What the death rattle and capital punishment have in common

By Joel B. Zivot and Ira Bedzow

Death rattle. That’s the sound some dying people make, caused by a buildup of mucus and other secretions in the throat as the body begins to slowly lose its life force. It can sound wet and crackling, or like a soft moan or snoring or gargling.

No one knows if a dying person finds the death rattle disturbing or distressing, as no one can pretend to know with certainty the inner subjective experience of anyone too ill to express it. The common medical assumption, though, is that they are not distressed by it. But the death rattle is disturbing to family members and loved ones who are with their loved ones as they are dying. They typically interpret the sounds as indicative of pain and the absence of a “good death.”

A team of researchers in the Netherlands conducted what they call the SILENCE clinical trial to see if an injection of scopolamine butylbromide, an antispasmodic drug, could stop, or at least reduce, the death rattle. It did.

In an accompanying editorial, two U.S. physicians make the case that administering a drug to reduce the death rattle is justified, even when one cannot know the inner experience of a dying patient. They claim that “when in doubt regarding comfort, it is best to try treatment.” They also write that it can relieve the distress not of the patient but of those bearing witness to the death.

The first reason reveals a technological imperative that is permeating health care delivery. The technological imperative says, “If it’s possible, it should be done.” While moral philosophers since Immanuel Kant have held that “ought implies can” — meaning that having a moral duty entails that one is able to fulfill it — the premise doesn’t work both ways. Shooting first (in this case a subcutaneous injection of scopolamine butylbromide) and asking questions later is not the best approach. Of course, it may become best practice to reduce the death rattle, but the medical profession should at least consider why before deeming it so.

The second reason — to alleviate the discomfort of those bearing witness — speaks to the current debate over the legality and morality of capital punishment, especially now when the Biden administration wants to reinstate the death penalty for Boston Marathon bomber Dzhokhar Tsarnaev, even though earlier this year the U.S. attorney general ordered a moratorium on federal executions.

Death by execution and death in the setting of end-of-life care have something in common. Both involve the presence and witness of interested parties. And what is witnessed — rather than what is occurring to the dying individual — matters a great deal.

The law stipulates that punishment cannot be cruel and unusual. The experience of execution also confronts society’s aversion to see itself as inhumane. But the absence of cruelty does not create humaneness. Punishment must not be tortuous or deliberately degrading and should not exceed the severity of the crime committed.

The Biden administration may see execution fitting for the crime of the Boston Marathon bombing. That decision will rest with the court. Whether or not execution on its face is inhumane, it is certainly extreme and should be used judiciously — not politically.

The idea that execution may be a form of torture is one of the primary reasons for its medicalization. The American Society of Anesthesiologists strongly discourages anesthesiologists from participating in executions, and says that legal execution “should not necessitate participation by an anesthesiologist or any other physician.”

Execution wrongly impersonates a medical act and the impersonation is so convincing that even doctors and the public are fooled. In the United States, no method of execution has ever been set aside as unconstitutional, though methods of execution have come and gone — think hanging, firing squad, and electric chair (though this last one may be coming back) — based on public perception of the outward appearance of death by execution.

Administering paralytics and other drugs may make lethal injection look more humane, even peaceful. Yet autopsies performed on individuals executed by lethal injection have shown that they suffered from pulmonary edema — their lungs were drenched with body fluids. In a self-aware person, such lung congestion would be akin to death by drowning.

Society’s opinion about what it finds to be cruel continues to evolve. But it should primarily take into account the sufferer, not those who are watching.

At the bedside of someone who is dying, families and friends are increasingly welcomed to be present, to accompany a loved one in their last moments. This is a good thing, as it returns death and dying to the realm of the home and community so people do not have to die alone. It also helps drive home that death is part of life and not something to hide away or ignore.

The danger that the SILENCE trial presents is the risk that hospitals will curate the dying experience for the sake of loved ones, just as lethal injection curates a medicalized execution for the sake of the witnesses.

If the death rattle is not painful, instead of muting it — and instead of simply paralyzing the executed — it may be better to recognize the bright line that separates the living from the dead. Mollification of observers’ experiences in both instances may anesthetize feelings regarding natural death or killing. It may also lower the bar for what constitutes facilitating death or moral killing.

As a society, we must be sure to uphold our collective humanity and alleviate suffering. But we should be focused on the suffering of the dying and not those who are watching.

Complete Article HERE!

Sexual Bereavement

— A Challenge That Few Talk About

By

When Sarah’s husband died of cancer at the age of 50, they had been married 25 years. An accomplished man, active in their community, he was deeply missed and Sarah’s circle of friends joined forces to help her through her mourning. Support and succor were offered, but after eight years, when one friend suggested she try to help her create an online dating ad, she remarked that no one had even brought up the subject in all that time. “I know everyone accepted that I deeply loved my husband, and that was part of it,” Sarah says. “But it was as if my life as a woman died along with him in my 50s.” But she had been lonely for the intimacy she had shared with her husband, and was very relieved when someone finally brought it up.

