Quest Magazine

 Printed in the Fall 2016 issue of Quest magazine. 
Citation: Samarel, Nelda, "Meeting the Needs of the Dying" Quest 104.4 (Fall 2016): pg. 114-117

By Nelda Samarel

As with physical needs, it is essential that we understand the emotional, mental, and spiritual needs of the dying individual in order to be of assistance. To understand these needs, expressed or unexpressed, it is helpful to consider what is known of the actual experiences of the dying. Awareness of these will help us to feel more comfortable in their presence and also to communicate more helpfully, making the entire experience less intimidating.

Contexts of Awareness

Four basic types, or levels, of awareness are shared by the dying and their loved ones: closed, suspected, mutual pretense, and open (Glaser and Strauss, 2005).

In closed awareness, the person does not recognize that they are dying, although everyone else does. All join in a conspiracy to help keep the secret well-guarded by withholding information that may lead to a realization that death is a prospect. If the person begins to ask questions about their condition, the family may improvise explanations to distract from or explain away new symptoms or developments in the progression of the illness. As the person becomes increasingly ill, the explanations become unconvincing, and the relationships become strained as family and friends be on guard in an effort to protect their secret. Closed awareness causes great tension and is deceitful; everyone is engaged in the conspiracy of silence so that the dying person has no one with whom to speak.

In suspected awareness, the person suspects what others know and attempts to verify the suspicion by luring or tricking family or friends to divulge that information. The person’s suspicion is often aroused by others’ changes in attitudes and behaviors, changes in medical treatment, and noticeable deterioration of condition. In this situation, caregivers usually prefer to allow the dying person to recognize their impending death independently rather communicating it directly. This often results in avoidance of answering direct questions related to the condition. Suspicion usually leads to either mutual pretense or open awareness.

Mutual pretense involves the best known and yet the most subtle of the awareness contexts. Although everyone involved in the situation is aware that the person is dying, all continue to act as if this were not so. The pretense is continued, often with great effort, through a mutual conspiracy of silence fostering an avoidance of death talk. Occasionally the dying person may offer cues signifying that they know they are dying, but loved ones are unwilling to speak the truth. This results in a “let’s pretend” situation in which all are aware of the others’ knowledge, but will not openly admit it and thus keep up the pretense that recovery is possible. Mutual pretense may be useful in giving some dying persons more privacy, dignity, and control. It may, however, result in alienation.

Open awareness exists when the dying person and loved ones know that death is near and acknowledge the fact in their interactions. It affords the opportunity to complete the necessary tasks associated with dying, such as bringing relationships to closure, reflecting on one’s life, and coping with psychological problems such as fears and regrets. Although the open awareness context is preferable to the other three, it may be the most difficult because of the many questions and problems faced by loved ones. For example, they need to decide whether the dying person should be made aware of all facets of the situation, including the details of the prognosis. Would such knowledge cause depression or, possibly, suicide?

It is helpful to understand the awareness context in which an interaction takes place, because all talk and action are guided by what one knows. Although a shift toward open contexts of awareness is usually encouraged, it is not always possible or desirable to maintain an entirely open awareness. Some dying persons, or their loved ones, may not be prepared to function with open awareness because of high anxiety, limited communication ability, or a tendency toward denial. Denial, in fact, may be healthy and necessary for many individuals. What is most important is not to impose a particular context of awareness on another, remembering that every individual has developed different coping skills and views death differently.

The Trajectory of Dying

Dying may be considered a process that occurs over time. As such, it may take a variety of forms, or trajectories (see Glaser and Strauss, 2007, and Benoliel). All trajectories take time and have a certain shape through time. For example, the trajectory may plunge straight downward; move slowly and steadily downward; vacillate slowly, moving slightly up and down before plunging downward; or move downward, reach a plateau and hold, then plunge rapidly downward toward death.

