|Meditation Part III: How Meditation Can Heal
||Most people would agree that meditation is beneficial to one’s health, which is part of the allure that has kept it around for so many years. But did you ever stop to think exactly why meditation was healthy or how it affected your health? Meditation creates a state of relaxation;...
|Fast-acting antidepressant appears within reach
||In mice, a drug produces evidence of a mood lift within 24 hours and then continues working for sustained depression relief. A fast-acting antidepressant would be a welcome development for patients who must wait weeks for current drugs to take effect.
|The Overly Anxious Child
||“Worry is the thin stream of fear trickling through the mind. If encouraged it cuts a channel into which all other thoughts are drained.” ~ Arthur Somers Roche. Many adults wonder what children have to worry about. After all, they have all their basic needs met by others in the...
|Brain, cognitive reserve protect long-term against cognitive decline, MS researchers find
||MS researchers have found brain reserve and cognitive reserve confer long-term protective effect against cognitive decline. In this study, memory, cognitive efficiency, vocabulary (a measure of intellectual enrichment/cognitive reserve), brain volume (a measure of brain reserve), and disease progression on MRI, were evaluated in 40 patients with MS at baseline and at 4.5-year followup. After controlling for disease progression, scientists looked at the impact of brain volume and intellectual enrichment on cognitive decline.
|My Crooked Path Toward Perfection
||When I returned to piano lessons as an adult, I never dreamed how much I would learn about myself.
|MRI-guided biopsy for brain cancer improves diagnosis
||Neurosurgeons have, for the first time, combined real-time magnetic resonance imaging (MRI) technology with novel non-invasive cellular mapping techniques to develop a new biopsy approach that increases the accuracy of diagnosis for patients with brain cancer. As many as one third of brain tumor biopsies performed in the traditional manner can result in misdiagnosis.
|Avoid These 3 Mistakes When Going Through a Transition
||Life is full of 180-degree turns. Just when we think we have things figured out, life throws us for a loop with both “good” things and “bad.” Falling in love turns our world around. Having children, moving to a new place, getting married, getting divorced, getting a new job, retirement,...
|A Conscious Re-Writing of Your Life Story: Three Optimal
||The authentic wise-self and the wounded ego-self are often at odds with each other. Some competition between them is natural, in vying over which lense, love or fear, will be the primary voice of your experience of life. It’s an ongoing aspect of personal growth and development. As discussed in Part 1, each...
|A Conscious Re-Writing of Your Life Story: 3 Optimal
||The authentic wise-self and the wounded ego-self are often at odds with each other. . Some competition between them is natural, in vying over which lense, love or fear, will be the primary voice of your experience of life. It’s an ongoing aspect of personal growth and development. As discussed in Part 1,...
|5 Reasons We Struggle to be “Trauma Responsive” –
||I listened to her. She was young, an overnight worker in a congregate care facility. She was in anguish, her voice tight with pain, as she described seeing another worker taser a youth who was upset, and then high-five a co-worker and say “Got another one!” How could her organization...
|Your stress is my stress: Observing stress can trigger physical stress response
||Merely observing stressful situations can trigger a physical stress response, research shows. Stress is a major health threat in today's society. It causes a range of psychological problems like burnout, depression and anxiety. Even those who lead relatively relaxed lives constantly come into contact with stressed individuals. Whether at work or on television: someone is always experiencing stress, and this stress can affect the general environment in a physiologically quantifiable way through increased concentrations of the stress hormone cortisol.
|In recognizing speech sounds, brain does not work the way a computer does
||How does the brain decide whether something is correct? When it comes to the processing of spoken language, the common theory has been that the brain applies a set of rules to determine which combinations of sounds are permissible. Now investigators support a different explanation -- that the brain decides whether a combination of sounds is acceptable based on words that are already known.
|When Should You Make the First Offer?
||There are many situations in life that involve negotiations. Obviously, business is full of negotiations in which two parties have to come to an agreement. Couples negotiate over who will do various chores. Friends negotiate about how to spend an evening out.
|Little Things Swing Big Doors
||“Little hinges swing big doors,” W. Clement Stone I don’t remember where I first heard that saying, but life has taught me that it is true. Life turns and changes on the smallest and seemingly inconsequential events. Occasionally a major event will intrude in our lives to set us on...
|Use These 5 Wise Teachings & Improve ALL Your
||Always look for the good points insider yourself. Focus on these good points and turn depression into joy....
|Seven Keys to a Good Death
||Some years ago, I helped tend to a friend of mine who was dying of cancer. Near the end of his life, he had reached a place of equanimity around dying.
