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Awakening to Life and Death

Ron Valle, Ph.D.
9701 Deer Valley Road
Brentwood, CA 94513

Within the American culture, traditional ways of being with suffering and the dying process continue to reflect, on an institutional level, the deepest individual human fear: the fear of death. Rather than being recognized as the natural companion of life, death continues to be an enemy, something to be conquered with our latest drugs and surgical techniques. Or, when it cannot be avoided or significantly delayed, it is hidden away in nursing homes or the back rooms of special hospital floors.

The impact of this institutionalized fear and denial on the individual facing a life-threatening condition is often immense. Surrounded by those who have not examined their own feelings or faced their own fears, many suffer and die alone without an opportunity to express their emotions or to share their experience with a compassionate, listening other. Literally tied to life-sustaining machines, many die in an atmosphere ranging from cool, professional distance to active avoidance on both a physical and emotional level. This pervasive attitude also affects issues related to death and dying, including the nature of grief and the grieving process (Leech & Singer, 1988; Staudacher, 1987; Tatelbaum, 1980), and euthanasia and the right to die (Humphry & Wickett, 1986). An examination of these areas is, however, beyond the scope of the present discussion.

Although still very much the norm, this collective response to death and dying is undergoing a slow but steady change. The first more formal sign of this change has been the hospice movement which began in Europe and has taken root here in the United States (see, e.g., DuBois, 1980). In an attempt to "humanize" the dying process by providing sensitive and sympathetic care for the terminally ill and their families, hospice advocates have designed and established special programs for dying people who wish to die peacefully at home or at a separate hospice facility. Regardless of where death occurs, hospice care is intended to make the last months or weeks of our lives easier to bear and, ideally, free from pain and fear. Although there are many aspects to the movement, the main focus of hospice is to bring emotional support into the dying process for all involved.

It is from this context of increased emotional sensitivity and support that the contributions of Elizabeth Kubler-Ross naturally evolved. The efforts of Kubler-Ross (1969, 1975, 1981) to bring a deeper and more sensitive understanding to the nature and pattern of the dying person's experience has led directly to a more compassionate way of being with the dying. More specifically, she was the first to systematically observe and categorize five psychological sets or stages that the terminally ill experience progressively as they proceed through the dying process. Although not always appearing in exactly the same order or a one-time only manner (e.g., a person may go back and forth among several different stages in a short period of time), these stages have a tendency to appear in the following order:

1. denial--- Avoidance of or refusal to accept the fact that one is dying is often the initial response.

2. anger--- Feelings of rage, envy, and resentment then arise when the denial can no longer be maintained.

3. bargaining--- Attempts to enter into some sort of agreement that may postpone the inevitable may then appear for brief periods.

4. depression--- Denial, anger, and bargaining are then replaced with a great sense of loss.

5. acceptance--- A quiet expectation of the inevitable follows.

These stages, thus identified, have become a definitive map for those working with the dying. Kubler-Ross' insights represent a new level of awareness regarding the experience of the dying person.

In this same arena of investigating experience in the dying process, Raymond Moody (1975, 1977) has described the nature of the near-death experience (see also, Ring, 1984; Morse & Perry, 1992). Individuals who have been declared clinically dead, but who in some way return to life and waking consciousness, describe this experience with remarkable consistency across different persons, cultures, and medical conditions. The near-death experience often includes some or all of the following characteristics: a sense of the ineffable, hearing another's report of one's death, feelings of peace and quiet, being in a dark tunnel, hearing specific noises, being out of one's body, meeting others who have previously died, encountering a being of light, reviewing one's life, reaching a border or limit, and coming back to one's body and life. In Moody's presentation of these descriptions, the reported evidence of trans-physical and trans-emotional ways of being offer more subtle dimensions of experiences related to the dying process.

