We talk a lot about physical pain at the end of life. Not all illnesses have pain as a symptom, but physical discomfort is something we are always trying to relieve. As those last breaths are being taken, I truly believe there is no pain, so I feel confident in saying that death itself is not painful physically, however the disease process can be as it leads to death.
Emotional pain is just as real and equally experienced, however it is not talked about as much.
"Emotional pain is pain or hurt that originates from non-physical sources. Sometimes this emotional distress is the result of the actions of others. Other times, it might be the result of regret, grief, or loss."
I witness this often. I can sometimes tell when I hear a patient moaning, whether it is physical pain, or emotional pain, which helps me to determine if they need medication, or physical touch, and the reassurance that they are not alone.
Both require a response; both deserve a response.
There is emotional pain from grief as well… this quote really resonated with me:
“Everyone keeps telling me that time heals all wounds, but no one can tell me what I’m supposed to do right now. Right now, I can’t sleep. It’s right now that I can’t eat. Right now, I still hear his voice and sense his presence even though I know he’s not here. Right now, all I seem to do is cry. I know all about time and wounds healing, but even if I had all the time in the world, I still don’t know what to do with all this hurt right now.” ― Nina Guilbeau, Too Many Sisters
People can sometimes assume nothing is wrong if they cannot see it, or if there is not a clear understanding of the why. We tend to question or doubt emotional pain, dismiss it even. Emotional pain is real and requires you (us) to truly lean in and listen and validate what they are experiencing.
How can you help someone with emotional pain? Listen to them, without trying to fix them. Hear them. Try not to give advice, although encourage them to seek professional help if needed and to practice self-care, and always follow up and check back in with them.
And if someone is dying, and they are experiencing emotional pain, reassure them they are loved, and they are not alone. If they can speak and verbalize their feelings, listen… but remember that sometimes, they might need you to be present but silent… honor that as well.
I had a patient once who was hours before death and he was moaning. It was a deep moan, which to me felt emotional, not physical. Everyone around me wanted to give more medication, but I didn't feel that was what he needed. I sat next to his bed, I held his hand and I talked to him. He was non-verbal at the time, but I could feel his breathing calm. I whispered in his ear... "I am not going anywhere... you are not alone, I am right here... I've got you." He died about thirty minutes later... just before his moaning subsided.
If someone is dying, and you know they are struggling with emotional pain, lean in a little closer, place your hand gently on their chest, and let them know you are there for them, and that they are not alone. Sometimes we cannot remove the ache that they feel, but at the very least... we can make their landing a little softer by taking their hand and being fully present for them.
Validate their feelings and their words.
Emotional pain is real; acknowledge and respect it and those who are experiencing it.
It can hurt so much, it can become physical.