Here's the excellent dharma talk that John Corbaley gave this last Sunday on dealing with living with grief. Thanks John!
A couple of weeks ago, The Hospice Foundation of America sponsored an annual conference titled “Living with Grief.” The program considered issues of spirituality and end-of-life care, discussing the differences and relationship between spirituality and religion with special attention to spirituality during illness, death and grieving process. Unity Temple hosted this event here in the Charles Fillmore Chapel. About a hundred people, mostly hospice staff, social workers, and hospital chaplains attended the afternoon seminar.
The meeting was split between a two hour national panel of experts that was broadcast via DVD onto a large screen at the back here, and a local panel for discussion and fielding questions from the audience. This local panel was comprised of pastors, ministers, chaplains, rabbis--and me. I’m not exactly sure why I was asked to be a part of the local panel--I suppose because my training allowed me to provide some useful information on matters pertaining to Buddhist practices.
Anyway, the national panel of participants represented some really amazing talent and wisdom on end-of-life issues--professors of gerontology and social work from major academic institutions. They discussed things like spiritual assessment, empowerment and life review.
All the participants to this conference were given a copy of the book Living with Grief: Spirituality and End-of-Life Care. This is an excellent book covering end-of-life issues from the perspective of many different religions. One chapter dealt with Buddhist views on end-of-life care. It was written by Betty Kramer, one of the national panelists who spoke that day. She is a professor of social work from the University of Wisconsin. She is also a long time practitioner of the Buddhist path. She did an excellent job of presenting her views in a clear and understandable way.
Explaining end-of-life issues from a Buddhist perspective was not a particularly easy task. She cited research which shows that there are at least 31 different forms of Buddhism practiced in the United States today, each with distinct features and cultural practices. She offered this advice to those caring for the dying person:
“Listen deeply to ascertain the individual’s wishes and preferences...If they have a guru or lama, it will be especially important to consult with these spiritual authorities for their instruction regarding the most appropriate care....For those who belong to a spiritual community, they could also offer valuable expertise in providing care, support, and reciting special prayers and mantras (p. 213).”
She concludes by saying:
“Buddhists practice for death over the course of their life, seeking to cultivate virtuous states of mind and abandon harmful states of mind so they may be better prepared to hold a virtuous state of mind at the time of death. Buddhists do this by deliberately cultivating awareness of the certainty of death, the preciousness of life, and the uncertainty of the timing of death to support their commitments to make spiritual progress (p. 216)”
One of the critical issues at this conference was counter-transference. This is a ten-dollar word which means how the “stuff” of the caregiver gets in the way of doing the work of the person going through the dying process. The national panel moderator, Frank Sesno, confronted two of the panelists during the discussion, Betty Kramer, and Martha Rutland, and said, “OK, Betty you’re the Buddhist patient, and Martha, you’re the Christian pastor, how do you counsel Betty?” The upshot, after some discomfort on both sides, was basically that the pastor’s job was to listen, to identify needs, if any, and meet those needs once they were identified.
At the live panel, the issue of counter-transference really never came up. There was an over-arching sense of courtesy that didn’t allow anything uncomfortable to occur. I think if we had gotten to know each other more beforehand, we might have had the space to allow more productive controversy to come up and make the discussion more practical.
What was very interesting to me in this book was the chapter on dealing with atheists. Marilyn Smith-Stoner wrote an amazing chapter on the raw edge of hospice work in this country today. The raw edge is this: In a society which is predominantly Christian the current demographics can produce the potential of unwanted preaching about God and salvation.
She feels that even though there is a chaplain on the palliative care team in organizations caring for those at the end-of-life, the social worker should be the primary team member addressing the spiritual needs if it is an atheist going through this process. The chaplain will be able to offer support to religious family members of the dying person, but the social worker is better prepared to, “help patients identify the meaning in their own lives, affirm or repair their connection to family members, and assist with life completion tasks (p. 226).”
Marilyn commented that these tasks often take the form of interventions reaffirming life accomplishments, offering and giving forgiveness, life review, rejoicing in good deeds, and connection with the natural world to provide experience with pets, plants, and the outdoors that can all possess meaning for someone with an atheist world view.
She provides this benediction for a funeral service from a funeral guidebook for atheists:
“We now come to the final moment of the physical existence of X, with respect, honor, affection, regard and love. His passion and intelligence we commit to our memories. His humanity and caring we commit to our hearts. His body we commit to be burned and returned to the cycles of nature he understood so well. “Earth to earth, dust to dust, ashes to ashes (p. 228).”
This view cleanly and clearly presents a perspective which honors the individual, provides a recognition of the worth of that person, and the esteem in which his memory is held by the attendees. I think it would honor any person without favoring a particular religious viewpoint.
Something I said during the panel discussion regarding Buddhism was that in the United States today, 75% of Buddhists are converts. This often means that in a similar way to atheists, family members may not be the best resources for providing information about end-of-life practices. The most informed people may be friends who share the spiritual path rather than family members who may be supportive, but have little actual information on these matters.
This is something for us all to think about. Who would we want contacted in this situation, and what exactly would our wishes be? What observances, rituals, or practices would we want to occur if we were incapacitated and unable to tell anyone? Who would we want present, and what would we want them to do?
I would like to end now with a favorite quote of mine. It is from a translation of the Tibetan Book of the Dead. I think it would bring me peace when that time comes. I have placed a copy of it alongside my Durable Power of Attorney papers, living will, and the obituary I wrote for myself as an exercise some years ago. It goes like this:
My friend,
Now is the moment of death.
The time has come for you to start out.
You are going home.
Oh, nobly Born,
Now is the moment.
Before you is mind, open and wide as space,
Simple, without center or circumference.
Now is the moment of death.
Your mind in this moment is total transparency;
No color, no substance, emptiness.
Sparkling, pure and vibrant,
A mass of light
Not stopped by any obstacle.
It has neither beginning nor end.
Go toward the light.
Merge with it.
Merge with the light.
Death has happened.
It happens to everyone.
Merge with the clear white light.
Don’t long for what’s finished.
You can’t stay here anymore.
Death has happened.
It happens to everyone.
In this crucial moment,
Don’t be afraid.
Whatever appears,
Recognize as the form of your own thoughts.
Please don’t be afraid of your own radiance.
You no longer have a physical body.
Death has happened.
So nothing can hurt you.
You can’t die again.
Don’t be afraid.
Merge with the light. Merge. Merge.
You’ve wandered so long
In this muddy swamp.
If you continue to see
What is transparent
What shimmers, as solid
You will wander further yet.
Your mind itself is only an idea.
It has never been anything more.
You hear only echoes,
You see only dreams.
Cities are mirages.
The mountains are like the moon reflected in water,
Waves of your own mind.
This mind, shimmering, transparent,
Without beginning,
Without obstacle,
Is like water poured into water,
Water poured into water.
References:
Doka, Kenneth J. and Tucci, Amy S, eds. Spirituality and End-of-life Care, Hospice Foundation of America, Washington, DC. 2011.
Van Itallie, Jean-Claude. The Tibetan Book of the Dead for Reading Aloud. North Atlantic Books, Berkley, California, 1998.
n John Corbaley, M.S., M.A.