The duration of the dying trajectory may be either lingering, expected quick, or unexpected quick. The varying factors of certainty and time yield four types of trajectories: (1) certain death at a known time (e.g., late-diagnosed metastatic cancers); (2) certain death at an unknown time (e.g., chronic fatal illness, such as chronic kidney failure); (3) uncertain death, with a known time when certainty will be established (e.g., radical surgery for cancer, where a successful outcome may be known, but the threat of recurrence may be continually present); and (4) uncertain death at an unknown time (e.g., multiple sclerosis or other chronic diseases of uncertain outcome).

It is important to recognize that these dying trajectories are subjective rather than actual courses of dying and may, in fact, be inaccurate.

Uniqueness of the Personal Experience

There is the notion of an appropriate death: a style of dying that is adapted to each specific person. Respect for each individual’s personality and values defines what may be appropriate for that person. Each must live his own life and death in a manner consonant with his own pattern of living and dying, his definitions of life and death, and within his own context. Thus an appropriate death is different for each individual.

It is imperative to understand the ways in which dying individuals have lived through and experienced previous stressful life events in order to understand how they respond to the challenges of the dying process. How individuals have behaved during earlier life crises will give significant clues to how they will behave during dying. In other words, people die in the same way that they live. The situation—dying—may be extraordinary, but variables such as personality traits and coping history remain long-established and will result in similar styles of dealing with the challenges of dying.

Stages of Dying

Five stages that refer to the person’s successive mental and emotional responses to dying have been identified: denial, anger, bargaining, depression, and acceptance (Kübler-Ross).

Denial (“No, not me”), the first response, is an attempt to negate or escape from the idea of one’s own death. Most individuals experience partial and temporary denial. It is a form of natural protection and allows us to manage fear. To provide support for persons who are in denial, it is helpful to invite them to talk about their fears, but without attempting to force them out of denial.

The second stage, anger (“Why me?”), often characterized by envy, rage, and resentment, is often difficult for family members, who may be the target of the anger. This stage is stimulated by fear and frustration. Understanding that anger is a normal response to a terminal illness can help keep outbursts in perspective and accept this behavior as temporary and normal.

In bargaining (“Yes, me, but . . .”), the third stage, the dying person attempts to forestall the inevitable by making a deal with the doctor, family, God, or fate if he or she is permitted to live somewhat longer. At this point, the person recognizes the prognosis but is still attempting to modify the outcome. Sincere listening and realistic support can be offered.

Depression (“Yes, me”; grieving) is associated with the ultimate future loss of life and may be characterized by fatigue, loss of function, feelings of guilt, and fear of dying. The dying person realizes that bargaining is of no use and becomes sorrowful and withdrawn. Simply being present and accepting when a person is depressed is more helpful than attempting to talk them out of their depression or to distract them.

The final stage, acceptance (“Yes, me”), signifies the end of the struggle. It is not always accompanied by a happy or serene feeling. In fact it is often associated with an absence of all feeling.

These stages are not rigid, nor are they mutually exclusive. Moreover, hope tends to persist in all stages, even depression and acceptance. Indeed it is asserted that, without hope, death follows shortly (Kübler-Ross).

Although many dying individuals do experience these stages in clearly observable ways, they will not necessarily move through the five stages in a linear fashion or experience all stages.

Factors Influencing the Dying Process

Several factors influence the experience of dying: age, gender, the nature of the disease and environment, and religion and culture.

Chronological age affects the way in which dying and death are comprehended, since the intellectual grasp of death is related to the individual’s developmental level and extent of life experiences. Accordingly, the experience of a mature adult will differ considerably from that of a young child, who may not comprehend the nature of death.

One example clearly illustrates the influence of age on the experience of dying. A young child with a diagnosis of terminal cancer and a life expectancy of less than six months began to question her future when the pain from her bone cancer interfered with her ability to walk. She struggled to understand the concept of death but could not easily move beyond the fear of being alone, that is, without her parents. Her major concern was who would take care of her.

