Pain, Suffering, and Redemption: Where Faith and Reason Mingle

Much has been said about the compatibility between faith and reason, religion and science. But they are more than parallel tracks that share mutual respect. Rather, they are integrated; they inform one another. In a particular way, the relationship between pain, suffering, and redemption may be the prototype by which the integration of faith and reason can be especially appreciated.

What is the intelligible pattern behind pain, suffering, and redemption? Pain is understood through the eyes of science; redemption is seen through the lens of faith. Suffering is the bridge between the two. It is what links pain to redemption. It is the link between physiology and theology. Suffering is where the human and divine meet. You cannot understand redemption unless you understand suffering, and you cannot understand suffering unless you understand pain. Pain and suffering drive us toward Jesus.

Pain and suffering — two words often used interchangeably, yet they are not the same. Pain does not necessarily cause suffering. The pain of childbirth can be extremely severe, but it is endured or even experienced as rewarding. Athletes readily submit themselves to painful workouts, knowing that they are more likely to succeed in competition. Catholics have a particularly complicated relationship with pain. We do not seek it for its own sake, yet the experience of pain is at the heart of asceticism or acts of mortification.

And then there is the question of suffering. While not exclusive to Catholics, suffering as redemptive is a very Catholic thing. The mention of “redemptive suffering” to most non-Catholics is likely to be met by a quizzical shrug, as if to say “I have no idea what you are talking about.” Furthermore, the Catholic tradition does not speak of “redemptive pain” but rather “redemptive suffering.” So there appears to be a hierarchy: not all pain leads to suffering, not all suffering is redemptive.

Things become even more complicated when the obvious is acknowledged: pain is experienced on multiple, intertwined levels. The physical, psychological, and spiritual are all connected when it comes to pain. Physical pain can lead to emotional distress and psychological problems can manifest through physical symptoms.

So there are a number of questions that need to be answered: How is pain experienced? When and how does pain lead to suffering? When and how does suffering become redemptive? To answer these questions, we need to look at the physiology, phenomenology and theology of pain and suffering.

Physiology of Pain and Suffering

For ease of simplicity, I will focus primarily on the experience of physical pain. The anatomy and physiology of physical pain has been extensively studied and is fairly well understood. Emotional or psychological pain are equally as important but not as easily quantified.

First and foremost, physical pain is a good thing. It is protective. It raises an alarm that something is wrong in the body, motivating the person to do something to reduce it. Touching a hot stove results in the immediate response of withdrawing the hand, even before the actual perception of pain reaches consciousness. The lack of pain has serious consequences. Leprosy is a long-term mycobacterial infection that leads to damage of nerve cells which may result in an inability to feel pain, which can lead to the loss of parts of a person’s extremities from repeated injuries or infection through unnoticed wounds. Congenital insensitivity to pain and anhidrosis (CIPA) is an inherited disease where there is an inability to feel pain and temperature, and decreased or absent sweating (anhidrosis). The signs and symptoms of CIPA usually appear at birth or during infancy. The inability to feel pain and temperature often leads to repeated, severe injuries and unintentional self-injury is common.

The perception of pain is a quite complicated process, involving pain receptors, neurotransmitters, pathways through the spinal cord, processing in the brain and so on. A detailed explanation of the anatomy and physiology of pain is not needed for our purposes, but some understanding is helpful.

There are a variety of pain receptors scattered throughout the body. Also called nociceptors, pain receptors respond to three types of noxious stimuli: mechanical, thermal and chemical.

The painful messages are relayed up the spinal cord to the thalamus. In turn, the thalamus serves as the major “relay station” for sensory information to the cerebral cortex. The brain does not passively receive pain information from the body, but instead actively regulates nociceptive information by descending pathways to the spinal cord. A host of neurotransmitters (norepinephrine, GABA, and others) are involved with the perception and modulation of pain

Pain can be reduced or even eliminated by targeting one of the elements of pain perception and this has been the focus of most medical treatment of pain. For example, opioid receptors are found throughout the nervous system. Both endogenous opioids (e.g. endorphins) and exogenous opioids (e.g. morphine) bind opioid receptors, triggering a series of chemical changes within and between neurons that lead to feelings of pleasure and pain relief. Cannabis and cannabinoids act by binding specific receptors or reducing inflammation.

