At their best, religions comfort and support people in the face of suffering. But sometimes the reasons religions offer for suffering can make things worse. If religious communities are to be places where those who suffer are able to communicate the truth of their reality and receive the support they need, the religious stories we tell need to be spacious enough to hold the grief, loss, and despair that accompany traumatic experiences like living with life-threatening illness. And for Christians, one way to do this is to take on the typical storyline and let it breathe.
Most renditions of the Christian story begin with creation and the fall, then quickly move on to incarnation and redemption. But spending time in the psalms can help us see that the biblical story is less plot-driven and more complex than a tidy, linear, sin-redemption storyline often makes room for. Because Old Testament writings are Christian Scripture too (four-fifths of Christian Scripture, in fact, a reality often overlooked by Christians), prayer practices of the Psalms belong in any version of the Christian Story being told to those who are undone.
In Psalm 77, the psalmist cries out, “I am so troubled that I cannot speak.” Placing experiences of living with serious illness within lament psalms and other irresolute spaces within the biblical story allows us to explore what it means to be undone by illness before God. The central character in these biblical stories is God, the One who creates and calls human beings into relationship with the divine and with one another. It’s important to note, as preacher Thomas Long does, that questions of God’s existence are not really on the table within the biblical text. The characters in the Bible do not ask, “I am undone by illness, I wonder if there’s a God?” Instead they cry out, “O God, why illness?” These moments are important not just because they open up space for those undone by serious illness to express their grief and anger. They’re also important because they speak to God’s relationship with and response to the people enduring illness and the trauma related to it.
The psalms help us see that there is space to protest toward God, to be angry at God, to complain to God over suffering that simply is but that we desperately wish would not be. While some people who express such emotions do so because of a loss of or rejection of faith, the psalms help us see that such emotions are also belong inside the experience of faith. “I cry out and you do not answer me,” complains the psalmist in Psalm 22.21. Making more visible the spaces within religion for interrogation of God can be crucial for those who tend to view challenges to God as unfaithful. If people who are angry at God are given more opportunities to consider that their protest and anger can actually be part of a close, resilient relationship with God, they might be able to come to terms with protest as an aspect of a faithful relationship with God rather evidence of a lack of faith.
One psalm that deserves more attention by those undone by trauma is Psalm 88, the most irresolute of all psalms. The psalmist’s soul is full of troubles (v. 3), buried under the weight of isolation brought on by psychic, spiritual, and emotional distress. There are repeated petitions to God, pleading for some sign of divine responsiveness: But I, O Lord, cry out to you; in the morning my prayer comes before you. O Lord, why do you cast me off? Why do you hide your face from me? This calling God to account emerges in response to testimony throughout the biblical narrative that the character of God is One who will always present, without fail.
But the insistent questioning of God throughout the psalm indicts any attempt to cram suffering in a tidy framework. Why such suffering? Why doesn’t God respond? The questions hang suspended, unanswered.
Even though experiences of the absence of God fill the prayers of the psalms and are so ubiquitous that even Jesus himself cannot avoid them, this particular kind of affliction often fails to get the attention it deserves. Biblical testimony of human beings’ relationship to God illustrates that the experience of God’s absence is much more than a momentary phenomenon for those who are struggling. From Solomon’s testimony in I Kings that God dwells “in thick darkness” to the lament in Psalm 88 over the hiddenness of God’s face, the people of God give voice to that anguished experiences of God’s apparent silence over suffering we so wish were not a part of our lives.
Praying the psalms opens up pathways for those living with serious illness to see themselves as more than simply victims of the disease. Praying the psalms gives voice to the intense connection between the disease in our bodies and the inner turmoil of the heart. Praying the psalms gives voice to protest and anger and grief that accompanies life with serious illness, but it does so within the larger context of a relationship to the God who hears and responds to such anguished prayers. Lamenting together, to God, can open a way for the unendurable to be endured.
Each of our lives bear the marks of suffering. And when we face intense experiences of suffering, we crave explanations for the “Why?”—answers for why things happen the way they do. Knowing why reassures us that we live in an orderly world that operates according to understandable laws. We want life to make sense. We want things to happen for a reason.
It is not surprising, then, that dominant versions of the cancer story strive for meaning by placing life with serious illness in a moral framework. Those of us who live with cancer are cast in the role of warriors called on to battle our cancer with all we’ve got. Telling cancer stories through the use of military images provides a certain logic to illnesses like cancer: cancer is cast as an evil invader, and we are called to take the moral high ground by fighting and ultimately defeating it.
A moral framework often remains in place when the cancer story meets up with the Christian story. The question of Why? becomes an insistent one. Why would a good God who overcomes moral evil allow illnesses like cancer to exist? Where’s the justice in such a diagnosis? We crave answers from a religion built around just conceptions of God.
But when we pay attention to the lives of those with life-threatening illness—whether they are religious or not—the most insistent question tends less to be “Why?”—for so many of us, there’s simply no logical explanation as to why we were stricken with serious illness—than “How?”—as in how do I live into this reality that is now my life? And for those of us who claim the Christian Story as our story, the question becomes: how does the Christian story offer a framework of meaning to this cancer-filled life where meaning is constantly under threat?
When events like a cancer diagnosis occur in the absence of any clear explanations as to the why, we are confronted with an unordered, unstructured, even lawless sense of the world. Unexplainable evil, or that which seems to be unexplainable, threatens the sense we try and make of our lives. What’s needed is more space in the tellings of the Christian Story—as well as in communal enactments of that Story and the living out of the Story’s call to care for those who suffer—for the unexplainable that comes from living with serious illness.
