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Old Testament Essays

versão On-line ISSN 2312-3621
versão impressa ISSN 1010-9919

Old testam. essays vol.32 no.3 Pretoria  2019 



The Travail of Pain: An Interpretive Perspective from Scripture



Gudrun E. Lier

University of Johannesburg




The concept of pain and grieving in the Hebrew Bible is often linked to the context of travail in the birthing process. This perspective suggests that experiences and emotions of pain are associated with feelings of deep distress which, when properly resolved, give way to positive dimensions of care, hope and empowerment as well as the vitality to face new challenges of life. This paper investigates the conceptualization of pain in Scripture from linguistic expressions and ceremonial practices. It compares these findings with phenomenological perspectives of childbirth experiences and how these can assist to explain biblical labour metaphors. The aim is to show how the conceptualization of pain in Scripture can assist to resolve pain in contemporary contexts.

Keywords: travail; pain; labour metaphors; ceremonial mourning practices; travail of God; suffering Messiah




Pain or trauma cannot be explained logically nor can it be demarcated in terms of an abstract concept. Rather, pain is always subjective. It is defined as an unpleasant distressing feeling caused by intense or damaging stimuli. The same cause of pain does not imply that two people feel the same degree of pain.1Moreover, pain can be felt without a clear physical cause. It can be a sensory experience as well as an emotional experience and acts as a warning sign that all is not well. Pain is divided into three categories: acute, chronic and labour pain.2

This contribution aims to investigate:

1 How pain is conceptualized in the Hebrew Scriptures; in particular, pain as "travail" where travail refers to the struggle with pain.

2 Ceremonial practices from Scripture that demonstrate the travail of pain.

3 How the phenomenology of childbirth, in terms of its consciousness and the objects of direct experience, exhibits the struggle with pain and is used as a metaphor for pain in Scripture.

4 How the pain of the suffering Messiah epitomizes the ultimate travail.

The research approach is multifaceted and conducted from an interdisciplinary perspective because pain or trauma is experienced through a multiplicity of realities. Lisa Cataldo defines trauma as an experience that "[...] overwhelms the psyche's ability to assimilate or integrate experience and is characterized by neurological and physiological changes and adaptations focused on survival."3 [My emphasis, G.L.] She notes, furthermore, that many studies of the relationship between trauma and spirituality conclude that spirituality is a positive force for healing and that religious connection can provide a framework to locate suffering.4

The study will first explore the notion of pain from an assortment of lemmas, which the Hebrew Text employs to describe expressions of pain. It will be shown from Scripture how the struggle with pain was accepted as part of life in ancient times through the demonstration of ceremonial practices.5 The study will, furthermore, seek to reveal from the phenomenology of labour, how childbearing women demonstrate their struggle with pain, and how their struggles can assist with understanding the metaphors of travail in Scripture. In line with this metaphorical understanding, the study will reason from a theological perspective, how the suffering Messiah in Old and New Testament Scriptures is perceived to epitomize the travail of pain through the childbirth metaphor, birthing hope and new life for mankind.



Job 14:22 possibly provides the most typical description of pain in the Hebrew Scriptures, portraying Job's physical agony in correspondence to the anguish of his inner self: אַךְ־בְּשָׂרוֹ עָׂלָׂיו יִכְּאָׂב וְּנַפְּשׁוֹ עָׂלָׂיו תֶּאֱבָׂל "But his flesh upon him is in pain, and his soul within him mourns".6 [My emphasis, G.L.] (cf. Ps 69:29; Isa 65:14: Jer 15:18).7 The verse makes use of the literary device of parallelism to connect outer pain with inner pain as an integrated experience, where the body as a whole entity is subjected to suffering.8

Job's physical pain is linked to the Hebrew noun בָׂשָׂר "flesh" and entails the corporeal agony from nerve stimulation, whereas the term נֶּפֶּשׁ "inner self refers to the severe distress of the part whereby a person thinks, feels, wills, and desires.9 In the latter instance, the preposition על is used idiomatically to give pathos to the expression of emotion by emphasizing the individual who is its subject, and who, as it were, feels the emotion acting upon him.10

Significantly, the root meaning of כְּאֵב "anguish" can denote pain as a symptom of physical hurt or disorder (Isa 17:11); in the same, pain as a fundamental feeling of emotional distress that people try to avoid (Jer 15:18; Job 16:6 [2χ]).11 This suggests that physical pain is not perceived detached from emotional pain (Ps 39:3-5; Job 2:7-13 [3x]).12 However, whereas physical pain is perceptible from various manifestations, the trauma of the inner self can be subtly evasive.13 Significantly, it is the trauma of the נֶּפֶּשׁ or "inner self that Scripture invariably seeks to address, e.g., in Psalm 42:5 the psalmist soothes his inner being by speaking to his soul and asking it why it is so dejected. The aspect of soul trauma or emotional pain will be further explored in the following subsections from linguistic and empirical evidence in the Hebrew Scriptures and from observing pain in relation to phenomenological parameters.14



The Hebrew Bible describes the concept of pain in several Hebrew words.15 Of these words, as noted above, the noun כְּאֵב encompasses pain as emotional distress or a state of psychological pain (Job 16:6; Isa 17:11; 65:14; Jer 15:8), and pain as a physical sensation (Job 14:22; Ps 69:29). The derived noun מַכְּאֹב is similarly employed in the context of suffering, denoting feelings of mental as well as physical pain (Job 33:19; Ps 38:17; 69:26; Jer 30:15; 45:3; 51:8). The root עצב occurs in 3 variations to describe pain: (1) עֶצֶב "hurt; strenuous work; pain" (Gen 3:16); (2) עֹצֶּב "anxious toil, hardship; agony" (1 Chr 4:10); and (3) עִצָׂבוֹן "anxious toil, hardship" (Gen 3:16; 3:17; 5:29). The adjective מַר is used to describe pain, attributively, in terms of its "bitterness" (Num 5:24; 5:27; Job 10:1).

