Attending to Suffering: Helplessness and Proximity

If you know me at all as a doula or death lit writer, you know I reference “intensity” far more often than “suffering.” This is because intensity—during birth, death, or grief—is pretty much a given. Whether it’s felt by the person actually journeying through or those surrounding them, and whether it’s emotional, physical, spiritual, or social in nature, intensity is to be expected. It might be fleeting or lasting, but it’s an almost guaranteed classification.

Suffering, while still often present, seems much more subjective. People react differently to difficulty. One person facing a certain kind of intensity might view it as a transformative challenge while another might feel overwhelmed or even tortured by it. In other words, one person rises and thrives, while another suffers. There’s no right or wrong way here, and no room for judgement. What’s needed is acknowledgement and understanding.

From the outside, it’s impossible to know how intense times will unfold or how people will react to them. When caring for others throughout major life transitions, we need to be clear about our own lens, conditioning, and lived experience. We can’t make assumptions about how someone else might interpret and manage their situation, or how suffering may or may not manifest. When a local palliative care physician asked me to join a panel discussion about “Being with Suffering” for medical students recently, two themes immediately came to mind: helplessness and proximity.

Helplessness

When witnessing a person enduring hardship, it’s not uncommon to feel helpless.

As a doula, I try to remind myself that while I can’t always help relieve all forms of suffering, I can ensure that my client doesn’t feel alone in it. I am a steady companion. I try not to shy away from struggle. I remain present and trusting as people lean into sources of distress. I avoid escalating things by not panicking. I make an effort to remain calm and composed, finding relief in the knowledge that the person I’m supporting isn’t feeling neglected or isolated as they face their suffering.

This offering, which sometimes feels a lot like “non-doing,” isn’t nothing.

It isn’t rescuing or saving someone, as that generally isn’t actually supportive or even possible. It’s trusting them with their experience. It’s believing deeply in their inherent wisdom and strength, especially when they’re doubting both. Of course, this non-anxious presence is also balanced with action. I might offer beneficial options for them to consider (without pressure). I might bridge them to beneficial resources.

In the end, though, suffering is part of the human condition. It happens. We may not have sufficient answers, reasons, or solutions to offer, but we can be there. And that isn’t nothing. Often, it’s everything to the person receiving it.

Proximity

When circumstances surrounding someone else’s suffering are similar to our own, providing support tends to be more challenging. Perhaps we’re the same age as the person we’re caring for, or we’ve had the same roles or identities, or their relational dynamics mirror our own. This level of “proximity” can activate our own memories and fears.

To be clear, being activated is a cue to tune in. It’s also natural and to be expected, not a sign of failure or poor professionalism. As much as dedicated “carers” are committed to doing our own work—contemplating and healing our own suffering—we are still human. We are constantly evolving and being tested.

When I was providing respite to family friends during their long goodbye, the themes of helplessness and proximity both surfaced. This couple was my age. Like me, they had two young children. Yet the father was living with terminal cancer and his time was running short. I visited weekly for a stretch so my friend could have a few hours to handle the regular demands of life. I stayed with her husband and witnessed his decline in physical and verbal abilities.

Sometimes he would feel up to working on remembrance gifts for his kids—love-filled messages and a favorites list. Other times, he’d be too frustrated by his condition and fate. Either way, I was along for the ride. I’d celebrate his efforts to make sure his children knew him and felt an unending sense of connection, and I’d validate his deep suffering for being forced into such an early goodbye. It was all real and true, beautiful and gut-wrenching.

Outside of these visits, I contemplated my own mortality with more sincerity. It reached closer. I hugged my loved ones harder. I appreciated my current abilities more, recognizing nothing is promised. I added entries to my death journal keepsake.

And I reminded myself that although I couldn’t change my friend’s situation, what I could do was show up. I could invite forward whatever needed to be exhumed and expressed. I could turn toward the joy, the anger, and everything in between alongside him. And I could urge myself to remember:

It isn’t nothing.