**Abstract**

There have been suicides at the Hansen's disease sanatoria in the past. What is the level of suffering that makes a person think of suicide? Through the analysis of a Hansen's disease survivor's life, we clarified that the nature of sufferings is spiritual pain that is brought by the "loss of autonomy and independence for carving out my life." The patient was stuck in a negative cycle for about 20 years: All my dreams and hopes cut off → Despair → I want to die but cannot die easily → Lethargy∙Desperation∙Nihilistic → Momentary pleasure by gambling → I do not feel like living → I ask myself why am I alive → Self-criticism → Repeat again. Recovery from spiritual pain was achieved with time and by reflection. The bellwethers led to a turning point that helped to change the flow of his life. He also started using time effectively. Spiritual well-being of aging survivors has a trilaminar structure, comprising the following: (1) establishing the existential foundation of a sustained self; (2) living in the moment while contemplating the future; and (3) dovetailing within the society and transcending space and time. It indicates that they can achieve the developmental tasks related to old age, personal integration containing spirituality, and the wisdom and strength to get over difficulties. This study consists of the first report and the second report.

**Keywords:** Hansen's disease, spirituality, spiritual pain, suicide, spiritual well-being, gerotranscendence, life review, Leprosy Prevention Law
