Living in the Light of the Lessons from Death and Dying

Frank Ostaseski in an interview with Rheanna Hoffmann about death and the process of dying, mentioned his book based on his experiences of being with a thousand people as they died.  His book, The Five Invitations: Discover What Death Can Teach Us About Living Life Fully, provides five principles or guides for living life with integrity, meaningfully and in alignment with our true purpose.  Frank was the co-founder and director of a thousand-bed hospice, so his book is based on lived experiences and real stories of how people faced death, as well as the distillation of the “wisdom of death” from these deeply personal and moving experiences.

Frank maintains that death is the “silent teacher”, imparting understanding and wisdom about how we should live.  He expounds his ideas and principles in a number of recorded podcast interviews, including What Can Death Teach Us About Living Mindfully. His recoded talk at Google focused on his book through the theme, Inviting the Wisdom of Death Into Life.   A succinct explanation of the principles in his book, which he describes as “invitations to living”, is provided in his 26-minute edited interview with Steve Heilig of Palouse Mindfulness.

The five invitations to living learned from the dying

Frank emphasises that these invitations to living have been taught to him by the dying and by compassionately helping many hundreds of people with the process of dying.   Understanding the following five principles and putting them into practice enables us to live life fully and mindfully:

  1. Don’t wait – we assume that life will go on as it always has, that our health, wealth and relationships will persist into the future.  If nothing else, the Coronavirus should disabuse us of this belief and the associated perceptions.  There is a tendency to put off changing the way we live because of this belief in continuity.  However, living is precarious, nothing is certain.  We can become absorbed in the busyness of life and put off any change – avoiding the need to slow down and really experience life and relationships.  We can spend so much of the day planning our next activity or sequence of events. Frank maintains that we are reticent to fully “step into life” – “waiting for the next moment in life, we miss the present”.  Frank urges us not to wait till our death to find out the lessons of dying.
  2. Welcome everything, push nothing away – whether it’s grief, loneliness, boredom or suffering, there is a lesson to learn if we don’t push away the feelings, emotions and thoughts that pervade our life.  Frank suggests that we should welcome grief and fear and difficult feelings because these “moments” of discomfort are pivotal in our life for developing sustainable personal change, if we fully face them.  He spoke of the grief he experienced working with the dying and how he adopted meditation, bodywork (the touch of a practitioner on a source of physical pain in his body) and holding and rocking newly born babies (a life-affirming activity) as a way to face the full emotional, physical and mental experience of grief – it’s as if he ritually experienced the life cycle of birth, living and dying as a way to manage his overwhelming grief.  
  3. Bring your whole self to the experience – Frank made the point that in his work with the dying, the part of him that was most helpful was his vulnerability and helplessness because it acted as an “empathetic bridge to their experience”.  These “weaknesses” became his strengths and enabled him to be fully present to them, to be-with-them.  He has stated previously that authentic presence and compassionate listening are healing and supportive of people’s transition in both the challenges of living and of the dying process.  He asserts that none of us is perfect but that we can bring our whole self to whatever we are experiencing – leaving no part of our self out of the interaction.
  4. Find a place of rest in the middle of things – we can find a place to rest amidst the turmoil and tenuousness of life and despite overwhelming emotions that beset us.  The “place of rest” could be a breathing exercise, a ritual, mindfulness practice or reconnecting with nature.  Finding such a “place” is critical as a self-care approach for healthcare professional, particularly in these challenging times. Rheanna Hoffmann, who volunteered to work in the Emergency Department of a New York Hospital during the height of the Coronavirus, stated that this principle, explained in Franks’ book, helped her deal with the exhaustion, grief and overwhelm she experienced in helping suffering and dying patients while working under unimaginably difficult conditions. Frank also recounts the story of how he helped a woman to find a place of rest who was dying and experiencing extreme difficulty breathing, a struggle to breathe exacerbated by fear.  He asked her, “Would you like to struggle a little less?”  He then helped her to put her attention to the gap/pause in her breathing and began to pace her by breathing in and out with her.  He reports that “fear left her face” and she died peacefully.  Frank pointed out that none of the conditions had changed for her (including difficulty with breathing), only her relationship to her experience of dying.
  5. Cultivate a don’t know mind – this is not designed to encourage ignorance.  Frank quoted a Zen saying, “Ignorance is not just ‘not knowing something’ but the right thing”.  Ignorance is knowing the wrong thing and insisting on its truth and universality.  The principle is not about accumulating information (the “what”) but cultivating a mind that is “open, receptive and full of wonder” – a mind that is curious and pursues the truth and understanding in everything.  Frank suggested that we should talk with our children about death and, in the process, learn from them (not tell them).  He recounts his experience as a Director of a pre-school when he organised for the children involved to go and collect dead things in the woods nearby.  He marvels at the insight of the children and their perceptiveness.  They had been discussing the theme of endings becoming beginnings, e.g. a caterpillar becoming a butterfly, when a four-year old girl said, “I think the leaves on the trees are very, very generous – they fall and make room for new leaves”.  Frank maintains that a “don’t know mind” is fluid and flexible and “infused with a deep interest to know” and to know what is true right now.

