How to Avoid “Comforting” the Bereaved with Uncomforting Sayings

Announcement on March 22nd–Just in: on this date my post called Why I Am a Stuffed Shirt about Jeans at a Funeral is the top trending one in the Los Angeles Jewish Journal. The link is: http://www.jewishjournal.com/expiredandinspired/item/why_i_am_a_stuffed_shirt_about_jeans_at_a_funeral

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This week’s guest post is by professional listener  Mr. Marc Wong:

Have you ever found yourself tongue-tied, in the middle of an awkward silence, with someone else who is going through an emotional situation? In moments like these, it’s easy to say something wrong and make people feel worse.

Fortunately, there’s a simple way to determine what to say. If you wouldn’t say it in a movie, then you shouldn’t say it to an upset friend.

Let me use one of my favorite movies to explain this. It’s called “A Few Good Men.” Jack Nicholson was nominated for an Oscar for playing the arrogant Colonel Jessop in the movie. In the climactic courtroom scene at the end, he yells the famous line at Lieutenant Kaffee (played by Tom Cruise), “You can’t handle the truth!” Lieutenant Kaffee doesn’t back down. He bears down on Jessop, and ultimately gets him to confess to the crime.

But imagine if Colonel Jessop had simply said, “Maybe it was all for the best.”

And Lieutenant Kaffee agreed, “You’re right. Let’s just move on.”

And the jury returned a not guilty verdict for the wrongfully accused and the movie ended.

This vastly unsatisfying alternative ending helps to explain why we shouldn’t say certain things when we’re comforting someone (and in the case of the movie, confronting someone.). Karen Kaplan, in her Feb 16, 2015 interview on the Homestead Hospice radio show, explored the subject of how to listen to people who are grieving. A well-meaning person might say one of the following to their friend:

“At least they died peacefully.”

“Feel better. They’re not suffering anymore.”

And of course, “Maybe it was for the best.”

Unfortunately, these comments don’t honor the pain, suffering, confusion, and efforts of the grieving. Imagine the characters saying these things in the middle of a movie. It would never work. The comments come from nowhere and just throw you off.

You see, the delicate emotions we feel in a movie are similar to the real emotions that life thrusts upon us. What works or doesn’t work in movies is similar to what happens in life. We can’t magically make things better or help the process along with a few simple comments.

The truth is, these comments are more about our haste to put an upbeat spin on things, to end the awkwardness, or even to vent our own fears and confusion. But it’s tough for our friends to deal with our stuff on top of their own turmoil.

What we can do is to share the pain and discomfort. We can share the journey. We can offer a hug or other concrete assistance. If we really don’t know what to say, we can just keep quiet and be an audience, which is often more useful than we realize. We can walk by our friend’s side and allow them to discover at their own pace, their own dignity and courage.

—- Marc Wong helps people unleash the power of listening. Web: www.8steplisten.com Twitter: @8Steplisten (Twitter is how I originally met Marc. We share an interest in enabling compassionate listening.) Have a romp through his site to see some engaging graphics and more on his movie imagery.

Marc Wong, author of "Thank You for Listening: Gain Influence & Improve Relationships, Better Listening in 8 Steps".

Marc Wong, author of “Thank You for Listening: Gain Influence & Improve Relationships, Better Listening in 8 Steps”.

My Fascination with Detractors

As I was setting up my display table for a book reading at Crane’s Mill Retirement Community, a woman hurried over to point to the subtitle of my book and say, “Why would anyone want to know what other people said at the end?” As I answered, I had the feeling that no answer would do, because after I did so, she retorted, disappointment marring her face, “That’s what I thought you would say,” and took off before I could refine the dialogue further. My answer had been, “As we hear what people say at such a poignant and intimate time, we can gain some insight as to what is important and meaningful to ourselves, and ponder how we want to spend the rest of our own lives.”

I wonder what she was after, and why she was so unsatisfied by my answer. Shall we speculate? (I say “we” because you can respond in the comments section after this post.) If she had lingered longer, perhaps our dialogue would have gone like this:

Me: What do you wish I had said?

Her: Well I’m not sure, but that is the expected answer.

Me: (Nodding in agreement) Uh-huh. A canned answer.

Her: (Flustered) Well no it’s you see it’s just like wanting to know what is going through a prisoner’s mind before they get executed.

Me: What would be scary about finding out?

Her: Oh I don’t know about scary. Some things are better left to the imagination.

