The Loneliness of Pain

"Ivan Ilyich suffered most of all from the lie, the lie which, for some reason, everyone accepted: that he was not dying but was simply ill, and that if he stayed calm and underwent treatment he could expect good results. Yet he knew that regardless of what was done all he could expect was more agonizing suffering and death. And he was tortured by this lie, tortured by the fact that they refused to acknowledge what he and everyone else knew, that they wanted to lie about his horrible condition and to force him to become a party to that lie. This lie, a lie perpetrated on the eve of his death, a lie that was bound to degrade the awesome solemn act of his dying to the level of their social calls, their draperies and the sturgeon they ate for dinner, was an excruciating torture for Ivan Ilyich. And oddly enough, many times when they were going through their acts with him he came within a hairbreadth of shouting: 'Stop your lying! You and I know that I'm dying, so at least stop lying!  But he never had the courage to do it." 
- The Death of Ivan Ilyich by Leo Tolstoy

"No one stood with me in my first court hearing; everyone abandoned me." 
-  2 Timothy 4:16

Tolstoy's 1886 novella is bad reading material for a depressed person, but better than most reading material. A story with such soul-crushing anguish illustrates the reader's own pain and therefore simultaneously re-injures and relieves. Mentally stable people don't hang on to the negatives, but Ivan Ilyich's fixation was an overcompensation for something else, as it is for many sad folk. Tolstoy's character is wasting away from a physical malady, but that is not his greatest pain. He suffers more from his loneliness.

Doctors, family members and friends assure Ivan that he is only sick. He feels himself on an inevitable downward trajectory, but they rebuke him for feeling that. Perhaps they inwardly share his fears, but for some reason – whether apathy or misguided optimism – they refuse to validate him. And a horrible sense of isolation creeps over him as he realizes that he is alone in all senses of the word.

Depressed people understand this lonesomeness. They often point to it as the worst part. How strange it is that the effects of pain are also its cause.

Doctors assure you that you'll be better. They say you'll ride again, so to speak, but you know in the pit of your stomach that they're wrong. You want to scream out, "Does anyone care about what's actually going on?" but you've probably been taught to think that's self-pity. So you bury your disappointment deep down like Ivan, and of course Tolstoy himself, whose cold isolationism wounded his wife emotionally:

"After supper his friends went home, leaving Ivan Ilyich alone with the knowledge that his life had been poisoned and was poisoning the lives of others, and that far from diminishing, that poison was penetrating deeper and deeper into his entire being. And with this knowledge and the physical pain and the horror as well, he had to go to bed, often to be kept awake by pain the greater part of the night. And the next morning he had to get up again, dress, go to court, talk and write, or if he did not go, put in those twenty-four hours at home, every one of them a torture. And he had to go on living like this, on the brink of disaster, without a single person to understand and pity him."

We can't control genetics, accidents and most of all death. But isolation is on us. Pain, sadness and death are guaranteed, but there's no requirement that we walk through them alone. It doesn't have to be this way. Below are a three practical countermeasures for both the sufferer and the comforter:

1) Acknowledge the shame cycle that I mentioned two paragraphs above. We feel ashamed to express our pain. I've spent most of my life conflating self-pity with self-care, and in my effort to be selfless I've actually managed to throw self-care out the window while giving self-pity free reign. I often  think I don't deserve to talk about my pain to other people, but there's the conflation again. It's not self-pity to say aloud, "Ouch, that hurt when I stubbed my toe." It's nothing more than an acknowledgement that lends itself to a miniature form of closure, which humans so desperately crave. Human beings are expressers, and yeah, sometimes we express ourselves in unhealthy ways, but we shouldn't throw the baby out with the bath water. You're not wicked for wanting closure. Talk to somebody about it.

2) Please stop trying to fix things. They have therapists and nurses and IT guys and insurance agents for that. Ivan Ilyich's friends found their value in giving him medical advice and hounding him about his pills. The sick person also wants things fixed, but they know that healing starts with acknowledgement and closure. Your job, though you may find it deplorably unsexy, may be to just listen. Some people just need a safe place to be sad. We won't always need that place and we definitely don't want to stay there, but it's a necessary motel-stop on the journey for now.

3) For the love of God, please stop forcing optimism on people. Friends in their attempts to encourage me in the midst of a hard transition tell me that things are still good and that I haven't really lost the things I think I've lost. One thing I've heard a few times is that people view me no differently than before. That may be 100-percent true and probably is, but it stings to hear. I know that you don't feel any differently about the situation, and that's one of the underlying problems.Things may not be different for you, but they're very much different for me. I can't operate from your perspective as much as you try to force it on me. Telling me that nothing has changed is a well-intentioned but apathetic pat on the head. It doesn't serve me to say that, but it does make you feel a bit better. Please don't conflate the two.


Things aren't always going to suck, but right now they suck. And that's okay. We don't need to change the situation any more than we're capable of changing it. We have hope, but being hopeful and seeing the glass half-full aren't the same thing. For now we have each other, and even just writing this is a weight off my shoulders. So thanks very much for reading.