This problem is one that Dr. Alice Radosh, a neurobiologist who lost her husband, terms:

” ‘Sexual bereavement,’ which she defines as grief associated with losing sexual intimacy with a long-term partner. The result, she and her co-author Linda Simkin wrote in a recently published report, is ‘disenfranchised grief, a grief that is not openly acknowledged, socially sanctioned and publicly shared. … It’s a grief that no one talks about. … But if you can’t get past it, it can have negative effects on your physical and emotional health, and you won’t be prepared for the next relationship,’ should an opportunity for one come along.’ ”

Most adults retain sexual feelings as they age and statistics show that they are sexually active, despite popular misconceptions. The New York Times reports: “In a study of a representative national sample of 3,005 older American adults, Dr. Stacy Tessler Lindau and co-authors found that 73 percent of those ages 57 to 64, 53 percent of those 65 to 74 and 26 percent of those 75 to 85 were still sexually active.”

Older adults are often embarrassed to make their interest known, fearing ridicule or disapproval. Even health care professionals routinely fail to inquire about their older patients’ sexual health. Widows have the added burden of feeling, in some cases, that finding a new partner is disloyal to their lost loved one. Some, interested in intimacy but not necessarily remarriage, are ashamed to be associated with what they see as negative social stereotypes of sexually active older women. Despite considerable progress in our attitudes about sexuality, there is still a great deal of discomfort surrounding this topic.

The Times wrote about a recent survey that found:

“Even women who said they were comfortable talking about sex reported that it would not occur to them to initiate a discussion about sex if a friend’s partner died.” The older the widowed person, the less likely a friend would be willing to raise the subject of sex. While half of respondents thought they would bring it up with a widowed friend age 40 to 49, only 26 percent would think to discuss it with someone 70 to 79 and only 14 percent if the friend was 80 or older.”

Younger widows also feel the “disloyalty” factor when experiencing sexual longings. But older women face another common obstacle to re-entering the romance arena: the older they are the longer they are likely to have been out of “circulation.” There are a few common issues that tend to worry these women. One is that they feel intimidated about starting up a new romance with an unknown person after so many years of marital intimacy. Another major factor is worry about the “baggage” that they bring to a new relationship, usually in the form of children and their problems. No matter how grown-up, our children tend to be central to our lives, and worry that a stranger may not accept them or vice versa is common.

Complete Article HERE!

How Anticipatory Grief Differs From Grief After Death

by Lynne Eldridge, MD

Anticipatory grief, or grief that occurs before death, is common among people who are facing the eventual death of a loved one or their own death. Yet, while most people are familiar with the grief that occurs after a death (conventional grief), anticipatory grief is not often discussed.

Because of this, some people find it socially unacceptable to express the deep pain they are experiencing and fail to receive the support they need. What is anticipatory grief, what symptoms might you expect, and how can you best cope at this difficult time?

As a quick note, this article is directed more to someone who is grieving the impending loss of a loved one, but preparatory grief is also experienced by the person who is dying.

Hopefully, this article (as well as another on how to cope with anticipatory grief later on), will be helpful to both those who are dying and those who are grieving a loved one’s imminent death.

What Is Anticipatory Grief?

Anticipatory grief is defined as grief that occurs before death (or another great loss) in contrast to grief after death (conventional grief). Rather than death alone, this type of grief includes many losses, such as the loss of a companion, changing roles in the family, fear of financial changes, and the loss of dreams of what could be.

Grief doesn’t occur in isolation. Often the experience of grief can bring to light memories of other episodes of grief in the past.

Differences From Grief After Death

Anticipatory grief can be similar to grief after death but is also unique in many ways. Grief before death often involves more anger, more loss of emotional control, and atypical grief responses.

This may be related to the difficult place—the “in-between place” people find themselves in when a loved one is dying. One woman remarked that she felt so mixed up inside because she felt she kept failing in her attempt to find that tender balance between holding on to hope and letting go.

Not everyone experiences anticipatory grief, and it is not good or bad to do so. Some people experience very little grief while a loved one is dying, and in fact, find they don’t allow themselves to grieve because it might be construed as giving up hope. Yet for some people, the grief before the actual loss is even more severe.

A study of Swedish women who had lost a husband found that 40% of the women found the pre-loss stage more stressful than the post-loss stage.1

For those who are dying, anticipatory grief provides an opportunity for personal growth at the end of life, a way to find meaning and closure. For families, this period is also an opportunity to find closure, to reconcile differences, and to give and grant forgiveness. For both, it is a chance to say goodbye.

