How Meaningful Life Therapy helps those that are dying

There was a time when I believed that taking in more information (reading more books, taking more continuing ed classes, conducting research, advocating) would give me the self knowledge needed to solve many of life’s problems. Now I’m not so sure. Either we already know enough or our ways of knowing are saturated or distorted or limited?

Although I hold no master or any level of degree, my primary study in life has been anthropology, the study of humans. Most of that time I’ve been drawn to the study of the human mind and behavior, what makes us tick.  I’ve come to the conclusion that I don’t understand much of anyone’s behavior let alone mine sometimes.

I’ve recently become a student of Morita and Naikan therapy approaches based in Japan. Constructive living. Accepting feelings as just that, feelings..they come and go.  How we behave during them is the key.  How does this play into my Death Doula and End Of Life practice?  A chapter in one of the books I’m currently reading, addressed the topic of the dying and terminally ill using Meaningful Life Therapy.

Meaningful Life Therapy was first introduced in Japan by a physician at Shibata Hospital named Jinro Itami. Along with the usual radiation, and chemotherapy treatments for cancer, a new way of working through death and dying is being implemented with amazing results.Dying patients, must consider what is best to do about feelings and what is best to do about behavior.Fear and anxiety about death are normal. Attempting to eliminate fears associated with a terminal diagnosis is both useless and unnecessary. The more one tries to escape  from the anxiety, the more one focuses on it and the stronger the feelings become.

The theory of meaningful life therapy holds that it is in control over our behavior that hope lies. In spite of our fears, in spite of our personality traits, we can still take responsibility for  what we do in the time remaining to us. The terminally ill are encouraged to behave in ways that turn focus toward achieving purpose, observing and participating in external reality and being useful to others. In the doing of constructive activities a kind of life purpose is rediscovered. The terminal patient moves from private suffering to recognition that others are suffering too. Acceptance of the reality of the illness and the ability to live fully and deeply within the realistic limits imposed by the illness..the time that is remaining.Their final days take on increased life meaning.

We all must accept the inevitabilty of dying. It is impossible to eliminate our basic dread of death while we live alongside it. Behind our fear of death is the strong desire to live life. We must try and be present fully yet realistically.  We can live each day doing well what needs to be done in spite of what will come to us all.

The values underlying this approach to terminal illness “treatment” are worth consideration. Illness brings some loss but also some wonderful possibilities of tremendous gain. For the terminally ill,  lives can be rich and constructive just because of the knowledge of approaching death. Insights become more possible and priorities reassessed.. One may be a patient, but need not be a victim defeated by the diagnosis.There is a strong desire in all of us to leave something behind to others.

A hospital in Japan encourages the terminal to visit other patients if possible and do other minor task around the hospital. The arts and crafts exhibitions give opportunities for leaving something behind in the gallery. There is a sense of communal suffering. It is important to not suffer and die alone. One of my reasons for getting involved with end of life work. These patients agree to live constuctivily regardless of their fears.

Although the meaningful life therapy differs from hospice, there is clear value in both. Meaningful life therapy offers the possiblity of consturctive living and hope for extended living in tragic and terminal circumstances. We continue to live as we are dying. Dying is a special kind of living.

Death exists, to be sure. We shall die, death is natural and necessary. We can prepare for death and we can acknowledge death, but for all our faith and understanding and preparations, death can be terrifying. And that’s all right. Our bodies and minds resist death, we have a built in drive to survive. Yet isn’t it more practical to embrace our feelings and struggles surrounding death? We can’t will these feelings to go away.

Life brings us many kinds of deaths. When friends marry or move, losing contact with them. Parents divorce, loved ones die along with our plans and dreams for the future.We grow old. Parts of ourselves die and are replaced by new ones. Hair and fingernails die, pets, plants…we are surrounded by death. By knowing death, we can remember to use our lives well, to use the time we have to fully live. The greater the fear, the more determination we can have to live life fully.

Something constructive you might do is write your eulogy. Grab a cup of tea and imagine in detail your life from now until you die. What might your final words be if given the chance to speak them? Are you living a grateful life constructively? Could you do this even if given a terminal diagnosis?

Peace and blessings.





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