Five words are specifically associated with labour pains, describing not only aspects of somatic sensation of acute physical discomfort associated with contractions of the uterus during labour such as physical pangs and agony, but also emotional facets relating to feelings of anguish, fear and sorrow: (1) חֵבֶל "labour pains, foetus" (Isa 66:7); (2) חִיל "to be in labour; to writhe, to bring forth (through labour); fear and pain" (Job 15:20; Jer 51:29) and its variant (3) חִילָה "labour pains; (metaph.) pain" (job 6:10). (4) The word צִיר at 1 Samuel 4:19 and Daniel 10:16 specifically speaks of the physical pangs and spasms experienced when a woman is about to give birth. (5) At Jeremiah 48:41 and 49:22, the term צרר refers to the distressed state of the heart of a woman during labour i.e., to be wrapped, enveloped, tied up, cramped, hampered, constricted, depressed and worried.



Scripture attests to different roots of pain. Traumatic experiences such as death (Gen 50:10), abandonment (1 Sam 15:35), disobedience (Ezra 9:4-7), despair (Joel 1:9-10), disease (Job 2:11-13), oppression (Ps 42:9-11) and exile (Mic 4:10) were linked to various outward expressions of grief and demonstrated through different ceremonial practices.16

1 Ceremonial mourning practices

In the following, some mourning practices will be described in more detail.

a Judgement and exile

In the face of impending judgement and exile, Ezekiel was commanded to הֵאָנַחמָתְּנַיִםבְּשִבְּרון "groan with crushing of hips" as one would groan from the pain of physically crushed hips. To "groan with crushing of hips" was a figurative expression to indicate emotional distress. Hips represented the seat of strength (Ezek 21:11), and their breaking or crushing symbolized the entire collapse of strength.17

b Shame and despair

To exhibit sorrow and shame, Jeremiah physically slapped his upper thigh: סָפַקְּתִי עַל־יָרֵךְ בֹּשְּתִי "I struck [my] thigh, I was ashamed" (Jer 31:19).18 To parade the shame of Egypt, the Lord told Isaiah to loosen the sackcloth from his loins to expose his buttocks and to take off his shoes and walk barefoot for three years (Isa 20:2; cf. also Isa 47:2). After her brother Amnon had raped her, Tamar poured dust on her head, rent her tunic, and placed her hand on her head in distress, sorrow, and humiliation and as she left, she was "crying out" (וְּזָעָקָה) (2 Sam 13:19; cf. also 2 Sam 15:32).

c Death

Mourning over a deceased was expressed through a lyrical form of lament with the onomatopoeic interjection הוֹי "Oi" (Jer. 22:18). 19 When Jacob thought that Joseph had been torn to pieces, he rent his garments and put sackcloth on his loins as he "mourned" (וַיִּתְאַבֵּל) his favourite son's death (Gen. 37:34). David commanded that people should rend their clothes and gird themselves with sackcloth and "wail" (וְסִּפְדוּ) for Abner (2 Sam 3:31). Joab hired a woman to "be a mourner" (הִּתְאַבְלִּי־נָא) and put on "garments of mourning" (בִּגְדֵּי־אֵּבֶל) and not to anoint herself with oil as a woman would do that mourned for the dead (2 Sam 14:2). At Jeremiah 8:21 the verb קָדַרְתִּי "I am squalid" is used, which is a figurative rendering of the neglected, soiled dress of a mourner. Additional aspects of personal neglect for the show of grief were letting the hair hang loose or shaving the head, not tending to the feet or fingernails, not trimming the beard or washing clothes (Lev 10:6; Deut 21:12-13; 2 Sam 19:25). On hearing about Absalom's death, David enwrapped his face, which is figurative as a sign of mourning, and "cried out" (וַיִּזְעַק) "with a loud voice" (גָדֹולקֹול) (2 Sam 19:5).20 Other additional expressions for mourning were laceration of the skin and partaking in mourner's bread and the cup of consolation to comfort the bereaved for the dead (Jer 16:6-8); hiring professional wailing-women to wail in the streets (Eccl 12:5; Jer 9:16; Amos 5:16); convening friends or passers-by to join the lamentations of bereaved or aggrieved persons for a length of time (Gen 50:3; Judg 11:40; Job 2:11; 30:25) and displaying commensurate grief by sitting or lying in silence and weeping with fasting (Gen 23:3; Judg 20:26).

d Disobedience, disease, abandonment, and oppression

Wailing (V ספד), crying (V בכה), fasting (V צום) and becoming squalid (קדר) were also actions that expressed grief other than mourning for the dead (2 Sam 1:12). When David sought God in supplication for the child of his waywardness, he abstained from eating bread, wept and lay on the earth all night (2 Sam 3:35; 12:16, 22). Uncleanness (טֻמְּאָה) prohibited a person to participate in the sacrifice of peace-offerings (Lev 7:20; Deut 26:14). Disease also made someone unclean. Lepers had to cover their moustache, rent their clothes, let their hair hang loose and cry aloud "unclean, unclean" (טָמֵאוְּטָמֵא׀) (Lev 13:45). In a display of grief over Absalom's conspiracy, David covered his head and went barefoot, weeping (V בכה) (2 Sam 15:30). Oppression by the enemy caused the Psalmist to go about in a soiled garment (לָמָה־קֹּדֵר אֵלֵךְ "Why do I go about squalid?") to exemplify the darkness of his depression (Ps 42:9-11).



