The Oates Journal (ISSN: 1098-1446) is a publication of the Wayne E. Oates Institute addressing issues related to spirituality, ethics, and healing from the perspective of pastoral care and counseling.

My most remarkable model of ‘successful’ aging is Doris, a 74 year old woman who was forced to give up her home as well as her career as a real estate agent and community volunteer, due to a painful illness that had caused progressive debilitation. She clung to her independence fiercely and agreed to relocate to a nursing home only when the home health care company refused to continue to provide her with care due to safety considerations. The realization that she needed long term care catapulted her into a suicidal state, but she was too weak to harm herself. Finally, in a fierce demand that God tell her what God wanted of her in this state, she realized a new mission. In that prayer of desperation she believed that she received inwardly an amused response from God, “Open your ears and shut your mouth!” She interpreted that inner voice to mean that God was calling her to become God’s ears in her new living situation. In response, she asked for a rocking chair to be placed in her room, invited staff to sit in it for a minute of brief rest, and then inquired about their lives. After six months had passed, nearly everyone in the home sought a turn in her chair! Doris confided to me that she was happier in her frail and dependent condition than she had ever been in her past life, saying, “I feel as though I’m doing more important work now! Do you have anyone who will listen to you without interrupting you – for as long as you want to talk? That’s what I do for anyone who sits in my chair!” For me, Doris represents spiritual resiliency and the promise that even in physical decline I can continue to serve others.

Not all people can deal with pain, suffering and frailty with such generosity and creativity. Aging is a cornucopia of expected and unexpected challenges – all of which have the opportunity to enhance or diminish our experience of life. Younger people often view old age as a time of diminishment, but when formally surveyed, people over seventy consistently claim they are more contented with their lives now than at any other time. Many retirees express amazement that they are busier and happier after retirement than prior to leaving the workforce – because they are engaged in activities of their own choosing. Retirees generously contribute to societal well-being with hundreds of thousands of hours of civic engagement. This involvement with others is a source of pride and enjoyment to a large portion of the older adult population. But what happens when the active, engaged older adult becomes disabled or ill and can no longer remain involved in beloved activities? Often a feeling of meaninglessness sets in; they no longer feel needed, and believe they are a burden to their families and to society at large. A crisis of identity often occurs at the onset of frailty, disability, or illness – a crisis than can cause great pain and suffering.

Pain and suffering can happen at any time during the lifespan; however, such negative experiences most frequently occur to large numbers of people during the second half of life. With advancing age can come the loss of health with concomitant pain, death or the inaccessibility of friends and loved ones, diminishment of abilities, loss of meaningful work, and departure from beloved places ---to name just a few of the insults to happiness, comfort, and security in old age. While many older adults live very satisfying and meaningful lives, the specter of these diminishments looms large.

For those of us who are professionals working with elders, an unrelenting challenge is: how can we respond creatively to the experience of pain and suffering of those we serve? How do we respond to a person who asks, “I’m of no use to anyone any longer – why doesn’t God take me? Why do I have to put up with this pain? Why can’t I take my own life?” Among the pastoral responses I most often hear are, “God loves you in whatever state you are in,” “God isn’t finished with you yet,” “We still need your presence among us,” “You can pray for us!”, “What do you think?” or even “I just don’t know – suffering is a mystery of the human condition.” Also still heard (unfortunately) is “It’s God’s will.”

Along with our professional lives, we have personal lives and we are all growing older and are subject to the same diminishments as those we serve. We may find ourselves in similar situations of pain and suffering. How can we live satisfying and meaningful lives while suffering from persistent physical, emotional, intellectual, social, moral and/or spiritual pain?

In addition to experiencing our own private pain, we may also suffer intensely from witnessing the suffering of others. Witnessing another’s suffering often feels worse to the observer than to the person suffering. Speaking of a gravely ill child, a distraught parent will often say, “I can’t stand to watch him suffer --- I’d rather suffer for him rather that watch him like this” Friends and relatives of loved ones with dementia frequently say, “I can’t visit her any longer – I can’t stand to see what she has become --- she isn’t my mother any longer.”

How can we most effectively respond to such suffering? The question looms large and requires an answer. In the Judaeo-Christian heritage, there are five primary teachings about suffering to which we have recourse when responding to our own and others’ suffering.

(1) According to tradition, suffering can be an unwanted but often effective educational experience – a way to change one’s behavior or attitude for the better. Many persons afflicted with cancer say that they have gained something from the experience that they did not have prior to the illness. The experience has changed the way they perceive and live their lives.

