**Conflict of interest**

We have no financial relationships to disclose.

*Quality of Life - Biopsychosocial Perspectives*

**5. Conclusion**

achieved ego integrity at old age despite having to live in unfortunate circumstances. Thus, if we support such individuals, we can promote compensatory mechanism.

In this study, after discussing the conceptual structure of spirituality in the first report, we conducted an analysis of spiritual pain and discussed Mr. Takahisa Yamamoto's experience as a Hansen's disease survivor. In addition, we introduced our research on the spiritual well-being of aging Hansen's disease survivors.

has a cautionary tale to ensure that the same mistake is never repeated.

the current times, human relationships are sparse and require patience.

The construction of spiritual pain and recovery from it in the chapter is from the point of view of one survivor; therefore, the analysis cannot get be universal. We must continue to analyze the information. In addition, a certain survivor said, "I will take real my sufferings to my graveyard." Talking about sufferings is difficult for Hansen's disease patients/survivors. We must realize that it is also difficult to understand the real pain of the suffering, and we must have intellectual humility.

Next, Mr. Yamamoto's recovery from spiritual pain was achieved with time and reflection, and then the bellwethers, who continued to be there during his time of suffering time, led to a turning point to change the flow of his life, and he spent a substantial amount of time to get approval from others and to meet their expectations. By then, he had stopped his undisciplined way of wasting time and had found out how to use his time productively. Some aging Hansen's disease survivors tend to withdraw as they are not able to get a catharsis against the past bitter experiences. In addition, right now, some young people have lost or cannot find their reason to live, and they withdraw or become desperate, therefore recovering from spiritual pain is a universal issue throughout ages. In Mr. Yamamoto's recovery process, there were some people who were affectionate toward him and were concerned about him. These people included his mother and sisters who expressed their affection, his wife, who sustained their married life, the elders in the residents' committee who created the opportunity for changing the flow of his life, good friends in his new world, and old friends who were awaiting his return. It is evident that humans can only be healed by humans. Success in recovering from spiritual pain is dependent on people who continue to support a person during their suffering and recovery. If we think about the support for people who are lost or unable to find the hope to live, creating a support system in the period of suffering and recovery is important. In

Mr. Yamamoto's spiritual pain was because of *Loss of autonomy and independence for carving out my life* and *Going back and forth between life and death*, and he was stuck in the negative cycle for almost 20 years. In a psychiatric study on differences between the mental condition of condemned criminals and life imprisoned criminals, condemned criminals acted violently and were easily distracted and stressed, while the life imprisoned criminals exhibited emotional paralysis and regression. [3] The reason for this difference is that while condemned criminals faced their death every day, because the date of execution is notified to the condemned criminal only on the morning of the appointed day, life imprisoned criminals repeat the same daily life until they die. In other words, the life of condemned criminals is condensed to 1 day, while that of life imprisoned criminals is diluted across their lifetime. Mr. Yamaomto's sufferings are similar to that of criminals imprisoned for life, as both experience difficulties with delight and hope, owing to a repetitive and unchanging daily life. As a matter of truth, Hansen's disease is not crime, although it is one of the many diseases in which human rights were violated. We must hand down this information and stop it from being forgotten, because Hansen's disease

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