The truth will set you free, but first it will piss you off. – Joe Klass

Ram Dass and Reb Zalman

I have always been an independent person. I have jumped off mountains in California and Maine with rappelling gear, I rode my motorcycle to Key West alone for weekends in college, and I learned to jump my very large thoroughbred horse when I was nearly fifty years old.

Today, I find myself unable to move from the neck down with continued weakening of any peristalsis in my body’s alimentary canal that moves food North to South, or East to West if lying horizontally, an asana I assume throughout much of the day and night.

My sense of autonomy has always been important to me and is fiercely defended by my will – condolences to my parents and gratitude to my husbands. One of the most difficult parts of aging and/or disability is losing one’s autonomy. 90% of the people who choose to end their life using medical aid in dying (MAID) is due to loss of their autonomy.

Erik Erikson, a German-American psychologist whose work was covered extensively in my Masters degree program at Tulane University in the 70s, developed a theory of human development comprised of eight stages from birth to adulthood with each stage ending with a developmental crisis that led to the next stage. He was best known for coining the phrase identity crisis.

Stage II of Erikson’s model involves developing a greater sense of self-control. It has been commonly observed that when individuals age, they revisit the psychosocial stages of development from childhood. Often children end up parenting their adult parents either physically, emotionally, or both. I believe multigenerational healings can occur during this reversal of roles, when unresolved issues from the past resurface to be healed. Occasionally, the trauma is too great to be reworked or it is just not time, which can be overwhelming. Families get through this time the best way they can. Perhaps, if people can cultivate a sense of empathy, either through counseling or other support systems, working with these crises can be extremely restorative.

In this essay, I will explore my own personal experience of how Erikson’s second stage Autonomy versus Shame and Doubt has manifested to clear residual shame and doubt during the end of my life. Each stage has its own particular challenge, it’s crisis of identity, but each stage moves toward healing, interdependence, and communion/love.

For me, letting go of control has always been a challenging requirement in this theater called life and often I do it kicking and screaming, with sometimes bone shattering consequences, quite literally. During major transitions, letting go and trusting the natural process of life has been a challenge for me. Giving away my power to external sources of authority in lieu of trusting my own inherent wisdom has been a related and recurring life lesson. Mediating between the two tendencies of deferring authority and needing autonomy during this end-of-life time has been challenging.

Last week, I experienced a sense of anxiety so huge that with my level of frailty, it could have ended my physical life. Nevertheless, I decided to sit with the fear, not an easy ask. This is probably one of the hardest spiritual practices, to sit in the place of not-knowing. (Ironically, all I really can do is sit, but I could have distracted myself, or quite honestly, having the lethal prescription, I could have chosen this as my exit point, if the suffering was too great.) There is no right or wrong decision. Each has their own sovereignty to decide for themselves. Instead, I decided to just BE with it to see what would emerge. Fortunately, I also have been given healthy doses of determination and stamina to meet these areas of limitation.

I sat and felt more and more fear until it was beyond overwhelming. I called my very skilled caregiver/fellow traveler to be with me, revealing yet another challenge in my life – asking for help. I just knew I could not go there alone. She tenderly affirmed she was there, completely present, and available for whatever I needed. With someone I trusted deeply to hold the container, I went there.

It was like entering a dense orb of anxiety that had been suspended in time. I was transported to the pregnancy with my first child, which had been one of the most joyful times of my life. Once it was time for her birth, however, I found myself feeling completely alone and unsupported, with no sense of trust in the natural process. Feeling that vulnerable, I asked the doctor for a cesarean which started a series of events that spun completely out of control. I was given a general anesthetic that upon awakening left me in tremendous physical pain and completely disoriented – Where is my baby? Two days later, when the confusion began to clear, I demanded they bring my baby to me and called my mother who got on a plane immediately. The doctors threatened me, because that was the 70s and they didn’t yet have the practice of rooming in, nevertheless, I persevered – alone, helpless, and disoriented, I persevered. Two days post cesarean, I developed a postpartum depressive reaction, the likes of which I’d never before experienced. I just did not have the internal resources to integrate the trauma. This was before midwives and doulas were welcomed in hospitals. I felt completely ill prepared for the onslaught of feelings of fear, helplessness, and shame.

