THE SPIRITUAL NEEDS OF THE DYING: A BUDDHIST PERSPECTIVE
In discussing the spiritual needs of the dying from the Buddhist perspective,
we firstly need to look at several key points, namely: 1- gaining an understanding
of the shortness and preciousness of life, 2- considering what can help ourselves
and others at the same time of death, 3- considering what goes on after death,
4- the Buddhist concept of mind.
Reflections On Death In order to gain an understanding of the shortness and
preciousness of life and how to make it meaningful, we need to reflect on the
fact that death is certain and that the time of death is uncertain. These points
may seem obvious, but we rarely stop to consider the truth of them. For example,
when we consider that death is certain we can reflect on several points: 1)
there is no possible way to escape death (nobody ever has), 2) life has a definite,
inflexible limit and each moment brings us closer to the end of this life, and
3) death comes in a moment and it's time is unexpected (and even while alive
we devote very little of our life to spiritual
practice). When reflecting on the fact that the time of death is uncertain,
we can analyse this further by recognising that: 1) the duration of our lifespan
is uncertain - young people can die before old people, the healthy before the
sick, etc. 2) there are many causes and circumstances that lead to death but
few that favour the sustenance of life - in fact even the things that sustain
life and make it comfortable can kill us e.g. food, our house, our car. 3) the
weakness and fragility of our body contributes to life's uncertainty - our body
can be easily destroyed by dis- ease or accident. Reflecting on these points
can help us to realise that life is short and precious and that there is no
time to lose. It is good to remind ourselves of these points each day. It can
be very helpful when first getting up each day to say to ourselves "today
may be the last day of my life, let me live it therefore by making it as meaningful
as possible, being of benefit to others, etc." It can also be very helpful
to consider how we would react if we were told, for example, that we only had
3 or 6 months to live, to ask ourselves questions like: am I ready to die? what
unfinished business do I have? what do I want to do or achieve in the time I
have left? will my priorities change? what can help me at the time of death?
or as somebody put it "Live each day as though it were your last and one
day you'll be right!" The other critical point is to consider what will
help us at the time of death. Reflection here reveals that: 1) worldly possessions
such as wealth, position or money can't help us 2) relatives and friends can
neither prevent death nor go with us 3) even our own precious body is of no
help to us and we have to leave it behind. So ultimately the only thing that
can help us is the state of our mind, the state of our mental or spiritual development.
Karma and the mind How is this so? The Buddhist belief is that every action
of body, speech and mind that we create lays down a subtle imprint in our mind
which has the potential to ripen as future happiness or suffering, de- pending
on whether the action was positive or negative. These imprints remain in the
mind until they ripen or until they are purified or cleansed by spiritual practices.
This process in known as the law of karma. The mind itself is formless, shapeless,
colourless, genderless, and has the ability to know or cognize all phenomena.
It's basic nature is luminous and knowing. The mind also has different levels
- gross, subtle, and very subtle. The very subtle mind is very clear and is
usually only experienced at the time of death or during advanced meditation
practices. The imprints of our actions (karmic imprints) are stored in the very
subtle mind.
Death, intermediate state and rebirth At the time of death, the body and mind
go through a process of dissolution, where the 25 psycho-physical constituents
that we are comprised of gradually absorb and lose their ability to function.
This process of dissolution is associated with external and internal signs.
