For example, David, the author, says in verse 5.—"My wounds stink and are corrupt."
Psalms 38:1 - 22
ESV - 1 O Lord, rebuke me not in your anger, nor discipline me in your wrath! 2 For your arrows have sunk into me, and your hand has come down on me.
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To directly answer your question, I would say to interpret it as a lament from someone who is feeling defeated and abandoned by God, and is seeking understanding as to why! Written both symbolically and literally as descriptively as possible to convey his heart as best he could.
Jack: I believe that this Psalm is symbolic; I know that what David was experiencing was real, and he used metaphors to describe his pain and suffering for his sins. I also believe that this Psalm is Messianic, as well. It is a description of how our Lord and Savior suffered for the sins of the world. "But He was wounded for our transgressions, He was bruised for our iniquities; the chastisement for our peace was upon Him, and by His stripes we are healed." NKJV To God be the Glory!
It's a bit of both, really! David's own guilt-riddled sin is having an overwhelming effect on him physically, as well as a spiritual effect on him with the overwhelming sense of God turning His back on David because of his sins! The below Commentary has a very good explanation on this: https://explainingthebook.com/2017/09/18/psalm-38-commentary/
Various commentators have differing thoughts on whether the afflictions described in the psalm are spiritual or physical, but there certainly seems to be support for David describing actual bodily ailments that he had to endure as a consequence of his sin. At the same time, the believer should regard the spiritual consequences of sin in the same loathsome, repulsive light as an incentive to sorrow and repentance.
I believe that this Psalm is both literal and symbolic. It is included in scripture for our learning. David asks God for mercy. We too need to ask God for mercy. Yet we also know that because we trust Him, He will give us mercy. It is a matter of respecting God. He loves us. When our hearts are heavy, because of our sin, or because we have stood against wrong, we are to turn to God. As believers we will suffer at times. But God is our refuge and strength. He understands. We are also to accept discipline from God, because He loves us. He does not abandon us. We need God. We need Jesus, He has offered Himself to cleanse our souls from all sin. We go to God, confess our situation. Accept our part and trust Him. Our hope and rest is only found in God. 1 Peter 3:14: "But if ye suffer for righteousness' sake, happy are ye and be not afraid of their terror, neither be troubled." 2 Corinthians 7:9,10: "Now I rejoice, not that ye were made sorry, but that ye sorrowed to repentance: for ye were made sorry after a godly manner, that ye might receive damage by us in nothing. “For godly sorrow worketh repentance to salvation not to be repented of; but the sorrow of the world worketh death."
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