The essence of enduring and expressions of suffering: the reformulation of self.

In this study, biographical narratives of illness experiences were used to explicate the concepts of suffering and enduring. Three types of enduring were identified: enduring to survive (which occurs during physiological jeopardy), enduring to live (which occurs with untenable psychological stressors), and enduring to die (which occurs with inevitable degenerative and terminal disease). Suffering is defined as an emotional response to that which was endured, to the changed present, or to anticipating the altered future. Finally characteristics that differentiate enduring from suffering are delineated. The relationships between the two concepts are explored. Individuals move from enduring to suffering when they are able to acknowledge that which is being endured, and when they are emotionally strong enough to experience the emotional onslaught of suffering. If the latter is overwhelming, individuals may retreat to enduring. Once they have suffered enough and are able to accept the changed reality, individuals gain new insight and appreciation for life as a reformulated self.