It is not, however, until Stephen Levine (1982, 1984, 1987) and Ram Dass (Ram Dass & Gorman, 1985) speak of the essence in each of us that is unaffected by death that spiritual experience per se is addressed as an integral part of living, suffering, and dying. Seeing life and death as ultimately two facets of a single spiritual process opens new ways to be with those who are knowingly approaching the end of their lives.

Careful reflection reveals that life and death are inextricably intertwined. In fact, one has no meaning without the other. They are quite literally two sides of the same coin, not only in a philosophical sense, but a pragmatic one as well. If, for example, one would like to know how afraid one will be when receiving one's terminal diagnosis, one only has to look at how afraid one is to live fully right now. To live fully is to love without fear, to give of oneself to another who is suffering without any expectation or condition of something in return. Being compassionate is our natural way. From this perspective, fear of death and fear of life are truly one and the same.

Serving others selflessly in life and surrendering one's self-identity as a unique body and personality in death are, therefore, two manifestations of the same process--- spiritual awakening. Both entail a process of letting go of habitual ways of defining oneself and being with the fear of opening into the unknown, of realizing that one's nature extends beyond the self-imposed limits of the ego-self. It is here, in this process of self-transformation, that spiritual experience becomes the ground for understanding, not as a blind belief in something "greater" than oneself, but as an actual experience or felt presence, of a new way or mode of being.

From this perspective, the time of dying becomes a spiritually auspicious time, a space or opening in one's life where personal priorities are rearranged and deeper questions arise. This time, therefore, represents a very special opportunity both for the individual who is dying and for the one who chooses to be with this person to examine these deeper questions regarding the nature of life and death in a spirit of mutual exploration, questions such as: Who is it that lives and dies? What is the essence in each of us that is untouched by death? Is there a joy that goes deeper than our daily happiness and sadness, wellness and illness? What does healing really mean in the context of a life-threatening illness? (from the brochure of the Living/Dying Project, 1991). By opening to such questions with a loving and peaceful presence, the person attending thereby offers conscious and compassionate support for he or she who is dying.

To the degree that spiritual awareness and compassion are the cornerstones of this sacred, living relationship, dying, in this context, becomes a conscious dying. As an example of how this approach can manifest in the lives of two individuals who choose to be together in this way, I offer the text of an account I authored several years ago (Valle, 1988) describing my relationship with a man in the latter stages of AIDS:

Michael is dying of AIDS. He sees himself as a "long-term survivor" who has watched many of his closest friends die, one after the other, in the past few years. Of twelve or so friends who years ago tested HIV+, only Michael and one other remain. He claims that he cannot go to another funeral or shed another tear. It's not that he doesn't care any longer, but that he's reached a core place within himself that is at peace with how it is. All of the old reasons that his mind would offer up about what he should do or how he should feel are simply gone. After so much loss and so much grief, his caring heart has been burned clean.

From these experiences and others, he knows AIDS well--- what symptoms come along at what time and what they mean regarding the quality of life and the closeness of death. He has been through pneumocystis twice, had his spleen surgically removed, and is now dealing with vomiting after almost every meal. He couldn't deny what's happening to him even if he wanted to. He tires very easily at this point, wondering why he goes on.

I've been visiting with Michael for a few hours most every week. Sometimes we walk or run errands, most often we simply sit and talk, sketching out a spontaneous map of our experiences with each other, including those which touch his feelings about dying.

Last week he touched a deep and powerful place within himself as he described feeling the awesome inevitability of his approaching death, that he has newly realized that there is nothing he can think or feel or do to avoid going through death's door, a passage he now faces with both human fear and an authentic, almost child-like excitement. As he shared his feelings, I felt as if he was whirling in a vortex, an experience of such sheer power and speed that it blurs the mind as one feels inexorably drawn into the mystery. He later reflected on how all of those many moments throughout his life when he thought he had a choice or an important decision to make seem so illusory and quite irrelevant from where he is now, how liberating it is to feel freed from the demands of the deciding mind.