Reflection

Frank’s approach to fully facing all that life presents (both discomfort and joy) is in alignment with Jon Kabat-Zinn’s concept of Full Catastrophe Living and Frank’s personal process for handling his grief accords with Deepak Chopra’s recommendation that we adopt a ritual to symbolise our release from the stranglehold of grief.

Frank epitomises in his life and work what he advocates through his talks and video podcasts.  He pursues a life that is meaningful and purposeful.  For example, in addition to his book and public presentations sharing his knowledge and experience of the dying process and its lessons, he has established a creative approach to educating end-of-life carers through the Metta Institute.  His words and actions manifest a life of integrity, compassion and wisdom.

Steve Heilig, the person who interviewed Frank in one of the video podcasts mentioned above, has also found a way to live a life full of meaning and purpose.  One of his many mindfulness endeavours has been to collect resources and permissions from leading mindfulness practitioners, including Jon Kabat-Zinn, to enable him to provide a free, 8-week, online course in Mindfulness-Based Stress Reduction (MBSR).

As we grow in mindfulness, by employing the five principles that Frank espouses, we can live our lives more fully and expansively and truly aligned to our energy and purpose.  We can find our expansiveness and spaciousness which Frank evidenced with people who were dying – their capacity to find the personal resources to face their fear and death despite their belief that the challenge was beyond them.   We can also become a calming presence to others who are experiencing difficulties as we progressively overcome our own reactivity. If we develop the discipline of the daily practice of meditation, we can live in the light of the lessons of dying and death.

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Image by mostafa meraji 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.

A Framework for Reflection for Organisation Leaders

Chip Conley, author and hospitality entrepreneur, emphasised the importance of reflection, wisdom and lifelong learning for leaders.  He created the Modern Elder Academy to further that end.  He was especially interested in making the workplace a place for fullment, inspiration and self-actualization for employees – which he maintained was the means to achieve a sustainably successful organisation.  Chip acknowledged that his leadership philosophy was heavily influenced by the writing of two men Viktor Frankl and Abraham Maslow.

Viktor Frankl through his book, Man’s Search for Meaning, impressed on Chip the importance and power of a meaningful life for leaders and the critical role of leaders in providing an environment that is conducive to employees developing a “sense of purpose and meaning”.   Research has confirmed that a meaningful life is foundational to a person’s health, happiness and overall well-being.

Abraham Maslow and his work on developing a Hierarchy of Needs had a very profound effect on Chip and his approach to leadership, both as an owner/entrepreneur and a mentor to other leaders, especially the young founders of Airbnb.  Maslow’s work gave Chip an insight into how to develop a reflective framework to guide his own role as a leader and to assist other leaders to create meaningful work for employees.

A framework for reflection for organisational leaders – the transformative pyramid

Chip explained his reflection framework in a TED Talk© given in 2010 titled, Measuring What Makes Life Worthwhile.  He elaborated further on the evolution of the framework and how to put it into practice in a podcast interview with Tami Simon of Sounds True.  He was particularly concerned about the challenge of applying Maslow’s hierarchy of needs to business and the management of employees.

