You’re 80.’” The unknown root of her suffering combined with her doctor's paternalistic indifference make her feel like a foolish hypochondriac. I mean even though it hurts a lot, you're always busy asking questions.” She highlighted the events of suffering in her life, such as the birth of her son and her own illness, not only as bridges from one way of life to another but also as bridges from being one person to becoming another. Interestingly, the fear of one's life story not being heard, especially at the end of life, may be part of the experience of suffering (Picard, 1991). Later in life, she nursed her mother and siblings through their illnesses and deaths. In other words, time flew or dragged. She has told her family what she wants to wear for her “laying out,” and how her gravestone should be marked. In other words, suffering is a unique form of social communication. What do you think is the purpose of your suffering? I read different things like maybe all those things in the Bible, like an afterlife, [are] a fairy tale. The negative feedback mechanisms of the hedonic treadmill are as powerful today as they were millennia ago. A good example of how suffering can make one appreciative is the apostle Paul when he was in prison - cf. That says it all.” Because he perceived a crucified Christ as a model of suffering as well as the benefactor of eternal life, suffering offers inestimable value and an inherent promise of its end. Here, the concern is for the fragmentation and decontextualization of the person through standard health care practices, which in effect separate person from meaningful context. Elders revealed that they had not shared their experiences with health professionals or clergypersons because they described suffering as more than mental, physical, or spiritual pain, as having an existential quality that is rooted in being human, and because they were not asked. A 72-year-old European American man defined suffering as “physical agony. Suffering brings out the best and the worst in Life of Pi's characters. “It's a robot with empty eyes. Some of these categories, such as poverty and racism, influenced the lives of the elders we studied. Culture is our native starting point; it is the shared blueprint of both the local and larger world into which we are born and take part in shaping. By using Learn Religions, you accept our. Through the process of the interview, elders connect the suffering experience to the entirety of the life lived and the story of suffering to the life story. This is the one we’re all familiar with: the pain of birth, old age, sickness, and death, as the Buddha described it. That purpose is not always punishment, although sin does bring punishment. How do your past sufferings influence the present quality of your life? Jacobs’ decision to take a white man other than her master as a lover is more complex than a ‘poor choice’ that rejects virtue in favor of illicit sex. That's why I think it is useful to toss out English words like "suffering" and "stressful" and go back to "dukkha." Metaphors allowed a flow of thoughts to go back and forth between discussion of life and death. Sin always spawns misery. The fact is that suffering is an inevitable part of life, from aging and death to heartbreak and disappointment. Think of it as an algebraic "X," or a value you're trying to discover. A 78-year-old African American woman who recently survived a grueling double mastectomy defined suffering this way: “I had terrible pains and burns from the radiation. An 80-year-old frail African American man cannot leave his apartment without assistance. Objectives. Because of the heightened incidence of chronic and acute illness in later life, physical pain is often part of an elder's daily life. What we think of as our self, our personality, and ego, are temporary creations of the skandhas. It also permits an immediate paragraph-level analysis to orient readers to issues (e.g., the value of suffering) before the story moves on. We may go about our day-to-day life, oblivious to the For most elders interviewed, however, pain in itself did not cause suffering; they admitted that they could “take” pain. Resilience Living in a community that is resilient to disaster and decline . A 74-year-old European American man admitted that his suffering began after his parents died. Emotional suffering is betrayal, sadness, loneliness and feelings The outcome could be a dizzying sense of unreality and forced a question: “When will this end?” Suffering in age challenges the content and integrity of the future self. In the social sciences, the notion of “social suffering” has been introduced to examine “the devastating injuries that social forces can inflict on human experience” (Kleinman, 1997, p. ix). Give us the faith, strength and courage to face our storms so that we may be a help in times of suffering for others. An 82-year-old European American man imagined that “for parents to stand over the coffin of their child because of their own negligence, I think that would be real suffering (crying).” Because he reported he had never lost a child, we can only wonder what recollection this picture represents for him, or what part of his psyche it draws on. Many elders said that they seldom thought about this subject. A