(2) Suffering can be a source of empathy for others. When one has walked in another’s shoes, a unique, deep mutual understanding occurs which can be therapeutic for both. This is the basis for the effectiveness of support groups.

(3) Suffering can be a source of rehabilitation and purification – ‘no pain, no gain.’ All rehabilitation programs are difficult, but no positive change can occur if one doesn’t enter into the experience. If a person doesn’t endure the painful rehabilitation therapy after a knee replacement, the leg will never bend or move properly.

(4) Suffering is also a way to atone for the hurtful behavior of others. When a person sacrifices their own comfort, pleasure, security or even freedom for the well-being of a person damaged by society’s greed or ill-treatment, they are engaging in atonement – making up in their own bodies for the damage done to another. Mother Teresa is a prime example of a person engaged in atonement.

(5) Suffering can be a source of redemption -- reclaiming, restoration or healing -- of the lives of others. Jesus’ passion and death is the prime example of redemptive suffering.

The first four teachings about suffering and its value are well known and well-used as pastoral responses to suffering persons. However the redemptive value has almost exclusively been attributed to Jesus. But St. Paul makes an enigmatic statement in Colossians 1:24 (Jerusalem Bible):

“It makes me happy to suffer for you, as I am suffering now and in my own body to do what I can to make up all that has still to be undergone by Christ for the sake of his body, the Church.” What does this mean? How can Paul’s individual suffering make any difference to the well-being of the Church? As I stated in an earlier writing (10 Gospel Promises for Later Life, Upper Room Press, 2004, p.91) “Paul does not mean that through his death on the cross Christ did not fulfill his redemptive work; the redemption is definitive. However, the world is still not perfect; the Kingdom has not yet come, so the calling, privilege, and task of every follower of Christ involves continued participation in the ongoing work of redemption until all things are brought together in Christ.” This means that all people can use their suffering for the well-being of others. How can this be?

There used to be an old Catholic devotional practice, based on Colossians 1:24, called redemptive suffering – or, more colloquially, “Offering it up.” It has gone out of style since Vatican II, but was a widely used, meaningful and comforting practice for a very long time. In essence, when one was suffering anything – no matter how large or small – one offered that suffering to Jesus, to combine with his suffering for the continued redemption of the world. It was a practice that could be used by anyone, no matter what age or degree of pain and suffering. I found it useful early in life; when I was four years old I became ill with rheumatic fever, which caused extreme pain in all the joints. My mother, a nurse, did not like whiney children, so she taught me the practice of “offering it up.” She bought me a small notebook and told me that whenever I was in pain and wanted to complain, I should offer my pain for the souls in Purgatory and make a checkmark in the notebook whenever I did it. (In those days common Catholic teaching was that prior to going to Heaven, imperfect souls went to a place of purification. Living Catholics could help them speed up their purification by praying for them and by offering up their suffering for them.) I was entranced by the idea that I could help some poor souls get out of Purgatory and set myself to the task. (I remember that one day I was sure I helped at least 75 get out and on their way to Heaven! Focusing on others made my pain bearable and useful and I stopped whining.)

Fast forward forty years. I had been practicing as a clinical gerontologist in a university medical school setting and had become overwhelmed by the extent of pain and suffering I was witnessing every day. Patients were often saying to me “Why do I have to live with the pain of this arthritis – (or shingles, or emphysema, or loss of every kind)? I’m a burden – I’m no use to anyone!” Their children, who brought them to our clinic for memory assessment, would often reveal to me. “I’ve already told my kids that if this (dementia) happens to me, they’re to take me behind the barn and shoot me!” This was not said in jest --- the Baby Boom generation will not tolerate or endure the pain and suffering of old age and will take matters in their own hands. Many of my friends belong to the Hemlock Society.

The question of how to respond in a meaningful way to the problem of suffering in late life haunted me unceasingly until one day I remembered the devotional practice my mother had taught me, and how helpful it was to me, even as a small child. I knew it had been practiced rarely since the 1960’s, because it had become an excuse to avoid helping people out of their pain. It had also been seen as glorifying suffering for its own sake. The era of self-respect, self-care and Liberation Theology had rendered this type of devotion obsolete. The more modern, acceptable response to social and individual pain was to create and engage in social justice programs and teach people to avoid suffering by getting good medical and psychological care. Purgatory became obsolete as well. But I could not forget the thrill I’d had as a four year old knowing that I could give my pain to Jesus, who could then make something useful for others out of it. Somehow the pain was more bearable.

