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May 29
Dharma Teachings
Acknowledging Death

By Chogyam Trungpa

In discussing sickness, whether physical or mental, we should recognize the importance of our sense of survival.  We want to survive, and when we talk about healing, we are talking about how to survive.  Viewed from another angle, our strategy of survival is the pattern of our reaction to the fact of death.

"Life from death" - Miksang photo by Miriam Hall

"Life from death" - Miksang photo by Miriam Hall

We do not have to try to conceal the unspeakable; on the other hand, we do not have to push it to the extreme.  At the least, we should help a person to have some understanding of the idea of loss – of the possibility of nonexistence and of dissolving into the unknown.  The whole point of any relationship is to share some degree of honesty and to explore how far we can go with it.  In that way relationships can become extremely powerful and intense, and beautiful.  Sometimes we might only be able to get a hint of the intensity; we might only be open up to just the bare minimum.  Still, even then it is worthwhile.  It is a step in the right direction. 

Some people talk about healing in a magical sense, as when so-called healers put their hands on a sick person and miraculously heal them; others talk about the physical approach to healing, using drugs, surgery, and so forth.  But I think the important point is that any real healing has to come out of some kind of psychological openness – constant gaps in our conceptual and physical structures.  If we begin to breathe out, then we create room for fresh air to rush in. If we do not breathe, there is no way for the fresh air to enter.  It is a question of psychological attitude rather than of being taken over by external powers that heal us.  Openness seems to be the only key to healing.  And openness means we are willing to acknowledge that we are worthy; we have some kind of ground to relate with whatever is happening to us. 

The role of the healer is not just to cure the disease; it is to cut through the tendency to see disease as an external threat.  By providing companionship and some kind of sympathy, the healer creates a suggestion of health or underlying sanity, which then undermines naïve conceptions of disease.  The healer deals with the mishandling of the gaps that occur in one’s life, with one’s losses of spirit. 

People tend to feel that their particular sickness is something special, that they are the only person with such an illness.  But in fact, their illness is not so special – not so terrible.  It is a question of acknowledging that we are born alone and that we die alone, but that it is still okay.  There is nothing particularly terrible or special about it. 

Often the whole notion of sickness is taken as a purely mechanical problem:  something is wrong with one’s machine, one’s body.  But somehow that is missing the point.  It is not the sickness that is the big problem, but the psychological state behind it.  We could not have gotten sick in the first place without some kind of loss of interest and attention.  Whether we were run down by a car or we caught a cold, there was some gap in which we did not take care of ourselves – an empty moment in which we ceased to relate to things properly.  There was no ongoing awareness of our psychological state.  So to the extent that we invite it to begin with, all sicknesses – and not just those diseases traditionally considered to be psychosomatic – are psychological.  All diseases are investigated by one’s state of mind.  And even after we have dealt with the disease and the symptoms have disappeared, by pretending that the problem is over we only plant seeds for further neurosis. 

It seems that we generally avoid our psychological responsibility, as though diseases were external events imposing themselves upon us.  There is a quality of sleepiness, and of missing the gaps in the seemingly solid structure of our lives.  Out of that sense of carelessness, comes an immense message.  Our bodies demand our attention; our bodies demand that we actually pay attention to what is going on with our lives.  Illness brings us down to earth, making things seem much more direct and immediate.

Disease is a direct message to develop a proper attitude of mindfulness: we should be more intelligent about ourselves.  Our minds and bodies are both very immediate.  You alone know how your body feels.  No one else care; no one else can know but you.  So there is a natural wakefulness about what is good for you and what is not.  You can respond intelligently to your body by paying attention to your state of mind. 

Because of this the practice of meditation may be the only way to really cure ourselves.  Although the attempt to use meditation as some sort of cure may seem materialistic, the practice itself soon cuts through any materialistic attitude.  Basically, mindfulness is a sense of composure.  In meditation we are not accomplishing anything; we are just there, seeing our lives.  There is a general sense of wakefulness, and an awareness of the body as an extremely sensitive mechanism which gives us messages constantly.  If we have missed all the rest of the opportunities to relate with these messages, we find ourselves sick.  Our bodies force us to be mindful on the spot.  So it is important not to try to get rid of the sickness but to use it as a message.

We view our desire to get rid of disease as a desire to live.  But instead it is often just the opposite; it is an attempt to avoid life.  Although we seemingly want to be alive, in fact we simply want to avoid intensity.  It is an ironic twist:  we actually want to be healed in order to avoid life.  So the hope for cure is a big lie; it is the biggest conspiracy of all.  In fact, all entertainment – whether it is the movies or various programs for so-called self-growth – lures us into feeling that we are in touch with life, while in fact we are putting ourselves into a further stupor.

