Metaphor, Illness, and Identity in Ancient Religious Texts
Metaphor, Illness, and Identity in Ancient Religious Texts
Metaphor, Illness, and Identity in Ancient Religious Texts
Keywords. Metaphor, Illness, Identity, Psalm 88, Psalm 102, Medical Humanities
Abstract
This article argues that the Hebrew Bible is an important resource for adding insights into illness
language and narratives by making a case for the use of medical humanities in biblical studies. Using
an interdisciplinary approach, the article utilises existing research concerned with illness experiences
and identity as a heuristic tool for addressing the study of illness in the Hebrew Bible. However, as
well as providing a useful heuristic lens, this article argues that ancient texts can also bring a richness
to present day perspectives and analysis of illness accounts within medical humanities. A key
contribution of this article is the demonstration that ancient religious texts such as Psalms 88 and 102
share many of the themes, concerns, and motifs which resonate in modern day research concerning
illness experiences. We will initially examine modern illness experience research and then turn to
Introduction
There is no other adversity which can strike that is quite like illness. Illness affects everyone at some
point and of all the misfortunes it is certainly the most common. However, little attention has been
devoted to the potential relevance of the Hebrew Bible as a rich and fertile source for depicting the
way illness is experienced. This is surprising given that Scarry’s often cited work on pain, first
published over forty years ago, devotes a substantial chapter almost entirely to the Hebrew Bible. 1 It
is also surprising given that problems relating to suffering and theodicy, so regularly raised in present
day illness accounts, form major themes within the Hebrew Bible. This article argues that ancient
texts provide a voice from the past which brings richness to present day illness accounts; they are a
1
E. Scarry, The Body in Pain: The Making and Unmaking of the World. (New York and Oxford: Oxford
1
precious primary source which allows us a unique comparative glimpse at human experiences of
illness.
Attempting to define illness is complex. Many western lay people tend to think of sickness from a
dualistic, somatic perspective; the body and mind are like a machine which, when broken, can be
fixed. 2 In other words, the patient is an object who is the focus of the clinical gaze of the medic. 3 In
contrast, the preamble to the constitution of the World Health Organisation defines health as ‘a state
of complete physical, mental and social well-being and not merely the absence of disease or
infirmity’. 4 The connection between the ill person’s own, socially situated, understanding of illness
and its decisive role in the origin and development of health conditions is now widely recognised in
the social sciences, especially in the medical humanities. 5 Illness has been understood therefore, as a
social transformation or ‘biographical disruption’ which can be particularly erosive to identity causing
one to re-evaluate former identities and creating new fragmented, or spoiled, identities such as
“cancer survivor.” 6
2
On the distinctions between ‘disease’ and ‘illness’ refer to L. Eisenberg, ‘Disease and Illness: Distinctions
between Professional and Popular Ideas of Sickness’, Culture, Medicine and Psychiatry 1977 1, 9–23. A social
constructionist approach to illness is rooted in the widely recognized conceptual distinction between
disease (the biological condition) and illness (the social meaning of the condition). Cf. M. A. Glasby,
Wholeness and Holiness: Medicine, Disease, Purity and the Levitical Priesthood. (Apostolos Press,
2017).
3
M. Foucault, Naissance de la Clinique. (Quadrige: Paris, 1988).
4
Author’s italics. This definition can be found on the WHO website:
http://www.who.int/about/definition/en/print.html
5
But also in the medical sciences. Refer to the work of the health experiences research group at Oxford’s
F. Collyer, ed., The Palgrave Handbook of Social Theory in Health, Illness and Medicine. (Basingstoke:
2
From this broader understanding of illness comes a second observation: illnesses are ‘marked
with cultural salience in different epochs and societies.’ 7 Cultural meanings can ‘mark the sick
person’ with ‘significance often unwanted and neither easily warded off nor coped with. The mark
may be either stigma or social death’. 8 Part of the reason for this is that, far from being merely
“natural” and timeless, illness is socially constructed and people often enact their illness and endow it
When a physician diagnoses a human’s condition as illness, he changes the man’s behaviour
illness to disease. 9
Thus, substantial social consequences are associated with an illness label even in medicalised
environments. Nothing inherent about the illness makes it stigmatizing, rather, it is the social
responses to a given malady, or some of its manifestations, that cause it to be an object of stigma. 10 In
the stigma can begin with the societal reaction to the condition: that is to say, a person so
labelled is shunned, derided, disconfirmed, and degraded by those around him …. Eventually,
the stigmatised person comes to expect such reactions, to anticipate them before they occur or
Palgrave Macmillan, 2015), 582 – 598. Cf. M. Bury, 1982. ‘Chronic Illness as Biographical Disruption’,
Sociology of Health and Illness 1982 4 2, 167-82. Also refer to M. Bury, ‘Illness narratives: fact or fiction?’,
Row, 1970), 223. Refer also to P. Berger and T. Luckmann The Social Construction of Reality: A Treatise in the
Journal of Health and Social Behaviour 2010 51 5, 567–579. Cf. P. Conrad, ‘The Experience of Illness: Recent
and New Directions’, Research in the Sociology of Health Care 1987 6, 1–31.
3
even when they don’t occur. By that stage, he has thoroughly internalised the stigma in a deep
sense of shame and a spoiled identity. His behaviour, then, becomes shaped by his negative
self-perception. 11
Therefore as well as having a cultural significance, the identity of the one who is ill is vulnerable to
being reshaped by social interpretations of the illness.12 In some societies, ‘so powerful is the stigma’
which the ‘culturally marked illness label’ evokes that ‘it affects all … relationships and may lead to
ostracism.’ 13 Furthermore, Kleinmann argues, stigma ‘often carries a religious significance – the
afflicted person is viewed as sinful or evil – or a moral connotation of weakness and dishonour’ thus,
‘stigma helps to define the social identity of the group.’ 14 As Douglas suggested, illness and its
consequences threaten essential values, behavioural norms, and conceptions of order. To restore
order, threat is placed in a framework which brings social meaning to the experience. 15 Therefore,
illness can threaten constructed norms and values, and may even challenge the idea of the group.
This approach to illness is also taken by Good who argues that ‘a great many anthropological
studies of illness have shown that sickness is universally experienced as a moral event’ and ‘efforts to
bring meaning to such events require not only resort to theodicy … that is to answering “why me?” …
but to the yet more fundamental soteriological issues.’ 16 Thus, existential questions can sometimes be
answered with “religious” (when understood in a very loose sense) theories and stories, as Evans-
Pritchard illustrated with regard to witchcraft, or Fortes suggested in relation to troublesome spirits. 17
11
Kleinmann, The Illness Narratives, 160.
12
E. Goffman, Stigma: Notes on the Management of Spoiled Identity (Englewood Cliffs, NJ: Prentice-Hall,
1963).
13
Kleinmann, The Illness Narratives, 159.
14
Ibid, 159.