psychological scenario of “time running out,” being “passed by,” or “past one's prime” is culturally connected to old age. physical or mental pain that a person or animal is feeling: The war will cause widespread human suffering. Conversely, an 84-year-old African American woman described the anxiety attacks she experiences as suffering because she felt that they precipitated death. I feel like I'm just a shell of a person.” On a follow-up call, this respondent felt much better. According to the doctrine of anatman (or anatta) there is no "self" in the sense of a permanent, integral, autonomous being within an individual existence. Now she is at peace and her suffering is over. "Dukkha" is Pali, a variation of Sanskrit, and it means a lot of things. It’s all sin can do. For example, anything temporary is dukkha, including happiness. “Dying is suffering because you're sick and you're helpless, but death is just death. A 74-year-old European American man revealed that he continues a lifelong battle with alcoholism. Some of the core questions we asked in the interview are provided in the Appendix. Critical to the experience of suffering is the perception that common sense notions of life and living disappear. A classic distinction in medical anthropology has been made between disease, a biological construct, and illness, or the victim's experience of the disease episode. After months of suffering, his death was a mercy. Each account of suffering was given an identifier, usually a key line from the text. Most added that they hoped “to go quickly.” A 78-year-old European American man expressed himself succinctly. A final goal in recruiting respondents was diversity of experience (in regard to gender, ethnicity, education, religious affiliation, good or poor health as subjectively defined, and socioeconomic status) in relation to suffering. But that is only a small part of suffering's role in the life of the believer. Reevaluation and reintegration were accomplished by maintaining, somehow, the roles that gave meaning to identity, by assuming a new identity that is inchoate and breathing life into it, and by telling a story about it in the forum of the interview. As noted, research suggests that the experience of suffering, although in some way universal, has a local meaning and varies from culture to culture (Kleinman, 1997). Would you tell me the story of your life? After his grandfather died, his grandmother “lost her mind,” as well as a sense of time and place. Medical anthropology has pursued description and analysis of illnesses, focusing on the illness experience and on constructs such as “distress,” “misfortune,” “affliction,” and similar terms (Godoy, Jacobson, & Wilkie, 1998; Kleinman, 1980, 1988; Lewin, 1979; Morse & Johnson, 1991, chap. Suffering has been defined in medical, psychological, and religious idioms as “the state of severe distress associated with events that threaten the intactness of the person” (Cassell, 1982, p. 640); “a threat to our composure, our integrity, and the fulfillment of our intentions” (Reich, 1987, p. 117); and “as involving threats that constitute an alienation of our being” (van Hooft, 1998, p. 14). I feel like everything that's going on in here [points to head] is woozy. We reap what we sow (Gal. Because she does not know the cause or course of her phantom illness, she is unable to attach meaning, purpose, or value to it. She had been taken to the hospital after a fainting spell. Elders sometimes revealed what their religion taught about suffering and how they internalized those teachings. Some elders explain that negative events, such as depression or suffering, differ from each other in their causes, outcomes, and quality. The year before, he was sent to live with and watch over his elderly grandparents. These respondents, however, were not the “norm” in our small sample. Your heart is beating real fast; you get sweaty. In the Dhammacakkappavattana Sutta the Buddha said "desire is source of all suffering". SUFFERING is a ubiquitous human experience but is not specifically the same as depression, grief, illness, pain, or similar events that occur in later life. He believes his neighbors do not like him; he cannot regain his place in the “foreign” country of his neighborhood. Do you suffer when you experience certain feelings, such as regret, remorse, or guilt over things that you did or did not do in your life? Narrative analysis was appropriate for our study because it concerns human agency and imagination and is suited to studies of subjectivity and the self. Collective interpretations of suffering create its value as well as a rejection of its value (Graneheim, Lindah, & Kihlgren, 1997). Take for example a gold fish; most experiments claim they have a life span of three seconds, comparing that to a human life it can be said that we would suffer by recollecting old memories that brought us pain and suffering. Both the enveloping nature of the experience, which could and did lead to uncertainty about if and when it would end, yoked together two normally incompatible experiential measurements, closure and openness. The heightened incidence of chronic and acute disease, physical pain, depression, decline in mobility, more frequent loss, and nearness to death or finitude, although normative, may contribute to an overall sense that elders suffer. Remember, the Buddha didn't speak English, so he didn't use the English word, "suffering." Our goal was to elicit “folk models” or “explanatory models” of suffering. Suffering challenges the management of the self. Most respondents said that to endure the death of a close relation, especially one's child, is the capstone of suffering. 