A Reframing Approach to Chronic Illness

In ways I don’t fully understand, those who frame pain as spiritual, meaningful, redemptive, or even a divine mystery seem to fare better than those who consider pain mere biology. While I have only anecdotal proof of this, reframing pain in a well-chosen narrative, often called a, “metaphoric approach to pain management,” apparently unleashes some sort of analgesic that ameliorates pain in some … at least a little.

My wish to banish other’s pain entirely is futile–I’m neither doctor, magician, or faith healer. But some sufferers of chronic pain have found the reframing approach helpful and I’m happy to describe it as best I can so others may benefit. Here are the popular frames that have alleviated pain in some.

1. “I suffer from an illness, not merely a disease.” According to this definition a disease is biological and pathological. An illness however is philosophical and subject to interpretation. Disease is a mechanistic sensation, a function of nerve endings. Illness is a story we tell ourselves about pain. An analogy: water boils on my stove because the burner is 212° Fahrenheit. But it also boils on my stove because I want a cup of tea. The scientific cause alone isn’t sufficient to explain why the water is boiling. We need the philosophical cause, too. So too with pain. We need more than just an explanation for the biomechanics of disease. We need a narrative explanation for illness, too.

2. “The meaning of pain changes the pain itself.” Many people endure pain voluntarily because it means something: the pain of cutting means emotional relief, the pain of martyrdom means reward in heaven, the pain of getting a tattoo means looking cool, the pain of childbirth means she gets a baby, the pain of open heart surgery means he gets a new life-saving valve, blisters and muscle ache means a marathoner will finish the race, austerity/asceticism/fasting means advancing spiritual goals, the teenager who walks to school in winter without a coat means he’s tough, elective cosmetic surgery means increased beauty, boot camp means “weakness is leaving the body.” Those who attach meaning to their elective pain endure it better than those who see pain as pointless. Sufferers of chronic pain who attach new meaning to their suffering experience, so I’m told, greater resiliency.

3. “Faith makes pain a bit more manageable.” I never met anyone who refused medical help in favor of mere faith (though we read horror stories once in a while of parents who deny children proper medical treatment). But those who’ve found western and alternative medicine wanting have added these frames: “God allowed this for a purpose,” “I’m being tested,” “I’m following in the footsteps of my Savior who suffered,” “This cross [thorn, whirlwind, snare, trap, pit, net] is going to accomplish something good,” “I’m going to be a better person when this is all over,” “I’m storing up rewards in heaven,” “Chronic pain reminds me I’m a child of Adam battling unholy desires,” “In this world we’ll have tribulation,” and “Oh God give me the grace to get through this hell.” How does it work: placebo, miracle, trance? I don’t know.

4. “Pain is part of some bigger meaning.” Narrative therapy means we tell ourselves stories about our lot in life. If the story is, “My pain is a horrific joke played by a cruel and indifferent universe,” we’ll experience certain feelings. But if that story is, “Pain is a part of God’s plan,” we will (so I’ve been told) experience different feelings. St. Thomas Aquinas said, “The contemplation of divine things suffices to reduce bodily pain.”

5. “Shared sorrow is half the sorrow” (the corollary being, “Shared joy is twice the joy”). I don’t have hard data to prove this but it seems to me those who have an understanding and supportive mate, family member, doctor, or friend who loves the sufferer fares better than those who suffer alone. Is empathy analgesic?

If my 30+ years of pastoral and therapeutic observations mean anything, it appears to me that those who obsess over pain, avoid pain, reject pain, resent pain, and fight pain suffer more than those who face pain, accept pain, and resign their pain to divine providence. I know this approach isn’t ideal; I wish I could make others’ pain go away. But if the reports of the heroes I’ve met count, giving a religious meaning to pain helps.

Leave a comment


  1. Mike g

     /  March 8, 2011

    Erik, that was very interesting….

    You probably know that there was a joint and spine ad just following your ariticle.

    Blessings Brother,

  2. Yuk Hanford

     /  August 23, 2012

    Muscle aches can be remedied as fast as possible by taking in OTC pain killers like ibuprofen but be advised that they have some side effects too..:.:,

    Thanks again http://healthmedicinelab.com/sleep-deprivation-symptoms/


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