Dr. Paul D'Alton
The death of a loved one breaks open the heart and strips us back to our most tender selves
We humans are the only species with the capacity to reflect on our own mortality. The outpouring of grief for Anthony Foley touched the whole country.
We know intellectually that death is inevitable, that one day each one of us will painfully separate from the people we love. We know that each year 55 million people die on this earth, 29,000 of these in Ireland. In Ireland, close to 80 people die each day. With up to 10 people affected by each death, an estimated 290,000 people are profoundly emotionally and psychologically affected each year by the death of a loved one.
We are the only species that is faced with the responsibility of how we live with the knowledge that one day we will die. This capacity to know our impermanence is double-sided; it can liberate and it can terrify.
The fear of death can petrify us emotionally and psychologically. We can end up living half-lives when we do not acknowledge that one day we will die. Conversely, the acknowledgement of our impermanence on this planet can allow us to live with greater ease, live more full lives and love more deeply. This is based on very fundamental psychological principles of avoidance: when we confront what we most fear, like death for example, we are more free to live the life we have.
There is an existential wisdom that tells us that if we want to live full, happy meaningful lives, we need to face up to our most greatest fear. The psychiatrist Irvin Yalom says: "The more unlived your life, the greater your death anxiety. The more you fail to experience your life fully, the more you will fear death."
There is a tendency for pop psychology to jump into the scary gap created by the existential challenge death and dying presents. This pseudo-science of 'positive thinking' and 'being positive' often adds further suffering to the unavoidable hurt of death and dying. The powerful and seductive myth of 'positivity' often results in significant psychological isolation and interrupts the most important moments of our lives. We can become emotionally isolated by the pop psychology industry telling us that the secret to happiness and health is to 'stay positive'.
The relentless emphasis on 'being positive' closes down the very conversations that keep us connected to our loved ones. One of the terrible consequences of this is the closing down of the conversations with our loved ones at the end of life.
The loss of a loved one breaks open the human heart and strips us back to the most desolate and tender version of ourselves imaginable. It shatters our personal illusions of control and permanence, leaving us in a world that feels very fragile and fleeting. Our turning away from this deep knowing that death is part of life and the heartbreak of loss itself in the early stages of loss is completely understandable.
I think it might be what TS Eliot was alluding to when he wrote the lines: "Humankind cannot bear very much reality."
However, our psychological capacity as individuals and as a society to face up to death as part of life impacts hugely on the day-to-day reality of how we live our precious, finite lives and how we contribute to the betterment of society. The acknowledgement of death has enormous capacity, personally and politically, to contribute to creating a more mature and compassionate society. When we stop avoiding the reality of death, we start living more deeply because we connect to what matters most. Death clarifies in an instant what is the essence of what matters most - our relationships.
I have worked for a decade with people who are at the end of their lives and this is the one constant concern - did I love and was I loved? Toni Morrison captured something of this beautifully in an interview in 'The Guardian' when she said: "You have to talk, and exercise those feelings of almost witless affection for another human being. If we lose that feeling for the other, or the ability to talk to another, there's really not much left. Personally, politically, culturally, it's death."
We know that for 95pc of us, our time spent dying, caring and grieving is 95pc outside of the formal remit of services and is in our homes, at work, and in our leisure activities.
Increasing longevity does not bring immortality, but it may distance us from the inevitability of our demise - so much so that two-thirds of us have never discussed our end-of-life care preferences. Almost 40pc of us have not made a will. We need to actively encourage and support people to think and plan ahead.
This means that we must work collaboratively (and compassionately) in our Government departments and agencies, in the Oireachtas, our councils, in our families, in our communities and with and through our community organisations.
In many areas, citizens have taken the initiative and are developing key resources to help us as a society to respond to our mortality and the challenges it brings. Initiatives such as:
The Compassionate Communities project at Milford Care Centre, Limerick, which seeks to work in partnership with individuals, groups and communities to enhance the social, emotional and practical support available to those living with a serious life-threatening illness, those facing loss and those experiencing bereavement;
The Grief at Work resources developed in partnership by the Irish Hospice Foundation, Ibec, ICTU, ISME, the SFA, the Department of Jobs, Enterprise and Employment, and others, to help workplaces support employees; and
The Think Ahead initiative by the Forum on End of Life in Ireland and the Irish Hospice Foundation. This citizen-led planning tool encourages and provides a way for people to think about and pre-record their wishes in the event of serious illness or death. Together, members of the public, emergency services, medical, legal and financial professionals recognised the importance of planning ahead to make sure that an individual's right to make decisions for themselves and to be heard are honoured.
The State must learn from these initiatives and catch up with community-led creative solutions. We need the full range of State services to help us to think, talk and tell about dying, death and loss. To support us and enable us to support each other.
We need to look at what we do well and what we do badly and pull all of those strands together.
Just before last Christmas, the Oireachtas enacted the Assisted Decision Making (Capacity) Act 2015. This vital and long-overdue legislation recognises the capacity of people to make important decisions for themselves - including advance healthcare directives. This important Act perhaps signals that it is now time for the State to take a lead, for the next government to take a lead, in encouraging people to acknowledge and embrace their mortality, to support them in their loss and encourage and enable them to make important decisions for themselves - to think and plan ahead. We can then all get on with the business of living.
Originally published in The Irish Independent 22/10/2016