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 Cloak Room

Noticing that the man I mentioned yesterday died so soon after my visit I got curious about the effectivity of the cloak room metaphor.

I remember I was called to the bed of a dying woman. When I arrived she was breathing about once per minute. I didn’t know that a person could breathe so little and still be alive. Her daughter and her son in law were there. I asked if it were appropriate to speak a prayer, to which they said “Yes”. After telling the dying woman that her daughter and son in law were there, who I was and what I was going to do I put my hand on her arm and spoke a prayer. Then I said to her: “I would like to tell you something, Mrs. S. I imagine there’s a door. When it will be the right time for you, you can go through that door. Next to the door there’s a cloak room. There’s someone who can have an eye on your things so they’re safe. It’s a special wardrobe. You can had in anything that’s a burden to you.
If you’re afraid – take it off. You don’t need any fear over there.
If you’re sad – hand it in. For what? You don’t have any use for that now.
If you bear a grudge or haven’t forgiven someone – hang it on the big wardrobe.
If you feel obliged to anything – take it off.
If you think you need to stay – there’s nothing you need to! If you want, give it to the one who’s standing there for guarding it.
If you think there’s still something left to do or that there’s anything missing – hand it in to the one who will guard it for you.
If there’s anything unpleasant in your body – give it to him as well.
If there’s any problem with breathing – give it to him as well.
If there’s anything else you would like to give to him – hand in anything that you don’t need any more.
Give him anything that has become a burden for you. Take it off. You don’t need it any more. And when you notice that it’s time for you, go through the door.” I finished with a blessing.
During the prayer the breath frequency of the woman had gon up to about six breaths per minutes, and thus it stayed for a while. Her daughter and son-in-law were observing her breath silently. The silence felt somewhat heavy for me and I had the imagination it could be the same for the dying woman. So I asked: “Can you tell me what happened so your mother got in this state?” The daughter said a few sentences. Her mother’s breath got very slow again. After five breaths there was a very tiny one. Then everything was still. (Stefan Hammel, Loslassen und leben. Impress, Mainz 2016)
I’ve used this metaphor a number of times now. Often the effect seemed to be very strong. The structure is thus: There’s door and a cloak room and an attendant next to it. You say: Whatever burdens you concerning the past: Hand it in. This can be specified as a bad conscience or anger against someone else or sadness about something that happened. Whatever burdens you concerning the future: Hand it in. This could be specified as worries about the relatives or about what comes after death. Whatever burdens you concerning the present, hand it in. This could for example be specified as a discomfort of the body (pain) or breathing problems.

Luís

Yo todavía era niño. Pero también si hubiera sido mayor, no habría podido decir como el carpa se hubiera explicado a si mismo su curioso viaje. Es que algunos amigos míos se habían permitido una jugarreta con él. De noche, clandestinamente lo habían sacado de su estanque con una red. Lo habían llevado en un cubo a través de bosques y campos por muchos kilómetros. La piscina en el jardín de mis padres debería ser su nuevo hogar. Tengo que admitir: No fue poco nuestro asombro cuando lo vimos nadando sus rondas en el agua. Me parece que fue en septiembre. Ya no se echaba cloro al agua, la temporada de nadar casi se había acabado. Entonces pez y ser humano ya no se hacían tanta competencia el uno al otro, y así Luís, como lo llamamos, podía quedarse allí por el momento. Vino el invierno y con él una espesa capa de hielo.
En la primavera, el agua fue cambiada. Como se puso en manifiesto , Luís había superado bien el invierno. El consejo familiar acordó devolverlo a su hogar. Otra vez Luís fue despachado en un cubo. Lo más grande que pudimos encontrar era un cubo ya inservible de pintura. Siguiendo caminos de bosque y de campo, nos fuimos para devolverlo a sus amigos y familiares. En el cubo, Luís dio sus vueltas, en círculos bastante pequeños, porque había crecido durante el invierno, y un viejo cubo de pintura no es una casa señorial para un carpa. Encima de eso, la mitad del agua se nos derramó a lo largo del camino. Pero finalmente llegamos. Con un empuje Luís acabó en su estanque para reencontrar sus viejos conocidos. Lo que hizo después fue muy sorprendente: Luís dio sus vueltas allí, pero lo hizo como que si no se encontrara en un estanque sino en un pequeño cubo, como antes. Trazó seis o siete círculos de un diámetro inferior a medio metro. Después los círculos se convirtieron en una espiral, estrecha al inicio y ampliándose más y más. Finalmente Luís comprendió donde se encontraba. En una larga línea se disparó fuera de su órbita de cubo.