Age further influences the dying process, because children and adults have different opportunities to exercise control over the situation. The same young child mentioned above understandably had little opportunity to participate in the decision making process regarding her treatment, and attempted to control the situation in other ways. For example, she would refuse to respond to adult conversation at times, indicating that she would be the one to decide when and if conversation would be initiated, emphatically declaring in response to a statement or question, “Not now! We’ll talk after the cuckoo (clock) strikes!” Age also influences the perceptions of others and the ways in which one is treated. Although this child clearly was in the terminal phase of cancer, the treatment team found it difficult, if not impossible, to make the final decision to terminate treatment, as is often the case when treating young children. In cultures where youth is greatly valued, it is often difficult to become reconciled to the untimely death of a child. Conversely, advancing age may result, not always appropriately, in a less aggressive treatment protocol.

Gender affects the dying experience because of the difference in life roles for men and women and the resulting difference in values. For example, a man who is facing a life-threatening illness may be more concerned with financial provisions for his family, while a woman may be more concerned with family integrity and caregiving (“Who will cook for my husband?”).

Disease, treatment, and environment critically influence the experience of dying. Each individual dies of a particular cause in a particular place. For example, a lung condition associated with breathing difficulty and with being treated in a hospital is likely to cause more alarming symptoms than is a home death due to chronic kidney failure, where one may simply become increasingly lethargic as death approaches.

Attitudes and beliefs about life, living, and death, as shaped by religion and culture, influence the dying process. For example, a person who believes that death signifies the end of all life may fear death. Conversely, a person who believes in an afterlife or in reincarnation may fear the anticipated separation from loved ones, but not the dying process or death itself. The profoundly different nature of these two individuals’ fears will influence how they respond to the process and the ways in which loved ones can assist them through it. One way of initiating conversation about the dying person’s beliefs about an afterlife is simply to ask, “What do you believe happens afterwards?”

Having a faith, too, influences the experience of dying. One hospice nurse said, “At the end, those with a faith—it really doesn’t matter in what, but a faith in something—find it easier. Not always, but as a rule. I’ve seen people with faith panic, and I’ve seen those without faith accept it [death]. But, as a rule, it’s much easier [for those] with faith” (Samarel, 64–65).

Words from Those Nearing Death

Persons nearing death quite often will speak, within their own frames of reference, of preparation for travel. For example, the businessman may fret about needing to find his passport, while the sailboat buff may ask about the tides. The recurrence of this theme is consistent with the concept of death as a passage or journey. Often the dying person has a sense of being accompanied by another who already has died. Most often, the dying recognize a deceased relative or close friend; occasionally they speak of angels or religious figures.

In one beautiful situation, an elderly dying woman was seen by her adult granddaughter to be conversing with her long-dead husband. Following this “conversation,” she told her granddaughter with great serenity that Grandpa had stopped by to tell Grandma not to be afraid and that she would be joining him soon. He also said that he would be guiding her on her journey among beautiful gardens. She shortly drifted off to sleep, her face tranquil and calm; she died a short while later.

One imminently terminal man, asleep in his hospital room, awoke with a start, became quite alert and called the nurse to his bedside. He said that, while asleep, he had seen two angels who would be with him when he was ready “to go.” Several days later he serenely pointed to a corner of the ceiling and announced in a matter-of-fact manner, “There they are, the angels. They’ve come for me.” He then took one final breath and closed his eyes. The messages here are that dying persons are not alone and may, in fact, be blessed with help in a form unique to them.

SOURCES

Benoliel, Jeanne Quint. “Health Care Providers and Dying Patients: Critical Issues in Terminal Care,” in Omega 18, 1987–88.

Glaser, Barney G., and Anselm L. Strauss, Awareness of Dying. New Brunswick, N.J.: Aldine Transaction, 2005.

———.Time for Dying. New Brunswick, N.J.: Aldine Transaction, 2007.

Kübler-Ross, Elisabeth. On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families. New York: Simon & Schuster, 2009.

Samarel, Nelda. Caring for Life and Death. Washington, D.C.: Taylor & Francis, 1991.