As Michael spoke, I felt myself cross an edge inside of me as I opened into the vortex with him. At that moment I felt not only my own fear and excitement, but my unmistakable love for him, and, at that moment, felt our deep human connection as well as the simple fact that my own pain would be very real whenever it was that Michael died. It was here that I saw how much of my life and feeling I push away, how the vortex is always there to experience, yet how we all seem to live as if we were above it all, unaware of life's constant movement and constant change.

There is so much more to share--- Michael's struggle with his ambivalence towards both life and death, his humor and joy at moments where the melodrama of life seems so absurd, his feelings about those close to him who need his support to help them cope with their feelings about his illness, and his incredible clarity and spiritual courage in opening to the process he finds himself in. There are my own feelings of wonder and awe, wanting to help, spiritual presence, awkwardness, and just not knowing what to say or do much of the time--- letting myself "be done"' rather than doing; and how the vortex he describes approaching death is so very similar to the vortex of love--- the inevitable pull we all sense when we feel our hearts connect, the same pull we all believe we can resist by keeping our distance, defining boundaries, and keeping our hearts closed when the feeling of love gets too strong.

Being with each other continues to be an incredible teaching. In our shared exploration, the secrets of opening to life and death slowly reveal themselves in whatever ways he and I are ready and willing to hear (p. 1).

My meetings with Michael continued until his death three months after these reflections first appeared in print.

New writings continue to emerge reflecting this approach to conscious living/conscious dying (e.g., Doore, 1990; Feinstein & Mayo, 1990). Time will only tell to what extent this perspective, that calls us beyond our denial and fear to the quiet of natural compassion, will be integrated into our individual and institutionalized cultural understanding.

References

Doore, G. (Ed.) (1990). What survives? Contemporary explorations of life after death. Los Angeles: J. P. Tarcher.

DuBois, P. (1980). The hospice way of death. New York: Human Sciences Press.

Feinstein, D. and Mayo, P. (1990). Rituals for living and dying: How we can turn loss and the fear of death into an affirmation of life. New York: Harper Collins.

Humphry, D. and Wickett, A. (1986). The right to die: Understanding euthanasia. New York: Harper and Row.

Kubler-Ross, E. (1969). On death and dying. New York: Macmillan.

Kubler-Ross, E. (1975). Death: The final stage of growth. Englewood Cliffs, NJ: Prentice-Hall.

Kubler-Ross, E. (1981). Living with death and dying. New York: Macmillan.

Leech, P. and Singer, Z. (1988). Acknowledgment: Opening to the grief of unacceptable loss. Laytonville, CA: Wintercreek.

Levine, S. (1982). Who dies? An investigation of conscious living and conscious dying. Garden City, NY: Anchor Press.

Levine, S. (1984). Meetings at the edge: Dialogues with the grieving and the dying, the healing and the healed. Garden City, NY: Anchor Press.

Levine, S. (1987). Healing into life and death. Garden City, NY: Anchor Press.

Living/Dying Project Brochure (1991). 75 Digital Drive, Novato, CA 94949.

Moody, R. (1975). Life after life. New York: Bantam Books.

Moody, R. (1977). Reflections on life after life. New York: Bantam Books.

Morse, M. and Perry, P. (1992). Transformed by the light; The powerful effect of near-death experiences on people's lives. New York: Villard Books.

Ram Dass and Gorman, P. (1985). How can I help? Stories and reflections on service. New York: Alfred A. Knopf.

Ring, K. (1984). Heading toward Omega: In search of the meaning of the near-death experience. New York: William Morrow.

Staudacher, C. (1987). Beyond grief: A guide for recovering from the death of a loved one. Oakland, CA: New Harbinger.

Tatelbaum, J. (1980). The courage to grieve: Creative living, recovery, and growth through grief. New York: Harper & Row.

Valle, R. (1988). Reflections of a volunteer. Living/Dying Project Newsletter, September, 1988.