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 Conversations with Leaders in Self-Care: What We Can Learn from the Dying 
Interview with Stephen Levine
   as interviewed by Tom Ferguson MD

Letting Go
The dying teach us that happiness comes from learning to let go of the things that cause suffering. Though they've lost much that they desired, they've found much that is of even greater importance. Through their investigation of suffering, they have gotten in touch with something deeper.

The dying teach that it is possible to let go of wanting, that desire is only a cloud that obscures our real nature. We see that our true sources of satisfaction lie in what we already have, and have always had: simple awareness.

Before we began working with the dying, we used to think of those who had not suffered losses as the truly fortunate. No more. We feel sorry for them now.

These well-intentioned people who have, by luck or planning, isolated themselves so well from life may feel perfectly secure in their possessions and their loved ones. They may feel that the whole business of dying has nothing to do with them. They may feel that they have what they want in the world, that they are safe from the flow of change. But we can assure you that for them, the inevitable loss of possessions, the inevitable loss of loved ones, will be the most difficult.

The dying teach us that the real tragedy is not the loss of possessions, not even the loss of loved ones. The real tragedy is losing our connection with humanness, with compassion, with kindness, with forgiveness -- for ourselves and those about us -- closing off to life. In their efforts to find a safe place, to avoid the inevitable suffering of life, these seemingly safe, secure people have merely saved up their suffering. They have put off their pain. They have carried it around without realizing it. And, in the meantime, they have piddled their lives away maintaining their defenses. We have come to feel deeply sorry for such people, because they will experience death with the greatest horror.

Dying at Home

In a recent survey, four out of five people said they would prefer to die at home, yet in practice, four out of five people die in institutions. To die at home is to die in the midst of life, in the midst of love. Many of the people we have taken home to die have found they needed less pain medication because of the support and relaxation available in the home environment.

Many have said in the last weeks of a loved one's dying in a hospital: "I wish I could do more." We always think to ourselves, "Take them home to die and don't worry, you will!"

Giving a loved one round-the-clock support may draw on energy reserves long unexplored, while feeding some place deeper than bodily fatigue. To bring loved ones home to die is like accompanying them on their last pilgrimage. There is no experience more intimate. To share that time with another, to encourage a loved one to let go gently while we ourselves practice what we preach, can bring beings together as no other situation can.

Here are a few things that can make the experience easier:

  • A cassette recorder so the person can listen to a variety of music and guided meditations.
  • A bedside bell so the person can feel in contact and summon help.
  • Plastic bedpans, which aren't as cold as metal ones.
  • Daily baths, for human contact and protection against bedsores.
  • Massage for decreasing tension and anxiety while deepening contact.
  • Don't force someone to eat. You are sharing an openness and ease with what is.
    If the person wishes not to eat, so be it.
  • A blender is useful when one does not wish to take in too much at a time.
  • A hot plate or plug-in teapot in the person's room lets you have a cup of tea
    or light snack without having to leave the room.
  • Water and juice should always be available.
  • A hospital bed with side rails is convenient and comfortable, but many prefer
    to die in their own beds, and would rather use a foam wedge and a few extra pillows.
  • Pain medications should be given as the person wishes. Don't push your own ideas
    of how they should work with pain.
  • The best place for the bed may be in the living room, near the window. This lets the
    person maintain contact with the familiar.
  • It is not uncommon for people who are dying to feel that their illness may be a
    punishment for past actions. Supportive measures that can help dissolve the guilt
    should be encouraged.
  • You may wish to call the Visiting Nurses' Association in your town for further
    information and support.

—Stephen Levine

Experiences That Will Give You Great Insight into Aging, Illness and Dying

  1. Volunteer at a Nursing Home.
  2. Volunteer at a Hospice.

People who've done either of the above -- even if it's only for one week -- invariably have a memorable experience. You'll see how your body is going to grow old some day, and all that entails -- how difficult it can be just to sit up, just to life your fork and eat, just to walk, just to sit in a chair. You'll see how, for the elderly, the being inside has not changed a bit since they were 15. Highly recommended and unforgettable.

—Ondrea Levine

Choosing a Practice

We encourage the people we work with to adopt some kind of practice, one that suits their own life and preferences, but ideally a daily practice, one they can stay with, something to which they give first priority, something they do at a regular time, and do even if they don't feel like it on that particular day.

It might be meditation or yoga, tai chi, running, silent prayer, massage, playing an instrument, karate, judo, writing in a psychological diary, breathing exercises, or the practice of an art or craft —whatever is right for their temperament and their preferences. Something that will encourage them to pay attention. We find that this kind of a daily practice is perhaps the most powerful tool for building awareness.

