Saturday, 16 July 2016

Suffering and hope

When we’re caring for someone going through difficult experiences in their life, there are two main things we need to do: acknowledge suffering and offer hope. 

I’m going to explore these two themes in a series of posts over the next few weeks.  
Let's start with acknowledging suffering.
Suffering may be expressed in the poetry of Gerard Manley Hopkins: No worst, there is none. Pitched past pitch of grief/More pangs will, schooled at forepangs, wilder ring […..] O the mind, mind has mountains; cliffs of fall/ Frightful, sheer, no-man-fathomed. 
Or in the paintings of Francis Bacon – currently on exhibition in Tate Liverpool - portraying his subjects ‘enclosed in the wretched glass capsule of the human individual’.
Or in the expression of collective suffering when (as WB Yeats puts it) ‘Things fall apart; the centre cannot hold; Mere anarchy is loosed upon the world’:  be it the continuing effects of the Iraq war or the migration forced by political turmoil in Syria and Libya.
Or in the bristling, frustrated anguish of 19 year old Darren, piercings through lip, nose and eyebrows, scarring up both arms, who tells me about parental separation, fostering and sexual abuse, bullying in school; and how booze keeps him from feeling too much but leads to fights with friends, nightclub doorman and police. His only comfort is beating the hell out of his drum kit in the middle of the night.  He doesn’t think he’ll live much longer, and I fear he may be right. 

The first thing we need to do is to listen. In the words of the British psychoanalyst Wilfred Bion, we should be listening ‘without memory or desire’: when we listen with memory, we are intent on making the speaker part of an old agenda; when we listen with desire we are intent on making them part of a new one.
To listen purely, to just listen, is the most valuable thing. But it is also the most difficult thing. I don’t know about you, but I often find it exhausting, debilitating, to give my full attention to the suffering of others.
We often find ways to protect ourselves – to distance ourselves - from the full emotional impact of what our patients are trying to tell us. A bit of me doesn’t want to hear what Darren is telling me – it’s too raw, too real, too painful.   
But we can do better.
Ronald Epstein recommends that we turn toward suffering: actively seek to recognise it, become curious about the person’s experience, and intentionally become more present and engaged. 
What help me to turn toward suffering are daily mindfulness meditation, my weekly 5k parkruns, and being able to discuss knotty problems with my wise wife Sue.
What helps you turn toward suffering?   
Next time - the first steps in offering hope.


  1. Dear Chris
    Thank you for this. As a GP my ideal is to offer this level of listening to my patients. As a human being trying to see 40 patients per day, I become too exhausted. I suspect many, including policy makers, don't see such pure listening as part of the GP role. How to remain a GP, but offer the kind of care to my patients that you describe? Kind regards, Ros Johnston

    1. Hi Ros,
      Absolutely - the urgent and greatest challenge for our profession? Might be a cop out, but for me - one element has been getting better at listening to ( allowing myself to listen to) my own suffering. So I can then listen to others ... ? I know I really struggle to listen to particular stories that are too close to one of my own at the mo. I also talk with patients about doing the themselves 'space'/permission to acknowledge their own suffering ( when they feel like they are all used up with other peoples' suffering?).
      But we do also need to change the 'system' we work in too!
      Come the revolution...?!
      Bye for now
      Joanne ( also a gp)