Psychological support at the last stage of life path of human. Илья Андреевич Басов
on us30. Communication is extremely important (we believe it is unnecessary to dwell on why it is important), and this is precisely a question of communication, its quality, its humanity, mutual enrichment in it and a mega level – if it takes place at least at times in an atmosphere of spirituality.
4. Spiritual. There is such a terrible expletive in terms of semantic content – "soulless". Denoting something like the following: devoid of humanity, kindness, robotic, insensitive, morally empty, cold, "dead". Probably, this is the most terrible death that happens with (selected by) person during lifetime. We do not know what happens to a person's soul when he becomes a "vegetable"; but we again assume (with greater certainty) that when spiritual death occurs (dissolution, or more correctly, betrayal of the noetic dimension), the soul experiences inhuman suffering. In addition to the person himself, we can talk about Bushichumai31, in the aspect of psychological support, it is a "struggle" for the spiritual: a quiet offer to "pray" at the end of life, a kind of reminder by oneself of the priority of the spiritual32.
Separately, we will focus on the issue of freedom to leave life. This freedom itself does not objectively belong entirely to man himself, in the sense that it is subject to the outside world. Actually, that's why there are two camps in the world "for" and "against", who are at war and give their arguments, half-truths. We will not express our intention to maintain this separation, including due to the fact that whatever position (pole) you do not occupy, you will still turn out to be an enemy and continue the war.
In general, we can say that, for example, children are not obliged to agree with their parent's choice to do euthanasia, but also not to recognize such a right to freedom, how is that too? I will cite here the dry residue of my living experience with which I had the happiness-misfortune to come into contact and pass. There is no desire to give examples with people, because it feels like it exposes them, and there is no need to ask for permission; so I will not disturb them. But my conscience will allow me to give a very, very revealing analogy with a hamster. Somehow the beloved and dear to the heart of the hostess pet hamster got sick. Of course, they treated him, took him to the vet, fed him pills, gave him injections… but it didn't help. And the poor hamster experienced such torments, such pains that it gnawed off two paws. Let's feel it please… how brutally much it hurt the animal, how unbearable the suffering was that he bit his paws… Why did the hostess so unwilling to let him go, did not dare to put him to sleep? Was it love and caring for an animal? Or is it attachment, a selfish desire to realize a hopelessly elusive opportunity to once again experience joy and tenderness with an amazingly recovered hamster?.. And if animal advocates intervened, what would be the torment: to leave the hamster alive or to put it to sleep and stop the suffering?
A holistic view of the problems of euthanasia implies an understanding of both poles: on the one hand, we can say that this is an escape from life – the fear of staying; however, if you look from the other pole, then those who remain are afraid to leave. The same picture is in any opposing views (any fragmentary perception), for example: is the one who leaves or those who do not let go selfish? Is it the one who wants to leave does not understand those who forbid him to do it, or are those who prevent leaving refuse to understand the one who resorts to euthanasia?
The main provisions of psychological support of the dying process
In this section we will look at the new psychological support of the dying process (PSDP), which will be useful, as it seems to us, to everyone. The starting position of the one who is next to you at the last stage is, so to speak, without show–offs; it is presence, an existential meeting, authenticity, sincerity, openness. There is no need to teach and broadcast how it would be right and wise to act, and if, for example, you are also scared, tell me about it (if I am sitting next to my mother at the bedside of a dying father, and it hurts me like my mother to admit that he has a few days left to live, then why will "well, nothing, nothing, don't cry mom"?). A close, dear person is passing away, you are experiencing sadness, so have the courage to live this sadness; there is a potential for development in suffering, this is not something that you need to get rid of as soon as possible, this is something that needs to be comprehended.
I remember an episode from working in a boarding house for the elderly and disabled, where people died not infrequently, including those with whom I managed to get close. And more often it happened that they tried to avoid leaving (which can also be understood); and in understanding this, you sit down by the bed and just take a person by the hand, he doesn't say anything, you don't say anything, it lasts less than five minutes, but it's outwardly simple and possibly meaningless for someone it is of great importance and depth.
