Facing Death and Finding Hope – A Guide to the Emotional and Spiritual Care of the Dying
Review of Presentation by Christine Longaker at the NHO National Conference, Dallas, November, 1998 by Paul Barry

Christine Longaker, author of Facing Death and Finding Hope – A Guide to the Emotional and Spiritual Care of the Dying, was among the presenters at the NHO Symposium in Dallas, Texas in November 1998. Ms Longaker, a long time associate of Sogyal Rinpoche, author of The Tibetan Book of Living and Dying, addressed the personal qualities that caregivers can nurture to bring to bedside of the dying, and the pertinence of the approach to living and dying emerging from Tibetan Buddhist thought.

Ms. Longaker opened the session with an exercise. She asked the audience to just sit quietly and use the image of a shaken glass of muddy water to represent the usual state of our mind, and to imagine that by sitting quietly we could allow another aspect of mind, the natural clarity, to emerge. She asked that the audience members allow their minds to slowly settle as they sat. She ended this opening exercise with the suggestion that such an exercise allows a person to be a little more present. She emphasized the importance of the quality of presence that caregivers bring to their care for the dying.

Ms. Longaker then spoke of her entry into a spiritual path. She spoke of the death of her husband 20 years ago of leukemia, and how her experience with his death moved her toward an involvement with issues related to end of life care. She spoke of her involvement in a hospice program and her introduction to Sogyal Rinpoche. She spoke of her continuing involvement with Sogyal Rinpoche, Rigpa (Sogyal Rinpoche’s network of training centers), and the Spiritual Care Education and Training Program, with which her role is Senior Educator. She spoke of putting into daily practice, from whatever spiritual tradition a person follows, an experience that supports the ability to more present in moments of caring for the dying.

Ms Longaker noted that such daily practices also provide care for the caregiver, creating an atmosphere of greater peace, and the ability to be more present. Ms. Longaker spoke of personal qualities that contribute to care for the dying. She noted genuineness, confidence, and presence.

In speaking about the quality of presence Ms. Longaker addressed the dual aspect of presence. She spoke of our habitual way of being outwardly active but internally absent. The counter to this was seek internally, and act from, a deep clear awareness. She said that recognizing the dying person as a whole person could enhance this quality of deep presence. She spoke of seeing the dying person as more than their suffering. She used the image of mist on a mirror to describe a patient’s suffering. The suffering was not always there. The patient has an essence: intact, whole, infinite, unborn and undying. She described a point of view of death as a transition, that essence continues past this transition. She addressed the possibility that care can support the infinite part of person.

Ms Longaker spoke of genuineness from the point of view of recognizing that there was not a huge difference between the caregiver and dying person. She suggested that caregivers be open to letting the dying give their final lessons about life. She used the image of little boats on a river moving toward a waterfall – the moment of death. She pointed out that no one could be certain when that moment would come for him or her.

In referring to some ideas described in her book she spoke of four tasks of living and dying. She described death as a very active time of life. The four tasks she described as follows: 1. understanding and transforming suffering; 2. making a connection, healing relationships, and letting go; 3. preparing spiritually for death; and, 4. finding meaning in life. She indicated that her main focus in her talk was to address the third task of spiritually preparing for death and assisting patients in this task. She noted that in attending to this task with clients causes us to look at our own death, our fears and how we are applying ourselves to the task of living and dying.

Points that Ms. Longaker made were often accompanied by a story. She said that she used stories rather than overheads. Several points that she made included quotations and references to Sogyal Rinpohe’s work. One quotation, she indicated, summed up a great deal related to the spiritual practices around dying. She repeated several times: “At the moment of death, there are two things that count: Whatever we have done in our lives, and what state of mind we are in at that moment.”

Ms Longaker made a significant point using details from descriptions of Near Death Experiences (NDE’s). She described the sense of expansion, peace and joy that characterize many NDE’s. She described death as a great opportunity to recognize a connection to the infinite. She also offered the view that a risk is present that a person in death may “smuggle across” all theirs fears, attachments, troubles, etc., which would make any after death experience a continuation of the suffering present in the current life. She spoke of a choice that individuals make in how they live and the many moments of transition in everyday life in which a person may choose to continue the habits and suffering that they experience in life. She noted the many “little deaths” that we experience on the way to the “big death” at the end of life. She spoke of the moment of first waking in the morning, a time of presence and awareness, before all the thoughts and concerns about life flood back in to awareness. She spoke of the possibility that we habitually regenerate our suffering every day, and that there is a choice to do other than that through a daily spiritual practice.

Ms. Longaker shared a number of stories to elaborate her points. She told a story about what she described as the practice of the continuous prayer of the heart. A woman took on the practice in her dying of saying, “Lord Jesus Christ have mercy on me.” Ms. Longaker described how this practice transformed the woman’s process of dying. She spoke of the importance of facilitating a dying client’s effort to find meaning in their life and death. She spoke of the importance of compassion. She told a story of concentration camp victims in W.W.II dedicating their suffering to the wish for the well being of others whom they loved.

Ms. Longaker referred to Elizabeth Kubler-Ross’s work. She spoke of a Reverend Mwalimu Imara and the notion of three commitments for a meaningful life. She described the three commitments as follows: To become aware of and accept ourselves; to invest ourselves in authentic dialogue with others; and, to decide on a positive direction of growth.

Ms. Longaker offered a description of a spiritual practice from the Tibetan Buddhist tradition. She spoke of Phowa: Traditional Phowa and Essential Phowa. She described the process of Essential Phowa. The reader may be interested to know that this practice as described is on pages 124-5 of Ms. Longaker’s book. Ms. Longaker’s book is available through Main Street Books, Doubleday, New York (on the web at http://www.bdd.com). The Spiritual Care Education and Training Program is at 499 Powell Street, Suite 200, San Francisco, CA, 94102-95103 (also on the web at http://www.atlantech.net/rigpa/spcarenw.htm). There is a link to an interview with Ms. Longaker on the Rigpa site at http://www.microtec.net/~inerson/ondeath/longaker.html.