Hope When the Body Won't Heal
by Daniel G. Bagby, Ph.D.
Several years ago those of us who read Dave Dravecky's courageous autobiographical account of his struggle with cancer celebrated his faith and determination as he strove to conquer a dreaded disease that appeared to threaten his professional baseball career. We cheered as he disciplined himself through the torture of amputation, surgery, treatment, and exercise to regain the physical prowess that had made him a standout ball player in the seventies and eighties. Faith was bolstered by recovery, and hope was accelerated by his promise of recovery.
But then the cancer returned, more debilitating than ever, and the man who wrote so engagingly in Coming Back was forced to rewrite his story and entitle it, When You Can't Come Back. The deeper and more difficult journey of struggling to accept a disabling amputation and the permanent loss of a dream was just beginning.
Physical Loss and Hope
How can healing or hope emerge after such cardinal losses? Let's consider first the issue of healing and hope after permanent physical loss. How do those who lose find hope in the absence of full recovery? Is it possible to heal—when healing means never recovering what was lost?
Those who teach us most about such hope and healing are those who have conquered irreversible physical conditions. The most obvious examples to us are people we know (or have heard about) who have survived adversities and learned to live with debilitating circumstances. Folks like Johnni Eriksson Tada are celebrated reminders that human beings sometimes face the unchangeable and still overcome loss. How do people find healing and hope in the debris of major loss?
Survivors of physical maladies report that one of the central issues in their recovery from tragedy was learning to distinguish between physical loss, and emotional and spiritual loss. We know that the long and painful grief experienced with the loss of a part of oneself eventually produces either despair and rejection, or gradual acceptance and adjustment to the change. Victims of polio who processed the loss of physical mobility have emerged either with bitterness over their permanent debilitation, or a reconfigured outlook on life that encompassed their handicap in a manageable way. Though grief, bitterness, and frustration were usually reported along their path toward healing and hope, these survivors recorded those experiences as chapters in their journey toward a new sense of self that included peace of mind and acceptance of themselves with their loss.
Victims of loss from physical injury describe an evolving attitude that seems to have a lot to do with whether or not they eventually achieve a peace of mind and self-acceptance. Persons who report an acceptance of their modified condition seem to have found an acceptable new identity, a redefined center to their purpose. They also evidence a sense of humor that bridged their struggle through the changes. They have even eventually reported joy in their new condition, and describe the development of a positive spiritual outlook over a long period of recovery.
These survivors speak of certain choices they remember making in regard to how they saw themselves, how they thought about what had occurred, and how they saw their future. They eventually chose to see themselves not as victims of a cruel fate, but as survivors of a near catastrophy. Robbed of certain functions, they talked themselves into viewing their existing skills as building blocks for a recovered self-worth—and as the focus of their attention.
Such positive attitudes obviously did not occur overnight. Each of them had their "dark season of the soul," wrestling with despair and defeat. There appear to have been certain moments that were crucial in their turning from despair to hope and anticipation. This gradual development seems to have been fueled by the discipline of regular self-examination, challenge, and prayer. Victims of loss who survived loss and rebounded from it described themselves as growing weary of blaming, and eventually seeking to improve how they saw life. Healing occurred, they state, when they began to accept their loss as inevitable, chose to focus on what remained, and began to believe in their altered self as useful and worthwhile.
What loss-survivors teach us is that there can be an emotional healing when full physical recovery is not possible. Following a physical loss, there is apparently in the grief journey a series of events that allows a person the opportunity to accept his or her loss and move on. Such events are not "automatic" to each griever, but seem to depend on certain specifics. To the best of our learning, here they are, as described and identified by "losers who became winners."
A normal grief process, which includes acknowledgment of anger, sorrow, pain, and bitterness (avoidance or postponement of grief makes healing or hope improbable).
A moment or several moments in the grief journey in which a conscious and intentional decision is made to accept the loss sustained as irreversible.
A deliberate and intentional decision by the griever to focus on remaining skills, capacities, and available resources — in a positive manner.
A disciplined and continuous orientation to interpret the future as purposeful, to think of oneself as useful, and to image oneself positively.
A gradual and increased focus on looking ahead and not back, and on overcoming seasons of despair by "outlasting dark visitations."
An emerging inner peace that embraces the reality of loss, accepts the altered self as one's new identity, and generates hope about the future-independent of any physical recovery.
- A cultivation of an attitude that fosters inner healing, a mental process that includes a growing perspective on what is important in life, and a sense of confidence about one's self-worth "as is."
Healing, as described above, refers to an inner process of accepting loss. Such acceptance includes the capacity to maintain an emotional and spiritual balance in the face of a loss. People who achieve this state of emotional and spiritual equilibrium are neither paralyzed nor controlled by their loss. Rather, through the healthy processing of their grief, survivors who heal emotionally develop a positive outlook about their present possibilities and their anticipated future.
The spiritual and emotional aspects of this healing are intertwined, and integrated in their development. The capacity to perceive a loss as only a small portion of one's self-identity is crucial to this emotional recovery. Hope is born in the emergence of this healing, as the griever learns to focus not on what she has lost—but what she has left. Emotional healing then, is the capacity to recover emotionally from irreversible losses. The human spirit, acting independently of the physical loss, chooses to conquer the physical event by taking charge emotionally of how life will be interpreted, The human mind, capable of affecting attitude, mood, and outlook, leads the way for the recovery of the individual, who begins to experience hope in the face of a positive interpretation of the present and future.
