Did you know that there are two different types of anguish? So what are they and why does it matter? The significance of distinguishing between existential anguish, which has a spiritual origin, and psychological anguish, which originates from human relationship problems, is that the tools for alleviating them are different. Let us consider this now.

Anguish is a more philosophical or spiritual word for anxiety. They can be used as synonyms. Soren Kierkegaard, a philosopher from Marquis, in his book called The Concept of Anxiety, said that those who have learned to deal with their anguish have learned the most important thing. Interesting, isn’t it?
Have you learned to deal with your anguish? We all have anguish. The question is whether or not we are aware of it, its level of intensity, and how it interferes with our lives.
Psychotic people, who are commonly referred to as crazy, seem to possess massive anguish that alienates them from reality. Artists from various fields have experienced anguish and expressed it through their works of art, whether in painting, writing, sculpture, music, or other forms. The production of artwork can be a defense against madness, against paralyzing anguish. Similarly, for many financially successful entrepreneurs, work can be a defense against alienation.
Several philosophers call existential anguish what the Bible refers to as human mental suffering produced by sin. Sin is everything that makes you unhappy and destroys you. There is existential anguish of spiritual origin and there is psychological anguish originating in trauma and emotional complications in relationships, especially in childhood, in a difficult family, which affects a sensitive person. When the prophet Nahum says that anguish will not come a second time, what is the first time? It is now, in this life.1)Nahum 1:9
So I agree with Kierkegaard, the philosopher, who says that learning to deal with anguish is healing. I will repeat that. Learning to deal with anguish is healing. It seems like a paradox, doesn’t it? A contradiction, because anguish is a normality that will no longer exist in New Jerusalem, but here in this life it is, in quotation marks, normal in the sense that it exists in every being born of a woman.
So mental health has more to do with learning to manage anguish than eliminating it, because you can’t eliminate it.
Addicts, including alcoholics, try to eliminate distress with their drug of choice. But the distress remains; the drug does not end it. It only numbs the distress, but it continues to disturb between one dose and another and another dose of the drug. Therefore, the great challenge for addicts and for us is to stay sober and endure distress without using drugs.

Whether it’s alcohol, cocaine, marijuana, crack, Rivotril, and other psychotropic drugs, sex, work, shopping, food, controlling others, or the craving to make money, that’s a drug too. Many people have excessive anxiety that they try to relieve through competition, and competition increases anxiety. It’s a two-way street. We were not created to compete, but to share.
Even in church we see competition, but I don’t see anything in the words or actions of the Lord Jesus that is competitive or encourages competition. The Bible approves of competition with ourselves in the pursuit of personal growth.
Even so, we must be careful not to fall into perfectionist cruelty. Sincere people who seek spiritual light may come to understand true doctrines, but while remaining sincere, they feel that something is missing, that they lack liberation and more light for what lies beyond the doctrines. From a Christian point of view, what are we going to do with our anguish after receiving Bible studies and understanding doctrinal truths?
Intellectual understanding does not solve anguish, nor does vegetarianism, although it is indeed the best diet for our bodies and minds. It seems that there are two types of truths. One that produces information related to doctrines and the other that produces salvation, which has to do with spirituality. I have met non-religious people who are full of spirituality.
The Bible gives a great example of this. Remember the centurion who asked Jesus to heal his servant, the centurion’s servant. That soldier had spirituality, even though he did not yet understand religious doctrine. And Jesus drew everyone’s attention, saying that he had never seen such faith in the church as he saw in that pagan. The advantage of the biblical view of anguish is that it is more comprehensive, neither superficial nor one-sided.
It goes beyond the social, beyond the biological and psychological. It reaches what the Bible calls the heart, right? Which is the virtual part of our mind, from which comes what contaminates our character.

The biblical view of anguish is also true, because there is no person who is born without this disgrace, or lack of grace, which is anguish. And it is the only one that shows the solution to anguish, which has to do with glorification, that is, being made like Jesus when he is coming back soon.
The best that psychology offers is relief from anxiety caused by interpersonal conflicts. We can learn to manage our anxiety so that it no longer arises in our lives, for example, through panic attacks or phobias, obsessive-compulsive disorder, and other forms.
It is possible to understand the psychological causes of anxiety and practice some guidelines for reducing it. Indeed, we can become less anxious.
Some people don’t know what anguish is. Strange, isn’t it? Perhaps they are happier because they are unaware of their personal anguish. God is honest. He says in the book of Psalms: “I will be with him in trouble.”2)Psalm 91:15
And the Psalmist continues to say what God is teaching him: “This is my comfort in my affliction, For Your word has given me life.”3)Psalm 119:50
There is anguish in all of us, whether in the Pope or the president of your church, in billionaire Bill Gates or the simplest information technology employee at the institution where you work. There was anguish in Mother Teresa of Calcutta, as in the writer Ellen White. Paul, the apostle, says that once when they arrived in Macedonia, he felt fears inside, that is, anguish.
And Ezekiel said that on that day he was sad and anguished, but that the hand of the Lord was strong upon him.4)Ezekiel 3:14
So, in this life, having anguish is not the absence of God, it is the lack of His presence in the way it existed in Eden before the fall. It is also linked to emotional deprivation, family tensions, fear of the pandemic, the suffering of workers who have dictatorial bosses, persecutors, sadness at seeing so much corruption in our country, in addition to other problems. Thank God, we can learn to deal with our anguish in a better way, one day at a time, slowly, as we endure, and thus become better people, especially more merciful to ourselves and others.

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Dr. Cesar Vasconcellos de Souza is working as a psychiatrist and international speaker. He is author of 3 books, columnist of the health magazine “Vida e Saúde” for 25 years, and has a regular program on the “Novo Tempo” TV channel.
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