At Dying Beds

At dying beds I’ve experienced a lot of silence – which felt at times good, at times disturbing. Dying people will be almost always be in coma in their last hours (and, mostly, days). What hinders us from speaking with the dying?

  • As family members, we may be in a shock state, frozen or confused.
  • We may be insecure if they hear and understand us.
  • We may be insecure what is relevant and helpful for them.
  • We may feel insecure what the staff thinks of us if we behave unconventional.
But surely, if we find out what hinders us from speaking and acting, this can free us and widen the range of our possibilities, to the benefit of both ourselves and the patient.

Sometimes it’s extremely difficult to notice and interpret any nonverbal reactions of coma patients. In other cases we need to sharpen our senses. With no other body reactions left, often there are still reactions on our words, or on caressing, in the patients’ changing his of breath style and rhythm (unless on a breathing machine).
If we do find tiny nonverbal reactions or changes of the way of breathing, the questions are:

  • Does the patient show this behavior repeatedly (every time) when we bring up a certain topic or do something particular (or when a certain person is arriving or leaving or being mentioned)?
  • Do we rather see the reaction as one of stress or relief?

I would like to summarize a few things that I have learned from the Encounters I had with dying people.
1. Treat dying people as living people.                                                                              2. At a dying bed, get aware of what hinders you from acting and speaking free. Free yourself to get flexible.
3. Observe which tiny reactions (movements, mimics, breath) the dying person shows repeatedly on certain key words, persons, behavior. Are they reacions of stress, relief or interest? Which are the triggers?
4. Dying patients may be in coma, but they’re usually not deaf. Choose your words well. No catastrophic medical descriptions or burial talk.
5. Create rapport. Introduce yourself and tell your aim shortly. Use body contact, use your voice and breath pacing.
6. See a coma patient as someone who is already in trance. Create rapport. Interventions can start right away, without induction
7. The subconscious responds strongly to imagery. Speak in a dream language. Use metaphors, avoid abstract words.
8. Breath pacing and leading can regulate pain or breath problems (and can regulate breath down till it almost stops).
9. Breath, blood pressure and heart rate can also be regulated by metaphors (f. e. of a flying eagle, a pulsating jellyfish or a manta ray).
10. Speak about emotional content rather than about facts.
11. Express in metaphors or more directly that it is possible and good to let go – of live, of psychological problems of body problems.
12. Use metaphoric terms to speak about the good future.
13. Introduce thoughts like “You can love them from the other side”, “things will change, relations go on”.
14. Use negative terms only with a good reason. Except for pacing strong pain, don’t mention “pain” but “body sensations”. Teach this to the relatives.
15. People will rather die when they’re ready to go. What may help: Rituals, a bye-bye from family members, messages of “letting go”.

The Librarian

The story “The Librarian” shows a metaphor for the cooperation of conscious and unconscious thinking and represents a useful viewpoint of how memory functions. It is useful in any context where learning and gaining access to memories and capacities plays a role…

Do you sometimes try and think of somebody’s name and it just doesn’t come? And then you do something else and don’t even think about it any more and then suddenly – hey presto! – the name pops up! Isn’t it strange that you sometimes don’t find the solution while you are looking for it, but indeed and very so often, afterwards? How is this possible? There is only one answer…
A friendly librarian works in the brain that manages the stockpile of your knowledge. He sits in the service area on the ground floor near the lobby. The most frequently used books and folders he has nicely to hand and clearly presented in this zone. He has well ordered long shelves in the basement for the material that is rarely required. Sometimes when a book is out of place or your request does not meet the specifications of the registry, he needs more time to research. Because you’re not used to waiting, you are likely to think that he has forgotten you. But as the librarians are not like that, they are in fact very service-oriented and extremely meticulous! With your request in his hand off he goes through all of the basement rooms. He hunts and searches and finally: “Aha! I’ve got it!” With the book in hand, he comes up the stairs. He brings you what you need.

