By: Dr. Kumar Raka, Bureau Chief-ICN Delhi
Tel Aviv: Suffering has been defined in different contexts in different social and also the medical sciences. Suffering can be mental, physical, social, economic and heavily influenced by the cultural, religious and spiritual orientations.
Moreover, it is an objective as well as subjective phenomenon and closely related with the well-beingness and happiness of individual, groups, community or the nations when we talk about measurement of suffering. Finally, the threshold of suffering is inherent in its psychological definition which emphasizes pain, distress, sorrow, and grief an individual feels that may be absolute or relative or both due to the various factors.
A person with high emotional cognizance may suffer more compared to a very practical individual. For example, a person with deep religious instincts may suffer less in comparison to a non-believer for worldly things; whereas, it can be opposite if the sin committed are religious.
Going through the various definitions, interpretations and academic writings about suffering, I would like to emphasize that even if two different individuals are suffering in almost same adverse conditions the threshold cannot be the same and they may experience different levels of suffering individually based on their socio-economic status, religious-spiritual beliefs, mental & psychological orientation and also culturally imbibed norms and mores.
In this situation, a universal measurement tool for suffering seems to be inadequate. Further based on this research, I would like to stress that there would be no universal threshold, measurement tools or indexes for suffering in an individual, group, community, society or a nation.
Interpretation of Definitions
In common and scholarly usage, suffering encompasses “mild unpleasantness up to excruciating torture and intense agony (an intense paradox for understanding a psycho-social phenomenon)”. Wilkinson (2005) in his book “Suffering: A Sociological Introduction” observes “The problem with suffering is that it involves us in far too much pain….Suffering destroys our bodies, ruins our minds, and smashes our ‘spirit’.” He continues by arguing that social science researchers have been unable to understand human suffering because it raises so many unsettling questions about the nature of humanity, meaning, and morality.
Most scholars of suffering tend to focus on very narrow dimensions of suffering such as aging (Black, 2005), children (Lauredan 2010), mental health (Fancher, 2003), nursing (Ferrell & Coyle, 2008), cancer (Gregory & Russell, 1999), and various others on different parts of the world: Asia (Nagappan, 2005), North America (Parish, 2008) or Africa (Chabal, 2009). In what is perhaps a growing trend, researchers are addressing the bigger picture and the underlying the inherent ethics (Hirata, 2011).
Social suffering, in contrast to psychological suffering, refers to the pain and distress of a social system and its consequences. Bourdieu’s (1999) in his book “The Weight of the World – Social Suffering in Contemporary Society” exemplifies this perspective by elaborating many themes of social suffering across multiple societies.
Vollmann (2007) in “Poor People” also conveys the anguish of the destitute and community climates of fear, violence and victimization. Both social analysts build a large body of evidence on how the social dimensions of suffering produce intractable cultures making individuals’ escape from suffering nearly impossible.
Although a negative phenomenon, there are progressive aspects as well. Suffering unfolds an array of deeply human ironies. Every major religion calls for compassion and aid for our fellow humans who suffer, yet the number who struggle with severe suffering continues to enlarge.
Those who reach out to others who suffer, themselves encounter subjective suffering, even if they feel joy from having reduced someone’s suffering. Arguably, the noblest human emotion, compassion, cannot exist without suffering. Without suffering, would we have humanitarian actions and charitable givings (not counting on tax savings here)?
Interpreting the definition of suffering in medical sciences, Pain, very much a neurological signal, has been synonymous with suffering. Whereas in religion, the First Noble Truth of Buddhism is: “Pain is inevitable; suffering is optional” (the medical science and religious teachings are at sharp contrast). Hundreds of book titles advertise religious techniques for avoiding suffering, yet it persists.
Underlying the principles of most religions, especially Buddhism defines the premise that leads to the path to nirvana or salvation consists of accepting pain and distress without self-pity (Dalai Lama, 2011). The premise of “self-pity suffering” is that anger, resentment, retribution and such negative states of mind are justified, when in fact they arise from self-pity. The eradication of self-pity makes it also possible to accept life’s painful episodes with much less suffering (but it exists).