Nelda Samarel, Ed.D., R.N., a longtime student of the Ageless Wisdom, has been director of the Krotona School of Theosophy and a director of the Theosophical Society in America. She serves on the executive board of the Inter-American Theosophical Federation. A retired professor of nursing, Dr. Samarel has numerous publications and presents internationally. Her article “A Visit to John of God” appeared in the summer 2016 issue of Quest.

This article is excerpted from Samarel’s booklet Helping the Dying: A Guide for Families and Friends Assisting Those in Transition, published by the Theosophical Order of Service. For a free copy, please write to: Theosophical Society in America, Attention: Helping the Dying, P.O. Box 270, Wheaton, IL 60187-0270, or to helpingthedying@hotmail.com.

Printed in the Fall 2016 issue of Quest magazine. 
Citation: Smoley, Richard, "From the Editor’s Desk" Quest 104.4 (Fall 2016): pg. 90

National secretary David Bruce reminds me that this year is the 400th anniversary of the death of Shakespeare. Which raises a question: what exactly was Shakespeare’s worldview?

Technically, Shakespeare was a Christian. But Christianity is far in the background in Shakespeare’s work. Often he seems more comfortable setting his plays in pagan contexts—as with Julius Caesar or King Lear—than in Christian ones. If you search for Jesus or Jesu in his plays, you will see that they mostly occur as interjections.

Some argue that Shakespeare was an atheist. But he does not seem to be an atheist. His plays are full of spirits of all kinds — nature spirits, the dead, even the occasional pagan god. And these details all point to one thing as the source of his worldview: the occult philosophy of the Renaissance, which was the version of the Ancient Wisdom known and practiced at that time. It was essentially a mix of Hermeticism, a Christianized version of the Kabbalah, and Neoplatonic ideas that persisted in Western thought after the end of classical antiquity.

Scholar Frances Yates has written, “Shakespeare’s preoccupation with the occult, with ghosts, witches, fairies, is understood as deriving less from popular tradition than with deep-rooted affinity with the learned occult philosophy and its religious implications.” This quotation is taken from Yates’s book The Occult Philosophy in the Elizabethan Age, which is a good place to go if you want to know more about this subject. Many educated men of the time understood this philosophy, and Yates points out numerous allusions to it in Shakespeare.

One example is the famous speech about the “seven ages of man” in As You Like It, act 2, scene 7: “All the world’s a stage, / And all the men and women merely players; / They have their exits and their entrances, /And one man in his time plays many parts, / His acts being seven ages.”

I don’t have the space here to reproduce the entire passage. It has been quoted very often.

But the structure behind it is not widely understood.

These seven ages are correlated to the seven planets as they were known in Shakespeare’s time. These planets surround the earth (it was believed) in concentric spheres. Shakespeare’s stages of life correspond to them. The “mewling, puking” infant corresponds to the moon, which governs growth. The “whining schoolboy with his satchel” correlates with Mercury, which has to do with study and learning. The stage of the “lover” is of course the stage of Venus, while the “soldier” is that of Mars. The justice, “full of wise saws,” relates to Jupiter, the planet of counsel. And “the lean and slippered pantaloon” corresponds to Saturn, the slowest of all the planets then known, associated with old age and melancholy. The seventh stage, “second childishness and mere oblivion,” corresponds to the primordial space to which we all return. The seventh “planet,” the sun, does not appear here, because esoterically the sun correlates to the Self and thus encompasses all levels. (For more on this subject, see Priscilla Costello’s recent book Shakespeare and the Stars.)

It’s hard, even for those drawn to esotericism today, to grasp how much this occult philosophy informed people’s lives in those days. Remember that this seven-planet system, centered on the earth (the Copernican theory had not yet been fully accepted), was believed to be the way the universe was physically composed. That it had correspondences in the life of man, even in terms of the ages, meant that the human being was seen as much more integrally connected to the cosmos than today.

Theosophical literature often speaks of the astral body, but the reason for its name is sometimes forgotten. The original idea was that this astral body was made up of subtle starry stuff—what H.P. Blavatsky, following Éliphas Lévi, called the astral light. We can think of it as the medium by which the planets affect our moods and feelings, just as the forces of the earth affect our physical bodies.