This process continues even after the breathing ceases, for up to 3 days. During
this process the mind becomes more and more subtle and clear until it eventually
reaches the point of the 'clear light of death,' where it is said to be approximately
9 times more clear than in the normal waking state. At this point the mind separates
from the body, taking with it all of the subtle imprints from that life and
previous ones. This very subtle mind or consciousness and the very subtle wind
upon which it rides then arises into an intermediate state (bardo) being which
has a subtle (non-physical) body that can move through solid objects, travel
anywhere just by thinking of that place, and so on. The intermediate state being
stays in that state for up to 7 weeks, by which time a suitable place of rebirth
is usually found. This place of rebirth is determined by the force of karma,
whereby the intermediate state being dies and the consciousness is propelled
without control towards the place of rebirth. The consciousness enters the fertilized
egg at or near the moment of conception and the new life begins. Crucial in
this whole process is the state of mind at the time of death, because it is
this that determines the situation a person will be reborn into. If the mind
is calm and peaceful and imbued with positive thoughts at the time of death,
this will augur well for a happy rebirth. However, if the mind is in a state
of anger or has strong desire or is fearful etc, this will predispose to an
unhappy or lower type of rebirth. The mind that arises at the time of death
is usually the one that the person is most habituated to. People tend
to die in character, although this is not always so. So in the Buddhist tradition
it is emphasised strongly that the time to pre- pare for death is now, because
if we develop and gain control over our mind now and create many positive causes,
we will have a calm and controlled mind at the time of death and be free of
fear. In effect, our whole life is a preparation for death and it is said that
the mark of a spiritual practitioner is to have no regrets at the time of death.
As a friend of mine said recently on hearing about these concepts, "Perhaps
it's time I started swotting for the finals!"
The spiritual needs of the dying When considering the spiritual needs of the
dying, the basic principle is to do whatever you can do to help the person
die with a calm and peaceful mind, with spiritual/positive thoughts uppermost.
This is because it is believed that the state of mind at the time of death is
vitally important and plays an important role in determining what will happen
to the person after death. So whether we are a doctor or nurse relieving pain
and other distressing symptoms and reassuring the family, a counsellor helping
to resolve emotional issues, a minister of religion offering spiritual counsel,
or a volunteer who offers companionship and support for the dying person and
their loved ones, we are all contributing significantly towards obtaining this
calm and peaceful state of mind. Within this basic principle, there are several
ways we can categorise people which will help to determine the type of spiritual
support that they need, namely: Is the person conscious or unconscious? - if
conscious, you can do the practices with them or get them to do them, - if unconscious,
you have to do the practices for them. Does the per- son have specific religious
beliefs or not? - if religious, remind them of their religious practices, -
if not religious, encourage them to have positive thoughts, or remind them of
positive things they have done. For a person with a spiritual faith it is beneficial
to have spiritual objects around them e.g. an altar, a rosary, photos of their
spiritual
teacher, or to play spiritual music, or to burn incense, and so on - whatever
reminds them of their spiritual practice. It is good also to talk to them about
their spiritual practices, recite prayers with them and so forth. For an unconscious
person it is said to be good to recite prayers, mantras etc into their ear.
If a person does not have a spiritual faith, it is helpful to remind them of
positive things they have done in their life, or of positive qualities such
as love and compassion and kindness. It is important to avoid religious activities
that are inappropriate or
unwanted by the dying person. Someone standing at the end of the bed reciting
prayers may be an annoyance, and I have seen a case of an attempted deathbed
salvation which greatly angered the dying person. The basic aim is to avoid
any objects or people that generate strong attachment or anger in the mind of
the dying person. From the spiritual viewpoint it is desirable to avoid loud
shows of emotion in the presence of the dying person. We have to remind ourselves
that the dying process is of great spiritual importance and we don't want to
disturb the mind of the dying person, which is in an increasingly clear and
subtle state. We have to do whatever we can to allow the person to die in a
calm/happy/peaceful state of mind.
Meditations for sick and dying people For those who have advanced illness but
are still conscious there are a
number of simple meditation techniques or visualisations that can be very helpful.
