Maneesha presents The Sammasati Project and explains why support in ill health is important
Recently, a friend diagnosed with a serious illness was asked if she’d like me to visit her in order to have some sessions together. She responded with some alarm, saying something to the effect: “Oh, I’m not that far down the line, as to need Maneesha to visit, am I?’ She viewed me as a kind of angel of death!
My work as a support person – and the Sammasati* Support-Person Training I offer (more of which follows below) – is not solely concerned with those who are clearly dying.
First of all, how to define ‘clearly dying’? When is someone no longer merely sick but actually dying? Where an observer might see their friend as dying of cancer, that friend might well feel that they are living with cancer … and that can hold true, for both, right up to the point of the person’s death.
On the other hand, as Osho points out, we’re all ‘clearly dying’: dying started the very day we started living. As some wit put it: Life is a terminal condition.
I’ve seen a lot of people suffering from sickness, during my training many moons ago as a nurse, working as a meditation facilitator-counsellor for years and more recently as a psychotherapist. (I’ve also had my share of physical pain and psychological distress through my [famous!] migraines.) A health crisis, or simply being at a low point physically, can be very challenging on many levels – the physical, psychological, social, emotional and spiritual.
When we are physically vulnerable, thoughts and feelings can emerge that otherwise – when we are healthy and actively engaged in life – we manage to ignore or deny. Weakened and demoralised by illness, we can find our normal defences are not so effective: anxiety, fear, grief, anger or depression can take hold of us and such feelings can be difficult to confront and express.
Interestingly, a controlled study conducted by Dr David Spiegel some years ago revealed that women with breast cancer who regularly attended group therapy sessions – in which they were encouraged to face their anxieties, to allow the release of their feelings and to be more authentic in their relationships – were less likely to be depressed or anxious; they even experienced less physical pain. Not only that: the more regularly a woman attended the group, the longer she lived.
Dr Spiegel maintains that “Feelings you can’t express become an internal obstacle. They use up resources we don’t completely understand. Expressing them and accepting them stops using these resources to keep them out of awareness. How that translates in how the body fights illness is still a mystery but I’ve come to believe it does, and we are beginning to understand the mechanisms” (Bill Moyers, ‘Healing and the Mind’ PBS; 1993).
(Of course, not taking responsibility for our feelings and, instead, ‘dumping’ them on those close to us and/or caring for us, can bring its own problems.)
Once we enter the hospital system, inevitably, the dehumanizing process starts: we cease being seen as a person and become a patient (or, worse, a case number or a disease). Dr David Servan-Schreiber, a psychiatrist and neuroscientist, writes (in his excellent book, Anti-cancer: a new way of life), “When I found out that I had a brain tumour, I discovered overnight a world that looked familiar but in fact I knew little about – the world of the patient…a colourless world… a world where people were afforded no recognized qualifications, no profession. A world in which nobody was interested in what you did in life, or what might be going through your mind. Often the only interesting thing about you was your latest scan. I discovered that most of my doctors didn’t know how to treat me as a patient and colleague at the same time…. Suddenly I had the feeling that there was a club of the living and I was getting the message that I wasn’t a member. I began to feel frightened that I was in a category apart, a category of people defined primarily by their disease. I was afraid of becoming invisible. Afraid of no longer existing even before dying. Perhaps I was going to die soon but I still wanted to live fully up to the end…. From this day forward, for the rest of my life, I would be marked as a person condemned to die” (pp. 23, 24-25).
That all-too-common experience of hospitals, along with other aspects of being sick, can evoke many of the big existential questions, such as: ‘Now that I’m not an active member of the world/ society/ my neighbourhood/ family, who am I’? And: ‘Why has this happened to me? What does it mean? What did I do wrong?’ And: ‘Without my hair/ eyebrows/ breast(s) /libido, with my colostomy bag/ zimmer frame/ zero energy/ dependency, am I still lovable? Still valued?’ ‘What if I don’t recover…if this is it? Has my life been worthwhile, significant? What have I contributed? Will I be remembered? How will I be remembered?’ … and so on.
In any phase of life there is a physiological benefit to having harmonious, loving and supportive relationships, but perhaps never more so than when we are ill. According to Joan Borysenko MD, cell biologist and author of Minding the Body, Mending the Mind, healing is fundamentally about connectedness – the rediscovery of our connection with self, with the community, and the transpersonal. Dr Servan-Schreiber endorses that when he points out that immune cells are sensitive to our emotions. ‘They react positively to emotional states where joy and feelings of connection with those around us predominate. It’s as if our immune cells mobilize better when they are in the service of all life that is objectively worth living” (Anti-cancer: a new way of life, p 44).
Ironically, precisely when we really need supportive relationships and the understanding of family and friends – that is, when we are unwell – those people towards whom we instinctively turn may be struggling with their own issues related to our being ill. In addition, ‘protecting’ the other from their own concerns, rather than using the situation to come closer, the person who is sick and those around them may, in fact, move further apart. On the other hand, illness can open a door to inner growth, to great intimacy with both oneself and others.
We may try to avoid what we see as ‘negative’ experiences in life, yet it’s interesting to remember how a pearl is formed in an oyster. It’s not a product of the oyster being in a joyful, positive and creative mood, but of its being irritated (by a grain of sand)! As Osho points it: when we use the strategy of awareness, we grow through inner friction.