In the 1990s, life-threatening illness was added to the list of events and conditions that can cause post-traumatic stress disorder (PTSD). In so doing, psychiatrists were acknowledging that the threat to life and bodily integrity due to cancer or other serious illnesses can precipitate deep senses of fear, devastation, a lack of control—all symptoms of PTSD.
But applying a post-traumatic stress diagnosis to those who live with life-threatening illness remains an unsettled issue. There are ways in which trauma associated with illness does not fit neatly into the framework of post-traumatic stress. While conventional understandings of traumatic events focus on extraordinary occurrences in the past and have a beginning, a middle and an end, trauma associated with illness typically does not arise from a single event but from recurring events extending from diagnosis through treatment and beyond, possibly throughout the rest of a person’s life. Given this reality for people living with serious illness, researchers wonder whether those living with cancer can ever become “post-trauma.”
Even as important similarities exist between the ways trauma works in the lives of those who’ve endured traumatic acts of violence and the lives of those who live with life-threatening illness, a key difference is this: rather than an enemy invasion or threat from the outside, illnesses like cancer are primarily internal threats. As Augustus Waters, the teen-aged character dying of cancer in John Green’s The Fault in Our Stars, wonders out loud, “What am I at war with? My cancer. And what is my cancer? My cancer is me. The tumors are made of me. They’re made of me as surely as my brain and my heart are made of me. . . .” That our cancer is “us” creates a distinctive way of experiencing trauma related to living with an internal reality that threatens to destroy us from the inside out.
Applying the lens of trauma to those living with life-threatening illness deepens our understanding of the range of emotional responses that occur when living with cancer; talk of trauma opens up more breathing room for those who live with cancer, and it offers those who care for people who are really sick a broader framework in which to offer that care. Sociologist of illness, Arthur Frank, argues that when those of us who are ill get to tell our stories and have them really listened to, the potential for healing increases. The language of trauma helps us resist versions of the cancer story and the Christian story that are too tidy, too resolute. Instead, making space for trauma allows us to acknowledge our not-yet-resurrection reality. And acknowledging where we really live can empower us to tell our messy, irresolute stories, and move into a space where healing becomes possible.
By the time I was diagnosed with metastatic cancer in December 2008, the cancer had spread from breast to bones, fracturing two vertebrae and camping out in my pelvis and hips. Intense treatment regimen made me even sicker, forcing a trip to the ER and a New Year’s Eve in the hospital talking with my husband about where I would be buried.
While family and friends immediately located statistics on my prognosis, it took being weaned off oxycodone before it occurred to me to find what others had found: the pronouncement that five years out, eight percent of people who have the cancer I have are dead.
As a religion professor, I get paid to talk about God. But being diagnosed with stage IV cancer left me without words for (or directed toward) God, without words for what it might mean to live with or in spite of incurable cancer.
Effects of treatment and back surgery made death’s nearness seem even nearer. I struggled to get out of bed and dress myself; I couldn’t drive to and from the mountains of appointments. I resigned from virtually every part of my full and wonderful life.
When I cried my way through an entire appointment, the oncologist referred me to a cancer counselor. The counselor encouraged me to write letters to my daughters for them to open on their graduations, wedding days, expressing how much I wish I could be there to celebrate their special day.
But as winter turned to spring, the pain from back surgery receded enough for me to take off the Fentanyl patch and start physical therapy. I started driving again and even made a couple meals each week.
After months of being overwhelmed by the incurable status of my cancerous life and fearing the end was near, I went into remission, a lovely, disorienting, state of being.
Friends and family through me the party of a lifetime, and I interpreted my cancer story in light of the dominant version of the Christian story I know so well:
And in this feasting amid the crying and the grieving, my life mapped the movement of the Christian gospel story in a way I never imagined it could: I have experienced firsthand a death and a resurrection. I have witnessed new life growing out of the ashes of death and destruction. It doesn’t get more Christian than that.
For months following my diagnosis it looked likely that this cancer story would swallow me whole. When it didn’t, it was the Christian story that helped make sense of what had happened. Dawn had come. I had been given new life.
In the past nine years I have lost and found remission not once, but three times. And while any day with remission is better than any day without it, there are lots of days when the death-to-new-life storyline seems too constrained to hold the frayed edges of life with cancer.
From the earliest days of my cancer story, the diagnosis-treatment-survivorship plotline has seemed too streamlined, too linear, to allow enough space for the incurable version I’m living. The fickle status of remission, ongoing oncology visits and chemo treatments leaves me searching for bigger versions of the stories that interpret my life.
While our tellings of the Christian story bend toward resolution, the plots of our own lives tend to stubbornly resist it. One insight from the field of trauma studies is that living in the aftermath of traumatic events requires attending to ways traumatic after effects interrupt life in the present. Emerging research on illness-related trauma can contribute to a more complicated telling of the Christian story that makes more space for those traumatized by serious illness.
My new book, Glimpsing Resurrection, explores what it’s like to become undone by cancer and how the lens of trauma enables us to better understand the long-lasting emotional, psychological, and spiritual effects of illness. Paying closer attention to places of lament and irresolution in the biblical narrative helps create a spaciousness that can hold our undoneness. The language of trauma and the practice of lament equip us to better minister to those who live with serious illness, and when the trauma of illness is acknowledged and addressed, it becomes possible, even when illness remains, to glimpse resurrection, both here and now and in the life to come.