What Chip realised is that, for employees, meaning provided inspiration which in turn developed intrinsic motivation.  He came up with the idea of a framework which he called the “transformative pyramid” – built on Maslow’s hierarchy of needs which was illustrated as a five-level pyramid with physiological needs at the bottom of the pyramid and self-actualization at the top.

To simplify things and make his framework easy to implement, Chip developed his transformative pyramid as a three-level pyramid with “survival” at the bottom, “success” in the middle and “transformation” at the top.  He pointed out that many leaders focus only on the bottom of the pyramid, the survival needs, by using all their energy to create non-sustainable, extrinsic motivation in the form of pay, bonuses and financial rewards while ignoring what truly influences and shapes employee motivation.

In Chip’s model, “success” relates to recognition that an employee is achieving their role and contributing to the organisation.  He understood that positive feedback was a powerful motivator and that people often left their jobs because of the way they were treated, including feeling a sense that they had been “taken for granted” and their efforts were unrecognised.   Chip explained, by way of example, that during the dot-com crash, he introduced a process of recognition at his weekly managers’ meetings that not only provided some positive element to what was a relatively sober discussion but also helped to spread recognition and positivity throughout the organisation. 

The initiating process for giving recognition was simple – he introduced a ten-minute period at the end of each meeting where a manager would mention someone in one of the teams who “deserved recognition” for something they had done in the workplace or in the field.  This recognition was communicated personally to the individual involved who felt that they were “noticed” and respected, and their contribution was appreciated.  Chip suggested that great companies are differentiated by the fact that they are “first-class noticers”.

At the highest level of the transformation pyramid is personal reframing of work from “just a job” to something that is meaningful and worthwhile.  Chip suggested that this can be achieved by helping employees to understand the higher purpose of the organisation – the inspirational “why”,  and to find meaning in what they do by understanding the connection between their daily work and something broader that makes a difference in people’s lives.  

Chip indicated that he learned this lesson from a maid who had worked for a  long time in one of his hotels.  When he asked her why she seemed so happy doing mundane work every day (such as cleaning the toilets), she said that she was able “to create joy” for people who stayed in their hotel away from their home and often without their family or partner.  She was able to mentally connect what she did every day to a “noble purpose”.  This realisation and reframing were “transformative” for her – putting her mundane work in a totally different light and acting as a source of intrinsic motivation.

Chip encapsulated his “transformation pyramid” and its underlying principles in his book, PEAK: How Great Companies Get Their Mojo from Maslow.  He encouraged leaders to use his framework to reflect on their relationships with their employees, customers and investors.  Since the first edition of the book, many organisations worldwide in different industries have used his framework to transform their businesses. In particular, they have found innovative ways to recognise the contribution of their employees.

Reflection

It is often the simplest ideas that have the greatest impact.  Chip demonstrated that focusing on intrinsic rather than extrinsic motivation was the way forward to transform companies and he proved this through his own roles as founder and CEO of Joie de Vivre and as mentor to the founders of Airbnb.  In the process, he addressed one of the key underlying problems associated with the growth of depression – the loss of connection to meaningful work.  As we grow in mindfulness, we can increase our understanding of leadership and what is meaningful in life for us and others, and notice, appreciate and provide recognition to people we encounter who contribute in whatever way to our own welfare and that of our organisations.  Noticing, appreciating and giving recognition require us to be present in the moment – a key aspect of mindfulness.  Being present builds awareness of our self and others.

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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.

Trauma-Informed Mindfulness: Relationship Building through Music

Sam Himelstein has developed several basic principles and a series of guidelines to assist mindfulness teachers to sensitively work with people who are impacted by trauma. While these principles have been developed over more than a decade working with trauma-impacted teens, the principles and guidelines are also relevant to anyone working with adults who have experienced trauma. 

