Escaping the Guilt and Shame of Chronic Illness and Pain


The weight of guilt and shame lies heavily on many individuals with chronic pain, illness, and disability. While I have long been aware of this common burden in the lives of many with physical limitations, I was recently forced to pause and truly recognize the extent to which these feelings can take hold. A somewhat offhand comment on one of my posts stopped me in my tracks and caused me to think through this issue more seriously.

Reflecting on her physical limitations and inability to do and accomplish, a commenter stated, “they shoot horses, don’t they…”

And I don’t want to embarrass or draw attention to the individual who made this comment, but as this statement was posted in a public place, I feel at liberty to respond in a public manner.

Unchecked guilt and shame intermingle in such a way that we begin to feel worthless, inadequate, insignificant, and invaluable. At their worst, guilt and shame leave us feeling as though we are simply dead weight in the midst of a productive world, and it would be far better if we were “taken care of” for good.

Guilt is fairly straightforward to wrap my brain around. We feel guilty for being a burden and guilty for not doing our share. We feel guilty for the things we can’t do, guilty for cancelling plans, and guilty for needing so much help. We feel guilty for being sick, because it affects others so drastically.  We feel guilty because perhaps it is our fault and perhaps we are just not trying hard enough to get better.

But shame is a bit more complex. We feel guilty for the things we are unable to do, but even worse, many of us begin to feel shame for who we are and who we believe others perceive us to be. Shame cuts to the deepest fragments of our identity, telling us we don’t matter, screaming that we have no worth, whispering words of inadequacy in our ears into the wee hours of the morning. Shame attacks our character; we are lazy, incompetent, unreliable, or weak. The stigma of pain and illness leaves a mark of shame on our foreheads for all to see. Whether spoken or unspoken, conveyed in reality or created in our imagination, we are fakers, catastrophizers, and inconveniences at best; malingerers, addicts and criminals at worst. 

When deep-seated shame comes to stay, that is when we begin to feel really and truly worthless. And when shame and guilt intermingle, the stage is set to begin comparing ourselves to a useless and soulless horse, no longer able to pull its own weight, so perhaps we should shoot it to relieve its suffering and ease the burden it places on the rest of society. Perhaps we should commit suicide so no one has to deal with us anymore.

Offhand comments come from somewhere. Passing thoughts come from somewhere. Far from insignificant, they surface from the depths of our unconscious, revealing what we truly feel about who we are. Worthless. Inadequate. Humiliated. Invaluable. Ashamed. Useless. Insignificant. A waste of space.

At our worst, we feel of no use to anyone. At our very worst, we feel there is no point for our continued existence.

From some frames of reference we have little value. Speaking for myself, when it comes to survival of the fittest, I am worth close to nothing. I am literally the lowest on the totem pole. In any sort of survival situation, end of the world apocalypse, or real-life emergency needing physical agility, I would be the first to go. I am at the very bottom dregs of society when it comes to fighting for my own survival in a dog-eat-dog world.

From a purely evolutionary perspective, if we are simply descendants of some ape-like creature, if we are simply masses of cells, tissues, and organs that somehow slowly evolved into our current human state, then a disabled human is no different than a lame horse that needs to be compassionately shot to save it from suffering and presenting a burden to its owner.

But we are not descendants of some prehistoric creature. We are image bearers of the living God. 

We are not isolated masses of cells, tissues, and organs. We are human beings relationally connected to the Creator of the universe. 

We are not akin to a soulless animal. We are embodied souls, our weak and disabled physical bodies housing a glorious and unbroken soul, a soul that can never be touched or tainted by the things of this world or the decaying of our physical selves. 

Health, physical prowess, and the abilities and accomplishments that flow from them do not make us more valuable, worthy or important.

“For it is by grace you have been saved, through faith – and this is not from yourselves, it is the gift of God – not by works, so that no one can boast.” Ephesians 2:8,9

Because of God’s grace to save all those who believe, we are free to simply be. We don’t have to do anything to be valuable or worthy. We don’t have to accomplish anything to be somebody. We have literally nothing to boast in of our own doing, leaving us only to boast in what has been done for us.

