Mary Talbot interviews Judith Lief, author of Making Friends with Death: A Buddhist Guide to Encountering Mortality.
What does it mean to “make friends” with death?
That title might be intimidating to some people, but it is really about seeing the immediacy of death as an aspect of everyday life, and appreciating the relationship between the “little d” deaths we experience all the time – like losing a pen, or a job or a relationship – and “big D” deaths – that of someone we love or our own death. If we can open to these lesser deaths, and begin to accept the ongoing reality of impermanence and transition, we start to let go of our preconceptions and expand our perspective. Then, when we encounter Big D death, we can meet it with less fear.
In your book you talk about people’s strategies of hope and fear about death – seeing it as the great loss or the great reward, the great oblivion or the great rest, among other things. But isn’t there room for hope when someone is dying?
I think there’s room for optimism, but hope is often simply the flipside of fear. We tend to cycle between hope and fear, one moment believing someone will recover and the next moment that she is about to die. It is a painful flip-flop. We look for clues as to whether to “hope for the best” or “expect the worst.” But from a Buddhist perspective, rather than trying to interpret the “real meaning” of any given sign, we try to develop the mental and emotional steadiness so that when hope goes up, our mind doesn’t have to go with it and when fear arises, our mind doesn’t sink down. We keep our balance. Not falling prey to false hopes is not about writing people off, or thinking there’s nothing to live for, but appreciating that it’s okay to be healthy, and it’s okay to sick. It’s okay to live and it’s okay to die. Whatever the situation, we can be with it as it is.
You devote part of your book to working with other dying people, but begin with chapters on exploring our own mortality. Why is it so important to start with developing an ongoing awareness of death ourselves?
Everybody wants to talk about death when it comes to somebody else, but we get fidgety when it gets close to home. Nonetheless, we need to go through the painful process of sticking with our own reactions, our own fears, hopes and beliefs, so that our notion of death is not just a conceptual idea in the distance. Relating to the reality of our own death breaks down the fixed idea of us as healthy and someone else as sick. Apart from how this helps us develop a more sane relationship with our own death, it’s very important in being with someone who’s dying to come from the perspective that we’re going to be dying, too. It’s part of being human.
Why is meditation practice so helpful in dealing with death and dying?
Meditation allows us to see our emotions as they come and go. We can watch our self-images begin to fall away and we’re left with this sort of barren ground that’s not so defined. That is the place where the mind can expand. As we become familiar with the unbounded quality of mind that arises in meditation, we will be able to recognize the possibility for it when we encounter death.
What about the actual meditation of contemplating death you describe in the book?
Even though it’s a conceptual exercise, it has the power to evoke our personal experiences and concepts of death. So we can use it to examine our relationship to both life and death. Afterwards you may begin to notice everyday experiences you hadn’t seen as relevant before, and learn from them. For instance, when some little thing happens, like losing a favorite possession or an allergy attack, you can observe how you react – does it throw you into a crisis, or can you stay with it? How we react to little losses and changes reflects how we will deal with more serious changes in the future. So each time we experience loss or change, we have an opportunity to evolve our relationship to impermanence, death, and change. Ultimately, the exercise helps us begin to appreciate that we’re going to die, and by staying with that experience, reawaken our appreciation for life.
How has working with dying people changed your practice or your view of death?
Apart from the quality of sadness that comes with death, the time I’ve spent with dying people and their families has been profoundly moving and an honor. It always brings me back to the essential quality of life. In the face of death, lots of petty preoccupations fall away. And death is not as frightening when you’re involved directly with it. It’s when it seems apart that it’s scary and upsetting. When you’re with a dying person, it’s so simple, so human, and you realize how much time we all spend obsessing about unimportant things.
Of course, there can be a lot of upsetting things going on and needless pain, as families and the dying person may be fending for different interests. But in cases like that, which are common, there’s another teaching involved: When a person is dying, we can become attached to trying to control the situation, but it’s often not manageable. Here I’ve learned a lot about letting go, about accepting things as they are.