It is striking that pain in its various forms and manifestations is overwhelmingly described in Scripture in connotation with the birthing process. Thus Jeremiah 13:21b metaphorically describes Judah's exile to captivity in terms of labour pains: הֲלוא חֲבָלִים יאֹּחֱזוּךְ כְּמו אֵשֶת לֵדָה "shall not labour pains seize you, such as a woman bringing forth?"21 and Jeremiah 49:24 likens Damascus to a travailing woman: צָרָה וַחֲבָלִים אֲחָזַתָה כַיּולֵדָה"anguish and labour pains have seized her, as she who is bringing forth". At Isaiah 13:8, the imminence of the day of the LORD is compared to labour pains: צִירִים וַחֲבָלִים יאֹּחֵזוּן כַיּולֵדָה יְּחִילוּן "pangs and labour pains shall seize [them], as she who is bringing forth, they will writhe." Isaiah 66:7 recounts the rebirth of Israel as labour preceding travail: בְּטֶרֶם תָחִיל יָלָדָהבְּטֶרֶם יָבוא חֵבֶל לָהּ וְּהִמְּלִיטָה זָכָר "Before she writhes [in labour pain], she bears; before labour pains shall come to her, she causes a son to escape." [My brackets, G.L.] The figurative use of labour pains as a literary device to graphically illustrate the severe anguish, paroxysmal pain and dread of impending doom, paradoxically entertains the overtone of hope, the anticipation of the birth of new life.22

In a qualitative phenomenological study on women's experience of pain during childbirth, Beigi et al. describe labour pain as one of the most severe pains that has ever been evaluated and its fear is one of the reasons women wouldn't go for a natural delivery.23 Labour pain leaves no room for logical dialogue or niceties. It does not permit moments of calculated reflection but imposes with unrelenting eruptions of agony. Labour pain tests a mother's physical and emotional stamina. With the progress of labour, the mother may experience cramps, nausea, pressure and intensifying pain. Breathing and relaxation techniques assist to combat the growing discomfort. Trying to push out the baby too soon delays the birth because the mother becomes tired and the cervix swells. To combat the urge to push too early, the mother is encouraged to pant.24 In this context, little or no opportunity remains for talking.

Job 16:6 speaks to the illogicality of speech and calculated reflection in the presence of pain and grief: אִם־אֲדַבְּרָה לאֹּ־יֵחָשֵךְ כְּאֵבִי וְּאַחְּדְּלָה מַה־מִנִי יַהֲלֹךְ "Though I speak, my pain is not assuaged; And though I restrain myself, how much of it leaves me?" (Cf. also Isa 65:14).25 The awkwardness of talk in the presence of severe pain resonates in the study of contemporary lived experience of women in labour by Beigi et al.26 It was found that the feeling of fear contributes to a woman's disability to talk when she is in labour, "I was so scared that I couldn't talk." Fear accompanying labour pain was found to be compounded by loneliness and relieved by company, "[.. .]if they hold my hand I would relax."27 Support from the treatment personnel effectually decreased labour pain, "[.. .]if the nurse is mild and warm-hearted you will feel less pain." Hope in view of the time of delivery assisted women to tolerate the pain better. Beigi et al furthermore found that subjective beliefs and religious thoughts were effective and important factors in decreasing labour pain. Socio-cultural aspects linking to beliefs on how to react to pain were noted to be of superior importance. Crying helped some women to tolerate the labour pains, "When the pain increased, I began to cry."28 Another woman lamented that her husband was not informed about her right as a woman to scream with labour pain, "I only wish he had heard me scream because men don't understand this subject".

Some women opt for a caesarean to escape the labour pains. Yet, this only disguises the pain of labour for a short period; the surgical incision is the greater trauma.29 A similar scenario can be observed from land prophecies. Jeremiah 51:8 poses the question of whether balm possibly will assuage the pain of Babylon's fall: קְּחוּ צֳרִי לְּמַכְּאובָהּ אוּלַי תֵרָפֵא "Take balm for her pain; perhaps she may be healed." [The term צֳרִי refers to sap (resin) from the trunk of the mastic tree (pistaccia lentiscus). The gum was prominently used in the pharmacopeia of Israel to make plasters for the healing of wounds.30 However, at Jeremiah 51:9 that illusion is discarded: וְּלאֹּ נִרְּפָתָה "but she was not healed."] At Jeremiah 59:29, the verb תָחֹּל (V חיל)"she travails (i.e. writhes in pain)" is metaphorically employed to describe the impending desolation of Babylon with no expectancy for cure: וַתִרְּעַש הָאָרֶץ וַתָחֹּל כִי קָמָה עַל־בָבֶל מַחְּשְּבות יהוה לָשוּם אֶת־אֶרֶץ בָבֶל לְּשַמָהמֵאֵין יו שב "The land trembles and writhes in pain, for the LORD's purposes against Babylon stand, to make the land of Babylon a desolation, without inhabitant" (cf. also Je 6:24; 22:23; 50:43; Mic 4:9).31

The travail of pain can end in bitterness and despair when there appears to be no hopeful outcome. Job expresses his disgust with life and speaks in the bitterness of his soul: נָקְּטָה נַפְּשִי בְּחַיָּי אֶעֶזְּבָה עָלַי שִיחִי אֲדַבְּרָה בְּמַר נַפְּשִי׃ "My soul is disgusted with my life; I relinquish my discourse about it; I speak in the bitterness of my soul." Stacey Smith groups spiritual hopelessness into the category of "negative religious coping."32 Cataldo observes that negative religious coping is associated with greater risk of depression, guilt-feelings, and Post Traumatic Stress Disorder.33



Christian commentators understand the clause מֵעֲמַל נַפְּשו יִרְּאֶה at Isaiah 53:11 as a reference to the travail of the Divine Redeemer or suffering servant e.g., Torrey speaks of "his mortal travail."34 Jesus speaks of himself in Luke 22:37 as fulfilling the prophecy at Isaiah 53:12b: אֲשֶר כָתוּב עָלָי וְּאֶת־פֹּשְּעִים נִמְּנָה "which is written about me, 'and was he numbered with the transgressors.'" Matthew 8:17 links the healing ministry of Jesus to Isaiah 53:4: לְּמַלאֹּת אֵת אֲשֶר נֶאֱמַר בְּיַד־יְּשַעְּיָהוּהַנָבִיא לֵאמֹּר חֳלָיֵנוּ הוּא נָשָא וּמַכְּאֹּבֵינוּ סְּבָלָם׃ "This was to fulfil what was spoken by the prophet Isaiah: 'He took our illnesses and bore our diseases.'"35 Perhaps the most significant text in the New Testament that speaks of the suffering Messiah is the interpretation of Isaiah 53:9b at 1 Peter 2:21-24.36