Clearly these are subtle forces—so subtle that one might be forgiven for believing that they don’t exist at all. But there are many energies that science has not discovered, or has just barely discovered. I’m thinking of a recent news item saying that astronomers have discovered a “magnetic rope” that extends between Saturn and the sun. Although they had known such magnetic links existed between the sun and the inner planets, including the earth, they had never found one for an outlying planet such as Saturn. It is possible, even likely, that other such forces govern our existence in ways that are still undreamt of.

It may be useful to imagine our astral, and perhaps mental, bodies as coextensive with the solar system, whose planets govern their currents and impulses, just as the astrologers claim. If so, then possibly the higher bodies still—the causal body and those above it—are governed not by the planets but by larger and still more comprehensive entities. We might imagine that the causal body, say, is coextensive with the galaxy and is influenced by its movements—although these are, of course, on a scale that goes past the bounds of a single lifetime. But then so does the causal body.

I find these speculations both comforting and plausible. It may be the case that, as the old occult philosophy taught, the stages of human life are attuned to the planets. It may also be the case that the stages of life far outstrip, not only the life of the body on earth, but the life of the solar system, of the galaxy, and of the universe itself.

Richard Smoley

Printed in the Fall 2016  issue of Quest magazine. 
Citation: Wehr, Janet, "Peaceful Passages:Glimpses into the Life of a Hospice Nurse" Quest 104.4 (Fall 2016): pg. 118-119

By Janet Wehr

The First One

The call came at 2:15 a.m. It was my first on-call summons since I had become a hospice nurse a month earlier. I dressed quickly, running a comb through my sleep-flattened hair, feeling more than a little as firemen do as they jump into their boots and slide down the pole when the alarm sounds. I reviewed the patient’s name and address and the message the triage nurse had given me on the phone: “Madeline D. is close to dying. Her family is expecting you as soon as you can get there.” On the way, I carefully remembered what I had been taught to do when I arrived. My heart would tell me what to say.

Taking a deep breath, I knocked on the door of the small but cozy apartment. Madeline’s granddaughter, Christine, answered, and it was obvious that she had been crying. Christine’s husband, Jack, was there to support her. I took a moment to comfort them, then went into the bedroom. Madeline lay in a hospital bed under a pink comforter. She was very old and frail, shrunken to just a wisp of a person. Her knees were drawn up to her chest as if she were going back into the womb. Her fingernails and toenails were a pale shade of blue, the color of the inside of a seashell, showing that her weakened heart could no longer perfuse even this child-sized body. Her breathing was raspy with the death rattle, and there were long gaps between breaths. I knew that she was only a few hours, maybe minutes, from dying.

I began gently to discuss with Christine and Jack the physiology of what they were witnessing in Madeline’s condition—the signs and symptoms of dying. They listened carefully, relaxed in knowing that what was happening was the normal process of a body letting go of life. Christine related to me that, only two days earlier, Madeline had shared that she was tired, she was old, she had had a rich life, and now she wanted to rest. She had said this calmly, quietly, and with complete satisfaction and conviction in her voice.

Unexpectedly a man then burst through the door into the apartment. It was apparent that he was angry and wanted to take charge. He was introduced as Christine’s brother, Robert, who was a prominent surgeon at our hospital. Robert stormed past us and went into the room where Madeline lay so close to dying. He visually assessed her for no more than a few seconds, then moved briskly to the phone and dialed 911. When he had ordered an ambulance, he turned to me and yelled, “What do you think you’re doing? My grandmother is dying! She needs emergency treatment NOW!”

I’m a good “diffuser” in most situations, and I calmly began to explain why this was not an emergency. “Your grandmother is ninety-nine years old,” I said. “Her doctor explained to your family that there was no treatment for her age-related illness and decline. She can’t see, she can’t hear, and now she can’t swallow. Perhaps she doesn’t want to stay any longer.”

Robert simply glared at me, tapping his foot with impatience, waiting for the paramedics to arrive.

