Many of us will experience or witness loved ones enduring some sort of pain - whether it be physical, emotional, psychological, or spiritual. This article provides insights on how to cope with or support loved ones when experiencing prolonged pain and adversity.
First, in general, being in pain and seeing others in pain, especially if they are loved ones, can be difficult and uncomfortable. As a society, we do not like to see pain or weakness or vulnerability. While that may stem from a genuine desire to wish health and happiness for ourselves and others, it does not truly help someone experiencing prolonged pain because resisting or ignoring difficult emotions does not make them disappear.
Dr. Susan A. David, Ph.D. and psychologist expands on this in her book "Emotional Agility" and in her Ted talk "The gift and power of Emotional Courage". Dr. David's research shows: “The most agile, resilient individuals, teams and organizations , families and communities are open to normal human emotions... It's this that allows us to say what is my emotion telling me and which action will bring me closer to my values." She defines emotional agility as "being with our emotions with curiosity, compassion and especially the courage to take values-connected steps".
Unfortunately, we are not always taught ‘emotional agility’ or how to cultivate resilience in the face of pain and suffering as a core component of our education in school, unless one chooses to pursue post-secondary studies in counselling for example. Moreover, receiving that kind of learning at home may also not be available due to the general societal culture previously mentioned which does not validate all emotions, no matter how difficult they are. So parents, as much as they love their children, may not have the necessary resources to pass on this important learning unless they actively seek it and model it to their children.
So this article is an invitation for all of us to become more comfortable with how to deal with pain, struggle, and loss more effectively and more compassionately. I will draw both on research in the areas of psychology, health and well-being as well as the Islamic faith tradition.
There seems to be a misconception sometimes that being Muslim makes you immune to sadness. This misconception is in spite of the fact that the Prophet Muhammad’s life, peace be upon him, had many painful moments and losses. He was already born with loss with his father having passed away, then his mother, grandfather, uncle, then his beloved wife Khadijah and then his children. When his uncle and beloved wife Khadijah passed away in a short span of time, that year was called the year of sadness. When his young son Ibrahim died, and the companions witnessed his grief, he said “Truly the eye will shed tears and the heart will experience sadness and we are to depart with you oh Ibrahim, truly sad, but we do not say except that which pleases God”. So we have here an example of the Prophet, peace be upon him, embracing his grief and his vulnerability and showing us how we can manage loss and grief as he embodies a tender heart and sensitive spirit.
Prophet Muhammad (PBUH) asked God to protect him from sadness and anxiety among other things in his prayers/supplications, as we should too. The dua he made peace be upon him was: 'O Allah , I take refuge in You from anxiety and sorrow, weakness and laziness, miserliness and cowardice, the burden of debts and being overpowered by men' (Bukhari). And the fact that he asked to be protected from sadness and anxiety among other things indicates he recognized their existence. He did not pretend they weren’t there. It wasn’t considered taboo or unusual for him to speak of sadness and anxiety and to ask God to protect him from it on a regular basis.
Being in pain for a long time which can span over months or years, is different than being in pain for a few days or even a couple of weeks. Chronic physical pain can occur due to a chronic illness or condition and prolonged emotional pain may occur due to dealing with grief over the loss of a loved one for example or managing emotional turmoil after a divorce or a job loss or any other adversity or trauma that may leave people in pain for years. Please note people will have unique experiences with pain and adversity; however, research shows people with prolonged or chronic pain have some common challenges.
Based on Islamic traditions and research by experts such as Dr. Brene Brown, a best-selling author and social worker by profession with a PhD who has conducted research for years about vulnerability and courage, here are some steps to keep in mind when wanting to care for yourself or support someone who has been in pain for a long time or is still in pain. Please note this list of recommendations are general and should not replace the support of a qualified counselor or therapist.
Here are six points to keep in mind:
1. Trials: Misery or Mercy?
Sometimes, we may jump to concluding that struggles or trials are only intended for the purpose of erasing one’s sins. While it is not readily apparent that specific reference is made to the idea of trials serving as a form of ‘punishment’ or ‘misery’ in the Quran, there is reference that trials can serve to elevate one and remind us to reflect and be grateful. And there is a hadith (narration) by Prophet Muhammad (peace be upon him) that explains, "No fatigue, nor disease, nor sorrow, nor sadness, nor hurt, nor distress befalls a Muslim, even if it were the prick he receives from a thorn, but that Allah expiates some of his sins for that” (Bukhari).
However, my thoughts on this narration is that for someone who has been in pain for several months or years, being constantly reminded their struggles are a form of removing sins, it may lead to feelings of blame or shame on behalf of the one struggling and that the trial they are experiencing is a form of punishment as opposed to a form of Divine mercy. I believe this hadith is meant as a form of consolation and comfort that not a single instance of harm or hurt, even the prick of the thorn, goes unseen by a Loving and Compassionate Creator.