15
M. Douglas, ‘The Healing Rite’, Man 1970 5, 302-308.
16
B. Good, Medicine, Rationality, and Experience: An Anthropological Perspective. Lewis Henry Morgan
M. Fortes, Oedipus and Job in West African Religion (Cambridge: Cambridge University Press, 1959).
4
Answers provided through shared explanatory models 18 to such questions can function in a positive
way, giving the sick person a sense of agency. Or, they can be disruptive causing the ill person to take
on the burden of guilt in addition to coping. Nevertheless, some agency and power is claimed in the
very act of telling a story since it allows narrators to communicate what is significant in their own
I hope to shift the dominant cultural conception of illness away from passivity – the ill person
as a “victim of” disease and then recipient of care – towards activity. The ill person who turns
Thus, both societies and individuals either experiencing or observing illness react in a manner which
attempts to read meaning, often religious meaning, into it. Although we must acknowledge that
meanings often vary, 21 cultural meanings attached to illness nevertheless ‘shape suffering as a
distinctive moral or spiritual form of distress. Whether suffering is … the ritual enactment of despair
… or as the ultimately existential human dilemma of being alone in a meaningless world.’ 22 The
impact of the illness experience on the individual is, therefore, considerable. Since we create, rather
than merely discover, meaning in experiences the process of identity change through illness can be
discerned through narrativization. As Good argues, ‘narratives are central to the understanding of the
experiences of illness … to placing pain … in relation to other events and experiences in life…. [such
18
Concerning explanatory models refer to Kleinmann 1988:105. Explanatory models seek to explain etiology,
that is, origins and causes; time and onset of symptoms; pathophysiology; course of sickness; and treatment.
19
A. W. Frank, The Wounded Storyteller: Body, Illness, and Ethics, (Chicago: University of Chicago Press,
1995)
20
Ibid, xi.
21
M. Bury, Meaning at Risk: The Experience of Arthritis’, in R. Anderson, and M. Bury, Eds, Living with
Chronic Illness. The Experience of Patients and their Families (London: Unwin Hyman, 1988), 91.
22
Kleinmann, The Illness Narratives, 26.
5
narratives] bring a certain coherence to events.’ 23 Sometimes such narratives may be dramatized. For
example, telling your story in an Alcoholics Anonymous meeting brings illness narratives and
performance together in a ritual-like manner. 24 Therefore, illness evokes powerful questions about
Placing illness in a cross-cultural and social context is especially helpful for exploring its
broader social impacts and consequences for identity. The ill person has to rethink their ability to
engage with the world, and thus their entire identity. Another advantage of viewing illness in this
manner is the ability to trace, through narrativization, the way in which identities and definitions of
the group are reconfigured through illness. For example, just as group identity can become more
pronounced in periods of migration and social upheaval 25 so too, group identity may be challenged
and reconfigured through the occurrence of illness. To use an analogy, exclusion of those who are
perceived to be ‘foreigners’ reaffirms the group’s own identity just as the sick person’s ostracism
In this analysis two possibly exilic Psalms (88 and 102) have been selected as exemplars on account
of their reflection on the common experience of individual suffering in which sickness is a given
component and on account of the overlap of themes and motifs in the two Psalms. 26 Texts which
23
Good, Medicine, Rationality, and Experience, 133. Refer also to the essays in B. Hurwitz, T. Greenhalgh, and
V. Skultans, Narrative Research in Health and Illness. British Medical Journal Books, (Malden, Mass., and
88 is one of the most prominent. Like many Psalms, both 102 and 88 are first-person singular accounts. They
share common themes and motifs (as will be demonstrated). Additionally, they share similar language. Like 88,
in Psalm 102 the petitioner requests that YHWH does not hide his face (Ps. 88:14; 102:2). Similarly, like 88, the
6
explore and narrativize illness provide a wealth of data for exploring the connections between the
topics. Nevertheless, a few points of clarification are in order. It must be emphasised that this is not an
anachronistic attempt to make retrospective diagnosis, exploring ancient texts through snake oil and
exegetical quackery. Instead the focus is on human interpretations and experiences of illness. It is an
attempt to take seriously the sufferer’s view of illness. 27 In addition, this is not an attempt to
manipulate the two Psalms to match some modern experiences; neither is it an attempt to bend the
modern discussions to fit the text. Rather it is simply a way of looking afresh at both fields of selected
evidence and discerning the significance of similarities and differences. Thus, neither the Psalms in
question nor the material concerning illness experiences is understood as “superior”. Furthermore, we
must acknowledge and avoid the difficulty of engulfing the distinctiveness of the Psalms, or of the
modern research, in barren simplifications thus risking misrepresenting both domains of research.
Another consideration is that we are not able to engage in anthropological participant observation.
insurmountable hurdle: the focus is on illness accounts, and the way narrators attempt to find meaning
supplicant requests that the deity inclines his ear (Ps. 88:2; 102:2). Furthermore, the theme of illness connects
both prayers, as is seen through the use of the term ‘ עניaffliction’ in both; indeed, Psalm 102 is even entitled ‘a
prayer of the afflicted when he is weak’ (Ps. 102:1; עני88:1, 7, 9, 15; 102:1). Similarly, both Psalms are
described as ‘prayers’ ( תפלהPs. 88:2. 13; 102:1, 17). Likewise, both Psalms include the term ‘answer/to be
afflicted’ ( ענהPs. 88:7; 102:23). Additionally, both interpret illness as a consequence of YHWH’s anger. This is
28
It should be acknowledged that methodological problems also exist within participant observation. These
include, for example, communities modifying behaviours in light of the presence of the fieldwork researcher,
the anthropologist’s interpretation of practices being different from the community’s understanding, problems
with translation of indigenous languages and terms, and unhelpful emic explanations such as “it’s just tradition”.
Thus, attempting define and explain the social through fieldwork research involves numerous challenges, just as
7
in illness, rather than on observing sickness behaviours and symptoms (which would be more aligned
with the medical diagnosis approach). 29 Furthermore the social and cultural, although not obvious
through participant observation, may be reconstructed to some extent both through the illness
accounts of Psalms 88 and 102 themselves and also, albeit partially, through accessing existing
scholarly arguments pertaining to the dates of the Psalms in question. An example may help to
demonstrate. If we were reading Sontag’s work on aids, we might be able to reconstruct from the
work itself, regardless ethnographic reports or fieldwork, that a pervasive social response to aids at the
time and in the situation culturally of her writing was to react with anxiety. Such was the scale of fear
evoked by the illness as depicted in her writing that one might suppose it caused a fight-flight-freeze
response with the dominant response from clinicians and fund-raisers being focused on the struggle to
achieve a future where the illness might be less life-threatening, and also therefore, a future where
such uncomfortable anxiety may be avoided. Thus, from a text itself it is possible to gain some
important cultural and social information. However, it must be acknowledged that this information is
Also important is the problem of genre; the Psalms are poetic prayers, rather than narrative in
a strict sense. 30 One thing that the Psalms do have in common with present day illness accounts is,
however, a first-person account of illness. Thus, they may be understood as “narrativised” in the sense
29
As Seybold argues, ‘the situation of the sick person from the inner perspective of an individual’s own
experience is expressed in the Old Testament’s literature of prayer.’ K. Seybold, Sickness and Healing. Biblical
Lowth, ‘Lectures on the Sacred Poetry of the Hebrews’ G. Gregory (trans.), in D. A. Reibel, ed., Robert Lowth
(1710–1787): The Major Works. 2 vols. (London: Routledge, 1995). Also see the discussion between J. L.
