Tag: healthcare professionals

Understanding Death and the Process of Dying

Rheanna Hoffmann recently interviewed Frank Ostaseski on healing grief through compassion and love.  Frank founded the Metta Institute whose mission is to provide innovative educational approaches to developing skills in “mindful and compassionate end-of-life care”.  Rheanna herself is the founder of The Whole Practitioner, dedicated to helping nurses move beyond frustration and burnout to “rediscover, health, balance and their core values”.

Frank and many other writers on the process of dying maintain that it is not just a medical event but is much broader and more holistic than this form of the mechanical model.  Increasingly, research is confirming too that consciousness is more than our physical brains.  Frank argues that the unwillingness in our culture to talk about death and the dying process is preventing us from learning the lessons that the dying can teach us and our children.  He contends that if we learn about the dying process and face the reality of our inevitable death, we can better appreciate the “preciousness of life” and live our lives more fully and in alignment with our values and purpose.

The process of dying

Frank describes dying as a process of “stripping away”.  It’s as if everything that is associated with our “ego” – our sense of self – is peeled away.  Undoubtedly, our mental and physical capacities decline, and this begins with the aging process.  But the stripping away is much more than that – it is losing attachment to everything including our spouse or partner, our home, our roles, our possessions, and the animals in our life.  Frank also talks about dying as a “sacred process of transformation” through which we see things in a new light, have a deeper understanding of the meaning of life and the value and true purpose of our own life – in other words “an awakening”, no longer limited by our concept of a “small separate self”.

Peter Fenwick, when talking about What Really Happens When We Die, suggests that the more we hold on to our ego needs and refuse to let go, the more difficult is the dying process.  Living our life in a selfless way – not totally self-centred — makes the process of dying easier because we are not absorbed in holding on to our attachments.  Being “other-centred” in the pre-transition phase of our life makes dying easier and enables the final transformation that Peter describes as entering a “spiritual domain” where you lose your identity as a separate self and become identified with the total cosmos – the universal whole.

Peter discusses the change in our level of consciousness in the light of research into Near Death Experience (NDE).  He maintains that consciousness research focused around NDE experiences confirm a “widening of consciousness” that manifests in:

  • Losing the self-narrative – the self-talk that we employ to boost or deflate our egos
  • Being just in the moment – not absorbed in the past or anxious about the future
  • Experiencing “unbelievable” happiness
  • Tending to be transcendent – losing a sense of duality (our self and others) and becoming merged with the cosmos.

Peter has co-authored The Art of Dying with Elizabeth Fenwick which provides personal accounts from those who have been dying and people (healthcare professionals, carers and family) who have been with them and supported them in the process of dying.   The accounts discussed, as well as other research into NDE experiences, confirm that consciousness is much more than our physical brains.  Monica Renz, author of Dying: A Transition, provides a process-oriented approach to end-of-life patient care that incorporates confirming the dignity of the patient, understanding the transition process of dying and being able to sensitively engage in the symbolic journey described by dying patients.  Her observations and detailed accounts are based on attending 1,000 cancer patients during the process of dying.  Monica describes the dying process as both an archetypal and a spiritual process and contends that, in the process of transition, patients move through fear into a “space of peace, acceptance, dignity and tranquillity characterised by connectedness and even luminosity”.

Reflection

Our cultural blinkers blind us to the reality of the dying process and the nature of our own inevitable death.  As we become more aware of the dying process through our own research and study, we can learn to appreciate how precarious our life is and how precious is the process of both living and dying.  As we grow in mindfulness through meditating on death and reflecting on its implications for how we live our life, we can progressively come into more alignment with our life force, our values and our life purpose.

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Image by Hans Braxmeier from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Healing Grief through Compassion and Love

Frank Ostaseski was recently interviewed during the 2020 Mindfulness & Compassion Global Summit by Rheanna Hoffmann on the topic, Grief and the Healing Power of Love and Compassion.  With so many deaths worldwide from the Coronavirus (410,000 at the time of writing), the issue of grief and its manifestations becomes increasingly prevalent.   Frank is the cofounder of the Zen Hospice Project (now called The Zen Caregiving Project) and founder of the Metta Institute designed to provide creative education in the art of “mindful and compassionate end-of-life care”.

Healthcare professionals may not have lost loved ones through the virus, but they can experience grief too with the loss of patients that they have been caring for – this is in addition to other stressors that challenge their resilience.  In his interview responses, Frank explained the nature of grief and the power of compassion and love to heal people who have experienced profound grief.

The nature of grief

Frank who has supported more than 1,000 people in the process of dying maintains that grief is not a single point but a process – an evolving process of “loss, losing and loosening”.  There is the initial shock of the loss that can result in physical collapse and total disorientation.  Shock impacts people differentially – some people may experience numbness, there is no “one way”.   Beyond the initial shock of the loss, is a process of “losing”, where in the midst of other things an overwhelming sense of loss returns accompanied by strong emotional and physical symptoms.  “Losing” can persist for many years and eventually become an intermittent event.  In the meantime, the process of “loosening” commences with progressive release of the hold that grief has over a person.