(Por Stefan Hammel, traducción: Bettina Betz)

La flor en la isla

En una pequeña isla en medio del océano extenso crecía una hermosa flor amarilla de oro. Nadie sabía cómo había llegado allí, porque en esta isla no había ninguna flor aparte de ella. Las gaviotas venían volando para contemplar este milagro con asombro. “Es linda como el sol”, decían. Los peces venían nadando. Levantaban las cabezas encima del agua para admirarla. “Es linda como un coral”, decían. Un cangrejo salió a la tierra para mirarla. “Es linda como una perla en el suelo del mar”, dijo. Y todos venían casi cada día para admirar esta flor.

Un día, cuando volvieron para contemplar la flor, se encontraron con que los pétalos dorados de la flor se habían vuelto marones y secos. “Ay de nosotros”, dijeron las gaviotas, los peces y el cangrejo. “El sol quemó nuestra flor. ¿Quién ahora nos refrescará el corazón?”. Y todos se pusieron tristes.

Pero algunos días más tarde apareció en lugar de la flor una maravillosa bola de color blanco tierno. “¿Qué es eso?”, preguntaron los animales. “Es tan blando como una nube”, dijeron las gaviotas. “Es tan ligero como la espuma de las olas”, dijeron los peces. “Es tan fino como el resplandor del sol en la arena”, dijo el cangrejo. Y todos los animales se alegraron.

En este momento un golpe de viento barrió la isla y sopló este milagro blanco dispersándolo por ella en miles de copos. “Ay de nosotros”, hablaron las gaviotas, los peces y el cangrejo. “El viento ha dispersado nuestra bola. ¿Qué alegrará nuestro ánimo ahora?” Y todos estaban tristes entonces.

Un día por la mañana, al levantarse el sol sobre la mar, allí en la luz dorada matinal relucieron cientos y cientos de hermosas flores color amarillo de oro. Entonces bailaron las gaviotas en el cielo y los peces en el agua, y el cangrejo bailó con sus amigos una danza de rueda en medio de las flores, y todos se alegraron.

(Por Stefan Hammel, traducción: Bettina Betz)

Midsummer Night’s Dream

Another beautiful story by Katharina Lamprecht

One day, it was Midsummer and the Swedish days where as long as the dinner table for the king’s birthday. A wise old moose on his evening stroll met a young boy, sitting on a moss covered tree trunk, sobbing deeply. The old moose stopped and looked at the boy who did not notice him because of all his despair. Not until the moose nudged him with his soft muzzle did the boy raise his eyes. And just in front of him he saw the big brown eyes of the moose. He saw in those eyes all the stars in the heavens that he could not see before on this Midsummer night. So big, so deep and so endless the eyes seemed to be that he got the feeling he could just take a walk right into them. The stars where so beautiful, like jewels, iridescent and glittering in all colors he could imagine, scattered like the crumbles on grandma’s apple-pie, big ones and small ones, thick and thin ones, each of them meaningful and unique. At the sight of all those treasures the boy got the feeling he was surrounded by good friends, who bestowed upon him potency and love.

So they stood for a long time and looked at each other, the young boy and the old moose. Then the moose blew his warm and soft breath through the boy’s hair, turned around and faded into the forest. The boy looked after him for a long time, as if in trance, and only after a while did he discover that his infinite sadness had transformed. It was still there but all of a sudden there was also a happiness and cheerfulness. And he somehow felt that this had something to do with the stars he had seen in the fathomless eyes of the old moose.

He turned around and walked back home. And whistling happily away he kicked at the stones that laid on his way.