Kugel, The Idea of Biblical Poetry: Parallelism and its History, (Baltimore and London: John Hopkins Press,
1998) and R. Alter, The Art of Biblical Poetry (New York, Basic Books, 2011). Refer also to F. W. Dobbs-
Allsopp, Poetry, Hebrew. In K. D. Sakenfeld, ed., The New Interpreter’s Dictionary of the Bible. Vol. 4, Me-R.
(Nashville: Abingdon, 2009), 550–558, and to W. G. E. Watson, Classical Hebrew Poetry: A Guide to its
8
of lyricism, that is, the building of an autobiographical narrative through poetry, as is done in song-
cycles. 31 As Woods argues ‘narrative does not have a monopoly on expressivity … experiences of
distress and of physical vulnerability can be brought to life and given shape in a wide variety of
media.’ 32 Therefore, since representation of experience can occur through many avenues, “narrative”
Also potentially confusing is the abundance of metaphor in the Psalms. As Culley comments,
‘the descriptions are so vague the condition might in some cases stem from other causes like fear or
despair.’ 33 How do we know that sickness is not just a metaphor for suffering more generally given
that the Psalms are constituted in such a way that they can capture common human experiences of
The individual complaint psalms are not diagnosing texts, but rather prayer literature.
Consequently, they can be expected to present experiences of sickness and different kinds of
suffering caused by sickness. The same psalm can depict suffering with several different
dimensions: mental, physical, social, and spiritual. ... Suffering is not depicted “objectively,”
but through subjective experiences. Sickness is such a general human experience that it is a
suitable metaphor for every (other) … human suffering…. Several metaphors can be
31
Poetry plays an important role in modern research concerning illness experience. C. Pointdexter, ‘Research as
Poetry: A Couple of Experiences HIV’, Qualitative Inquiry 1998 8 6, 707-714. C. Glesne, ‘That Rare Feeling:
Re-presenting Research Through Poetic Transcription’, Qualitative Inquiry 1997 3 2, 202-221; M. Kendall, and
S. Murray, S., ‘Poems from the Heart: Living with Heart Failure’, in B. Hurwitz, T. Greenhalgh, and V.
Skultans. Eds, Narrative Research in Health and Illness. British Medical Journal Books, (Malden, Mass. and
in H. Carel and R.Cooper, Eds, Health, Illness and Disease : Philosophical Essays, (Durham, GBR: Acumen,
Lord. Biblical and other Studies in Memory of Peter C. Craigie. Journal for the Study of the Old Testament.
9
combined in the prayers and descriptions of affliction in a psalm, such as war, hunting, trial,
descent into the kingdom of Death, etc. ....the different aspects and dimensions of suffering
intertwine. Is it wise to break apart such circles in order to forge them into causal chains? Is it
correct to exclude … psalms which do not explicitly use metaphors for sickness, that is, the
psalms which do not express affliction with terminology referring to somatic injuries? 34
Similarly, Seybold comments ‘the psalms do speak about sickness and healing and not just about
suffering of a general nature.’ 35 Therefore, as we have already argued, the definition of sickness
should not be restricted to somatic injuries, or limited in a monocausal way. What we are not doing is
some sort of bland and banal distinction between “real” and “fake” illness in ancient texts. Neither are
we restricting the idea of sickness in the selected Psalms to unambiguous references to somatic
injuries. Rather, we are taking account of the social aspects of illness wherein the sufferer’s own view
and experience of illness is important and acknowledging the power and ongoing resonance in the
Sontag fiercely criticised the use of metaphor when thinking about illness arguing that
negative metaphorical meanings, which distort biological “facts”, attached to cancer have a significant
impact on cancer patients. 36 For example, Sontag argues that the prevalence of military metaphors
‘contribute to the stigmatizing of certain illness, and by extension, those who are ill’. 37 Therefore, for
Sontag, ‘nothing is more punitive than to give a disease meaning.’ 38 Although Sontag’s arguments
34
Lindström, Suffering and Sin, 25-26.
35
Seybold, Sickness and Healing, 44.
36
S. Sontag, Illness as Metaphor, (New York: Farrar, Straus and Giroux, 1978); S. Sontag, Aids and Its
commented upon. Clarke and Everest illustrate this trend thoroughly in light of battle metaphors and the mass
media. J. N. Clarke, and M. M. Everest, ‘Cancer in the Mass Print Media: Fear, Uncertainty and the Medical
10
have been accepted by some, 39 they have also been the subject of criticism. Raffel, Rhys, Sarlos, and
Ball, for example, present meticulous, convincing analysis which highlights the many flaws in her
case, eventually concluding that ‘it is both the case that metaphors can help us understand illnesses
and that illness metaphors can be helpful in illuminating other aspects of reality.’ 40 Far from better
being banned, metaphor is a significant feature of the way people talk about their experiences and is
pervasive in everyday life and thought. 41 Indeed, Gibbs and Franks present a particularly strong case
for the relevance and beneficial aspects of metaphor for illness accounts.
[M]etaphor provides the intellectual and linguistic tools for communication about senseless
suffering, and yet also offers a plan for personal transformation in coping with illness….
illness brings with it the need to make sense of what is happening to someone in very personal
terms. Metaphor appears to have both a representational and determinative function for
individuals…. 42
Therefore, the use of metaphor allows people to retain a transformed identity but also to communicate
imaginatively about their experience. Indeed, while not necessarily healing, metaphorization of
suffering provides a person who is ill with options and creative possibilities. Through structuring the
experience of illness in terms of another concept, where inevitably some aspects of the experience are
highlighted and others obscured, a process of interpretation and re-evaluation of identity can begin.
For example, as Mazanderani, Locock, and Powell highlight metaphor is interesting since is
underlines ‘the embodiment of a particular identity tension’, and ‘metaphor offers a distinct way of
39
S. Neilson, ‘Pain as Metaphor: Metaphor and Medicine’, Medical Humanities 2016 42, 3-10.
40
S. Raffel, E. Rhys, S. Sarlos, and B. Ball, The Method of Metaphor. (Bristol, and Chicago, Illinois: Intellect,
2013), 54. Refer also to B. Clow, Who's Afraid of Susan Sontag? or, the Myths and Metaphors of Cancer
1980), 3.
42
R. W. Gibbs, and H. Franks, ‘Embodied Metaphor in Women’s Narratives About their Experiences with
11
expressing relations between similarity and difference.’ 43 Given these considerations we suggest that
in their use of metaphor the Psalms actually align well with modern research agendas which highlight
the positive aspects of metaphor in illness experiences and are therefore a useful and relevant source.