But instead of honoring his wishes for a peaceful death, his doctors ordered aggressive chemotherapy treatment, which did nothing to halt his cancer. The treatments caused him immense suffering, rendering him unable to sleep, eat, or converse with family and friends as he was dying.
Unfortunately, deaths like my friend’s are not that rare. Though more than 70 percent of Americans surveyed say they want to die in their own home without unnecessary procedures to extend their lives, 50 percent of all deaths occurs in facilities away from home. Of those, 40 percent occur in ICU’s, where physicians are charged with doing everything they can to keep a person alive, regardless of the outcome.
Sometimes, the quest to avoid death can seem extreme, like in the much-publicized cases of Terry Shiavo and Marlise Munoz, where unnecessary life-extending procedures created exorbitant medical bills and emotionally burdened their loved ones.
But, if Shiavo and Munoz are examples of a bad death, is there any better way? Is a “good death” just an oxymoron? Or can the experience of death be far more positive—an opportunity for growth and meaning?
Listening to the dying
These are questions that I first began to consider when I was a young psychologist at the oncology unit at UCSF in the mid-1970’s. At that time, I was the first and only mental health worker on the staff on a 40-bed unit. Modern palliative care was not widely understood or employed yet, and hospice care was not as readily accessible as it is now. My job was to help these patients with whatever emerged psychologically around their deaths.
And, there was a lot going on psychologically which wasn’t being attended to. The physicians and nurses in our unit were talented, skilled, well-intentioned people. But they focused on staving off death at all costs. Their training gave no guidance on how to provide their patients with the conditions for a good death—one that allowed patients to come to terms with their life and find peace and wellbeing at the end.
Since then, I’ve worked with hundreds of dying people. To help combat the lack of trained support staff, I founded Shanti—a peer counseling program that provides compassionate, trained listeners to help patients and their families through serious illness and the transition of dying. Shanti volunteers have supported many people facing death to do so with grace through their presence and compassion.
What I’ve learned through my experience is that what people most need on their deathbed is to be heard—to have their wishes considered and, whenever possible, fulfilled. But even with Shanti’s success, and the proliferation of palliative care programs and hospices around the nation, there are still many dying Americans who don’t get that chance. Here are seven ways to help create the conditions for a good death.
How to die well
1. Experience as little pain as possible.
When I talk of being pain-free, I mean physically, psycho-socially, and spiritually pain-free. Nowadays, there are medications that can manage most people’s physical pain and make them far more comfortable, and these should not be denied to any patient. Spiritual pain can occur, too. In fact, I have sat with several clergy who had crises of faith on their deathbeds. Sometimes, easing spiritual pain can be accomplished by the presence of a person of faith or readings from sacred texts; other times, it’s better to have someone who can engage in spiritual questioning. Either way, spiritual issues are common at the end of life, and they need attention.
2. Recognize and resolve interpersonal conflicts.
We must also recognize psycho-social pain, the residue of life’s unresolved conflicts with other people. There are almost always interpersonal issues within families, and sometimes between close friends, when one is dying—people who’ve become estranged, “I love you”’s that were never expressed, and more. Ira Byock, a palliative care doctor, wrote in his book, The Four Things That Matter Most, that there are four basic messages a person needs to communicate at the end of life:I love you.
I forgive you.
Please forgive me.
These, I think, are a good start. A good death creates a space for people to say those words.
3. Satisfy any remaining wishes that are consistent with their present condition.
Some people want to live long enough to go to a grandson’s graduation, to see a book published, to see a cousin they were close to who lives 3000 miles away. But, be careful that these are the wishes of the patient and not just the patient’s significant others. There’s a difference between a good death and an appropriated death—one that’s stolen from the dying person by other forces, including the agenda of close family members.
