Emotional Pain and the Possibility of Finding Hope


I’d like to begin with some words about a remarkable woman who first touched my life over 50 years ago. In 1966, during my training to become an Army medic, the Major that led our training unit was a combat veteran WAC (Women’s Army Corps) nurse. One morning about a month into our training, she called us to attention and gave us our orders for the day:

“Today you troops will be on a hospital ward caring for men who all have been severely injured, and many are in great pain. Some of them will show no sign of the pain they are in. But some of them will shake, cry out and whimper uncontrollably.

Hear me now. As you change their bandages and touch them and turn them in their beds, I don’t ever want to see one of you treat them differently because of how they experience pain. I don’t ever want to see you make the men who openly show their pain feel ashamed. The men who endure pain silently are no braver or better men than those who don’t.

They all must have your equal respect, and you must do your duty in caring for each of them. Remember this: we all have different tolerances for pain. No one should have to suffer alone.”

She had served in World War II and the Korean War. I remember her very kind but soul-piercing eyes. She intimately knew the horrors of war and she stood for mercy. She taught us that a large part of our jobs as medics, in addition to the physical work of putting on tourniquets and applying bandages, was to communicate a heartfelt caring that itself was a necessary healing balm for the wounded to receive.

By practicing that way of being openly caring, I saw firsthand that when physically wounded or injured people are faithfully shown that they are valued and respected and that they will not be abandoned to suffer in isolation, an emotional shift happens inside them. They often report a shift from feeling despair and fear to feeling relief and a palpable hope that they will get better soon. I learned that feeling hope is a key element in physical and emotional healing, and that we as caregivers can help hope come alive in others when they are most vulnerable and in need of our compassionate assistance.

It was several years later, and after I’d had a harrowing passage through a painful year of suffering in a protracted extreme state, that I decided to go into psychology and become a therapist. But during my own emotional crisis, the Major’s intensely direct words about deserving compassion and her credo that no one should have to be left alone in their suffering stayed with me and comforted me.

In “Initiatory Madness,” my first blog here on MIA, I share how crucial it was that I felt the emotion of hope stir within me as I responded to the merciful presence of compassion from caregivers. That unceasing compassion gave me hope that I could survive and be relieved of the terror I was in. The people who loved me didn’t abandon me. This helped me weather the persecutory voices and nightmarish fear.

For the last 40 years, the Army nurse’s message has also informed how I try to be as a caregiver when I’m with people in extreme states and in every form of emotional pain. I still spend time several days a week being with people in this way. I’ve written here on MIA about the value of being with people with an open heart while they are in extreme states. I have seen how receiving compassionate caring can ease pain and fear and help people begin to feel the most welcome emotion of hope.

To experience hope beginning to surface is greatly needed when painful emotions such as intense anguish, rage, self-hatred, feelings of abandonment or of terror may swamp us to the point that our emotions become unbearable. Feeling the emotion of hope lets us believe that the pain we are in will recede a bit — before we can’t stand it anymore, before we become at risk for taking desperate measures just to get some relief. I came close to suicide before I felt the hope that my emotional pain could actually become less overwhelming.

When we feel trapped in emotional pain, we may only see two choices open to us and both of them may look terrible. When that kind of bind happens, hope can get lost.

How can we keep the sometimes fragile emotion of hope alive? How can we find hope when it seems to be lost?

One way is to start to doubt that the trap or bind we are in is permanent — to believe instead that there may in fact be a third way forward that will break open the impossible-seeming bind between two excruciating choices. The emotion of hope helps us form the doubt that we will stay permanently trapped in pain. But so often we need someone to prime that pump of hope for us.

The real life binds that can keep us from feeling hope may form into self-talk or be openly expressed in words such as:

Should I live on the terrifying streets or return to the psychiatric hospital where people who are supposed to help me might ignore me, or hurt and abuse me instead?”

“Should I take the street drug that keeps me trapped in addiction, or suffer the intense emotions that make me cry out uncontrollably in an agony that only the drug temporarily numbs?”

“Should I stay in this relationship where I’m abused or leave it and be isolated and all alone again?”

Should I end my life to escape this pain or should I keep suffering without an end in sight?”

The path of hope can lead us free from such grinding forces that bind us, but if we’re left alone in our suffering we may come to doubt that such a path exists at all.

It’s very tragic that a hope-inspired way out of the binds of intense emotional pain is too often invisible or nonexistent if we’re mired down in psychiatry’s disease model of care. Under that model, our emotions of pain are almost always temporarily silenced with emotion-numbing drugs. Our intense emotional expressions aren’t received with empathy and compassion — instead they are subtly frowned upon if not openly feared and shunned. Such a reception to our painful emotional truth can make us feel invisible. Such a pathologizing response can make us suffer alone because no one has reached out to us with the non-clinical, human-hearted caring that we need.

