Conscious Dying

Thirty years ago the conscious dying movement was born in the modern West. Basically, conscious dying is the process of utilizing the dying process as an opportunity to become more present and loving, an opportunity for profound healing, for spiritual awakening. Eastern traditions such as Hinduism and particularly Buddhism, as well as shamanic traditions, have explicit teachings that guide the dying to a conscious and graceful death.

In the West, however, this wisdom was lost in the rush to industrialization and modernity. For example, there is a body of Medieval Christian literature called Ars Moriendi or Art of Dying that provided guidance for the dying and for those attending them. This tradition fell into disuse in the late eighteenth century. For much of the twentieth century, death was almost completely denied in the West. The dying patient was told  you’re really looking better today. Family members were encouraged not to upset their dying loved one.

Things began to change in the late sixties. In 1967, Dame Cicely Saunders founded the first modern hospice in London. In 1969, Elisabeth Kubler-Ross’ On Death and Dying was published. Then the first American hospice was founded in New Haven in 1974. Death was coming out of the closet. A few people began to talk about death openly and honestly.

Originally there were spiritual underpinnings to the hospice movement, but as it grew in America, the need to subsist on third-party payments from insurance companies and from the government forced most hospices to deeply reduce their chaplaincy services. There are a few shining exceptions; our local Hospice by the Bay in Marin is one. Certainly each hospice is as spiritual as the individual human beings who are part of that hospice, but the hospice movement in general is no longer a spiritual movement.

Before the modern hospice movement, death was denied. Dying was about the body only, so the mind and the spirit were avoided. The main benefit of the hospice movement and of the work of Elisabeth Kubler-Ross was that death could be discussed, psychological issues were addressed directly, families could find closure, patients could finish business. People could make the best of a bad situation.

As long as we think we are only our body and our mind, dying most certainly is a bad situation. We are, however, two-fold beings, human/divine, relative/absolute, imperfect/perfect, at one and the same time. In fact, since we are losing our body and our mind in the dying process, the spiritual or soul dimension that each of us fundamentally is, becomes crucial.

When the physical and psychological needs of the dying patient are met to the extent that they are no longer overwhelming, dying becomes a great spiritual opportunity. (Whenever I mention dying or the dying patient, I am using shorthand to refer to someone confronting death who may be healed in body as well as mind and soul.) Bringing consciousness to the confrontation with a life-threatening illness adds to the possibility of physical healing.

In the early 1970s, my friend and associate Ram Dass began to talk publicly about the possibility of dying consciously. Ram Dass had been intensively studying and practicing Eastern mystical traditions and saw that the wisdom contained in The Tibetan Book of the Dead and other sacred writings was nowhere being utilized here in the West, though Aldous Huxley, whom he knew, had earlier written about this possibility in his novel, Island. In fact, though death was finally beginning to be talked about, it still remained the topic which carried the most unconscious fear in our culture, and hence held the potential for the most profound collective transformation.

Thirty years ago Ram Dass invited Stephen Levine, a poet and meditation teacher, to begin a project that would explore, put into practice and teach the possibility of making the dying experience a conscious act, a spiritual opportunity. Stephen founded the Dying Project in Santa Cruz, California, under the umbrella of Ram Dass’ service-oriented non-profit Hanuman Foundation, of which I was the Executive Director. This was the first organization in the West whose mission was to promote conscious dying. It soon became clear to Ram Dass and me that Stephen’s project was the most compelling work being done in the Foundation and we joined him in teaching workshops and in-service trainings around the country.

After a couple of years of this teaching, which was very well received, we decided that the time was ripe to create an actual physical place where people with life-threatening illnesses could come to heal and/or to die consciously. This home, called the Dying Center, was founded in 1981 in Santa Fe, New Mexico, where Stephen, Ram Dass and I had moved, and was the first such residential facility in the West.

I was Director of the Dying Center and for three and a half years the staff and I offered care and guidance to seventy patients.

During this time Stephen decided he no longer wanted to be part of our non-profit structure, though he continued with his skillful and inspiring teaching and counseling. I became the Director of the entire Dying Project. Feeling that the name Dying Project was confusing (was it a project about dying or was the project itself dying), the name was changed to The Living/Dying Project.

The Dying Center closed when the building that housed it was no longer available. I moved back to the San Francisco Bay Area in 1986 and started the next incarnation of the Project, which no longer had a physical home for the life-threatened. A group of trained volunteers in five Bay Area counties visited the homes and hospital rooms of our clients and offered free-of-charge spiritual support, which meets the clients wherever they may be and has no dogma to promote.

Twenty years ago we fully expected this important work to become widespread, since clearly there was such an obvious need. Many of the tens of thousands of people who have attended trainings with the Dying Project and then the Living/Dying Project are now working in hospitals and hospices around the country, but there are only a handful of organizations whose primary mission is to offer spiritual support and guidance for the dying.

Besides our project there is Joan Halifax’s Upaya Institute in Santa Fe, and in the Bay Area are the Center for Attitudinal Healing, the Zen Hospice Project and the Metta Institute of Frank Ostaseski. Fear of death is still the unacknowledged elephant in the room of our culture, the largely denied and unexamined force that continues to compel us individually and collectively to the out-of-balance situation which we find ourselves in politically, economically, environmentally and socially.

This collective denial of our mortality has lead us to a near future in America and in the West that appears problematic and deeply uncertain. The Living/Dying Project is not so much about dying as about the slash between the living and dying in our name, the interface where our certain mortality can inform the way we live. This work is about healing in the fullest sense.

Our society is at a vital choice point where each of us is invited to again and again choose healing rather than the denial and avoidance that clearly are no longer viable.
Dale Borglum