It makes sense to interpret the inseparable pronoun מat Isaiah 53:11(מֵעֲמַל נַפְּשו יִרְּאֶה) as causal, in line with Keil and Delitzsch.37 Goldingay and Payne submit that עֲמַל refers at least as much to outward and humanly inflicted trouble, as to inner pain, where its agony penetrates the inmost recesses of the soul.38 The semantic domain of the root ראה connects to "coming to an understanding as a result of perception or observation."39 The verb יִרְּאֶה is therefore suitably translated with "he shall get to know." This then would entail that the clause מֵעֲמַל נַפְּשו יִרְּאֶה"because of the trouble of his soul, he will gain insight" infers that the conscious acceptance of pain generates a realization of the hope that an end of suffering is in sight. For Job, the moment of transformation arose when he accepted the destruction of his skin and through faith looked to God as the source of his life: וְּאַחַר עורִי נִקְּפוּ־זאֹּת וּמִבְּשָרִי אֶחֱזֶהאֱלוהַ׃ "Even after my skin has thus been destroyed and separated from my flesh, I shall see God" (Job 19:26).40

Matthew Henry interprets the agony of Jesus described at Luke 22:44 ("his sweat was as it were great drops of blood falling down to the ground") as the travail of his soul that became manifest in his sweat:

Sweat came in with sin, and was a branch of the curse, Gen. 3:19. And therefore, when Christ was made sin and a curse for us, he underwent a grievous sweat, that in the sweat of his face we might eat bread, [...]. Every pore was as it were a bleeding wound, and his blood stained all his raiment. This showed the travail of his soul. He was now abroad in the open air, in a cool season, upon the cold ground, far in the night, which, one would think, had been enough to strike in a sweat; yet now he breaks out into a sweat, which bespeaks the extremity of the agony he was in.41

From Luke 22:41 , it appears that the outward manifestation of Jesus' bleeding sweat reflected the horror and pain his innermost being experienced when he was confronted with the cup of sin. With the consciousness of the horror of sin, came the understanding (יִרְּאֶה) what the price entailed he would have to pay in order to take the spoil (שלל)(Isa 53:12).42 The idea that a person gains insight through a traumatic experience is articulated at Job 35:15, "He equips an afflicted person by his affliction and he opens by anguish their ears." [My emphasis, G.L.]

Murray Rae reasons that Isaiah 42:14, כַיּולֵדָה אֶפְּעֶה אֶשֹּם וְּאֶשְּאַף יָחַד "like a woman in labour, I will groan; I will pant and gasp together" speaks of "The Travail of God." 43 He links this prophecy to Jesus' cry of God-forsakenness on the cross: אֱלָהִי אֱלָהִי לְּמָה שְּבַקְּתָנִי 'My God, my God, why have you forsaken me?' (Matt 27:46; Mark 15:34).44 To be sure, in this God-forsaken shriek, the depth of the Messiah's alienation from God reverberates throughout eternity.45It is a scream of anguish that encompasses the trauma of all souls. It consummates humanities' fear of separation; resonating, metaphorically, the fear of loneliness that compounds labour pains in women.

Notwithstanding, in Rae's argument the travail of God is not negative since it does not end in despair. God's travail has a positive outcome, "The metaphor of travail describes the labour of God in bringing to birth new life and hope. stresses the costliness and anguish of divine love" and adds, "Christ labours to bring forth new sons and daughters of the Father."46

Pain that has not travailed remains unresolved. In unresolved pain, the trauma of the inner self is compounded through escapist mechanisms. This means that inner trauma is muted through distracting activities or symptomatic treatment. It is not actively identified and acknowledged and released for regeneration by way of self-partnering. Travail that brings forth life is a conscious decision to allow the inner self to partner with its pain, as in labour. In the birthing process, pain is embraced for the positive outcome that is awaited. The woman who embraces her travail in the knowledge that it is an indication that her baby will soon be born is able to instinctively recognize the moment of release for pressing out her baby.47 In contrast to the study of Beigi et al., Anthea Thomas advises that the method where women are anaesthetized and therefore unable to recognize their body's lead to work with the natural expulsive reflex is archaic. Forced, directed pushing creates stress for the birthing mother; it is counterproductive and potentially dangerous for both mother and baby.48 In Thomas' experience, when a woman is given the space to work with the wisdom of her body, the experience can be amazing, irresistible, ecstatic and in some cases orgasmic, as her body gently stretches and opens, and she receives her baby into her arms. She notes, "Asking the mother questions, constant verbal coaching, side conversations in the room, clicking cameras" draws the mother from her ancient brain trance.49 Allowing the birthing woman to partner with her inner soul during the birthing process results in a positive travail of pain. Cataldo notes that the reframing of trauma can be seen as a "gateway to spiritual growth" where the focus is on a more contextual, compassionate perspective on suffering.50 The Messiah's final cry on the cross, "It is finished!" can be seen as such a gateway. Therein the epitome of triumph over pain, over humanity's separation from God, is celebrated. With the conscious release of his last breath on the cross, this breath became the culminating victory over death, opening the gateway to eternal life.



The study shows that the Hebrew Scriptures conceptualize pain as physical agony corresponding to the anguish of the inner self where the physical pain is not perceived detached from emotional pain. Linguistically, pain is expressed by several different words in Scripture of which the majority specifically link to labour or birth pains. Scripture reflects that different types of pain were resolved through ceremonial practices in such manners that the onlookers were able to identify the pain a person was experiencing. Phenomenological parameters of pain from the study of labour pains in women provide insights to understand the metaphoric use of labour pain in Scripture where such metaphors imply both negative and positive outcomes for the travail of pain. Scripture also employs the figurative sense of the travail of pain in the prophetic context of "birth pangs of the Messiah". In Christian theology this metaphor is interpreted in reference to the travail of God and to express the travail of Jesus in Gethsemane and on the cross. In this instance, the outcome of travail is celebrated as culminating victory over death.