My question became, “Could this practice be resurrected and modernized for use today?” Surely we are responsible for taking care of ourselves and should take all necessary medications and therapies our MD’s advise, but, especially in old age, there is always some ‘left-over pain’ that will not respond to medications, support groups, rehabilitation programs, or even time. The pains of old age are even greater than for most young people because time is too short --- there is no expectation that time will heal grief or provide a cure.

To modernize the practice, to bring it up to date and find it a believable practice, I had to first look more closely at pain and suffering. These are the considerations that emerged:

1. Pain and suffering makes us feel bad. It can pull us away from society and even God. It focuses our attention on self and can create a sense of isolation. We experience life through a cloud of pain constantly surrounding us, interfering with life.

2. Pain and suffering have very little meaning or value in today’s society. Sufferers have little status because they often cannot contribute to society through work and may be accused of ‘using up’ resources.

3. We all have a human obligation to try to alleviate suffering, but in many cases there is ‘left-over’ suffering that lingers indefinitely and begs for palliation.

4. Suffering of all kinds both uses up and creates an enormous amount of real, physical energy. Just enduring pain, depression, sickness takes the energy away from us. We want to withdraw from active interaction with the rest of the human community – we may just want to go to bed, draw up the covers, and vegetate! Also, we often create energy around dealing with the pain. For example, if I have a pain in my stomach, I may get myself to the doctor, endure tests, buy and take medications --- all energy I would not have created and expended if I’d not had the pain.

5. If suffering involves an enormous amount of concentrated energy, which is usually endured, subdued, or avoided, why waste this energy? Why couldn’t we offer the energy of our pain to God to take and to transform into God’s own loving energy for someone else who needs it? This is very similar to the concept and practice of intercessory prayer, except that instead of asking God in words to help someone, we offer our suffering energy to God to use for another. When it is re-conceptualized as a potential gift for someone, one’s suffering energy can have meaning both for self and for the larger community. Suffering energy thus becomes a gift one has the power to give, reestablishing one’s role in society, reliving the sense of isolation from others.

6. There is support for the idea that we can use our suffering energy for others:

a. Quantum physics asserts that we are all physically ‘interconnected’ and that all matter is actually energy.

b. Jesus teaches:

“I am the vine, you are the branches. Those who abide in me and I in them bear much fruit, because apart from me you can do nothing…If you abide in me and my words abide in you, ask for whatever you wish and it will be done for you.” John 14: 5 and 7

c. Chief Seattle stated that “Humankind has not woven the web of life. WE are but one thread within it. Whatever we do to the web we do to ourselves. All things are bound together. All things connect.

d. The basis of energy medicine is the use of the energies in and outside of the human body.

“There is evidence to suggest that mind and matter interact in a way that is consistent with the assumptions of distant healing. Mental intention has effects on non-living random systems (such as random number generators) and may have effects on living systems.” (Jonas and Crawford, 2002)

How does this concept ‘work’ in pastoral practice? First, to make it more attractive to a new audience, I have re-named the practice. Instead of calling it by the old labels, ‘offering it up’ or ‘redemptive suffering,’ (which cause some derision in modern Catholic circles) I call it the practice of ‘dedicated suffering’ wherein the person dedicates her suffering energy for another person or cause. The practice can be done on the traditional individual basis or as a group practice. When practiced individually the person in pain prayerfully offers her suffering to Jesus or God and asks that it be transformed into God’s loving energy for the other person (beneficiary.) When practiced in a group of 7 or 8, each person states his or her current or past suffering in one or two sentences, with no explanation or elaboration. When each person has spoken, the group discusses to whom the combined group’s suffering energy should go. The only two rules are that there can be only one beneficiary and that no one in the group may be a beneficiary. (The practice is to be viewed as a ministry, not a therapy session or healing service). Once the decision has been made the group facilitator prayerfully offers the suffering-energy gift to God to be transformed into loving energy for the beneficiary. The group then spends one minute visualizing God pouring out love to the beneficiary.

Dedicated Suffering can be used by Christians, mono-theists such as Jews, Unitarians, and Islamic people, and by people with no religious belief or are a-theistic. When engaging in this practice, Christians offer their suffering energy to Jesus who takes it, transforms it into his loving energy, and gives it to the person to whom it is dedicated. Monotheists give their energy to God the Creator, who transforms it into loving energy for the person receiving it. Non-theistic practitioners intentionally transform their suffering energy into love energy and send it directly to someone in need.

