Dignity cannot be granted; it must be acknowledged via engaged collaboration and solidarity
  • Solidarity is not pity but active compassion
  • Hope is not some naive utopian dream, it is “what we do”
  • We all need to be political. The first act of politics: speak the truth; The second act: listen
  • The worst form of suffering is suffering alone
  • We must see it, acknowledge it, give voice to the voiceless and thus allow for dignity even if we cannot solve it
  • Optimism and Hope are two distinct concept. Optimism is confidence that one’s actions will work for the best. Hope is confidence that the action you are about to undertake is the RIGHT one no matter the outcome
  • We need those with daring ideas, with visions of possibilities. That is all there is. Hope, is in his estimation, in himself–that he will do the right thing.

While I do not agree with his definition of hope, I do agree that we need more people to move from insight (that a problem exists) to action (that I can do something of value in a hopeless situation). Folks like Orbinski certainly put many of us to shame.

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June 18, 2009 · 4:02 pm

Making sense of things and the suffering it brings


Ever had the experience of having your brain work overtime to try to make sense of some action, something done to you?

Some things make no sense and we know it–things like the premature death of a single parent, a genocide, impulsive choices that make matters much worse, etc. Yet our minds keep trying to figure it out. Why? How come? What does it mean? If only I could understand what God was up to then I could…

Sometimes, trying to understand the incomprehensible compounds and adds to our present sufferings.

We then tend to respond in one of three ways, (a) give up and stop functioning, or (b) develop antiseptic conclusions (e.g., God is going to use this to bless me later), or (c) put our heads down, ignore the pain and do the thing in front of us.

Response b may in fact be true but often it is used to help the person dissociate from the incomprehensible in a way to keep living and moving.

What do you find most helpful when dealing with an unsuccessful attempt to make sense out of suffering? How do you avoid giving in to ruminations about unanswerable angsts or hopelessness or its opposite, baseless optimism that denies the present reality?

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June 4, 2009 · 10:18 am

Biblical Seminary Summer Offerings


Every summer we have a summer counseling institute where we offer electives for current students, alum, and other interested parties (graduate counseling credit counts for required CEUs!). This summer we have three fabulous offerings!

1. **ON-LINE** Models of Counseling(2 credits) by Dr. Bryan Maier. From 7/6 to 8/31. This class has NO on-site time. If you have ever wanted to study the historic models of counseling from a Christian perspective this class is for you. Bryan really understands the basics of these models, offers great insights and careful thinking. Plus, Bryan’s material includes narrated PowerPoints and short videos made to stimulate your thinking. 

2.  Theology of Suffering & Disability(2 credits) by Jerry Borton and Kevin Kain. Class meets two weekends (7/10-11, 7/24-25). Jerry works for Joni & Friends and both Jerry and Kevin have intimate understanding of Cerebral Palsy. This is not, per se, a counseling course but open to all who want to think biblically about suffering and disability and apply that to their counseling or ministry practices.

3. Counseling Victims in the Criminal Justice System(1 credit) by Jenn Zuck. Class meets one weekend (August 7-8). Jenn has tremendous experiences working with victims of abuse and crimes in the justice system. Sadly, the church has not supported these individuals as it could have (I have heard several Christian prosecutors tell me that they have yet to see a pastor come in support of the victim, but many times observed the pastor supporting the alleged perpetrator). If you don’t live in the area, consider a visit. Class meets Friday night and Saturday. Philadelphia is a great town to visit!

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January 22, 2009 · 5:18 am

The impact of illness on marriages


One last nugget from the book Madness on the impact of serious illness on the marriage relationships. Marya explores the impact of her bipolar disorder on her second marriage and her very devoted husband who spent two years entirely focused on caring for her. When she begins to recover, she notices that he is rather a shell of himself.

In some ways it is simpler to be married to someone who is all need and no give. It’s an enormous drain. But there is benefit too: you become the hero, the center of someone else’s existence. You are the saint. You have, in this sense, a great deal of power. You tell this person what to do, and she does it. You feed her. You hold her, You are her mother, her father, her husband, her priest. And you are never required to her on an adult level. There is never anything wrong with you; any problem is caused by her, her illness, her meds not working, her malfunctioning mind.  …

You relish your role and resent it enormously at the same time. And when your role is upset–when the patient climbs out of bed and walks on her own, makes her own food, drives her own car…–you see she now does everything wrong….And–who does she think she is?–She doesn’t always agree with you…she doesn’t need you anymore. This is unacceptable. This won’t work. (222-3)

What she describes is oh so true. Whether mental illness, disease of some other organ, or impact of an affair, one spouse picks up the slack to make life work. And so it does for a time. But when the sick one gets better, when the alcoholic gives up the bottle, when the adulterer gives up the affair and wants to renew a partnership again, the “strong” spouse often then experiences rages, resentment, distance, etc. At the just the time when a partnership is possible–the thing that the strong spouse most desired and fantasized about, they find it now difficult to allow or participate in such a partnership.

Why is this? In part it is due to comfort in one’s role and the dislike for change. It is a changed belief that the “sick” spouse is now incapable of really being a partner. In part it is due to the the hidden belief of the unfairness of the previous imbalanced relationship and the desire for some level of payback.

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Filed under anger, conflicts, marriage, Psychology, suffering

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December 19, 2008 · 5:58 am

When you sit with endless human depravity…


you can become quite cynical about Christians, christian organizations, etc. is there any church or pastor who isn’t completely hypocritical? Are there churches or boards that handle abused individuals with care? Do any of our leaders actually admit their wrongs and seek forgiveness? Does anyone in a difficult marriage stay and avoid bitterness?

The answer, of course, is yes (to the last three questions). But we counselors rarely get the opportunity to hear those stories. Why would anyone pay us or bend our ear to tell us how great something worked out. But we humans have a propensity to collect “look how screwed up the world is” stories. Isn’t that what the news is all about. When I go home to my parents in Maine they actually do have some feel good stories and it feels rather strange and unnewsworthy. Where’s the killings, the rapings, the pillagings? This is news?

And yet it is good to recount stories where humans treat each other better than they deserve, where they admit to failings and refuse to excuse wrongs. Frankly, we must admit these stories aren’t exceptions. They happen all the time but we are blind to them. We fail to record these behaviors because we know how easy it is to not show mercy, to not show humility–because this is how we act sometimes!

So, listen for those vignettes where leaders, parents, spouses, etc. either suffer well or are willing to own up to failings (and then do the right thing about them). These stories are all around. And while they don’t dismiss those where leaders fail us they do round out the picture.

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