Me: My curiosity does get the better of me sometimes.

Her: I suppose there’s no harm in that. But why about such a….such a (look of distaste on her face) subject.

Me: I guess finding out what people think towards the end makes you uneasy. Maybe for you it’s not like what people say who are about to start a new job or how are about to retire or who are trying something else that’s new for the first time.

Her: Yes, those are different.

Me: (I keep quiet, wondering if I’ve struck gold.)

Her: This is too close to home. (She pauses and I refrain from any potential diversions from what she needs to articulate.) It’s private. We shouldn’t know about what other people say. It’s like, I don’t know, it’s like catching someone in their pajamas. Like you first said, it’s a very personal time.

Me: When someone is dying, or looking back on their life as a whole, it can be very intimate. And when we hear about these conversations, we can feel very vulnerable and unprotected. Perhaps you have lost a loved one recently. I hope, though, that in the spirit that I reveal these encounters, that readers will feel accompanied and understood rather than intruded upon.

Her: (She nods and thanks me, leaving me wondering what even deeper layer would evolve if we were to speak at a future time. Had she lost someone recently? Had that person not talked with her towards the end and left her feeling alienated? Had she herself not broached important but scary subjects and regrets not having done so while she still had the chance? Perhaps she did not like my initial answer because it reminded her that she failed to make use of that intimate and irretrievable time.)

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You: (If that woman had engaged in a dialogue with you about her repugnance at finding out what other people say at the end, what other direction might it have gone?)

How to Help by Not Helping

Ever wonder what is inside a chaplain’s head as they ply their trade? How they counsel grievers and persons facing their own end? In a Homestead Hospice radio interview, I explain how I “help by not helping,”  a Zen-like concept which meets with some resistance from the host, a hospice professional. The interview is about 50 minutes long, which I realize is quite an investment of time compared to reading my written posts. So I most recommend it to: (1) aspiring chaplains (2) aspiring bereavement therapists, (3) anyone who wants to understand what might go through chaplains’ minds in the middle of interacting with you  and (4) anyone curious about what I sound like!

The Youtube link is as follows: https://www.youtube.com/watch?v=D8VsIb1rKcA

 

 

The Holding Cell

If you want to make  hospice workers wince, just tell them about an unresponsive patient with no discernible quality of life alive only on account of feeding tubes and the like. And not only that, some family members insist on this even with no anticipated increase and possibly even a decrease in the patient’s quality of life. As one of my clients who did not request this for his own dying loved one said, “There is a difference between living and between merely existing.” However, the common wisdom is that the motive for family members who do beg to differ and wish to “do everything possible” to maintain their loved one’s life, stems from their own fears of death. Or that by pulling the plug they are sinning or at the very least will feel guilty about giving up.

I think a different fear drives some families to keep their loved ones nominally alive. It is the fear of launching probably the hardest task one can undertake: grieving. Let us suppose for the moment that we are looking at a case where avoiding grief is the primary reason the ventilator and whatnot are plugging away with no end in sight. As awful as that is, it is a way to psychologically stall time. It sticks the patient in the twilight zone between living and being dead. He is being put on hold if I may say. But the family too is in suspended animation, no longer relating to their loved one in the usual understanding of “relating.” Yet, neither can they go full swing into grieving because the patient is not dead. No funeral can take place to do its job of acknowledging the end of a life and of lending public support to the family’s grief. No friends can affirm how sad it is and be there to offer condolences and ongoing offers of help. Whatever grieving does leak through “in advance” is lonely and unarticulated and unsupported.

Fear is so powerful that it can cause cruelty and unethical behavior. A supervisor’s fear of being outperformed by a subordinate can result in that subordinate’s dismissal. Fear of grieving can result in keeping someone alive even when there is a “negative” quality of life due to pain. Let us release them and us from our holding cells. Let us a face the repercussions on our own souls and our own reduced quality of life if we let fear rule over us. Muster enough strength to let our loved ones rest in peace.

The Very Odd Couple

One circumstance even more intimidating for me as a chaplain than offering pastoral care to other clergy is to do so for Holocaust survivors and their family members. I imagine it must be daunting for Jewish burial society volunteers as well. The “prime directive” for chaplains is to say little and listen a lot, but in the presence of Holocaust survivors I have to make sure I do not take refuge behind that rule rather than use it for spiritual healing.