One person related that the night their grandmother died they were lying in bed with her. She turned to them and said, “We’ll miss each other,” and hugged them. It was her goodbye gift.

Family members will sometimes avoid visiting a dying loved one. The comments they make include, “I want to remember my loved one the way they were before cancer,” or “I don’t think I can handle the grief of visiting.” But anticipatory grief in this setting can be healing.

One study found that anticipatory grief in women whose husbands were dying from cancer helped them find meaning in their situation prior to their husband’s deaths.1

Though anticipatory grief doesn’t necessarily make the grieving process easier, in some cases it can make death seem more natural. It’s hard to let our loved ones go. Seeing them when they are weak and failing and tired makes it maybe just a tiny bit easier to say, “it’s OK for you to move on to the next place.”

Does It Help Grieving Later On?

Grief before death isn’t a substitute for grief later on, and won’t necessarily shorten the grieving process after death occurs. There is not a fixed amount of grief that a person experiences with the loss of a loved one. And even if your loved one’s health has been declining for a long time, nothing can really prepare you for the actual death.

Yet, while anticipatory grieving isn’t a substitute or even a head-start for later grieving, grieving before death does provide opportunities for closure that people who lose loved ones suddenly never have.

Symptoms

The emotions that accompany anticipatory grief are similar to those which occur after a loss but can be even more like a roller coaster at times. Some days may be really hard. Other days you may not experience grief at all.

Listed are some of the typical emotions associated with anticipatory grief. That said, keep in mind that everyone grieves differently:

  • Sadness and tearfulness: Sadness and tears tend to rise rapidly and often when you least expect. Even small things, such as a television commercial may be a sudden and painful reminder your loved one is dying; almost as if it is again the first time you are aware of your impending loss.
  • Fear: Feelings of fear are common and include not only the fear of death but fear about all of the changes that will be associated with losing your loved one.
  • Irritability and anger: You may experience anger yourself, but it can also be difficult coping with a dying loved one’s anger.
  • Loneliness: A sense of intense loneliness is often experienced by the close family caregivers of someone dying from cancer. Unlike grief after a loss, the feeling that it’s not socially acceptable to express anticipatory grief can add to feelings of isolation.
  • A desire to talk: Loneliness can result in a strong desire to talk to someone—anyone—who might understand how you feel and listen without judgment. If you don’t have a safe place to express your grief, these emotions can lead to social withdrawal or emotional numbness to protect the pain in your heart.
  • Anxiety: When you are caring for a loved one who is dying, it’s like living in a state of heightened anxiety all of the time. Anxiety, in turn, can cause physical symptoms such as tremulousness, palpitations, and shaking.
  • Guilt: The time prior to a loved one’s death can be a time of great guilt—especially if they are suffering. While you long for your loved one to be free of pain, you fear the moment that death will actually happen. You may also experience survivor guilt because you will continue with your life while they will not.
  • Intense concern for the person dying: You may find yourself extremely concerned about your loved one, and this concern can revolve around emotional, physical, or spiritual issues.
  • Rehearsal of the death: You may find yourself visualizing what it will be like to have your loved one gone. Or if you are dying, visualizing how your loved ones will carry on after your death. Many people feel guilty about these thoughts, but they are very normal and are part of accepting the inevitability of death.
  • Physical problems: Physical problems such as sleep difficulty and memory problems. Learn more about the physical toll of grief.
  • Fears of loss, compassion, and concern for children: One study found that fears about what was going to happen and how they would be cared for were very strong in children who are facing the death of a parent or grandparent.2

While you may have heard of the stages of grief and the four tasks of grieving, it’s important to note that most people do not neatly follow these steps one by one and find that they wake up one morning feeling they have accepted what has happened and have recovered.

Instead, any of these stages may be present at any one time and you may find yourself re-experiencing the same feelings of shock, questioning, or despair many times over. As noted above, there is no right way to feel or grieve.

Treatment and Counseling

Anticipatory grief is a normal process in the continuum of grief. But in some cases, this grief can be so intense that it interferes with your ability to cope. It’s also common for people to develop depression when faced with all of the losses surrounding grief and it can be difficult to distinguish grief from depression.

Coping With Anticipatory Grief

It’s important to express your pain and let yourself grieve. Finding a friend or another loved one you can share your feelings openly with is extremely helpful, just as maintaining hope and preparing for death at the same time is difficult.

It can be even harder as people may wonder why you are grieving—even become angry that you are grieving—before the actual death.

Keep in mind that letting go doesn’t mean you have to stop loving your loved one—even after they die. During this stage, some people begin to find a safe place in their heart to hold memories of their loved one that will never die.

Frequently Asked Questions

  • What is anticipatory grief?

    Anticipatory grief is a sense of deep sorrow that occurs before someone’s death, as you’re anticipating what will happen.3 Your feelings can be very confusing and may leave you lonely and anxious on top of feeling great sadness.

