This book is subtitled, "Toward a Psychology of Suffering." In the first chapter, Bakan sketches a theory of disease as telic decentralization. He defines "telos" as that which is "determinant of form." In multicellular organisms, there are multiple, subsidiary tele, as well as an overall telos of the organism. Growth and development can occur only if there is a certain degree of telic decentralization, yet disease can also result from this internal separation or estrangement. Bakan supports this theory with arguments from post-Darwinian evolutionary theory, Selye, and Freud.
In the second chapter, Bakan considers pain as the psychic manifestation of telic decentralization. Suffering is a pain-annihilation complex: the experience of pain external to the ego, associated with an internal fear of annihilation. In the last chapter, the author considers the Book of Job as a literary approach to understanding the meaning of pain, sacrifice, and suffering.
