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Psychological Insights
By Sri Dhira Chaitanya

Sri Dhira Chaitanya practised for years as a child pshychiatrist in New York and later he studied and taught Sanskrit and Vedanta. He is therefore able to address both the psychological and spiritual issues involved in death and dying with a special insight. He has kindly permitted Ganga Prem Hospice to reproduce parts of his book on Bereavement and Final Samskar in Hindu Tradition.

Sri Dhira Chaitanya

Attitudes toward Death and Dying

Emotional Reactions
A person deals with one’s own impending death in a variety of ways. The kinds of responses that one has are influenced by one’s culture, beliefs, personal values and personality. Upon becoming aware of one’s impending death, it is natural and quite common to become anxious. Every individual cherishes his life. So, the real likelihood of its coming to an end is an unwelcome thought that one does not want to entertain. Often a person’s initial reaction is one of denial. The anxiety in such a person’s mind does not permit him to accept the reality and inevitability of his own impending death. There is an apprehension in talking about death or dying, expressing one’s feelings, planning for the well being of one’s family and taking care of one’s personal affairs. Initially the person talks and behaves as if everything is as usual. Denial is not a conscious, deliberate decision not to talk. It is an unconscious protective mechanism of the mind to cope with a highly anxiety provoking situation at a particular time. The period of denial may be transient or remain with the person until his death. Denial may at times lead to a feeling of invulnerability, even leading to reckless behavior.

Sometimes a person does not deny the inevitable but avoids dealing with it directly. This is done in order to protect himself or others from the unpleasant and difficult emotions associated with death. Such a person may preoccupy himself with mundane matters that are unconnected with the fact of his death and thereby spare himself and others the agony of painful feelings.

Fear is another common emotion experienced by a dying person. The possibility of impending death evokes a fear of the unknown. No one knows for sure, what would happen after one’s death. The continuity of one’s very existence is put to question. And, no one is ready to die to find the answer. Additionally, there is the fear of loss of one’s family and friends. These are the people who have been the source of support in one’s life and have helped one deal with many difficult situations in the past. However in this particular instance, when death is at one’s doorstep, they are as helpless as oneself in doing anything to prevent it. Often, there is illness associated with dying which gives rise to fear of pain and suffering. Quite often, one has ideas of the process of death that are dramatic and frightening, because one may have witnessed a traumatic death, or have been influenced by what one sees in the media.

An individual who is aware of his impending death often experiences sadness. He worries, his sleep gets disturbed and he may lose his appetite. He is unable to enjoy anything pleasant. He may cry and appear morose. Any experience of loss or the possibility of loss evokes sadness in an individual, even when it is the loss of oneself due to death. To begin with, there is the concern that one would cease to exist and thus be lost forever. Even if one were to continue, it certainly would not be in the current shape and form, as one has to necessarily give up one’s body at the time of its death. Whatever complaints one may have about one’s body, it is the only one that one has had and is familiar with. The thought of losing it forever naturally evokes sadness. Besides experiencing sadness, one may go through a process of mourning for the impending loss of oneself, much the same as one goes through bereavement process after any loss. Sometimes, one can become melancholic and withdrawn to the extent that one isolates oneself from one’s own loved ones emotionally and/or physically.

Individuals may also experience guilt in varying degrees. One starts recalling a lifetime of acts of omission and commission. In retrospect, one realizes that there is much that one would like to have done, and maybe much more that one could have avoided doing. This is not only in regards to one’s personal pursuits, but also in one’s relationships with others. Knowingly or unknowingly, one invariably becomes instrumental in causing hurt in another individual, either by one’s action or by one’s words. No individual wants to maliciously and deliberately hurt someone he is related to. Thus, one experiences guilt and given a chance would like to make amends for all the hurt that one may have caused. Guilt can cause considerable fear in an individual who has grown up to believe in the prospect being punished after death for eternity, with varieties of horrible experiences for not conforming to prescribed codes and dogmas.

Anger is another common emotion experienced by the individual facing immanent death. Anger arises when one perceives oneself as a victim of an act of injustice that one has been subject to. It also arises when one feels helpless in a given situation. Even though death is an inevitable fact of life, it is also true that one does not willingly accept its occurrence. Moreover, a significant part of ones time is devoted to maintaining one’s life and extending it as long as one possibly can. Even if one acknowledges that death is bound to occur one day, the timing of it’s arrival always seems premature. One wonders, “Why am I the chosen one at this time, I am not ready to die, to leave my loved ones” and so on. These thoughts make one feel helpless and give rise to anger. Sometimes, sadness is also expressed as anger. Thus we find that a person facing impending death becomes irritable, easily angered and may even unreasonably blame others such as family, friends, doctors and sometimes even God for what is happening to him or her.

