suffering
Finding freedom
Edith Eger, a Czechoslovakian Jew, was only sixteen when, in 1944, she was deported to Auschwitz. She was sent on death marches and into forced slave labour, where she endured unimaginable horrors, starvation and brutality. She was made a human shield for Nazi ammunition in a thin striped dress lying on top of German trains. And finally, emaciated and infested, she was left for dead in a pile of bodies.
After her liberation it took years for her to work through the trauma and damage and guilt, overcoming enormous obstacles – both external and internal – to become an acclaimed psychologist and psychotherapist.
Her book,The Choice, (written with co-author, Esme Schwall Weigand) is not simply another account of survival during the Holocaust. That’s a profound and powerful part of it, but Dr Eger weaves her own personal experiences together with clinical cases where, in her professional capacity, she has used the wisdom she gained to help her patients to confront their suffering and free themselves from the shackles that imprison their minds. And in the process she finds her own redemption.
She writes stories:
…stories of choices, big and small, that can lead us from trauma to triumph, from darkness to light, from imprisonment to freedom.
She shares deep and wise insights:
Suffering is universal. Victimhood is optional.
There is no hierarchy of suffering.
Our painful experiences aren’t a liability – they’re a gift. They give us perspective and meaning, an opportunity to find our unique purpose and our strength.
It’s not what happens that matters – it’s what you do with it.
She has high ambitions:
…to help you escape the concentration camp of your own mind and become the person you were meant to be.
…to experience freedom from the past, freedom from failures and fears, freedom from anger and mistakes, freedom from regret and unresolved grief – and the freedom to enjoy the full, rich feast of life.
She knows her own limitations:
Overcome? I haven’t overcome anything. Every beating, bombing, selection line, every death, every column of smoke pushing skyward, every moment of terror when I thought it was the end – these live on in me, in my memories and my nightmares. The past isn’t gone. It isn’t transcended or exised. It lives on in me. But so does the perspective it has afforded me: that I lived to see liberation because I kept hope alive in my heart. That I lived to see freedom because I learned to forgive.
She has arrived at a most important perspective:
…the biggest prison is in your own mind, and in your pocket you already hold the key: the willingness to take absolute responsibility for your life; the willingness to risk; the willingness to release yourself from judgment and reclaim your innocence, accepting and loving yourself for who you really are – human, imperfect, and whole.
Revisiting Auschwitz, she discovers a profound anomaly:
This is the geometry of systematic torture and death. Mathematical annihilation.
The immensity crushes.
There is no language that can explain the systematic inhumanity of this human-made death factory.
Here in the world’s biggest cemetery there is not one single grave.
A colleague, Professor Philip Zimbardo, sums up the reach of The Choice:
…extraordinary chronicle of heroism and healing, resiliency and compassion, survival with dignity, mental toughness, and moral courage. All of us can learn from Dr Eger’s inspiring cases and riveting personal story to heal our own lives.
The clock is ticking …
Big week this week. Tomorrow (29 November) Westminster Parliament will debate and vote on the Assisted Dying Bill in England and Wales – or more properly The Terminally Ill Adults (End of Life) Bill.
NB. Scotland has formulated and debated its own version of the legislation for assisted dying which is currently being examined minutely by Holyrood’s Health Committee, although they will be unable to proceed to formally legalising assisted dying without authority from Westminster.
It’s an emotive and conflicting topic, and I can see arguments for both sides. But it’s by no means as straightforward as some suggest. Of course, no one wants people to die horrible painful undignified deaths, but is medically assisted dying the answer?
Proponents of the proposed new bill claim that safeguards will be stringent; in essence:
- Patients must be over 18, registered with a GP for at least 12 mths
- 2 independent doctors must be involved in the decision
- They must ensure there is no coersion or pressure, the decision is voluntary and informed and a settled wish, and the patient is fully aware of other options, eg palliative care, and that they can change their mind at any time
- An expert should assess mental capacity
- The patient must declare their wishes for death on two separate occasions, witnessed and signed
- A high court judge must approve the case
- The Chief Medical Officer must monitor and report on how legislation works in practice.
Stringent …? Ahem. That’s just how such bills were introduced in countries like Netherlands, Canada, Belgium. Within a few short years the safeguards had already been eroded. Scary statistics and reports show a huge escalation in numbers dying this way, and they include couples choosing to die together, young people with autism or anorexia, people who are depressed or lonely but otherwise well, young children. Indeed in the Netherlands plans are in process to allow the healthy elderly (>75) to be helped to die if they undergo 6 months of counselling.
And there’s another stumbling block which hasn’t had much airing. Human rights barristers and legal scholars have warned that slippage is not just likely but inevitable, because to deny other groups of people access to assisted dying would be seen to contravene the European Convention on Human Rights, and be discriminatory. So initial qualifying conditions are sure to expand here as they have done elsewhere regardless of the care taken with framing the law.
Even if all the intentions are really sincere, there are issues too with the criteria themselves. We all know medical prognoses can be wildly wrong. Who can really confidently predict death will occur within six months? Senior practitioners and experts in palliative care agree, it’s impossible until very much closer to the end than ‘months’, and research has verified this fact. Then, who is going to train doctors in this additional work? How will the medical world deal with doctors whose consciences don’t allow them to be party to this service, even referring patients on? Are there going to be enough high court judges available and willing to add this task to their existing load? Prominent legal experts have already questioned the role of the judiciary in what is essentially a medical matter.
