Spiritual Care Supports Patients and Providers
Kocher, CMT, a full-time massage therapist in San Francisco, works
with many patients who have serious
illnesses. She's able
to maintain her own energy level, she says, and offer her patients
consistent help, due to Tibetan meditation and compassion practices.
first learned these practices in 1994, when she read The
Tibetan Book of Living and Dying. The book, by Tibetan teacher
and meditation master Sogyal
Rinpoche, offers basic instructions on meditation as well as advice on many
aspects of life, illness and healthcare.
"The first thing that caught
my attention," Kocher recalls, "was the practice of the 'three
noble principles.' This practice gave me a way to contain my work in
a very practical way. It allows me to be present with potential pain and
suffering, and helps me maintain the physical and mental energy I need
in order to do
Before starting any session with a client, Kocher does a short meditation
practice and reminds herself that her goal is to benefit her patient, and
the session, whatever arises, I just return again to calmness and kindness
and clarity within myself. At the end of the session, I dedicate my efforts
and pray they will benefit all beings. This allows me to let go of whatever
happened during the session, and reenter a clear state."
Kocher frames her day with half an hour of meditation practice, morning
and evening. In recent years, she has started to learn ways to share these
with her patients, through the Spiritual Care Program founded by students
of Sogyal Rinpoche. She says these methods can make a significant difference
patient's lives, and in their experience of illness.
One woman she knows has been dealing with metastatic breast cancer for
a dozen years. "Recently she has been so hard on herself, questioning some
her own choices. When you live with cancer, you always face the possibility
it may come back, and so you want to make the best use of your life," Kocher
says. "I reminded her of the enormous courage she's shown in
living with cancer. I encouraged her to do the practices of loving-kindness
and self-forgiveness described in The Tibetan
Book of Living and Dying.
those practices, she's been able to develop more spaciousness, an ability
to hold her situation more lightly, and to transfer that courage to the
other decisions she needs to make in her life."
Methods of Meditation and Compassion
What are these methods that can be so enriching and revitalizing for healthcare
providers and for their patients? The first is meditation, which means watching
the breath, or repeating a short mantra, to calm the mind. "Especially
for people who've been coping with illness for years, who are experiencing
suffering, frustration and exhaustion, it is remarkable to be able to find
peace and a place of rest in the midst of that confusion and pain," says
Kirsten DeLeo, a full-time educator in the Spiritual Care Program. (For more
information on meditation, see Chapter 5 of The
Tibetan Book of Living and Dying.)
Then there are practices designed to help us develop compassion for others. "People
who experience physical suffering often ask 'why me?'" DeLeo
says. "A sense of hopelessness and meaninglessness magnifies the suffering.
Compassion practice can open our eyes to the world around us, and give us a
larger focus. Even though the pain doesn't go away, our experience of
that pain can shift." (For more information on compassion practice,
see Chapter 12 of the same book.)
DeLeo recalls a comment from the Dalai Lama. "He says that when you
open your heart and cultivate compassion, who is the beneficiary? It's
you. These practices open us up so we connect with other people's suffering.
We see we're really not alone and isolated; instead, our mind and heart
can be filled with love and compassion."
Training Available for Providers and the Public
To share these ideas about the importance of spiritual care for patients and
providers, for several years DeLeo and Annie Eichenholz, BS, RN, CRNH, have
been offering training in spiritual care to healthcare professionals and
the general public, in a variety of settings. Eichenholz is a hospice nurse
at Sutter VNA and Hospice in Sonoma County, California and is certified as
a nurse educator in end-of-life care by the End-of-Life Nursing Education
The Spiritual Care Program offers weekend or one-day workshops as well as
inservice trainings in hospitals, hospices and nursing homes. These programs
for continuing education credit, and are usually geared to people working in
end-of-life care, including doctors, nurses, social workers, massage therapists,
hospice volunteers and other caregivers. The training is offered "wherever
people invite us" Eichenholz notes; organizations that could benefit
from this training should contact the Spiritual Care Program.
In addition, the program offers weekend and one-day workshops for the general
public, for people who are coping with chronic illness as well as others who
want to use meditation and compassion practice in daily life. The suggested
donation for a daylong program usually runs about $80; for a weekend program,
During the 2003-2004 academic year, Eichenholz and DeLeo served as instructors
in a certificate program for healthcare professionals called "Contemplative
End-of-Life Care." Offered through Naropa University, in Boulder, Colorado,
it combined meditation and other contemplative practices with the skills and
best practices of hospice and palliative care. The program included three residential
sessions in Boulder, totaling 16 days, plus on-line lectures, discussions and
journals. It will be offered again in fall, 2004.
"This program offers
a special opportunity for people who are often experts in their own fields
to hear views from people with different experience and training, so our
discussions have been really rich," Eichenholz says. "It's been very
fruitful for people who are searching for a new approach to take within their
In some cities, Spiritual Care study groups are forming. For example, in
the San Francisco Bay Area people who work in healthcare and human services
on second and fourth Tuesdays of each month to study the spiritual dimensions
of caregiving and offer mutual support. Topics include caregiving as spiritual
practice, meditation, working with difficult situations, compassion in the
workplace, preventing burnout, communication, and responding to the needs
of the dying.
Don't Give Up
Eichenholz often recalls the story of an emergency room doctor who studied
meditation, but found he could not sit in the traditional upright posture,
due to severe back pain. "He discovered he could lie on the floor,
in the most comfortable position possible, and meditation could happen while
he was lying on his back. This story is so important for us to remember,
when we are in physical pain. These contemplative practices of meditation
and compassion can be useful in whatever way works best for each of us. Don't
give up, because the most important point isn't the physical posture,
but what happens in your mind and heart."
more information, email email@example.com or visit www.spcare.org/us
For information on the Naropa program, call 303-245-4800 or visit www.naropa.edu/contemplativecare/index.html
For books and other materials on Spiritual Care, visit http://store.yahoo.com/zamamerica/spircarfordy1.html
Elaine Zablocki is the editor of CHRF
News Files, a bimonthly emailed
newsletter about the emerging integrative medicine industry, published
by the Collaboration for Healthcare Renewal Foundation.