7. The Buddha didn't speak English. Do this even if—especially if —you don't understand what "dukkha" means. In order to acknowledge the uniqueness of each elder's definition of suffering, the conceptual framework of our research was based on a model of the person derived from work in cultural anthropology and gerontology (Rubinstein, 1989, 1992). That is a mistake. Buddhist philosophy is extremely subtle and complex, the product of thousands of years of study and contemplation by Buddhist monks and nuns al… Over the centuries, Buddhism has grown and evolved into a highly diverse tradition with many different sects who emphasize different aspects of the Buddha’s teachings. A 72-year-old frail African American woman, when asked what a picture of suffering would show, drew on an image of science fiction. In most cases, the context, experience, and meaning of suffering were clearly described by informants. Each elder in our sample uniquely defined suffering, sadness, and depression and rooted his or her definitions in the context of the joys and sorrows, triumphs and struggles of a lifetime. Culture cannot be abstracted from a society's historical reality; interaction among members is central to inheriting and bequeathing a culture (Hall, 1959; Turner, 1996). An overarching theme in elders' narratives was their experience of suffering as a lack of control over the self, one's body, or the circumstances of life. Although this work is different from our concern with elders' suffering outside of patienthood, it is similar to our approach to the experience of suffering as common, unique, both observable and hidden, and complex. Generalizations also fail to penetrate problematic emotions, such as guilt, regret, shame, or a failure to forgive or perceive oneself as forgiven that cause suffering in later life, especially if elders believe that they have no second chances to “right wrongs” done early in life. Even though God never leaves us, we are often unaware of his presence. B2. We describe how individual experiences of suffering in later life can be organized thematically. The Lord, our Teacher, doesn’t hide himself anymore. There are few studies, however, that specifically examine suffering in the aged-based way we discuss here. Content concerning suffering consisted of two categories: responses to direct questions about suffering and materials about suffering that occurred elsewhere in the interview, not in response to direct questions. An adult's ability to direct his or her comings and goings and to satisfy his or her needs remains a benchmark of maturity. An 80-year-old European American man lost his only son more than 10 years earlier in a car accident. These are: This takes us to the Buddha's teachings on the self. They are all impermanent, all constantly changing. Other work obtains here as well. How to use suffering in a sentence. An 81-year-old African American man describes suffering as a torturous lack of self-knowledge. 16, pp. We recruited 40 informants who were 70 years old or older from the Philadelphia, PA, area for extended qualitative interviews, which elicited their life story and experiences and philosophies about suffering. "Dukkha" is Pali, a variation of Sanskrit, and it means a lot of things. Examples of pain and suffering settlements could involve: Someone is the victim in a car accident and suffers whiplash and a concussion. Do you think older people suffer more than younger people? Rather, the experience of pain darkly colored their self and worldview. Prior research on and around suffering has examined the experience from a variety of perspectives. Natural selection Because of it, they existed in a social, psychological, and experiential liminal state. Many elders experienced suffering as transformative. The historical Buddha once summarized his own teachings this way: "Both formerly and now, it is only dukkha that I describe, and the cessation of dukkha." Elders note that the enduring nature of suffering might overwhelm their aging minds and bodies; they worry that they will die before suffering ends. Then we sorted the materials into general themes of suffering. An 82-year-old European American woman interpreted suffering before death as a summons to take final control over her life. Suffering became an outside enemy that had somehow gained entrance inside an elder. A 76-year-old European American woman suffered when she finally accepted the fact that her son, born with an incurable congenital disease, “would never get better.” At that moment she “stopped praying and gave up hope.” Although she said that she suffered because her son was unable to realize his “wonderful potential,” she revealed that suffering also resulted from her loss of faith. First, part of the immeasurable and paradoxical nature of suffering is that, as an experience, it is both bounded and unbounded. Discussion. This is sometimes represented in informants' inability to narrate their suffering experience within the context of their life story; the flow of narrative may be interrupted at the point of suffering. 