In "Sonny's Blues," Sonny is alienated from his brother, with whom he struggles to reconnect. This central element of the plot brings together several internal and external causes of suffering. First, Sonny has always felt misunderstood and misjudged. He struggled to escape from the drug culture that was all around him as he grew up in Harlem, but his brother never saw this struggle and regarded him as weak for dropping out of school and running away.
Sonny is lonely and afraid, unable to express himself except through music, and unable to find peace except through drugs. His internal conflict and isolation lead to the external suffering of addiction, prison, and continued estrangement from his family, his brother in particular. Most of the time, he attempts to hide this pain, but he finds that his very failure to communicate with his brother becomes another factor which causes his suffering. Paradoxically, it is only by facing his suffering and allowing himself to feel it fully, share it, and express it in both words and music that Sonny has at least the chance to escape from it. The story's ambiguous ending, however, shows that Sonny's triumph over suffering is by no means guaranteed and must be renewed continually.