For decades, a great many people in emotional pain have reported to me the huge failure of empathy and compassion that took place when psychiatry’s fatalistic message and disease-model approach combined to make them feel outcast, judged, bad, wrong, deviant and ashamed for experiencing and expressing emotional pain. In my blog “Does the Psychiatric Diagnosis Process Qualify as a Degradation Ceremony?” I share how the “othering” that happens when we are labeled can actually act as a hope-destroying medical curse. The implicit devaluing inherent in the psychiatric disease model works to demoralize us via its fatalistic diagnoses, predictions, prognoses and treatment plans for our alleged lifelong “mental illness.”

But if, instead, a respectful and comforting hand is offered to us in our pain-filled hour of need, then we are given much of what can kindle the emotion of hope in us.

In my experience, the human need to not be left alone when we are suffering is very great. During such times our very basic human needs for being valued, seen, heard and cared about arise as we are at our most vulnerable and are dependent on the goodwill of others. Hopelessness and a self-devaluation set in if we’re detachedly analyzed, labeled, silenced, shunned and isolated.

But when we are reached out to with a gentle, upturned hand of kindness, hope is kindled.

We do need each other when we are at our most vulnerable. No one should have to suffer alone.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.


  1. Hi Michael, these double binds you reference are terribly familiar to me, I remember it well. That’s a treacherous feeling. I remember a time when absolutely no one was on my wavelength, so the “choices” I perceived at the time were particularly limited and unappealing. I was fortunate to find a good pathway out of all that, thank God, and that took more faith, trust, patience, and self-compassion than I ever thought I could muster.

    I am curious if you are aware of the notion of ascending these double binds by shifting vibrational frequency and taking the emotional journey to expanded feelings as spiritual awakening, toward consciously co-creating our life path by following that internal emotional guidance as a reflection of our spirit selves, to find our alignment with who we are, in essence, for ease, clarity, and grounding our sense of self. Ascension seems to be a path a lot of people are embracing at present, given the multiple double- binds we are facing during these especially stressful times of awakening to illusions and social programming. I believe this applies to everyone right now.

    Report comment

    • Hi Alex, thank you for writing. In this article I mainly focused on the value of receiving compassion from others as a way that hope may arise in us, but yes, clearly individual practices such as meditation and other soul sustaining rituals can support people greatly during those periods of emotional suffering such as you describe going through.

      Report comment

      • I’m not talking about specific personal practices, but more about a certain aspect of transition in awakening, going from linear to multi-dimensional perspective. From that point of view, how we receive love and compassion has everything to do with how we perceive ourselves–either separate from each other or united in one consciousness. It is the perspective that we each mirror each other, so when we give love to and receive love from others, we are, in this multi-dimensional reality, giving and receiving to ourselves–the difference between duality and unity consciousness.

        I talk about this because giving/receiving love and compassion has become complicated in our society, I believe. Our collective perception of separateness has messed with our minds, hearts, and spirits quite profoundly, I think, and has disoriented the collective consciousness.

        This perspective from unity consciousness is filtering quickly into the collective now and is being grounded by a lot of people, giving tremendous hope to others. I do think it heals double-binding at the core, and opens the door to personally empowered sense of self, which, I believe, is the only thing that can ultimately heal us–that is, ourselves.

        Although I do feel that acting lovingly and generously as a lumen for others is soul nourishing, in and of itself. When we extend love, it may or may not be received, but regardless, we can still feel the quality of that love as we offer it to others. And being able to receive love is a gift. I do know the challenges here, from both sides of the fence.

        Report comment

        • Alex, the transition in awakening as you describe it seems to fit how my daughter experiences hope. She always knew that her ‘psychosis’ was a double edged sword. The terror and unfamiliarity of the things she experienced while in an altered state such as the fragility of our so-called ‘reality’ was definitely balanced by the positive, spiritual aspects of her ‘awakening’ such as the feeling of oneness and the interconnectedness of all things. Unfortunately, seeing the ‘big picture’ helps individuals very little, deal with the day-to-day worldly concerns of survival, so the harshness of crashing back to earth after one is facing the consequences of a ‘manic’ or ‘delusional’ spree such as criminal charges, ruined credit, broken relationships, job loss, etc. is followed by a long period of trying to honor the good things one learned in ‘awakening’ while reckoning the high cost of the speed or clumsiness at which one tried to implement personal changes or realign one’s life purpose to be in alignment with the ‘awakening’.