“Spiritual healing?” Are we kidding ourselves? Surely it is presumptuous of us to think we can offer that to people who have faced absolute evil.  I feel absurd talking with them about such things as God and the sources of evil unless of course they are the ones who bring it up. Who am I, so unschooled in evil with my petty experiences of sorrow? I remember a phone call I had with a deceased Holocaust survivor’s sister who I will call Madge. The subject had surfaced somehow in reference to her brother about how Kabbalah (Jewish mysticism) accounts for the existence of evil. The gist of the explanation is that when elements of existence are out of balance, then what is normally wholesome gets distorted into evil. When Madge dismissed that as “rubbish,” I certainly was not going to argue the point or even explore it to gain a deeper understanding of why she felt that way. Just as trying to make sense of the Holocaust is absurd, it felt ludicrous to bring in any theology surrounding it. She was expressing anger, and my job was to accept and affirm her emotion, nothing else.

What also gives our efforts to comfort Holocaust survivors a false note is what their very existence implies: they suffered, and we have had it so easy (“Survivor guilt” is the term for this feeling, as when a child dies but the parent lives on in perfect health). We may have felt that God is present in our own privileged lives, which may feel like nothing more than a conceit on our part given God’s lack of presence with Madge let alone with her brother.

We cannot offer comfort in the midst of our own discomfort. We cannot give answers to unanswerable questions. But the paradox that can lead to spiritual healing is to acknowledge the lack of it in people like Madge. We help by not helping, as a Kabbalist might say. When we make no pretense of offering answers to their laments, when we do nothing more than hear their distress and not attempt to ease it, the very act of making ourselves vulnerable and entering their overburdened world is precisely what renders it more bearable to them.

–Reprinted from my guest post entitled “The Very Odd Couple.” This appeared in the blog “Expired and Inspired” (hosted by the Jewish burial society Kavod V’Nichum) in the online Los Angeles Jewish Journal December 17th, 2014

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Additional note: It is especially fitting to post an article at this time related to the Holocaust; January 27th, was the 70th anniversary of the liberation of the concentration camp Auschwitz.

A Spiritual Olympics

I think the majority of people engage in or at least admire physical challenges, such as how many pushups they can do or how many days they can fast. Even I, normally completely apathetic towards sports, am drawn to the prowess of the participants in the Olympics because of the beauty of their performance and the ardor that brought them to that pinnacle. In my last post, I spoke to a minority: aspiring chaplains and others who are drawn to other sorts of challenges: emotional and spiritual ones. We peculiar people admire the strength of listeners who can calmly yet attentively hear a sufferer speak at length about the nature of their suffering. We admire the dexterity of healthcare colleagues who can intuit when and how to put in a word or two to let such sufferers know that they are understood and not alone and not crazy to feel as they do.

In my last post, I described what it is like for aspiring chaplains to get their training in a program called Clinical Pastoral Education (called “CPE” for those in the know). In a very timely manner, author and doula Amy Wright Glenn recently sent me an excerpt from her book which describes her own experience as a CPE student and why she took up that challenge:

“We were an eclectic bunch. Presbyterians, Baptists, Catholics, evangelical Korean Protestants, and rabbis joined me for this journey. I was the only UU. Most of my fellow students were completing their CPE unit as a requirement for their future in church ministry. My goals were more personal. I wanted to experience the bookend of doula work. Knowing how powerful it had been to hold the hands of the birthing, I knew that much wisdom was to be gained from standing at the other end of life’s threshold. One learns much about life by witnessing death.

Every Wednesday night, we gathered for a five-hour training session… Together, our group considered the following questions: What does it mean to enter a patient’s room and be a compassionate witness to his or her pain? What does it mean to embody an open heart in the presence of great and unimaginable loss? What does it mean to die?

We spent many hours discussing the stages of grief and the process of dying, which provided ample material for sleepless nights’ reflections. For nine months, we tried to befriend, or at least acknowledge, the fear that is death’s companion. Author and teacher David Deida writes, ‘Almost everything you do, you do because you are afraid to die. And yet dying is exactly what you are doing, from the moment you are born.’ I had encountered this sentiment before during my time in India. According to the philosophy of Advaita Vedanta, all fear is rooted in abhinivesh, the fear of death. For example, we fear shame because it is a death to the ego. We fear aging because it is a death to our youth. In Buddhist teaching, all moments are born and die into each other. Leaving the womb is a death of one state of existence and a birth into another realm. Childhood dies into puberty and the elderly have experienced the death of their young adult years…

We were each assigned a direct supervisor. The stars aligned and I considered myself lucky to be assigned to the only Quaker in the mix. I received extensive feedback and superb supervision. Weekly reports detailing encounters with patients were read aloud and processed as a group… Sometimes the feedback challenged my ego’s pride. Sometimes the feedback opened the door of my heart, facilitating a deeper experience of compassion.