Analysis
A possible background to Psalm 102 is ‘likely the destruction of Jerusalem in the sixth century
[BCE]’. 44 It may have existed as an original composition (consisting of vv. 1-12, 24-25) which was
redacted in the exilic period. 45 Within the Psalm, illness is not isolated into disparate elements (such
as social, physical, and emotional). Rather the suffering is experienced as a whole. Somatic features
include the heading ‘a prayer for the afflicted when he is overwhelmed’ (Ps. 102:1); ‘my days are
consumed like smoke, 46 and my bones are charred as dry wood’ (Ps. 102:3); ‘my heart is struck and
withered like grass… I forget to eat my bread’ (Ps. 102:4); ‘my bones cleave to my skin’ (Ps. 102:5);
‘I am withered like grass’ (Ps. 102:11). Similarly, in Psalm 88 some somatic characteristics of illness
are listed such as the mention that ‘my being נפשis full of troubles’ (Ps. 88:3). Additionally, we are
told that the petitioner is ‘like a man who has no strength’ (Ps. 88:4). Similarly, ‘my eye languishes on
account of my affliction’ (Ps. 88:9). Finally, we are informed that ‘I am afflicted and dying … I am
43
F. Mazanderani, L. Locock, and J. Powell, ‘Being Differently the Same: The Mediation of Identity Tensions
in the Sharing of Illness Experiences’, Social Science & Medicine 2012 74 4, 546-553, 552.
44
W. H. Bellinger, ‘Psalm 102: Lament and Theology in an Exilic Setting’, in R. L. Foster, and D. M. Howard,
Eds,, "My Words Are Lovely". Studies in the Rhetoric of the Psalms, Library of Hebrew Bible/Old Testament
Studies. Library of Hebrew Bible / Old Testament Studies, 467 (New York and London: T&T Clark, 2008),
147-155, 150.
45
An idea going back to H. Schmidt, Die Psalmen (Tübingen: Mohr, 1934). Cf. S. L. Terrien, Strophic
Structure and Theological Commentary. Eerdmans Critical Commentary, (Grand Rapids, MI, and Cambridge:
William B. Eerdmans, 2003), 698. Also refer to J. W. Rogerson, and J. W. McKay, Psalms. Book 2 51-100.
Cambridge Bible Commentary, (Cambridge and New York: Cambridge University Press, 1977), 21.
46
Westermann suggests that this is a picture of all that is fleeing or transient C. Westermann, Praise and Lament
12
helpless (( ’)פוןPs. 88:15). 47 In the following analysis, attention will be focused on the account which
46F
accompanies the descriptions of illness and the way illness is contextualised socially.
Perhaps the most dominant theme of Psalm 102 is isolation. The Psalmist feels like a social
outcast and this is explicitly stated. The Psalmist describes himself using various animal metaphors
such as ‘a pelican of the desert [and] an owl of the wilderness’ and ‘as a sparrow alone ( )בדדupon the
house top’ (Ps. 102:6-7). Similarly, there is a description of enemies who ‘reproach me all the day’
(Ps. 102:8). The term “alone” ()בדד, which means to “separate,” “withdraw,” or “to be isolated,”
highlights the Psalmist’s position as a social outcast. However, the supplicant in Psalm 102 is not
entirely isolated; rather he has the company of “enemies” who taunt, perhaps emphasizing and
concretizing the outcast status of the petitioner. What is particularly striking, however, is the choice of
self-ascription with the metaphor of unclean birds that inhabit the desert (Lev. 11:17-18; Deut. 14:16-
17; Isa. 34:11; Zeph. 2:14). As DeClaissé-Walford, Jacobson, and Tanner point out ‘the unclean status
of these birds adds a religiously symbolic dimension to the psalmist’s isolation, and thus to his
vulnerability.’ 48 The supplicant is exiled from his social group and is alone. This gives us quite a lot
47F
of information about the particular cultural setting wherein the Psalmist operates; illness, and by
extension the ill person, is clearly a source of fear. Moreover, the way illness is interpreted culturally
is in symbolic and ritualistic terms; perhaps pointing to a culture associating causation of, and
treatment for, illness with magic or the gods. Again, this association implicates the ill person by
marking them off as having offended the gods. Death is also an important theme and metaphor in
Psalm 102; we are informed that the petitioner’s days are ‘consumed like smoke’ (Ps. 102:3), that
‘ashes have been eaten like bread’ (Ps. 102:9), and that ‘my days are like a shadow that declines’ (Ps.
47
The term פוןis a hapax and the meaning is uncertain. The editors of BHS suggest in the apparatus that the
term be emended on the basis of the LXX (which has καὶ ἐξηπορήθην “and despair”) to “ אפוגׇ הto be weary”. A
text from the Dead Sea Scrolls, 4QPst has “ פורI am frustrated”. Refer also to J. A. Emerton, ‘Some Problems in
Psalm 88.16’, in K. J. Cathcart, C. McCarthy, and J. Healey, Eds, Biblical and Near Eastern Essays. Studies in
Honour of Kevin J. Cathcart, Journal for the Study of the Old Testament. Supplement Series. Journal for the
Study of the Old Testament. Supplement Series, 375. (London and New York, T&T Clark, 2004), 95-103.
48
DeClaissé-Walford, R. A. Jacobson, and B. L. Tanner, The Book of Psalms, 752.
13
102:11). This can be seen in Terrien’s commentary wherein the title given for the beginning of Psalm
is ‘Supplication of a Man Sick unto Death.’ 49 Thus, in Psalm 102 the petitioner not only understands
illness in powerful metaphoric terms as social death, but also casts himself as one on the brink of
death.
There are lots of similarities with the way illness is portrayed in Psalm 88. For example, the
theme of isolation is explicitly stated on two occasions, the second of which is the final line of the
Psalm.
You have caused my companions (literally ‘those who know me’) to shun ( )רחקme
You have caused friend and neighbour (literally ‘lover and friend’) to shun ( )רחקme;
49
Terrien, Strophic Structure, 697.