Just recalling the memory makes me cry all over again. Then I realized that this orb of unresolved feelings, now relegated to my unconscious, were familiar and had recurred a few times later in my life. Each recurrence left me with the exact same feelings – fear, helplessness, and shame. It began to make perfect sense that it would resurface as I was preparing for another major transition – dying! With this awareness, I felt gratitude that this ominous trauma had reemerged into my awareness. I felt in awe of the natural order of life during this auspicious time. When confronted with the end of one’s life, the holes in our souls caused by past trauma can become more evident, along with the neurosis that had taken up residence. These are the places that most need our love and acceptance for healing. In our culture, I’m sure these karmic appointments often get medicated away. Again, no right or wrong. For me, this was an important piece to clear before my final transition of birthing myself through the doorway called death.

At this point, I would like to digress to the timely issue of aid in dying in our culture. Personally, I am grateful to have the safety net of having the prescription in my possession, whether I choose to use it or not. I am grateful I was able to open to my greater suffering necessary to meet the emotional crisis presented at this sacred time of transition. When I secured the prescription, I made an agreement with myself that I would not use it to avoid anything emotionally uncomfortable, but because I was ready to go forward. I intuitively know I don’t need to endure needless physical suffering. It is my style to confront obstacles for my greater good. I wouldn’t begin to make this decision for others or take it away. One of Erickson’s criticisms has been that he excluded the emotional and spiritual aspects of development. I don’t have that limitation in my toolkit. If you know me, you know I am fierce with passion and determination to fill these holes in my soul with love and joy (and anybody else who crosses my path).

During the aging process, losing one’s independence and sense of control in life can lead to despair as the body deconstructs. In his own words, Erikson reflected on his view of his life now in his 80s, You’ve got to accept the law of life, and face the fact that we are disintegrating slowly. Deconstructing the developmental stages that were so hard won when we were young is a mirror image which requires acceptance and letting go of will. From a spiritual perspective, one needs to shift from the egoic level to the spiritual, which is not a path for everyone. Sometimes, what is called for is just planting seeds and that is enough.

In their ninth decade together Erickson and his wife, his lifelong collaborator, expanded their theory which included issues that arise during the old age years. They identified the conflict during this stage as Integrity versus a Sense of Defeat (despair). The fruit of this tension can ripen into wisdom. The Ericksons further posited that the lessons during this time of life involve developing empathy and resilience, that having the courage of our convictions to move toward greater wholeness dispels the ominous sense of despair that so plagues many elders. This is not unlike Viktor Frankl’s theory of attributing greater meaning to adversity, a practice he developed while in the concentration camp with his family in the 40s.

In his seminal work, Rabbi Zalman Schachter-Shalomi described the importance of mentorship in one’s older years, or as he called it spiritual mentoring when he wrote From Age-ing to Sage-ing. (It should be noted that Reb Zalman was ordained as an Orthodox rabbi until he experimented with the “the sacramental value of lysergic acid” in 1962. His experimental style along with the cross-cultural influence, which included feminism and LGBT rights into Judaism, mysticism, and a rainbow prayer shawl he designed, inspired me to reconnect with my Jewish heritage in the 80s.) He traveled with other rabbis to India to meet the Dalai Lama. His holiness was interested in knowing how the Jewish people had survived with their culture intact, a significant issue for the Tibetan Buddhists in exile. If this interests you, read Beyond the Ashes, written by a rabbi ordained by Reb Zalman and Jew in the Lotus, a book that chronicled this journey.

If you read my last essay, you likely understand when I describe the anomalous quest of those of us who need to reach the summit of the Himalayas. Having been a psychotherapist and in therapy myself much of my life, I have had the privilege and opportunity to develop a huge capacity to ride the suffering with the faith that in doing so, I would eventually find liberation.

During the height of my anxiety, my prayer was for PEACE. Reb Zalman spoke clearly about anxiety, how it helps the ego become more translucent and transparent, to remove the opacity so the divine light can shine through. These words hold such TRUTH for me now.

It is my hope that anyone facing adversity find the same comfort I have found during this sacred time. Here is medicine for all who are facing life’s sacred transitions. It is a trailer from Ram Dass’ documentary Going Home:

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