Creativity and Dying: Communication in Caring for the Spirit at the End of Life

Meg Hegarty

Illustration: Michael Leunig

Ageing & Dying

Living fully and preparing for dying: -“the final career in life: moving towards death”

(MacKinlay E, 2006)

Time of transition: “in-between time”/liminal or thin space

Do we recognise and hear the language with which the person’s

spirit is speaking?

Expressions of spirit(uality)

Depend on

personality,

culture (social, religious & family),

the times in which we live,

life experiences and developmental capacities.

Language of the spirit

Whole person - includes head, heart, gut, spirit

Embodied: dance, touch, tears, laughter, and physical symptoms

Symbolic language

“We forget that the strongest influences upon our lives are always symbolic.   Contrary to common belief, we do not respond to the actual or the concrete; we respond to what each event, relationship or feeling means to us symbolically.”

Reeves, 1999, p73

Symbolic language

• Metaphors– Physical: “Signs, symptoms and

symbols of spiritual distress” – Heyse-Moore, ….

– Verbal: Words, phrases, stories• John’s story

– Art, music, poetry, silence, beauty

– Dreams

Language of the spirit

Whole person - includes head, heart, gut, spirit

Embodied: dance, touch, tears,laughter, and physical symptoms.

Symbolic – image, metaphor, story – meaning

Ritual

The place and healing creativity of ritual

Prayer

How do we see spiritual struggle?

Or a sense of being abandoned by God, or what gives meaning?

Silence

Some experiences are too deep for words…

Silence

Silence is the language of God.” - Rumi

“Dying people in particular are often in a purgatory of routinized communication, and they crave silence.” (Halifax J, 2009, p 109)

“To be silent enough to stay with something… without feeling so uncomfortable you have to say something or do something or change something…The longer I stayed in palliative care the less I spoke.” (Nurse 3)

Language of the spiritWhole person - includes head, heart, gut, spiritEmbodied: dance, touch, tears, laughter,

physical symptoms...Symbolic – image, metaphor, story – meaningBeauty, nature, poetry, music, art, literature… Ritual – celebration, letting go…Prayer / meditation - awe & intimacySilenceValues-holding in compassion, living fullyStruggle AND peace, trust, letting go

How do we hear and speak this language?

Compassionate presence and

Contemplative listening

…often in silence

Hearing the language:3 Kinds of Listening

• Diagnostic listening - listening for

• Empathic listening – listening to

• Contemplative listening – listening with

(Byrne M, 2011)

Contemplative listening:

“the vulnerability of listening and having no answers”

(Lunn, 1990)

“living the questions…”(Rainer Marie Rilke, 1934)

Shift from “fixing” to presence/staying with

(Hegarty et al, 2010)

We speak this language when:

• We “live the questions” with people

• We’re present with suffering, in silence often, contemplatively and compassionately, letting go of our need to fix things, so we can be fully present

• We hear and use the dying person’s language

• We facilitate simple, meaningful rituals

• We respect & reverence struggles as much as peace

• We remember that this language is of the whole body and person, and deeper than cognitive function.

Enabling the gifts in dying

creativity,resilience, hope,

through being held safely, listened to, heard, reverenced.

ReferencesMargaret Byrne, 2001, lecture notes in “Care of the spirit in palliative care” postgraduate topic, Flinders University.Fischer K, 1995, Autumn Gospel. Integration

Books: New Jersey.Halifax J 2009 Being with Dying: Cultivating

Compassion and Fearlessness in the Presence of Death. Shambhala: Boston.

Hegarty M 2007 Care of the spirit that transcends religious, ideological and philosophical boundaries. Indian Journal of Palliative Care, 12(2):42-47.

Hegarty, M.M., Breaden, K.M., Swetenham, C.M. and Grbich, C.F. (2010). Learning to Work with the "Unsolvable"; Building capacity for working with refractory suffering. Journal of Palliative Care, 26(4 ), p.287-294

Heyse-Moore LH On Spiritual Pain in the Dying. Mortality, 1 :297-315, 1996

Keen S,1990 To a Dancing God: Notes of a spiritual traveller. Harper Collins.Mackinlay E, 2006, Ageing, Spirituality and Palliative Care, p69.Mako C, Galek K, Poppito S 2006 Spiritual pain among patients with advanced cancer in palliative care. Journal of Palliative Medicine, 9(5), pp1106-1113.Nolan S, Saltmarsh P and Leget C 2011 (for EAPC Spiritual Care Taskforce))

Rilke RM The Selected Poetry of Rainer Marie Rilke. New York: Random House Inc., 1987.Reeves P, 1999, Women’s intuition: unlocking the wisdom of the body. p73. Conari Press: Berkeley. Savage, 1996, cited in Mundle RG, 2011, The spiritual strength story in end-of-life care: two case studies. Palliative and Supportive Care, 9(4), pp420-21.PicturesMichael Leunig - slides 2 & 9,Belinda Clatworthy – slides 14, 17, Meg Hegarty – slides 5, 12, 15, 19, 23

Points for discussion

What do we need to develop in ourselves to recognise and speak the language of the spirit effectively?

How do we learn this?

meg.hegarty@flinders.edu.au

What do we need?

• Deep reverence for the wisdom of the other’s spirit

• Ability to stay with, in the struggle• Ability to be silent, to cope with

not knowing, not fixing• Own spiritual awareness and

practice• Doing our own spiritual / inner

work (healing wounded healers)

Spirit

• Essence• Energy / life force • Spark of the Divine / God

(known by many different names)

• Ground of Being, Deep Mystery

• Higher Self / The Self• The Human Spirit• “One closer to me than I

am to myself”

‘Spirituality is the dynamic dimension of human life that relates to the way persons (individual and community) experience, express and/or seek meaning, purpose and transcendence, and the way they connect to the moment, to self, to others, to nature, to the significant and/or the sacred.’   - Nolan S, Saltmarsh P and Leget C, 2011

(for EAPC Spiritual Care Taskforce)

Anam Cara

“We live in the shelter of each other.”

(Celtic wisdom)