Suffering

Suffering: So it goes
Copyright 2013 David J. Bookbinder. All Rights Reserved.

Helen Keller once said that the world is full of suffering, but also of the overcoming of it. But it is also full of suffering that is unrelieved.

I have thought about suffering most of my life. When I was much younger, I wanted to be a psychotherapist, but I didn’t think I could bear the suffering of 20 to 30 people each week. So instead I became a writer and teacher. By the time I reached my 50s, however, I’d had my fair share of suffering, both situational and self-inflicted. Because of what I had endured, I was no longer afraid to bear the suffering of others, and I began my training.

In this profession, I see, and empathically experience, a wide variety of misfortunes and maladies. In any given week, the forms of suffering I might witness include anxiety, depression, abuse, neglect, illness, financial collapse, addiction, poverty, loss, death, relationship struggles, shame, jealousy, rage, loneliness, disappointment, despair, hopelessness, and, potentially, suicide, as well as an equally wide range of self-inflicted pain that replicates problems from the past. Sometimes I am able to help transform this suffering. Sometimes, all I can do is feel and accompany it.

There are many kinds of suffering that I cannot relieve. I cannot undo the traumatic events of the past, much as I might wish I could. I cannot remove the anguish caused by loss. I cannot alter biology. I cannot erase the recognition that everything we love, everything we know, will ultimately crumble to dust, and that dust will be dispersed, and even the dust will eventually disappear without a trace.

Although all of this is obvious, what may not be as apparent is that my helplessness is itself a source of pain. As an antidote, I remember a quote by Gandhi that my first internship supervisor posted on his door: "Whatever you do will be insignificant, but it is very important that you do it." I think of suffering I have endured, and how the difference between bearable and unbearable was almost always the presence of someone who cared, who I knew was willing to ride along with me no matter where my suffering led us. I think, too, of great humanitarians such as Mother Theresa, who would pass through crowds of thousands whose suffering she could not hope to alleviate, but whose bearing witness to it still made a difference.

During my first counseling psychology internship, my own therapist suggested that I create a name for my future private practice and write the first paragraph of a brochure. Although we both knew it would be years before I would have such a practice, I did the exercise anyway. My working title was "True Companion," after a love song by Marc Cohn. The first paragraph of my hypothetical brochure read:

"I am a deep listener, committed to following my clients as they ride the sometimes smooth, sometimes roller-coaster-like pathways of their lives. I sit beside them, a true companion on their trip for as long as they wish me to be their therapist. I feel – and hope to generate – a sense of deep acceptance, as if I am extending a force field around them, providing a taste of what it is like to be loved, seen, protected, and empowered."

The idea of accompanying is still central to my approach. I have also, however, tried to clarify the kinds of suffering that I might actually be able to allay. These are the broad categories of suffering I have observed:

1. Physical suffering caused by congenital infirmities, injury, disease, and aging.
2. Suffering caused by difficult circumstances.
3. Self-inflicted suffering caused by our reactions to the conditions of our lives.
4. Suffering caused by sensing that things are seldom fully as we hope them to be, that even those that are cannot stay that way, and that ultimately all of it ends when we die.

I find I can only occasionally help with the first two forms of suffering, physical and circumstantial. Sometimes I can sense when a psychological problem might have a physical origin and can persuade a client to get medical help. Sometimes I can help a client strategize a way around or out of difficult circumstances. But with the third type of suffering, however, I can often have more sway.

I can help people cope with things they cannot change, either in their pasts or in the present. I can help them learn to accept whatever limitations and losses they have experienced. I can help them develop new skills for managing their emotional states, for responding differently in relationships, and for actualizing potentials that have lain dormant within them. I can help them find allies, separate from detractors, and break out of dysfunctional patterns that heretofore imprisoned them. Through all of this, I can also help them become more resilient, so that when the next blow comes, though they may not be able to avert it, the impact is more easily endured and its suffering, eventually, overcome.

Compared to the magnitude of the world’s suffering, what I do may be insignificant, but in the lives of the people I am able to touch, I can see that it is important that I do it. At the end of most days I feel I have fostered some good that might not otherwise have occurred. This gives both an easement of, and a meaning to, my own suffering, without which I may never have attempted this work.