50
It should be noted that many petitions from various cultures depict the sick person as being “bound” or not
being able to escape. For example, in Babylonian prayers and incantations, healing a sick person is to release a
prisoner. Furthermore, the connection between suffering and captivity is common in the Hebrew Bible (Ps. 18:6;
31:9 49:16; Hos. 13:14; Job 3:23; 19:6, 8; Lam. 3:7). Lindström, Suffering and Sin, 208. The metaphor of
imprisonment for illness fits neatly with Frank’s chaos story ‘But in the lived chaos there is no mediation, only
immediacy. The body is imprisoned in the frustrated needs, of the moment’ (Frank, The Wounded Storyteller,
98). The LXX does not translate “shut in” כלאbut instead has παρεδόθην “I betray” (indicative aorist passive
deliberately) ends with darkness and a verbless clause. Howard suggests reading v.18b in apposition to 18a,
understanding the final utterance is a ‘despairing gasp or moan’. D. M. Howard, ‘Psalm 88 and the Rhetoric of
Lament’, in R. L. Foster, and D. M. Howard, Eds,, "My Words Are Lovely". Studies in the Rhetoric of the
Psalms, Library of Hebrew Bible/Old Testament Studies. Library of Hebrew Bible / Old Testament Studies, 467,
14
Isolation is expressed through the metaphor of physical proximity. Those who used to be acquainted
with the sufferer are now far from him ()רחק. Even the most significant people in his life (lover and
friend), are not available to him; they are in darkness. Particularly interesting is the metaphoric self-
status, on account of illness, as social outcast. 52 This is powerful since the language of ritual purity is
51F
used to highlight the extent of the Psalmist’s stigmatised position, again suggesting that the cultural
response to illness at the time was founded on connecting it with fear. This has attracted wide-
recognition. For example, Lindström states that ‘traditional is the idea that there has arisen a social
vacuum around the sufferer that makes him vulnerable and completely abandoned …. the idea that a
life emptied of positive social relationships is comparable to an existence in the chaotic darkness.’ 53 52F
lamentation about being left alone, as an outsider.’ 54 In both Psalms, therefore, powerful metaphors
53F
Another similarity is the prominence of the motif of death. This may be a reflection of the
level of isolation on account of illness felt by the Psalmist, a reflection on dwindling physical health,
or some combination of the two. We are informed that ‘my life draws near to Sheol’ at the Psalm’s
opening (Ps. 88:3). 55 In the Hebrew Bible, Sheol can also be used figuratively for exile and for
illness. 56 In the next verse, the Psalmist suggests that he is counted ‘among those who go down to the
52
The term abomination is used of something which is ritually unclean or impure such as the sacrifice of an
animal with a blemish (Dt. 17:1; 11QT 48:6), images of foreign gods (Dt 7:25-26; 4QMMT C6), or sexual
Job’s illnesses (Isa. 38:10; Job 33:22). It can also be used metaphorically to refer to situations of perceived
difficulty (Ps. 107:18). Terrien suggests ‘descent into the realm of the dead is so proximate and certain that it
15
pit… like a man who has no strength (( ’)אילPs. 88:4). 57 The motif of death is repeated again in the
56F
next verses
for they are cut off (niphal גזרcan mean excluded) from your hand.
It is important to note here the ambiguity between injured or profane (as expressed through the term
)חלל. Like the term ‘abomination’ ()תועבה, the simile ‘profane’ may be understood as suggesting the
ritual language of impurity. This adds another dimension to the sense of isolation within the Psalm;
the author is not only socially shunned, but is also ritually unacceptable. Effectively, all the different
aspects of illness, mental, physical, social are depicted as death; or, as Lindström comments ‘Death is
may be considered a fait accompli’ (Terrien, Strophic Structure, 627). Similarly Seybold suggests parallels
from the Gilgamesh epic, that the sick person may think of the nether world as a continuation of his state at the
ambiguity of the motif of death in the Psalm as either physical health or social seclusion. ֱאי ָלis a hapax
legomenon in the Hebrew Bible. It is listed in BDB lexicon as an Aramaic loanword meaning “help”. It comes
up once in the Dead Sea Scrolls meaning “arbitration” but this does not make sense in the context of Psalm 88
(4Q416 2:9). It may be related to the term אילותwhich occurs in Psalm 22:20.
O LORD, do not be far away! O my help (or ‘strength’ )אילות, come quickly to my aid (!)עזרה
Since on this occasion, a synonym for help occurs ( )עזרהand the two terms are in parallelism it is possible to
argue that strength is most fitting. Strength also correlates with the use of the term ‘ גברman’ in verse 4.
58
The Hebrew in the last line is plural ‘darknesses’, perhaps for emphasis. The Hebrew is not in construct,
although LXX has a genitive and uses the term ‘shadow’ σκιᾷ θανάτου ‘the shadow of death’. ‘The deep’
()מצולה, may be understood as related to chaos. It is the abode of the monster Leviathan (Job 41:23) and it also
occurs in Jonah’s Psalm from the whale’s belly, a place of no escape (Johan 2:3; cf. Ps. 69:2).
16
active in all of these areas of the petitioner’s life.’ 59 The Psalmist’s identity is gravely affected by
illness; not only has the illness taken away his physical power, it has also left him socially isolated
and emotionally desperate: not even God can help since the Psalmist is beyond the realm of help in
Sheol. 60 Being socially excluded on account of being ill is not surprising in the context of the Hebrew
Bible. As Seybold comments ‘if one refers back to the social relationships found … in Job 19, things
become clearer ... this was a society that considered the sick person to be stigmatised, or at least
marked by guilt, and in which no remedies were known for many or almost all sickness.’ 61 Just as the
supplicant in Psalm 88 described himself as abominable and profane, terms relating to ritual purity, so
too does the Psalmist in Psalm 102. Both accounts emphasise the feeling that they are exiled from
In light of the research concerning illness narratives, stigmatization and social isolation are
not surprising reactions to illness. As Kleinmann commented, cultural meaning marks the sick person
with ‘significance often unwanted and neither easily warded off nor coped with. The mark may be
either ‘stigma or social death.’ 62 Social death is certainly a good way of describing the predicament of
59
Lindström, Suffering and Sin, 207.
60
According to Seybold’s classification the Psalm is ‘with certainty’ to be understood as among the ‘sickness
psalms’, presupposing a case of illness (Seybold, Sickness and Healing, 113-117) As Haag states ‘die ‘Leiden’
als ein durch Sünden heraufbeschworenes Unheil das Tod und Untergang ... bringt’ (E. Haag, Psalm 88. In E.
Haag and F. L. Hossfeld. Eds, Freude an der Weisung des Herrn. Beiträge zur Theologie der Psalmen.
Festgabe zum 70. Geburtstag von Heinrich Gross. (Stuttgart: Katholisches Bibelwerk, 1986), 149-170, 158).
The connection between suffering, death, misery and penitence is frequently noted. Refer to C. Ziegert, ‘"Mein
Auge verschmachtet vor Elend": Zu Kontext und Struktur von Psalm 88’, Biblische Zeitschrift 2010 54 1, 73-
82; B. Weber, ‘"JHWH, Gott der Rettung" und das Schreien aus "finsterem Ort": Klangmuster und andere
Stilmittel in Psalm 88’, Old Testament Essays 2007 20 2, 471-488; E. Zenger, ‘Mit Gott urns Leben kampfen:
Zur Funktion der Todesbilder in den Psalmen’, JahrbuchfiirBiblische Theologie 2004 19, 63-78; W. S. Prinsloo,
‘Psalm 88: The Gloomiest Psalm? ’, Old Testament Essays 1992 5, 332-345.
61
Seybold, Sickness and Healing, 46.
62
Kleinmann, The Illness Narratives, 26.