Interview with Teresa Gottlieb, Santiago, Chile, publisher of Spanish translation of Making Friends with Death: A Buddhist Guide to Encountering Mortality
When did you start working in the field of death and dying, and who have you worked with most: health professionals or sick and dying people?
I began by teaching the Naropa University course on The Tibetan Book of the Dead in the summer of 1976, as described in the introduction to the book. Subsequently, I taught that class many times, at Naropa, in intensive Buddhist retreats, and in shorter weekend introductory formats in various Shambhala centers in North America and in Europe. These programs tended to draw many people from the general public, along with experienced Buddhist practitioners. In teaching this material, I noticed that some students were primarily interested in an exposition on the text and its implications for Buddhist practitioners; other students were looking for a way to understand and apply techniques and insights of the Buddhist tradition more broadly, in facing death and working with dying people. Many of my students were health professionals or hospice workers or people facing serious illness themselves, or the illness or death of someone close to them.
I saw that there was a need to present a more general introduction to these principles, which I called “A Contemplative Approach to Working with the Dying.” I designed these programs to be practical and nonsectarian. I also taught, with Dr. Ed. Podvoll, a course in the Naropa MA in Contemplative Psychology program, called “The Psychology of Birth and Death”. This course focused on the psychology of change and transition, drawing on both Eastern and Western models.
During this time I was introduced to Florence Wald, who had a strong interest in the spiritual care of the dying. We ended up teaching together at Naropa and at Karme Choling. Florence invited me to participate in a conference at Yale on the spiritual care of the dying. She introduced me to many leaders of the early hospice movement and the palliative care movement. She invited me to attend the International Palliative Care conference in Montreal to participate in a work group on this topic. At a later International Palliative Care Conference, I was invited by Balfour Mount to give a keynote address on Attentive Care.
Although I am primarily a Buddhist teacher and writer, I became quite active in this area, primarily working with caregivers. I am not a health professional or hospice worker; instead my involvement with the dying has primarily been as a Buddhist teacher. I have been present and hands-on with many dying Buddhist practitioners, who asked for my assistance. I have also been asked to advise and help students caring for relatives who were not Buddhist practitioners. I have conducted many funerals, and worked with people in that context. In 2001, I served as a pastoral counselor at Maitri Day Health Center in Yonkers New York, leading a group on loss and change and counseling formerly homeless people living with AIDS.
What is the relationship between meditation and this kind of work? What do they have in common?
In my years of teaching, I have heard many stories and learned a tremendous amount from my students. I have found that the practice of mindfulness-awareness and other meditation techniques described in the book are both practical and relevant to this line of work. It is easy to become either hardened or overwhelmed, and to burn out. Meditation is about learning how to be attentive, how to let the mind settle, how to regroup, how to lighten up. It is a tool for learning nonverbal ways of connecting to another person. I have noticed that people with a lot of experience working with the dying are very aware of the need to work with their own state of mind and heart in order to more effectively help others. That is also what meditation is about. Working with the sick and dying can be a powerful teacher, reminding us of our own mortality and leading us to reflect on how we lead our lives and what we truly value. Meditation practice is an effective method for dealing with such questions.
Do you work alone or as part of a team?
I generally teach alone, but I have also taught with others and participated in many conferences on the spiritual care of the dying, most recently with Sogyal Rinpoche, Frank Ostaseski, Rabbi Zalman Shachter, and Christine Longaker.
Have you met Kubler-Ross? What is the difference between her approach and yours?
I have not met Kubler-Ross, but I admire her pioneering work. There is still a great need to listen to what the dying have to say. What we have in common is the view that death needs to be out in the open, not hidden away; talked about, not covered up. Also, we share the sense that death is not simply a medical event but a multi-dimensioned experience—physical, spiritual, psychological, social, relational. In terms of contrast, my focus has been 1) the importance of examining ones own personal relationship with impermanence, and 2) the value of contemplative training.
What in your book is traditional Buddhist teaching and what have you added?