How then can biblical experiences of pain assist to resolve pain in contemporary contexts? Three aspects from the study of pain in Scripture stand out as significant: (i) the irrationality of pain; (ii) the overarching emphasis on labour pain; and (iii) the celebration of pain.

In civilized modern societies, the endeavour is to silence the scream of the soul where "soul" refers to the entire being of a person's mind, body, and emotions. It is not considered aesthetic; it is not becoming for someone to be explicit in the demonstration of their pain. Such individuals are deemed asocial; they disturb the attractive norm of civilized living. The pain of screaming souls is conveniently silenced in the close surrounds of doctors' rooms, hospitals for the mentally unsound as well as through administration of antidepressants, psychotics, and pain "killers". Life simply demands to go on uninterrupted. The "unsound" person needs to find answers in logical discussions and at times through repetitious questioning concerning "How does it feel?" In the process, the pain of the soul may be compounded and not healed as strikingly expressed at Job 16:6, "Even if I speak, my pain is not relieved, and if I hold back, how will it go away?"51

Scripture reveals that wounds are sacred, to be revered within the context of empathy, respect, and protective support for the suffering soul. Pain was celebrated through fitting ceremonial practices in which the suffering of the soul was externalized through screaming, beating of the breast, ruffling and pulling out of hair, tearing and soiling the garment as well as sitting in sackcloth and ashes. Everyone knew when a soul was damaged, traumatized, hurting. Everything about the hurting soul displayed humiliation, shame, embarrassment, dishonour; like childbirth exposes the bleeding nudity of the woman. She is not in control of her pain; the pain controls her. Words are inappropriate to describe her dishabille of mind, body, and emotions. It simply is. She suffers her condition; she must embrace the pain, even celebrate it in view of the outcome: the birth of new life. From this perspective, the metaphor of labour pain in Scripture presupposes a positive force that is based on trust, hope, and faith in God's benevolent intervention.52

Pain is not logical and muted pain cannot heal. Pain needs an outlet for it to be resolved from despair to hope, from death to life. This happens when the struggle with pain is embraced for the sake of the glorious outcome that is anticipated to be the result. The new-born baby must scream to express the trauma of separation from the womb. Its scream evokes in the mother the sensation of nurturing love and compassion to embrace and cuddle it at her breast and herein the new-born finds solace to grow and emerge into its own destiny.

Pain is a symptom of the soul's separation from the source of life and love. The birth metaphor illustrates this hurt in terms of a new-born's scream, voicing the fear of parting from the nurturing shelter of its mother's womb. As the mother comfortingly responds to its scream, the trauma of separation evolves into a new dimension of living for the child.53 Job's moment of rebirth comes with the realization that he has a compassionate Redeemer: וַאֲנִי יָדַעְּתִי גֹּאֲ לי "But as for me, I know that my Redeemer lives" (Job 19:25a).54 The Messiah's travail did not take place behind closed curtains but openly for all the world to behold in the greatest celebration of struggle with pain in time memorial.



Avrahami, Yael. The Senses of Scripture: Sensory Perception in the Hebrew Bible. New York: T & T Clark, 2012.         [ Links ]

Andersen, Francis I. & A. Dean Forbes. The Hebrew Bible: Andersen-Forbes Analysed Text. Lexham Press, 2008; Logos 8 edition.         [ Links ]

Barry, John D., David Bomar, Derek R. Brown, Douglas Mangum, Carrie S. Wolcott, Lazarus Wentz, Elliot Ritzema & Wendy Widder. The Lexham Analytical Lexicon of the Hebrew Bible. Bellingham, WA: Lexham Press, 2017; Logos 8 edition.         [ Links ]

Beigi, N.M., K. Broumandfar, P. Bahadoran & H.A. Abedi. "Women's Experience of Pain during Childbirth." Iran JNurs Midwifery 15 (2010/2): 77-82.         [ Links ]

Bell, Melissa. "12 Types of Chronic Pain Directly Related to Emotional States." No Pages. Cited 27 February 2016. Online:         [ Links ]

Brown, Francis, Samuel R. Driver & Charles A. Briggs. Enhanced Brown-Driver-Briggs Hebrew and English Lexicon. Oxford: Clarendon Press, 1977.         [ Links ]

Cataldo, Lisa M. "I Know that My Redeemer Lives: Relational Perspectives in Trauma, Dissociation and Faith." Pastoral Psychology 62 (2013): 791-804.        [ Links ]

Childs, Brevard S. Old Testament Theology in a Canonical Context. Philadelphia: Fortress Press, 1986.         [ Links ]

Cunliffe-Jones, Hubert. Deuteronomy. London: SCM Press, 1951.         [ Links ]

Du Gas, Beverly W. Introduction to Patient Care: A Comprehensive Approach to Nursing, 4th ed. Philadelphia, Toronto: W.B Saunders, 1983.         [ Links ]

Easton, Matthew G., ed. Easton's Bible Dictionary (1897 Edition). No Pages. Cited 26 November 1994. Online:         [ Links ]

Ellicott, C. J., ed. A Bible Commentary for English Readers, Jeremiah-Malachi. Vol. 5. Eugene, Oregon: Wipf & Stock, 2015 [1897].         [ Links ]

Gatchel, Robert J. & Dennis C. Turk. Psychosocial Factors in Pain: Critical Perspectives, 1st ed. New York: Guilford Press, 1999.         [ Links ]

Gesenius, Wilhelm, Emil F. Kautsch & A. E. Cowley. Gesenius' Hebrew Grammar. Oxford: The Clarendon Press, 1909.         [ Links ]

Goldingay, John & David Payne. A Critical andExegetical Commentary on Isaiah 4055. Vol. 2 of International Critical Commentary. Edited by G. I. Davies & G. N. Stanton. London, New York: T&T Clark, 2006.         [ Links ]

Grant, Robert. "Spirituality and Trauma: An Essay." Traumatology 5 (1999/1): 11.         [ Links ]