Then there’s the whole question of viable alternatives. Hospice care is an amazing service and certainly one I personally support wholeheartedly. It focuses on living well right to the end. It’s sensitive to all aspects of a person’s well being – physical, emotional, spiritual, psychological. It includes caring for the whole family. What’s more, it is already assisting people to die humanely and compassionately. But – and it’s a colossal but – we all know that palliative care is woefully underfunded and its availability seriously limited. Only a small fraction of its total cost is paid for by the Government. In order to survive at all it must rely heavily on fundraising, and the escalating cost of living crisis has meant the generous public now have less to donate. As a consequence of this proposed new legislation, it’s feared governmental support will be reduced further if hospices deline to sign up to ending lives in line with the new bill.
Another avenue that’s under-utilised is that of Advance Directives or Living Wills, legally binding documents that state a person’s wishes for the future in certain circumstances or conditions where they might not be able to convey those choices for themselves. Withdrawing or withholding treatment is legally permissible already. However, only a small proportion of the population fill out such an expression of their wishes.
Should we then return to the pre-Shipman era where doctors could give sufficient opiates to end pain and distress, even if the double effect was to hasten death? This was generally regarded as a kind and compassionate response to intractable suffering before suspicion clouded the supposed intentions of healthcare providers.
This is by no means an exhaustive discussion of the issues, but hopefully underlines the need for huge care in deciding on this matter while there is still time. As one doctor put it: It’s a dangerous trajectory from which there can be no return.
Making sense of suffering
Some news just feels overwhelming, doesn’t it? This week it’s the devastating earthquakes in Turkey and Syria. Thousands killed, even more injured, families broken, countless people rendered homeless, houses and businesses reduced to rubble. How can anyone make sense of it?
It took me back to a book I read donkey’s years ago, first published in 1977, revised in 1990: Where is God when it Hurts? by Philip Yancey, which I still have on my shelves. I’d forgotten how honestly it addresses the difficult questions, and how much sense it talks, though I don’t share all his fundamental premises, nor indeed come to exactly the same conclusions. But Wondering about God is an almost universal part of the experience of suffering seems a fair starting point. And it’s eminently readable.
Many years ago, the young Yancey was blown away by the insights given to him by Dr Paul Brand who worked in a colony for lepers in India and taught him that pain is essential to life and health. Without the ability to feel pain – because of diseases like indifference to pain syndrome, leprosy, advanced diabetes and alcoholism – the individual is at great peril of damage and even death. The first 66 pages are devoted to establishing this fact in a most engaging way.
Looking beyond the medical dimension, the author points out the importance of perspective. Individual pain is a very different thing from a biological appreciation of the wonderfully designed nervous system, or a philosophical discussion of the sum total of human suffering.
Pain may have been intended as an efficiently protective warning system, but something about this planet has gone haywire and pain now rages out of control.
Perhaps suffering is a better word for our purposes to capture the breadth of agony humans are subject to. Look around you at the earthquakes and tsunamis, deadly viruses and bacteria, chromosomal anomalies and diseases, and the question becomes, How can God allow intense, unfair suffering?
Yancey sees much of the suffering on our planet as a result of two principles which operate: a physical world that runs according to consistent natural laws, and human freedom.
Suffering caused by man’s freedom? Well, we’ve all seen human’s capacity to foul things up – just look at climate change. But it’s bigger than that; as Yancey puts it, the inhabitants of this world have been emitting a constant stream of low frequency distress signals, for a long time. The planet is groaning. The God Yancey believes in is sorely displeased with what man has done on and to this earth; that it still exists is a measure of his mercy not his cruelty.
For CS Lewis, famed for his insight into suffering, God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains. Pain is His megaphone to rouse a deaf world – to draw our attention to what mankind has done to ruin things.
Examples from real life are scattered throughout the book, but some sixty plus pages in the middle are devoted to details about outstanding people who came through catastrophic suffering and responded in astonishing ways – not all in accordance with Yancey’s own conclusions incidentally. There are, of course, many contrary instances of people destroyed by suffering, but Yancey’s examplars have all achieved a state of being, inner strength and courage, that leave me totally humbled. I’m pretty sure I would not have responded to unremitting pain, quadriplegia, and utter dependence as they have done. Does this hold a clue to questions about the value of suffering? You’d need to make up your own mind. But whatever else, these extraordinary lives of creative suffering will challenge you.
Yancey’s own experience of being alongside those who are struggling confirmed for him the ‘megaphone value’ of pain, and he has no glib answers. Knowledge of what pain is and how we deal with it can be used to handle its consequences better, but there are no definitive satisfying answers to the problem of Why?, no magic formula as to how to help effectively. What people need is love – especially when God seems to have forsaken them – the kind of love that instinctively understands and supports.
There are lots of helpful tips and hints in Part 4 of the book, hints on how to reach out to others when we have no answers, and how to learn acceptance – without blame or anger or fear – of those things which we simply don’t understand. But for the purposes of this post I’ll single out a few useful conclusions:
The Why? question is unanswerable and religious platitudes are at the very least unhelpful and can be positively damaging. It’s more important to ask, not ‘Why has this happened to me?’, but ‘What should my response be?’
Yancey would change the question, Where is God when it hurts? to Where is the church when it hurts? He writes: We form the front line of God’s response to the suffering world.
Meticulous controlled scientific experiments have concluded that hope, faith and a purpose in life are medicinal. Courageous hope can’t be taught, but it can be caught. Strong moral and religious conviction certainly play a significant role in coping and endurance.
Thinking less of oneself and more of others, looking outward rather than inward, can be hugely beneficial to personal growth and spiritual health.
The greatest happiness comes in sacrificial service – through pain we can find pleasure. We see the finest examples of this truth in those selfless people who devote their lives to helping others without recognition or remuneration.