Hope, in the aftermath of physical loss then, depends on a long journey of processing inner pain, and tenaciously rehearsing a positive personal attitude that lifts the survivor's spirit above the physical loss. The willingness to accept the present loss, imagine a possible positive self, and embrace a worthwhile future—all contribute to emotional healing and personal hope in the face of irreversible loss.
Terminal Conditions and Hope
Is hope still a viable issue in the face of continuous disease or terminal physical conditions? Both healing and hope can develop independent of physical improvement, and hope can flourish even in the process of physical deterioration and death. The apostle Paul is a cogent example of both: He spoke of an emotional and spiritual healing in the turmoil of unabated physical distress (2 Corinthians 12:7-10). He also alluded to a conquering outlook in the face of death, and described a peace of mind that expressed deep hope and healing (2 Timothy 4:5-8).
Elizabeth Kubler-Ross has done us all a great favor in identifying significant personal stages dying persons experience: Denial, anger, bargaining, resignation, and acceptance. The loneliness of facing the unknown at each stage is an anxious ingredient in the grief process of the dying. How do healing and hope emerge under such sober circumstances?
As in the case of the griever who comes to terms with an irreversible physical loss, the dying person who travels redemptively through stages of personal grief encounters his first taste of healing in the stage of gradual acceptance. In this scenario of acceptance, however, acceptance is not a question of coming to terms with a lost part or function of oneself—but with coming to terms with the reality of one's own death.
Older citizens who have lived full lives often verbalize this "peace with death" by expressing a desire to die. Separated from loved ones and dear friends, struggling with mounting physical and emotional limitations, elder adults frequently develop an inner peace about dying that buoys them and brings them a serenity of spirit and a sense of anticipation and hope. Such stalwart saints actually pray to die and eagerly anticipate their passage through death to a desired eternal life.
What about those persons deprived of a long, abundant life, and cheated or cut short of experience and time by the tragedy of a terminal condition? Can they find healing or hope? Yes, after an arduous journey of grief and self-reflection. Like those assailed by a physical loss that cannot be reversed, terminal persons must struggle through their loss, pain, and frustration before they can discover healing or hope.
How do they heal? They obviously do not heal physically. Those who find healing face their grief, process their pain, let go of hopes and dreams long-held, and begin to accept a new timetable for themselves. They also begin to see themselves in a new way: They understand their past from a new perspective (through the eyes of dying), their present with a different emphasis and urgency, and their limited future in an even more remarkable way.
Not every person facing death experiences healing or hope. Those who hold on to the bitterness of their disappointment, the frustration of losing control, and the anger of feeling cheated rarely find emotional or spiritual healing. What some people call arrested grief is a recurring challenge for those facing an unexpected end to their life. Struggling with a modified timetable, some people give in to the natural depression and melancholy of grief and allow it to determine their remaining posture on life. Enabling the crippling negative thoughts and feelings that inevitably assail the terminally ill, these tortured and despairing people feed the negative attitudes and outlook that make any emotional healing or hope almost impossible.
How do those who heal and hope achieve such prized experiences in their terminal condition? Those who do, inform us again, and describe a set of characteristics that appear to be crucial to both healing and hope:
Those who healed emotionally worked through their grief and faced each difficult emotion and experience. Anger, denial, doubt, sorrow, loneliness, self-pity, and depression each had their day—but none of these cruel workings apparently took permanent control of the dying person's outlook.
Like the victims of permanent physical loss, these terminally ill folks refused to give in to negative thoughts and feelings, and took charge of their mental outlook by paying attention to what they were saying to themselves and how they responded to their condition.
An eventual acceptance of their terminal condition freed these dying persons from the torment of continued struggle with the reality of death. These dying patients experienced emotional healing first as an inner peace that came from coming to terms with the impending reality of their own death. A serene focus on the present was also reported.
In processing their own death, hopeful patients began to focus on a belief system independent of physical healing or recovery; their faith interpretation allowed for a distinction between dying—even with pain—and their view of a beneficent God and providence at work beyond death. Some dying patients entered the journey of dying with such beliefs in place; others acquired positive interpretations to their death and to their faith during their physical trauma. In either case, emotional and spiritual healing were linked to a positive view of God and faith.
Personal healing also emerged as these dying persons reflected on their life and gave purpose to their own journeys. Emotional and spiritual healing was also strengthened when the dying person gave meaning and value to his own death (usually in relationship to loved ones and to a community of faith).
Hope, as expressed by dying patients, focused on distinct issues in regard to their past, their present, and their future. In reference to the past, hope emerged when patients evaluated their own life as worthwhile, and/or as valued by family, friends, and the community (most often a church). Hope in the present was centered on the person's capacity to act as a good model for others while in the throes of disease, dying, and pain. Hope was mostly identified in the future as a positive inner faith that life after death would hold relief from pain and sorrow, permanent healing, and eternal fulfillment and joy.
Healing and hope are clearly not issues predicated by physical recovery or escape from death. Emotional and spiritual healing are a function of the individual's attitude and outlook, along with a capacity to process one's losses and deal realistically with the future. Hope exists not just when people can get better physically, but when they can interpret their own life, their current condition, and their future with a sense of purpose and expectation.
Dr. Daniel Bagby is Professor of Pastoral Care at Baptist Theological Seminary in Richmond, Virginia.
Benson, Herbert. Timeless Healing. New York: Fireside Book, 1997.
Bozarth, Alla Rene. Life Is Goodbye, Life is Hello. Center City, Missouri: Hazeldon Educational Materials, 1986.
Kubler-Ross, Elizabeth. On Death & Dying. New York: MacMillan Co., 1969.
Stone, Howard W. Depression and Hope. Minneapolis. Fortress Press, 1998.