          What helped me support my daughter more honestly was to throw out all of the personal dogma had been conditioned to believe, particularly scientific dogma and religious dogma. The only scientific dogma that seems to fit her experience was the newer findings in quantum physics which proves that it is terribly difficult, if not impossible to objectively record/measure matter which is in a constant state of movement, which underscores our fragile hold on ‘reality’ and the nature of consciousness. The only religious dogma which seems to offer any hope are those religions which have a ‘golden rule’ to treat others with dignity, respect, and love. Sometimes Buddhism offered a truth here and there

          My daughter’s recovery was complicated by years of psychiatric torture while institutionalized. She was not encouraged to find meaning in her experiences only taught that she could never trust her visions, voices, or feelings. All of these things were considered to be a symptom of her lifelong disease so confiding anything that she was experiencing internally to a ”professional” was fraught with danger and risk, leading to more torture, longer incarceration, and more erosion of her rights. While locked up, She was given no role or responsibility in society, which is also bullocks because recovery is relational. How can one reintegrate and make sense of one’s experiences if one is locked up for years and years, deprived of social opportunities, deprived of ability to make decisions, or take social risks? Our entire mental health system if f*cked up. MindFreedom is right. We need a full scale non-violent revolution in the mental health system. I suggest that we start by firing all of the ‘professionals’ and start over. I also suggest that we take the microphone away from organizations like NAMI and all of the parents in distress who adore the ‘professionals’. Instead, we should get informed by people with lived experience of madness and mandate that all mental health policies, services, and/or programs be designed and delivered specifically by people with lived experience.

          Report comment

  2. Michael,
    Thanks for this article; hope is the most potent Rx, far more powerful in the long term than any antipsychotic, antidepressant or so on. It was interesting to hear the story about the combat nurse and the veterans you treated; shows the parallels between caring for physical wounds and caring for the soul.

    Report comment

  3. This is the core problem with the psychiatric model. It’s not the drugs, it’s the MESSAGE that comes along with them – you are permanently faulty, and you personally can do NOTHING to change it. You are doomed to a life of dependency and half-living, never capable of moving beyond because your had the bad luck to be born with an inadequate brain. The message of hopelessness is far worse than any drug side effects, if the poor patient buys into it.

    I would have a lot less trouble with someone saying, “You feel like crap right now. A lot of people have similar experiences, and there is nothing wrong with them. I can provide you with a drug that might blunt those feelings a big while we work on another plan.” That’s at least an honest assessment of what the “doctor” can actually offer. But to say “you have a lifelong disability and will have to take drugs for the rest of your life” – well, if you weren’t depressed before hearing this, you sure would be afterwards!

    Thanks for a very direct and compassionate description of what is really needed – HOPE!

    — Steve

    Report comment

    • Nope. For *me*, the PAWS/ID is much much much much much worse than the original distress that fed me into the “MH” system.

      I went into the system believing that I was deviant, unnatural, inadequate thanks to my milieu growing up and the marriage I made with a so-called partner who just repeated my childhood messages.

      Everyone is different, but I don’t think I’m the only one who has had things come down the way they have.

      Report comment

      • I certainly don’t mean to minimize the incredible damage done by the drugs! What I’m trying to say is that while some experience horrible drug effects and some don’t, the labeling process harms almost everyone who comes in contact with it, and is in fact a large part of how and why they are able to convince their clients to take the drugs they offer. If they really told you, “We don’t know what is going on, but this drug may or may not make you feel temporarily better,” a lot more people would just say “NO” or would contemplate other options for the longer term. The drugs are horrible, horrible abominations, but they would be much less of a problem if the diagnosis and labeling process could be dropped. Additionally, the labeling process invalidates each person’s own knowledge and certainty of what is going on and what might help, and encourages dependence on doctors, which of course helps them to peddle their evil pharmaceutical wares more effectively.

        Report comment

  4. Hi Micheal,
    My use of attachment theory in my wife’s healing from d.i.d. has been foundational to so much that I do to help her heal. In the beginning, when the various girls (‘alters’, gag) were experiencing panic attacks, flashbacks and mild self-injury, I would wrap them in my arms and gently whisper, “It’s ok. You aren’t alone anymore. I’ve got you now.” And slowly my role as each girls’ safe haven brought them thru the terrors and emotional storms, and happily, it’s been a long time since we’ve had to deal with any of that stuff.

    But even with the less dramatic stuff, I made sure to keep the (appropriate)physical and emotional attachment with each girl constant as it helped calm them and help them securely attach to me and then begin the process of connecting with the other girls in my wife’s system.

