A true story
The pain was intense. It began in the right side of his neck and spread into the shoulder muscle. He could feel it coming, just the way it had first come almost two months ago. Almost always, once it started, it grew in fierceness, forcing him out of bed — to walk, to stand, to sit in a chair, to try TV for distraction (a book kept his head too low and too immobile), sometimes to go to another part of the house, shut the door, and cry. Crying helped. A little. He didn't know why. But his training was such that he wouldn't cry unless the pain was agonizing, unless he was desperate. "Oh, God!" he would moan. "Oh, Jesus!"

Then he would close his eyes and sob.

During the two months since the pain began occurring several times a day, he had paid repeated visits, first to one doctor and then a second, not counting the one who saw him at the hospital emergency room where he had gone on a long holiday weekend after losing two nights of sleep in a row, feeling he would crack if this kept on.

As yet there was no real diagnosis. "Pinched nerve" was as close as they came. The X rays, as one of the doctors put it, "didn't look so bad," explaining that there was no sign of injury. Arthritis and spinal degeneration were not terribly far advanced for a person of his age. Then why did the pain feel so bad?

One night he had gone to bed in comfort. There had been no pain to speak of since the previous night and no hint of any when he lay down around 10:00. Maybe the cortisone, begun a few days earlier, was starting to have some effect. At 12:22, the pain woke him up. He first thought that it wasn't going to be very painful, but this wishful thinking was soon routed by a ferocious attack. After pacing about for a time, he climbed upstairs to his study, hoping to distract himself with the computer rather than the inanity of TV channels. No dice. The thing came at him like a wild beast. No physical position into which he could put himself availed him for more than a second. The pain gnawed at him. It pounded. It twisted him. It was the work of a faceless, senseless torturer, sadistic in nature.

Desperation moved him in the direction of ritual. At first, he attempted to use liturgical language, silently mouthing the words of the Lord's Prayer, which in other circumstances were often a comfort to him. Not now. The pain mocked the familiar images and cadences of the prayer, which seemed to come from another world. "Forgive us our trespasses" and "lead us not into temptation" for some reason made the pain worse, and "deliver us from evil" felt like a cruel joke. Later he realized that the prayer bespoke an utter faith and confidence which the pain had removed from him. It was not, under these circumstances, his truth.

So he did, without forethought, one of the things that makers of ritual do when they are not sure what they ought to do. He began to focus, as intently as he knew how, upon the experience he was having. He concentrated upon the pain itself, for the truth was that it had become nearly all-absorbing. Now he put it at the center of his attention, all else fading to the shadowy edge — the Why? the Why Me? the How Long Will It Last? the Who Can Help? the Where Can I Turn? the What's Going to Become of Me? the Oh, God. Now there was just the pain and the rhythm of its throbbing, not simply there but attended to. It occurred to him that what he should do was just "do" the pain. He had been "having" it. Now he would "do" it. First to give it ever fuller attention. Then to get behind it, inside it, with it. To will it. To perform it.

Thus the words came to him: "I am hurting. I am doing the hurting. I pain myself." It was not just about thinking that. It was joining the words to the rhythm of the pain. "Here I come. I pain myself now. I let go a bit. I do it again. I breathe. Here now once more. I pain myself again. Again. Here. Now. Again." The will of the pain became his own will. The action of it became his action. The rhythm was his. He performed it.

Sometime between 1:00 and 1:30, he realized that the pain had subsided.

Commentary
The problem of healing begins (and ends) with the patient. We might even say that the problem begins with the naming of the patient as patient. For patient comes from the same root as pathos and passion, which means "to suffer" or "to undergo." From the same root also comes passive. The problem of healing begins with the regard of the patient as the passive one, the one upon whom the affliction has come. The victim.

This is perhaps a natural way of thinking: The pain has "been sent." It is the work of an evil spirit, a demon. It is a punishment for some offense against divinity. It is an attack, an invasion.

This way of thinking is changed, but also magnified, by medical science: Pain has an origin in some malfunction of the body, called a disease and given a specific name if possible. The aim of medicine is to find the offending disease, analyze its cause, eradicate that cause, and thus bring an end to the pain. For weeks, the patient in our story had been virtually obsessed with locating the cause of his suffering. He faulted his doctors because they could neither tell him what it was nor prescribe a remedy.

The search for offending causes is a rational way of thinking and has led, as we know, to an enormous array of cures. But it compounds the problem of suffering. This is where ritual wants — needs — to come in.

Among the many functions of ritual, the one I focus upon here is its turning of the sufferer into the actor — that is, into an active agent. Rituals vary in the degree to which they do this. There are occasions, and also traditions, in which the performers of ritual (priests, liturgical leaders) are few, while the more or less passive attendees, including the ill who seek healing, are many. But this is a late development in ritual, stemming from a certain professionalization that is analogous to, and sometimes actually part of, the professionalization of the medical arts. In principle, it may be argued, there are no spectators at ritual, for ritual is not, in the first instance, something to watch or listen to but something to perform.

The impulse to make ritual is the impulse to become actively involved in a process transcending one's rational comprehension. This is what is meant by calling ritual a kind of "magic." In the beginning, there is nothing irrational or superstitious about such an impulse or such a practice. It is a way of participating actively in something that one is already involved in but cannot well understand. It is a means of linking the known and the unknown in the mystery of the self's own willing participation. It is an embrace between the mystery beyond and the mystery within, brought about not in theory but in practical activity.

This view of ritual is pragmatic and hands-on. It is not antiprofessional but counterprofessional, since it advocates ritual making as a do-it-yourself activity. I have much respect for the medical profession, which has more than once come to my rescue. Moreover, I am myself a professional religious leader, being both a clergyman and a theologian. Nonetheless, I know the truth of the words George Bernard Shaw put into the mouth of a character in The Doctor's Dilemma: "All professions are a conspiracy against the laity." To counter this, we should encourage ritual as a means to empower the sufferer.

In such empowerment, the professional, whether of the medical or the clerical kind, has an important role to play, a role perhaps more like that of a physical therapist than a surgeon or a drug therapy specialist. It is the work of showing the patient, who is really a learner, what she is able to do for herself. The patient needs to learn a practice of heightened attention to, and willing participation in, the mysterious process of pain and restoration, of death and life, that is going on within her, through her, and by her, in this place at this time in this way.

The first thing to know about ritual is that it is a way of calling ourselves to a radical affirmation of the here and now. Pain and all. The business of ritual is to unify. That is why tears are sometimes effective: They are the first outcry of empathy and as such are a primitive form of ritual.

Tom F. Driver is the Paul Tillich Professor Emeritus of Theology and Culture at Union Theological Seminary in New York. He is the author of Liberating Rites: Understanding the Transformative Power of Ritual (Westview Press, 1998).