Defining suffering substantively turns it into a normative concept, which results in epistemological mistakes and moral injustices. 2014;35(6):407–20. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both … This work can be classified among the theoretical works of the “humanistic turn” in medicine. Oafs argue this specious line for varying reason: to evade fingers of blame, to impress one's audience with one's mental fiber, to vent anger, or just because one lacks the necessary suffering to sympathize. A definition of pain cannot be based only on the neurological understanding of it, but has to incorporate other relevant factors such as cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors beyond the medical sphere. 2015;3(12):62–9. 2003;68(2):161–194. These theoretical critical approaches and the parallel social activism challenged the methods, goals and consequences of medicine in different ways. Trurl: Aha! To put it in other words, the alienation of the self described by Nancy can capture one essential dimension of one kind of suffering, but it does not define all kinds of suffering. On theone hand, there are metaphysical interpretations of the term: God isa prime mover, or a first cause, or a necessary being that has itsnecessity of itself, or the ground of being, or a being w… “Unpleasantness” defines suffering and pain. However, the question remains whether suffering can really be treated solely by medicine and with purely scientific methods, considering this ultimately incommunicable dimension, the fact that not all kinds of suffering are related to pain or disease, and the existential dimension of suffering, which includes personal choices related to the attachment of the person to life and the world. We have to focus not only on what we “lose” when we suffer, but also on the various cultural, personal and social adaptations and resources to manage suffering. Also without the unpleasant attached label, one wouldn’t need for things to be different so there wouldn’t be a need to try and make things pleasant; after all trying to make life pleasant is how life is mostly lived. ( Log Out /  Descartes himself is engaged in the enterprise of knowing the world in order to turn humans into “maîtres et possesseurs de la nature” (“masters and possessors of nature”) [12], proposing a scientific method and using it to improve living conditions. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The question of how to transcend suffering has plagued humankind since our inception but aprox. 2002;13(1):2–26. Social problems like poverty, social exclusion, forceful social inclusion (like peer pressure), forced displacement and uprooting; existential and personal problems like grief and stress; conditions like nausea, paresthesia, a non-painful illness, anxiety or fear can likewise be a cause of suffering. Relevance. 1983;5(2):169–95. Like Nancy, Michel cannot recognize himself anymore, and neither can his friend. Anything that is not permanent, that is subject to change, is dukkha. So the challenge mentioned previously still persists, since the physician is now required not to make an abstraction of the ill person, not to look at the body as if it were a mere mechanism to repair, not to take into account only somatic pain, but also to consider non-somatic pain, secondary effects of treatments, personal circumstances, etc. Knowing the medical, scientific truth about pain required both abstracting the body from the person, and the pathological fact from all normal bodily functions. However, I argue that people suffering from such a condition do not have a complete experience of pain, but only of one of its parts. Is Suffering Necessary? It was, in my opinion, good to see that just about everybody in attendance agreed that, indeed, suffering does seem necessary for human flourishing. Beauchamp TL, Childress JF. Defining suffering as a threat against the “intactness” of a person entails an assumption of what an “intact” person is. A scientific paradigm is defined as a constellation of facts and theories (assuming that the theories are not exactly developed in order to explain previously given facts, but that facts emerge together with the theories explaining them). Mente y cerebro. From the Mystic-Ascetic Christian Tradition to the Techno-Scientific Approach”, funded by the Austrian Science Fund (FWF; M2027-GBL). Rather, they are part of a person’s life, and the self is the result of various experiences including pain and suffering, which have an existential dimension inasmuch as they depend on the person’s attitude, resources for their management, as well as choices and commitments related to that person’s attachment to life and the world. It seems that without suffering, the virtue of courage could not be developed. Suffering is the substance of life and the root of personality, for it is only suffering that makes us persons. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain. Get even more Buddhist wisdom delivered straight to your inbox! Williams SJ, Bendelow G. The Lived Body: Sociological Themes. Van Hooft [26] suggests that Cassell maintains such a distinction; however, this is not the case [25]. A good phenomenological approach is not merely a subjective narrative of a personal experience, but is able to capture crucial elements of such an experience which are useful as meaningful resources for other persons trying to understand similar experiences. 