Religions and other ethical systems generally accept the premise that suffering calls for moral responsibility (Bowker, 1970). Thus, suffering is the spark that energizes the compassion of the sympathetic bystander. For those believing in universal moral responsibility for suffering human beings, everyone is a global bystander.
The Fourteenth Dalai Lama (2011) said “We must recognize that the suffering of one person or one nation is the suffering of humanity (another relative paradoxical statement)”. According to Thomas Merton (2011), “It is through suffering that we grow into the beings that we are born to be, and cultivate compassion for ourselves and for others.” Pruett (1987) argues that “Buddhist claim of craving as the root of suffering is equivalent to Freud’s claim that neurosis is the root of suffering”.
Measuring and Indexing
Surprisingly, “Suffering” is one such phenomenon in modern sciences which has taken an unpredictable turn-over in terms of measuring and indexing, losing all its inherent meaning, objective, absolute and individualistic approach. This is one of very few such phenomenon which the Western world has accepted in terms of subjectivity, relativity and collectivity. Thresholds have been defined accordingly, and ‘quality of life’ including happiness, human welfare and well-being has become antonymous to counter the absolute, objective “suffering”.
In 1995, the professional association International Society for Quality-of-Life Studies (ISQOLS) was formed and continued with a bi-annual conference and publication of several academic journals; dominated by economists, this social movement tends to oppose the assumption that wealth or income is the primary determinant of well-being (Diener, Kahneman, Tov, & Arora, 2009; Diener, Lucas, Schimmack, & Helliwell. 2009). Well-being research, which more and more is conducted under the banner of “quality of life” research encompasses both individuals and societies and explores a wide range of contexts including the built environment, physical and mental health, education, recreation and leisure time, and social belonging etc. (Sirgy, Phillips, & Rahtz, 2011) and encountered the notion and phenomenon of suffering in its objective absolute terms.
Strangely, well-being and happiness research also have become intertwined, perhaps because they sometimes use the same measurement strategy. The emerging consensus is that happiness is a more temporal mental state than well-being. So, typically happiness is measured by asking about respondents’ moods at the moment or during the previous day. Life satisfaction, which is sometimes called well-being or subjective well-being, is based upon respondents’ evaluation of their life as a whole at the present time, during the last five years, or during the next, projected five years. The inherent objective and absolute meaning of Suffering is deleted, devaluated or intertwined with systematic arrangements of well-being and/or happiness in modern social sciences just for the sake of measurement and indexing.
Contemporarily, there are two measurement indexes which quantify suffering in relative terms based on measurement of happiness and well-being. But in my opinion suffering although related to happiness and well-being, cannot be quantified or measured with well-being or happiness and same is true vise-e-versa, like absolute pain cannot be measured with a moment of joy that an individual feels at a given time. Suffering is also a time phenomenon, so as the well-being and happiness. Although the most sought indexes for “indirect” measurement of suffering is described as below:
The Gallup adaptation of the Life Evaluation Index includes a self-evaluation of two items (present life situation and anticipated life situation five years from now) using the Cantril Self-Anchoring Striving Scale (ladder-present and ladder future) with steps from 0 to 10, where “0” represents the worst possible life and “10” represents the best possible life. Taken together, respondents are then classified as “thriving,” “struggling,” or “suffering,” with “thriving” respondents evaluating their current state as a “7” or higher and their future state as a “8” or higher, while “suffering” respondents provide a “4” or lower to both evaluations.
The Cantril Self-Anchoring Striving Scale (Cantril, 1965) has been included in several Gallup research initiatives, including Gallup’s World Poll in 150 countries, and in Gallup’s in-depth daily poll of America’s wellbeing (Gallup-Healthways Well-Being Index; Harter & Gurley, 2010). The Cantril Scale measures wellbeing closer to the end of the continuum representing judgments of life or life evaluation (Diener, Kahneman, Tov, & Arora, 2009). Research conducted across countries around the world (Deaton, 2008) indicates substantial correlations between the Cantril Scale and income.
Here Gallup categorizes suffering as “wellbeing that is at high risk”. In his research respondents have poor ratings of their current life situation (4 and below) along with negative views of the next five years (4 and below) and they are more likely to report lacking the basics of food and shelter, more likely to have physical pain, a lot of stress, worry, sadness, and anger. They have less access to health insurance and care, and more than double the disease burden, in comparison to “thriving” respondents.
