Gender Differences in Response to Pain and Suffering

Note: I used the following sources for my text today:

https://www.science.org/doi/full/10.1126/science.308.5728.1574

https://www.psychiatrictimes.com/view/religion-spirituality-and-mental-health

Last week, Sharon talked about how people in various cultures respond to suffering. Today, I want to explore how different genders respond to pain and suffering, specifically how that response is based on their biology, culture, and spirituality. 

First: Is there a difference between man and women according to the Bible? To answer this question, we must first look at the creation of Adam and Eve. 

The Lord God took the man and put him in the Garden of Eden to work it and take care of it. (Genesis 2:15)

The Lord God said, “It is not good for the man to be alone. I will make a helper suitable for him.” (Genesis 2:18)

In these two verses, we see that God’s purpose for creation of man and women is different. Adam was created to work and take care of the garden and Eve was created to be a suitable helper. But “suitable helper” is a bad translation. The Hebrew words used for suitable helper were ezer kenegdow (עֵזֶר כְּנֶגְדּוֹ).. Kenegdow literally means “according to the opposite of him” or “complementary” and ezer means “ally”. Interestingly ezer was also used for God in reference to how He rescued Israel from enemies. So ezer is not a subservient helper to a primary but a rescuer or an ally. Thus, Eve’s primary purpose is to be an ally or a rescuer to help Adam accomplish things he could not accomplish himself. 

Next, if we observe how God cursed both Adam and Eve after the fall, we can see these differences in how men and women suffer. When God cursed Adam, He cursed the land. Tending the land is the purpose of Adam. That is his professional identity. Because of curse, success in profession doesn’t come easily and this became a major cause for Man’s suffering. When God cursed Eve, besides increasing labor pains, He cursed her relationship with man. Today, with the advancement of pain medications, most women choose to lesson labor pains. But the pain of relationships specifically with their husbands, fathers, brothers, and sons is ever more complicated and painful. Psychological studies show that major cause of stress among women is relationships with their family, friends, and co-workers whereas men stress more about professional success. 

Now, let’s look at how men and women deal with pain. In a study, researchers asked both men and women to put their hands in ice bucket for certain amount of time and asked them to rate their pain. Women reported feeling more pain compared to men. Men had higher pain threshold and were able to keep their hands in ice bucket for longer periods. In general, in one’s lifetime, biologically women experience more episodes of physical pain resulting from menstrual cycles and childbirth. Based on this many falsely think that women have higher pain tolerance, but the evidence is contrary. Why is it that for same physical stressor such as ice bucket, women report more pain? 

From a biological standpoint, 

• Women have greater nerve density which allows them to feel pain more intensely. 
• The fluctuating nature of sex hormone, estrogen also amplifies the body’s perception of pain. When estrogen levels are low for instance during menstrual cycle or after menopause, pain perception is high due to increase in pain receptor activity. But during pregnancy and childbirth, elevated levels of estrogen reduce pain perception and increase pain thresholds. 
• Another interesting finding lies in how both men and women process pain. Men typically focus on pain sensation itself whereas women focus on the emotional aspects of pain. Focusing on emotional aspects of pain enhances pain perception. 

Psychologically both men and women suffer with stress differently. 

• Women are more likely then men to report having great deal of stress.
• Women are often more stressed about money and economy whereas men are more stressed about work. 
• When it comes to relationships, having right relationships with family, friends and co-workers is of utmost importance for women. But for men more than relationships, success in their profession is of utmost importance. 
• When dealing with stress women report experiencing physical symptoms such as headache, feeling irritable and angry and experiencing fatigue and feeling as though they could cry. For men such experiences are low, but they do manifest such as chest pain, back pain etc. 

When it comes to mental health, scientists are now beginning to understand and focus on how men and women deal with suffering of the brain (Holden, 2005). 

• Women feel more anxious compared to men when dealing with diseases like cancer. 
• Women are more likely to get depressed than men whereas men are more severely afflicted by schizophrenia which is one of the most devastating mental illnesses. 
• In general, females exhibit more anxiety, whereas males exhibit antisocial behavior. 
• Females have more eating disorders, and most alcoholics and drug addicts are male. 
• Females make more attempts to commit suicide whereas males are more successful in committing suicide (Suicide rate is 5 times higher in men).
• Women exhibit more intense fear response whereas, men express more aggressive or risky physical behavior. 
• Women have strong negative reactions for social rejection whereas men have strong negative reactions for lack of achievement. 