People grieve in different ways – some withdraw and have a strong desire to be alone with their grief, others experience tears and crying uncontrollably, while still others may take out their grief by aggression and violence (such as is occurring in the riots in America in relation to the Black Lives Matter movement).  Grief and our response may be aggravated in challenging times such as the pandemic where everyone is experiencing a form of “emotional inflammation”.

Frank maintains that grief has many faces, e.g. anger, rage, sadness, depression, fear and even regret.  He also suggests that grief results not just from the sense of loss of a loved one but also from the associated lost opportunities – a young life cut off in their prime, a missed opportunity to reconcile with a loved one, a lost chance to say goodbye or to be physically present with someone as they were dying.   For people exposed to dying and death as a result of the Coronavirus, there can be a collective grief brought on by the lost opportunity to save lives, as well as the lost opportunity of the lives lost.

Healing grief through love and compassion

The starting point for being able to show compassion towards the people experiencing grief is having an understanding of the nature of grief and its many forms of expression. It is important not to add to the stress of people who are grieving by communicating expectations of how their grief should be expressed.  Grieving is a very personal process and requires compassionate attending and listening, not the projection of personal preference.

Pema Chödrön discusses ”compassionate abiding” in our own grief and suffering as the pathway to expressing compassion for others.  Frank suggests that we need to “metabolize” our own fear and suffering by facing it fully, experiencing it in our body, mind and heart and converting it to compassion for others.  He maintains that when we can explore our own experience through self-observation and self-inquiry we can “build an empathetic bridge to other people’s experience”.  Otherwise we can be working out of our own distress and needs rather than the needs of others who are grieving.  Without this level of self-intimacy we can appear dishonest or disingenuous to others we are trying to help in their grief.

Frank explained that he has difficulty expressing self-compassion but has developed a number of processes that enable him to express compassion for others.  Each night before going to sleep, he focuses on the suffering of others – those who might be suffering through loneliness, those experiencing grief or those who are caring for others who are dying.  Through this process he feels love and warmth towards others and the emergence of his “innate compassion” that is broad and deep enough to absorb or dissolve his own experience of suffering.   In the morning, with his hand on his heart, he asks himself, “What would love have me do today?”

Reflection

Self-intimacy is a key to genuine compassion towards others who are grieving.  Compassion and love help to heal grief because they involve abiding fully with someone who is experiencing grief, not trying to fix them.  Our very presence, uncontaminated by unrealistic expectations of the other person, can be a source of healing just as “listening generously” can be.   As we grow in mindfulness, we can develop self-intimacy, calmness and peace and be better able to be present to and compassionate towards others.

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Image by Gordon Johnson from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Building Resilience through Compassion Towards Others

In a previous post, I discussed Pema Chödrön’s ideas of developing resilience through self-compassion by “compassionate abiding” in our own pain and suffering during these challenging times of the pandemic.  This entails abiding in, or dropping into, the full depth of our painful experience through our bodily sensations and conscious breathing.  As we undertake slow, conscious breathing we hold our suffering with self-kindness and warmth.  Lulu & Mischka in their mantra meditation, Warriors of Light, remind us to “breathe into our hearts” because breath is our chariot enabling us to face the unknown and stand on our own.

In her interview podcast with Tami Simon of Sounds True, Pema extended the concept of compassionate abiding by moving beyond self-compassion to compassion towards others.  She maintained that embracing the pain and suffering of others particularly in these times, when everyone is suffering in one form or another, contributes to our resilience – we realise we are not alone and we are able to move beyond self-absorption and “panic storylines” to extending kindness to others.

Pain and suffering: a doorway to compassion for others

In these challenging times of the Coronavirus, we can be very sure that there are millions of people around the world who are experiencing suffering like we are.  People are experiencing all forms of loss – of loved ones, their jobs, their business incomes, their health, their financial security or their homes.  They may have become physically disconnected from their workplaces, their family and their friends, even stranded in a foreign country because of international travel restrictions.  They could be healthcare professionals working on the frontline and/or living away from their families for a number of months to protect their loved ones from cross-infection.  We can be very confident that there are people around the world who are feeling pain and suffering like we are.

Pema argues that abiding with compassion in our own pain and suffering is the doorway opening us to compassion towards others.  In experiencing fully our own suffering, not denying its intensity or pervasiveness, we develop a deep sense of connection with others who are also suffering at this time.  Pema spoke of the principle of Tonglen, a Tibetan word meaning “taking in and sending out” – taking in our own experience of pain and suffering and sending out desire for relief for others.  She suggests that once we become grounded in our own suffering (this may take 10-20 minutes), we can take in the suffering of others.  On our in-breath we can imagine others who are experiencing similar pain and suffering and on our out-breath, wish them relief and insight to enable them to move beyond their own discomfort, distress, grief or loneliness.  Connectedness and resilience lie in this mutual experiencing.