El lobo de mar y el lobo de madriguera

Antaño el lobo de mar recibió visita del lobo de madriguera. Ambos se conocían ya de la escuela de lobos. Después de terminar la escuela el lobo de mar había salido para recorrer medio mundo, había superado muchas aventuras y al final había regresado rico de tesoros y de vivencias.
El lobo de madriguera se había quedado en su propia cueva. Había encontrado a una loba de madriguera y habían tenido pequeños lobos de madriguera. Mientras tanto tenían muchos nietos y bisnietos de lobo y todos se habían hecho verdaderos, buenos lobos de madriguera.
“A veces deseo poder recomenzar mi vida”, dijo el lobo de madriguera al lobo de mar.
“A mí me pasa lo mismo”, contestó este.
“Haría de otra manera muchas cosas”, dijo el lobo de madriguera.
“Sí, yo también”, contestó el lobo de mar.
“Sería marino”, soñó el lobo de madriguera.
“Yo me casaría”, suspiró el lobo de mar.
“Superaría aventuras”, declaró el lobo de madriguera.
“Engendraría hijos de lobo”, constató el lobo de mar.
“Yo sería un lobo rico. Habría hecho experiencias malas y lindas de las que podría contar”, se apasionó el lobo de madriguera.
“Tendría nietos y bisnietos que me quisieran y que cuidaran de mi cuando me pusiera viejo y enfermo”, sostuvo el lobo de mar.
“Y ahora estaría sentado contigo en esta guarida de lobo de mar”, continuó el lobo de madriguera.
“… y yo contigo …”, le interrumpió el lobo de mar.
El lobo de madriguera confirmó: ”Y entonces me dirías ahora: ’A veces desearía que pudiera volver a vivir otra vez.’ Y yo contestaría: ‘Sí, a mi me pasa lo mismo’.”

(Por Stefan Hammel, traducción: Bettina Betz)

Le village de montagne

J’ai demandé à un client : « Si vous voulez, imaginez-vous une fois votre vie comme un village de montagne, dans lequel le fleuve a débordé et a amené beaucoup de boue et d’éboulis. Après ce malheur le conseil municipal se réunit avec les villageois, les pompiers et la protection civile et ils discutent de ce qui est à faire. Il arrive tout d’abord des gens avec des pelleteuses, des bulldozers et des camions pour enlever le plus gros des éboulis. Pouvez-vous vous imaginer cela ? » « Oui. » « Vous pouvez voir comment ils déblaient tout ça. Après l’équipe de rangement il arrive des gens avec des tuyaux et des balais. Ils enlèvent toute la boue et le sable du village, toute cette saleté qui est venue de l’arrière-pays. Vous pouvez voir comment ils font tout couler vers le bas dans la vallée. Vient ensuite l’équipe des artisans. Il y a des maçons, des plâtriers, des peintres, peut-être aussi des électriciens, des installateurs, des stucateurs, des restaurateurs. « Que font-ils d’après vous ? » « Ils peuvent plafonner ou cloisonner. » « Exact. Quoi d’autre ? » « Poser une moquette. Câbler. Placer des tringles à rideau. » « Exact. Après les artisans arrivent les jardiniers. Ils aménagent de nouveau les parcs et les jardins. On rajoute peut-être un puits au village ou un tilleul au village pour améliorer encore plus le village, pour qu’il soit mieux qu’avant. Et un monument commémoratif. Peut-on imaginer cela ? » « Pas très bien. » « Eh bien, vous n’avez pas besoin de vous imaginer tout ça. Dites bonjour à votre âme, pour qu’elle fasse ça pour vous, comme ça vous n’avez pas à vous en occuper. Après il y a des personnes très importantes qui arrivent. C’est l’équipe de prévention. Ce sont eux qui veillent à ce que cela n’arrive plus. Ils peuvent planter la pente au-dessus du village par exemple, pour que les racines des arbres fixent la terre. Ils peuvent construire des murs et des grillages dans le style d’un paravalanche. Ils peuvent creuser un lit plus profond pour le ruisseau, peuvent construire des marches de barrage et des bassins de retenue ou même une déviation pour l’eau du ruisseau qui est de trop. »

The Balloon

A therapeutic story by Katharina Lamprecht, with whom, along with our Swiss friends Adrian Hürzeler and Martin Niedermann, I have written the book “Wie das Krokodil zum Fliegen kam” (How the crocodile learned to fly)…

No one in the community knew, when exactly the festivity would take place. But that it would happen, everyone was sure of it.

When the day came, they all gathered at the meadow near the village. So many people. Not only from the village but also wanderer, passing by accidentally, stopped and many shared the moment. In the middle of the meadow was a booth where everyone could choose and take a balloon filled with helium. There were red, green, blue, yellow and purple ones. Some had faces on them, some stripes or dots. It was all very colorful.

