Chapter in Confrontng Death
Jungians reflections about preparing for the inevitable goal of life
Edited by Luis Moris
During my life, I have had many encounters with death. These had profound influence on me as a person, but also in guiding my journey toward becoming a Jungian analyst as well as becoming a specialist in the anthropology of death. In the later part, I will discuss two Jungian texts which were extremely helpful in dealing with clinical aspects of difficult issues such as the death of a patient or the death of an analyst.
My Grandfather
My first encounter with death happened long before I was born, but cast a significant shadow over my life. My grandfather for whom I am named, comes home from hospital, after a pointless surgery revealing death-bringing stomach cancer. He arrives home, weak, disheveled. He groans at each step as his climbs up to the cramped living quarters about his small country store. Somehow, he makes it to his bed, where he flops down exhausted. But gathering his strength, he calls out to his wife, my grandmother, Sura. He asks for all his five young children to join him in bed.
They jump in and snuggle up next to him. He then turns to his wife and with a massive smile says: “Am I not a lucky man? Week later he is dead. My mother, only 4 years old, is one of those children, the middle of five. She grows up without a father. Nevertheless, my mother embodies and transmits my grandfather’s message: the proper response to the reality of death is to live all the more intensely. Confronting death is designed to bring us all the more fully back into life.
How to Die
My next experience confronting death occurred when I was a little more than four years old. We lived with my grandmother, Sura, who had been widowed so long before. A vital, energizing woman she had suffered a paralyzing stroke. In my eyes, she was a very old woman with wild hair who lived in the room next to ours, unable to get out of bed. She would call us her ‘doctors and nurses’. She was friendly but also scary. My main job was to bring her a glass of water. One night, her breathing slowed. My uncles and aunts began arriving. The atmosphere was numinous, imminent. Something was happening but no one told me what. When she died, there was an emptiness in the room she had lived in. My mother, her brothers and sister sat “shiva”. Sitting on low chairs, eating a boiled egg, remaining inside while relative and friends came to sit with them. After a week, they arose and went to the cemetery. A year later, there was a grey stone above her body. I wondered whether she was cold there deep inside the earth. Later, I understood that this is the natural way to die: at home, in bed, surrounded by those you love best, saying shma’ Israel[2].
His Heart Stopped Working
My third encounter with death was more intense. I remember well, waking up in the middle of the night, waking over to my parents’ bedroom and saying, “Mommy, my head hurts.” Then I collapsed and started convulsing on the floor. This was in the mid-fifties. There was no intensive care unit, nor even emergency rooms as we know them today. My mother called our family doctor who rushed over with his car, took one look at my condition and swept me up in his arms and rushed to Neurological Institute. When my parents arrived there, they were told to wait… and wait… and wait…
not knowing whether their child was alive or dead. Finally, a neurosurgeon emerged. She brushed up against to my mother and said, “Well, his heart stopped working… but we got it going again.” And walked away. A pediatrician followed. Before he spoke, he took her hand in his. Then he said, “Pray for him. Speak to him. Maybe you can bring him back.” I lay in a coma, between living and dying, for many, many days. My mother was speaking to me. I remained unconscious, unresponsive. Until one day, I suddenly opened my eyes and blurted out “My brother stole me toy!” She reacted by laughing and crying at the same time. I had suffered a near death inflammation of the entire brain, encephalitis. Later when I was training at Hadassah University Hospital in Jerusalem, I would meet people who had serious psychiatric sequelae as a result of the encephalitis. In retrospect, I understood there had been two miracles: one that I came back to life at all, and the other that I did so without damage. I would tell only closest friends “my secret”. I was really a ghost that had died and came back to life.