  • Why do I feel guilty about my friend dying?

    Guilt can be related to many emotions. You may have a sense of relief that a person who’s been ill is at the end of their suffering, but that feeling comes with guilt that you’re “happy” they’ll die soon. Sometimes, guilt comes from unresolved issues you may have had with the person who is dying.

  • Complete Article HERE!

The 11 qualities of a good death

Opening up about death can make it easier for ourselves and our loved ones.

By Jordan Rosenfeld

Nearly nine years ago, I received a call from my stepmother summoning me to my grandmother’s house. At 92 years old, my Oma had lost most of her sight and hearing, and with it the joy she took in reading and listening to music. She spent most of her time in a wheelchair because small strokes had left her prone to falling, and she was never comfortable in bed. Now she had told her caregiver that she was “ready to die,” and our family believed she meant it.

I made it to my grandmother in time to spend an entire day at her bedside, along with other members of our family. We told her she was free to go, and she quietly slipped away that night. It was, I thought, a good death. But beyond that experience, I haven’t had much insight into what it would look like to make peace with the end of one’s life.

A recent study published in the American Journal of Geriatric Psychiatry, which gathered data from terminal patients, family members and health care providers, aims to clarify what a good death looks like. The literature review identifies 11 core themes associated with dying well, culled from 36 studies:

  • Having control over the specific dying process
  • Pain-free status
  • Engagement with religion or spirituality
  • Experiencing emotional well-being
  • Having a sense of life completion or legacy
  • Having a choice in treatment preferences
  • Experiencing dignity in the dying process
  • Having family present and saying goodbye
  • Quality of life during the dying process
  • A good relationship with health care providers
  • A miscellaneous “other” category (cultural specifics, having pets nearby, health care costs, etc.)

In laying out the factors that tend to be associated with a peaceful dying process, this research has the potential to help us better prepare for the deaths of our loved ones—and for our own.

Choosing the way we die

Americans don’t like to talk about death. But having tough conversations about end-of-life care well in advance can help dying people cope later on, according to Emily Meier, lead author of the study and a psychologist who worked in palliative care at the University of California San Diego’s Morres Cancer Center. Her research suggests that people who put their wishes in writing and talk to their loved ones about how they want to die can retain some sense of agency in the face of the inevitable, and even find meaning in the dying process.

Natasha Billawala, a writer in Los Angeles, had many conversations with her mother before she passed away from complications of the neurodegenerative disease ALS (amytropic lateral sclerosis) in December 2015. Both of her parents had put their advanced directives into writing years before their deaths, noting procedures they did and didn’t want and what kinds of decisions their children could make on their behalf. “When the end came it was immensely helpful to know what she wanted,” Billawala says.

When asked if her mother had a “good death,” according to the UCSD study’s criteria, Billawalla says, “Yes and no. It’s complicated because she didn’t want to go. Because she lost the ability to swallow, the opportunity to make the last decision was taken from her.” Her mother might have been able to make more choices about how she died if her loss of functions had not hastened her demise. And yet Billawalla calls witnessing her mother’s death “a gift,” because “there was so much love and a focus on her that was beautiful, that I can carry with me forever.”

Pain-free status

Dying can take a long time—which sometimes means that patients opt for pain medication or removing life-support systems in order to ease suffering. Billawala’s mother spent her final days on morphine to keep her comfortable. My Oma, too, had opiate pain relief for chronic pain.

Her death wasn’t exactly easy. At the end of her life, her lungs were working hard, her limbs twitching, her eyes rolling behind lids like an active dreamer. But I do think it’s safe to say that she was as comfortable as she could possibly be—far more so than if she’d been rushed to the hospital and hooked up to machines. It’s no surprise that many people, at the end, eschew interventions and simply wish to go in peace.

Emotional well-being

Author and physician Atul Gwande summarizes well-being as “the reasons one wishes to be alive” in his recent book Being Mortal. This may involve simple pleasures like going to the symphony, taking vigorous hikes or reading books He adds: “Whenever serious sickness or injury strikes and your body or mind breaks down … What are the trade-offs you are willing to make and not willing to make?”

Kriss Kevorkian, an expert in grief, death and dying, encourages those she educates to write advance directives with the following question in mind: “What do you want your quality of life to be?”

The hospital setting alone can create anxiety or negative feelings in an ill or dying person, so Kevorkian suggests family members try to create a familiar ambience through music, favorite scents, or conversation, among other options, or consider whether it’s better to bring the dying person home instead. Billawalla says that the most important thing to her mother was to have her children with her at the end. For many dying people, having family around can provide a sense of peace.

Opening up about death and dying

People who openly talk about death when they are in good health have a greater chance of facing their own deaths with equanimity. To that end, Meier is a fan of death cafés, which have sprung up around the nation. These informal discussion groups aim to help people get more comfortable talking about dying, normalizing such discussions over tea or cake. It’s a platform where people can chat about everything from the afterlife (or lack thereof) to cremation to mourning rituals.

