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A Soulful Guide to Caring for Yourself While You Care for the Dying and the Bereaved
By Alan D. Wolfelt
Center for Loss and Life TransitionCopyright © 2012 Alan D. Wolfelt
All rights reserved.
Understanding Your Own Companioning Philosophy and Style
My Companioning Philosophy
Before we continue on with our conversation about the whys and hows of self-companionship for caregivers to the dying and the bereaved, I'd like to take a step backward to reiterate my basic companioning philosophy. After all, if you're not clear about what I mean by companioning others, how can you understand and embrace companioning yourself, for heaven's sake? (If, on the other hand, you're already a companioning insider and advocate, you may want to skip ahead to the next section.)
I've always found it intriguing that the word "treat" comes from the Latin root word tractare, which means "to drag." If we combine that with "patient," we can really get in trouble. "Patient" means "passive long-term sufferer," so if we treat patients, we drag passive, long-term sufferers. Simply stated, that's not very empowering to me.
On the other hand, the word "companion," when broken down into its original Latin roots, means "messmate": com for "with" and pan for "bread." Someone you would share a meal with, a friend, an equal. I have taken liberties with the noun "companion" and made it into the verb "companioning" because it so well captures the type of counseling relationship I support and advocate. In fact, that is the very image of companioning — sitting at a table together, being present to one another, sharing, communing, abiding in the fellowship of hospitality.
Companioning the dying and the bereaved is therefore not about assessing, analyzing, fixing, or resolving another's grief. Instead, it is about being totally present to the mourner — even being a temporary guardian of her soul.
The companioning model is anchored in a "teach-me" perspective. It is about learning and observing. In fact, the meaning of "observance" comes to us from ritual. It means not only to "watch out for" but also "to keep and honor," "to bear witness." The caregiver's awareness of this need to learn is the essence of true companioning.
If your desire is to support a fellow human in grief, you must create a "safe place" for people to embrace their feelings of profound loss. This safe place is a cleaned-out, compassionate heart. It is the open heart that allows you to be truly present to another human being's intimate pain. (Yet it is this same open heart that puts you at risk for compassion fatigue.)
As a caregiver to the dying and the bereaved, I am a companion, not a "guide" — which assumes a knowledge of another's soul I cannot claim. To companion our fellow humans means to watch and learn. Our awareness of the need to learn (as opposed to our tendency to play the expert) is the essence of true companioning.
A central role of the companion to a mourner is related to the art of honoring stories. Honoring stories requires that we slow down, turn inward, and really listen as people acknowledge the reality of loss, embrace pain, review memories, and search for meaning.
The philosophy and practice of companioning also interfaces naturally with the art of hospitality. Hospitality is the essence of knowing how to live in society. Among the ancient Greeks, hospitality was a necessary element of day-to-day life. In a land where borders were permeable, it was important to get to know one's neighbors as potential friends. One way to do this was to share meals together. First, the guest and host would pour a libation to the gods. Then they would eat ("break bread") together. Then, after the guest was full, they would tell each other their stories, with the guest going first. Often, tears were shed because their stories were highly personal; battles, family, histories, and life tragedies were retold. After the evening together, the host and guest were potential allies. Still today, breaking bread and sharing personal stories are key elements of companioning people through death and grief.
Henri Nouwen once elegantly described hospitality as the "creation of a free space where the stranger can enter and become a friend instead of an enemy." He observed that hospitality is not about trying to change people, but instead about offering them space where change can take place. He astutely noted, "Hospitality is not a subtle invitation to adopt the lifestyle of the host, but the gift of a chance for the guest to find his own."
Also interesting to note is that the Oxford English Dictionary defines companion as "to accompany, to associate, to comfort, to be familiar with." This definition is actually illustrative of what it means to companion. In one sense, the notion is of comforting someone, which relates clearly to what the dying and the bereaved need and deserve. In another sense, the notion is of knowing someone, of being familiar with that person's experiences — and needs. This clearly relates to the process of becoming familiar (being open to being taught by another), which can take place through the "telling of the story."
"As a hospice grief counselor and intern supervisor, I sit with clients every day who have lost a loved one, as well as listen to the client stories the interns share with me. There is no way I can carry all the pain shared within the walls of my office. Besides my faith, my saving grace and what keeps me sane and returning to work each day is Dr. Wolfelt's companioning model of grief counseling. I remind myself daily that it is not my job to take away my client's pain. It is their journey, not mine. I need only be present to witness their pain, to companion them on their journey, to walk alongside them, not in their shoes. Oh, I take vacations and I travel and I spend as much time with my grandchildren as possible. All of those things refresh and energize me. But at the end of the day, and at the beginning, it is knowing that I am not responsible for taking away anyone's pain, knowing that I need only to be present as a companion, that is most helpful for me. I express gratitude every day for the privilege of doing this 'heart and soul' work. I am truly blessed."