One after the other the people let go of their balloons. And up they rose into the blue-grey sky. And what a beautiful sight it was. At the beginning they all stayed together, a colorful bunch of balloons, like grapes on a grapevine. But after a while, some of them got loose, they peeled away and began their very own journey.

And one of them, I don´t recall whether it was the red one or the green one or perhaps the one with the little dots, this one made its way calmly and silently to a place where the others didn´t go and he got lost in the vastness of the sky, to fly far far away. Perhaps even to the stars.

Après la vague

Quelqu’un m’a écrit : »J’ai été chargé de préparer un séminaire d’aide à soi-même ayant pour sujet « l’angoisse ». Tous les participants souffrent d’une épilepsie. Auriez-vous quelques idées sur les histoires que je pourrais y raconter ayant pour sujet l’imprévisibilité des crises et la détresse qui y est liée ? »

Ma réponse fut la suivante : »Je propose que vous racontiez quelque chose sur les habitants de quelques villages sur la côte ayant survécu au grand tsunami il y a quelques années. Ils ont été pour ainsi dire des témoins qui s’en sont sortis avec plus de peur que de mal. Les habitants d’un village ont toujours regardé la mer avec les nerfs à vif en attendant la grande vague suivante. Ils ont organisé toute leur vie de manière à y être préparés. On pourrait dire aussi qu’ils ont gâché toute leur vie avec cette préparation. Et la mer était presque toujours calme… Les habitants d’un village voisin y ont vécu presque comme si rien ne s’était passé. En abordant les dangers de la mer ils disaient : « Si nous partons, nous partons. Mais maintenant nous sommes là, complètement. » Et il y avait d’autres villages … Vous pouvez dessiner une carte sur un tableau à feuilles mobiles sur lequel ces villages sont représentés. Demandez aux participants de vous dire dans lequel des deux villages ils veulent vivre, ou comment vivent les habitants dans un troisième et quatrième village, ou alors où les participants du séminaire si ça se trouve aimeraient mieux vivre. Demandez aux participants ce que signifie ce contact souhaitable avec la mer, à quoi on le reconnait et à quoi est dû le fait que les villageois mènent une vie d’assez bonne qualité malgré l’ancien tsunami. Vous pouvez demander aux participants de dessiner d’autres villages pour d’autres comportements avec la mer qui est rarement sauvage et dans la plus part des cas calme. Vous pouvez demander aux participants de dessiner le comportement avec la mer sur la carte ou, si la carte est placée au sol, de le marquer avec des maisons de Monopoly. Il serait aussi possible de marquer le site actuel avec le comportement d’une mer qui est rarement sauvage et la plus part du temps calme et de marquer le site souhaité et de réfléchir pour savoir qui et quoi peuvent les aider à déménager du domicile A vers B. »

Two cactuses

Another story by Katharina Lamprecht

“This is awful!”, one cactus complained, “My thorns are so long that no animal dares to come near me. No lizard, no bird not even the tiniest termite! I feel so lonely”.

“Why are you complaining?” the other cactus answered, “Mine are so weak and thin and soft that I cannot defend myself at all. No animal shows me any respect. The lizards climb all over me and tickle me with their little feet and the birds dig their claws so deep into my flesh that it hurts. I hate it”.

“You are a lucky one”, the first cactus replied, “I would give my roots for an experience like that. Imagine, feeling all that life on oneself”.They went on complaining and lamenting in this way to each other for a while. But suddenly they had a wonderful idea: they would swap their thorns so that each other could get the feeling they wanted. And for a short time, both were happy. One, to feel the birds and lizards and the other to enjoy peace and quiet. But that didn´t hold on for long and soon each began to complain again. They felt their new lives to be exhausting or boring and they longed for their old lives. So they swapped their thorns back. But again, after a short period of contentment they began whining again as before.

Then one day the wise old snake came along and rested for a moment in the shade, the two cactus casted. She listened to the two of them, complaining away, and suddenly she whispered “instead of wailing to one another you better learn from one another”. And with these words said, she slithered on.

The cactus thought about these words for three days and three nights. Then they began to try and find out, how they each managed to let their individual thorns grow. When they knew how to do that, each started to explain and teach the other how to do it. After some practice they knew precisely how to grow strong and how to grow weak thorns. And the more they experimented the better they became and the more colorful and different their thorns got.

Now they were able to keep a perfect balance between peace and quiet and lively action. And for the wise little snake they created a thornless and shady space right between them.