17
the Psalmist in Psalm 102 where the motif death operates metaphorically to describe stigmatization
We noted the critical affect this has on the Psalmist’s identity, and this also aligns well with
Kleinman’s observation that stigma can be internalised and cause a deep sense of shame and negative
self-perception. 63 Furthermore, Kleinman’s suggestion that culturally marked illness labels affect ‘all
… relationships and may lead to ostracism’ is certainly discernible in the narratives of illness in both
Psalms. 64 The level of ostracism present in the Psalms is unlikely to be beneficial to the supplicant,
It is also important to acknowledge, however, the link between illness and death which those
who are ill may become more aware of. As Carel, who draws on Heidigger’s notion of humans as
“beings towards death,” comments ‘death is a central problem for humanity, especially for ill people
who face concrete and imminent concerns regarding it.’ 65 As such, the dual focus found in both
Psalms concerning death (both, as a means of illustrating social exclusion and also as a genuine
awareness of mortality) which is achieved through metaphor is very striking. Indeed, death awareness
is something which, certainly in cases of chronic illness, 66 is ‘likely to be a process of meaning that is
63
Ibid, 160.
64
Ibid, 159.
65
Carel, Illness: The Cry of the Flesh, 89.
66
An insightful definition of chronic illness is provided by Moss and Dyck:
Chronic illness is readily deemed a long-lasting sickness with no definitive cure on the horizon, a
indeterminacy … fluctuation…. These indistinct patterns envelop the everyday life of someone with
P. Moss and I. Dyck, Women, Body, Illness: Space and Identity in the Everyday Lives of Women with Chronic
Illness Lanham, Boulder, New York, and Oxford: Rowman & Littlefield Publishers, 2003), 16.
18
constructed and reconstructed by the individual.’ 67 As such it is unsurprising that in contemporary
medical care, ‘spiritual and religious narratives are most often invoked in end-of-life care.’ 68 Through
approaching the topic of death metaphorically in the illness account of Psalms 88 and 102, a powerful,
Spiritual and religious meanings are also drawn from the experience of social death. As
Kleinmann suggests stigma carries a religious significance which helps to define the social identity of
the group. 69 If this is the case, we can make a number of guesses about the identity of the group whom
the stigmatised supplicant is severed from. Given the likely exilic context and the fact that we know
that the Babylonians kept refugee groups together, 70 it is possible that the social group in question are
fellow refugees. However, given the ethnic diversity and level of assimilation at places such as Al-
Yahudu and Bit-Nashar 71 it is equally possible that the group in question are a mixture of host society
and refugees. It is also possible to suggest that the religious significance which the group who
stigmatise the petitioners in Psalms 102 and Psalm 88 attribute to the illness, and indeed to the one
who is sick, is that God has caused the petitioner to be ill therefore the group turn against him.
67
E. J. Grassman, ‘Chronic Illness, Awareness of Death, and the Ambiguity of Peer Identification’, in D. J.
Davies, and C. Park, eds, Emotion, Identity, and Death: Mortality Across Disciplines. (Farnham, UK and
Ram date roughly from 572-477 and therefore, precede the evidence from Murashu and Elephantine. Refer to L.
E. Pearce, and C. Wunsch, Documents of the Judean Exiles and West Semites in Babylonia in the collection of
David Sofer. Cornell University Studies in Assyriology and Sumerology, 28, (Bethesda, Maryland: CDL Press,
2014).
71
Refer to Tablets 5, 9, 45, and 77 in Pearce, and Wunsch, Documents of the Judean Exiles.
19
Psalm 88 is particularly vehement in its accusation of Yahweh for illness and its lack of
acknowledgement of wrongdoing. For example towards the beginning of the prayer, the petitioner
begins three sentences with a second person singular clearly addressing God.
These verses resemble more an accusation than a prayer. As Lindström argues, the poet is ‘an object
confession of sin, but protest.’ 72 This can be seen particularly in the powerful image of “ ענהanswer”.
The verb ענהcan be translated “affliction” or more literally “answer”. 73 Given the accusatory tone, the
72F
translation “answer” may be better; the Psalmist’s calls to God are met with yet more turmoil.
The suggestion seems to be that God is unfaithful; even when approached for help by the
supplicant, the ‘answer’ is more suffering. The metaphor of ‘waves’ washing over the petitioner is a
common image in the Psalms, used to express God’s fierce anger (Ps. 42:7). It evokes a sense of
chaos, being overpowered, gasping for breath, while also depicting a recurring action. Just as the
72
Lindström, Suffering and Sin, 213.
73
The LXX has ἐπ᾽ ἐμὲ ἐπήγαγες ‘you bring upon me’. Thus the editors of BHS suggest an emendation from
ָ ִענִּיתto ‘ ִאנִּיתָ לִיyou have allowed to come to me’. The suggestion assumes the confusion of a guttural (ע/ )אand
the insertion of the preposition לwith a first-person suffix. The lamed preposition is possibly questionable since
in manuscripts this letter often protrudes up above the rest of the letters and is less likely to be missed. However
this does provide an object for the verb. Nevertheless, while attractive, it is not absolutely necessary to change
the text, given the verb “ ענהaffliction” is used regularly in the Psalms.
20
prayer is cried out ‘day and night,’ so to the answer is repeated (Ps. 88:1). God is almost depicted as
an enemy to the Psalmist. 74 It is ‘the God of the petitioner who has removed … the protective net of
the social system.’ 75 Unlike other Psalms, the mood of the prayer does not improve 76: following
accusations comes cynical questioning: ‘Shall you do your miracles to the dead? Shall the ghosts arise
and praise you?’ (Ps. 88:10); ‘Shall your compassion be recounted in the grave? Or your faithfulness
in a destroyed place?’ (Ps. 88:11); ‘Shall your miracles be known in the darkness? Or your
righteousness in the land of oblivion?’ (Ps. 88:12). In this prolonged attack on the deity, the Psalmist
‘takes a step beyond the conventional language of piety: he uses sarcasm.’ 77 There is some small trace
of hope in the next verse where the Psalmist suggests that in the morning his prayer will confront
God, but this is quickly followed by a renewed sense of abandonment ‘why do you cast of my soul?
Why do you hide your face from me?’ (Ps. 88:14). The metaphor of a question concerning YHWH
hiding his face is a common way to express feelings of abandonment in the Psalms (Ps. 13:1; 27:9;
30:7; 51:9; 69:17; 102:2; 143:7) and in the Hebrew Bible more generally (Ezek. 39:29; Mic 3:4). Thus
the connection between sickness and sin cannot possibly capture anything important about the
interpretation of suffering found in Psalm 88. Instead, we are given an expression, saturated with
Interpretations of illness are often understood in terms of religious significance. Either God or
the gods are punishing a crime, thus the sick person is guilty, or, there is some unacknowledged
wrongdoing, therefore the sick person is weak and stupid. Furthermore, shame is often connected to
illness on account of this religious interpretation. This idea is widespread, and is not confined to
74
W. Gross, ‘Gott als Feind des einzelnen? Psalm 88’ in J. Schreiner, ed., Studien zur Priesterschrift und zu
The Genres of the Religious Lyric of Israel. (Macon, Ga.: Mercer University Press, 1988). Refer also to
21
Yahwistic exiles. 78 The connection between illness and religious transgression is so strong that even
during the Persian, Hellenistic, and Roman periods, when diseases were explained by various other
means such as the devil or demons, Gods own purposes, or fallen angels, and where ideas about the
afterlife were emerging, connecting illness and religious transgression was still popular.79 Indeed,
78
The Babylonians had exorcists and ritual penance as well as confession and appeals for divine
mercy. Refer to M. J. Geller, Ancient Babylonian Medicine: Theory and Practice. Ancient Cultures.