In conclusion, some individuals are more accepting of the inevitability of death than others. Even though they feel a certain degree of sadness for various reasons such as loss of their loved ones, they have essentially reconciled to the fact that they are dying. They can articulate their thoughts, feelings, and fears, seek and gain comfort and support from those around them. Their beliefs and traditions provide them with strength, reassurance and comfort.

For one who ascribes to Hindu traditions, one’s beliefs and the basis of the Hindu religious and cultural traditions become a source of strength, reassurance and comfort. Hindu tradition emphasizes that the occurrence of birth underscores the certainty of death at some point.

Know that for the individual who is born, death is inevitable indeed.’

The Vedic tradition places a certain value on dispassion, vair¡gya, in regards to the world and the people one encounters in one’s life. This attitude is based on an understanding of the ephemeral nature of the whole universe. Vair¡gya is not viewed as a fatalistic attitude that impairs one from functioning in the world and relating to it appropriately. It is an appreciation of the truth of it’s nature, which in fact makes one relate to the world as it is. It permits one to make the most of one’s association with the world and the people one spends one’s life with.

The following verse highlights the attitude of vair¡gya based on the transient nature of the world:

‘One’s possessions are left behind at home and relatives (left behind) on the cremation grounds. The body is consumed in the funeral pyre; only punya ( merit) and papa (sin)accompany (one).’

Vedic tradition also enquires into the ontological status of the world of experiences, and the relationship between oneself, the universe and it’s cause. An understanding of these matters helps an individual deal with not only himself and others, but also with life and death.

Bertrand Russell eloquently described death as a concluding episode of one’s life and an integral part of existence. Using a metaphor he said that an individual’s existence should be like a river –small at first, narrowly contained within its banks, and rushing passionately past boulders and over waterfalls. Gradually, as the river grows wider the banks recede, the water flows more quietly and in the end, without any visible break, it becomes merged in the sea and painlessly loses its individual form.

Reactions in Family Members
The ones who are close to a dying person also have to deal with a variety of emotions of their own. They too get anxious about what is happening around them. They may be engaged in the medical and nursing care of the person that can be tiring and overwhelming, not to mention confusing. They feel a profound sense of helplessness because of their inability to prevent what is happening to their loved one. They feel that they are letting him down.

Their profound sense of helplessness sometimes evokes anger at others for not doing more than what they are doing. This anger can get directed towards other caretakers, such as doctors, nurses or other family members. It can result in petty misunderstandings between family members that in turn, evoke guilt as one feels embarrassed at one’s own reactions. Anger can also get directed towards God, who is seen as being responsible for causing them pain and not responding to their prayers to spare the one they love.

They experience fear of losing someone they love and perhaps rely upon. The possibility of never again being able to see and live with a loved one evokes both fear and sadness. They begin to imagine what it would be like to live without their loved one. Ruminating over the future is the way a person’s mind tries to prepare itself for an undesirable experience that it anticipates and fears.

Families also feel pressured to maintain an appearance of normalcy in front of their dying member. They are afraid that if they reveal how upset they are, the person may not be capable of handling their distress. Thus, they avoid showing their feelings, which does not really serve any purpose, as people who are close to each other can usually sense each other’s unexpressed feelings. Thus, their attempt at protecting one another in this manner does not usually work.

There is no ideal way which would be universally applicable, in order to cope with the difficult situation of impending death in a family. Every individual affected by it, deals with it in the way he knows best and in the manner in which his mind is comfortable and capable. However, one can say that, in general, it is advisable to be as communicative as one possibly can. When a person does not know what another thinks, they start guessing what might be in the other’s mind. Very often what they imagine is not only inaccurate, but also exaggerated and worse than it is. Additionally, it is generally easier to deal with something that one knows than with the unknown. This is so even with respect to dealing with another person’s thoughts and feelings. Protecting one another in a difficult situation that involves death, only compounds one’s sense of helplessness as one is unable to change what is happening and also unable to prevent other’s agony. Sharing one’s thoughts, feelings, concerns, fears and so on, is comforting, even though it may be difficult to do. People discover a tremendous amount of strength from each other during difficult times. When faced alone, a difficult situation looks impossible to overcome. However, a seemingly impossible situation becomes manageable when endured along with people one trusts.

