Pastors and Chronic Pain
Jeremy Wright
For most pastors who serve in normative-sized churches, pastoral ministry is rarely boring. You wear a number of different hats for people, and it isn’t uncommon for a week to include meeting some needs you didn’t anticipate and for which seminary didn’t prepare you. If someone has a flat tire, we help them change it. We fix it. Most of us know how to help with that, and online tutorials could get the rest of us through it. But what if the entire tire falls off? What about when the axle drops out of the rear end? We’re not pulling out our phone to look up a “how-to” at that moment; we’re using it to dial a tow truck. We refer that kind of care to a skilled professional.
Living with chronic pain/illness is a life with missing parts: The wheels are falling off. The car started veering off the road a while ago. Many times, the sufferer(s) are struggling to understand how to adapt, much less how to invite others in or to explain themselves. And so pastoral care for those suffering with chronic pain and illness can look different than your standard models of care, because the journey that they’re on is so wildly different than the majority of others.
Understanding Their Journey
If you’re blessed to be ignorant of how life works with chronic pain/illness, let me introduce you to a different way of life by way of personal testimony. Our experience is similar to countless men and women, many of whom would love to be more faithful on your pews, in small groups, and on mission trips.
CDC statistics make it clear that you’re likely shepherding those in this demographic when they share that between 2019 and 2021, the prevalence of chronic pain among U.S. adults ranged from 20.5% to 21.8%, and the prevalence of high-impact chronic pain ranged from 6.9% to 7.8%. (See source).
Thanksgiving 2019 was the first sign of major trouble for my wife when our holiday plans were interrupted by unexplainable pain in her legs and feet. The nagging pains she’d had for the last few months were now much, much worse. That marked the beginning of a journey of countless doctor visits, tests, and specialists that continues still.
The first two years were optimistic: we’ll find the source of this pain and a fix for it. There is always another doctor, another test, another option. By year three, we were less optimistic, and the pain was so severe that we’d lost all sense of normalcy in our previous routines. We wanted to be able to go out to eat as a family, host dinners in our home, or even just attend church functions like before, but year three marked our slow embrace of disability and a new identity.
We couldn’t be or do the things we used to be and do. Coming to this realization took us longer than we like to admit, because the optimism of finding a cure keeps you hanging on to the hope of things returning to normal. Unlike a sudden accident or major life event, our experience with chronic pain was gradual, and it required us to adapt and reshape our lives over and over again. Now we’ve settled into a diagnosis that tells us that our lives will continue to be more limited year after year. Our “new normal” will continue to be a worse version of the normal we’ve known before.
How Does That Shape Pastoral Care?
If shepherding requires us to know our sheep, then knowing the unique, life-altering challenges of chronic pain/illness can quickly become one of the most important things to know about those who are afflicted. You should know that for many who suffer their wounds are not visible.
Severe nerve pain makes it impossible for my wife to attend church gatherings every week, but for years, when she was able to make it and wasn’t yet using a wheelchair, she looked perfectly healthy, wearing a smile and glad to be there. What our friends couldn’t see was the inner strength it took to prepare for the outing and the days of discomfort that she’d feel after as she paid the price of “not neglecting to gather together.” This kind of quiet suffering is hard to see, but it is pivotal to understand if we’re going to care well.
(1) We aren’t who we used to be
Life with chronic pain/illness is usually a life that has been remade. We’ve gone through a kind of new birth, and the life we now live we live with far less. Less ability. Less energy. Less bandwidth. Less money. Less hope of comfort or relief. It is a life of loss where the memories of your former abilities and the old life are a source of persistent grief.
As pastors we’re used to walking with people through grief, but the grief we’re most acquainted with usually arrives suddenly and then recedes gradually. The grief associated with chronic pain is more often a grief that sets in gradually and (at least over the first few years) grows stronger with time as the losses stack up and take a cumulative toll.