— Laura Larson, LCSW
In sum, companioning is the art of bringing comfort and bearing witness to another by becoming familiar with her story (experiences and needs). To companion the grieving and the dying, therefore, is to break bread literally or figuratively, and to listen to the story of the other. Of course this may well involve tears and sorrow, and tends toward give-and-take: I tell you my story and you tell me yours. It is sharing in a deep and profound way.
My Personal Tenets of Companioning the Bereaved
I believe that every caregiver must work to develop his or her own theory or point of view about what helps the dying and the bereaved. Challenging yourself to explain what happens in your caregiving relationships with dying and grieving people and families will, in my experience, assist you in understanding and improving the results of the work you do to assist those you desire to companion.
Developing your own tenets encourages a coherence of ideas about the helping process and also generates new ideas about how to be helpful. Outlined below are 20 principles that undergird my work. My hope is that you will challenge yourself to write out your philosophy of effective caregiving to the dying and the bereaved.
For the Companion to the Dying and the Bereaved:
1. Bereavement, grief, and mourning are normal and necessary experiences; however, they are often traumatic and transformative.
2. The helping process is seen as a collaborative, "companioning" process among people. The traditional medical model of mental health care is inadequate and complicating. As a companion, I try to create conditions that engage people actively in the reconciliation needs of mourning.
3. True expertise in grief or death lies with (and only with) the unique person who is grieving or dying. Only he can be the expert. The companion is there to learn from the griever and to bear witness to and normalize his journey.
4. The foundation upon which helping the bereaved or the dying person takes place is in the context of an encouraging, hope-filled relationship between the counselor and the client. The widely acknowledged core conditions of helping (empathy, warmth and caring, genuineness, respect) are seen as essential ingredients in working with bereaved and dying people and families.
5. Traditional mental health diagnostic categories are seen as limitations on the helping process. The concept of "gardening" as opposed to "assessing" better describes efforts to understand the meaning of the journey in the dying or bereaved person's life. I strive to understand not only the potential complications of the journey, but also individual strengths and levels of wellness.
6. The counseling model is holistic in nature and views bereaved and dying people as physical, emotional, cognitive, social, and spiritual beings. Each person is unique and seeks not just to "be," but to become.
7. The underlying theoretical model is systems-oriented and sees the bereaved or dying person as being a node in a web of interdependent relationships with society and other people, groups, and institutions.
8. The focus of companioning the bereaved or dying person is balanced between the past, the present, and the future. Learning about past life experiences (particularly family of origin influences) and the nature of important relationships between the client and the important people in her life help me understand the meaning of the dying, grief, and mourning process for this unique person.
9. A dying or bereaved person's perception of her reality is her reality. A "here and now" understanding of that reality allows me to be with her where she is instead of trying to push her somewhere she is not. I will be a more effective helper if I remember to enter into a person's feelings without having a need to change her feelings.
10. A major helping goal is to provide a "safe place" for the dying or bereaved person to do the work of mourning, resulting in healing and growth. The dying or bereaved person does not have an illness I need to cure. I'm a caregiver, not a cure-giver!
11. People are viewed from a multicultural perspective. What is considered "normal" in one culture may be perceived as "abnormal" in another culture. On a shrinking planet, my caring and concern must be global in its perspective.
12. Spiritual and religious concerns and needs are seen as central to the reconciliation process. To be an effective counselor, I must be tuned in to helping people grow in depth and vitality in their spiritual and religious lives as they search for meaning and purpose in their continued living.
13. Men and women are seen in androgynous ways that encourage understanding beyond traditional sex -role stereotypes. Artful companions understand that bonded relationships exist outside the boundaries of traditional male-female partnerships and marriage.
14. The overall goal of helping the dying and the bereaved is reconciliation, not resolution. As a companion, I have a responsibility not to help the dying or bereaved person return to an "old normal," but instead to discover how death and dying change him in many different ways. Traditional mental health models that teach resolution as the helping goal are seen as self-limiting and potentially destructive to the dying or bereaved person.
15. Right-brain methods of healing and growth (intuitive, metaphoric) are seen as valuable and are integrated with left-brain methods (intentional, problem-solving approaches). This synergy encourages a more growth-filled approach to death and bereavement caregiving than do historical mental health models (primarily based on left-brain methods) of caregiving.
16. "Complicated" mourning is perceived as blocked growth. The "complicated mourner" probably simply needs help in understanding the central needs of mourning and how to embrace them in ways that help him heal. Most people are where they are in their grief journeys for one of two major reasons: 1) That is where they need to be at this point in their journey; or, 2) They need, yet lack, an understanding, safe place for mourning and a person who can help facilitate their work of mourning in more growth-producing, hope-filled ways.