One Day in September
My next encounter with death was even more shocking. One day in September, visiting home in the liminal time between undergrad and graduate school, I walk into my parent’s master bedroom. My mother has had cold, perhaps a flu and I am looking after her as she had looked after me in childhood. I walk inside and see my mother, lying turned around on the bed, her exquisitely beautiful blue eyes staring up at the corner of the ceiling. Strange, I thought. Then I realized she was not breathing. Using my water safety training, I tried to give her the kiss of life, but her entire passageway was clogged with vomitus. Using an alternative form of artificial respiration, I held her flaccid hands together with mine and pressed down hard on her diaphragm. From out of her mouth came a fountain of vomit. My brother was with me and said, “She’s gone.” “No!” I screamed back. But she was. Dead. In one moment, I became a hero crushed down by failure to save my mother and by my inability to make sense of her senseless, sudden death. I was barely 21. I remember feeling how lucky I was to have had her for 20 full years, when she herself had her own father for barely four. Part of me wanted to jump into the grave with her; but another part knew she had set me on a journey to find answers to the place of life in death, like Gilgamesh.
Madagascar
Still bearing the weight of an enormous mother complex, I looked for ways to come to terms with her loss. As an anthropologist-psychologist, I searched for a society that knew how to make peace with the dead. I stumbled across Madagascar, the island continent off the east coast of Africa. How I got there is a story in itself, but once I found my place on a small island, I became immersed in spirit possession healing and rituals surrounding death. The island is today called, Ile Sainte-Marie de Madagascar, but you can understand my synchronicity when an Abramovitch, “Son of Abraham” discovered that the original name of the island was Nosy Ibrahim. the Island of Abraham.
In this culture, burial at the time of death is a relatively simple affair, but years later, the entire extended family and clan gather in the cemetery for the fahamadiana or “second burial.” The white bones of the deceased are dug up from the earth and laid out on a woven reed mat. The head of the lineage goes down on one knee and speaks to the soul of the dead relative, saying, “See, we have not forgotten you; look how many people are here; look how much ancestors’ beer we have made ready in your honor.” After he makes his peace with the spirit of the deceased, he turns to call on all the great ancestors, the razabe, to receive this “fresh soul” in the midst of the family as a junior ancestor. Then everyone—young men and old men, young women and old women—start drinking and dancing ecstatically in the cemetery. Some may even dance with the bones, rewrapped in the white cloth and the reed mat. The bones are placed in a wooden or cement sarcophagus that resembles their huts, so that the cemetery looks like a miniature village for the dead. Infertile women prize the reed mat upon which the bones had lain for its fertility powers, so much so that contact with the dead is seen as a source of living vitality. I had always associated graveyards with separation and sadness. Yet this ritual of becoming an ancestor remains the most joyous event I ever witnessed. I am still struck, many years later, by how the most important event in their life cycle occurs years after they are dead, when they become ancestors.
The ancestors remain ever present through dreams, illness, prophesy, sacrifices, and spirit possession. As Roger Bastide
has noted, such community live within a ongoing dialogue of the dead with the living. In the West, social life involves a monologue; a monologue of the dead.
A Resurrection Experience
The Malagasy are wonderfully friendly and open people but have a dark xenophobic shadow. Naively, I did not realize that I was entering deeply into cultural secrets that certain people did not want me to know. One day, following a terrible bout of diarrhea, I became confused and found myself drinking salt water, wandering aimlessly, unable to concentrate, and thinking that I was going to die. Passing out, I had a vivid vision: I had indeed died and was buried, and the process of bodily disintegration had begun. My dead body was being pulled apart by worms, moles, and insects. Suddenly, a voice called out, “Stop!” The process was halted and then reversed. My decomposed body was reconstituted, revived, and resurrected, rather like in a shamanistic initiation. I had other intense psychotic-like visions and eventually found my way to a clinic and then to a hospital. I was told that I might have been poisoned. Because I was a foreigner, the culprit had given me enough poison to get rid of me but not to kill me. Whatever actually happened, I was deeply traumatized and recovered very slowly. My persona had been stripped away. I could not travel by myself, and my sister had to come and take me home. I had left Madagascar, but my soul had not yet caught up.
When I finally managed to return to my university and told the story of my experiences and visions to one of my professors, he said, “You would be a good candidate for Jungian analysis.” One of my doctoral supervisors, Daniel Levinson, had discovered Jung via his own midlife crisis and had done pioneering work on adult development published in bestselling, The Seasons of a Man’s Life. He suggested that I see a Jungian colleague who was part of his research team, Ray Walker, who had trained at the C. G. Jung Institute of New York. We started working on my dreams, and I felt I had arrived back “home” at last.
