Death - Mindful living mindful dying
by Thanissaro Bhikkhu
Itís only when people are faced with a fatal illness that they start thinking about meditation, and often by that point itís too late to get fully prepared. Itís best to be prepared, to practise the skills youíll need when medicine can no longer help you and youíre on your own. The only way to develop these skills is to train the mind. If you are caring for someone with a fatal disease, meditation offers you one of the best ways to restore your own spiritual and emotional batteries so that you can keep going even when things are tough. What Iíd like to present today is a userís manual for meditation to help you when the chips are down.
Books that deal with meditation in treating illness tend to focus on only two aspectsórelaxation and visualisation. Meditation as a complete process involves three steps. The first is mindful relaxation, making the mind comfortable in the present, for only then can it settle down and stay there. The important word is Ďmindfulí. You have to be fully aware of what youíre doing, of whether or not the mind is staying with its object, and of whether or not itís drifting off to sleep. If you simply relax and drift off, thatís not meditation, and thereís nothing you can build on it. If, however, you can remain fully aware as the mind settles comfortably into the present, it develops into the next step.
As the mind settles into the present, it gains strength. You feel as if all the scattered fragments of your attentionóworrying, remembering, anticipating, whateverógather together and the mind takes on a sense of wholeness and unification. This gives the mind a sense of power. As you let this sense of wholeness develop, you find that it becomes more and more solid in all your activities, regardless of whether youíre formally meditating or not, and this is what leads to the third step.
As you become single-minded in protecting this sense of wholeness, you become more sensitive and gain insight into the things that can knock it off balance. On the first level, you notice that if you do anything hurtful to yourself or others, it is destroyed. Then you notice how the simple occurrence in the mind of things as greed, lust, anger, delusion and fear can also knock it off balance. You begin to discern ways to reduce the power that these things have over the mind, until you reach a level of awareness that is untouched by these things, or by anything at all.
Itís these higher stages in meditation that can be the most beneficial. If you practise meditation simply as a form of relaxation, thatís okay for dealing with the element of your disease that comes from stress, but thereís a lot more going on in illness, physically and mentally, than simply stress, and if you limit yourself to relaxation or visualisation, youíre not getting the full benefits that meditation has to offer.
Now we come to the topic of what meditation can do for you as you face serious illness and death. On the one hand, there are books that tell you that all illness comes from your mind, and you simply have to straighten out your mind and youíll get well. Once a young woman suffering from lung cancer asked me what I thought of these books. I told her that there are some cases where illness comes from purely mental causes, in which case meditation can cure it, but there are also cases where it comes from physical causes, and no amount of meditation can make it go away. If you believe in karma, there are some diseases that come from present karmaóyour state of mind right nowóand others that come from past karma. If itís a present-karma disease, meditation might be able to make it go away. If itís a past-karma disease, the most you can hope from meditation is that it can help you live with the illness without suffering from it.
At the same time, if you tell ill people that they are suffering because their minds are in bad shape, and that itís entirely up to them if they want to get well, youíre laying an awfully heavy burden on them right at the time when theyíre feeling weak, miserable, helpless and abandoned. I know a lot of people who believe that the state of their health is an indication of their state of mind, which is fine when theyíre feeling well. As soon as they get sick, though, they feel that itís a sign that they are failures in meditation, and this sets them into a tailspin.
The purpose of meditation is to find happiness and well-being within the mind, independent of the body or things going on outside. Your aim is to find something solid within that you can depend on no matter what happens to the body. If it so happens that through your meditation you are able to effect a physical cure, thatís fine, and there have been cases where meditation can have a remarkable effect on the body. My teacher had a student, a woman in her 50s, who was diagnosed with cancer more than 15 years ago. The doctors gave her only a few months to live, yet through her practice of meditation, she is alive today. She focused her practice on the theme that although her body may be sick, her mind doesnít have to be. A few years ago I visited her in the hospital the day after she had had a kidney removed. She was sitting up in bed, bright and aware. I asked her if there was any pain, and she said yes, 24 hours a day, but that she didnít let it make inroads on her mind.
