Monday, February 11, 2008
Guilt and Pain
Guilt and Pain have a lot in common. Both are unpleasant, both are sometimes unnecessary, and yet both sometimes keep us out of trouble.
Pain often acts as a warning. We know not to touch a hot stove, run a knife over our hands, or drink bad water because we know it will hurt us. Pain prevents us from overstretching muscles, and it can let us know that there may be an internal problem like gallstones before they become dangerous.
Pain also, though, may not be so useful. The pancreatic cancer patient in pain doesn't need the warning. What warning does fibromyalgia pain bring?
We treat pain, trying to be wise and not suppress the pain that is a warning, but at the same time treating the pain enough to prevent useless suffering.
I think of guilty feelings as a sort of spiritual pain. In its useful form, guilt helps to prevent evil, hurtful, harmful, cruel actions. In its gratuitous form, guilt can be as pathological as other types of pain, leading to avoidance of behavior because of imagined transgressions.
I think a lot of us moderns think of guilt as always pathological, always to be suppressed, treated, medicated. That idea ignores the useful, warning aspect of guilt/pain. Of course, the modern or secularist really doesn't have much to offer the guilty person. As John Patrick MD says, the treatment of guilt really involves words like confession, repentance, penance, restitution, and forgiveness rather than words like antidepressants, antipsychotics, or psychotherapy.
Do you or your patients have guilty feelings? Perhaps the treatment really is spiritual?
Pain often acts as a warning. We know not to touch a hot stove, run a knife over our hands, or drink bad water because we know it will hurt us. Pain prevents us from overstretching muscles, and it can let us know that there may be an internal problem like gallstones before they become dangerous.
Pain also, though, may not be so useful. The pancreatic cancer patient in pain doesn't need the warning. What warning does fibromyalgia pain bring?
We treat pain, trying to be wise and not suppress the pain that is a warning, but at the same time treating the pain enough to prevent useless suffering.
I think of guilty feelings as a sort of spiritual pain. In its useful form, guilt helps to prevent evil, hurtful, harmful, cruel actions. In its gratuitous form, guilt can be as pathological as other types of pain, leading to avoidance of behavior because of imagined transgressions.
I think a lot of us moderns think of guilt as always pathological, always to be suppressed, treated, medicated. That idea ignores the useful, warning aspect of guilt/pain. Of course, the modern or secularist really doesn't have much to offer the guilty person. As John Patrick MD says, the treatment of guilt really involves words like confession, repentance, penance, restitution, and forgiveness rather than words like antidepressants, antipsychotics, or psychotherapy.
Do you or your patients have guilty feelings? Perhaps the treatment really is spiritual?