Pema maintains that we do not have to confine this compassion towards others to a time of extreme challenge, we can use our pain and suffering as the doorway to compassion and connectedness at other times.  We may be experiencing distress because a family member is suffering from Alzheimer’s or feeling panic and anxiety because someone we are carer for is experiencing the black dog of depression.  At these times, we can drop into conscious breathing, embracing our distress and anxiety with kindness, and gradually move beyond this abiding self-compassion to compassion towards others who are experiencing the intensity of our own emotions. 

Reflection

I think that Pema’s profound insight into compassionate abiding opens the way to develop self-compassion, compassion towards others and personal resilience.  As we grow in mindfulness through conscious breathing and extending relief to others, we can move beyond our self-destructive narratives, restore our inner equilibrium and peace, and develop the resilience to not only survive these challenging times but also be able to extend help and support to others. 

Compassion towards others can be expressed in many ways even in these times of social distancing – the virtual choir of women physicians singing “Rise Again” is but one example of many where people are moving beyond their own overwhelming challenges and distress to reach out to others.

Pema provides multiple resources including her many books, her free e-book titled, 5 Teachings of Pema Chödrön  and her online course, Freedom to Love, which expands on the principles and practice of compassionate abiding.

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Image by Evgeni Tcherkasski from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Mindfulness and Resilience in Challenging Times

The Awake Network and Mindful.org have collaborated to provide a free resource for healthcare professionals in the form of The Mindful Healthcare Speaker Series.  Jon Kabat-Zinn speaking on Mindfulness and Resilience in Challenging Times was the first in the series of six speakers.   While Jon is not an MD, he has a PhD in Medicine and focuses on mindfulness in medication, healthcare and society.

Jon and host, Dr. Reena Kotecha, spoke of the enormity of the challenges facing everyone with the advent of the Coronavirus and especially the frontline healthcare professionals who, in many instances, lack adequate resources and training to deal with the magnitude of this pandemic.  They spoke of the trauma experienced by these healthcare professionals who are witnessing the suffering and death of so many people.  Reena spoke of one frontline female doctor who had to move out of home to live in a hotel for three months to protect her mother who was suffering from cancer. 

A truly disturbing event was the suicide death of Dr. Lorna M. Breen, an emergency center doctor, who continually witnessed the very worst of the impact of the Coronavirus on people, including people dying at the hospital before they could be removed from the ambulance.   Her heroic efforts to save people through her frontline medical work contributed to her own death.  Jon reiterated that mindfulness does not lessen the enormity of the physical and mental health impact of the pandemic on the lives of healthcare professionals but emphasised that mindfulness acts as a ballast to provide stability in the face of the turbulent winds created by the pandemic.

Mindfulness as ballast for stability

Jon referred to the 25 years of quality scientific research that showed the benefits of mindfulness, extending to positively altering the structure of the brain, increasing functional connectivity (e.g. of the mind-body connection) and enhancing neuroplasticity.   Neuroscientist Richard Davidson co-authored a book, Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, and demonstrated the powerful effect mindfulness had on building resilience.

Jon spoke of “full catastrophe living” and emphasised that it is truly human to experience fear, anxiety and grief.  He argued that mental health is enhanced by feeling and accepting everything we experience, rather than denying its existence or intensity.  He stated that no matter how emotionally rending our circumstances are we can find refuge in mindfulness, by being “in the present moment, moment by moment”.  In this way, we are better able to recover from the “trauma” of the present reality and to do so without total depletion of ourselves.   

Mindfulness as awareness

Jon maintained that “we are not our narrative” – we are not our negative self-talk that diminishes us and depletes our energy in the face of life challenges.  He argues that our life is “one seamless whole” – our mind, body, thoughts and emotions.  In his view, our breath serves as the integrating factor and energy force.  Awareness of our breath in the present moment enables us “to get out of the wind” and “to recalibrate, recover and respond instead of reacting”.  To reinforce this message, he provided a guided meditation during his presentation focused on the breath for about ten minutes (at the 30-minute mark).

Jon maintained that awareness of our breath can enable us to be fully awake to what is going on inside us and to be more deeply connected to others.  He argued that we don’t have to achieve a particular goal – to become more or better – in his view, “we are already okay”.  In these challenging times, what is needed to help ourselves and others we interact with is to be authentically present, without a “mask” (metaphorically speaking), but with openness and vulnerability. 

Reflection

Jon highlighted the importance of trusting our “human creativity” when confronted with the need to help people who are stressed out by the pandemic.  As we grow in mindfulness through mindful breathing, we not only build our resilience in managing our personal challenges but also “modulate the tendency to put self ahead of everyone else” – we can diminish our self-absorption and self-doubt.  He maintained that awareness of our breathing reinforces our ecological connectedness.  

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Image by Jill Wellington from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.