They realize that pain comes from outside, that he has a need for it to be taken away and doesn't know how himself, that he has turned to them. The pain is dependent on them, too - how they react to knowing their part. If they think of pain and feel love, the symbol is taken in. If they think of pain of the man as a patient, the symbol is useless. Symbols, taken into our consciousness, permit us to feel love and pain.
Life represents goodness.
Air represents breathing and goodness. Water is life giving and goodness. All these symbols, better realized, make us aware of our own goodness. Inside our mind and selves, we see light, goodness. The bad symbols do not share that light.