Relationship building through music

In his podcast interview with David Treleaven, Sam discussed a particular case that was a primary catalyst to the development of his principles and guidelines.  He provides a more detailed discussion of the case in his blog post, Trauma-Informed Mindfulness with Teenagers – 9 Guidelines.  The case involved a 17-year-old high school student, Jeanette, who had experienced a traumatic childhood with many categories of traumatic events in her life, including drug addiction of her father.  She had approached Sam, a registered psychologist, for help with her trauma-related issues.

During initial psychotherapy treatment, Sam was helping her to locate her estranged father so she could establish a connection with him.  However, before this reconnection happened, the young woman learned that her father had died from a drug overdose.  This intensified her trauma and when she presented at Sam’s clinic after the death of her father, she was unable to talk about her father, follow a line of discussion or formulate coherent sentences.  Sam described this in terms of “her brain down regulating”.

Sam’s first principle – “do no harm” – came into play as he realised that getting her to talk would take her outside her window of tolerance.  As he knew about her interest in music and her favourite genre, he intuitively realised that listening to music that she liked would enable her to establish some degree of equanimity, build trust and reinforce the relationship through a shared pleasant experience. 

As they listened to the music together, she slowly began to move her head in line with the beat and rhythm of the music.  Then, she began to talk.  Sam described the effect on Jeanette of listening to the music as regulating her central nervous system, bringing her back within the window of tolerance and enabling her to access her language ability so that she could express her emotions such as anger, grief and sadness.

Sam had realised that while Jeanette was positive about the utility of mindfulness in the context of therapy, “conventional talk therapy or mindfulness meditation wasn’t going to work”.  This music intervention was in line with what he described as practising an INCRA, an “inherently non-clinical relational activity” that is not a therapy technique in itself but effectively builds the relationship.  Sam discusses case studies where he has used INCRA in a clinical setting with teens in his forthcoming book, Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.

Reflection

As we grow in mindfulness through meditation and reflection, we can better access our intuition when working with or training people who have suffered trauma.   Being present to the person needing help will enable us to let go of conventional, trained responses and be open to activities that are non-clinical in nature but develop the relationship – the foundation for all helping.  Trauma-informed mindfulness, then, involves not only sensitivity to trauma-impacted people but also the flexibility to depart from habituated responses or processes.  Mindfulness helps us to tap into our innate curiosity and creativity.

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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.

Trauma-Informed Mindfulness: Guidelines for Effective Helping

Sam Himelstein, in a podcast interview with David Treleaven, discussed the principles for teaching mindfulness that he has developed over more than 12 years working with teens impacted by trauma.  His principles and related guidelines have relevance for anyone using mindfulness to help people who have experienced trauma. 

Besides his discussion in the interview mentioned above, Sam provided a blog post that addresses the guidelines explicitly.  The principles and guidelines (together with examples from real cases, teaching material and  practical exercises) are explained in depth in his forthcoming book,  Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.

Guidelines for effective helping of people impacted by trauma

The guidelines developed by Sam Himelstein provide clear and consistent actions that can be taken by anyone helping people impacted by trauma:

  • Do no harm – this is a fundamental guideline informing the others.  Through research, study and practice of trauma-informed mindfulness practice, we can be more aware of potential harm and have the tools to do the best we can to avoid further harming the person suffering from trauma.  Sam mentions two resources that he draws on, The Meditation Safety Toolbox and Chris Willard’s Guidelines for Ethical Teaching of Mindfulness.
  • Avoid prescription about “meditation logistics” – people who are impacted by trauma are often unable or unwilling to start with formal meditation.  Sam urges us to avoid being inflexible through insisting on a set posture or closed eyes when initiating our helping interaction.  This requires letting go of the structural prescriptions of our own meditation training.  It is important to recognise that the people we are helping will be in a “different space” but can still develop mindfulness (inner and outer awareness) with processes other than formal meditation.  We need to acknowledge that mindfulness is more than just meditating.
  • Establish safety – it is critical that the person we are helping feels safe.  If they do not feel safe, they may experience re-traumatisation.  In addition to physical safety, this involves relationship and emotional safety through developing trust, being authentic and being prepared to modify our approach to suit where the person is at.  A more involved aspect of safety is what Sam calls cultural safety developed through “intersectional awareness”.  This requires an awareness of our implicit biases when dealing with people who have characteristics different to our own, e.g. gender, ethnicity, religion, age, sexual preference, disability or “class”.
  • Employ somatic practices first – this involves recognising the role of body memory in trauma and being cognisant that cognitive approaches commenced too early in the intervention can exacerbate the situation for the trauma-affected person.  Sam indicated that he often uses deep breathing exercises and basic somatic meditations.
  • Understand the “window of tolerance” – relates to a personal zone within which a person is able to effectively employ their cognition to “receive, process and integrate information”.  If a person is outside their window of tolerance than are unable to engage effectively in talking, telling stories or undertaking meditation practices.  Sam suggests that a sign of this “intolerance” is the person’s inability to use language, e.g. unable to formulate complete sentences or follow a line of discussion.  He recommends the book Trauma and the Body, as a resource for understanding the “window of tolerance” and learning about somatic approaches to trauma healing.