In many ways, our training was uncannily similar to group therapy. Until chaplains deal with their own grief, life traumas, and individual fears around death, they won’t be able to clearly respond to the difficulties that hospital patients encounter. The danger is that we will project our personal issues and dramas onto those we are called to serve. For example, we risk walking into a hospital room and seeing our own ailing grandmother or grandfather rather than the person actually lying in the bed. Processing our own fears is a tonic that enables us to be of service. We can hold an open heart for others only to the extent that we are able to do so for ourselves.” [Excerpt from Amy’s book, Birth, Breath, and Death: Meditations on Motherhood, Chaplaincy, and Life as a Doula (reissued 2014), available on Amazon. A regular contributor to PhillyVoice, she also has a stunning website that includes insights about birthing and chaplaincy, and even an advice column. www.birthbreathanddeath.com ]

Amy Wright Glenn

Amy Wright Glenn

We hereby invite all aspiring chaplains to go for the gold!

Dear CPE Students: Leave Your Assumptions at the Door

Someone about to start her first Clinical Pastoral Education unit (CPE; a chaplain training program) emailed me some provocative questions recently: “What would you have said to your younger self when she started this course to train healthcare chaplains? What would it have benefited her to know sooner? What needs to be in place in one’s life besides a close walk with God, and a burning desire to help the hurting and the sick in their darkest hour with the ministry of presence?”

Another such student wrote me, “What can I expect from CPE? I feel insecure about not having much ministry experience and feel like my theological and biblical background is not as strong or deep as most people’s.”

I told both of them that CPE is full of paradoxes. First, what is more important than the factual content of their questions is what the questions reveal about the students themselves. Thus when we think we are communicating one thing, we are implying another, often deeper one. CPE instructors (called “supervisors”) might zero in for instance on the first student’s concern about what “needs to be in place in one’s life.” She might in turn ask the student, “How important is it for you to feel that things are ‘in place’ for you?” As for the second student, she might focus on his word “insecure” and ask why not having much experience would make him feel that way. (It is not a given that all people who do not have much ministerial experience would feel the same. They might be excited by starting fresh for instance.)

Now such reactions from a supervisor would not imply a judgment of any kind, but rather a way to get their students to become more self-aware. This is the name of the game of the educational philosophy of CPE. The more we are aware of our assumptions and feelings, the better we can serve our patients. The less we are self-aware, the bigger the blinders are that will interfere with our understanding what a patient needs. Suppose for example you grew up with a lot of criticism from one of your parents. So when a patient says something about you such as how your hat looks, you might erroneously interpret that as a criticism, even when it is not. Such a misunderstanding would naturally throw off the conversation and perhaps make you act as you did when your parent criticized you, such as by emotionally hiding. (Dear readers who are CPE supervisors: Yes, I am aware that my examples are not random and are letting you in on my own issues.)

Another paradox I am fond of pointing out is a Zen-like adage: chaplains help patients the most when they are not helping. Part of what this means is that one of the prime rules of good chaplain care is NOT to give advice or try to “fix” a patient’s problem. Nope, not even when they ask for it! Often the very best thing to do, which requires restraint and no wish to say something clever, is to listen as undistractedly as possible until the patient is clearly finished venting. Chaplains are not there to give answers, but to pose questions. We are there to give the patient a safe sacred and nonjudgmental space for them to talk about whatever they need to talk about, from golf to God, from divas to death. The emptier we are of our own agendas, including assumptions about what we ourselves think patients should be discussing, the more they will convey what they most need for us to hear. And if I may tuck in one last paradox, our goal is to do all that exhausting intense listening and be what supervisors refer to as a “non-anxious presence.” To paraphrase that CPE mantra, you have to be connected with your patients yet maintain a distance from them at the same time.

If you are a CPE beginner, do not stress about how much knowledge you have or “what to say” in a given instance to a patient. Rather, you will get “points” for how much you are willing to be vulnerable, thus narrowing the divide between the well and the sick.