Toward An Adventist Theology Of Health (5) - On Pain

According to the Spanish essayist and philosopher Miguel de Unamuno (The Tragic Sense of Life in Men and Nations, Madrid 1912), pain is the universal human experience of vulnerability and woundedness. It has an objective dimension usually given by the presence of physical damage and a subjective perception conditioned by the religious, cultural and psychological background of the involved person. The distressing feelings and unpleasant sensory and emotional experience is a disturbing challenge because sometimes it lasts beyond our expectations and doesn’t resolve easily. It can touch us in our primordial foundations and certainties and cruelly become an eroding event from within. Its universality doesn't respect age, gender, religion, or ethnicity. When it persists, it compels us to try to understand and make some sense of it, knowing in advance that whatever the resulting description, it will always remain a precarious, fragmented, and insufficient explanation in the unexpected and weary path of life. This unavoidable vulnerability nevertheless – and surprisingly – coexists with a parallel and unquenchable desire for living that universally engraves every human, making one structurally and pre-rationally resilient.

Religion and culture don't create these two universal human conditions: Pain and Resiliency. They only propose well-intentioned paradigms, explanations, and motivations to encourage people to go on. We need to continually revise such explanations in an open, humble, and honest dialogue with ourselves, others, history, and God. In this sense, the Adventist approach to human pain is certainly not the only existing one, not automatically the best, and not necessarily fully Biblical. The dignity, meaning, and reasonableness of the Adventist approach to pain doesn’t uniquely depend on its Biblical foundations or its universal abstract declarations. It must have the wisdom to be aware of its own cultural roots and the openness to perceive specific situations and exceptions. Pain is never a general, impersonal category but always a unique, personal experience with a name.

In fact, even though the experience of pain is universal, the meaning given to it is particular and circumstantial. It is important to briefly describe the meaning pain has had in three different cultural and historical periods.

1. Far-Eastern tradition

Far-Eastern traditions have, generally speaking, an opposite view on pain than Western traditions. That’s visible, for instance, in the teaching of “The Four Noble Truths of Buddhism.”

  1. Pain, suffering, and dissatisfaction are part of a normal life. This suffering is called “dukkha.” Human nature is imperfect, as is the world we live in. During our lifetime, we inevitably have to endure physical suffering such as pain, sickness, injury, tiredness, old age, and eventually death.

  2. Pain and suffering arise from attachment to desires. The cause of suffering is called “samudaya or tanha.” It is the desire to have and control things such as craving of sensual pleasures. Attachment to material things creates suffering because attachments are transient and loss is inevitable. Thus suffering will necessarily follow.

  3. Pain and suffering cease when attachment to desire ceases. The end to suffering is called “nirodha.” It is achieving Nirvana which is the final liberation of suffering. The mind experiences complete freedom, liberation, and non-attachment. It lets go any desire or craving, attaining dispassion. Nirvana means freedom from all worries, troubles, and ideas.

  4. Freedom from pain and suffering is possible by practicing the “Eightfold Path.” This liberation from suffering is what many people mean when they use the word "enlightenment.” The path to the end of pain and suffering is gradually seeking self-improvement through the eight elements. The path to the end of suffering can extend over many lifetimes, throughout which every individual rebirth is subject to karmic conditioning. Craving, ignorance, and other effects will disappear gradually as progress is made through each lifetime.

There are millions of people who have lived and still live according to this understanding. As Christians, we are very critical of this world-view, but, behind the details and particular explanations, Far-eastern tradition has a cultural point to make. For them, the pain in which the transience of human existence expresses itself does not have its own reality. It is only “appearance” and stems from an incorrect attitude toward existence. Therefore, we just need to change our attitudes in face of the world and life. For instance, we must give up voluntaristic obsessions and greed that wants and pretends to control everything. Then pain will be seen for what it really is: “pure appearance.”

2. Judeo-Christian tradition

We’ll not consider here the details of the Biblical teaching on pain and suffering but rather its practical interpretation as it’s widely internalized by most Christians. For the majority of Christian believers, both Catholic and Protestant (and beyond doctrinal differences and nuances), pain is the result of a human fall. It gives birth, in the human soul, to an indelible feeling of guilt that demands to be repaired and, therefore, is susceptible to redemption. In this vision, pain is seen as a punishment and, at the same time, as a purifying agent. As such, it contributes to redemption and salvation. Pain is, thus, not constitutive of existence itself but rather the guilt of existing and, at the same time, a means of redemption. If pain and suffering are the result of a fault susceptible to redemption, this earth and our earthly existence are only transitory. The expected future soothes the cruelty of pain because those suffering today may be liberated tomorrow. Pain is no longer something inevitable in life but something that happened as the result of a fault and, therefore, fundamentally separable from life. That means true life does not know pain, and if life on earth is not exempt from pain, it’s only because life on earth is not the real one, the one for which we were born. This widely shared Christian interpretation often leads to a devaluation of earthly life. “Life is a valley of tears” that, as Isaiah says, finds its justification only in the expectation of a new heaven and new earth. Pain, then, is both the element that leads to devaluation of this world and the most powerful factor that leads to hope and faith.