Doctors and nurses must also confront their own resistance to openly discussing death, according to Dilip Jeste, a coauthor of the study and geriatric psychiatrist with the University of California San Diego Stein Institute for Research on Aging. “As physicians we are taught to think about how to prolong life,” he says. That’s why death becomes [seen as] a failure on our part.” While doctors overwhelmingly believe in the importance of end-of-life conversations, a recent US poll found that nearly half (46%) of doctors and specialists feel unsure about how to broach the subject with their own patients. Perhaps, in coming to a better understanding of what a good death looks like, both doctors and laypeople will be better prepared to help people through this final, natural transition.

Complete Article HERE!

Grief-induced anxiety

— Calming the fears that follow loss

By Jessica DuLong

Millions of Americans are grieving loved ones taken by Covid-19. Yet even outside of a pandemic — with its staggering losses of lives, homes, economic security and normalcy — grief is hard work.

“The funny thing about grief is that no one ever feels like they’re doing it the right way,” said therapist Claire Bidwell Smith, author of “Anxiety: The Missing Stage of Grief.” But there is no right way, she insisted. The only “wrong” way is to not do it.

What often trips people up is misattributing the sensations of grief-related anxiety to some unrelated cause. “Probably 70% of my clients have gone into the hospital for a panic attack following a big loss,” Smith said.

After doctors rule out physical illness, clients come to her for counseling, frequently struggling to understand the link between their physical symptoms and bereavement.

This becomes especially problematic in grief-averse places like the United States, Smith explained.

With over 4 million reported Covid-19 deaths reported worldwide since December 2019, grief and loss have touched an untold number of hearts and minds. Smith recommends connecting the dots between loss and anxiety as a critical first step toward healing.

This conversation has been edited and condensed for clarity.

CNN: How are grief and anxiety related?

Claire Bidwell Smith: When some big change comes seemingly out of nowhere and disrupts life, we realize we’re not safe, things aren’t certain, we’re not in control.

All of that is true all of the time, but loss is a huge reminder. The life changes and emotional upheaval are so much bigger than most people understand. Grief, which is the series of emotions that accompany a significant loss, can drop you to your knees. That feeds anxiety.

Grieving people can begin feeling anxious about their own health or the safety of other loved ones. Sometimes, they don’t even realize what they are experiencing is anxiety or is in any way related to their grief.

Anxiety, a psychological condition that causes fear and worry, can present with many physical symptoms. These can be misleading, making you think you have heart palpitations, a stomach issue, a new sweating problem, headaches, insomnia. Many people think they have a medical problem and not an emotional one.

CNN: How do you help people ease their grief-related anxiety?

Smith: My first job is to help people connect the dots between their loss and their fears by tracing their anxiety on a time line: When was I last anxious? How were things before my loved one died?

If the loved one had a long illness, the anxiety might begin before the death. After a sudden death, the anxiety might start right away. Usually if someone’s going to veer into anxious territory, it’s something that happens quickly following loss.

Some people I see, who have never had anxiety in their lives, suddenly begin to have panic attacks right after the death of a loved one. Others, long familiar with anxiety, see symptoms really ratchet up after a loss, or maybe take on new manifestations.

CNN: What coping strategies can people use?

Smith: Seeking out support is really vital. There are so many more support groups and grief therapists available right now. And because of the pandemic, many are available virtually. You can often find support online and start tomorrow. If the therapists or groups you find are booked, get on a wait list. It’s never too late to work through your grief.

If people don’t seek out help to untangle their emotions, they get stuck in anger or guilt. Those play out in substance abuse, depression and anxiety, in relationship issues and in trouble at work and school. So, the domino effect of trying to muscle through and not seeking out support isn’t good.

CNN: What advice do you have for those resistant to formal mental health treatment?

Smith: Self-guided online courses are one option that many therapists provide. Even reading articles or books or listening to a podcast about grief can normalize your experience and help you give you more permission to mourn. You can feel like you’re going crazy, like something else is wrong with you, when really, it’s grief.

Social media offers so many grief resources. A simple search on Instagram for #grief can help you find solidarity with others. Even just reading about other people’s experiences through their posts and comments is valuable because it can help you realize you’re not alone.

CNN: Because of the pandemic, so many people have been unable to be with their dying loved ones. What impact might that have?

Smith: We will see more complicated grief, with extended periods of grieving where people may get stuck in a loop of guilt or regret or anger. That comes, in part, from the feeling that a lot of the losses were preventable, and because people were forced to say goodbye to loved ones over Zoom and FaceTime with nurses wearing masks and face shields. Those kinds of endings can lend themselves to complicated grief.