What may happen when a person or group engages in ‘Dedicated Suffering”? Here are a few examples:

Aggie, a 78 year old woman who is home-bound and lives alone, could no longer attend church services. Prior to her illness she had spent a great deal of time as a Stephen Minister for her congregation, but once she could no longer serve others, she became despondent and began withdrawing from any interaction with her friends and other Stephen Ministers. Her pastor visited and tried to persuade her that her calling was now to let others serve her, but she wouldn’t accept that. When she asked Aggie to adopt a prayer ministry for the church, Aggie agreed, but confided that, because she was in so much pain, she found prayer very difficult. Her pastor then introduced her to the concept of ‘Dedicated Suffering’ and Aggie was intrigued. “I think I can do that,” she said and agreed to dedicate daily her suffering to the well-being of two teenagers in the congregation who were in trouble with the law. Her pastor told her she would visit again in a month.

At their next visit, Aggie’s demeanor was very different. She was animated and the first question she asked her pastor was “How are my fellows doing? I’ve been dedicating everything negative I experience for them!” The pastor was happy to tell her that instead of a jail sentence the judge had agreed to assign them to community service, working in a shelter for homeless men. Both of the boys, who had never witnessed such poverty, had been shocked and disoriented at first and one had tried to run away. However, with counseling and positive feedback from the staff and even the men they helped, they both had experienced an awakening to how meaningful their own lives could be for others. The pastor reported that she felt the boys were on a new and positive track.

Aggie was ecstatic --- a felt she had contributed to the outcome, and as important, she now felt re-connected in a very strong way to the church community she so loved.

After thirteen years of teaching the practice of ‘Dedicated Suffering” to patients in nursing homes, church congregations, religious orders, and individual clients I have received anecdotal evidence of its effects on the person engaged in the practice. I have never sought evidence for its effects on the beneficiary. In addition I did a small non-randomized qualitative study of fifteen persons who participated in a church-based ‘Dedicated Suffering Group’ for twelve weeks. In summary, these were my findings:

1. Suffering participants reported a renewed involvement in their own lives – they experienced a decrease in self-involvement and a re-connection to the human community.
2. Sufferers reported a renewed sense of meaning and purpose to their lives. They had found an answer to the question, “Why am I still here?”
3. Sufferers reported a lessening of the sense of being a burden to others. They felt they had something to contribute to others.
4. A few (about 10%) of the participants reported a decrease in the experience of their pain or suffering. Because this was not the purpose of the group I did not pay undue attention to these reports. If I had done so the attention might have turned to their own symptomatic healing rather than the gift of their suffering energies to others.

Since beginning to offer the practice of ‘Dedicated Suffering’ to individuals and groups, I have been very affirmed by the response and by two theologians.

Jesuit paleontologist Pierre Teilhard de Chardin (Hymn of the Universe, 1977). states in a chapter entitled “Suffering as Potential Energy,”

“Human suffering…is potential energy …for if all the sick people in the world were simultaneously to turn their sufferings into a single shared longing for the speedy completion of the kingdom of God, what a vast leap toward God the world would thereby make. If all those who suffer in the world were to unite their sufferings so that the pain of the world should become one single grand act of unification, or consciousness, would not this be one of the most exalted forms in which the mysterious work of creation could be manifested to our eyes?”

And in his recent encyclical, “Spe Salvi” Pope Benedict XVI states in Chapter 40,

“There used to be form of devotion – perhaps less practiced today but quite widespread not long ago – that included the ideal of offering up the minor daily hardships that continually strike at us like irritating jabs, thereby giving them a meaning….Those who did so were convinced that they could insert these little annoyances into Christ’s great ‘com-passion’ so that they somehow became part of the treasury of compassion so greatly needed by the human race…even the small inconveniences of daily life could acquire meaning and contribute to the economy of good and of human love. Maybe we should consider whether it might be judicious to revive this practice ourselves.”

 

 

Jane Marie Thibault, M.D., is a gerontologist and clinical professor of Family and Geriatric Medicine at the University of Louisville School of Medicine, where she directs the geriatric assessment program and teaches social gerontology in the school of social work. She also serves as an adjunct faculty member at Louisville Presbyterian Theological Seminary, teaching Pastoral Responses to Aging.

References:

Benedict XVI. (2007, December 8). Spe salvi, Encyclical Letter on Christian Hope. Accessed online: http://www.vatican.va/holyfather benedictxvi/encyclicals/documents/hfben-xvienc2.

De Chardin, Pierre Teilhard (1977). Hymn of the universe. London: Fountain Books, 85-86.

Jonas, Wayne B. and Crawford, Cindy C (2003). Healing, intention, and energy medicine. New York: Churchill Livingstone.

Thibault , Jane M. (2004). Ten gospel promises for later life. Nashville: Upper Room Press.

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