Henry, Matthew. Matthew Henry's Commentary on the Whole Bible: Complete and Unabridged in One Volume. Peabody: Hendrickson, 1994.         [ Links ]

Hurtado, Larry W. Lord Jesus Christ: Devotion to Jesus in Earliest Christianity. Grand Rapids: Eerdmans, 2003.         [ Links ]

Keil, Carl F., & Franz Delitzsch. Commentary on the Old Testament. Grand Rapids, Michigan: Eerdmans, 1975.         [ Links ]

Lee, Jung Y. God Suffers for Us: A Systematic Inquiry into a Concept of Divine Possibility. The Hague: Martinus Nijhoff, 1974.         [ Links ]

Mayo Clinic Staff. "Labor and delivery, postpartum care." No Pages. Cited 15 May 2019. Online:         [ Links ]

Melender, Hanna-Leena. "What Constitutes a Good Childbirth? A Qualitative Study of Pregnant Finnish Women." JMWH 51 (2006/5): 331-339.         [ Links ]

Morse, Donald R. "Spirituality and Pain." JRPsyR 24 (October 2001): 209-233.         [ Links ]

Mumford, David B. "Emotional Distress in the Hebrew Bible: Somatic or Psychological?" BJP 160 (1992/1): 92-97,         [ Links ]

Natural Medicines Comprehensive Database Consumer Version. "Mastic." No Pages. Cited 2018. Online:         [ Links ]

O' Collins, Gerald. Interpreting Jesus. Vol. 2 of Introducing Catholic Theology. Edited by Michael Richards. London: Geoffrey Chapman and Ramsey, 1983.         [ Links ]

Odendal, C.L. "What is Pain?" No Pages. Cited 8 July 2014. Online:         [ Links ]

Pasero, Chris & Margo McCaffery. Pain Assessment and Pharmacologic Management. St. Louis, Mo: Mosby/Elsevier, 2011.         [ Links ]

Rae, M. "The Travail of God." Int. J. Syst. Theol. 5 (2003/1): 47-61.         [ Links ]

Salkinson, Isaac E. & Ginsberg, Christian D. Ha-Berit ha-Hadashah. Vienna: British Missionary Society, 1886.         [ Links ]

Shiel, William C. Jr. "Medical Definition of Pain." No Pages. Cited 12 December 2018. Online:         [ Links ]

Smith, Stacey. "Exploring the Interaction of Trauma and Spirituality." Traumatology 10 (2004/4): 231-243.         [ Links ]

Smith, William. Smith's Bible Dictionary. Nashville: Thomas Nelson, 1986.         [ Links ] "Latest studies find that body pain correlates with spiritual and emotional pain." No Pages. Cited 12 March 2018. Online:         [ Links ]

Stibbe, Mark W.G. John. Sheffield: JSOT Press, 1993.         [ Links ]

Swanson, James. Dictionary of Biblical Languages with Semantic Domains: Hebrew (Old Testament). Oak Harbor: Logos Research Systems, Inc., 1997.         [ Links ]

The Holy Bible. American Standard Version. Oak Harbor, WA: Logos Research Systems, Inc., 1995.         [ Links ]

The Holy Bible. Berean Study Bible. Copyright ©2016, 2018 by Bible Hub. Used by Permission. All Rights Reserved Worldwide. No Pages. Cited 18 June 2018. Online:         [ Links ]

The Holy Bible. English Standard Version. Wheaton, IL: Crossway Bibles, 2016.         [ Links ]

Thomas, Anthea. "To Push, or not to Push?" N.P. Cited 21 December 2018. Online:         [ Links ]

Torrance, Thomas F. Theology in Reconstruction. London: SCM Press, 1965.         [ Links ]

Turk, Dennis C., & Akiko Okifuji. "What Factors Affect Physicians' Decisions to Prescribe Opioids for Chronic Noncancer Pain Patients?" Clin J Pain 13 (1997/4): 330-336.         [ Links ]

Vingerhoets, Ad. Why only Humans Weep: Unravelling the Mysteries of Tears. Oxford: OUP Oxford, 2014.         [ Links ]

Wachholtz, Amy B., Michelle J. Pearce & Harold J. Koenig. "Exploring the Relationship between Spirituality, Coping, and Pain." J Behav Med. 30 (August 2007/4): 311-318.         [ Links ]

Witthoff, David, ed., The Lexham Cultural Ontology Glossary. Bellingham, WA: Lexham Press, 2014.         [ Links ]



