Transcript excerpt from a December 2010 YouTube discussion about the psychological and spiritual challenges faced by seriously ill or dying patients—particularly feelings of guilt, responsibility, and failure. Speakers critique belief systems that claim people 'cause' their own illnesses and emphasize counselors’ role in protecting patient dignity by countering self-blame and absolute certainty about causes.
When we approach people, our clients, people we've known, in many cases, years, and they've been told by a doctor or by whoever, this is what caused your illness with some definiteness, some, again, absolute knowing, and they're kind of saying they're left with a feeling of, did I do something wrong? Or is it really that clear? Where does the not knowing part of what we're bringing to this help them in that healing process when they're dealing with certainties and uncertainties and the. The more mysterious or unknowables of their illness?
One of the worst features of going through the dying process for so many people is the feeling of guilt or responsibility or failure. And so if it's a spiritual tradition that's saying you caused your illness, or if in some way it's reinforced that you're causing your own illness even by the medical profession in some way where it's already too late, there's no benefit to it. So I think that the importance of the patient being able to not feel utterly guilty and like a failure is a critical part of the optimizing the dignity process or the supporting their dignity. You know, it's one thing if somebody has abused their body their whole life, and a doctor at some point has said to them, you know, you reinforced your heart condition, I think something like that's unavoidable. But when it gets into theoretical areas to do with esoteric assumptions as to how you've caused your illness, that I think is very, very dangerous. And we as counselors want to support with our patient clients that, you know, I don't know, who really knows the nature of things. Life is so complicated. There are so many variables, so many people that have so many positions about what causes things. I hope you're not going to make yourself responsible for this. I hope you're not going to blame yourself, because if you do, we're all screwed because we're all dying. And in that way, we have a great opportunity as counselors to let the person know we're all in the same boat. And really, in a merciful way, please don't take responsibility at this point, or else we're all really guilty failures. And it would ultimately make our whole lives meaningless if we were to take that kind of neurotic responsibility. And so I think it's very important to be wary of philosophical, spiritual assumptions that say we cause our own reality, we create our own realities, and the impact that can have on the people that are dying, which is all of us. And therefore, this not knowing is kind of a healing counterbalancing or hopefully even overcoming that belief structure.
There are approaches today that are very popular that take the position we're responsible for everything. Our illnesses, every thought, the things that come to us, the people that come to us, our financial conditions, everything. Are you saying those things are dangerous in some way? In this respect, yes.
I think the lack of relativity. In other words, if you were to say, you know what, we have tremendous influence over what's happening with us, and if we have a positive attitude, we're going to have healthier cells in our body. If we have a positive attitude and positive actions, we're going to be able to have better financial lives, we're going to have better love lives, better sex lives. You know, I would applaud that all day long, but if you're going to try to move that towards the 100% realm that's starting to speak of grandiosity, that's starting to speak of fanaticism, that's starting to think of black and white thinking, and that's extremely dangerous in every facet or almost every facet of life.