—Stephen Levine

Who Dies?
Imagine that the time has now come when the energy in your body is no longer sufficient to allow you to participate in the world. You can no longer continue your former work, or earn the money you used to earn. You are lying in bed wit you new car parked in the driveway outside your window. You realize that you will never drive that car again. You see your closet. You know that you will never wear your wardrobe again. your children play in the next room. You are too weak to get up and join them.

In the kitchen, your mate cooks supper; you will have to be spoon-fed because you are too weak to feed yourself. You want to get up to help, but it is no longer possible. You sense that in the not too distant future, your mate will be making love to someone else, that in a short time someone else will be raising your children.

You must let go of every model of yourself you have ever created -- wife, husband, father, mother, lover, breadwinner, parent, teacher, doctor, nurse, businessperson. Those models are no longer available for you . Can you see how you might begin to wonder, "Who am I? Who is it lying here in this bed? Who is dying? Who is it that lived?"

For those who remain attached to how it used to be, to how they thought it would always be, dying can be hell. But dying doesn't have to be hell. It can be a remarkable opportunity for awakening.

Forgiveness Meditation
Bring into your heart the image of someone for whom you feel much resentment. Take a moment to feel that person right there in the center of your chest.

And in your heart, say to that person, "For anything you may have done that caused me pain, anything you did either intentionally or unintentionally, through your thoughts, words, or actions, I forgive you."

Slowly allow that person to settle into your heart. No force, just opening to them at your own pace. Say to them, "I forgive you." Gently, gently open to them. If it hurts, let it hurt. Begin to relax the iron grip of your resentment, to let go of that incredible anger. Say to them "I forgive you." And allow them to be forgiven.

Now bring into your heart the image of someone you wish to ask for forgiveness. Say to them, "For anything I may have done that caused you pain, my thoughts, my actions, my words, I ask for your forgiveness. For all those words that were said out of forgetfulness or fear or confusion, I ask your forgiveness."

Don't allow any resentment you may hold for yourself to block your reception of that forgiveness. Let your heart soften to it. Allow yourself to be forgiven. Open to the possibility of forgiveness. Holding them in your heart, say to them, "For whatever I may have done that caused you pain, I ask your forgiveness."

Now bring an image of yourself into your heart, floating at the center of your chest. Bring yourself into your heart, and using your own first name, say to yourself, "For all that you have done in forgetfulness and fear and confusion, for all the words and thoughts and actions that may have caused pain to anyone, I forgive you."

Open to the possibility of self-forgiveness. Let go of all the bitterness, the hardness, the judgement of yourself.

Make room in your heart for yourself. Say "I forgive you" to you.

Like Worn-out Clothing
We have seen people experiencing the same falling away of the body, the same inability to be the individual they thought they were, who are able to leave their old roles and duties behind like so much worn-out clothing. As their bodies grow weaker, their spirits and their participation in the moment grow stronger and stronger, until their old roles and old masks are seen as the bars of a cage, and they experience a joyful release from the part of their life that was made up of models and ideals of how they were supposed to be.

We have seen these remarkable people flow wholeheartedly into the vastness of what is, no longer kept captive by their models of the world. They see everything as present in each moment. It seems that all blocks to their perceptions are gone. They see how identifying with fantasies of the future and dreams of the past has kept them in prison for their whole lives. As one spiritual teacher said shortly before his death, "Today I am released from jail."

The Work of the Dying
It is from these remarkable people that we have learned that the work of the dying is to let go of self-protective control. To open, to live fully in the present moment, to accept the richness of each moment with an open heart, with a mind that does not cling to models.

These people are able to open up to an appreciation of all that is, beyond life, beyond death. They realize that they don't have to do or be anything to be who they really are. They have escaped from the tyranny of the mind, the tyranny of models and shoulds and musts.

We see them touch the real. We see them become part of what is. We see them let go of wanting things to be any other way.

Those who are able to open into the experience of dying are the most open-hearted, clear-minded people we know. If we might share a composite of what we hear them say, it would go something like this: "It's strange, but I've never been so happy in my life. I don't really know who I am, but it doesn't matter, because no matter who I think I am, I keep turning to to be something else.

"My knowing has always blocked my understanding, but now I am full of not-knowing, vulnerable, open. I had to lose it all to see how little of it was worth having. Somehow there is much more to me than I had ever imagined."

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 About The Author
Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher who virtually led the movement to advocate informed self-care as the starting point for good health. Dr. Ferguson studied and wrote......moreTom Ferguson MD
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