An Approach to Suffering in the Pastoral Care of the Sick

Brother Schafer Knostman, O.Carm.

Most of us spend some time with a serious illness, which often becomes what ends our life on earth. A seriously ill person experiences pain, loss of purpose, and concern about their relationship with God. A gentle discussion about possible reasons for pain, ways to discover purpose, and consolation from God’s goodness can be of great help to them.


Illness brings with it physical pain, which can be overwhelming. For example, someone could be a burn victim, or have paralyzing pain from a spinal cord injury, or another condition that is greatly painful. Pain is a kind of punishment, something to suffer on behalf of others, and even something that can unite us to God. Having some understanding of these reasons for pain can do much to help a person endure the discomfort.

First, pain is a kind of general punishment on humanity, since it is a consequence of original sin. Suffering can easily feel personally punitive as well, so it is best not to use this point to start a conversation with someone who is suffering. As a pastoral minister, I am not in a position to judge whether someone is suffering due to their own sins. In some situations, though, such as obesity or liver disease caused by lack of self-care, it can help to explain how pain can serve as a guide to what is virtuous[1]. Then, it would be good to start by asking about the patient’s backstory, and helping them identify what they could do differently. It also may happen that a patient presses the issue of why we suffer, as I have experienced once in hospital ministry. In that case I would include punishment in the explanation of suffering in a way that is not accusatory.

 We may suffer as a personal correction, but also for the sake of others, which can happen in several ways. For one, it may be in order to offer the pain on behalf of someone else. Generally, it is helpful to offer our pain to God, bringing our experience to Him through thoughts and words of prayer, since He is allowing the experience for some good reason. Since that reason is often mysterious to us, we may also think of someone or something else to offer our pain for, as an intercessory prayer. In any case, it is important to keep an inner dialogue with God going, since He is the only fulfillment of our desire for healing and peace, and focusing on Him, we hope to reach that fulfillment in Heaven.

Suffering also works on behalf of others to invite them to act lovingly[2]. The real lack of a good that a patient experiences is used by God to draw others into love for that person, which in turn draws them to Himself, the Source of Love. Additionally, if we suffer well, we give good witness to others of hope and the worth of life, which can also lead them toward God. And, it is often comforting that our suffering due to an illness can be used to alleviate that of others, by serving to produce medical knowledge through study or licit experimental treatments.

Pain can also work to redirect our souls toward God[3]. This can come about through forced detachment from the goods of this world, which include our well-being. Detachment is what is painful, but it invites us to look beyond ourselves to God, who is of supreme value, and ask if Heaven is worth accepting the loss of health. For someone with a serious illness, it is likely helpful to hint at this, by referencing the infinite goodness and beauty of God, and how He uses suffering to bring us to Himself.

This brings us to how suffering can unite us to God in Jesus Christ. It’s important that a patient knows that Jesus took on our human suffering, even all of the abandonment, humiliation, and torture of His Passion and death, to bring us to the Father. Even more, He identifies Himself with us as we suffer today, and in every time as well. He intimates this remarkable truth in one of the key parables of the Last Judgment, as these excerpts show: “I was hungry… I was thirsty… a stranger… naked… ill… in prison… whatever you did for one of these least brothers of mine, you did for me.”[4] In the parable, Jesus is speaking as the universal king before the people of all history. Thus, His reference to “brothers” is a reference to every one of us when we suffer. It can be a significant comfort to know that suffering identifies us with Christ, in this certain way. And this identification is especially deep for Catholics, since we are graced to receive Christ’s very body in the Eucharist. Our bodies become part of His — in a real, spiritual way, so that He knows our suffering firsthand.

Loss of Purpose

A serious illness may also cause a person to lose their sense of purpose. We often take much of our sense of purpose from what we do or what we are able to accomplish, which abilities are often taken away in sickness. For example, a person who bases their life on exercising, working in the office, or even serving others experiences a particular challenge when they become ill. But, our real purpose in life is to share in the nature of God, which is possible for anyone at any time. We do this in large part through love of God and neighbor[5]. When sick, a person can find renewed purpose through love of God by working to accept their condition for His sake. This comes from trust in His plan both to use this evil for good, and to move them toward Himself in Heaven. Love of God also includes continuing to worship Him and put Him first in life, as far as the person is able. Serious illness often prevents a person from attending Mass in a parish, but participating in Mass in a hospital chapel might be possible. In any case, Sunday should always be a day specially reserved for the worship of God through prayer. Technology makes this simpler — for example, through access to live-streamed Masses on a hospital room TV or smart-phone. Most importantly, an ill person should request the Sacraments, when needed. Frequent reception of the Eucharist is extremely helpful, especially on Sunday, as one form of worship alongside prayer. The Sacrament of Reconciliation is particularly needed to prepare one for death, as well as Anointing to strengthen the person to suffer with Christ.