And we are meant to be more confident in the mercy of God over all else, which He emphasizes by describing Himself as “Arrahman Arraheem”, “The All-Compassionate, All-Merciful” and which He (SwT), in His Mercy and Kindness, repeats over and over again at the beginning of 113 chapters in the Quran.
Thus, an alternative approach is to remind oneself or loved ones when experiencing pain and adversity of this Overarching love, care and mercy of God that we are surrounded with and that Prophet Muhammad stated: “When Allah loves a servant, He tests him,” [Tirmidhi]”. We can gently remind ourselves or others that the reward of those who are patient is beyond our greatest imagination as God states in the Quran: “Indeed, the patient will be given their reward without account" (39:10).
We can also draw on this portion of a Hadith Qudsi in which God says: “Allah will say on the Day of Judgment, ‘Son of Adam, I was sick but you did not visit Me.’ ‘My Lord, How could I visit You when You are the Lord of the Worlds?’ ‘Did you not know that one of My servants was sick and you didn’t visit him? If you had visited him you would have found Me there....’ (Bukhari). This hadith points to the closeness of God to one when they are ill and in pain. Imagine the comfort, peace and honour that lies with this.
2. Gratitude Does not Invalidate the Struggle
We sometimes do not wish to see family or friends in pain so we may resort to saying “Oh you’re fine”, or “At least you don’t have cancer”. Again, while saying such phrases may be well intentioned, and it may be helpful for the person in pain to remind themselves of what they can be grateful for, for the person in pain to be constantly reminded that ‘they don’t have cancer’ may be belittling the magnitude of the pain they are in, which nobody else feels and knows, except them.
The practice of gratitude is by no doubt powerful; however, people in pain do not need their pain to be belittled - they need it to be seen and validated. Once again, that is uncomfortable for people, and that is why I am intentionally raising awareness about this. This does not mean that they want to wallow in their pain or want people’s pity - they simply do not want to be ignored or marginalized and feel isolated. And unfortunately feeling isolated is a very common challenge for people experiencing prolonged pain.
3. Healing Takes Time
Because we ourselves do not like to be in or see loved ones in pain, sometimes we want a quick fix so we may ask ‘is there a surgery one can do or medication to take’, etc. when I can assure you, someone who has been in pain for a long time, will have likely looked into every possible option to bring themselves out of pain. It is important to remember that healing, whether it be physical or emotional, takes time. The healing journey takes time for a reason and there is wisdom in that. A wisdom and a lesson which we may not understand during the experience; however, may come to know later, even if it’s years later. That wisdom may entail preparing the person in prolonged pain for a great and important role in the future which requires them to build high levels of strength and resilience. Yet, amazing advancements in healing can happen, sometimes in ways we did not imagine possible and differently that how we perceived the ‘healing’ will manifest. So remembering and reminding people of God’s Grace, Wisdom and Divine Plan, instead of expecting or asking about a ‘quick fix’, is more helpful and appropriate.
4. Holistic Self-Care: Spiritual, Physical, Emotional and Psychological
Sometimes people will say, “Remember to pray more or read more Quran”. While praying, Quran and dua are some of the most powerful tools a Muslim can have, when a person who has been in prolonged pain hears these statements repeatedly, on top of managing their pain, they may start to feel like they have a weakness in their faith.
These religious acts are intended to transform us spiritually when they are completed mindfully, and our faith and trust in God, and in His Divine Plan are essential. It’s important to remember though that people who are in pain for prolonged periods of time need to also pay very close attention to their physical, emotional, and psychological health and proactively take steps to prioritize their health and well-being. These additional practices are not considered a luxury, but a necessity. We all need to take care of our heart, body, mind and soul. They are all interconnected.
People who are in pain for a long time experience life very differently than those who are pain free: “Being in long term pain literally changes the structure of our brains. ..[impacting areas] which control learning, attention, memory, thought processes, motor control and coordination”. (D'arcy-Sharpe, 2020, Chronic Pain: Long-Term Effects on the Brain and Body Explained). Anxiety and depression are also a concern as people with chronic pain experience social isolation or the inability to work. However, research shows that these changes are reversible with seeking treatment, and the sooner one does so, the quicker they can return to “a normal level of functioning both physically and cognitively” (D'arcy-Sharpe, 2020).
5.Mindfulness and Meditation
There is a vast amount of research right now on the benefits of mindfulness and mindfulness meditation in managing stress and distress (prolonged stress) - which is usually the case for people managing chronic pain, or grief or post-traumatic stress. I first learned about mindfulness formally in a Western Education setting, when I completed a compassion cultivation training program in a University setting. The benefits of mindfulness include, but are not limited to “decreased levels of the stress hormone cortisol, brain changes that may be protective against mental illness, and better control over processing pain and emotions” .
