“You can’t die cured, but you can die healed. Healing is about a sense of wholeness as a person, and that wholeness includes understanding our mortality, our place in the world—death is not a betrayal of life, but a part of it.”
-Dan Frimmer, MD
Life is a terminal condition. We all die. Western culture, and especially in the United States, does not acknowledge and even denies death as a natural part of living. The fact that death is inherent to life is infrequently discussed and explored. Conversations about death and encounters with people confronting mortality due to cancer and any cause can be uncomfortable for many individuals.
When we die and how we die are major factors in how people relate to mortality. We can think life should be a certain way.
We are often attached to living. We are often afraid of dying. Only through exploring and embracing death can we liberate ourselves through releasing our fears to embody life more fully. This truth applies to people affected by cancer and every other human being.
“The conquest of the fear of death is the recovery of life’s joy. One can experience an unconditional affirmation of life only when one has accepted death, not as contrary to life but as an aspect of life. Life in its becoming is always shedding death, and on the point of death. The conquest of fear yields the courage of life.”
-Joseph Campbell, Power of Myth
Inquiring into Death and Dying
Human nature often involves fearing the unknown. By inquiring into your views about death, some of what feels unknown about death will become known to you. As a result, your fears around death will diminish. This will allow more of your energy to be used for healing and living instead of being consumed in fear and anxiety around illness and dying.
The following questions may help you explore and recognize your attitudes and beliefs, including fears, about death and dying. This list combines questions developed by Rachel Naomi Remen, MD, Joan Halifax, and O. Carl Simonton, MD.
- What is your personal definition of death?
- What do you wonder about regarding death?
- What are your beliefs about death?
- What beliefs about death are unhealthy? How would you language healthier beliefs?
- What is the best-case scenario for your death, including how, when, and with who you will die?
- What is the worst-case scenario for your death?
- What do you have to release so that the best-case scenario can happen?
- What do you need to create in your life now to support the type of death you want?
- If you could ask someone who died some questions, what would those questions be?
- If you could ask the person only one question, what would it be?
- What do you imagine the person would answer?
You may wish to also explore the questions about spiritual engagement in Spirituality Assessments.
Embracing death allows people to engage life more fully. Inquiring into living invites insights about who we are, who we are not, who we are with, where we are going, our meaning and purpose, joy, and much more.
- What activities and experiences in your daily life are joyful and provide deep fulfillment?
- Are you engaging joyful, fulfilling activities and experiences now? Where does your sense of what to do come from?
- What gives your life meaning?
- What is your clearest sense of the meaning of your life at this time?
- What is your purpose? Where does that sense of purpose come from?
- Does your life reflect these beliefs and values? How can you embody your meaning and purpose more?
- What people do you have meaningful connections with?
- What characteristics give those connections their meaning?
- How do you engage those connections and relationships?
- What are your most significant accomplishments and successes?
- What are you most proud of about yourself and life?
- What are your greatest hopes and dreams? What encourages your hopes and dreams?
- Where do you live your life fully? Where do you hold back?
- What can you do to come more fully into yourself and life?
- What will be your legacy?
Relationship Between Life and Death
O. Carl Simonton, MD taught that work on death is the same as work on life. Living more fully prepares people for a rich death. Deeper engagement with life includes focusing on three areas to become more comfortable with life and change.
1. Learn to grieve more effectively the smaller losses in life so that you can become more comfortable with change in general.
2. Resolve old issues in life where healing needs to occur. Ask yourself the question: “If I were to die tonight, who do I need to communicate with to feel more okay before I die?”
3. Live life today with joy and pleasure. Many people who have a lot of difficulty around thinking about their deaths are people who have been holding back on really enjoying their lives.
New York Zen Center for Contemplative Care provides compassionate, spiritual care to those facing life challenges, illness, and end of life. Their teachings and work helps create a supportive, nurturing environment to consciously face life and death. Listen to Dharma Talks on their website about many topics, including meditation, forgiveness, delusions, wisdom, anger, love, grasping, greed, ignorance, light, respect, dignity, Zen hospice care, compassion, attunement, and other subjects.
Being with Dying
This content was adapted through Joan Halifax’s Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death.