La respiration agréable

Une amie m’a appelée. Elle respirait extrêmement vite et de manière agitée et ne pouvait prononcer que quelques mots à la fois. Sa voix avait un drôle de son. Elle raconta que sa fille venait d’avoir un accident de voiture avec son bébé sur le siège arrière. Le bébé n’avait rien eu mais le SAMU avait transporté sa fille à l’hôpital car ils craignaient une fracture de la base du crâne. Elle-même avait dû rester où elle était ; elle devait garder le bébé et n’arrivait pas à savoir ce qui se passait avec sa fille. J’ai alors commencé à respirer et à parler de la même façon qu’elle et au bout d’un certain temps j’ai changé de rythme et ai ralenti peu à peu ma respiration et ma façon de parler. J’ai remarqué qu’elle me suivait instinctivement dans mon comportement et qu’elle se calmait. Sa voix sonnait claire et forte et ce qu’elle racontait maintenant sonnait plus positif qu’au début de la conversation. « Je te remercie de la façon dont tu m’as parlé », ont été ses mots quand elle termina la conversation.

After the storm

I’m using this story with stroke patients, with those who suffer from Multiple Sclerosis and with traumatised persons, including certain situations of separation and berievement. Most of all, it can be useful to support persons who want to recover their memory and access to their abilities.

The storm has done its work. The trees lay criss-cross in the forest. Their trunks block paths and streets. No traveller can make progress here. But when the storm is over, then comes the time of the lumberjacks. With their saws they cut free the paths, lift away the barriers and clear all the streets, starting with the outermost edge of the forest all the way to its innermost core.


After a while of pausing I would like to continue with some stories…
However, I would like to change the format a little bit and take turns between different languages. So, in addition to therapeutic stories in English there will be some in French and Spanish, as well. But, first of all, let’s continue in English . Here’s one which I have personwitnessed in our local hospital.

“Good morning. My name is … ” he began his speech. “She can’t speak,” explained the nurse. “Stroke… ” The helpless gestures of the young lady patient let him know that she did not understand his words, except for a few, for which he managed to coax from her a nod or a shake of the head. How can you still communicate with such a person? With gestures he painted in the air a steep staircase for her with high steps. But alas he sighed “Too steep!” He shook his head in disappointment. Then he drew with his hands a staircase with long low steps. With his fingers, he went along the whole staircase.
The woman looked attentively and nodded. With his hands he painted a high mountain in the air. A man of two fingers wanted to climb it. But he fell again. Then he found a path with a gradual slope, a zigzag, with many turns. He went this way. The woman’s eyes began to shine. And so the pantomime took its course. “Keep your eye on the goal” and “passion” followed as the next images. The movements of a marathon runner and an upwardly clenched fist; they inspired to perseverance and a fighting spirit.
The turning hands of a clock showed that it would take time. He continued the charade with his hands together on the side of his inclined head. “Sleep” and “wake”, “sleep” and “wake”, and many many times they would have to “sleep ” and “wake” until they would be at the peak, which he kept looking upwards at with his eyes and pointing to with his outstretched forefinger. With hands and feet, with his whole body, he portrayed the picture of how her children would hook into her left elbow, and her parents the right and how they would all go together with her, all the way.
Once again he stretched out his fist to the sky. She would have to fight for all she was worth. Three days later, he again visited the woman. “You know,” said the lady in the bed next to her, “she has been here for four weeks and nothing really happened but in the last three days she has made amazing progress”. He spoke with the patient again and this time she understood every sentence. Then he took his leave. “Goodbye” she said. It was her first recovered word.

Everything Else

In a land in our time there lived a man, who read a book and found lots of wonderful stories therein. There were true and invented stories, experienced and pensive, enjoyable and painful stories. There were stories which contained stories, and such which were actually not stories. For every story he read, there occurred to him nearly five which he had either experienced or thought up himself. So the thought came to him, that a lot in the world was a story which could be healing for himself and others; he only needed to absorb the healing stories well and to forget the terrible ones immediately. Then he would learn which story he had used when and for what. So he organised his own stories which he knew, and which had become a help to himself and others, or could become so. Sometimes he noted it down when a new story came to his ears and sometimes when a helpful story occurred to him, he memorised it.