Clients I’m working with who have lost a loved one to Covid-19 are feeling anger as they watch people get vaccinated — or choose not to get vaccinated. Everyone’s posting reunion pictures. Someone who lost a parent to Covid a month ago is painfully aware of just how close they were to not having to go through this loss.

Initially, they have to work through shock, anger and guilt. Then we can begin to find new ways to say goodbye. That can look like doing self-compassion exercises or speaking with a pastor, minister or rabbi to work on absolution of guilt. It can involve finding spiritual connections to someone they have lost by writing them letters. I urge people to embrace their own sense of ritual and perhaps even hold memorials.

CNN: What role do meditation and mindfulness play in healing?

Smith: When we are grieving, and when we are anxious, we spend a lot of time dwelling in the past and fretting about the future. Meditation and mindfulness help bring our awareness to the present moment.

Meditation also helps us to understand our own thoughts, and how we can learn to detach from negative ideas and irrational fears.

CNN: You write that imagination can be another powerful tool. How?

Smith: I wasn’t there the night my mother died. Even today, I imagine myself crawling into her hospital bed and holding her and saying the goodbye that I didn’t get to. I’ve found catharsis in envisioning what I would have done, had I been able. But it took me years — definitely more than five — to get to that point.

Just like when athletes envision a course the night before, imagination can almost give your body a sense memory, which can be soothing. But it’s not something that people are ready to do right away.

CNN: What role does story play in coping with grief and loss?

Smith: People carry around stories of loss and death, but they often feel like they are suppressing them because they haven’t found good places to share them. How we hold a story is very indicative of how we feel emotionally. When we are holding a scary story, an uncomfortable story, a story of regret for a long time, it plays out in our day-to-day life.

Healing comes from finding outlets to explore a story and possibly find ways to reframe it. We can do that in therapy, counseling, support groups, online grief forums and grief writing classes, among other places.

CNN: You’ve come to believe that staying connected with our lost loved ones can be more healing than letting go. What does that look like?

Smith: That looks different for everyone, and it isn’t something most of us can do right away — we often just want our person back in front of us. But once they are ready, I encourage my clients to call upon their loved ones, continuing to be in conversation with them internally. There used to be this emphasis on letting go and moving on. Now, I feel it’s more important to move forward with the person you have lost.

For example, pondering: What advice would my dad give me about this job offer? What would my mom think of my new boyfriend?

Developing and fostering a relationship with our person can include sharing stories about them, taking on certain aspects of work they did or doing things in remembrance.

CNN: You quote Hope Edelman, author of “The AfterGrief,” who has said the crux of grief work is making meaning out of loss. Is there a way to foster the meaning-making that can have such lasting value?

Smith: In some ways, that stage comes naturally. However, we can’t get there until we work through guilt, regret and anger that stand in the way of our ability to make meaning. If we’re angry with our loved one or a situation that happened, a lot of people will hold onto that anger because it’s a very powerful emotion.

But I’ve never seen a grieving client who hasn’t questioned life in a new way. Where’s my person? Can they see me? Will I ever see them again? Why am I still here?

It’s really hard to go through huge loss and not have those questions. Those inquiries lead to finding meaning and transformation.

Complete Article HERE!

Planning your funeral doesn’t have to be scary, says the author of ‘It’s Your Funeral: Plan the Celebration of a Lifetime Before it’s Too Late’

By

The pandemic has forced many to rethink and readjust their present with their future. Some have left jobs that provided steady paychecks and a predictable complacency for unknown, yet meaningful passion projects. Others are are taking more control of their destinies as they see fit. Unwilling to settle in life anymore. So why would you settle in death?

That’s the question Kathy Benjamin, author of “It’s Your Funeral! Plan the Celebration of a Lifetime — Before it’s Too Late,” asks. Amid the book’s 176 pages, Benjamin exposes readers to death in a light, humorous, and practical way, akin to a soothing bath, rather than a brisk cold shower.

The Austin-based writer’s niche is death (her last book centered on bizarre funeral traditions and practices). Having panic attacks as a teen, Benjamin said enduring them felt like she was dying. It was then that she started wrestling with the idea of death.

“I feel like I’m actually dying all the time, so maybe I should learn about the history of death and all that,” she said. “If I’m going to be so scared of it, I should learn about it because then I’d kind of have some control over it.”

It’s that control that Benjamin wants to give to readers of this book. She introduces readers to concepts and steps one should contemplate now, in order to make sure the last big gathering centered on you is as memorable as you and your loved ones wish. Poring over the book, one finds interesting final resting options such as body donation that goes beyond being a medical cadaver, “infinity burial suits” that lets one look like a ninja at burial, but also helps nourish plants as decomposition begins; and quirky clubs and businesses that allow one to make death unique (as in hiring mourners to fill out your grieving space and time, and designing your own coffin).