Because of what Christ has done, we are free to be. Because He was pierced for our transgressions and crushed for our iniquities, because the punishment that was peace was on him, we are free from having to carry any burden of guilt on ourselves, whether that guilt is true or perceived. We are free from the guilt of not being able to do or accomplish or succeed or achieve. By his wounds we are healed. By his wounds we are freed from the shackles of shame that tell us we aren’t anybody, we aren’t worth anything, we are better off dead.

Because of what Christ has done, we are free to simply be. Because of what Christ has done and who he is, and because of our connection to him, we have value, worth, and importance.

It means that you still matter, even though your pain destroys you every day.

It means that you are still valuable, even when you can barely lift a finger to do anything for anyone.

It means that you are still important, even though you can’t keep a job or care for your own basic needs.

It means that you can and should stop and rest. Less doing, more being.

And even though we are free to simply be, we are offered something better. We are given the chance to give of ourselves in small ways, completing works we are capable of accomplishing in our state of physical disarray.

“For we are God’s handiwork, created in Christ Jesus to do good works, which God prepared in advance for us to do.” Ephesians 2:10

I am quite certain that if God took the time to tailor-make us, creating good works for his hand-made children in advance, he would never create works that we are incapable of doing.

You have something to offer. You have something to give. You have something that someone else needs. The size of the offering is not what matters, just that we give of ourselves in whatever small ways we are able, no matter how small it may be or insignificant it may seem. And while these small offerings do not make us more worthy or valuable, and while these good works are not the catalyst that takes away our shame, in this free gift of being able to offer ourselves, we are able to see and feel that we do have a purpose and a place when it comes to living out life on this earth.

You matter.

You have something to offer.

Shame and guilt need not remain permanent fixtures in your life of sickness and pain. There is a way out.


  1. Thank you, thank you. You have an amazing gift to put into words a complex array of thoughts and feelings while suffering allowing those of us that also suffer with chronic pain and illness say “that’s it!”. Yet, your tact of vocabulary expression allow others who do not suffer first hand, say “wow, I get it!”. So, thank you again for sharing your gift.

  2. My son mentioned the movie “I, Robot” to me today as we were talking about the lack of humanity in society. Your prose came at just the right time. He is an IT guy and is always saying just because we can do something, it doesn’t mean we should. First we are human. We are all different. The differences are what makes us human. We should not have to apologize for that.

  3. Thank you so much for writing this, again. Your posts are so life-giving. I want to thank you from the bottom of my heart because I wrestle with the feelings of guilt and worthlessness at the deepest levels every single day. I think that I should probably print those lines out, so I can see those affirmations every single day because the guilt does FEEL like a permanent fixture, even when I know in my rational brain that it isn’t. Sometimes the rational part just gets eaten away at with pain and the feelings take over…

    1. Thank you for your kind words. So true that feelings can dominate in the midst of pain and suffering. I write this post when I am not in the midst of a flare, and it does wonders for my perspective. But as soon as I reenter another flare, it is so hard to think and I really become trapped in everything that I feel. But I am slowly coming around to a more permanent perspective on all this. I really do think it is possible – slowly working my way there.

  4. I struggle daily with the guilt of not being able to do the things I once could for myself and my family. Chronic pain is constantly in the forefront of my mind and what it had taken from me. This post was amazing and gives me hope that one day I will be able to fully accept my condition as it is and move forward and focus on the things that I can do rather than focusing on the things I cannot do!! Thank you from the bottom of my heart for this post!

  5. I really needed to read this today. Thank you so much for writing such an insightful post. We go through so much already with chronic pain and illness, sometimes the social stigma and shame is just too much to add onto it. Then, every time I’m feeling awful, I find a post like yours to help remind me that I am a child of God and I matter no matter what.

  6. Wow, once again, you nailed this post. I wish that I could have shared this with a friend/cousin in our community who succombed to the temptation of suicide last year. I hope that your words can instill hope in someone out there who may have those dangerous thoughts. Your ministry is so vital and alive here.

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