More recently, neuroscientists have identified that pain and suffering, while related, are processed in different parts of the brain. Furthermore, acute pain is distinct from chronic pain. Chronic pain is described as pain that extends beyond the period of healing of the original insult or injury. Typically described as pain lasting more than three months, chronic pain involves distinct mechanisms in the brain, and it can be recognized as a health condition in its own right.

Pain and suffering are processed in separate but interrelated networks. Painfulness, the experience of pain, is largely processed in the cortex of the brain. Pain sensation leads to suffering via a cognitive, emotional and autonomic processing, and is expressed as anger, fear, frustration, anxiety and depression. Suffering, by this definition, is processed in a separate part of the brain, the insula. Separate processing of suffering and pain is demonstrated by surgical procedures, such as fontal lobotomies or stimulation of the cingulate gyrus. With these procedures, physical pain is not eliminated but the patient does not suffer. Conversely, patients with congenital insensitivity to pain do not experience painfulness from noxious stimuli but can experience suffering by seeing others in pain. One can have pain without suffering and suffering without pain.¹

Pain treatment, therefore, can target one or more of these pathways. Medications, surgical procedures, therapy can be used to modulate these pathways to reduce pain and suffering. What is interesting for our discussion is that meditation or prayer results in structural changes in areas of the brain involved with the “suffering” pathway.²

Phenomenology of Pain and Suffering

Physicians intend to alleviate pain and suffering, but often the two are lumped together. Yet it is clear that suffering and pain are distinct experiences. In 1982, Eric Cassell published “The Nature of Suffering and the Goals of Medicine.”³ In this seminal article, Cassell observed that physicians are obliged to relieve human suffering, yet very little attention is given to the problem of suffering in medical education, research or practice. He observed that suffering is not confined to physical symptoms, and that suffering occurs not only from a disease but also from its treatment. He made three points. The first is that suffering is experienced by persons and ignoring someone’s personhood leads to suffering. An understanding of personhood in human illness requires a rejection of a dualistic split between mind and body. Secondly, suffering occurs when a person perceives impending destruction and continues until that threat has passed or the integrity of the person restored. Finally, suffering can occur in relation to any aspect of the person, including social roles, group identification, relation with self, body or family, or the relation with a transcendent source of meaning.

What are the implications of these observations? If the mind-body dichotomy is accepted, then suffering is either subjective or identified exclusively with bodily pain, which results in the depersonalization of the patient, creating its own source of suffering. As Cassell states, “It is not possible to treat sickness as something that happens solely to the body without thereby risking damage to the person. An anachronistic division of the human condition into what is medical (having to do with the body) and what is nonmedical (the remainder) has given medicine too narrow a notion of its calling . . . [which may] do things that cause the patient as a person to suffer.”

According to Cassell, suffering is experienced when a person perceives pain as a threat to their continued existence and their integrity as a person. This occurs when pain is overwhelming, when its source is unknown, when the meaning of pain is dire or when it is chronic. This suggests that suffering can be relieved by making the source of pain known, changing its meaning, demonstrating that it can be controlled, and the end is in sight. Cassell touches on suffering and theology, noting that in some religions suffering is seen as bringing someone closer to God.

This “function” of suffering is at once its glorification and its relief. If, through great pain or deprivation, someone is brought closer to a cherished goal, that person may have no sense of having suffered but may instead feel enormous triumph. To an observer, however, only the deprivation may be apparent. This cautionary note is important because people are often said to have suffered greatly, in a religious context, when they are known only to have been injured, tortured, or in pain, not to have suffered.

