Updated: Jan 9, 2020
“How can I be dying and not feel like I am dying?” These were the first words a terminally ill patient expressed to me.
When she first approached me, I was not sure if she was seeking me as a psychotherapist/counsellor, or through my more spiritual role. All I knew was that she had been told she only had a few months to live, was suffering considerably and was seeking my support.
I saw her at my rooms, and later at the hospital where she spent the last few weeks of her life. I have changed any identifiable information and will call this patient Sophie.
Although Sophie benefited from psychological support at times, much of our time together involved teaching her, and refining her skills in, the art of mindfulness meditation. She came to see this as learning the art of dying.
Sophie grieved over her young children’s impending loss of their mother, and then meticulously organised the provision of their care-taking for after her death. She anguished countless tears mourning over her personal loss of knowing she would never be able to attend her daughter’s wedding, and then made space to allow herself to enjoy the nine year old’s antics. She trembled at the terror of facing a painful death, and then relaxed into accepting, rather than fighting, her well-founded fears. Sophie learnt the art of living, and of dying, in the last five months of her life. I write this as a tribute to a remarkable person, who was gripped by confusion, sorrow, anger, anguish and terror when I first met her, and was at peace with a wisdom mind when I last saw her just prior to her death.
“I am so scared. I want to learn how to die without all this fear. I don’t want to spend the last months of my life like this. I don’t want this to be my children’s last memory of their mother”, Sophie sobbed.
I asked her, “How do you know you are afraid? Where in your body do you feel this?” I gestured by closing my eyes, suggesting she may like to do the same.
Sophie closed her eyes. She clenched her hand against her chest and said, “My chest is very tight, and my whole body is shaking”. She placed her hand back on her lap and said, “I feel so cold.”
I suggested, “Leave your hand on your chest. What do you feel with it there?”
She put her hand against her chest, then responded, “It’s so tight here, I can hardly breathe. I need to take a deep breath in”.
“Go ahead. Take a deep breath in”, I suggested. “What else do you feel?”
Sophie took a deep breath in. “I feel my chest expanding”, she said as she breathed in, “and relaxing a bit now”, she said as she breathed out.
I asked, “Can you feel your hand against your chest?”
“Yes”, she said. “It feels warm. Comforting. I’m not pressing hard, but just having this here feels like it is supporting my body, my whole being. Holding me together.”
“Leave your hand there”, I suggested. “What else do you notice?”
A slight smile emerged. “It feels nice. I’m not feeling as cold now. There’s warmth in my body again.”
I watched as she relaxed a little into her current experience. I asked gently, “What are you experiencing now? What has happened with the shaking?”
“It’s more subtle now, but still there”, she responded. “My whole body trembles all the time. I don’t like it shaking like that, so I try to distract myself with doing lots of things”, she frowned.
“Would it be alright to stay with the trembling for a little bit now?”
“Yes”, she said quietly.
“What do you notice? Where does it feel the strongest?”
Sophie did not hesitate. “In my guts. I suddenly remember that I am going to die and I feel somersaults everywhere. My whole body shakes and I think I may as well be dead now, because I’m not really living anymore. I don’t want to live like this. I can’t stand it.”
“Do you feel somersaults in your guts now?”
“Yes”, she responded, with a sense of urgency. “It’s intolerable. My chest is tight and I can’t breathe.”
“Can you still feel your hand against your chest?”
She paused. “Yes, I feel my hand. It’s not as comforting as before.”
“That’s alright”, I reassured her. “What does it feel like now?”
“It feels like my hand is moving with the shaking of my body”.
“Does that feel OK?”
“Yes. It’s strange. My body is shaking, but it feels OK for it to be like that.”
“Yes, it’s OK for things to be like this.”
Sophie was visibly more at ease, and the anxious tension in the room dissipated. I commented, “You look more comfortable now.”
“I’m still shaking, but I am comfortable”, she said. “It’s tolerable now. It’s OK”.
She opened her eyes and looked at me, puzzled. She hesitated, then asked, “How can this be OK? How can I still be shaking, still be afraid, still know that I am going to die soon, yet be OK?”
“It only needs to be OK for one moment: right now”, I responded. “You don’t need to worry about what it might be like next week, tomorrow, or even in the next moment. Just notice what is happening for you now, and make space for allowing whatever you are experiencing (be it pleasant, unpleasant or neutral) to be OK. Make space for being alright with whatever you are currently feeling, and notice when this changes”.
Mindfulness is simple, but the art not easy. Mindfulness is about noticing what is happening, while it is happening, no matter what it is. The act of noticing moves our experience out of the consuming contents of our lives, into experiencing and accepting the process of being alive. This movement of mind allows an ease and freedom in life not otherwise possible in our normal mode of living.
Sophie experienced this movement away from the grips of her overwhelming experiences to mindfulness over and over again, initially in my presence and later on her own. She smiled as she recalled her children calling her a Buddha, meditating all day and night through her terrors, anguish, pain, as well as joys.
Sophie became adept at noticing challenging experiences without fighting her aversion to them. Learning to acknowledge and accept whatever she was experiencing enabled her to comfortably be with the confusion, pain, fear and sadness that were there at times, as well as appreciate hearing birds sing, feeling a warm blanket around her and seeing her children smile. She invited and embraced all the experiences offered by the remaining moments of her life. By directing her mind to every single one of life’s experiences, without prejudice, Sophie learnt to be comfortable with the uncertainty of living. She perfected the art of living in her dying months.
If you are interested in learning how to come from the space of okay-ness through mindfulness, sign up for the self-paced, one-month course on Mindfulness for Inner Peace, which has helped a lot of people learn the art of living.