There is a biological reason for these differences. They are based on three broad areas: sex hormones, brain physiology and genetic factors. For example, abnormal levels of estrogen in women causes depression and abnormal levels of testosterone in men causes aggressive behavior. Next, due to more cross connections between left and right hemispheres, women cope better with suffering whereas men become isolated and withdrawn due to fewer cross-connections. Scientists are also looking at the genetic variations at various chromosomes and how they are making women more prone to bipolar disorder whereas men to schizophrenia. 

Culture also plays an important role in how men and women respond to suffering. This is mainly due to diverse norms, expectations and roles assigned to men and women in different societies. 

• In Western cultures, men are traditionally expected to maintain a stoic demeanor and suppress emotional expression, including sadness, vulnerability in response to suffering. In contrast, women in western cultures are encouraged or express their emotions more openly and seek emotional support from others. This is one of the leading causes of mental illness and suicide among men (Men are 5 times more likely to die from suicide than women)
• Women often have stronger social support networks in some cultures. They may turn to friends and family for emotional support and share their struggles more openly. Men, on the other hand, may rely less on social support networks and may be more self-reliant when dealing with suffering.
• When it comes to coping mechanisms, women seek solace in religious or spiritual practices, while men turn to activities that distract them from pain such as addition. In US overdose deaths are in rise since the 2002 and the overdose death rate among males is 2.5 times higher than females
• In some cultures, both men and women are discouraged from seeking help due to stigma whereas in Western cultures men are particularly resistant to seeking mental health support due to concerns about perceived weakness or shame. 
• In some cultures, gender roles are traditionally well defined. In such societies, typically, women are often responsible for caregiving and carry the burden of caring for family, elderly and sick which sometimes affects their mental well-being. Men are primarily expected to provide financially, and financial struggles impact their self-esteem and mental well-being. 
• In western society where traditional gender roles changed significantly, women struggle considerably in traditional male roles such as sales, entrepreneurship, politics etc. where they must deal with rejection regularly. 

Moving onto existential suffering, very little was known. However, there is some evidence to suggest that men and women may deal with existential suffering differently. 

• For example, one study found that women were more likely to endorse communal values, such as valuing close relationships and helping others, while men were more likely to endorse agentic values, such as valuing achievement and independence. What it means that women were more likely to seek social support in response to existential suffering, while men were more likely to cope with existential suffering alone. For this reason, men are more likely to experience existential isolation (EI). EI is the subjective sense that people are alone in their experience and that others are unable to understand their perspective. 

Moving on to how spirituality and religiosity affects men and women’s response to suffering and pain, there is mixed evidence. 

In some cases, religion and spirituality aided in remission of depression, anxiety, and fears whereas in some cases, it fostered depression, anxiety, and guilt among subjects. 

Prior to the 19th century, psychiatry and religion were closely linked. But in the 19th and 20th centuries, psychiatry dismissed religion and considered it to be the source of psychosis. Since the 1990s, this trend somewhat reversed. Now psychiatrists have started noticing the benefits of religion and spirituality in coping with depression and anxiety. 

• Around 724 quantitative studies showed that on balance, religious involvement is generally conducive to better mental health. 
• Around 93 observational studies reported that among individuals that are more religious, depressive disorders and symptoms are two-thirds lower in comparison to non-religious individuals. 
• Smith et al. performed a meta-analysis of 147 studies that observed 100,000 subjects. They found that there is a 20.1 times negative correlation between religious observance and depression. 
• Several studies also showed that among individuals that are more religious, substance abuse is 90% lower, anxiety is lower and self esteem is higher. 
• Vast majority of these studies were based on Christianity and there is lack of research in other groups. But Levav et al. study in 1997 indicated that there is an increased prevalence of depression among Jews. 

Most recent studies indicate that the relationship between religion and depression is more complex than previously shown. All religious beliefs and variables are not necessarily related to better mental health. 