Conclusion
In relating to individuals facing death, it is best to remain one’s natural self. It is not necessary to act as if nothing is happening. Doing so, only gives a message that one does not wish to deal with the difficult issue at hand. It prevents the dying individuals from expressing their wishes, and sharing their feelings. It places an added burden on them to deal with death alone and leaves them feeling unsupported. By encouraging them to express themselves to the extent they are comfortable, one can provide them with a lot of support. One needs to make them feel that they have someone, who though incapable of changing the inevitable, is willing to be by their side until the very final moment of their lives.

In order to help a loved one who is facing immanent death, it may become necessary to put aside for a while one’s own sadness and feeling of deprivation at one’s impending loss.

During such a difficult time one’s religious traditions and beliefs become a source of strength and comfort, for both the dying and those closely connected to him or her.

Coping with the Final Moments
There are occasions of impending death, when both the dying person and those connected to him know that death is inevitable and immanent. There is a fear of the unknown. There is fear of annihilation. And, there is fear of losing all one is familiar with. One may be overcome by a sense of helplessness. There is also sorrow at separation from all that one is attached to and one loves. Very often, those that one is connected to are also very sad. Both the dying person and his family try to protect each other, and may pretend that everything is as usual and fine. It is very difficult to suggest how one should behave during these times. People tend to do what is most comfortable to them and what may be appropriate in case of one family may not be so in case of another. When one is able to, it is very helpful to share one’s thoughts and feelings with those one is close to. To talk to a loved one about one’s feelings and fears is very comforting to both. Even if what one speaks causes sadness, when sorrow is shared with a person one loves, it is easier to experience.

It is a rare gift to be able to express oneself and share one’s thoughts and feelings with one’s loved one who is dying. This is so because, very often death comes unexpectedly, or a dying person may be incapacitated or in pain. It is a very common experience for people, to feel that they did not say what they would have liked to say to a person who is no more, and they live with this sense of incompleteness for the rest of their lives. It is in such difficult times that one’s Religious convictions and spirituality become a source of great solace.

Generally, Hindus recite verses from the Vedas such as Purusasuktam, the Bhagavad Gita, Ramayana, and Visnusahasranamam. It is believed that what one’s mind is attuned to at the time of death, determines one’s gati, direction of onward journey after death and also one’s next birth. Therefore, the family and friends of a dying person provide an environment of spirituality and comfort during the final moments of his or her life.

In Bhagavad Gita, (Chapter 8, Verse 5) Lord Krishna assures Arjuna of the following:

The one who gives up his body remembering me (the Lord) during his final moments reaches me. Of this there is no doubt.

Unless a person has lived prayerful life it is difficult for him to remember the Lord during his final moments. People everywhere have their own beliefs about what happens to an individual after death. But there is no one, who has seen a dead person come back to report to those alive about their experience, in a manner that can be verified by them with certainty. There are however, innumerable cases investigated, reports documented and available that have been verified indirectly to a greater or lesser degree about after death experiences and reincarnation. Most people do accept that there is an entity in addition to the physical body that survives death and remains in some form. However, not knowing for certain makes the unknown future frightening.

There is also a sadness that comes from the knowledge that one will never again see those that one loves and has spent one’s life with. Moreover, no one can take with them any of the possessions that they have accumulated in their lifetime and have to leave behind all that they are attached to. There can also be a fear of possible pain and suffering associated with the process of death itself.

Process of Bereavement
The human mind being complex as it is goes through intense and at times overwhelming reactions during the process of bereavement. Bereavement is defined as a reaction to the loss of a loved one and separation from those upon whom one depends on for comfort, sustenance and sanctuary. Even in the animal kingdom, it is striking to see the reaction of an animal to the death of one of the members of their family or group. For a moment or longer an animal will remain around the dead member as though perplexed at it’s lack of responsiveness, and the animal’s behavior implies an uncertainty or confusion about what has happened. Sooner or later it appears to leave reluctantly and continue with its life.

A human being reacts to any loss with grief and mourning. Grief is a normal and a common human experience, as no one is spared from the experience of loss, or from events that cause sorrow in one’s life. Mourning is a process by which a person experiences and resolves his grief. Most people go through a series of normal feelings and reactions during their bereavement.

Upon losing a loved one, a person often goes through an initial state of shock and feelings of numbness or bewilderment. The person is in despair and may react with disbelief over what has happened, by thinking or acting as if the deceased person is still present. Thus the initial response may be one of denial or anger. His distress and suffering is evident in crying, sadness, loss of appetite and difficulty sleeping. It is not uncommon for the bereaved to feel guilty and blame themselves, for acts of commission or omission towards the deceased person. There is a yearning for their presence, an inner restlessness and a preoccupation over the events leading to the person’s death, or of the final days or the past. A human mind deals with any trauma, whether minor or major, by ruminating over it. This helps a person get over the traumatic experience. Death of a loved one is a major traumatic event in one’s life, and it takes a length of time to adequately get over the trauma.