Kathy Benjamin knows death can be scary, but she's determined to show that planning your own funeral doesn't have to be.
Kathy Benjamin knows death can be scary, but she’s determined to show that planning your own funeral doesn’t have to be.

Now before you think this is all a bit macabre, Benjamin’s book also serves as a personal log so you can start planning your big event. Amid the pages, she offers prompts and pages where you can jot down thoughts and ideas on fashioning your own funeral. If you want to have a theme? Put it down in the book. You want to start working on your eulogy/obituary/epitaph, will, or your “final” playlist? Benjamin gives you space in her book to do so. It’s like a demise workbook where you can place your best photos to be used for the funeral and your passwords to your digital life, for your loved ones to have access to that space once you’re gone. If all the details are in the book, a loved one just has to pick it up and use it as a reference to make sure your day of mourning is one you envisioned.

As Benjamin writes: “Think about death in a manner that will motivate you to live the best, most fulfilling life possible. By preparing for death in a spiritual and physical way, you are ensuring that you will succeed right to the end.”

“Everyone’s going to die, if you’re willing to be OK with thinking about that, and in a fun way, then the book is for you,” she said.

We talked with Benjamin to learn more about the details of death and thinking “outside the coffin” for posterity’s sake. The following interview has been condensed and edited.

‘It’s Your Funeral! Plan the Celebration of a Lifetime — Before it’s Too Late’ is by Kathy Benjamin, Quirk Books, 176 pages, $14.40.
‘It’s Your Funeral! Plan the Celebration of a Lifetime — Before it’s Too Late’ is by Kathy Benjamin, Quirk Books, 176 pages, $14.40.

Q: How much time did it take you to find all this data about death? You share what was in the late Tony Curtis’ casket.

Kathy Benjamin: I have shelves of books that range from textbooks to pop culture books about death, and it’s something that a lot more people than you think are interested in so when you start doing online research you might just find a list of, here’s what people have in their coffin and then from there, you’re like: ‘OK, let’s check if this is true.’ Let’s go back and check newspaper articles and more legitimate websites and things and those details are out there. People want to know. I think of it as when you see someone post on Facebook — somebody in my family died. I know for me, and based on what people reply, the first thing is: What did they die of? We want these details around death. It’s just something people are really interested in. The information is out there and if you go looking for it, you can find it.

Q: Was the timing for the release of the book on point or a little off, given the pandemic?

KB: That was unbelievable timing, either good or bad, how you want to look at it. I ended up researching and writing during that whole early wave in the summer (2020) and into the second wave, and it was very weird. It was very weird to wake up, and the first thing I would do every morning for months was check how many people were dead and where the hot spots were, and then write … just a lot of compartmentalization. My idea was because people who were confronting death so much, maybe it would open up a lot of people’s minds who wouldn’t normally be open to reading this kind of book, they’d be like: ‘OK, I’ve faced my mortality in the past year. So actually, maybe, I should think about it.’

Q: Is there anything considered too “out there” or taboo for a funeral?

KB: I always think that funerals really are for the people who are still alive to deal with their grief, so I wouldn’t do anything that’s going to offend loved ones. I can’t think of what it might be, but if there’s a real disagreement on what is OK, then maybe take the people who are going to be crying and keep them in mind. But really, it’s your party. Plan what you want. There are so many options out there. Some people, they still think cremation isn’t acceptable. Because death is so personal, there’s always going to be people who think something is too far, even things that seem normal for your culture or for your generation.

Q: You mention some interesting mourning/funeral businesses, but many seem to be in other countries. Do we have anything cool in the U.S. as far as death goes that maybe other places don’t have?

KB: One thing we have more than anywhere in the world is body farms. We have a couple and just one or two in the entire rest of the world. The biggest in the world is at the University of Tennessee. For people who don’t know, body farms are where you can donate your body as if you would to science, but instead of doing organ transplants or whatever with it, they put you in the trunk of a car or they put you in a pond or they just lay you out and then they see what happens to you as you decompose. Law enforcement recruits come in and study you to learn how to solve crimes based on what happens to bodies that are left in different situations. I think they get about 100 bodies a year. I always tell people about body farms because if you’re into “true crime” and don’t care what happens to you and you’re not grossed out by it, then do it because it’s really cool and it’s helpful.

Q: You mention mummification and traditional Viking send offs, what about the burning of a shrouded body on a pyre? Have you heard about that? It was the way hunters were sent into the afterlife on the TV series “Supernatural.”

KB: I haven’t heard of anyone doing it in America but obviously that’s a big pop culture thing. For Hindus, that’s the way it happens in India … you go to the Ganges, and they have places specifically where you pay for the wood and they make a pyre and that’s how people go out. I doubt there’s a cemetery or a park that would allow you to do it in the U.S., but on private land, you’re pretty much allowed to do whatever. I would definitely check on regulations. You would have to get the pyre quite hot to burn the body to ash, like hotter than you think to make sure you don’t get a barbecued grandpa.