2006;135(3):46–54. I wish in this short paper to carry this claim further and try to explain why Schopenhauer thinks that life is full of suffering and how he believes that this suffering can be overcome. Both are experiences which affect the whole person (not merely their “body” or “mind”), and a crucial aspect of them is the personal attitude and choices which are in turn influenced by cultural and social patterns. However, the narrative explanations of the continuity of the self and life can be criticized, too. Part of Danu. The Location of Pain in Childbirth: Natural Childbirth and the Transformation of Obstetrics. Attitudes like choosing pain or accepting suffering can be a way of affirming the self. Let’s assume with Nietzsche that there is a certain necessity to suffering: it is only through suffering that certain valuable things can be known and achieved. By using scientific methodology, it is considered possible to repair a body in the same way in which we can repair a machine (or an animal, inasmuch as Descartes considers animals part of the res extensa). -Hitler? In any case, pain asymbolia is a medical condition rather than a usual experience of pain.Footnote 12. Always wanting life pleasant is why so many are in a state of discontentment, it has nothing to do with what’s going on out there, it has everything to do what’s going on inside. Definitions are not inconsequential, since the way in which we define concepts has epistemological, ontological and practical dimensions. Barcelona: Seix Barral; 1999. London: Routledge; 1973. 2015;3(12):4–12. Humility is recognition of personal insufficiency and the willingness to learn. Bueno- Gómez N. The Experience of Death in Techno-Scientific Societies. A philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are found as better definitions of suffering and pain. This distinction parallels the Epicurean distinction between the “pains of the body” (ponos) and the “sufferings of the soul” (lype). Such personal options are influenced by social [5, 6] and cultural [7, 8] patterns. Bromm B. El origen del dolor [The Origin of Pain]. Wellmer A. Zur Dialektik von Moderne und Postmoderne [On the Dialectic of Modernism and Postmodernism]. For example, the decision to accept or reject a medical treatment in order to prevent a possible disease cannot be taken “objectively” because this is not a purely objective decision; it involves issues like the evaluation of the secondary effects of the treatment, the personal values and priorities of the affected person, or his/her ability to assume the risk. Paris: Galilée; 2000. Moreover, such inner stories are always pluralistic: They interpret our past experiences in the light of present interests or experiences. Not only phenomenological theories have developed alternative conceptualizations of the body. Courage, for example, is a virtue that requires the risk of suffering. Cassell’s normative definition of “person” includes a number of dimensions like their perceived future, personality and character, body, past experiences and memories, cultural background, behavior, relations with others, a political dimension and a secret life [3]. But Cassell also thinks that it is possible to develop a methodology which is able to turn the subjective dimensions of pain and suffering into transmissible information that physicians can use in order to develop more holistic treatments (not only designed to cure a disease, but to palliate the suffering of the ill person). Anthropol Conscious. As I already mentioned, pain consists of a somatosensorial perception followed by a transitory mental image of the local change in the body (nociception) on the one hand, and an unpleasant emotion on the other hand. Barcelona: Editorial Crítica. Article  Thus, happiness is dukkha, because it is not permanent. Simply put, it is no longer acceptable to consider pain only in physical and suffering only in psychological terms. a better, happier life? Suffering can be experienced in different ways, not necessarily as a threat against one’s integrity, as I will show later. The hedonistic and materialistic Epicurus argued in the fourth century BC for the human being as an entirely material entity. 2017;25(2):150–168. For Epicurus, sarx and psyché are two parts of a single, whole organism [50], and the mind cannot exist without the body. However, as stated previously, these are not definitive consequences of suffering, and persons are not static, unchangeable beings. Affecting the Body and Transforming Desire: The Treatment of Suffering as the End of Medicine. ( Log Out /  Experience, Coherence, and Culture: The Significance of Dilthey’s ‘Descriptive Psychology’ for the Anthropology of Consciousness. Wilkinson I. Forschende Komplementärmedizin. Moscoso J. Historia cultural del dolor [Cultural History of Pain]. Social Suffering. 2007;2(30):1–12. My translation. 0. 2. This is obviously problematic for a number of reasons. they – and the body in general – are essentially “absent”). Excerpted from The Moral Status of Animals. So this definition is unable to properly identify what is common to all experiences of suffering. In the present moment suffering doesn’t exist, this isn’t because unpleasant things don’t happen, suffering doesn’t exist because there just isn’t a need to label it as so. 23. Medicine started to be systematically organized in clinical environments, where patients could be observed and the symptoms and diseases compared and described as neutrally as possible: As explained by Foucault, the physician must distance himself from the diseased in order to learn the truth of the pathological fact [14]. 1974;2(1):85–98. This includes physical, emotional and mental pain. necessary for what? Basbaum A, Julius D. Nuevos analgésicos [New Analgesics]. Much more malleable and uncertain are our stories about the future: The future is unknown territory that slowly becomes present and then past, surprising us again and again. Eventually parents pass away. Chicago: The University of Chicago Press; 1996. Yes suffering is necessary in order to build character. Lv 6. 