12:6). Because there is no single English word that neatly and tidily contains the same range of meaning and connotation as "dukkha," It's better not to translate it. The intention in interpretation is to describe, explain, and elaborate phenomena as related by the informant and based on the entire transcript (Stake, 1995). Unlike What he said, according to the earliest scriptures, is that life is dukkha. What do you think happens after we die? “My parents wouldn't like the things that I think now. The overall goal of our research was to investigate some of the ways a sample of elderly persons defined, experienced, and discussed suffering. (4) We may suffer persecution because of our faith—especially when we take a stand on biblical issues, i.e., suffering for righteousness sake (2 Tim. Would you describe an event or period in your life when you felt that you were suffering? For purposes of discussion, we define the terms that are integral to and related in this article, such as culture, self, and suffering. Rather, the sense that death was imminent paralyzed her. In America, suffering may be seen as a special property of the aged because of cultural myths about old age. Otherwise, you'll waste time spinning your wheels over a word that doesn't mean what the Buddha meant. Little has changed for sentient beings over the past 2500 years. This sense of unreality also led to an existential state of both living and watching oneself go through the motions of life, and it forced another question: “To whom is this happening?” The changes that suffering brought to bear on elders' bodies, roles, identities, and worldview often carried an acute sense of alienation. Most elders struggled to create or discover meaning for suffering and thus determine its value in their lives. If you were going to draw a picture of suffering, what would it show? Consequently, cells contained 10 African American men and women and 10 European American men and women each (N = 40). Pain evoked fear of mortality—the loss of this life as we know it. He is both waiting for his life to begin and, because of his age and frail health, waiting for death. Another example of suffering in the Bible is Joseph’s story in the book of Genesis. Although many informants felt, in many ways, ageless, internalizing the cultural view of old age as unproductive caused suffering. The Buddha taught there are three main categories of dukkha. He described suffering as an “inability to be active,” and then he added, “but you only suffer so much until you just give up. Suffering proves the authenticity of Beginning with the initial interview, we discussed each text as to its nature and where it might belong among themes. Physical suffering is pain, aging, deterioration and injury. For example, a long commute is often cited as having an impact on quality of life. She feels joy contemplating an afterlife in which “everyone will be young and healthy.” Unlike the gentleman just mentioned, this respondent widened her area of control to include the “heaven” that she believes will follow this life. Their “intimate” or “private” suffering occurs in a social milieu and is judged as suffering within the ethos of the larger public world (Lipton & Marbach, 1984; Zborowski, 1969). Breslau, N., Davis, G., Peterson, E., Schultz, L. Graneheim, U. H., Lindah, E., Kihlgren, M. Ngo, D., Tranh, T. V., Gibbons, J., Oliver, J. Simeon, D., Guralnik, O., Schmeidler, J., Sirof, B., Knutelska, M. Oxford University Press is a department of the University of Oxford. This process went through several iterations before the final themes of suffering were named. Do you think suffering is a “normal” part of life? Is there such a thing as quiet or silent suffering, or is suffering always expressed in some way through words or cries or gestures? Her question to herself became, “Who am I without others to care for?” When asked what a picture of suffering would show, she nodded, as though familiar with the picture. Generally, aspects of suffering have been treated in an event or disease-specific manner. In this definition the self includes an abiding identity that is both actor and acted upon, watcher and watched, and subject and object of life experiences. Her embarrassment about cancer and the mastectomy, and ignorance about its prevalence, became a dimension of the disease that added to her suffering. Narrative analysis has been widely used in gerontology (Becker, 1997; Gubrium, 1993; Kaufman, 1986; Myerhoff, 1979, 1984). He described suffering as “the weakness I feel when I can't pass a liquor store without going in.” He defined his depression as “an inability to get started or to finish things.” Sadness was the emotion he felt when his “long-time companion,” his pet dog, died. Suffering may be named acceptable, unacceptable, a cultural exemplar, or even an “outrage” in a given society (McGoldrick, 1996; Rosen & Weltman, 1996; Townes, 1997; Zborowski, 1969). Second, for some informants a sense of unreality was profound. The wisdom of her body provided a metaphor—that she was “like a shell”—that both heralded death and caused her to