As well as love of God, love of neighbor greatly contributes to a seriously ill person’s sense of purpose. It cannot be neglected, as it is implied by love for God. Now, a hospital patient, for example, may not be able to do much for others physically. However, they can love by complying patiently with the nursing staff and doctors, even though their work may cause some humiliation or pain in the course of treatment. Accordingly, social connection is important, especially with loved ones. It is sometimes the case, in my experience, that a person has to overcome a certain fear or pride that deters them from telling loved ones that they are suffering. It may be disturbing news to share at first. But, it is for the greater good, enabling those we care about to love us, as well as for the sake of honesty, and receiving needed much-needed support from them. In fact, willfully refusing to let people close to you know that you are suffering is a kind of rejection of their love. Through loved ones, and even perhaps connection with the staff, socializing contributes to a person’s sense of purpose by providing a way to love and be loved.

Concern about Relationship with God

Lastly, we may feel concern about our relationship to God when we suffer a serious illness. A person may feel abandoned by God, Whom they felt would protect them. Understanding God’s goodness, that He always works for our ultimate benefit, and that He is always willing to forgive, is of great consolation.

It might help to start by recalling that God is the Lord of the Universe, Who made everything good. Scripture describes Him as all-powerful and as love itself. God knows all that happens, and never abandons His creatures, which would betray His very character. These facts help explain that all things work for good for those who love God[6]. It would be helpful to present this to someone who is suffering in a gentle way. For example, a pastoral minister could simply say that God is perfectly good, and allows certain evils in order that good may come from them.

In the worst case, there may be someone who is in extreme suffering, near death, and deeply afraid of God. This may be because they know that they have committed a mortal sin, such as neglecting to go to Mass for years. The Sacrament of Reconciliation should be offered to them very promptly. Further comfort can be given by beginning an explanation as follows: Ultimately, it is separation from God that causes us to suffer. Our final illness and death are painful, but they are part of the way that God heals that painful separation from Himself, so that we can know the peace and joy of Heaven forever. Or, from a different perspective, one can say that to go to Heaven is to become like God. The life of Christ makes the experiences both of suffering and death part of the way of becoming like God. This is only possible through God’s free gift, His grace, which invites us into the life of infinite goodness and beauty in Heaven. 


Pain, loss of purpose, and concern about one’s relationship with God are significant challenges posed by serious illness. We have seen how working to accept the reasons for pain — our own correction, offering it for others, and union with God — gives important strength to us when we suffer. Similarly, a patient’s loss of purpose may be healed through refocus on the true purpose of life — love of God and neighbor. This is best done through worship and the Sacraments, as well as loving caregivers and receiving visits from loved ones. There is also anxiety about one’s relationship with God, which is best assuaged in the Sacrament of Reconciliation, as well as with the truths of God’s providence working through pain, to bring us to Heaven. Knowing these truths can help a person endure suffering with courage and acceptance, which can even give sense of joy[7] in the face of pain and death. Having begun to live by these truths oneself, it is the goal of a pastoral minister to help those who suffer to do the same, so that we may work with the Lord in our final illnesses, and be brought to union with Him in Heaven.

[1] Dr. Paul Chaloux, “Why All People Suffer”, (Manchester, New Hampshire: Sophia Institute, 2021), pgs. 21-27.

[2] Chaloux, “Why All People Suffer”, pgs. 39-49

[3] Ibid., pgs. 29-37

[4] Matthew 25:35-36, 40

[5] The Didache, Chapter 1

[6] Romans 8:28

[7] Chaloux, “Why All People Suffer”, pg. 209.


Brother Schafer Knostman is a Carmelite friar studying at Catholic University of America.

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