Then he saw before him in a picture the storystories of this life arranged in long shelves, as in a large pharmacy. And behind the counter there sat a man who had learnt to listen to himself and others. He was a master of his subjectspecialty. His talent was that he understood how to tell the right thing at the right time to himself and to those who visited him.

The Path to Silence

A teacher came into an unruly class. “It will be difficult to get them to be quiet”, he thought to himself. Then he imagined that all pupils were small atoms caught up in a turbulent vibration. He brought himself into the same vibration, fidgeted a little bit with the arms, swayed from one leg to the other, and murmured something to himself. When he reached the same vibration as his pupils, he gradually became slower and quieter. The class also became calmer and quieter. He had to be careful not to calm himself too quickly – better to fidget for one moment more, and then become quiet again. He needed about three minutes. Then the class was completely still.

Later the same day, these same pupils were loud again. “Don’t be so loud!”, he shouted. And they remained loud. “We can’t work like this”, he yelled. “Please work without noise on your task!”, he called. And they remained loud. “Mark, be quiet! Julia, close your mouth! John, be still! Frank, quiet!”, he ordered. Then they became quieter. “Even quieter!”, he murmured, and it became even quieter. “I’m listening to ascertain where it is the quietest”, he whispered. “Whoever is quiet the fastest and stays quiet the longest, has won”, he whispered. And it became very quiet. “Absolute silence”, he breathed. Not a sound was to be heard. “Stay exactly like this”, he said, and continued with the lesson.

The Empathizer

There are people who can listen well. And there are others who can observe well. I knew a man once who could do both really well. More than anything else, he was a good empathizer.

When he met another person, in thought or in action he took on his behavior. He looked as the other did, he breathed in and out like him, he moved like the other, and also took on his voice. He felt how a man felt, when he expressed himself and moved in such a way, as the one he met. Then he often asked himself, how a bridge could be created which led away from this experience to another, to a much more powerful, free, and liberated existence.

This man understood many languages. He not only understood them but he spoke them too, at least when he wanted to. Sometimes he spoke the language of an offended person who kept a tear in his voice and held his left hand at his throat, who rubbed his eye after a painful word and coughed at upsetting words. Sometimes he spoke the language of a melancholic person who breathed as if drawing deep breath caused him pain, who spoke of all the things which are lacking, and who almost unnoticeably and yet persistently, shook his head from side to side. He spoke the language of an angry person whose jaw is as hard as a fist, and in between whose shoulderblades one could effortlessly crack nuts. He spoke the language of a sick person, to whom all talk of health seemed disrespectful towards his suffering, and the language of one racked with pain who, for a long time, had no longer searched for words for joy and desire, enjoyment and well-being. He knew the languages of the body, the voice and the breath, and also the ones of the organs, which indeed have their own words. From time to time the empathizer also told a story to the people who came to him. And such a story began, without fail, in the language of those with whom he spoke.While the empathizer spoke in the language of the stricken, flowing from his mouth came the air of the daring. The language of one who no longer cared became the language of one who is propelled by curiosity, and the expression of the suffering became the gesture of the calm and relaxed, who, minute by minute, forgets his pain. And the strange thing was that the people who listened to these stories changed with them. Sometimes this happened secretly and unnoticeably, and sometimes surprisingly, yet the changes had been long on the horizon. Such a story often became a bridge, widely stretched from the suffering of the people to their longed for goal. For the people around him it was a miracle – he simply called it a transformation. This transformation succeeded because the empathizer always secured the first pillar of the bridge near the cliff of their suffering – and never forgot the second pillar of the bridge on the side of desire.