When I finished my doctoral studies, I decided I needed to take a moratorium. What followed was an important year that included a trip to my ancestral roots in Romania and hitchhiking around Eastern Europe with my sister. I remember the moment at which I actually decided to become a Jungian analyst. I was in Rome, staying with my friends in The Living Theatre, an international political theatre group. I found Jung’s Memories, Dreams, Reflections (1989), opened it at random, and read that ancestors represented the realm of the collective unconscious (p. 216). It was a Eureka moment for me: “Yes, that’s it!” That was the reality I had been living. My voyage continued eastward through Greece, Cyprus, Israel. When I arrived at Jerusalem, I felt once again this is home and I have lived there ever since.
My Experience with Illness
While I was doing my Jungian training, I continued my personal encounter with death in an ethnographic way, by joining hevra kadish, a Jerusalem Burial Society. They perceived themselves as doing the “highest form of loving-kindness,” since the dead could never repay their kindness.
Jewish burial is unique in the cross-cultural landscape in that they are done very rapidly, often within hours after the death and in Jerusalem, even at night. There are traditionally no coffins, but only cloth burial garments covered by a winding sheet, so the contours of the deceased are visible as is the smell often. There is no contouring, no embalming, no “open casket”. The body is laid out on simple stretcher. Despite the strong, historic tradition for eulogies, there are numerous days in the Hebrew calendar when eulogies are forbidden. At the graveside, forgiveness is asked from the deceased and sometimes the deceased gives forgiveness to the mourners. Then one of the Hevra Kadisha enters the grave to receive the body, lay it out in the grave and undo the last slips knots holding the body together, symbolizing the breaking of ties between the dead and the living. At the end of traditional funeral, the mourners walk between two lines of people and are ritually comforted. From the funeral they go directly home for seven day mourning period, called shiva, meaning “seven” (days). By Jewish tradition the visitor called “comforters” are urged not to speak until the mourner speaks. This allows a genuine dialogue to unfold. It is highly likely that Freud drew on this tradition in the creation of psychoanalysis. The most important ritual connected to mourning is saying of the kaddish, traditionally by eldest son, but now commonly by all children, including daughters. Not to have someone say kaddish after you is seen as an almost unbearable tragedy, severing the continuity between the living and the dead. The Kaddish prayer is paradoxical. It is not in Hebrew but Aramaic, as a result most people do not understand the words or their meaning. It says nothing about deceased or mourning but is a short extract with the daily prayer that praises God and wishes for peace in earth as in heaven. How it began the iconic prayer is also a mystery, although recent research suggest it may originate in Renaissance Italy. It must be said with a minyam, a quorum of ten people, highlighting the principle that one cannot mourn alone. Yet it is haunting chant, with call and response rhythm of mourner and community that is part Greek chorus, part symbolic containment. Saying kaddish at my mother’s funeral helped me accept what I ever wanted to accept: the reality of death, its inevitability and universality. Saying kaddish, this ancient, chanting, connected me to all my ancestors who had said it before me. Yes, I was weeping, sobbing but there was a cultural message which reverberated with my mother’s refrain: Don’t waste your money on the dead; money is for the living my mother. She was echoing Moses’ farewell speech: “I put before you life and death…therefore choose life.”
Being a student of the anthropology of death led me to surprising insights. I will just share just a few: Death, an intensely emotional and often taboo subject in West is considered as occurring at a specific identifiable moment, symbolized by the ‘time of death’ on the death certificate. This ‘punctual view of death’ (Bloch 1988) in which a person is thus either alive or dead is not shared by many cultures. Cultures express the degree of alive/dead using different metaphors. The Merina of Madagascar, for example, use the image of wet/dry to indicate degrees of alive/dead. A newborn infant is very wet and thus very alive; in contrast, a shriveled elderly person, almost totally dry, is mostly dead. The process of drying, and hence dying, will be only completed long after biological death when the bones are dug up and placed in communal tombs (Bloch and Parry 1982). Among Sa’dan Toraja of Indonesia, a dying person has the ability to ‘see everything’ but is not considered dead until the first sacrifice of mortuary rites has taken place, months or even years later (Tsintjilonis 2007).