As in pedagogy, the teacher himself is the tool, he himself is the methodology, so the inner world of a person will work with the accompaniment of dying, nothing special and artificial needs to be done. Do you want to say that "I am near" – say "I am near"; if you sincerely believe that a person goes to the best of worlds – say; I want to believe – say, "I want to believe"; if a person believes that he has lived an empty life and did not have time to do much, did not do it right, and you do not agree with this – "I understand that it seems to you that it did not make much sense, but I cannot agree with this, I would really like to tell you why I think so, you have got an important experience… your living life is sacred… there are higher, spiritual layers of being…". Carefully express yourself, carefully hear the one who is beside you, who is going on his last journey.
A very worthwhile experience of accompanying the dying process is presented in the Zen hospice33, where the approach of respect for the last page of the life path is implemented. Conditions and opportunities have been created in it for deep contact with oneself, one's deadly illness, one's experiences, certain final actions and events; without flight, hiding, a person meets with what is. One of the important rituals (I have not seen this in any other institutions of this type), when a person has left, they do not seek to remove the body as soon as possible and it is better so that no one sees it. On the contrary, he is slowly and respectfully carried out through the garden, where everyone, whether it's someone from the staff or other patients, can come up to say goodbye, say something, express themselves, let's say, in tears.
We believe that there are some invisible energy channels between people, some intangible communication. I remember an example from the book "Monsters and magic wands" (this is also about the fact that they do not always leave at an advanced age). An infant (an unwanted child) was dying there, the doctors were powerless, a psychologist (not an academic) came to this crumb and began to talk to him. He said that he understands that it seems to him that no one needs him, he said that he himself would be hurt, would not want to live … he said that there are many people in this world, including kind and good, that there are many beautiful things in it for which it is worth living, such as love, beauty, nature… And now it seemed to the psychologist that baby’s greenish face turned pink … the child went on the mend; he chose to live.
Question: what would happen if the same words were said by another person who would be indifferent to the future fate of the baby, who would internally disagree with these words?… Our semantic space works, our attitude, our openness, sincere interest, the ability to existential encounter. And the fact that everyone is an individual does not mean that we are not connected, does not mean that we cannot be one. Our delusion about the separation within is a consequence of the apparent physical separation, the separation of our physical bodies and human egoism. Understanding the alienation34 of oneself from the world as a matter of personal choice, outgrowing oneself as an ego is the key moment in unpacking the meanings of death.
We believe that the same example is suitable for illustrating the next issue of this chapter – overcoming death with meaning, going beyond it. We have already considered two of its key aspects in the book "New Horizons of Old Age": unity (the connection of everything with everything) and the answer to the question "Who am I?". And if the first aspect is eloquently reflected in the example with the baby (and most likely you, my reader, will be able to recall confirmations from your own life), then the second is a continuation of the question of the freedom of choice of perception and its purely applied
There is no charge in this. It's not about the fact that if there's no one around you, it's because you're a fool yourself.
Or "Boshetunmai" by V. Tsoi – don't sell.
We emphasize more than once that it is not so much words that work here, as the inner world, the content of the psychologist himself (or the person who chose to be around); and we are not talking about fanatical adherence to existential psychology, but about the resonance of its ideas (see in more detail: Basov I. A. Psychological support of people at a late age (for example programs of psychological support for the elderly and disabled living in a boarding house based on an existential approach): An educational and methodological manual. / I. A. Basov – St. Petersburg: NIC ART, 2017.).
What-really-matters-at-the-end-of-life-or-BJ-Miller. [video recording] // YouTube. Access mode: https://www.youtube.com/watch ?v=apbSsILLh28&t=30s
On alienation in more detail, see: Osin E.N., Leontiev D.A. Loss of meaning and alienation // Cultural and historical Psychology 2007. No. 4.