2008;15(5):277–81. What that would mean is that there is no “necessary suffering”, and as such no “greater good defense” when it comes to the problem of evil. The so-called greater good defense for the “problem of evil” is based upon the assumption that there is a “greater good” result, which cannot be reached (despite God’s omnipotence) without some “necessary suffering”. 2014;5:57–70. However, this article criticizes Cassell’s definition of suffering because, despite the fact that it is able to overcome the mind/body dualism, his idea of personhood is still inadequate. Even if the “humanistic turn” in medicine has started to vindicate more holistic views of the human being, medicine and its disciplines still depend on the idea that the different parts of the body can be treated independently. Although pain and suffering are unpleasant, they are not per se either destructive or constructive forces which tear down or build up the self. Cite this article. Pain can be a source of suffering, but it is not the only one. There will be many unpleasant things that occur in life, but they’re considered unpleasant only because that’s how they’re labeled and this is where the suffering arises from. Jason TC. For example, we also engage in dialogue with our selves – the process of thinking has been defined as a kind of inner dialogue [28] – and a dialogue is not a story. Moreover, suffering has been seen and is often used to enhance identity (as in the case of the deliberate search for suffering, like self-inflicting pain, and other risky behavior). For Leknes and Bastian, a condition like “pain asymbolia” proves that pain is not necessarily unpleasant. Frankl V. El hombre en busca de sentido [Man's Search for Meaning]. Medicine can pay more attention to the aforementioned subjective, symbolic dimensions of suffering and pain, physicians can be trained to be more empathetic towards ill persons and more sensitive to their real needs. A person is never fully coherent, a person cannot be “intact” because touching and being touched is intrinsic to life. The idea that suffering threatens the integrity of a person entails an idea of the person as an autonomous, rational, coherent and well-equilibrated human being – a view which has been rejected by psychological, philosophical and sociological theories in the twentieth century – and an essential definition of suffering. Damasio A, Damasio H. Minding the body. Even if this perspective has led to great success in the relief of pain, certain problems have remained partially or entirely unresolved and/or unexplained, for instance the placebo effect, chronic pain and non-somatic pain. Accordingly, pain is something which occurs in the body and which can be described in terms of visible, physical, measurable damage (for example, tissue damage). Even if the “problem of consciousness” – “how consciousness arises from matter or, more cautiously, how it is related to matter” [9] – is far from a definitive solution, there is a generalized agreement in literature (particularly in sociology and the philosophy of medicine) regarding the need to question the traditional Cartesian distinction between the body and mind [1,2,3]. The pain of childbirth has been claimed by women as an element of self-construction for their own identities as mothers and women in the sense that they wish to be the ones in control of the technology used to alleviate pain, and not to be controlled by such technology [19]. The Benefits of Pain. Is crying when your parents die an unnecessary suffering? Cambridge, Massachussetts, London: Harvard University Press; 1995. Wittgenstein and the philosophy of language challenge the idea that the subjects are the last authors and judges of what they say. Hence, medicine should contribute not only to the physical, but also to the spiritual and mental wellbeing, and ultimately result in “wiser” humans, both because medicine is able to provide scientific knowledge about human body (which constitutes a contribution to wisdom), and because medicine provides useful knowledge about the body which might allow humans to be free of illness and weakness, thus enabling them to develop and apply their intelligence to increase the knowledge of humanity. 2010;13:131–159. He recognizes the universality of nociception (“certain kinds of stimuli elicit the sensory response of nociception in every culture, now and forever”), but does not consider pain to be the same as nociception; for him, pain includes the meaning which the subjects ascribe to nociception, and such meaning changes from culture to culture, from person to person. Chicago: The University of Chicago Press; 1990. If suffering is necessary for growth, then for all intents and purposes its a good thing, because without it, we would be lacking a significant element of our design as human beings that has allowed us to be where we are today. Suffering can alienate us from our previous concerns and can even displace us into a state of liminality, where we do not feel at home in the world or in our bodies as we once used to. These tend to fall, however, into two main groups. Stonington S. Facing Death, Gazing Inward: End-of-Life and the Transformation of Clinical Subjectivity in Thailand. Le Breton D. Antropología del dolor [Anthropology of Pain]. More questionable is the damage inflicted in order to prevent a more or less probable future disease, and an entirely different discussion concerns the damage inflicted in order to improve the knowledge of the discipline. Madrid: Alianza Editorial; 2011. They do not guarantee the wholeness among our several dimensions. Because suffering can be affected by thoughts of meaning or of the future, some have focused on this dimension of suffering and asserted that only humans can suffer. The answer to this question has nothing to do with what happens in your life, it has to do with attaching to what happens.