on What to Do When the Going Gets Rough
From Tricycle Magazine, Summer 2001
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 confrontedwith.
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.
Frank Ostaseski founded the Zen Hospice Project in 1987. He currently serves as guiding teacher in the hospice and in a new venture, the Institute on Dying, the educational arm of Zen Hospice.