Transcript Spirituality in Grief - Hospice & Palliative Care Manitoba

Glen R. Horst
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Describe the activity of soul and spirit in relearning the world (Attig)
Identify sorrow-friendly practices (Attig)
Note mindfulness meditation’s potential for
deepening a grief response (Kabat-Zinn)
Explore how grief can open into compassion
(Halifax)
Spirituality is the dynamic dimension of human
life that relates to the way persons (individual
and community) experience, express and/or
seek meaning, purpose and transcendence,
and the way they connect to the moment, to
self, to others, to nature, to the significant
and/or the sacred.
EAPC taskforce on Spiritual Care in Palliative Care
http://www.eapcnet.eu/Themes/Clinicalcare/Spiritualcareinpalliativecare.aspx
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“It’s so hard to go on. I have great faith in
God, but just can’t seem to move forward.”
“Are my family members happy and content
after death?”
“Why???? Why did this happen?”
“It’s adjusting to life on my own that I find the
hardest.”
“I feel like I am going crazy, talking to him
when no one is around.”
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“The tears won't stop, I'm not sure what to
do, and can't sleep. Then again sometimes
that's all I want to do, is stay in bed and not
move.”
“I have a huge hole in my heart.”
“My soul hurts beyond words.”
“We have to create a new normal on a daily
basis.”
“Oh, the anger. It is like a poison.”
“People say ‘he knows, he sees.’ Really? I wish
I could see or feel him here.”
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“I felt so guilty about leaving her [after
midnight; she died the next morning]. She
said, ‘Don’t go; I’m afraid.’”
“I’m fighting my own demons. She wouldn’t
have had all those panic attacks towards the
end if I had taken that neck brace off in the
hospital [after her fall]. That was where it all
started.”
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Soul: “home-seeking” aspect (force, drive) of our
self
◦ Seeks nurture, connection, and grounding in the
familiar.
◦ Offers care, love, compassion in return
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Spirit: “meaning-seeking” aspect of our self
◦ Reaches beyond the known for meaning in the new
◦ Strives to overcome adversity and to understand
◦ Characterized by faith, hope, and courage
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Ego: sense of being a separate self that is in
control (This is “me”)
◦ Defends against threats to self-image, self-confidence,
and self-esteem
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all-encompassing suffering that involves
emotions, thoughts, body, and relationships
triggered by reminders of separation: things,
places, events, other people, aspects of our
self
Brokenness: sense of self; daily life pattern;
life story; web of meaning
Ego in crisis: cannot prevent bad things
Soul in crisis: uprooted, homesick, longing
Spirit in crisis: fearful, discouraged, lethargic,
loss of faith
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Has God abandoned us? Is God punishing us?
Do illness and death happen randomly? Is the
world out of control?
Where do we fit in the greater scheme of
things? Where do we belong?
Is there any point to going on day to day,
caring, pursuing purposes, hoping?
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Ego work: begin again to solve everyday problems
Soul work: reconnect with the familiar to make
ourselves at home in the world again and in its
surrounding Mystery
Spirit work: reweave web of daily life, joining new
threads to familiar; entering unknown with courage,
hope, and faith; stretching into new chapters of our
life story to find and make fresh meanings
Relationship with deceased: shift attention from pain
of separation to loving in separation
“When you are sorrowful, look again in your heart, and you shall see that
in truth you are weeping for that which has been your delight.” (Gibran)
Pain of
separation
Appreciation
and gratitude
Cherishing those we love by remembering their
legacies:
◦ Practical legacies: e.g. material goods, biological
inheritances, advice and counsel, interests
◦ Soulful legacies: roots in individual, family and
community traditions; ways of caring and loving.
◦ Spiritual legacies: ways of changing and growing,
overcoming adversity (including sorrow), and searching
for understanding and meaning.
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Beliefs about:
◦ the nature of the world (e.g. secure vs. threatening;
orderly vs. chaotic; just vs. unfair)
◦ the (possibly divine) forces that operate within it
◦ the meaning of life, death, and suffering
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To find plausible answers or better tolerate
living without answers:
◦ May deepen religious faith or secular convictions
◦ May change faith or convictions
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Dwelling with sorrows is a choice
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Meditation
Sharing and exploring sorrow with another
Ritual/ceremony
Experiencing or creating works of art
Catching and engaging dream images
Attending to sorrow in your body and to breath
Leaning into a faith
Opening heart in prayer
Keeping a grief journal
Seeking meaning in after-death encounters
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Learning:
◦ Moment-to-moment awareness (thoughts, feelings,
sensations)
◦ Focusing on your breath, taking each moment as it
comes
◦ Working with all your reactions
 Accepting yourself as you are – no judgment or
rejection of experience as undesirable
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Open up consciously to your suffering
◦ Observe it; be curious
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Thoughts and feelings coming and going
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Reliving what happened or a particular moment
What could you have done differently?
Blaming yourself or someone else
What will happen next?
What will become of you?
Intentional knowing of emotional suffering
contains seeds of healing
◦ Part of you that can know your feelings has an
independent perspective – participant rather than victim
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Acceptance of present as it is
◦ Natural tendencies:
 Non-acceptance, rejection of what has happened
(things as they are)
 Deny or avoid painful feelings
 Become lost in painful feelings
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Mindfulness = seeing what is transpiring
from moment to moment
◦ A compassionate intelligence that takes it all in
◦ A source of peace within the turmoil (cf. Mother who is
source of compassion, peace, and perspective for upset child)
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Times of great emotional upheaval and
turmoil. . .are times when we most need to
know that the core of our being is stable and
resilient and that we can weather these
moments and become more human in the
process.
(Full Catastrophe Living)
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Grieving can lead beyond our separate stories
to an awareness that we are related to a
greater whole and that our true home is in
the infinite
Our awakening can begin to happen when
we’re finally drawn through the tight knot of
suffering into the world of suffering around
us.
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Sorrow of our losses feeds into an underground
river running beneath our lives
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Grief individual, intimate, private
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Grief collective, communal
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Story of Ubbiri
◦ Initially sorrow feels like it is “my river” – no one else has
ever felt this pain - alone
◦ Eventually discover river runs beneath all human life
◦ We are bonded to each other in our sorrows
◦ Compassion: feeling and interacting with each other’s
suffering
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Slow work of swimming through pain and
longing
Initially, whole being seizes up with fear and
suffering – then something settles deep in
our bones that gives us strength
Nobody can tell you how to do it or do it for
you
◦ You have to learn to swim in the “black, rushing
waters of sorrow” and pull yourself to the other
shore
◦ Others can accompany, guide, encourage
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Grieving begins in losses over which we have
no control (Grief reaction)
◦ Need to be attentive to our reactions and patient
with ourselves– no judgment, no right way
◦ Mindfulness and sorrow-friendly practices
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Grief work is active and involves choices
(Grief response)
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Soul work
Spirit work
Loving in separation
Compassion
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Attig T. Catching Your Breath in Grief: and
grace will lead you home. Victoria, BC:
Breath of Life Publishing, 2012
_______. How We Grieve: Relearning the
World. Rev. ed. New York, NY: Oxford
University Press, 2011.
Halifax J. Being with Dying: Cultivating
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Shambhala, 2009.
Kabat-Zinn J. Full Catastrophe Living: Using the
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Compassion and Fearlessness in the
Presence of Death. Boston, MA:
Wisdom of Your Body and Mind to Face
Stress, Pain and Illness. New York, NY: Dell
Publishing, 1990.