(Oxford: Wiley-Blackwell, 2010). Similarly, in Man and his Ba, (an Egyptian text dating to the
middle kingdom) suffering and illness are connected with the sinful character of humans. This is
exemplified in the quotation ‘never has a sinless child been born to its mother.’ W. W. Hallo, and K. L.
Younger, The Context of Scripture: Canonical Compositions, Monumental Inscriptions, and Archival
Documents from the Biblical World. Volume 1 Canonical Compositions from the Biblical World. (Leiden: Brill,
In the Akkadian Dialogue between a man and his God, the sufferer suggests that his affliction
is due to no known sin but after charitable deeds, which may form some kind of penance, the response
Another example is Ludlul bēl Nēmeqi (“I will praise the Lord of Wisdom” [i.e. the God
Marduk], dating from 1000 B.C.E.), where illness features strongly and the sufferer seeks to
understand the origins of the illness, given that he considers himself blameless before the god
Marduk, thus implying that sin and illness are connected in a causal manner. T. Oshima, Babylonian
Poems of Pious Sufferers: Ludlul Bēl Nēmeqi and the Babylonian Theodicy. Orientalische Religionen in der
a cause of illness. Jubilees 10 also deals with the sin of the fallen angels and the sin of mankind as the cause of
suffering and illness. The Testaments of the 12 Patriarchs connect sin to the onset of illness (T Reuben; T Gad.
5:11). In the Genesis Apocryphon three factors bring about the affliction of Pharaoh and his household: his sin
in regard to Sarah, the evil spirit who brings about the affliction, and God who is said to have struck the
Egyptians with pestilence. Similarly, in the Prayer of Nabonidus at Qumran we may presume by the mention of
Nabonidus confessing and being forgiven that sin is responsible for his illness. Likewise, in Ben Sira while
22
even in modern times the idea that illness is a type of punishment exists at a widespread level. As
Sontag argues
The persistence of the belief that illness reveals, and is a punishment for, moral laxity or
turpitude can be seen … A theodicy as well as a demonology, it not only stipulates something
emblematic of evil but makes this the bearer of a rough, terrible justice.80
It is not surprising, therefore, that a sense of stigma and shame which is attached to illness often
becomes internalised. This is the case where the motif of human sin and guilt is found in many of the
individual lament Psalms (Ps. 22; cf. Ps 13; 28; 31; 35; 71; 143). What is particularly interesting about
Psalms 102 and 88 is that there is no expression of guilt or sin on the part of the petitioner. If
anything, the supplicant blames YHWH for causing his problems and perceives them to be unfair,
with obvious similarities to the book of Job. The illness is reported as being YHWH’s doing, but no
admission of guilt or request for forgiveness is present. Good’s observation that narratives bring
coherence to events may be appropriate here. Although no answers are given by the Psalmist, the
process of expression and giving voice to the suffering experienced in illness is interesting. This is
interesting not because of some sort of ill-defined “healing power of narrative” and not because of the
sense of control gained through being able to attribute blame or petition for restoration. What is
fascinating is the way that attribution of religious significance to illness creates and concretizes an
explanatory model which is erosive to identity, yet somehow enduring and self-perpetuating.
justifying the role of physicians and medical remedies, the ill person is encouraged to pray to God first then to
acknowledge one’s faults and make a generous sacrifice (38:15). In addition, the sins of Geliodorus (2 Macc. 3)
and Antiochus IV (4 Macc. 9) bring on their afflictions. Finally in the New Testament sin is given as a reason
for the paralytic’s condition (Matt. 9:1-8; Mark 2:1-12; Luke 5:17-26), and in 1 Corinthians a lack of charity
leads to illness of community members. Philo of Alexandria connects illnesses with sin and lack of virtuous
living. (De Sacrificio 70-71). Likewise, Josephus attributes the fatal illness of Herod to his wickedness
(Antiquities XVII 168-171 as he does the fatal illness of Catullus to his misdeeds, (War VII 451-453) L. P.
Hogan, Healing in the Second Tempel [sic] Period. (Freiburg: Universitätsverlag, 1992), 145.
80
Sontag, Aids and Its Metaphors, 145.
23
Psalm 102 is very confident of help, asserting ‘he will regard the prayer of the helpless 81 and
he will not despise their prayer’ 82 (Ps. 102:17). Furthermore, it contains a long hymn which focuses
on the rebuilding of, and return to, the homeland, Jerusalem (Ps. 102:12-28). As such, the Psalm is a
The return to Zion pictured in the hymnic section of 102 (vv. 19-23) is one that also resonates
with many other places in the Psalter, as well as in exilic and post-exilic prophecy in general
(e.g. Isa. 2:2-4). For, in 102, the psalmist … envisions a future where the captives of Israel
return to Zion, but also that “the peoples gather together, and kingdoms, to worship YHWH”
The return is depicted using the metaphor and imagery of exodus and pilgrimage, similar to that in
Isaiah 40-55. The response to lament is prophecy, therefore, rather than an appeal to YHWH’s
character or great saving activities of the past (cf. Ps. 77-78) and this makes Psalm 102 rather
unique. 84 Rather than looking to the past for comfort, the individual looks to the future with hope.
What is particularly interesting here is the dual focus; restoration is sought both in the form of longing
to return to a re-established homeland but also longing to return to a state of health. 85 This dual
character of hope, where return migration and regaining health are intertwined, can be seen
81
11QPSa has “ תולעתworm” instead of “ ערערhelpless”.
82
The term “prayer” ( )תפלהis repeated in the verse. However, the LXX has the term προσευχή “prayer”
followed by δέησις “entreaty” thus the editors of BHS suggest emending the second occurrence of “prayer”
תפלהto “ תחנתםtheir supplication”, a near synonym for prayer. This would create better synonymous parallelism,
and therefore be better stylistically, but perhaps there is not sufficient evidence or necessity to emend.
83
A. Witt, ‘Hearing Psalm 102 within the Context of the Hebrew Psalter’, Vetus Testamentum 2012 62 4, 582-
606, 603.
84
Ibid, 587.
85
Concerning return migration in the Persian period, refer to Southwood Ethnicity and the Mixed Marriage
Crisis, 191-210.