Q: In your research, have you come across anything that completely surprised you because it’s so unheard of?

KB: There’s been things like funerary cannibalism, which is where you eat loved ones after they’ve died. But once you’ve read the reasons why different tribes around the world have done it, you’re like ‘OK, I can see why that meant something, why it was meant to be emotional and beautiful.’ Things like sky burial in Tibet, they have a Buddhist monk chop up the body and lay it out for the vultures to come get. Part of it ties back to Buddhist tradition but also it’s Tibet, you can’t dig holes there in the mountains. So, there’s a logical reason for it. When you look at these things that originally seem gross or weird, once you learn the reasons behind them it all comes back in the end to trying to do something respectful for the dead, and trying to give the living that closure.

Q: What are your plans for your funeral?

KB: I definitely want to be cremated. I don’t know if I want people to necessarily come together for a funeral for me but like I have a playlist, and even before the book I had a whole document on the computer of what I wanted. I want all the people to know about the playlist and then they can kind of sit and think about how awesome I am while the sad songs play, and then there’s different places that I would want my ashes scattered.

Complete Article HERE!

Why Some Scientists Think Consciousness Persists After Death

We should not assume that people who are near death do not know what we are saying

By News

A very significant change that happened in the last century or so has been the ability of science professionals to see what happens when people are thinking, especially under traumatic conditions.

It was not a good moment for materialist theories. Here is one finding (there are many others): Death is a process, usually, not simply an event.

Consciousness can persists after clinical death. A more accurate way of putting things might be that the brain is able to host consciousness for a short period after clinical death. Some notes on recent findings:

The short answer is, probably, yes:

Recent studies have shown that animals experience a surge in brain activity in the minutes after death. And people in the first phase of death may still experience some form of consciousness, [Sam] Parnia said. Substantial anecdotal evidence reveals that people whose hearts stopped and then restarted were able to describe accurate, verified accounts of what was going on around them, he added.

“They’ll describe watching doctors and nurses working; they’ll describe having awareness of full conversations, of visual things that were going on, that would otherwise not be known to them,” he explained. According to Parnia, these recollections were then verified by medical and nursing staff who were present at the time and were stunned to hear that their patients, who were technically dead, could remember all those details.

Mindy Weisberger, “Are ‘Flatliners’ really conscious after death?” at LiveScience (October 4, 2017)

Death is probably, in most cases, a process rather than a single event:

Time of death is considered when a person has gone into cardiac arrest. This is the cessation of the electrical impulse that drive the heartbeat. As a result, the heart locks up. The moment the heart stops is considered time of death. But does death overtake our mind immediately afterward or does it slowly creep in?

Some scientists have studied near death experiences (NDEs) to try to gain insights into how death overcomes the brain. What they’ve found is remarkable, a surge of electricity enters the brain moments before brain death. One 2013 study out of the University of Michigan, which examined electrical signals inside the heads of rats, found they entered a hyper-alert state just before death.

Philip Perry, “After death, you’re aware that you’ve died, say scientists” at BigThink (October 24, 2017)

Despite claims, current science does not do a very good job of explaining human experience just before death:

Researchers have also explained near-death experiences via cerebral anoxia, a lack of oxygen to the brain. One researcher found air pilots who experienced unconsciousness during rapid acceleration described near-death experience-like features, such as tunnel vision. Lack of oxygen may also trigger temporal lobe seizures which causes hallucinations. These may be similar to a near-death experience.

But the most widespread explanation for near-death experiences is the dying brain hypothesis. This theory proposes that near-death experiences are hallucinations caused by activity in the brain as cells begin to die. As these occur during times of crisis, this would explain the stories survivors recount. The problem with this theory, though plausible, is that it fails to explain the full range of features that may occur during near-death experiences, such as why people have out-of-body experiences.

Neal Dagnall and Ken Drinkwater, “Are near-death experiences hallucinations? Experts explain the science behind this puzzling phenomenon” at The Conversation (December 4, 2018)

Such explanations are a classic case of adapting a materialist hypothesis to fit whatever has happened. They don’t explain, for example, terminal lucidity, where many people suddenly gain clarity about life.

Research medic Sam Parnia found, for example, that, of 2000 patients with cardiac arrest,

Some died during the process. But of those who survived, up to 40 percent had a perception of having some form of awareness during the time when they were in a state of cardiac arrest. Yet they weren’t able to specify more details.

Cathy Cassata, “We May Still Be Conscious After We Die” at Healthline (September 24, 2018) The paper requires a subscription.

So we should not assume that people who are on the way out cannot understand us. Maybe they can — and would like to hear that they are still loved and will be missed.

Complete Article HERE!