    Report comment

  5. Fantastic article, Dr. Cornwall. Just one minor problem – compassion, loyalty and hope all require COURAGE. That cuts out most of society and almost all of psychiatry. The quack-fest of psychiatry thrives because it makes us TERRIFIED to live in a society where people are valued (or devalued), based on their ability to feel and share pain, rather than on their power to repress or inflict pain. As the child of a veteran, I thoroughly enjoyed reading this article. Really, all of your articles have filled me with a wonder and relief. It’s a real comfort to know that military service and extreme states can end with a long, deeply meaningful, and highly productive career in the helping profession. After all that you’ve been through, living a full, calm life makes you a champion. Good for you!

    Report comment

    • I agree. There psychiatrists are not very courageous. They rarely cross or disagree with a colleague, rarely stick up for a patient that everyone else has given up on, rarely offer any overtures of restorative justice, such as to apologize for harm meted out by a colleague, rarely defy convention by assisting a patient wean herself off harmful meds, and they generally put maintaining their license, reducing their legal exposure, and their financial security ahead of the best interests of their patients.

      Report comment

  6. Thank you, Michael, for sharing this. I do like the theme of the personal stories this week – hope, love, acceptance of what is…

    I remember the shunning during my two-year-long depression quite vividly. Instead of reaching out with compassion, I was often asked to stop being so negative. I was told I was bringing everyone down. My problems were ‘first world problems’. I was overreacting. I was being immature. I was too emotional. The more I was shunned, the more angry I became at the lack of compassion. People who I’d heard call themselves empaths in other situations displayed their utter lack of empathy. I lashed out in anger at the mistreatment which only made matters worse. It became at one point quite a public spectacle, thanks to sharing on Facebook. However, thankfully, a very small group of people stuck by me and they have become some of the dearest people in my much smaller circle. I found that the same people who supported me during and after my extended depression were the ones who were also supportive of me exiting the MHS. They simply support me in whatever direction I choose to go. I can count the people I call friends on two hands now. But I know they are friends. They are not simply gawking at the train wreck. In some ways, I feel very lucky to have had this experience even though it was very painful as it was unfolding.

    Report comment

  7. Thanks Michael:

    Beautiful piece on hope. My adult daughter is home again at last and is making wonderful progress on all fronts. Seven years of institutionalization (bouncing from psychiatric facility to foster home to acute care hospital to state mental hospital back to psychiatric facility in an endless cycle) did not kill her hope or ours. But we have our challenges. In future, I hope you drill down even further into the mechanics of hope. How does a family member or a caregiver, untrained and uneducated but full of hope, coach or encourage a loved one without pushing them to do things that are uncomfortable, without being irritating or irrelevant?

    Report comment

  8. “The implicit [and explicit] devaluing inherent in the psychiatric disease model works to demoralize us via its fatalistic diagnoses, predictions, prognoses and treatment plans for our alleged lifelong ‘mental illness.'” So true, and defaming people to their families with these scientifically invalid DSM disorders destroys marriages and families, and the psychiatric drugs are slowly and torturously killing millions of people.

    Today’s DSM psychiatric system is nothing more than a gigantic gas light, then poison them, system. Gas lighting people is mental abuse, not mental health care. Hope is what saved me from the double binds I was put into by today’s psychiatric gas lighters. I knew I had no “genetic” history of the made up DSM disorders, it was just my insane and white trash psychiatrist, who had the gall to defame my grandmother in my medical records, that thought that. Hope is curative, today’s psychiatric gas lighting system tries to destroy hope. It is 100% the opposite of a “mental health care” system. Why is the DSM still being used?

    Report comment

  9. “Hopelessness and a self-devaluation set in if we’re detachedly analyzed, labeled, silenced, shunned and isolated.”

    Says it all really. Brilliant article – being supported in an extreme state – that never happened for me in my entire life. What I experienced was in the quote above. I have a PHD in being analyzed, labelled, silenced and shunned. I could make up a song about it. That I survived at all was due to rage – not love (because I didn’t get any of that); not hope (because I was told there was none). I don’t know how much longer the rage is going to keep me alive but it’s kept me alive this far.

    I like reading articles like yours – to get the humane perspective – that people can actually behave with kindness and decency – however it never happened for me.

    Report comment

    • I’m sorry that never happened for you. I had two partners when I had my first psychotic, hypomanic, and depressive episodes and was diagnosed.

      One partner stuck around while the other chose otherwise. They said it was too difficult even for them to visit me in the psych ward. It hurt so very much.

      I think, sadly, most people are not equipped to deal with all that comes with a diagnosis. It’s exhausting on their end. I’ve seen it in my own wife, who no doubt loves me. Our ‘people’ are just that though, people. I have to remind myself to give Grace to them because they may be managing their own life as best they can.

      Report comment