• Petts and Jolliff in their 2008 study observed that even though in general religious observance is negatively correlated with depression, this is not true for all races and genders. Among Asian adolescents, and Latino females, religious participation is associated with increased depression. 
• Ano and Vasconcelles in 2005 performed a meta-analysis and found a difference in how people use religion to cope with their suffering. For instance, positive religious coping involves focusing on forgiveness, conversion, helping, supporting, collaboration, surrender, benevolence, connection, and boundaries. Negative religious coping involves focusing on discontent, demonic reappraisal, passivity, interpersonal discontent, reappraisal of God’s powers, punishing God reappraisal, and pleading for direct intercession from God. What they found is that.
  • Individuals who used positive religious coping strategies typically experienced more spiritual growth, positive affect, and had higher self-esteem, etc. They also experienced less depression, anxiety, distress, etc.
  • Individuals who used negative religious coping strategies did not necessarily report lower self-esteem, less purpose in life, lower spiritual growth, but experienced more depression, anxiety, distress, etc.
• Among the cancer patients, women reported higher levels of anxiety and they also overwhelmingly reported that they used religious practices for coping with suffering with illness, anxiety, and pain. Men suffering with cancer reported to be less anxious and used isolation and self-reliance as cooping mechanism. 

Even after reporting all these studies, I feel that we haven’t scratched the surface when it comes to gender differences in response to suffering. I want to ask all of you have you observed how men and women differ in response to suffering? If so, what they are? What strategies would work best for helping men and women in suffering? 

David: The Hebrew definitions you gave reminded me of the Chinese yīn 陰 (literally: dark side; philosophically: female/passive) and yáng 陽 (literally: light side; philosophically: male/active), which are two equal and complementary parts of a whole. I’d like to think that that is what the Bible means to say with regard to the relationship between men and women. 

With regard to spiritual suffering: Some monastic orders appeal to people suffering spiritually and impose physical suffering (e.g. horsehair habits) and mental suffering (e.g. silence) to assuage spiritual suffering, as I see it. There are both male and female versions of Trappists, Discalced Carmelites (who don’t wear shoes) and others, although in  the Orthodox Christian, Buddhist, and Hindu traditions there are few (though still some) female monastics. 

A strict monastic tradition imposes a life of penury and discomfort for spiritual gain. I would imagine that the proportion of the global population living in monasteries, nunneries, and similar religious institutions is significantly smaller today than it was in the Middle Ages. One reason for this shift could be the Enlightenment and evolving ideas about God and spirituality. 

In earlier times, when the fear of eternal darkness was a recurring theme and excommunication represented the most existential threat one could face, the psychological toll must have been immense. Excommunication was perceived as not just the end of one’s earthly life, but also of one’s eternal life. 

Today, however, such beliefs have waned. Most people no longer fear divine disenfranchisement, which I consider a positive development. In this sense, there may be less spiritual suffering today than in the past. I guess I’ll stop there.

Don: I wonder how much of the differences in suffering and tolerance between men and women are due to genetics or hormones. Could these differences also be circumstantial or socially derived? Additionally, how feasible is it to change one’s view of God and the nature and meaning of spiritual suffering?

Kiran: Increasingly, research is exploring the biological and genetic factors involved, often through fMRI studies. These studies examine regions of the brain that are disproportionately larger in men and women who are suffering from various mental illnesses. Researchers are also investigating chromosomal changes and mutations that could be responsible for mental illnesses. However, I haven’t found any studies that extend beyond the realm of mental health to explore views on suffering or beliefs about God; the focus is overwhelmingly on mental illness.

Don: If this is the case, it suggests that determinism plays a more significant role than volition or decision-making in shaping our responses to suffering. This perspective could diminish the sense of personal responsibility for how one copes with suffering.

Reinhard: I believe that men and women are genetically different, and this extends to their experience of suffering and pain. Research indicates that women are generally more sensitive to pain than men, possibly because testosterone acts as a natural painkiller, giving men greater endurance and a higher tolerance for pain. In various cultures, men are often encouraged to be tough, especially in situations involving pain or even torture. This cultural conditioning may contribute to differences in endurance and pain tolerance.  

For Christians, Ephesians 6:13 advises putting on the “full armor of God” to withstand challenges and suffering. This spiritual armor, which includes faith, can provide additional resilience against life’s difficulties, depending on their severity.  

