Psalm 38 is an interesting one, because its overall theme is of feeling chastened by the Lord. To be ‘chastened’ means to be corrected by going through suffering. The speaker does not rail against God at all; he understands the purpose God must have in needing to correct him and bring him to task. He declares his own wrongness and his wretchedness. His trust in the Lord is sure and strong, and we get the sense that he fully understands that all this is the Lord’s way of salvation for him. The opening and closing verses talk about the Lord urgently and with conviction.

Spiritually, this psalm describes our need to understand and accept our frail and broken human nature. By "accepting" I don't mean being satisfied with our spiritual state, or resigned to it. We need even to be practising repentance daily in some way (see The New Jerusalem 163). Repentance involves examining ourselves and seeing our true state and bringing ourselves to the Lord for his aid, protection and illumination. This is an ongoing need. We keep learning to understand more about how the Lord works with us and how we are to manage our spiritual states.

This psalm also describes the Lord’s own deep temptations during his human life. Verses 1 to 10 describe these temptations, such as, “My wounds are foul and festering because of my foolishness” (verse 5). Verses 11 and 12 speak of even those ‘friends’ and ‘companions’ who love good and truth turning from the Lord, wanting his death. Verses 13 and 14 tell us that the Lord bears all this with patience, and verses 15 to 22 (and also verse 9) are about the Lord’s confidence that the hells will not prevail against him.

The psalm begins with the plea not to be punished by the Lord’s anger or his wrath. During our temptations, this is the appearance, yet it is essential that we appreciate that the Lord never punishes but only seek to save us. The Lord’s ‘anger’ is his resolve to free us from evils; the Lord’s ‘wrath’ is his determination to free us from false beliefs. (Arcana Caelestia 3614)

‘Arrows pierce me deeply’ means the way in which the Lord’s truths penetrate our spirit, speaking to it and challenging it and often bringing us pain. (Arcana Caelestia 2686).

The Lord’s hand ‘presses me down’ stands for the Lord’s opposition to our evils (not to us!) because ‘hands’ represent Divine power. (Heaven and Hell 232).

The speaker uses the various organs in our body to describe our various spiritual ailments: flesh, bones, head, wounds, loins, heart and eyes… quite a comprehensive list. ‘Bones’ stand for the truths which support our spiritual frame; ‘loins’ stand for our spiritual loves but also our passions. Each of these organs is defective in the psalm. (Arcana Caelestia 8364)

Verses 11 and 12 talk about the aloofness of friends and relatives, and the deceit of those who want to destroy. Spiritually, this describes the influences that come into our minds during temptation. The heavenly influence seems far off and unable to help us, the hellish influences seem close and condemning. (Arcana Caelestia 9348)

This is immediately followed by words talking about not hearing and not speaking out. In a general way, spiritually, this stands for us not being swayed by the influences – the “voices” – which come into our thought, whatever kind these may be, because we cannot determine their true quality. In a more specific way, it means the refusal to judge and condemn others for their actions. This would be most true of the Lord. (Apocalypse Explained 409)

Then comes the real reason and purpose for us during every temptation, that we are to put our trust in the Lord who hears and knows everything. Only this can be our full confidence.

The final two verses of the psalm are worded as a prayerful request to not be forsaken and to be helped by the Lord. The meaning is right on the surface here. We need to ask the Lord for help, and we also need to understand that the Lord never forsakes us or is unwilling to help.

678. And an evil and noxious sore formed. This symbolizes interior evils and falsities destructive of every good and truth in the church.

The sore here symbolizes nothing else than evil arising from a life in accordance with this chief point of the doctrine, that faith alone justifies and saves without works of the law. For we are told next that it formed in people who had the mark of the beast and worshiped its image, which symbolizes that faith and a life in accordance with it. Therefore an evil and noxious sore symbolizes interior evils and falsities destructive of every good and truth in the church. Its being noxious symbolizes its destructiveness, and evil cannot but destroy goodness, and falsity truth.

This is the symbolic meaning of the sore because sores of the body arise from a vitiated condition of the blood or some other internal malignancy. So, too, with sores viewed according to their meaning in the spiritual sense. Those sores arise from lusts and their accompanying delights, which are their internal causes. The evil itself symbolized by the sore, which in its outward expressions seems to be delightful, inwardly conceals in itself lusts, from which it arises and of which it consists.

[2] It should rightly be known, however, that the interior constituents of the human mind in everyone exist in a sequential order and in a concurrent one. They exist in sequential order from its higher or prior constituents to ones lower or subsequent. They exist in concurrent order in their outmost or final expressions, though they range in these from interior elements to outer ones, as from a center to the peripheries. The reality of this is something we showed many times in Angelic Wisdom Regarding Divine Love and Wisdom, nos. 173-281, in a section on degrees. It is apparent from those numbers that the outmost degree embraces all the prior ones.

It follows, therefore, that all lusts for evil exist inwardly in a concurrent order in the evil itself that a person perceives in himself. Every evil that a person perceives in himself exists in its outmost expressions. Consequently, when a person rejects evil, he at the same time rejects also its lusts, though he still does not do this on his own, but from the Lord. A person can indeed on his own reject evil, but not its lusts. Therefore, when he wishes to reject some evil and is fighting against it, he must look to the Lord, since the Lord operates from inmost elements to outmost ones. For He enters through a person's soul and purifies him.

We have said this much to make known that a sore symbolizes evil appearing in its outmost or final expressions, arising from an internal malignancy. This is the case with all people who persuade themselves that faith alone saves, and for that reason do not reflect upon any evil in themselves or look to the Lord.

[3] Sores and wounds symbolize evils in outmost expressions arising from interior ones, or lusts, also in the following places:

From the sole of the foot even to the head, there is no soundness... A wound and a scar, and a fresh blow, have not been expressed, have not been bound up, have not been softened with oil. (Isaiah 1:6-7)

...my iniquities have passed through my head... My wounds have putrefied, have decayed, because of my foolishness. (Psalms 38:4-5)

In the day that Jehovah binds up the fracture of His people... He will heal the blow's wound. (Isaiah 30:26)

...if you do not obey the voice of Jehovah..., being careful to do... His commandments... Jehovah will strike you with the sore of Egypt, with hemorrhoids and scabies, and itching... and with an evil sore upon the knees and upon the legs... from which you cannot be healed, from the sole of your foot to the top of your head. (Deuteronomy 28:15, 27, 35)

The sore of the boils that broke out on man and beast in Egypt (Exodus 9:8-11) has just this symbolic meaning; for the miracles done there symbolized the evils and falsities with which the Egyptians were taken up.

Moreover, because the Jewish nation engaged in a profanation of the Word, and this is the symbolic meaning of leprosy, therefore leprosy occurred not only in their flesh, but also in their garments, houses, and vessels. The various kinds of profanation were also symbolized by the various evil consequences of leprosy, namely swellings, the sores of the swellings, white and reddish pimples, abscesses, burning feelings, losses of skin pigmentation, scaly patches of skin, and so on (see Leviticus 13). For the church with that nation was a representational church, in which internal things were represented by external ones that corresponded to them.