On What to Do When the Going Gets Rough
Frank Ostaseski
tricycle
Caregiving from a Buddhist perspective is a
recognition that this person’s suffering is also my suffering. When
I see this, whether I’m the person in the bed or the person making
the bed, I have to confront this precariousness. Buddhist practice
can help us enormously in continuing to give our attention to
what’s actually appearing, as opposed to being swept away by the
drama of the process.
What are the basic attitudes that might be
helpful in being with someone who is dying? One of those that comes
to mind is to be completely ourselves. That means to bring our
strength and vulnerability to the bedside. And to recognize that
people who are dying continue to need very intimate and natural and
honest relationships. We can’t serve from a distance, this is
intimate work and we have to be part of the equation so it is
absolutely essential that we bring our entire selves to the
experience.
It’s important that we bring to the bedside
the quality of empathy. This is maybe the greatest gift we can give
another human being—our undivided attention. To listen without
judgment or agendas. The great psychologist Carl Rogers once
described empathy as “looking with fresh and unfrightened eyes.” I
think that’s a wonderful way of thinking about how to be with
someone.
Also, simple human kindness. When people
are sick, details matter. The manner in which we care for someone,
the way in which we come forward to offer service, is incredibly
important. How can we assist with the simple details? Holding the
hand of a frightened patient, doing the laundry, helping someone
fill out the insurance forms. Simple everyday activities offered
with loving attention that convey acceptance, build trust, and
enhance self-esteem. I would add “non-doing” to this list of
helpful attitudes. To really have the confidence in our human
presence. To slow down, and leave a lot of room for silence, to
reduce distractions. Don’t miss this moment waiting for some future
event, even the moment of dying.
Part of my task is to try to take Buddhist practice and make it
useful and accessible to people who are not experienced with it; to
use language that doesn’t create more barriers. There’s a lot of
talk out there about conscious dying. But we don’t speak so much
about conscious caregiving. In dying, spiritual support is every
bit as important as good pain control. But we rarely extend that
kind of support in a meaningful way. And as a result, too many
people are dying in distress and in fear.
So what is it to provide this support? I
would say first and foremost, it’s about bearing witness. And that
means not turning away when the going gets rough, staying present
in the territory of mystery and unanswerable questions. Sometimes,
depending on the person’s tradition, it means calling a priest to
give last rites, or getting a prayer shawl, or helping to write
letters of reconciliation. Rarely is it a matter of conducting
existential discussions. Or even introducing formal practices. It’s
helping people to face directly what’s occurring, to work with the
paradoxes that they’re confronted with.
Probably most important, is to become aware
of our own bodies and minds. Let’s not underestimate this. It’s the
most essential of all practices—one’s commitment to maintain
awareness of one’s own mind, body, and heart in the middle of this.
In doing this we help to create a calm and receptive environment
for the person who is dying. If there is one person in the room who
is calm—just one person—it eases the entire experience for
everybody.