I wrote this last year sitting in Adelaide airport just after I’d attended the Spiritual Care Australia conference. The next conference is in Tasmania and I’m sad that I’m missing it, but I have a full calendar to tend to. This post concerns the value of compassionate listening and how we can serve the dying – and the living – better by really being able to hear what people are saying.
After three days of extending my practice as a spiritual carer at the Spiritual Care Australia conference in Adelaide, my vocation really is all about LISTENING. Not listening in a one-dimensional or perfunctory way, but really listening. I like to call it active or compassionate listening.
Tenzin Chodron from Karuna Hospice gave a rousing speech yesterday. The energy in the room was palpable after she lead us through a gentle meditation, and continued to enthral delegates when she spoke about her Buddhist model of spiritual care and about some of her intimate experiences with the dying. I’ve been lucky enough to have studied under Chodron through Karuna as part of my ‘Spiritual Care with the Dying’ training, and compassionate listening is a skill I honed during my training. During both courses, the group did a listening exercise. We were partnered off where we had to actively listen for ten minutes to our partner without saying a word. No interruptions, no ‘me too’. We then swapped places so that the other person could speak.
It’s amazing how much you can really hear when you’re fully engaged with another person. Once the exercise was over, we discussed the listening activity and how it facilitated true listening, because when we think we’re listening to the person in front of us, are we ever fully engaged with that person and what they are saying? I would have to say that no, we’re not. But we can be.
From then on, whenever I have had to speak with someone as a fully engaged listener, I do a small meditation before I literally step or place myself into the conversation. This is also how I prepare when I’m about to speak with people who are sick or dying, which translates to me that there needs to be a quality of presence.
Clear the mind, set your intention and be almost hyper-attuned. I truly believe that by not listening properly we are failing the sick and dying.
It never ceases to surprise me what comes up for people who are dying. But as with speaking, there needs to be a greater respect for silence. Ofttimes, that is all the person can do until they know what they do want to speak about, or if they want to speak at all.
There are many ways in which we fail the dying. While palliative care nurses, spiritual carers, doctors and other practitioners recognise that suffering affects a person’s spirit, it is common for doctors who are not specialised in palliative care to treat people as just ‘a body in a bed.’ I’ve experienced this first hand, particular when I transitioned to an adult hospital. Everyone – patient or not – is more than the sum of their parts.
In Canberra, there is a much more holistic approach in palliative care medicine. Existential and spiritual suffering often manifests as physical pain, and I have heard stories that once this pain has been addressed, the need for morphine and other pain relief is lessened – particularly at night. This resonates with me because I’ve been to that place and I know that night time is both figuratively and literally the darkest of times where every layer of pain and suffering surfaces and is amplified tenfold. I’d be interested to know if you have had any ‘dark nights of the soul’.
As a spiritual carer, this interests me greatly. What’s more, it offers irrefutable proof that in order to fully understand other peoples pain and suffering, we must first recognise what kind of pain a person is in – emotionally, existentially, physically and spiritually. While pain relieving drugs are almost always necessary in palliative care, there’s evidence to suggest that the use of morphine and its ilk can mask spiritual pain. I have heard stories of many people who are dying who have refused pain relief so they could just BE. They wanted to experience dying in its infinite form and to be present. That takes momentous courage which the dying seem to have in spades.
The day before I flew to Adelaide for the conference, I was lucky enough to do a Death Midwifery workshop with Dr. Michael Barbato. During the workshop, Michael discussed these issues as well as quality of care, the evolution of spiritual care, and midwifeing the self, which is something I will address as another tool of my trade in another post. One of the last things Michael shared with us was a mantra for the living and the dying which I will leave you with as I sit at my desk on this early evening.
I forgive you.
I forgive me.
I love you.