Reflection

As we grow in mindfulness through meditation practices, research and reflection, we can develop our awareness and understanding of the sensitivity of trauma-impacted people to formal meditation.  This requires that we become more aware of the “window of tolerance” and develop our capacity to pay attention to the signs that someone we are working with is not coping with our processes.  Associated with this, is the need to build the relationship through establishing safety and trust.  Employing somatic approaches will be more effective if we have experienced their utility ourselves as part of our own mindfulness practice and experience.   The more mindful we become, the better we will be able to help people impacted by trauma – for one thing, we will be able to let go of our assumptions and become more aware of our biases.

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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.

Trauma-Informed Mindfulness: Principles for Effective Helping

Sam Himelstein has specialised for more than 12 years in using mindfulness to help teenagers impacted by trauma.   In a podcast interview with David Treleaven, Sam explained in depth his approach to teaching mindfulness to teens affected by trauma, as well as the evolving principles that shape his practice. While his focus is primarily on teens and educating others to work with teens, his approach and principles have relevance to anyone who is using mindfulness to assist people impacted by trauma (or anyone who is teaching mindfulness where a participant is a trauma sufferer).  He has developed his principles through ongoing reflection on practice.

Sam is a psychologist and youth worker and the author of A Mindfulness-Based Approach to Working with High-Risk Adolescents and the forthcoming book, Trauma-Informed Mindfulness for Teens: A Guide for Mental Health Professionals.  He is also the founder of the Center for Adolescent Studies.

Principles for trauma-informed mindfulness practice

In discussing his approach to working with teens impacted by trauma, including incarcerated youth, Sam identified several principles that guide his practice:

  • Avoid “adultism” – the assumption that as an adult you are superior to teens and have a lot to teach youth and they have very little in the way of wisdom to offer.  Associated with this false belief, is the assumption that you know best what is good for them – implying that they should learn from your teachings (that you try to impose on them).  This also involves recognising the wisdom they gained in their transition to a teenager. [You can also test your assumptions when working with adults – do you assume that they have no insights into the nature and practice of mindfulness?]
  • Work from where they are at – do not begin with formal meditation as they are unlikely to be ready for this.
  • Focus on relationship-building – consciously build trust in every aspect of your interaction, as their level of trusting others will have been severely damaged by their trauma experience(s). 
  • Assist teens to become comfortable with “sitting with themselves” and exploring “inner awareness”.
  • Be genuinely curious about what is happening for them and what they are doing to cope – bring an open mind to the interaction.  It can be helpful to identify and test your own assumptions before interacting.
  • Develop your own mindfulness continuously – your inner and outer awareness – and learn to let go of “ego” and the need to control the process.

Reflection

When teaching mindfulness to adults and youth, we need to be aware of the possibility that they may have been impacted by trauma(s) in their life.  Being conscious of the principles employed by Sam will help us to demonstrate sensitivity, build trust and relationships, and work at their pace – rather than to a pre-ordained progress schedule.  It will be imperative for us to grow in mindfulness – becoming fully aware of the assumptions we bring to the teaching/interaction, letting go of ego and the need for control, and genuinely engaging with curiosity, humility and openness.

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Image by Lubos Houska 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.