17. Helping avenues must be adapted to the unique needs of the dying or bereaved person. Some people are responsive to group work, some to individual work, and some to family systems work. Many people are best served, in fact, by seeking support from lay companions who have walked before them in the grief journey.
18. There is a commitment to using educational, primary prevention efforts to impact societal change because we live in a "mourning-avoiding" culture. I have a responsibility to inform other people throughout the world of the need to create safe places for people to mourn in healthy ways.
19. There is a responsibility to create conditions for healing to take place in the bereaved person. The ultimate responsibility for eventual healing lies within — the person. I must remember to be responsible to dying and bereaved people, not responsible for them.
20. Excellent self-care is essential, for it provides the physical, spiritual, emotional, social, and cognitive renewal necessary for the caregiver to be an effective, ongoing companion in grief.
"I've learned lots about myself as a caregiver. When I first started, I let it consume me. As I've grown and learned from courses, the dying person, families, and other individuals, each situation is different. I've learned that I'm not in control when someone will die. They choose when they will go, or our higher power, depending on your belief system, will make that decision. I at first thought that every person should have someone with them so as not to be alone when they die. But I've seen many times when a person has waited until everyone or certain people have left in order to die the way they want to. I've also learned to look after myself by exercising, eating properly, and just getting away from all of it. Even if it's just to play a guitar or read a book, sometimes you need to remember you are alive and you are still here, needed by family and friends, even though you don't forget what is happening with your patients. Sometimes stepping back is hard to do, but I've been in situations where stepping back is the best thing. People need to grieve and deal with things in their own way."
— Lorie Parsons
So that is what I mean by companioning (versus taking care of) the dying and the bereaved. The remainder of this book explores how to take this companioning lens and turn it on yourself in ways that bring you energy, joy, love, and a sense of peace — not only in your work with the dying and the bereaved but in every moment you breathe. For companioning others is indeed rewarding and honorable work, but if you are not at the same time companioning yourself, your life will be out of balance and you will likely be both unhappy and ineffective in your work as well as your personal life.
Embracing the Importance of Companioning You
For caregivers to the dying and the bereaved, good self-companionship is critical for at least three major reasons.
First and most important, we owe it to ourselves and our families to lead joyful, whole lives. While companioning the dying and the bereaved is certainly rewarding, we cannot and should not expect our work to fulfill us completely.
Second, our work is draining — physically, emotionally, and spiritually. Assisting bereaved and dying people is a demanding interpersonal process that requires much energy and focus. Whenever we attempt to respond to the needs of those in grief, chances are slim that we can (or should) avoid the stress of emotional involvement. Each day we open ourselves to caring about the dying and the bereaved and their personal life journeys. And genuinely caring about people and their families touches the depths of our hearts and souls. We need relief from such draining work.
And third, we owe it to our clients themselves. My personal experience and observation suggest that good self-companionship is an essential foundation of caring about the dying and the bereaved. They are sensitive to our ability to "be with" them. Poor self-care results in distraction from the helping relationship, and dying and bereaved people often intuit when we are not physically, emotionally, and spiritually available to them.
Excerpted from Companioning You! by Alan D. Wolfelt. Copyright © 2012 Alan D. Wolfelt. Excerpted by permission of Center for Loss and Life Transition.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
ContentsIf Someone Gave You This Book,
Part One — Understanding Your Own Companioning Philosophy and Style,
My Companioning Philosophy,
My Personal Tenets of Companioning the Bereaved,
Embracing the Importance of Companioning You,
Exploring Your Personal Loss Background, Current Issues, and Motivations,
Zen and the Art of Erasing Worktapes,
Understanding Caregiver Burnout,
The Spillover Effects of Burnout,
Emotional Involvement and Stress,
The Overcaring Caregiver,
The Perfectionistic Caregiver,
Part Two — An Eight-Week Self-Companioning Makeover for Caregivers to the Dying and the Bereaved,
Before You Begin,
Week 1: Acknowledge the Reality of Any Imbalance and Surrender to It,
Week 2: Inventory Any Hurts and Unhappiness You Are Experiencing,
Week 3: Create a Vision for Moving Forward and Set Your Intention,
Week 4: Set Aside Time Each And Every Day From Now On To Touch Base With Your Spirit,
Week 5: Rebalance Your Daily Habits and Schedule,
Week 6: Carve Out More Sacred Downtime — Weekly, Monthly, Yearly,
Week 7: Seek Joy,
Week 8: Revise,
A Final Word,
A Self-Companionship Manifesto for Caregivers to the Dying and the Bereaved,