staunch the loss of her life's blood. Our goal in this article is to describe a significant aspect of the aging experience that is infrequently discussed. An 88-year-old European American woman who traveled extensively throughout her life describes herself as presently suffering because “I can't even walk to the corner without pain.” Her pain from heart disease reduced her world and diminished her view of herself. Why do you think God allows us to suffer? Some translators are chucking out "suffering" and replacing it with "dissatisfaction" or "stress." On the other hand, suffering … Unfortunately, the literature here rarely is gerontological, although many of its issues, including the relation of social structures and social suffering to individual subjectivity, are important gerontologically. When asked if she had ever suffered, an 80-year-old European American woman answered in this way: “The most I'm suffering is right now because I get all this medicine, but I don't get any help. Where my breasts were just raw.” For her, suffering was the physical pain that resulted from the “cure” of losing her breasts and from radiation treatments. In sum, issues of suffering are ultimately issues of identity—those of self and important others—in the face of finitude. The period of present-day time was focused on intently, yet it did not follow the kind of “time” passed in presuffering life. As a result of Joseph’s Example sentences with the word suffering. And … Here is what Paul said in Philippians about his life: Here is what Paul said in Philippians about his life: "Indeed, I count everything as loss because of the surpassing worth of knowing Christ Jesus my Lord. For example, we suggest that just as there are elders who are not ill and yet suffer, there are also elders who are ill and do not perceive themselves as suffering (Charmaz, 1995). 6:7-9). Similarities concern informants' connection of suffering with finitude. Ph 1:3-8 V. SUFFERING MAKES US MORE DEPENDENT UPON … The suffering period, through its strangeness from or similarities to previous times in life, related to other biographic events. To suffer through loss is not only to lose loved ones but also to lose the roles that one held in relation to them. On the basis of this research, it appears that, although they have some similarities, elders' experiences of suffering are unique and incomparable. Because he believes that his wife lost her identity along with her memory, he feels that “for all intents and purposes, she is dead.” His present circumstance seems to parallel his wife's liminal state—she is betwixt and between life and death and he is betwixt and between knowing “where” his wife is. When our sins catch up with us and we feel the pain, in humility, let’s humble ourselves and accept it. The person can no longer depend on the “self” as it was, as elders eloquently state in their interviews. In this research, elders seemed pleased to be asked to disclose their life stories and stories of suffering to the intimate stranger—the interviewer—in the personal yet professional forum of the interview. Then we examined the texts of the interviews in order to locate materials about suffering. Some elements of suffering, such as grief, pain, misery, are inherent in the experience of living and cannot be avoided. There are several excellent studies that have explored the experiential problems of old age, such as decline, fear, illness, loneliness, and grief, and, through these experiences, suffering (Kaufman, 1980; Myerhoff, 1979, 1984). Do you think that being older and closer to the end of life is a form of suffering? This variation regarding the aforementioned domains was easily accessed at a screening contact. On the basis of our research, most individuals have experienced suffering. The self may be defined as two complementary faculties: a process that is unfolding and an object that is observed (Charmaz, 1995). We offer these definitions because they speak to the all-encompassing nature of suffering as a threat to an integrated existence, which resonates with our informants' accounts of suffering. SUFFERING is a ubiquitous human experience but is not specifically the same as depression, grief, illness, pain, or similar events that occur in later life. To find value in suffering, some informants transformed seemingly purposeless suffering into an admission that there may be a spiritual or nonmaterial aspect of themselves that needs acknowledgment or nurturance. Moreover, the role of suffering in the spiritual life is ultimately based on mysteries of our faith; and, as with so many mysteries, we are likely to live with them without attempting to fathom them. You can't help it.” Her internal–external distinction between depression and suffering was common in our sample. And then the real suffering began. He has kept his integrity and his testimony, and sung the praises of his Lord throughout his many physical trials. A similar sensibility is found in work that focuses on the whole self in end-of-life care, and on the efficacious treatment of emotional and physical pain in clinical and hospice settings (Kaufman, 2000; Kleinman, 1997; Lawton, 2000). We do not always see it, but that does not mean it does not exist. 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