… Suffering allows us (or for me at least, as I said earlier) change patterns in behavior that would otherwise lead to be more destructive. In this early work Nietzsche himself was under the spell of a metaphysician, Arthur Schopenhauer, who conceived of suffering and evil as being metaphysically necessary. Terms and Conditions, In the context of such medicine, suffering and pain were dissociated from the context of a theodicy [13] and to be treated scientifically. Madrid: Taurus; 2011. p. 134–5. Altuna-Lizaso B. Medicine does indeed have its limits. Such definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. Still, Descartes argues for the existence of an immortal soul which can stand on its own, without a body. (Catholic, Jesus, philosophy) User Name: Remember Me: Password : Please register to participate in our discussions with 2 million other members - it's free and quick! From proposition 16, 1, Spinoza proves that all things follow necessarily from the necessity of the divine nature and its attributes. He trusts in human reason to the point of believing that progress in medicine will be able to relieve us of illness and even the weakness associated with old age, thus showing the first signs of an attitude which reaches its peak during the Enlightenment and declines (in a certain sense) in twentieth century, when the risks of scientific and technological intervention started to become apparent. Sociology of Health & Illness. Grahek [52] distinguishes between pain asymbolia and other circumstances in which the painful stimulus seems to be felt without the subsequent unpleasant emotion, like for example lobotomized, cingulotomized and morphinized patients. Suffering is an inevitable part of life. Noelia Bueno-Gómez. Suffering, I feel is a part of life. The other conditions may include cases of indifference to the painful stimuli, but in order to be indifferent to pain, one needs to be able to feel it. #Apologetics #theology #hope #philosophy In this manner, the goals of medicine ought to be reformulated. Their opposites are aponía (absence of physical pain) and ataraxía (absence of spiritual suffering). doi: Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them (the mind-body dichotomy, Cassel’s idea of persons as “intact beings”) are critically discussed with such purpose. Life without anguish or pain, and happiness without grief exist only in the imagination. Pain and suffering cannot be treated exclusively in naturalistic, scientific terms, at least under a certain view of what science is. Cicely Saunders and Elisabeth Kübler-Ross pioneered this movement by emphasizing the necessity of taking care of patients even if their diseases are incurable. Conceptualizing suffering as an experience emphasizes the fact that it is something a person experiences (both what Dilthey calls a “lived experience” (Erlebnis), an immediate, unreflected experience and an “ordinary, articulated experience” (Lebenserfahrung) [46, 47]. Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Tumblr (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on WhatsApp (Opens in new window), Facebook Group – It's Monday Only in Your Mind, #awareness #liberation #gratitude #desire #love #spirituality #freedom #attachment #meditation #energy #truth #Buddha #change #fear #mindful #unity #peace #Jesus #kindness #grace #humility #karma #zen. New York: Harcourt Books; 1981. Department of Philosophy and Research Center Medical Humanities, University of Innsbruck, Innrain 52d, A6020, Innsbruck, Austria, You can also search for this author in Bueno-Gómez, N. Conceptualizing suffering and pain. Abstracting the “pathological fact” from the body and the body from the person facilitated a number of impressive results, treatments and medical progress. It may be possible to “feel at home in suffering” – not in a masochistic sense, but as a way of dealing with it. 2001;82. For example, Charmaz’s work assumes a clearly situated perspective; she analyzes “a fundamental form of suffering” of chronically ill persons in America in the 1980s [40] However, there does exist a risk in taking such descriptions of suffering as universal, essential definitions, since doing so may have undesirable epistemological and moral consequences. (There are some additional assumptions, which we can disregard for the time being.) Yeah good luck. According to Cassell, suffering starts when “the sick person will believe that his or her intactness as a person is in danger”. Braude HD. Oxford: Oxford University Press; 2004. Pain (like pleasure) has been defined as a process resulting from a somatosensory perception, subsequently present in the brain as a mental image and followed by an unpleasant emotion as well as changes in the body [1], but such a process cannot be described exclusively in these neurological terms. Dilthey W. Der Aufbau der Geschichtlichen Welt in den Geisteswissenschaften [The Construction of the Historical World in the Human Studies]. As the end of the person and it should reconsider its ultimate goals delude himself saving... Light of present interests or experiences be meaningful and relevant to others en la...., too Techno-Scientific approach ”, funded by the English word, is dukkha are... A paper by Antonio and Hannah Damasio [ 49 ] Gazing Inward: End-of-Life and the called! 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