Despite these benefits brought to us by science and research, some Muslims may shy away from mindfulness meditation, although in reality, they are very much a part of our faith and mindfulness is an important part of our daily prayers. There are a wide variety of mindfulness meditations available that are ‘religion neutral’ and simply focus on deep breathing and positive affirmations. Engaging in thikr/remembrance of God may perhaps be considered one form of mindfulness because we are repeating uplifting words of gratitude and faith which can keep us grounded and present.
Just like we walk or engage in our physical activity as a form of exercise for our body, I think of meditation as a form of exercise for our brain and as mentioned there is a vast amount of research on its benefits for the brain and mind. Moreover, mindfulness meditation is a prevalent tool currently prescribed by both traditional and alternative/holistic healthcare practitioners as they may prescribe acupuncture for example. It is also a tool used in schools and colleges/universities to increase student achievement and well-being, and is also starting to receive attention by Muslim teachers and researchers (See the suggested article link at the footnote below published by Yaqeen Institute which was founded by Dr. Omar Suleiman: How to be a Mindful Muslim: An Exercise in Islamic Meditation ) .
6. Social Support is Crucial
If you are experiencing prolonged pain, intentionally strive to create a steady social support system. While in person social support may be best, online support can be very helpful - there are groups on social media, online classes to join, and individuals you may be able to connect with one on one who are experiencing a similar situation on social media.
If you have a loved one experiencing prolonged pain, think of how you can help someone you care about who is in pain nurture their heart, body, mind and soul. Maybe you invite them out for a walk regularly, if they can, even if it’s a 5 or 10 minute walk, because sometimes that may be all they can do. Being in nature can truly be a great contribution to the healing process. It may also include cooking a healthy meal and delivering it to them, because even cooking regularly may be difficult for them. It may be taking them out for tea, or inviting them and a few other friends out so they have a steady and positive social support system around them, which once again is crucial to the healing process and their well-being.
Also, when supporting a loved one in pain, it may be helpful to say “I can only begin to imagine how difficult this must be for you. I know it will take time, and I am here to support you”. Saying “I can only begin to imagine” not “I know” or “I understand” is helpful because the cornerstone of effective relationships is honesty and authenticity. So while we sometimes say ‘I know’ or ‘I understand’, the reality is for someone in chronic pain, nobody else really understands their very unique and personal experience. So saying “I can only begin to imagine” helps one to show empathy but not claim that they really know exactly what they’re going through because the reality is they likely do not know the intensity of the pain that someone experiencing prolonged pain is in.
Social support is crucial so if you have a loved one in pain, remember to tell them that you appreciate them and love them no matter how much pain they are in. People who are in prolonged pain will sometimes feel like they are not enough because of their ‘limitations’, forgetting that everyone has challenges and limitations. Remind them of their skills and talents. Remind them of all the goodness they can still give to the world. Encourage them to continue pursuing their ambitions and aspirations, no matter how ‘small’ they may be, given that sometimes the ‘smallest’ things can mean the most. And once you do that, see how they light up and how much strength they can exhibit, regardless of the magnitude of the pain they are in.
Remind them to practice more self-care, self-compassion and healthy self-love which will help them to treat themselves more kindly, deal with any inadequacy they feel because of the limitations their pain may impose on them, and remind them that all human beings struggle as part of the human experience. Research has shown that self-compassion can lead to lower levels of anxiety and depression and higher levels of happiness and well-being (Please see the source in the footnote for an excellent resource on Self-Compassion). So remind them they are not alone. Remind them that they are doing their best. And healthy self-love will enable them to continue to see the strengths they have even amidst all of the limitations they may be experiencing.
I pray God will grant us and our loved ones health, healing, well-being and contentment. One of the prayers (duas) which the prophet repeatedly cited as the best one when he was asked was “To ask for wellbeing and cure in this world and the next”.
1-Chronic Pain: Long-Term Effects on the Brain and Body Explained, Ann-Marie D'arcy-Sharpe, 2020
2-Mindfulness Meditation Benefits: 20 Reasons Why It's Good For Your Mental And Physical Health, Amanda Chan, 2013 (http://www.huffingtonpost.ca/entry/mindfulness-meditation-benefits-health_n_3016045)
3-How to be a Mindful Muslim: An Exercise in Islamic Meditation, Justin Parrott, 2017 (https://yaqeeninstitute.org/en/justin-parrott/how-to-be-a-mindful-muslim-an-exercise-in-islamic-meditation)
4-Self-Compassion, Dr. Kristin Neff. https://self-compassion.org/