And they did. When Robert opened the door to let them in and introduced himself in a loud, authoritative tone as “Doctor,” all the king’s men jumped into action and whisked Madeline out of the house and into the waiting ambulance, leaving Christine, Jack, and me with our mouths hanging open.

What had just happened here? None of the training I had received as a hospice nurse had prepared me for this. I felt that I had let Madeline down and prayed that she would not die in a speeding vehicle or in the emergency room among strangers. I prayed that the emergency room personnel would not intubate her or perform CPR. I wanted what Jack and Christine wanted, which was for her to be in her own bed, in her own home, with people who loved her and understood her desire to leave. I packed up my nursing bag and left Madeline’s home, feeling as if I had failed her.

I was called back to Madeline’s home the very next day, to hear from Christine what I already knew: the emergency room staff had taken one look at Madeline the night before and told the “Doctor” that his grandmother wasn’t sick, she was dying, and that they felt they should send her back home. Madeline held on until she was back under her fluffy down comforter, in her little pink bedroom, and quietly slipped away.

Hospice on Call

When the pager goes off, it’s 2:00 a.m., and I reluctantly leave my dreams and my soft bed and jump into action. I go to where my clothes had been laid out the night before to save time if a call came. I dress quickly, barely bothering with my hair, because I am needed somewhere.

Someone has died.

I leave home in the dark, following directions from the hospice information sheet. Even though I’ve been to this home many times in the daylight, I surely don’t want to get lost at this hour.

I pull up in front of the house. I center myself for a minute so that I can be the calm in the storm that is probably waiting inside.

A man with a tear-stained face greets me wordlessly at the door and walks me to the back bedroom. Then he disappears around a corner, not wanting me to see him cry.

There, in the hospital bed, is the person who has died. A tiny attractive grandmother. No heartbeat, no breaths. Pupils fixed and eyes at half-mast. I wonder about who she was, what things she had done during her life, who she loved, and who loved her.

I tell a young woman, who introduces herself as the patient’s daughter, that her mother has died. Two teenaged granddaughters standing at the door burst into tears as they hear the word they expect but have been dreading.

I turn off the oxygen and remove the oxygen tubing from the grandmother’s nose. I whisper condolences and tell the family to take as much time as they need. I explain that there are official phone calls that need to be made to the coroner, the doctor, and the funeral home, and I excuse myself to make the calls while they grieve. I call the doctor and to report that his patient has died. The physician has cared for this patient a long time, and I can sense sadness as he asks me to give his condolences.

I call the coroner and the funeral director, both of whom I know now on a first-name basis—these people who work during the wee hours of the morning, just as I do. I tell them the official time of death I pronounced: 2:00 a.m.

I offer to bathe the patient and dress her before the funeral director arrives to take her away. The daughter leaves to gather the necessary items, and I sense her relief at being able to perform one last, loving task for her mother. I bathe the body, tenderly and respectfully, while the rest of the family waits in the next room. This woman has been sick a long time. She is withered and wasted away. She still has blue ink marks on her chest and abdomen where the radiologists aimed the radiation treatments that were meant to help her. I dress her in the clothes provided by her daughter: clean undergarments; a soft blue sweater; black velour pants; cozy socks. I comb through her hair and take a moment to spread lotion on her face so that she will smell good when they kiss her goodbye.

The doorbell rings, and there is a white van in the driveway: the funeral director is here. I encourage the family to say their goodbyes and explain that it might be easier if they wait in the other room while we transfer the body. They decide to stay.

I help the director transfer the woman’s body to a gurney and watch as the bag is zipped up over her face. This is always difficult—the finality of it—although I’ve witnessed it hundreds of times.

I pack up stray medical supplies, strip the bed, and tidy the room. I dispose of medications in the bag of kitty litter that I keep in my nursing bag just for this purpose. I turn off the light and close the door behind me.

The family is grateful for my guidance and support during this difficult time. After my numerous visits over the past several weeks, they say they will never forget me. Despite the fact that I will repeat this scenario over and over again, little do they realize that they, and their loved one, are likewise etched in my heart forever. My watch says 4:00 a.m. I leave the home, get into my car, and turn the key. The pager goes off.

