Understanding the Subtleties of Communicating With a Dying Patient

Being in the presence of somebody who is in a state where they are dying or where they are close to that circumstance is by its very nature, for many people, awkward. And for a counselor, for a therapist, how do they find a way through that to ask questions, to have the right tone, to be with the person, but enter in? How do they find a way to enter into a dialogue, a conversation?

I think the first thing really is that they really need to recognize that they're in over their head. That really just going to be with someone who's dying or is that ill is so humbling that they go in with a sense of reverence and recognition that they're not in their normal role, that they're in a roleless situation where it's one human being reaching their heart to the other and needing to rely more on the heart, more on silence, more on just being present than on any technique that's ever been used. And that the interest in supporting the person that's dying to come forward with whatever they may or may not want to come forward with is an invitation. And so you may ask a question if somebody's looking ready for a question, or. Or you may just stay in silence. So it's requiring going beyond book learning. It's going to require you to have some sense of mortality inside yourself, optimally, which would automatically allow you to realize that it's a privilege really to be in their presence, because they are really serving a role in a subtle way to prepare you, us, to face our own mortality. Because anytime we actually are in the presence of someone that's dying, we're dying with them. It's really the greatest opportunity to face what we normally avoid like the plague. So just having that sense of humility and realistic awareness that we're in so deep just by being in their presence allows us to enter with much greater care and warmth.

So you're saying that there's really no agenda we can bring, that we have to be a response in some way to where we see and feel they are coming from. There is no technique, there is no avenues that we can just automatically assume would work generally with the person in that situation?

Well, I think the realization that you don't have a technique that works is the technique and that really just having the understanding that you need to be in the moment, that you need to be responsive, that you need to allow yourself to be the follower rather than the leader. You need to bring your heart as much as possible. You need to bring your humility as much as possible, and your vulnerability at the same time not project your own ideas of what you think they might be going through. There are many, many people that would come forward and feel like they have to automatically be sad while the person that's dying might be in a moment or a day where actually they're quite peaceful. So another part of the techniqueless technique is some kind of matching the tone or the feeling state of where the person is. So if a person's really, let's just say in the sad state, of course you're going to be coming in in a gentle kind of sadness with them, but if they're feeling kind of warm and engaging, you're going to be warm and engaging. And so the importance is really to recognize that the vast majority of what we're dealing with is non verbal. And the vast majority of what's needed is a sensitive presence, a responsiveness and a curiosity of what does this person really need at this given moment where that's in the background as a questioning kind of inquiry inside you and that will allow you to see is a question appropriate now, is this a moment where silence is needed, or 15 minutes or half an hour where silence is needed? SA.