In many societies, the occurrence of a death disrupts social life severely, so that ‘it is stricken in the very principle of its life in the faith it has in itself’ (Hertz 1960, p. 78). Cultures and their rituals must provide an answer to the meaning of life for the community at a time when it is most threatened. The wandering spirits, for whom no rites were performed, may return as hungry ghosts. That is why we say “rest in peace.” These ghosts yearn to be reincorporated into the world of the living. Since they cannot be, they behave like hostile strangers consequently must find sustenance at the expense of the living. Many cultures use elaborate strategies to confuse the spirit of the deceased so that it will not return to the realm of the living. Illness, misfortune, and associated healing rituals are often attempts to incorporate these lost souls. The ‘tomb of the Unknown Soldier’ in modern states, provides a resting-place for unincorporated spirits of the war dead.
Cultures inevitably speak of a “good death” and “bad death”. The Talmud compares a good death to the ease of plucking a hair from a bowl of milk and a bad death to the interminable agony of pulling wool from off a thorn bush. An Indian Hindu ideally should die in the open air, as an act of self-sacrifice, abandoning life to the sound of the chanting of the names of God, for his thoughts at that moment may determine his subsequent fate and rebirth. A reluctance to die at the appropriate time may lead to the death of a young relative in his place (Parry 1994). In the West, most individuals say they prefer to die in their sleep, not knowing they are going to die. But for Jews and Christians, historically, saw just such a death as a very bad death, because you arrive at this crucial rite of passage, unprepared.
What’s wrong with your eye?
My most recent encounter with death was no less powerful, but begin insidiously.
I discover my left eyelid was drooping. I felt no pain, no discomfort and only knew of it when a neighbor said, “What is wrong with you eye?” Overcoming a natural tendency to ignore health issues, I went to numerous doctors – ophthalmologists, neurologists and internists, and underwent many tests none of which uncovered the cause. At the same time, I began losing weight, eating less and feeling without my usual bounce. Sleeping became painful from what I later discovered was a hugely swollen spleen and liver. One day I became breathless. I couldn’t even walk up a flight of stairs, when I used to zip up 9 flights to my office at the university. Still, I felt it would pass; it was nothing to be worried about.
Later, I sit with the hematologist in a deserted cancer institute. She explained what a lymph node was – I barely knew. For a whole month I had almost daily tests to discover what had been brewing in my body. CT revealed suspicious sightings in the soft tissue, near the spine, behind the kidneys, in the abdomen. Finally, my breathing got so bad – the lymphoma was blocking the drainage of the pleura, the sack around my right lung, compressing and compromising my oxygen supply – that they started treating me with even before they have a definitive diagnosis. Hematologists love histology. They need to see how the cell looks like as an individual and how it grows in culture into a community. It sounds very Jungian, the individual and the collective. But since they do not know for sure what I have got or whether I am truly dying, they treat me for the worst with the strongest possible treatment.
Now in a more poetic mode:
Towards evening, my breathing becomes even worse
And pain stalks each sitting position
I do not know what to do with myself.
For the first time,
I feel really miserable.
I cannot face another unslept night.
I have my first scary dream:
I am driving in a car in a city street with my wife.
We are going down a gentle incline
And I want to slow the car down
But I cannot move my foot from pedal to brake
momentarily immobilized
I cry out for help…
Lying awake in dark’s early light
I think of yesterday’s:
“I will laugh this lymphoma under the table”
and start sobbing.
Lymphoma also in the bone marrow,
in clumps and more: an infected pelvic lymph node
hidden and inaccessible
But the real shock comes
when I ask about staging.
naively I had thought since there were no obvious lymph nodes
I might be Stage I
or II.
My doctor hesitates and I know it is bad.
In Hebrew, I say, "dugri." “Tell me straight.”
I have been strong
staring death down
but I am not prepared for her reply:
“Stage IV.”
Today, there are no tests.
I am not a patient but take care of my own patients.
I think I must construct an up-to-date patient list
just in case
in the event of my death
and suddenly I am sobbing
for the first time since I heard,
alone
in the bath
I go to my office and make that list
prepare copies to give to colleagues
in case sessions need to be canceled
when I have chemo or worse.