Be sensitive to the changing abilities and the associated grief that comes with loss. For the first couple of years, we desired so strongly to have people in our home for meals and fellowship that we’d schedule it week after week, only to cancel those plans on the day. We were losing an aspect of our lives that formed a central part of who we were and how we ministered to people. We had to learn to grieve that loss even as we learned to adapt to our new, lesser abilities. The person under your care who is experiencing chronic pain/illness isn’t who they used to be. They can’t do the things they used to do, and that hurts.
(2) We’re often not sure who we are
Chronic pain/illness sufferers are typically on the margins of our congregations by default. The majority of sermon application and church programming won’t fit their lifestyle or abilities.
When we hear, “We have an international mission opportunity for everyone” we sigh inwardly knowing that it took every ounce of inner strength to endure the 5 minute drive and hour of sitting up for this church gathering. As a smaller percentage of the whole we recognize that we aren’t the target audience for most things.
Keep in mind, then, as you shepherd someone on the margin, that our tendency to find our identity in what we do is an even bigger challenge for the person who can’t do what they used to do. When the path to meaningful purpose is paved with “serve here” and “plug in to this group” opportunities, the disabled disciple feels the uncertainty of learning new, sadder limitations along the way.
Pastor, help us remember that our abilities are not our identity. As you do, make sure that you don’t perceive our inability as disinterest, but instead recognize it as a source of ongoing grief. We wish we could fit the mold of the typical church member and engage in every ministry, but the limitations of physical pain and the emotional toll of adjusting to a limited life keep us from doing most of what we want to do for and with the church.
There are times when those limitations ebb and flow—some seasons when we can be more active and others when we are even less able. With many of the underlying causes of pain/illness, those who suffer aren’t sure what the next week may hold in terms of their stamina or capabilities. Help us find our affirmation in the church through the gospel and the care of God’s people rather than our participation or attendance.
(3) We’re not sure where we’ll be tomorrow (we’re pretty sure tomorrow will be worse, not better)
We love and appreciate the faithful prayer support of our friends and church family. It means a lot to us. There is, however, a way that I tend to respond to invitations to bold or public prayer initiatives that can come off as pessimistic or faithless. Yes, we’d love to come down front and have hands laid on us as we call out to the Lord for healing, but I want you to know that on the other side of it we still expect that the physical damage causing this severe pain will still plague our lives.
I tend to explain it to people in more concrete terms: if someone has lost a limb in an accident or military service, we don’t bring them down front and pray boldly for the limb to be physically restored. Rather, we pray for their faith, joy, and patience as they adjust to a new life of walking faithfully before the Lord with this new physical limitation. The reality of our life is the same as so many with chronic pain. The factors that cause or contribute to their pain are not things that will physically improve before all things are made new. And so we’re learning to live a new life with new limitations and facing a reality that things will likely continue to get progressively worse.
The only thing that some sufferers can embrace about our physical future on this side of the resurrection is that it is going to be more painful than our past. Tomorrow is going to hurt a little bit more. So as you pray, pray for faithfulness, joy, and perseverance while you pray for physical relief. We know the pain is going to greet us in the morning, so ask the Lord for an increase in fresh mercies, gospel-rooted joy, and hopeful perseverance to meet us as well.
Conclusion:
Pastor, the sheep under your care likely have a wealth of wisdom and a number of hurts that they’ve gathered along their journey. Take time to listen attentively to them. Think creatively about how to strengthen your church’s ongoing care for sufferers as they walk through the grief of continued loss to chronic pain. When they’re absent or unable to gather, work hard to give them the gift of the church’s presence, whether digitally or physically. It is easy for the physical pain and resulting limitations to increase loneliness and add to the grief of loss of our former way of life, so the reminder of God’s love through the church means all the more to those who suffer quietly. As we suffer with the loss of who we used to be, the confusion around the present day, and the promise of future pain, help us to feel seen and safe in the church among those who can bring the love and hope of our Redeemer to us as they bear our burden with us.