In my book, I have tried to take what I have learned through my study and practice of Buddhism and joined that with what I have learned from my students and colleagues in the West. I have focused on those aspects of the tradition that I feel are most relevant and helpful to those facing death personally or as caregivers. The Buddhist tradition place a great emphasis on the truth of impermanence, not just as a theory but as a deeply felt reality. I hope I have not added to or distorted that ground. Buddhist practitioners could benefit by working closely with these teachings. At the same time, I wanted to provide an accessible and practical guide that would be helpful to anyone, no matter their background or religious tradition.
Have people (students, patients) openly rejected your approach?
I had one student proclaim that death was not inevitable, but would soon be overcome technologically. I have had students proclaim that everyone should just trust in Jesus. Someone told me that God was punishing people by giving them AIDS. But for the most part, people seem to appreciate these tools and perspectives, and find that they can be applied in action.
How would you describe our culture’s conventional approach to death?
In brief, death is marginalized, medicalized, institutionalized, romanticized, sanitized, and trivialized. Death is considered to be a mistake to be overcome, outsmarted, conquered, and avoided at all costs. People are embarrassed and uncomfortable round the topic. Example: “I heard you wrote a book?” “Yes.” “What is it about?” “It is about making friends with death.” Awkward silence, end of conversation, change of topic.
Are there people who have had a direct influence on you in this field?
Definitely. In terms of the Buddhist teachings, I have been most directly influenced by Chögyam Trungpa, Rinpoche, my root teacher. Many other teachers have also been important to me, including Suzuki Roshi and Thrangu Rinpoche, among others. In terms of working with the dying, I have been most influenced by Florence Wald, Balfour Mount, Frank Ostaseski, Sogyal Rinpoche and Christine Longaker.
What was the course, “The Psychology of Birth and Death,” taught at Naropa University, about?
This course, part of the MA in Contemplative Psychology, was about dealing with extreme states of mind and with transitions of all sorts. It included core teachings about bardos and realms, an overview of Buddhist psychology, and many Western psychological teachings on the topic. It was co-taught with Dr. Ed Podvoll, author of The Seduction of Madness. I have worked with similar topics when I have taught courses on The Tibetan Book of the Dead, a text Trungpa Rinpoche described as a geography of the mind and its dynamic interplay of wisdom and confusion.
How would you define enlightenment?
I am not enlightened, so anything I would say would be complete speculation. I think most practitioners aspire to lead lives that are more sane, more creative and spontaneous, more daring, and more expressive of compassion. It is often said that this comes about by realizing the clarity and luminosity of our own mind, and recognizing the basic goodness of ourselves and others.
What would it mean for people to adopt in very practical terms the approach to death and dying that you teach?
I view my book as a reminder of simple wisdom and guidelines we tend to forget in the stress of the moment. For those people interested in contemplative practice, the best way do work with this material is by going through the exercises in the book. The mindfulness practice described in the book is a method of lessening mental distraction by learning to tame and focus the mind. It connects us with a sense of being fully present here and now, which teaches us to be more at ease with uncertainty. The contemplation of death practice is a powerful way to explore repeatedly and in depth our relationship to the reality of death, moment to moment. The practice of loving-kindness, or tonglen, softens our self-absorption and open our heart to others in a way that combines vulnerability and strength. Personally, I have found simple mindfulness practice one of the most helpful tools there is for being with the dying.
For people interested in working with the dying, or facing their own death, the best way to work with this material would be to use the book as a reminder that to work with others we must also be willing to work with ourselves. Reflecting on our own death reminds us of the common ground we share with the people with whom we are working. Remembering the three principles of awareness, kindness and openness can bring us back to basics, which can be easily lost in the complexities of dealing with illness and death. In caring for others, we can work with the six guidelines, which can help us avoid pitfalls to care giving that arise out of nervousness, speediness, stress, and distractedness. We can use these guidelines as a way of coming into balance in our work and avoiding burnout. So, in short, we can work with these guidelines to help us be more present and effective as we go about our work.