Humans also employ psychological defense mechanisms like denial, projection, and displacement to cope with pain. When combined with spiritual beliefs and a connection to a higher power, these mechanisms can offer a more comprehensive approach to managing suffering. In essence, life requires us to use all available means—both psychological and spiritual—to navigate the challenges we face. The belief in a loving God can further ease the pain and suffering we encounter.

Carolyn: Women have traditionally been seen as nurturers, often more inclined to seek spiritual guidance in challenging situations. Men, on the other hand, are often prepared for different kinds of challenges, much like the rites of passage in some Native American cultures where boys spend a night alone in the woods. Both roles are valuable. Women generally tend to have closer personal and emotional relationships compared to men.

Sharon: Kiran’s analysis underscores the complexity of social science. For every study that claims one thing, there’s often conflicting data suggesting something else. While I’m excited about the distinct, complementary characteristics identified across genders, I think it’s crucial to remember that these are not absolutes. There are always individuals who defy gender stereotypes. For example, some families have fathers who are the primary nurturers, or churches have male pastors who excel in nurturing roles. God created this diversity intentionally, perhaps to keep our stereotypes in check.

Even though statistical variances exist, we should be cautious not to make assumptions about what men or women can or cannot do. Kiran’s research raises important questions about how the church can address the diverse needs of its community without projecting our own biases.

David: The projection of biases is indeed a significant issue and a source of much suffering. While there’s supposed to be a yin-yang balance, a complementary whole, the reality often skews towards male dominance, especially in leadership roles. It’s noteworthy that countries led by women, like Finland and New Zealand and Taiwan, have generally handled crises like the COVID pandemic more effectively than others.

On the global stage, the problems we see are often exacerbated by male leaders, whether it’s Vladimir Putin, Xi Jinping, or Donald Trump. This imbalance in complementarity contributes to a great deal of unnecessary suffering.

Kiran: A few years ago, I facilitated a men-only group at my apartment for nearly two years. It took several months before the members began to open up and be vulnerable, but once they did, it was incredibly beneficial for many of them. Research often suggests that women find it easier to be vulnerable and connect with others, but my experience shows that men can also open up in a safe, confidential environment. It was one of the most challenging yet rewarding experiences I’ve had.

Don: This leads me to ask: Should men only minister to men and women to women? Could we misinterpret or misguide each other if we try to cross genders? Kiran’s finding that religion seems to be a better aid to suffering than spirituality seems counterintuitive to me.

Carolyn: We need to define the difference between religion and spirituality.

Don: In my view, religion involves organized church attendance and adherence to doctrine, while spirituality is a more direct connection with God, without as much structure.

Carolyn: Is it ideal to be both religious and spiritual? Could the organized church encompass spirituality, allowing for a more holistic experience?

Don: Ideally, the structure of the church should serve as a stepping stone toward a deeper spirituality.

Reinhard: I agree. Spirituality and religion can coexist, as we’ve discussed in past group meetings. Social support from a community of fellow believers is crucial. It’s not just within the church; external social groups also play a significant role in human life. 

On another note, the role of women in religious settings has evolved. In biblical times, women were not allowed to speak in meetings and had to ask their husbands questions at home. Nowadays, with advancements in human and women’s rights, some churches even allow women to become priests or pastors. This is an interesting shift we’re witnessing. 

Kiran: These questions touch on the complexities of men’s and women’s ministries. Men often find it difficult to open up due to fears of rejection or being perceived as weak. This is especially true among single men, who feel that women may blacklist them for showing vulnerability. Therefore, there’s a need for men-only ministries. 

Regarding the paper on spirituality leading to more cases of depression, the abstract suggests that religion offers a structured community and set beliefs, which may be less anxiety-inducing than the nebulous nature of spirituality.

Jay: When discussing the difference between religion and spirituality, especially in the context of suffering, it’s important to consider the concrete versus abstract nature of these experiences. Religion often provides a more tangible, concrete experience, which may be why it’s more effective in alleviating suffering compared to the abstract concept of spirituality.

David: Caroline’s idea of merging spirituality and religion is intriguing. In free societies, one has the luxury of choosing a religion that aligns with one’s spirituality. Historically, however, this choice has often been limited by culture and geography. If your culture’s dominant religion exercises a monopoly and doesn’t support your spiritual needs, you’re out of luck. It’s a fascinating thesis that warrants further thought.

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