3. Greek tradition

For the Western mindset, pain, suffering, and human frailty – like everything else in this world – are not just “appearance,” they are true “realities.” But Greek and Christian traditions will explain the status of pain differently. For Classic Greek culture – and in opposition to Christianity – pain is not the consequence of a fault but is constitutive of existence. So we must recognize, accept, and even welcome pain as a structural and a natural component of life, with no illusions of otherworldly hopes for salvation from original sin. Once we welcome the transience of human existence, we then must learn to accept life’s expansion and contraction movements because this is simply the natural condition of mortals which no meta-narrative can really change. The praised Greek “Phronesis” (practical wisdom) consists precisely in this – in the capacity to accept our mortal life as it is and the refusal to be deceived by redeeming hopes or be destabilized by extreme despair. Wise people are led by a temperate wisdom where pain is endurable and tolerable and, within certain limits, even controllable. This is the heroic and tragic component of Greek anthropology.

We see, in these three explanations of pain, a kind of crescendo. Christianity is in between. It’s not so idealistic as Buddhism but not as realist as Greek culture. Now, on a pastoral, catechetical, or worship level, we Adventists don’t need to worry about all those alternative views of pain. We just need to quote the Bible and be lead by the Holy Spirit. But on a cultural, sociological, and anthropological level, when Sabbath is over, we still need – as a caring and responsible church – to think about all this. There are millions of people who have lived, and still live, following these various understandings of life, and some of these ideas have, paradoxically, also become part of our practical attitudes in facing pain. We need to learn, at minimum, to preserve the coherence of sound Biblical teaching, which can easily be deformed over time. But further, we also need to know that unfamiliar and even non-Biblical reflections are not automatically meaningless. Some of them incorporate, albeit perhaps in an unfamiliar form, legitimate human concerns and questions about pain and resiliency.

Western churches today and their parallel twin sisters – contemporary societies, are certainly not only Biblical or Christian based. They are also, in various degrees and ways, heavily influenced by non-Christian elements. And the apparently innocuous, theologically neutral, element that perhaps today better explains the nature of pain in our societies is – “Technics.” Technics has produced a massive process of the medicalization of pain. And this Medicalization doesn’t only mean that human pain is considered to be completely curable but also that the traditional multifaceted and heterogeneous human experience of pain has been reduced to be identical to medical pain. And the three main cultural presuppositions and biases underlying this technical comprehension is that pain is presupposed to be “understandable,” “controllable,” and “removable.”

This understanding of pain in Western societies configures what we could call a “Cultural dissociative disorder of Pain.” It means that in order to see pain as controllable, it has been artificially detached from its more natural human contexts. This analytical orientation tends to remove pain from daily life, and when it cannot, it kidnaps and isolates it specialized places called hospitals or nursing homes. The efficiency of work and scheduled goals of life certainly cannot be interrupted to give time and space to irrational experiences like pain.

More deeply, today's experience of pain has become paradoxical. It can't be compared to the perception of pain in Biblical, medieval, or renaissance times. Technique and drugs have deeply modified our relationship to pain and suffering, putting us in a unique historical condition. And it is paradoxical because technique and drugs have diminished the perception of pain so dramatically, a perception that previously was always intense. As Epicurus said, if pain is strong, it is also necessarily short, and if it is weak, you necessarily can accommodate and coexist with it. This classical formula on pain is no longer applicable. By separating the perception of pain with the real state of the sickened body, technique and drugs have paradoxically increased pain – generally. It has become psychologically more intense and chronic while physical pain can simultaneously be dramatically diminished.

For this reason I think that an innovative approach to pain necessarily needs to adopt an inclusive understanding. And this is fundamentally what non-Western traditions do. For them life and death, suffering and joy, health and pain go always together. They are not exceptional but rather constant life experiences. It is one of the reasons why these traditions are “slow” societies. For Western societies, suffering, death, and pain are separated and hidden from a functioning and functional life. In this perspective, suffering is not approached continually but only punctually – just in certain exceptional and programmed moments like sickness or death. This easily becomes a managerial and administrative approach to suffering and pain. But the inclusive approach of non-Western societies contain three important attitudes. First, an “ecological integrative view” of pain that, while refusing to consider pain as a redemptive experience, treats it as a natural component in life. Second, a “mythological view” of pain that, while rejecting mystifications of pain, dares to offer non-rational approaches to pain, such as the rich aesthetic narrative of the American Black community, as immortalized in Gospel and Black Spirituals. Third, a “relational view” of pain that, while opposing tribal and corporate views that deny personal autonomy and self-determination, guarantee the experience of a shared and delegated pain.


Hanz Gutierrez is a Peruvian theologian, philosopher, and physician. Currently he is Chair of the Systematic Theology Department at the Italian Adventist Theological Faculty of “Villa Aurora” and director of the CECSUR (Cultural Center for Human and Religious Sciences) in Florence, Italy.

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