When Professionals Weep: Suffering and Care Providers

Article excerpt

Every day, thousands of professionals-physicians, nurses, social workers, psychologists, clergy, nursing assistants, physical therapists, volunteers and others-provide skilled and compassionate care to those who are suffering and in need. While doing so, they negotiate a delicate interplay of their own unspoken needs and expectations with those of their patients. Helping professionals, though they care about their patients, may resist getting close enough to recognize, understand and share in the patients' suffering.

Rita Charon, director of the Program in Narrative Medicine at Columbia University, calls this phenomenon parallel suffering, where the suffering of the patient and the suffering of the professional remain separate. By distancing from a patient's suffering, the clinician loses opportunities not only to strengthen the patient's ability to fight for hope-such as the hope that the patient will be able to endure physical, emotional or spiritual pain-but also to help the patient find meaning in his or her struggle. When distancing happens, sick and dying people are left isolated and alone in their pain and suffering.

BEYOND PHYSlCAL PAIN

The relationship between pain and suffering is complex; if left unrecognized and unaddressed, neither will be alleviated. In an attempt to reduce pain, medical practitioners may not notice the extent of the patient's emotional suffering and, thus, target their interventions exclusively to the physical pain. However, complete cessation of physical pain cannot be achieved without concurrently addressing emotional or psychological pain.

Working with dying and bereaved patients and families requires that we professionals look at our internal resources regarding our ability to work with those who suffer. In their book How Can I Help? Stories and Reflection on Service (New York: Knopf, 1985), Ram Dass and Paul Gorman emphasize that to enable patients to reperceive their pain so they can become more comfortable, we must offer support that comes from the truth of our being. That is, we must offer assistance that comes from a genuine and empathie place in ourselves.

It is difficult to be present and willing to accompany those who suffer through their pain. Many helpers, in an attempt to feel safe in their feelings, retreat from the pain of their clients by becoming objectively professional. This retreat often manifests as distancing or aloofness.

Staying close to a patient can be especially hard when the sufferer weeps: The tendency is to want to comfort the individual by stopping his or her tears. Psychotherapist Irvin D. Yalom suggests in The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients (New York: HarperCollins, 2002) that the helper may wish to encourage sufferers to go more deeply into their tears by inviting them to share their thoughts about the tears. Also helpful can be encouraging people who are suffering to explore their pain, not aggressively, but in a gentle way that allows them to experience compassion for themselves and what they are enduring.

BEARING WITNESS

As caregiving professionals, we must not only encourage our patients to give voice to their suffering but also be ready to accompany them into their pain. …