Cases like this are by no means guaranteed, though, and you shouldnít really content yourself just with physical survival for if this disease doesnít get you, something else will, and youíre not really safe until youíve found the treasure in the mind that is unaffected even by death. Your most precious possession is your mind. If you can keep it in good shape no matter what, then you have lost nothing, for your body goes only as far as death, but your mind goes beyond it.
So in examining what meditation can do for you, focus more on how it can help you maintain your peace of mind in the face of pain, aging, illness and death, for youíre going to have to face these someday. Actually, they are a normal part of life, although we have come to regard them as abnormalities. Weíve been taught that our birthright is eternal youth, health and beauty. When these things betray us, we feel that something is horribly wrong, and that someone is at fault. Actually though, once we are born, there is no way that aging, illness and death canít happen. Only when we accept them as inevitable can we begin to deal with them intelligently in such a way that we wonít suffer from them.
How to use meditation to face these things and transcend them? First, pain. You first have to accept that itís there. This in itself is a major step, since most people when they encounter pain think they can avoid it by pushing it away. The way to transcend pain is first to understand it, get acquainted with it, and this means enduring it. Meditation can offer a way of detaching from the pain while you are living with it, so even though itís there, you donít have to suffer from it.
If you master the technique of focussing on the breath and adjusting it so that itís comfortable, you can choose where to focus your awareness in the body. You can focus it on the pain, but in the earlier stages, it is best to focus on the parts of the body that are comfortable. Let the pain have the other part. Youíre not going to drive it out, but at the same time you donít have to move in with it. Simply regard it as a fact of nature, an event that is happening, but not necessarily happening to you.
Another technique is to breathe through the pain. If you can become sensitive to the breath sensations that course through the body each time you breathe, you will notice that you build a tense shell around the pain where the energy in the body doesnít flow freely. This increases the pain. So think of the breath flowing right through the pain as you breathe, to dissolve this shell of tension. In most cases, this can relieve the pain considerably. When I had malaria, I used this to relieve the mass of tension that gathered in my head and shoulders. At times I could scarcely breathe, so I just thought of the breath coming in through nerve centresóthe middle of the chest, throat, the middle of the foreheadóand the tension would dissolve away. There are some people who find that breathing through pain increases it, which is a sign that they are focusing improperly. The solution in that case is to focus on the opposite side of the body: if the pain is in the right side, focus on the left. If itís in front, focus on the back.
As your concentration becomes stronger and more settled, you can analyse the pain. First, divide it into its physical and mental components. Distinguish between the actual physical pain, and the mental pain that comes along with itóthe sense of being persecuted, the fear that the pain may grow stronger or signal the end, whatever. Remind yourself that you donít have to side with those thoughts. If the mind is going to think them, you donít have to fall in with them. When you stop feeding them, after a while theyíll begin to go away.
As you strip away the mental paraphernalia surrounding your pain, including the idea that the pain is yours or is happening to you, you finally come down to the label that simply says: ĎThis is a pain and itís right there.í When you can get past this, thatís when your meditation undergoes a breakthrough. One way is to simply notice that this label will arise and pass away. When it comes, it increases the pain. When it goes, the pain subsides. Then try to see that the body, the pain and your awareness are three separate things, like three pieces of string tied into a knot, but which you now untie. When you can do this, there is no pain that you cannot endure.
Living with illness
Another area where meditation can help is to live with the simple fact of your body being ill. For some people, accepting this is one of the hardest parts of illness. But once you have developed a solid centre in your mind, you can base your happiness there, and begin to view illness with equanimity. Illness is not cheating us out of anything. Itís simply a part of life.