Our normal defences being down can have an upside: being more vulnerable may throw light on otherwise-hidden aspects of ourselves. For example, where we might have prided ourselves on being self-sufficient and capable, illness now forces us to acknowledge our limitations and the need to rely on others. Where we were always on the go, now we are experiencing what it is to not constantly do, but just to be. And so the value and richness of our softer, more feminine part can reveal itself.
Or consider how it is to be sick when in the past you have been something of a ‘control freak’; you needed to feel you had hold of the reins. Experiencing the space of not-knowing, of insecurity – confused about what treatment to choose; not convinced that it is working; not sure if your doctor really knows what she is doing; not knowing ‘if this is it, how long I’ve got,’ or who you are anymore; being ‘in the gap’ – offers you the opportunity to grow towards acceptance of your not being in charge of life, and to know what it is to truly let go.
Who hasn’t heard or read of a cancer survivor who says, “Actually, having cancer was a huge wake-up call for me … a Zen hit…” or “I never thought I’d say this, but looking back, cancer was a gift.”
To quote Dr Borysenko again: “Times of adversity and serious illness can also be times of great personal growth because the false self and its way of being in the world serve us so poorly in times of difficulty. With little energy to spare we realize the true difficulty of maintaining the artificial façade. [There is a] necessity to accept who we really are…” (Minding the Body, Mending the Mind).
In his book, Choices in Healing, Michael Lerner talks of the “creative role in illness is helping us find our true selves – in moving us forward on our life paths.” He also notes that “In a society that has forgotten how to meditate while healthy, many people are guided to deep contemplation of the meaning of life only through illness.”
Psychiatrist and author, Irvin Yalom, writes in his book, Existential Psychotherapy, of a letter that a senator wrote shortly after he had been told he had a very serious cancer: “A change came over me which I believe is irreversible. Questions of prestige, of political success, of financial status, became all at once unimportant…. In their stead has come a new appreciation of things I once took for granted – eating lunch with a friend, scratching Muffet’s ears and listening for his purrs, the company of my wife, reading a book in the quiet cone of my bed lamp at night…. For the first time I think I am actually savouring life.”
It’s that possibility of change – the rediscovered joy of the unremarkable, the reappraisal and re-prioritising of one’s values – that attracts me to working with people when they are ill and/or dying. If every other phase of living, every other challenge offers the chance to learn something about ourselves – to become a little more aware, more present; more familiar with ourselves as emptiness; to be less identified with our bodymind; to be more accepting, open, loving and grateful – why would sickness be an exception? And of course Osho has spoken heaps on the potential in passing consciously through dying.
The Sammasati Support Person Training is based on two premises, viz: An experiential understanding of what clients may be feeling is pivotal (hence the first module of the Training allows participants to face their own death), and, secondly: Meditation provides a natural preparation for a conscious entry into death (so participants will be introduced to a wide variety of Osho meditative methods).
In addition, the training offers some basic skills to identify, understand and address the kind of concerns that being ill and/or dying bring up. That ’addressing’ includes being present with totality, openness, calmness and centering; being observant and responsive; listening, talking, and being-silent-with the other. Participants learn self-care (vital in order to avoid burnout), along with the practicalities involved in setting up or being part of a support system around a client, friend or family member.
Offering support to someone who is sick may be pivotal in their being able to return to health. However, if no more can be done for them physically, already you two have done much valuable work together – work that is part of the conscious preparation for leaving life. The opportunity for learning, the chance to grow in awareness, acceptance, present-being, emptiness, disidentification, openness, lovingness and gratitude, continues. Why would it not? In fact, surely that opportunity becomes more significant, not less, as your client or friend moves towards the crescendo of their life. We enter the world crying. We don’t have to exit in the same way!
Many of us have been with a friend or a family member as they passed through ill-health and then, perhaps, death too. I have found the experience to be an enormous privilege, and a tremendous learning. A gift. Osho suggests we participate when someone is ‘disappearing into nothing, because great energy is released then.
“If you are in a silent space around him, you will go on a great trip. No psychedelics can take you there. The man is naturally releasing great energy; if you can absorb that energy, you will also kind of die with him. And you will see the ultimate – the source and the goal, the beginning and the end” (The Heart Sutra).
And, to give our meditative, celebrative support is a gift for the person dying too; in fact Osho regards it as ‘the greatest gift that is possible in existence….
“…There cannot be a better gift than this, because this gift can change [a person’s] whole future journey. If he dies peacefully and silently, he will be born on a higher plane” (The Transmission of the Lamp).
* Formerly known by the working title of ‘The Last Resort’, The Sammasati Project – in health, illness & dying – comprises, in the first instance, a training for those wanting to learn how to be there for a friend, family member of client. There are plans to create a Training Centre, so that many of us will have the expertise to offer an outreach service in our own towns. We would like then to expand the Training Centre to become a Wellness Centre. Here, both general public, as well as those who are sick and needing help in returning to health, along with those who are dying, will all be welcome. At this stage it might well be feasible to incorporate a hospice for anyone wanting to die consciously and/or with the support of a meditator.
Text by Maneesha