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Suffering, Hope, and Healing

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Abstract

Suffering is the experience of distress or disharmony caused by the loss, or threatened loss, of what we most cherish. Suffering involves dissolution, alienation, loss of dignity, and/or a sense of meaninglessness. Hopelessness is an extreme manifestation of suffering. However, hope is a natural human resource that can relieve suffering and contribute to healing. Hope is also more flexible and resilient that physicians, who traditionally withheld or manipulated the truth about dire prognoses, believed it to be. Maintaining hope, especially deep hope, is an antidote to suffering.

The vocation of physicians and other health professionals is, insofar as possible, to relieve suffering caused by illness, trauma, and bodily degeneration. However, since suffering is an existential state that may not parallel physical or emotional states, health professionals cannot rely solely on knowledge and skills that address physiological dysfunction to be effective at relieving suffering. Rather, clinicians must learn to engage the patient at an existential level and to engender hope.

For several decades medical educators have taught young physicians to approach their patients with “detached concern,” a relationship that they believe preserves objectivity and protects the physician’s emotional resources, while it also acknowledges medicine’s beneficent motivation. However, in reality, contemporary medical education and practice favor a process of progressive detachment from patients that devalues subjectivity, emotion, and solidarity as irrelevant and often harmful. Such an ideal – fortunately not achieved by most clinicians – almost ensures that practitioners lose the ability to fully appreciate and respond to human suffering, or to facilitate hope. The term compassionate solidarity summarizes an alternate model of the clinician–patient relationship that promotes hope and healing.

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Correspondence to Jack Coulehan MD, MPH .

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Coulehan, J. (2013). Suffering, Hope, and Healing. In: Moore, R.J. (eds) Handbook of Pain and Palliative Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1651-8_37

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