The healing relationship is a meeting of two minds:  that of the healer and patient, or for that matter, of the spiritual teacher and student.  If you and the other person are both open, some kind of dialogue can take place that is not forced.  Communication occurs naturally because both are in the same situation.  If the patient feels terrible, the healer picks up that sense of the patient’s wretchedness:  for a moment he feels more or less the same, as if he himself were sick.  For a moment the two are not separate and a sense of authenticity takes place.  From the patient’s point of view, that is precisely what is needed:  someone acknowledges his existence and the fact that he needs help very badly.  Someone actually sees through his sickness.  The healing process can then begin to take place in the patient’s state of being, because he realizes that someone has communicated with him completely.  There has been a mutual glimpse of common ground.  The psychological underpinning of the sickness then begins to come apart, to dissolve. The same thing applies to meetings between a meditation teacher and his or her student.  There is a flash of understanding – nothing particularly mystical or “far out”, as they say – just very simple, direct communication.  The student understands and the teacher understands at the same moment.  In this common flash of understanding, knowledge is imparted.

At this point I am not making any distinction between physicians and psychiatrists:  whether we are dealing at the psychological or at the medical level, the relationship with one’s patient has to be exactly the same.  The atmosphere of acceptance is extremely simple but very effective.  The main point is that the healer and the patient are able to share their sense of pain and suffering – their claustrophobia or fear or physical pain.  The healer has to feel herself to be part of that whole setup.  It seems that many healers avoid that kind of identification; they do not want to get involved in such an intense experience.  Instead they try to play extremely cool and unconcerned, taking a more businesslike approach.

We all speak the same language; we experience a similar type of birth and a similar exposure to death.  So there is bound to always be some link, some continuity between you and the other.  It is something more than just mechanically saying “Yes, I know; it hurts badly.”  Rather than just sympathizing with the patient, it is important to actually feel her pain and share her anxiety.  You can then say: “Yes, I feel that pain” in a different way.  To relate with total openness means that you are completely captured by someone’s problem.  There may be a sense of not knowing quite how to handle it and just having to do your best, but even such clumsiness is an enormously generous statement.  So, complete openness and bewilderment meet at a very fine point.

There is much more involved in the healer-patient relationship than just going by the books and looking up the appropriate medicine.  According to Buddhism, the human essence is compassion and wisdom.  So you do not have to acquire skillful communication from outside yourself; you have it already.  It has nothing to do with mystical experience or any kind of higher spiritual ecstasy; it is just the basic working situation.  If you have an interest in something, that is openness.  If you have an interest in people’s suffering and conflicts, you have that openness constantly.  And then you can develop some sense of trust and understanding, so that your openness becomes compassion. 

It is possible to work with sixty people a day and have something click with each of them.  It requires a sense of complete dedication, and a willingness to stay alert, without trying to achieve a specific goal.  If you have a goal, then you are trying to manipulate the interaction and healing cannot take place.  You need to understand your patients and encourage them to communicate, but you cannot force them.  Only then can the patient, who is feeling a sense of separation, which is also a sense of death, begin to feel that there is hope.  At last someone really cares for him; someone really does listen, even if it is only for a few seconds.  That allows intense, very genuine communication to take place.  Such communication is simple: there is no trick behind it and no complicated tradition to learn.  It is not a question of learning how to do it but of just going ahead with it.

Psychiatrists and physicians, as well as their patients, have to come to terms with their sense of anxiety about the possibility of nonexistence.  When there is that kind of openness, the healer does not have to solve a person’s problem completely.  The approach of trying to repair everything has always been a problem in the past; such an approach creates a successive string of cures and deceptions, which seem to go hand in hand.  Once the basic fear is acknowledged, continuing with the treatment becomes very easy.  The path comes to you: there is no need to try to create the path for yourself.  Healing professionals have the advantage of being able to develop themselves by working with the great variety of situations that come to them.  There are endless possibilities for developing one’s awareness and openness.  Of course, it is always easier to look down on your patients and their predicament, thinking how lucky you are that you do not have their diseases.  You can feel somewhat superior.  But the acknowledgment of your common ground – your common experience of birth, old age, sickness and death, and the fear that underlies all of those – brings a sense of humility.  That is the beginning of the healing process.  The rest seems to follow quite easily and naturally, based on one’s inherent wisdom and compassion.  This is not a particularly mystical or spiritual process; it is simple, ordinary human experience.   The first time you try to approach a person in this way it may seem to be difficult.  But you do it on the spot. 

And finally, what do we mean when we say that a patient has been healed?  To be healed, ironically, means that a person is no longer embarrassed by life; she is able to face death without resentment or expectation.


From The Heart of the Buddha, by Chögyam Trungpa, ©1991 by Diana J. Mukpo. Reprinted by arrangement with Shambhala Publications Inc., Boston, MA. www.shambhala.com.

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1 response to “ Acknowledging Death ”
  1. Great to read this reprint. For some reason it made me recall something a colleague said to me decades ago when I worked in an medical ward with high mortality at LA County Hospital. “There is only one thing better than not being in pain, and that is the relief of pain.”

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