For those who are anxious or fearful of dying, teaching them relaxation or guiding
them through a simple relaxation technique can be very beneficial. I will usually
leave them a relaxation tape that they can use any time of day or night, whenever
the need arises. When appropriate, touch, massage, reflexology and similar techniques
can also be very soothing and stress-relieving, especially as the person may
be somewhat starved of touch due to the fears and awkwardness of
people who visit them. A simple meditation technique that is very effective
is awareness of the breath. The per- son becomes aware of the movement of the
breath inwards and outwards at the level of the nostrils, breathing naturally
and easily, not forcing or exaggerating the breath. At the same time, any thoughts
that arise are let go of, constantly bringing the mind back to the breath. This
technique, although simple, can generate very calm states of mind and relieve
anxiety. When the awareness of breath is then combined with the recitation of
certain words or mantras or prayer it becomes very powerful. Just to say "Let...go...let...go..."
in time with the in and out breaths can be soothing and relaxing. A person with
a spiritual belief can use a prayer or mantra with the breath. For example,
one lady whom I was visiting who was an ex-Catholic nun chose the prayer "not
mine, Lord, but thy will be done". She shortened this by reciting "Not
my will" on the in-breath and "but yours" on the out-breath,
repeating this over and over again. The beauty of this technique is that 1)
it can be done for short periods of time and requires little concentration,
which is often reduced by the effects of disease and medication, 2) it helps
to calm the mind and reduce anxiety, 3) it utilizes and strengthens the person's
spiritual refuge, 4) it does not re- quire anything other than the breath. For
both a religious and a non-religious person a white light 'healing' meditation
can bring a lot of comfort and benefit. The person visualizes a brilliant
ball of white light above their head, with the light streaming down through
their bodies, re- moving sickness, pain, fear, anxiety and filling the body
with blissful healing light energy. Depending on the person's belief system,
they can see the light as being in the nature of Jesus, or Buddha or some other
spiritual figure, or they can just visualise it as a source of universal healing
energy. This meditation combines very well with the breath awareness technique
and is also good to have on tape to leave with the person, to be used whenever
needed, day or night. When a person is close to death they can
also be encouraged to let go into the light, into the heart of Jesus or Buddha
seated above their head, whatever is appropriate for that person. The use of
guided imagery or gentle music can also be soothing and relaxing and help the
person to have a calm and peaceful mind as they approach death. A person in
pain can also be guided through a pain meditation, a technique whereby the pain
is explored in detail, often leading to a reduction or eradication of the pain.
A very profound meditative technique is to actually use the illness or pain
as a way of developing compassion. For those who can use this technique the
results can be very great. The person is encouraged to think that "by me
experiencing this cancer/AIDS/pain etc, may all other beings in the world be
free of this, and may they have good health, happiness and long life,"
The person uses their sickness or pain as a way of opening their heart to others
who are in a similar situation. People who have used this technique have often
gone from being totally caught up in their own misery to a state of open-heartedness
and peace. An even more advanced technique is the meditation on "taking
and giving on the breath" as described in the Tibetan Buddhist scriptures.
In this meditation, one visualises taking on the suffering of all other living
beings (or this could be restricted to those with cancer or AIDS etc) in the
form of black smoke, which is taken in on the in- breath. Then on the out-breath
all of our health and happiness and all positive qualities are sent out to other
living beings in the form of white light, and we visualise them receiving everything
that they want. At our heart we visualise a black rock of selfishness, and as
the black smoke is inhaled we visualise it hitting the black rock and smashing
it completely, thus eradicating all trace of selfishness from our minds. This
meditation is a profound method for developing compassion quickly but there
will only be a minority of patients who will be able to use this method. The
usual way to progress in these meditations is to start with small problems such
as a headache or tiredness etc, then gradually train our minds to transform
bigger and bigger problems. The aim of all these methods is to help the dying
person die with a calm, happy and positive mind. Anything that we can do to
achieve this ill benefit the person, whether that be good nursing care and pain
relief, massage, the presence of a loving family, or whatever. It is said that
the best thing we can bring to a dying person is our own quiet and peaceful
mind. In this way we will help the dying person make the transition from this
life to the next as smooth and as meaningful as possible, recognising the vital
spiritual importance of this transition. My wish is that this short paper may
in some way be of benefit to those who read it and reflect on it, and hence
to the sick or suffering people that you serve. (Ven Pende Hawter)