' Someone has died.

Janet Wehr, R.N., has devoted most of her nursing career to hospice care. A Qualified Therapeutic Touch Practitioner, she is a member of the Therapeutic Touch International Association and the American Holistic Nurses Association. She is also on the board of directors for the Saret Charitable Fund of DuPage County, Illinois. These stories are excerpted from her book Peaceful Passages: A Hospice Nurse’s Stories of Dying Well, published in 2015 by Quest Books. Reprinted with permission.

Printed in the Fall 2016issue of Quest magazine. 
Citation: Bull, James L., "Levels of Awakening" Quest 104.4 (Fall 2016): pg. 112-113

By James L. Bull

For many years I believed that retirement was only a sad commentary on the unpleasantness of most work. After all, if work is an unpleasant necessity and to be avoided, as it is for many, then why not seek relief at every opportunity? Weekends are to the work week as vacation is to the year, as retirement is to a life’s work. The assumption is that leisure is what’s enjoyable and work is the price one pays to get it. The solution, of course, is to have not just a job but a satisfying life’s work, thereby blurring the distinction between work and nonwork.

Now in my early eighties, I’m no longer working, but I’ve found that being active as a volunteer satisfies needs that were there all along. Energy and output may not decline much, but there may be a qualitative shift that comes with age. On a deep level a shift may occur which sends reverberations to the surface that influence the course of my life. Parallel to the natural physical changes and declines, there may be a spiritual shift which is its own developmental stage, a period of reflection and deepening.

Of this the commercial world has no clue. From that point of view, aging is some sort of malady. A recent magazine cover announces that there is a “cure for aging.” Is aging a disease? Another magazine reports on an “anti-aging’’ medication. Is aging an adversary, to be fought? Of course, it is fought in countless ways, from face lifts to sexual potency enhancers. This oppositional attitude parallels other struggles against natural phenomena to be conquered or overcome, such as the wilderness. But aging, if engaged consciously and without a disabling fear of death, may open the door to a deepening of appreciation and an enhanced capacity for reflection, made possible by having more of life to remember.

To enjoy these benefits, we first need to loosen our grip on some of the skills that served us so well earlier, including rationality, linear thinking, necessity, and precision—all those left-brain qualities. Intuitive skills may now be more important, and with this softening process, we may discover vulnerability within us. The strength required to be vulnerable is more appropriate to age, just as the strength to be tough serves the young and ambitious. The deeper, more appreciative qualities that may now emerge are not as well expressed with words; when words are used, poetry probably works best.

None of this means that we leave the world of necessity and responsibility. We still pay the bills and keep the car running. But we may be able to choose more consciously between the world of adoration and the world of necessity. I was reminded of this distinction on a recent camping trip. While fixing dinner, I paused to appreciate—and to praise and pray in thanksgiving for—the setting sun and the clouds illuminated by it. But soon I was pulled back to the ‘‘necessities”—checking a pot, adding more wood to the fire.

I’m not suggesting that the perspective of necessity is any less important than that of appreciation; they are complementary. They are the two modes of attention that we carry through this life. They are the content and context of life. Because we are normally only aware of the content of our daily lives, we may naturally overlook the context in which it all takes place. Earlier in life, it may not have been useful to spend as much time in reflection. Now we can allow ourselves to drop down, away from the necessary and toward the essential, closer to the soul. There, there may be moments of nonduality, of recognition: not everything is content; there is a surrounding meaning, or context, in which all takes place. Life has meaning; we are not here by accident; there are no accidents.

In order to give ourselves to the surrender of awe and wonder, we need to be well-grounded in the first place. To be insufficiently grounded in this life, and in our bodies, is unhealthy. I have often had the impression that some mentally ill persons are not well-grounded in their bodies—not fully located here. But once we are fully grounded —and reasonably secure —we may allow ourselves a reverential pause. How absolutely natural that we should become completely absorbed in the details of this life! We are provided with the combination of extraordinary sensory equipment and equally rich experiential potential—and a world to match. We are placed in a world of such richness, how could we not been enraptured by it all—longing, sadness, taste, laughter, beauty! It can be thought of as a sort of divine joke: we are dropped into a life so inviting that we become caught up entirely, Spirit chuckling all the while. Perhaps it is useful for us not to see this life in its full context while we are living it. This way, we are allowed to focus on our present situation without distraction.