Submitted: 07/08/2019
Peer-reviewed: 01/11/2019
Accepted: 04/11/2019



Dr Gudrun Elisabeth Lier, Department of LanCSAL, Block K, Blue level, Room 15, Bunting Road Campus, Auckland Park 2006, Johannesburg, University of Johannesburg, South Africa. E-mail: ORCID:
1 Hanna-Leena Melender, "What constitutes a good childbirth? A qualitative study of pregnant Finnish women," JMWH 51 (2006/5): 331-339.
2 C.L. Odendal, "What is Pain?" n.p. [cited 8 July 2014]. Online:; William C. Shiel Jr. "Medical Definition of Pain," n.p. [cited 12 December 2018]. Online:; Beverly W. Du Gas {Introduction to Patient Care: A Comprehensive Approach to Nursing, 4th ed. [Philadelphia, Toronto: W.B. Saunders, 1983], 528-530) observes that pain is a phenomenon that hasn't been understood and discovered completely yet and its clinical measurement could be difficult.
3 Lisa M. Cataldo, "I know That My Redeemer Lives: Relational Perspectives in Trauma, Dissociation and Faith," Pastoral Psychol 62 (2013): 793.
4 Cataldo, "Relational Perspectives in Trauma," 794.
5 Robert J. Gatchel & Dennis C. Turk (Psychosocial Factors in Pain: Critical Perspectives, 1st ed. [New York: Guilford Press, 1999], 302) observe, "Historical documents show that some societies have accepted pain as a part of their life and considered it as a fundamental element for growth and spiritual promotion." [My emphasis, G.L.]
6 Translations from Hebrew into English are my own, unless indicated otherwise.
7 Hebrew texts are taken from: Francis I. Andersen & A. Dean Forbes. The Hebrew Bible: Andersen-Forbes Analyzed Text (Lexham Press, 2008; Logos 8 edition).
8 David B. Mumford notes ("Emotional Distress in the Hebrew Bible: Somatic or Psychological?" BJP 160 (1992/1): 92, doi:10.1192/bjp.l60.1.92): "Usually somatic and psychological expressions were paired together, utilising the 'parallelism' of Hebrew verse form. Biblical Hebrew thus incorporated a powerful and sophisticated language of emotional expression." Amy B. Wachholtz, Michelle J. Pearce & Harold J. Koenig ("Exploring the Relationship between Spirituality, Coping, and Pain," J BehavMed. 30 [August 2007/4]: 311), doi: have found that there "is growing recognition that persistent pain is a complex and multidimensional experience stemming from the interrelationship among biological, psychological, social, and spiritual factors." Yael Abrahami (The Senses of Scripture: Sensory Perception in the Hebrew Bible [New York: T & T Clark, 2012], 26) observes that the distinction between body and mind, mental and physical perception is alien to the biblical worldview.
9 Francis Brown, Samuel R. Driver & Charles A. Briggs, Enhanced Brown-Driver-Briggs Hebrew and English Lexicon (Oxford: Clarendon Press, 1977), 456.1.
10 Brown, Driver & Briggs, Lexicon, 753.
11 John D. Barry et al., The Lexham Analytical Lexicon of the Hebrew Bible (Bellingham, WA: Lexham Press, 2017; Logos 8 edition).
12 Barry et al., Lexham. N.M. Beigi, K. Broumandfar, P. Bahadoran & H.A. Abedi ("Women's Experience of Pain during Childbirth," Iran JNurs Midwifery 15 [2010/2]: 77-82) found that labour pain is a complicated result of interactions between numerous mental and physiological factors so to control the pain.
13 "Latest studies find that body pain correlates with spiritual and emotional pain," n.p. [cited 12 March 2018]. Online: "Physical pain functions to warn a person that there is still emotional work to be done", said Dr Susan Babel for Psychology Today (Melissa Bell, "12 Types of Chronic Pain Directly Related to Emotional States," n.p. [cited 27 February 2016]. Online:
14 The phenomenological approach relies solely on personal experience.
15 In this section, all lexical translations are according to Barry et al., Lexham.
16 David Witthoff, ed., The Lexham Cultural Ontology Glossary (Bellingham, WA: Lexham Press, 2014); William Smith, Smith's Bible Dictionary (Nashville: Thomas Nelson, 1986). Dennis C. Turk & Akiko Okifuji ("What Factors Affect Physicians' Decisions to Prescribe Opioids for Chronic Noncancer Pain Patients?" Clin J Pain 13 [1997/4]: 334) found that physicians believed that behavioural demonstrations of pain indicated something important about the nature of a patient's pain.
17 Brown, Driver & Briggs, Lexicon, 608.
18 Brown, Driver & Briggs, Lexicon, 706.
19 Brown, Driver & Briggs, Lexicon, 222.
20 Brown, Driver & Briggs, Lexicon, 532.
21 English translations according to the American Standard Version (Oak Harbor, WA: Logos Research Systems, Inc., 1995), unless stated otherwise.
22 Donald R. Morse, "Spirituality and Pain," The Journal of Religion and Psychical Research 24 (October 2001): 209-233.
23 Beigi et al., ("Pain during childbirth," 77) extracted four main categories of pain: the nature of delivery pain, the related factors in labour pain, the results of labour pain, and the perception of caseworkers.
24 Mayo Clinic Staff, "Labor and delivery, postpartum care," n.p. [cited 15 May 2019]. Online:
25 Avrahami (The Senses of Scripture, 216) notes in relation to Job that a silent response is evaluated as positive when directed at God; yet evaluated as weakness when directed at other people.
26 Beigi et al., "Pain during childbirth," 77-82.
27 Avrahami (The Senses of Scripture, 215-216, 218) argues that situations of fear and pain damage the senses.
28 In his book abstract, Ad Vingerhoets (Why Only Humans Weep: Unravelling the Mysteries of Tears [Oxford: OUP Oxford, 2014]) notes that emotional tears are a unique human characteristic since ancient times. Chris Pasero & Margo McCaffery (Pain Assessment and Pharmacologic Management [St. Louis, Mo: Mosby/Elsevier, 2011], 28) found that patients with pain may deliberately engage in certain behaviours that are helpful in coping with pain.
29 Beigi et al., "Pain during childbirth," 75.