4. Review their life to find meaning.
There are two main ways that people on their deathbeds find meaning: in the recognition of all of the people they have loved and who have loved them, and in the work that they’ve done that has contributed to the greater good. In some cases, contributory work will be obvious; in others, it may be less so. But, helping the dying to articulate what brought meaning to their lives will help them feel more at peace with their death.
5. Hand over control to a trusted person, someone committed to helping them have the kind of death they desire.
The whole issue of deathbed conversations—asking a person what he needs or wants—is very important. What does the dying person want? How can they get that? Is it reasonable? Sometimes it’s not reasonable: A friend’s dying mother wanted help in ending her own life; well, that wasn’t going to happen. Sometimes you can have the conversation without acting on it, and any conflicts or issues can be addressed.
6. Be protected from needless procedures that serve to only dehumanize and demean without much or any benefit.
Emergency rooms, ICU’s, and 911 are set up to preserve life and are not typically supportive of the conditions for a good death. If a person is suffering tremendously, there may be cause to get emergency help; but for most situations, when you throw a person into the larger healthcare system, the prevention of death becomes the imperative, and that can serve to increase suffering for the dying person. One has to be very persistent and clear to avoid procedures that are unwanted—to insist on palliative or hospice care, instead. It can help to have an advanced directive or a “physician-orders for life sustaining treatment” in writing and communicated to loved ones; but often a person also needs a vocal advocate—a family member, friend, or volunteer caregiver.
7. Decide how social and how alert they want to be.
Sometimes a dying person wants solitude; sometimes he or she wants friends and family around. Whatever the case, the dying person should decide. And, though trickier, dying people should be allowed to decide how much consciousness they want. Some people want to sleep all of the time; others want to be alert as much as possible. Once these wishes are known, an advocate can help make that happen.
A good death is possible
People who are dying should be treated as living human beings. They will have good and bad days. The important thing for caregivers is to be mindfully present. The poet John Milton wrote, “They also serve who only stand and wait.” We are so addicted to action that it may feel like we’re doing nothing if we just sit by someone’s deathbed. But it’s often very important to bear witness and listen or hold a hand.
The potential for growth through dying is definitely there. It doesn’t mean it will automatically happen, though. Death can bring out our goodness—our capacity to transcend, love, and grow—or it can bring out our capacity to hate, create enemies, and deteriorate psychologically. To help promote the former, we should create sacred spaces for those who are dying so that they can benefit most from the experience. If we know the conditions for a good death, we are more apt to prepare ourselves and the ones we love to die with dignity and the sense of a life well-lived, rather than treating death as a calamity requiring a trip to the hospital.
A good death is no oxymoron. It’s within everyone’s realm of possibility. We need only realize its potential and prepare ourselves to meet it mindfully, with compassion and courage.
|Why Smells Evoke Memories So Vividly
||Brain regions are synchronized as neurons fire at a common frequency.
|MRI shows disrupted connections in brains of young people with ADHD
||Children and adolescents with attention deficit hyperactivity disorder have disrupted connections between different areas of the brain that are evident on resting-state functional magnetic resonance imaging, new research shows. The findings point to the potential of rfMRI to help provide objectively accurate, early diagnosis of a disorder that affects approximately 5 percent of children and adolescents worldwide.
|Deep brain stimulation for obsessive-compulsive disorder releases dopamine in brain
||Some have characterized dopamine as the elixir of pleasure because so many rewarding stimuli - food, drugs, sex, exercise - trigger its release in the brain. However, more than a decade of research indicates that when drug use becomes compulsive, the related dopamine release becomes deficient in the striatum, a brain region that is involved in reward and behavioral control. New research suggests that dopamine release is increased in obsessive-compulsive disorder and may be normalized by the therapeutic application of deep brain stimulation.
|Happiness With Others 6: Choose Friends and Lovers Wisely
||Happiness in life in part requires happiness in your relationships. In addition to being healthy of attitude and skillful of technique, relationship happiness requires you to choose carefully whom you will have a relationship.