Cassell pushes against scientific reductionism in an understanding of the whole person, “Any suggestion of mechanical simplicity should disappear from my definition of suffering.” Much of the work on the neural processing of suffering was done after his paper was published, but I suspect he would still hold to this statement. As mentioned above regarding the suffering pathway, pain sensation leads to suffering and is expressed as anger, fear, frustration, anxiety and depression. But as Cassell says,

Injuries to the integrity of the person may be expressed by sadness, loneliness, depression, grief, unhappiness, melancholy, rage, withdrawal or yearning . . . But we often forget that the affect is merely the outward expression of the injury, not the injury itself . . . If the injury is sufficient, the person suffers. The only way to learn what damage is sufficient to cause suffering, or whether suffering is present, is to ask the sufferer.

To relieve suffering, the injury or illness itself must be addressed, and relief from pain usually relieves the suffering, but not always. The memory of the pain may cause continued suffering. The injury may be healed but the consequences persist: the pain of an amputation eventually goes away, but life is forever changed. Recovery from suffering often requires the help of family, friends, or groups of those similarly affected. Cassell also proposes that assigning meaning to an injury or illness often reduces the suffering associated with it.

But perhaps his most stunning proposal goes beyond medical treatments and support systems.

Transcendence is probably the most powerful way in which one is restored to wholeness after an injury to personhood. When experienced, transcendence locates the person in a far larger landscape. The sufferer is not isolated by pain but is brought to a transpersonal source of meaning and to the human community that shares those meanings.

Cassell does not think a transcendent experience has to involve religion in a formal sense, but in its transpersonal dimension, it is deeply spiritual.

Redemptive Suffering

Cassell recognizes that transcendence brings the sufferer to a transpersonal source of meaning and to the human community that shares those meanings, thereby ameliorating suffering. This is of course a good thing, but it stops short of suffering as something redemptive.

In the eyes of the world, the existence of suffering is the trump card in arguments against the existence of God. Absent a suffering savior, our afflictions are meaningless. But scripture describes a Messiah who “was wounded for our transgressions, crushed for our iniquities; upon him was the punishment that made us whole, and by his bruises we are healed” (Is 53:5).

St. Pope John Paul II best articulated the nature of redemptive suffering in his apostolic letter, Salvifici Doloris. First and foremost, suffering is universal. In our fallen world, suffering occurs whenever we experience any kind of evil. And since we, as human beings, are a composite of body and spirit, we suffer in this double dimension, experiencing both moral and physical suffering.

In the face of its universal nature, the experience of suffering inevitably stirs up within us THE question: why? Why do I suffer? Why does suffering even exist in the first place? In Salvifici Doloris, St. John Paul draws from the story of Job to help answer this question. The story of Job is the story of a just man who suffers greatly. He loses his family and all his possessions. Why? His friends accuse him of having committed some sin and his is receiving his just deserts from God. But Job protests; he has done nothing wrong; he has no reason to suffer. He cries out to God, demanding a response. Does God provide him with the answer to the question of “why”? Unfortunately for Job, and for us, God does not. Rather, “His suffering is the suffering of someone who is innocent and it must be accepted as a mystery, which the individual is unable to penetrate completely by his own intelligence.”⁴

It would be thoroughly unsatisfying if the only response to the reason for suffering was, “It’s a mystery.” There must be more to it. And there is: “In order to perceive the true answer to the “why” of suffering, we must look to the revelation of divine love, the ultimate meaning of everything that exists. Love is also the richest source of the meaning of suffering . . . Christ causes us to enter into the mystery and to discover the “why” of suffering, as far as we are capable of grasping the sublimity of divine love.”⁵ Suffering is conquered by the love of Jesus Christ. How so?

According to Pope Francis, every suffering person has the need to be heard and to understand that Christ knows what it means to feel alone, neglected and tormented by the prospect of pain.

