The Unconscious at Work: Individual and Organizational Stress in the Human Services

By Anton Obholzer; Vega Zagier Roberts | Go to book overview

Chapter 10

Working with dying people

On being good enough

Peter Speck

For most people, death only enters their lives a few times. When it does, it can precipitate a significant crisis as the individual seeks to adjust to the impact of the event. But what of the professional who in some settings faces death almost every week, if not every day? How does he or she cope with this abnormal exposure and still manage to maintain a professional role? Death is universal and will come to us all and to those we care about at some time. We know this intellectually, but we may well try to defend ourselves from the emotional impact of personal death or the death of someone close to us.


STRESSES OF WORKING WITH DYING PEOPLE

Working intimately with people who are dying can put one in touch with personal loss; unresolved feelings and anxieties may be evoked by the death of someone we are caring for professionally. Attempting to suppress or deny the personal impact can be stressful, leading to fatigue, sickness, compensatory over-activity, loss of effectiveness at work and at home, together with other symptoms often referred to as ‘burn-out’. Attitudes expressed by others may add to this excessive stress. People may make comments such as, ‘Oh, those poor people! All that suffering! You must have to be quite hard, or very dedicated.’ Or, ‘I don’t know how you do it, day after day. Isn’t it all terribly depressing? I mean …they die.’ Comments such as these make explicit an expectation people have that the carer must be an extraordinary person offering perfect care. If the carer knows that the reality can often be somewhat different, then the expectation can be a source of stress. If the carer shares the expectation, then this gives rise to stress, too. One often shared expectation is that good care will make for a ‘good’ death. But death is not just sad or beautiful; it can be ugly, painful and frightening.

One of the unconscious attractions to working with dying people is that the work-role can serve to maintain the fantasy that death happens only to other people. When this defence breaks down because the work situation is too close to one’s own, there is a real risk that one may be disabled from working—or staying in role—at all, as the following vignette illustrates:

-94-

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