I know that understanding suffering will be a lifelong endeavor, but these are some things I have learned that will, I think, stay true for me until the end.

I’ve come to see that self-inflicted suffering is the most persistent. I have witnessed amazing triumphs over many kinds and degrees of physical and circumstantial suffering. As a species, we seem well equipped to bear pain, poverty, adversity, illness, injury, and losses. Paradoxically, the less tangible suffering is what many of us find most difficult to endure, the suffering created within our hearts and minds.

A decade ago, I lost to suicide a close friend who, like me, had nearly died about ten years earlier. Left for dead on a cot in a small hospital in a remote area of Thailand, he suddenly showed signs of life and was airlifted to a major hospital in Bangkok, where he slowly recovered. His spinal cord, however, was seriously damaged, and the accident left him quadriplegic. Unwilling to accept paralysis as his fate, he demonstrated heroic resilience, eventually regaining most of the use of first his hands and arms, and then later his legs. By the time we met, although he walked with the aid of a cane, he had regained most of his ability to function. But when he reached the limits of his physical recovery, he began to relapse into old patterns of addiction, hopelessness, and despair, and ultimately took his own life. His despair seemed rooted not in the physical pain and limitations of his unhealable injuries, but in his realization that this was all he was going to get back. He saw his injured self as fallen, bereft of the qualities he valued most in himself – his appearance, his agility, his ability to make beautiful things with his hands. These would not return, and he could not bear the thought of continuing without them.

In my own life, the most trying forms of suffering have not been life-threatening illnesses or being a crime victim, but rather emotional and psychological ones: recurrent feelings of loneliness, fear, depression, shame, and anxiety, among others, often dating back to early childhood wounds.

I have come to see that hoping for a time of no more suffering causes more suffering. We often think: If only we had this or didn’t have that, then we would be happy. If only I had a girlfriend. If only I had a job. If only I didn’t have this illness. If only my husband would... my children would... I could...

I don’t mean that we can never be happy. Far from it. Or that much of our suffering cannot be avoided or mitigated. Far from that, too. But it seems important to remember that none of us is likely to be spared the suffering of illness or the loss of a loved one or a difficult turn of fortune, and that nobody escapes death. Attempts to avoid all suffering often add to anxiety about potential loss, or frantic efforts to make things that are already changing stay the same, or to striving for "perfection" when "good enough" is something to be grateful for.

The most startling example is denial of death. As a people, we seem increasingly preoccupied not only with looking and feeling younger than we are, but also with extending health and life indefinitely. Google, for example, recently announced a new medical company called Calico whose aim is to take on aging itself. Ray Kurzweil, pioneer inventor in the fields of optical character recognition, text-to-speech machines, speech recognition, and music synthesizers, is now devoting his life to extending it. By taking advantage of a series of existing and projected advances in technology, he hopes to live long enough to be successfully frozen, and then, ultimately, to "upload" his mind into a non-biological brain, outrunning death itself.

But is "more" life actually "better"? I have often pondered this question. One outcome of my 1993 near-death experience was the visceral understanding, just before I blacked out, that all lives, regardless of their lengths, are lives, just as all books in a bookstore are books, and all of them are complete. Had I died at 41, my life would have been a shorter but still complete one. If I live to twice that age, my life will still be, only a single completed life. Despite 50 years of reading science fiction, the notion of living forever appeals only to my sense of curiosity: I want to know what happens next. But I can let that one go. There is a purposefulness to entering this final stretch of my life that is enhanced by a growing awareness that I will not return from my next experience of death. The low-level sense of dissatisfaction that comes from awareness of mortality, I believe, can be alleviated not by striving for immortality, but by accepting that this is how things are.

Some cultures teach that we should be grateful to suffering because of what we can learn from it. I am not yet there. But I do not believe that suffering imprisons us. We are all suffering somehow, but there is nothing unfair about that. As the Buddhists say, this is the nature of samsara, the endless cycle of birth, suffering, death, and rebirth. So it goes.

Text and images © 2013, David J. Bookbinder. All rights reserved.
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