In the Cross of Christ are concentrated all the sickness and suffering of the world: all physical suffering, of which the Cross is a symbol; all psychological suffering, expressed by Jesus’ death in the darkest solitude of betrayal; all moral suffering, manifested by the condemnation of one who is innocent; and all spiritual suffering, displayed in a desolation that seems like the silence of God.⁶

Eternal life is only possible because of the salvific love of Christ. Even though His victory over sin and death does not abolish our suffering here on earth, it nevertheless throws a new light upon suffering: the light of salvation.⁷

So then, the salvific love of Christ sheds light upon the nature of suffering. But why did Christ have to suffer? Could not his love be shown in some other way? Was it really necessary for him to die on the cross? In short — yes. Yes, it was necessary for Jesus to suffer. Why? John Paul responds emphatically:

Christ goes towards his Passion and death with full awareness of the mission that he has to fulfil precisely in this way. Precisely by means of the suffering he must bring it about “that man should not perish, but have eternal life.” Precisely by means of his Cross he must strike at the roots of evil, planted in the history of man and in human souls. Precisely by means of his Cross he must accomplish the work of salvation. This work, in the plan of eternal Love, has a redemptive character.⁸

It matters that Jesus suffers. It also matters how he suffers. The prophet Isaiah tells of a messiah who will be “despised,” “wounded for our transgressions,” “bruised for our iniquities.” An innocent messiah who suffers voluntarily. A messiah who takes upon himself the sins of the entire world. “In his suffering, sins are cancelled out precisely because he alone as the only-begotten Son could take them upon himself, accept them with that love for the Father which overcomes the evil of every sin.”⁹ Christ gives the answer to the question of suffering through his own suffering.

But Jesus does not stop there. He suffered for us, but he wants us to participate with him through our sufferings. He wants us to share in his sufferings. Through Baptism, we become the adopted sons and daughters of God and heirs to His kingdom: “For all who are led by the Spirit of God are children of God. For you did not receive a spirit of slavery to fall back into fear, but you have received a spirit of adoption. When we cry, ‘Abba! Father!’ it is that very Spirit bearing witness with our spirit that we are children of God, and if children, then heirs, heirs of God and joint heirs with Christ — if, in fact, we suffer with him so that we may also be glorified with him” (Romans 8:15–17). This is one of those good news, not so good news passages. Good news: we are children of God and heirs of God and joint heirs with Christ. Not so good news: provided we suffer with him. If we are going to be glorified with him, we must suffer with him. This is the core of redemptive suffering.

As St. John Paul says, “Every man has his own share in the Redemption. Each one is also called to share in that suffering through which the Redemption was accomplished . . . In bringing about the Redemption through suffering, Christ has raised human suffering to the level of Redemption.”

St. Paul goes even further: “I am now rejoicing in my sufferings for your sake, and in my flesh I am completing what is lacking in Christ’s afflictions for the sake of his body, that is, the church” (Col 1:24). Two things stand out: 1) Paul is rejoicing in his sufferings; 2) His sufferings matter. In a strict sense, nothing is lacking in Christ’s afflictions. His sacrifice was total and perfect, lacking in nothing. So when St. Paul says his sufferings are completing what is lacking in Christ’s afflictions, is he implying that the Redemption of Christ is somehow incomplete? No! What St. Paul means is that Redemption remains always open to love expressed in human suffering: “Yes, it seems to be part of the very essence of Christ’s redemptive suffering that this suffering requires to be unceasingly completed.”¹⁰

Conclusion

What is the intelligible pattern behind pain and suffering? They push us toward Jesus. The journey of pain leading to suffering leading to redemption is best understood in the light of physiology, phenomenology and theology. This continuum is an example of how faith and reason not only are compatible with one another, but even more, how religion and science inform each other. Pain pathways are well described based on scientific methodology. Suffering can also be described in physiological terms, but only to a point. Scientific analysis of suffering comes up lacking. It is intensely personal and defies reductionistic “scientism.” Suffering is best ameliorated by transcendence which does not necessarily equate with faith, but transcendental experience is fundamental to religious faith. The movement of suffering to redemption is indeed mysterious and ultimately is a matter of faith, but not devoid of reason. Faith and reason, religion and science do not run parallel courses; they are separate yet intertwined expressions of truth.