Why would envy have anything related to someone in physical pain? At first blush you might say it wouldn’t, in part because we typically assume that if someone is in physical pain, especially, our automatic reaction should be empathy. That is a natural response. But there are going to be cases that provoke a different reaction. We actually feel good about the misfortune. And in the context of pain management, when this occurs, it has implications for how folks who are in pain are cared for.
When asked to think about it, the clinician may be able to recount such instances. Cases where they may not have felt good about someone suffering, but they didn’t feel quite so bad; that is, their empathy level was not as high. Maybe the patient is just a constant complainer about all kinds of pains. Maybe there is feeling that pain is deserved because clinical advice has been ignored. Or there may be occasions where the patient/client relationship is the source of grief for the practitioner, and they just may not care that much about the person’s situation.
To cope with schadenfreude, it may help to acknowledge the feeling. I think you could say that knowing who you are, knowing your feelings well, and acknowledging schadenfreude without inappropriate guilt is probably a good thing. Acknowledging would not be the same thing as encouraging it and fostering it. I think that every time someone feels schadenfreude it can lead to kind of self-examination. Why am I feeling it? What does it mean about me. To the extent that it’s self-knowledge and self-insight and accurate then it’s probably a good thing but it could be a slippery slope too if you start fostering it in yourself.