The alienation of the sufferer.

Suffering is a particularly human experience that often brings with it loneliness or alienation from others. The theory described in this article explains the mechanisms through which suffering affects an individual's sense of community and connectedness with others. The intricate patterns are explained to provide a basis for prescriptive nursing to prevent or reverse this loss of connectedness. First, the article develops the concept of suffering and its influences on relationship with the self and with others and the relationship of others with the sufferer. Then, the concept of alienation is developed in this context, its philosophical roots explored, and a continuum described that encompasses alienation through connectedness. Related concepts of separation, shame, and stigma are briefly described as partial cases of alienation of the sufferer that also show the pervasiveness of the phenomenon. Next, the personal characteristics of an individual who might help are developed through the concept of wisdom. Last, an explanation is given as to why care is the contextual framework through which alienation is reversed and connectedness achieved. Although suffering, alienation, and care have gone by many names, the essences of these phenomena have been recurrent theme in descriptions of human response.