Nevertheless, as I grow older I get more of a sense of hidden meanings. Our inner task is to stay aware, to sense the context, to be in touch with who we really are and who we were all along.

Otherwise, we might be swept away and lose the self.

Kierkegaard understood the tragedy of those who live their lives “outside of themselves.” In Either/Or he writes:

And this is the pitiful thing to one who contemplates human life, that so many live on in a quiet state of perdition; they outlive themselves, not in the sense that the content of life is successively unfolding and now is possessed in this expanded state, but they live their lives, as it were, outside of themselves, they vanish like shadows, their immortal soul is blown away.

The context of this life may be far more subtle than the immediate content; it is usually sensed intuitively; it may seem elusive and more a matter of revelation than verification. It is everything we sense that surrounds this life and makes it possible, the aura of meaning and mystery which encloses all we know. Although there are effective methods for tapping into this realm, such as meditation and prayer, the maxim seems to apply that “this thing we tell of can never be found by seeking, yet only seekers find it.”

In a recent workshop, poet Robert Bly referred to a poem by Kabir that reads in part:

We sense that there is some sort of spirit that loves
       birds and animals and the ants—
perhaps the same one who gave a radiance to you
       n your mother’ s womb.
Is it logical you would be walking around entirely 
       orphaned now?

In this workshop, Bly used the poem as a point of departure to ask the question, “What did you know before you were born?” I wrote: ·

What we knew before we were born is like one of Rilke’s sealed letters, an epistle we carry through life in our bodies. Perhaps we dare to peek, tearing back the envelope at one comer, seeing a word or two. Rarely would we read the whole thing. Perhaps when we are old, the paper yellowed and brittle, we may find the courage to open, to read, to weep.

What could it be that I carried with me always, but never knew? What I knew before I was born might literally be whatever I learned in my mother’s womb, plus whatever I brought to this life before that. But in a larger, more metaphorical sense, this question asks that I pause to consider the context of this life. As I grow older, my birth and death (the two most important events of my life) may begin to come together. (As Shakespeare wrote, “This little life is rounded with a sleep.’’) If there is a part of me that transcends my birth and death—call it the soul—I can stay in touch with it along the way.

The idea that we brought something with us to this life is not a new one. It is described excellently by James Hillman, who asserts, “Each person enters the world called.” He continues,

The soul of each of us is given a unique daimon before we were born, and it has selected an image or pattern that we live on earth. This soul-companion, the daimon, guides us here; in the process of arrival, however, we forget all that took place and believe that we come empty into this world. The daimon remembers what is in your image and belongs to your pattern. And therefore your daimon is the carrier of your destiny.

Clearly Hillman believes we were loved before we were born:

Despite this invisible caring, we prefer to imagine ourselves thrown naked into the world, utterly vulnerable and fundamentally alone. It is easier to accept the story of heroic self-made development than the story that you may well be loved by this guiding providence, that you are needed for what you bring, and that you are sometimes fortuitously helped by it in situations of distress.

We are born into situations and families that give us opportunities to work out issues that require our attention. This may not be easy: the son of the macho father goes on to become a ballet dancer; the maternally overprotected child finds assertiveness and learns to be bold. So there may be a great deal, on a deep level, that we knew before we were born. Our lives take place on the surface of a very deep sea. As I grow older, I sense that all is not forgotten. The accidents of my life dissolve into purposes; the purposes become harder to explain, and explanation matters less and less.

James L. Bull, Ph.D., first learned about Theosophy from his mother, Evelyn Bull, who had a number of articles and poems published in The American Theosophist. Now a retired psychologist, he remains active as a hospice volunteer.