Many people complain that the hardest part of living with a terminal disease, like AIDS or cancer, is the feeling that they have lost control over their bodies, but once you gain control over you mind, you begin to see that the control you thought you had over you body was illusory in the first place. The body never entered into an agreement with you to do as you like. You simply moved in, forced it to eat, walk, talk, and so on, and thought you were in charge. But even then it did as it likedógetting hungry, urinating, defecating, passing wind, falling down, getting injured, getting sick, growing old. When you reflect on the people who think they have the most control over their bodies, like bodybuilders, theyíre really the most enslaved, having to eat the food for ten people each day, having to push and pull on metal bars for hours, expending all their energy on exercises that donít go anywhere at all. If they donít do this, their pumped-up bodies will deflate in no time.
So an important function of meditation, in giving you a solid centre, is that it keeps you from feeling threatened or surprised when the body begins to reassert its independence. Even if the brain starts to malfunction, those who have developed mindfulness through meditation can be aware of the fact, and let go of that part of their bodies too. One of my teacherís students had to undergo heart surgery, and apparently the doctors cut off one of the main arteries going to his brain. When he came to, he could tell his brain wasnít working right. For instance, he would think that he had said something to his wife, when actually he had only thought of it without really saying anything. When he realised what was happening, he was able to muster enough mindfulness to keep calm and simply watch what was going on in his brain, reminding himself that it was a tool that wasnít working quite right, and not getting upset when things didnít jive. Gradually he was able to regain normal use of his faculties, and as he told me, it was fascinating to be able to observe the functioning and malfunctioning of his brain, and to realise that the brain and the mind were two separate things.
Preparing to die
Finally, we come to death. As I said earlier, one of the important stages of meditation is when you discover within the mind a knowing core that does not die at the death of the body. If you can reach this point in your meditation, then death poses no problem at all. Even if you havenít reached that point, you can prepare yourself for death in such a way that you die skilfully.
When death comes, all sorts of thoughts will crowd into your mindóregret about things you couldnít do, about things you did do, memories of people you have loved and will have to leave. I was once almost electrocuted. Many things went through my mind at that time, beginning with the thought that I was going to die of my own stupidity. Then I made up my mind that if the time had come to go, Iíd better do it right, so I didnít let my mind fasten on any of the feelings that came flooding through the mind. I seemed to be doing okay, and then the current ceased.
If you havenít meditated, this experience can be overwhelming, and the mind will latch on to whatever offers itself and get carried away. If you have become skilful at letting go of your thoughts, youíll be able to refuse to fall in line with any mental states that arenít of the highest quality. If thereís pain, you can see that no matter what, the pain will go first, for that core of awareness cannot die.
As long as you live, meditation will improve the quality of your life, so that you can view pain and illness with equanimity and learn from them. When the time comes to go, the skill you have developed in your meditation is the one thing that wonít abandon you. It will enable you to handle your death with finesse. Even though we donít like to think about it, death will come. Remember, a death well handled is one of the surest signs of a life well lived.
Meditation offers caregivers a place to rest and gather your energies. It can help provide the detachment required to view your role in the proper light. When an ill person relapses or dies, itís not a sign of failure on the part of caregivers. Your duty, as long as the patient is alive, is to do what you can to improve his quality of life. When the time comes for the patient to go, your duty is to help improve the quality of his death.
An old man who had been meditating for many years once came to say farewell to my teacher after learning that he had an advanced case of cancer. My teacher told him to stay and die in the monastery. We arranged a place for him to stay and had his daughter, also a meditator, look after him. Soon, his body systems started collapsing, and it looked like the pain was beginning to overwhelm him, so I had his daughter whisper meditation instructions and chant his favourite Buddhist chants. When he did die, he seemed calm and fully aware.
If both the patient and the caregiver are meditators, it makes things a lot easier, and the death of the patient does not necessarily have to mean death of the caregiverís ability to care for anyone else.†
Thanissaro Bhikkhu, known more informally as Ajaan Geoff, is an American Theravada monk who has been abbot of Metta Forest Monastery in California, USA, since 1993.
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