The rest of the day, I sit and listen to other people.
one lady, a senior mental health professional
recalls the brutal abuses of her father
and then of the men in her life
She sobs, “I am damaged, so damaged”.
Later I want to transfer him to another analyst,
but she cries again, saying, “Don’t you understand,
I cannot go to another analyst. I just cannot.”
Another younger man is about to be married.
Every moment of joy brings the anguish of a missing father, murdered in a terrorist attack
He says he will never be happy again, not even on his wedding day.
I am suddenly terrified that this will also be
my children's fate.
“To be well is a hobby;
to be sick is a full time job.”
One of the central experiences of illness is loss.
In English, the word for illness is “Dis-ease”
The loss of ease –
the ease not to know
when you next treatment or blood test is coming.
The loss of ease that each sensation, pain, sweaty night,
each ache, does not signal another medical earthquake.
The loss of a future spreading out before you like a set table.
Above all, for every cancer person,
there is the loss of “my body as I knew it.”
For me, the bodily change was not
weight loss, a half closed eye, massively swollen spleen which stole sleep or
even panicking white blood cells
but one day after chemo, touching my chin
to see my beard fall like fresh snow.
Since I was 19. I have had a beard.
No one in Israel had seen my naked face;
Not my wife, my children, my students or my patients.
People did not recognize me; I did not recognize myself.
I would look in the mirror and say “Who stole my face?”
I would walk up to old friends and start speaking only to be told,
”Excuse me, sir, who are you?”
“Who am I, indeed?” I was another Henry: Henry the sick.
Finally, a specific diagnosis is confirmed. It is “marginal zone” lymphoma. In those days, I was surely in the margins. I am given CHOP-R, a combination of treatments that include 4 types of chemo and one new biological agent:
Chemo is like an artillery barrage.
Biological treatments are more like a targeted assassination.
The assassination to C24 lymph receptor sites worked.
My splendid hematologist tells me with luck, I will die of something else.
The Dying Patient
Religious traditions see preparation for dying as a necessary part of the spiritual journey. In the Jewish tradition, it is sometimes expressed in phrase, “Return [to the way], a day before you die.” But because you cannot never know the time of your death, one must be always ready to die. Joy Schaverein (2020), an English Jungian analyst and art therapist, received a middle age man into treatment because of long standing issues of isolation, emotional stuckness and his unlived life. However, three months in the analysis, he was diagnosed with a fatal disease. The book with profound clarity and sensitivity describes the journey of both the man and the analyst working together in psychotherapy, through chemotherapy, hospice and the funeral. More recently, Schaverein shared the drawings she made during the time of their work together and these are truly moving in its own right. (Schaverein 2020b). Her pioneering work help prepared me for what was my worst experience as an analyst. I was treating a young, idealist International Peace Worker of mixed Scandanavian and Latin American Heritage. We met in person while she was working in Jerusalem. After she was transferred to the Democratic Republic of Congo, we decided to continue working on zoom. Our work was deep and fruitful. We continued, until one day, she did not show up for our online session. All my attempts to communicate through email and text went unanswered. I hoped there were problems with Wifi, or that she had gone working in a more remote area. I lived of life of not knowing. Her absence was all around me, but I was going on ‘as if’ normal, in a kind of gray zone. Then the following week, I learned the bitter truth from a shocking press release. She had strayed into unprotected “rebel” areas, where she and a companion were seized, murdered and then decapitated. I often think we are often protected from the harrowing stories of our patients, because we have heard worse. This was a horror and a death beyond my worst imagination. I needed to mourn but there was no one to mourn with. I was alone in my solitary grief. Helplessness danced all round me. I felt as if evil done to her had entered my own soul.
But with time, the help of colleagues and dreams, I came to see my role not only as a bereft father-analyst, but as someone who had been be privileged to accompany her on her journey until it was time to part. At some point, I was forced to let her continue on her journey, by herself. In Hebrew, at funeral, we say the dead person has “gone to their world”, halach leolamo, a world created just for them, as if in the ultimate stage of individuation.
