Winter Passage: Acknowledging Spirituality in Life's Final Journey

By Seaburn, David | Psychotherapy Networker, September/October 2007 | Go to article overview

Winter Passage: Acknowledging Spirituality in Life's Final Journey


Seaburn, David, Psychotherapy Networker


Winter Passage Acknowledging spirituality in life's final journey

by David Seaburn

When I first met Andrea, she was a walking, talking spitfire of a woman, who could swear like a truck driver and weep like a baby. A vibrant 52, she laughed, patted my knee, and talked freely about her husband, with whom she fought continuously, and her daughter, whom she considered her mainstay.

She'd been referred to me by a friend after receiving a diagnosis of advanced ovarian cancer. Yet during our first session, she reviewed her medical history as if she were bragging about what she'd bought on a recent shopping spree. It all started, she said in a sprightly tone of voice, with a hysterectomy, then a bladder repair, a cyst on her ovaries, and finally a diagnosis of ovarian cancer. Surgery gave way to chemotherapy, which gave way to radiation, which led to embarrassing hair loss, which she turned into a fashion opportunity: "Hey, how do you like this scarf?" she said, almost coquettishly.

As we started working together, it seemed unlikely that she'd die, if only because she didn't have time for it. She kept working, kept moving, kept running as fast as she could, staying one step ahead of what was chasing her. She met daily with friends to shop, to lunch, to talk. She injected herself into the life of anyone who came near her, turning the black-and-white of daily existence into vivid color through her hold on living itself. She wanted to "make everything better" before she died; and she meant that quite literally, although she'd laugh and say, "I know, I know" each time I said, "Really?"

Once in a while, though, it caught up to her: "I'm crying every day and I don't know why. How long do I really have? I just want to focus on feeling good and getting through this." Then, as we stood to say our good-byes and hug each other at the end of our twelfth session, she looked at me, her eyes filled with tears, and she asked, "Dave, would you do my funeral?"

Andrea's husband, Tom, was desperate to support her, but could seldom see beyond his own worries and insecurities. When the pressure was too much, he disappeared into his work, only to be chided by Andrea for not being more available to her. He wept about her dying when she was talking exuberantly about living; and when she was depressed, he tried to stay with her, admitting that he didn't know what to do. Nevertheless, he loved her. He was affectionate and wanted to care for her, and went at it with workmanlike commitment, if limited emotional stamina.

Most of us live in a wonderful, protective dreamworld, in which others die as we project our lives into the future with careless confidence, rarely considering the reality of our own mortality. Nothing calls this insouciance into question more than a terminal illness, with its relentless progress toward death. As a psychotherapist focused on health care for almost 20 years, I, like my colleagues in the field, often worked with people confronting their imminent death. But there was a difference between the other clinicians and me: in addition to being a psychologist and family therapist, I'm an ordained minister. Although at the time I saw Andrea and Tom, I hadn't served a church in more than 25 years, I carried with me a deep respect for the spiritual dimension of life and its role in the way people struggle to make existence meaningful. In fact, my theological roots in the Judeo-Christian tradition and organized religion had often made it easier to talk with patients who turned to church, synagogue, or scripture for solace. Many patients leave their religious beliefs and practices at the door when they see a therapist, assuming that it isn't something that a mental health professional would discuss. This is similar to patients who visit their physicians, but are hesitant to discuss emotional aspects of their lives because they believe the doctor is interested only in their bodies.

When patients find out about my background, or when I show interest in their religious traditions and spiritual practices, they breathe a sigh of relief because they can bring this part of their identity with them into the therapy office. …

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