The circumstances of death also affect the bereavement process. When death is sudden and unexpected, the initial reaction of disbelief is intense. It is difficult for one’s mind to accept the fact that a person, who was very much alive and part of one’s world, is gone in an instant. The experience of losing a loved one abruptly makes the uncertainty of one’s own life very evident, and one becomes very much aware of the ephemeral nature of one’s own existence. The void felt within oneself is very deep.

When a person dies after a protracted bout of illness or after a prolonged age, and his death is anticipated, the bereaved usually have some time to adjust to their inevitable, impending loss. In such an instance, one’s mind starts imagining what it would be like to lose the person, how one would manage their affairs and the feelings one might have. However, one is unable to truly anticipate what will happen until one actually lives through the experience.

After numbness and disbelief, comes the feeling of anger. Anger is born out of helplessness. The bereaved may express anger by blaming others for the death of their loved one. They often blame the medical personnel who had been involved in the care of the deceased. They may also blame other family members for not doing enough. Some of this blame is due to their own guilt, at perhaps not doing all that they could have done, to save their loved one. It is not uncommon to see misunderstandings between family members of the deceased. As each one attempts to deal with their own conflicting emotions, they take out their frustrations on one another. Sometimes people blame God, who is seen as having the ultimate responsibility for everything that happens in the universe. The average person understands God as someone who gives what one desires when prayed to. And, their experience tells them otherwise, because their God did not grant their wish for their loved one to survive. Thus, even a normally devout person may get angry and reject religious traditions that could have been of comfort to him.

Eventually the grieving process results in an acceptance of the reality, that is, the irretrievable loss of a loved one. One gets resigned to the reality of the loss, as one has no choice in the matter. Over a period of time the intensity of sadness lessens. One is able to participate in and enjoy pleasant things in life. The void that is created by the absence of a loved one is filled by his memories.

Sooner or later most people come to terms with their loss and are able to accept the reality that their loved one is gone from their life physically. Reconciliation of this loss permits them to continue with their own lives. To this end, they may identify with some of the characteristics of the person they have lost, thereby gaining strength and security from the person they cherished. The acuteness of pain and sorrow diminishes and the person feels like returning to their normal life.

It is important and necessary for an individual to go through the process of bereavement. Only by doing so, one is able to overcome the trauma of one’s loss, such that it allows one to continue with one’s life in an emotionally healthy manner. Sometimes, one has difficulty acknowledging one’s feelings because they are unpleasant and difficult to bear. In such instances one denies to oneself the reality of the emotions one experiences. Thus there is an inner contradiction in what one feels and what one allows oneself to experience. When one allows oneself to experience emotions that occur naturally in one’s mind, and is able to acknowledge them to oneself, one is more in touch with one’s nature and is able to grow from the experience, however unpleasant, difficult or painful it may be.

In current times, when families are scattered all over the world and separated by distance from their loved ones, one may have to deal with the death of a family member at a distance. Because of Hindu traditions, the initial ceremonies involving disposal of the body of the deceased, are performed immediately after death and one is not able to participate in it by one’s physical presence. In these instances an individual may wonder whether it is necessary to travel the long distance since “everything is over”. However, one need not minimize the importance of participating and being physically present for the remainder of the ceremonies during the grieving period. Being with one’s bereaved family, sharing the common loss, expressing one’s feelings to those who can relate to it intimately because of their relationship, are all important to the process of bereavement. Therefore, unless there is an unavoidable reason, it is advisable to physically participate in the ceremonies and be with one’s family during the prescribed period of mourning.

A loved one who is deceased is always remembered. There is no such thing as “completely getting over” or “resolving” the death of a loved one. There are recurring occasions in one’s life when the absence of a loved one is felt, with varying degrees of sadness. However, one is able to experience this feeling without much discomfort and continue to live happily.

There are rare occasions when a person is unable to overcome the grieving process. His sadness becomes more instead of less. He is incapacitated and unable to take care of himself fulfill his responsibilities. The passage of time does not seem to help and he becomes unable to function. When this happens, such a person may need extra help of a professional to help him overcome the intense reaction to the trauma.

From Bereavement and Final Samskara in Hindu Tradition
By Sri Dhira Chaitanya
Published by Purna Vidya Trust, Tiruvannamalai

 
 
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