I disagree with the Gallup formula as well as the Cantril Self-Anchoring Striving Scale methodologies for measurement of ‘suffering’ which undermines the arguments given in this paper. Measurement of well-being and happiness is not the measurement of suffering. For Example, an individual’s present age is not the measurement of his remaining life based on absolute life expectancy of his country; it may be an estimate but not a scientific measurement.
Yet another example, I may not have any physical pain, stress, worry, sadness, anger, or less access to health insurance and care, or a disease burden (as indicated in different definitions of suffering); BUT I have an spiritual burden imbibed in my religion I did not fulfill and that may be is the reason of my spiritual (do not compare it with psychological suffering) suffering.
Further paradox, assume that I am not a believer (in my religion), but culturally absorbed values and norms make me suffer (as per definitions of the suffering), what if I change my religion that helps me overcome the guilt of imbibed cultural norms and values because of what I suffered sub-consciously; surprisingly, I would not be suffering anymore. How that can be measured on any given universal scale?
Here comes the importance of ‘FACTS’; as described above where thresholds are completely different from the established definitions, measurement tools and indexing of the phenomenon. But when the phenomena has been observed and cannot be scaled or indexed on any universally established measurement scale, there is need to go for the ‘facts’ – the ability of researcher to correct the biases by identification of the facts; it is not so easy to be done as there is no universal measurement or indexing scale for analyzing the facts, especially when you are measuring a subjective, relative and comparative phenomenon like ‘Suffering’; although not impossible.
As a data interpreter one needs to go after correct identification of the facts without biasness, connecting the phenomenon with sequence of facts, perceiving different explanations rather than opting for an universal measurement scale or indexing. Complicated and time taking to connect the sequence of facts with observed phenomenon without any biasness. But this makes measurement of ‘suffering’ more accurate rather than measuring and indexing well-being and happiness on certain scales and based on the results derive a conclusion about levels of ‘suffering’.
My opinion goes against most of the established norms and researches about suffering, its measurement & indexing. Although it has not been scientifically measured, but the devastating effects of Tsunami (2004) have been different in indigenous, uneducated, untouched tribal communities and the modern, civilized, well-educated, financially well established societies. Here ‘resiliency’ inherent in cultural, religious and mental & psychological aspects of individuals, communities and societies are major thresholds understanding the differentiation and level of suffering. The same can be observed in cases of mental trauma in different individuals, groups, communities and societies and there may be various reasons for inherently developed resiliency.
Of course, if suffering only connotes physical pain and is taken as the threshold, it can be measured as per medical parameters but that also cannot be objective in totality. For example, in an individual case scenario, the level of suffering of a soldier and a civilian in case of being hit by enemy’s bullet or badly wounded in face to face combat with the enemy would be completely different; the soldier may feel happy and proud being even in acute pain; whereas, for a civilian this pain may be absolute, a mental trauma, causing intense suffering.
Therefore, the suffering as a phenomenon cannot be measured or indexed either in an individual, group, community, society or a nation solely based on any universal formula or threshold. First of all, definitions of suffering itself varies in different social, cultural, religious contexts and also in academic disciplines; secondly, it’s an absolute as well as relative, objective as well as subjective phenomenon based on various psycho-social-economic-cultural-religious-spiritual thresholds. Measurement and indexing of yet another time-based phenomenon (happiness and wellbeing) and deriving the results for individual or collective suffering out of it, without understanding the facts inherent, is of no use.
“Also level of suffering varies with the power of resiliency” and both the phenomenon are paradoxical in nature, there is no universal measurement or indexing for either of these phenomenon without going after the facts inherent behind the individual, group, community, society or the nation under research.”
(Note: The paper is written to enrich the research community dealing with complex issues of data interpretation of paradoxical phenomenon. The writer is not in agreement with the ten “trauma” indicators of UNDP Human Development Report, 2010 that derive results about suffering measuring other paradoxical time-based phenomenon; although correlated, they do not suffice to measure ‘suffering’ in its absolute terms.)