Call that the “fortunate” stage when a person has not yet been tested by any of the tougher blows life can deliver. Unconstrained at this stage, hope can be defined as the belief that something better is always possible.

Inversely, the middle or “setback” stage knocks hope off its very axis, as our health is threatened. Here we define hope as getting better, and fervently invest all of our energies in chasing that outcome.

However, if the condition becomes chronic, a person can feel quite powerless, with little control over being able to decrease their kinds or levels of suffering. Their ability to feel hope about improving their situation plummets.

We usually think in terms of beginning, middle and end with stages. However, what if there’s no end in sight, no “moving past” or “moving through” our medical plight? Chronic illness shoves us into the “enduring” stage.

While it may seem that hope eludes us in this stage, at a time when it is needed the most, that doesn’t mean it no longer exists or is unavailable. But the journey to uncover that hope is tricky. Some tell inspirational stories about being transformed by rediscovering hope in a new way.

Others seem to find a more self-empowering approach that influences how they will allow the latter stage to impact them. It’s not the happy, faux version of hope, but the livable version rooted in the hard work of finding a personalized realism.

Feeling stuck in the “setback” stage for years, it hit me that not only was I irreparably damaged by the surgery promised to “cure” me, I was also medically conditioned by multiple doctors that my situation was hopeless – harmed beyond help or relief.

I have come to define this equally destructive medical implication as “learned hopelessness.” No, not the popularized “learned helplessness.” People who learn to take action on the things within their control and bypass those they can’t aren’t helpless.

But a medical system that has little intellectual curiosity, compassion, or time to devote to tough cases can create further assault by unwittingly kicking the hard can of truth right over the line into hopelessness. That was true for me, until I realized that both suffering and hope needed to be untangled and redefined to fit my new reality if I was ever to endure the “enduring” stage.

With a damaged trigeminal nerve, I was still defining hope in improbable degrees of “getting better.” Even just the notion of holding a compromised, shaky steady state felt like defeat vs. a small victory.

Overcoming Emotional Traps

Once I caught on to these medical, mental, and psychological traps, I had to modify hope into feasible terms by translating it into the smallest incremental possibilities, and then some progressively larger ones.

I’m talking simple things like being able to take a short walk, Skype with my granddaughter, have a short visit with a friend, follow a yoga CD, go to a retail store, and such. Sometimes my best hope equates to making it through the next hour.

As I was able to redirect my focus on those smaller things in the enduring stage, I found that my repertoire for cultivating a smidgeon of hope expanded. I was onto something within my control that could influence my levels of suffering and hope. Even better, that something wasn’t dependent on what doctors did or didn’t say or do.

These small, successive flickers rekindled my battered relationship with hope. I felt as if hope could be resuscitated in spite of so many crashes.

My pain hasn’t decreased physically as much as it has shifted into my side view mirror at times, as opposed to blocking my windshield (which grieving over losses can do).

What works better for me is to remind myself that no matter how difficult a time I might be having, I’ve survived worse ones.

We also create twisted parallels when we perceive and talk about suffering and hope by comparing how we were (before chronic pain or illness) to now (with them). Such comparisons are faulty because they’re not apples to apples in time or circumstance.

Seven years in the “setback” stage taught me that if I focused on my level of suffering as it increased– which I call “suffering over my suffering” – it became a costly, self defeating exercise.

It’s tricky the way hope nudges us into a decision point to help us endure.

Instead of dwelling on the suffering of what we can no longer be, have, or do; it teaches us to lean into ways that side step the medical, mental, or emotionally dooming loops that sabotage the very thing we’d like more of – small reasons to still have hope.