- Not Knowing—cultivate a beginner’s mind and develop a tolerance for the inconceivable
- Being Witness—be in touch with and open to both the joy and suffering without preconceived notions
- Healing—create a whole cloth of myriad experiences and feelings toward cultivating a healing heart
Four Developmental Tasks
- Provide a situation and context for life review—encourage talk about the life that has been lived
- Encourage the expression of feelings—about the past, what is valued in the present, and what is anticipated in the future
- Assess a deep review of life
- Search for or create meaning—as a general life orientation, personal significance, causality, a coping mechanism, and outcome
Four Relational Tasks
- Provide a context for forgiveness to be expressed—self, others, and forgiveness of the dying person by other family members
- Provide context and support for reconciliation
- Encourage expression of lovingkindness—the dying person benefits from being kind when they are able to be kind as we all benefit from being kind
- Express gratitude
Two Transformative Tasks
- Acceptance—bearing witness to life as it is
- Realization and transcendence—to move from small mind to large mind that is the place of miracles
Support for People Dying of Cancer
People dying of cancer may experience nourishing support from integrative healing modalities providing assistance at the end of life into their transition. The specific modalities that are most supportive vary for each individual. Some of these therapies may include aromatherapy, acupuncture, massage, music, meditation, imagery, prayer, ritual, and others. Integrative cancer care modalities are listed throughout this website. Pain and stress relief, physical comfort, mental and emotional support, spiritual presence and expansion, and further integration toward wholeness are some of the benefits people dying of cancer have experienced from integrative therapies. A spoken word and music recording called Graceful Passages by Gary Malkin is designed to help open the conversation around mortality for anyone, especially those facing it directly. The CD supports a gentle, sacred atmosphere of compassion, awareness, and appreciation within a spiritual sanctuary for patients, family members, and health care providers.
Five Stages of Death
In On Death and Dying, Elisabeth Kubler-Ross, MD describes five stages of death that she observed in the psychology of many people with cancer. The stages may last for different periods of time and will replace each other or may exist simultaneously. All of these stages are necessary for the dying to work through their anguishes and anxieties to arrive at the fifth stage of acceptance and peace. Hope is described as the quality that persists throughout every stage. You may wish to reflect on your emotional terrain and coping in your own journey.
1. Denial and Isolation
- Initial coping strategy to deal with an uncomfortable and painful situation
- Temporary defense
- Denial functions as a buffer after unexpected shocking news
- Allows people to collect themselves and mobilize other less radical defenses over time
- Expressions of anger, rage, envy, and resentment
- “Why me?”
- Anger can be displaced and projected in many directions
- Frustrations due to a lack of control
- Offering to give something in return for a reward
- Sometimes includes a prize for good behavior with a self-imposed deadline and an implicit promise of not asking for more
- People with cancer most often wish for an extension of life followed by time without pain and physical discomfort
- Bargaining is an attempt to postpone
- Rooted in a sense of great loss that has already occurred or is forthcoming
- Depression is associated with hopelessness
- Loss can be associated with the physical, sensual, psychological, family, employment, finances, luxuries, and many other areas
- Contemplating the end with a certain degree of quiet expectation
- Almost void of feeling
- Circle of interest diminishes
- Deepened connection with silence and stillness
- Potentially desiring less time with other people
The Hospice Foundation of America defines hospice as a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. Hospice care neither prolongs life nor hastens death. Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management. The goal of hospice care is to improve the quality of a patient’s last days by offering comfort and dignity. Many organizations and websites offer information about hospice, hospice services, and support at end of life for people with cancer and their loved ones.
- Growth House
- Hospice Net
- Hospice Foundation of America
- Metta Institute
- National Hospice and Palliative Care Organization
- Zen Hospice Project
Poems about Life and Death
Is life the incurable disease?
The infant is born howling
and we laugh,
the dead man smiles
and we cry,
resisting the passage,
always resisting the passage,
that turns life
Blake sange alleluias
on his deathbed.
My own grandmother,
hardly a poet at all,
as we’d never seen her smile
Perhaps the dress of flesh
is no more than a familiar garment
that grows looser as one diets
and perhaps we discard it
or give it to the poor in spirit,
who have not learned yet
what a blessing it is
to go naked?
Do not stand at my grave and weep,
I am not there, I do not sleep.
I am a thousand winds that blow.
I am a diamond glint on snow.
I am the sunlight on ripened grain.
I am the gentle autumn rain.
When you wake in the morning hush,
I am the swift, uplifting rush
Of quiet birds in circling flight.
I am the soft starlight at night.
Do not stand at my grave and weep.
I am not there I do not sleep.
Do not stand at my grave and cry.
I am not there, I did not die.
-Mary F. Frye
How Dying Works (excerpt)
It takes different
degrees of time
for each soul
When it is ready
to drop from one
dimension into another,
the sac of matter
dies away from it
to release it.
throwing forth or
flowing or sliding
away, the sac returns
to earth, air, fire
and water, and when
Earth herself dies
will go back
Meanwhile, the individual
soul being born into
a new form becomes
a kind of supernova
star, gigantic, beautiful,
hot with Godfire
as it explodes into
Other souls who vibrate
to this light’s same music
through love or likeness
become opened, and by
magnetic resonance and
of the dying person’s
soulfire pierce the souls
…When we explode
into the Infinite
we are more than ourselves
already. We are many.
We are all who have become
a part of us in love
and all who will become.
Heaven is not a there.
Heaven is not somewhere,
Heaven is now, here,
-Alla Renee Bozarth
For More Information
- Being with Dying: Cultivating Compassion and Fearlessness in the Presence of Death by Joan Halifax
- Healing into Life and Death by Stephen Levine
- On Death and Dying by Elizabeth Kubler-Ross, MD
- On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss by Elizabeth Kubler-Ross, MD
- The Tibetan Book of Living and Dying by Sogyal Rinpoche