Death of Two Analysts
Another unique document is Pamela Power’ “Death of the analyst.” (2005), in which she describes the death of not one, but two of her analysts! One of her analysts was a very, well known Jungian analyst and she writes:
I went to my regularly scheduled appointment in early May of 1998. My former analyst began the session by telling me he had been diagnosed with wide-spread metastatic cancer in the lungs. He told me that it was the bladder cancer he had lived with for over twenty years that had metastatized. He further informed me that the doctors gave him 9 months to a year to live. Hardly able to speak, he answered my unformed question: “You are probably wondering what impact this will have on our work. I plan to continue to see you as long as I feel well enough.”
When I returned to my next session, two weeks later, he began by telling me he was “going downhill fast” and this would be our last session. At the end of the he invited me to contact him if I had any wish to do so. Almost two months to the day he was dead.
With negative synchronicity, around this time, Pamela, discovered enlarged lymph node; after intense diagnostic investigations, turned out to be lymphoma, cancer of the lymph – the system of white blood cells which serves to protect the body. When finally diagnosed, she was became a difficult patient ‘ in emotional turmoil’ and adds: “I was distraught, confused and desperately missed my dead analyst. I felt he could give me the larger psychological perspective and help I needed which I was getting from no one. I thought about the course of his cancer. He was diagnosed with a slow growing bladder cancer in the early 1970’s. He received no treatment except to have it scraped out when it caused symptoms. He refused radiation treatment which the doctors tried to insist upon. I wanted to learn more about how he thought about his illness so that I could learn from him and perhaps follow his course. After all, he lived 26 years after his initial diagnosis. I was full of regret that I had not asked him more about his condition and especially his attitude toward it. I felt very alone…I felt stuck in my grief over the loss of my analyst, I felt stuck in my physical condition, endlessly trying to make meaning of my situation, trying to find a way to move on…
Her vulnerability was clearly related to the fact that her own father died suddenly a few months after her 6th birthday. With devastating synchronicity, a previous analysis begun at age 27, ended after 4 years with the illness and death of that analyst. In the sparse literature, Pamela’s case is far from unique to have not one but two analyst die while in treatment! We often think of synchronicity in positive terms but clearly it is not always so.
Pamela Power goes on:
In spite of a lengthy analysis, the death of my analyst felt abrupt and premature. It precipitated a period of inner turbulence that lasted several years…When the analyst dies suddenly, before these [a release of creative energy and…resolution of transference..] have been accomplished, a precarious and dangerous situation can result. A premature end can bring about a state of “negative creativity”, a “transference chaos” expressed in somatic and psychological disturbances….
Pamela Power’s brave essay helped me think more deeply about how illness and dying impacts on analyst and patients. It helped me understand the tragic situation of fellow training candidate who died of breast cancer while still seeing patients. I had the unenviable duty of informing her patients that their beloved analyst had died. On follow up, 25 years later, one former patient said, “It was the worst thing that ever happen to me.” When I became sick with lymphoma, I felt more prepared to deal with the issues. Later, I began to give workshops on “Illness and death in the analyst” using active imagination, professional literature, experience of Freud and Jung as well as mine which had raised awareness of this crucial issue.
The World to Come
In our new play, My Lunch with Thomas, Murray Stein asks me: “What do you think about life after death?” I respond: “I think that we come into consciousness through our body. When our body ceases to function, we lose the ability to perceive, to reflect or to understand… What can I say then about life after death, or as we say in Hebrew, olam haba, “the world to come”? Perhaps I can only to cite Wittgenstein’s famous insight, “Of that which we cannot speak clearly, we must pass over in silence.” ”
Death will always remain a mystery; nevertheless, the cross-cultural and depth psychology investigation of death will continue to provide unexpected insights into how humans cope with that mystery and give it meaning.
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[1] This chapter is based in part on Abramovitch (1975; 1984;1991; 2000; 2001; 2005; 2010; 2015; 2020).
[2] Shma’ Israel, Hear Oh Israel, the Lord Our God, the Lord is One. (Deutoronomy 6:4) is a central prayer in Judaism, recited in synagogue, at bedtime before sleep, and is traditional last words of a Jew. Shma’ is incorporated in certain Christian Prayers and occurs in Sura 112.