30 Brown, Driver & Briggs, Lexicon, 863.1. On the topic of mastic, see also C. J. Ellicott, ed., A Bible Commentary for English Readers, Jeremiah-Malachi. Vol. 5. (Eugene, Oregon: Wipf & Stock, 2015 [1897]), 38. Mastic is used for stomach and intestinal ulcers. It reduces stomach acid and may protect the lining of the stomach and intestine. It contains a fragrant oil which is used to freshen the breath and assists with breathing problems, muscle aches, and seems to fight bacterial and fungal infections. It is also used to improve blood circulation (Natural Medicines Comprehensive Database Consumer Version, "Mastic," n.p. [cited 2018]. Online:
31 The Holy Bible, English Standard Version (Wheaton, IL: Crossway Bibles, 2016).
32 Stacey Smith, "Exploring the Interaction of Trauma and Spirituality," Traumatology 10 [2004/4]: 235.
33 Cataldo ("Relational Perspectives in Trauma," 795).
34 On the travail of Jesus see also Gerald O' Collins, Interpreting Jesus, vol. 2 of Introducing Catholic Theology, ed. Michael Richards (London: Geoffrey Chapman, 1983), 106; B.S. Childs, Old Testament Theology in a Canonical Context (Philadelphia: Fortress Press, 1986), 9; L.W. Hurtado, Lord Jesus Christ: Devotion to Jesus in Earliest Christianity (Grand Rapids: Eerdmans, 2003), 129; John Goldingay & David Payne, A Critical andExegetical Commentary on Isaiah 40-55, vol. 2 of International Critical Commentary, ed. G. I. Davies & G. N. Stanton (London; New York: T&T Clark, 2006), 323.
35 Hebrew Text taken from Isaac E. Salkinson & Christian D. Ginsberg, Ha-Berit ha-Hadashah (Vienna: British Missionary Society, 1886). English translation according to the ESV.
36 1 Pet 2:21-24:
כִי הֲלאֹּ לָזאֹּת נִקְּרֵאתֶם וְּאַף גַם־הַמָשִיחַ נִדְּכָה בִגְּלַלְּכֶם וַיְּהִי לָכֶם לְּמופֵת לָלֶכֶת בְּעִקְּבותָיו׃ אֲשֶר לאֹּ־חָמָס עָשָה וְּלאֹּ מִרְּמָה בְּפִיו׃ אֲשֶר חֵרְּפוּהוּ חורְּפָיו וְּלאֹּ הֵשִיב חֶרְּפָתָם אֶל־חֵיקָם נַעֲנֶה וְּלאֹּ יִפְּתַח־פִיו כִי אִם־הִפְּקִיד מִשְּפָטו לְּשֹּפֵט צֶדֶק׃ וְּהוּא נָשָא אֶת־חַטאֹּתֵינוּ בִבְּשָרו עַל־הָעֵץ לְּבַעֲבוּר נָמוּת לַחֲטָאָה וְּנִחְּיֶה לִצְּדָקָה וַאֲשֶר בַחֲבֻרָתו נִרְּפָ 488; לָכֶם׃ כִי צאֹּן אֹּבְּדות הֱיִיתֶם וַתָשֻבוּ כַיּום (Salkinson & Ginsberg, Ha-Berit ha-Hadashah, 1886) "or have you not been called to this, because Christ also suffered for you, leaving you an example, so that you might follow in his steps, who did no sin, neither was guile found in his mouth (Is 53:9b).When he was reviled, he did not revile in return; when he suffered, he did not threaten, but continued entrusting himself to him who judges justly. He himself bore our sins in his body on the tree, that we might die to sin and live to righteousness. By his wounds you have been healed. For you were straying like sheep but have now returned to the Shepherd and Overseer of your souls." [My translation, G.L.]
37 See Carl F. Keil & Franz Delitzsch, Commentary on the Old Testament (Grand Rapids, Michigan: Eerdmans, 1975).
38 Goldingay & Payne, Commentary on Isaiah 40-55, 323.
39 James Swanson, Dictionary of Biblical Languages with Semantic Domains: Hebrew (Old Testament) (Oak Harbor: Logos Research Systems, Inc., 1997).
40 Gesenius, Kautsch & Cowley (Gesenius' Hebrew Grammar,, 382 §119w) here assign the preposition
מן the sense of without (separated, free from.. ).
41 Matthew Henry, Matthew Henry 's Commentary on the Whole Bible: Complete and Unabridged in One Volume (Peabody: Hendrickson, 1994).
לכן אחלק־לו ברבים ואת־עצומים יחלק שלל "Therefore, I will allocate for Him many (3 instrumenti; see Wilhelm Gesenius, Emil F. Kautsch and A. E. Cowley, Gesenius' Hebrew Grammar [Oxford: The Clarendon Press, 1909], 380 §119q), and of the strong He will receive spoil (את before an undetermined noun; see Gesenius, Kautsch & Cowley, Gesenius' Hebrew Grammar, 364 §117d).
43 Murray Rae, "The Travail of God," International Journal of Systematic Theology 5 (2003/1): 60; Rae speaks to "The metaphor of travail" (51). He understands the death of Christ as the travail of God (59); see also Hubert Cunliffe-Jones, Deuteronomy (London: SCM Press, 1951), 175; Jung Y. Lee, God Suffers for Us: A Systematic Inquiry into a Concept of Divine Possibility (The Hague: Martinus Nijhoff, 1974), 21, 42-45, 59; Mark W. G. Stibbe (John [Sheffield: JSOT Press, 1993], 175) uses the childbirth metaphor in reference to the blood and water flowing from the side of Jesus at his crucifixion (John 19:34).
44 Hebrew New Testament (Salkinson-Ginsberg).
45 Cf. Thomas F. Torrance, Theology in Reconstruction (London: SCM Press, 1965), 125-127.
46 Rae, "Travail of God", 53 and 58.
47 Anthea Thomas ("To Push, or not to Push?" n.p. [cited 21 December 2018]. Online: observes, "As the body prepares to move the baby down the birth path, the woman begins to feel a deep and powerful pressure. This primal, unstoppable pressure moves completely through the woman, where she become intensely focused on her body and baby, almost in an amnesiac state, yet highly focused, where she is able to work with the power of her body in a physical and mental sense, her body moves her baby down to crowning."
48 Thomas, "To Push, or not to Push?"
49 Thomas, "To Push, or not to Push?"
50 Cataldo ("Relational Perspectives in Trauma," 795. See also Robert Grant, "Spirituality and Trauma: An Essay," Traumatology 5 (1999/1): 11.
51 The Holy Bible, Berean Study Bible, BSB, Copyright ©2016, 2018 by Bible Hub. Used by Permission. All Rights Reserved Worldwide, n.p. [cited 18 June 2018]. Online:
52 Cf. Smith, "Exploring the Interaction of Trauma and Spirituality," 794-795.
53 Cf. Grant, "Spirituality and Trauma," 11.
54 ASV. The noun "Redeemer" is derived from the Hebrew V bio "to redeem" (Matthew G. Easton, ed., "Goel," Easton's Bible Dictionary (1897 Edition), n.p. [cited 26 November 1994]. Online: The redeemer is one charged with the duty of restoring the rights of another and avenging his wrongs (Matthew G. Easton, "Redeemer," Cataldo ("Relational Perspectives in Trauma," 797-800) describes the book of Job as a "portrait of the inner world of the trauma survivor."

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