24
When YHWH builds up 86 Zion, he shall reveal himself in his glory
sons of death)
The dovetailing of the motifs of restoration and return highlights the robust way in which the ideas
were coupled and also adds new possibilities for interpretation of the metaphors of illness. As
Rogerson and McKay argue there is an intense longing for a return to and rebuilding of Jerusalem and
the merging of these ideas suggest a prayer ‘“as Jerusalem is restored, so may I be!”’. 89 Or, as Witt
suggests, ‘finding no hope in the present circumstances, the redactor focused on the future restoration
of Jerusalem … in attempting to overcome his suffering.’ 90 Not only are the two themes dovetailed in
the Psalm, the entire structure of the Psalm oscillates between an illness account (2-11), an expression
of hope for return migration and rebuilding of the homeland (12-22), and a renewal of illness narrative
(23-28). This is stated in numerous ways. Most significant are the images of YHWH as unchangeable
and unending, and the final statement ‘the sons of your servants shall settle and their descendants shall
86
The term ‘build’ בנהcan be understood literally as returning and ‘rebuilding’ Jerusalem.
87
The term ‘look down’ hiphil √ שקףrefers to looking down from heaven (Deut. 26:15; Ps. 14:2; 53:3; 85:12;
Lam. 3:50) or from a window (Gen 26:8; Judg. 5:28; 2 Ki. 9:30).
88
‘Crying’ may be a good translation for אנקה, a term which only occurs four times in the Hebrew Bible, given
that it is coupled with ‘weeping’ and ‘tears’ on one of those occasions (Mal. 2:13). Interestingly, on two
occasions, the term is linked with ‘the prisoner’ (Ps. 79:11; 102:20), refer to note 50.
89
Rogerson, and J. W. McKay, Psalms, 22.
90
Witt, ‘Hearing Psalm 102, 589.
25
be established before you’ (Ps. 102:28). Rather than ending on illness, the prayer turns to consider
future generations and the metaphor of return to the homeland. Therefore, a bold statement of
In total contrast, Psalm 88 portrays illness through anger and lack of religious confidence. As
Lindström comments ‘the attack on the entire personality is discernible in “the lamp of the body” (i.e.
the reactions of the eyes)’ [Ps. 88:9].’ 91 As such the Psalm may give voice to the Yahwist whose
illness has resulted in exclusion and questions about YHWH’s fidelity with accusations that YHWH is
the “prime-mover” in the Psalmist’s illness. The prayer is of one who is stigmatised as a sick person.
His illness is gives rise to ‘fundamental soteriological issues.’ 92 Most significantly, the near presence
of death raises lots of questions about God’s power and sardonic doubts about whether there can ever
be a salvation for him. Indeed, the sarcastic tone here and general dark nature of the illness expression
has caused DeClaissé-Walford, Jacobson, and Tanner to suggest that it is unclear whether the opening
reference to ‘God of my salvation’ ‘is an expression of great faith of great irony.’ 93 However, given
the sarcastic tone of the doubts that are expressed, and that fact that the prayer is drafted at all, the
Nevertheless, “Why me?” arises in the narrative which attempts to bring meaning to the
illness: ‘Oh YHWH, why have you rejected my being; why do you hide your face?’ (Ps. 88:14). The
He makes three urgent and passionate pleas, each appealing directly to God: “God of my
salvation . . . I cry out in your presence” (v. 1); “Every day I call on you, O Lord” (v. 9); “I, O
Despite this, it is also possible to maintain, with Lindström, that the Psalm ‘lacks all signs of wanting
to rationalise the causes of YHWH’s anger.’ 95 Thus, in the Psalm this gives way to what Kleinmann
91
Lindström, Suffering and Sin, 205.
92
Good, Medicine, Rationality, and Experience, 134.
93
DeClaissé-Walford, R. A. Jacobson, and B. L. Tanner, The Book of Psalms, 671.
94
R. R. Laha, R. R., Psalm 88. A Journal of Bible and Theology, 2015 69 1, 88-84.
26
called a spiritual form of distress, where suffering becomes the ritual enactment of despair, may be
discerned through the obscure form of the Psalm which lacks a Tierce de picardie like turn to praise.
Good’s observation that narratives bring coherence to events may be appropriate here. Although no
answers are given by the Psalmist, the process of giving voice to the suffering experienced in illness
may be observed. Although no answer to the existential “why me?” question is provided, the
metaphors used within the Psalm may be helpful in recreating an identity where the idea of illness is
integrated. Carel, who illustrates that answering this question can sometimes be a long process,
captures the anger and despair which can often accompany the question,
I fell into the beginner’s trap of suffering and asked: why did this happen to me? This
question had no answer … It was an arbitrary stroke of very bad luck…. Later, as I adjusted
to my situation, I felt increasingly angry. I spent several months asking: why did this happen
to me? I felt sorry for myself. I cried for days, with grief for the family I will never have, for
The grief and anger which Carel expresses so lucidly is very similar to the expressions of such
sentiments in the Psalm. Like the Psalmist, Carel asks the unanswerable questions which Good claims
Conclusion
It is interesting to re-analyse this material from the perspective of illness experiences. The processes
of narrativization and metaphorization can bring a sense of coherence to events and can also create a
space for manoeuvre for the patient who is facing illness. Both may instigate profound introspection
and can cause individuals, and communities, to reconsider, carefully, questions about identity, group
identity, and the values, beliefs, or components of such identity. Psalm 88 and 102 have much in
common. What makes them unique is, for Psalm 102, the dual focus on hopes for return to the
homeland and restoration of health. In Psalm 88, however, the sense of being overwhelmed, isolated,
95
Lindström, Suffering and Sin, 197.
96
Carel, Illness: The Cry of the Flesh, 31, 32.
27
and near to not surviving dominates as does the lack of resolution. However, what is particularly
interesting about both Psalms is the way that illness is expressed in powerful, sometimes embodied,
metaphors which can lead to a vital reconfiguration of identity. In both Psalms, therefore, it is helpful
to understand illness as a fundamental biographical disruption which creatively reconfigures the way
Although the study of ancient medicine and disability in the Hebrew Bible is flourishing these
areas have not yet fully converged with modern research concerning illness experiences. This article
has sought introduce a new perspective to address the study of illness in the Hebrew Bible and the
dynamic of the relationships between illness, theodicy, and identity in modern day narratives. By
centralizing questions concerned with the role of the body, both socially and individually in Psalms 88
and 102 two major, interrelated themes have emerged. First this article has demonstrated that Psalms
88 and 102 can sometimes have unexpected contemporary resonance, with many of the themes,
concerns, and motifs being repeated in modern day research concerning illness experience. Second,
we have highlighted the change to identity, and the role of religious questions in illness. Since illness
can give way to a spiritual form of distress it is important to acknowledge the significance of attempts
to find or create meaning in experience, in illness. Third, we have argued that the process of
metaphorization in expressions of illness is, far from the view of Sontag and her supporters, extremely
important in illness.
28