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Home or hospital for relieving physical and emotional suffering of dying persons. In patients expected to live only months or weeks, hospice care offers an alternative to aggressive life-prolonging measures, which often only increase discomfort and isolation. Hospices provide a sympathetic environment in which prevention (not just control) of physical pain has top priority, along with patients' emotional and spiritual needs. Care may be provided in a health facility, on an outpatient basis, or at home.
Description or study of death and dying and of the psychological mechanisms of dealing with them. One influential model proposed in 1969 by the psychiatrist Elisabeth Kübler-Ross (19262004) described five basic stages: denial, anger, bargaining, depression, and acceptance; however, not all dying persons follow a regular, clearly identifiable series of responses to their situation. Thanatology also examines attitudes toward death, the meaning and behaviours of bereavement and grief, and other matters.
© 2010 Encyclopædia Britannica, Inc.
Good afternoon. Thank you for coming out to support your local independent book seller, coming out to Book Passage on this beautiful day and to meet with our two wonderful authors, Dr. Stan Grof and Dr. Scott Eberle. I would like to take this moment to remind you if you have cell phones or pagers with you to please turn them down and I will give you the outline of our event this afternoon. Dr. Eberle is going to present and Dr. Grof is going to present. Then both gentlemen will sit up here and open the floor to questions and answers and then I am hoping they will stick around for a minutes after that to sign some books, which we have available at every register and if you would like have a book signed by either or both doctor we ask you to please purchase the book before you bring it up and have it signed. I would like to open with one of my favorite quotes, "with every thought of fear or terror set aside may I recognize what ever visions appear as the reflections of mine own consciousness." From the Tibetan Book of the Dead which I am sure most of you probably recognize. This afternoon's topic is very interesting and we have two gentlemen representing very interesting views on impending death and death as the big question. Let me tell you a little bit about our authors, Dr. Stan Grof who is here with his book, The Ultimate Journey: Consciousness and the Mystery of Death is a psychiatrist with over 40 experience of research into non ordinary states of consciousness, induced by psychedelic substances and various non drug techniques and one of the founders chief theoreticians of trans personal psychology He is the founder of the International Trans Personal Association and its past and current president. He is also Professor of psychology at the California Institute of Integral Studies in San Francisco and at the Pacifica Graduate School in Santa Barbara. He lectures and gives seminars world wide. First we are going to hear from Dr. Scott Eberle who is here with his book, The Final Crossing: Learning to Die in Order to Live. He is a physician specializing in end-of-life care. Scott serves as medical director of Hospice of Petaluma in his home town of Petaluma, California. Having first learned the science of medicine at UC San Francisco Medical School, he then learned the art of medicine from countless people living and dying with AIDS in the 1980s and 1990s. He survived this difficult time by regularly seeking sanctuary, either in monasteries or in the natural world, completing over 150 retreats during a 15 year period. He recently ended a 16 year career as an AIDS specialist so he could focus his energies on hospice work and the practice of living and dying work he does. And I am quoting Dr. Eberle here, "So now I am a physician who specializes in supporting life transitions. I am a hospice doctor who sits with the dying in their homes and I am a rite-of-passage guide who sits with the dying out in the desert." So please join me in giving a warm welcome to Dr. Scott Eberle and Dr. Stan Grof. Thank you so much for the introduction and I want to begin by giving a very special thanking the Book Passage for inviting both of us, but in particular inviting me because I wouldn't be here if you hadn't invited me. And then also to say a very special thank you to Dr. Grof Dr. Stan who has been an important part of the reading that I did. The foundational reading that I did for the writing of my own book beginning three four years ago was some of his important survey work around. The different wisdoms about how to die that come from early cultures. As the introduction has already said my background began as an AIDS physician doing lots of end-of-life work back in the time when the AIDS epidemic really was death and dying work. And I have you know sat at the bedside of many, many people who have died over these last now 20 plus years. The book, The Final Crossing: Learning to Die in Order to Live tells the story of one particular man who I took care, who died here in Marin County actually four years ago, this very month. It was a just a week or two earlier the month, four years ago, 2003. Steven Foster was along with his wife Meredith Little, pioneers who helps develop wilderness rites of passage commonly referred to in this day and age as the Vision Quest, actually began their work in Marin County in the 1970s and for 30 years, took first youth and the adults of all ages into the desert to enact a rite of passage. I find it fascinating to be going on this so called book tour, exactly a 100 years after the word rites or the phrase rite of passage was coined by the anthropologist Arnold Van Gennep, 1907 you know it was when he did that. And when you go back to original anthropological source you will see that Van Gennep saw or described the very process of going through a rite of passage as being a dying experience. You go through three phases in rite of passage according to Van Gennep. You savor from the old life which is the dying, you enter a threshold phase where you are in between worlds and then you are re-born or re-incorporated into the next phase of your life. So, what was so fascinating about Steven and meeting him and being there to help with his own final rite of passage, his physical dying was this was a man who had given 30 years of his life to helping people symbolically die and so there was an awareness, consciousness about how you prepare for death of any kind, that is it was quite singular. And Steven was a man bigger than life, quite literally. And so we had these incredible electric encounters when I would go out into visits. In the book, I mean it's fictionalized for structural reasons to four visits, in real life I made five visits over about four months while Steven was dying of a genetic lung disease. And in those visits not a single one was less than two hours and not only because and part because there was an electricity between the two of us when we would meet and talk. I mean the electricity as I now come to understand it spending a lot of time talking to Meredith even further for this several years since and then also writing about it. The electricity was because I was coming from a place of 30 years in a hospice movement and the wisdom that the modern world is beginning to rediscover about how to support people who are physically dying. And Steven had spent 30 years doing work with the symbolically dying, Rite Of Passage wisdom that was also for a time lost in our culture. Actually I think if you go back historically to the 40s, 50s and early 60s we Western people had drifted as far away from a consciousness and awareness about how to physically or symbolically die than any culture really probably in the history of human race. And so what I imagine much of the work that Dr. Grof has done over these last years are in consciousness, both prior to and after death as well as miriads of other authors over these last 30 years. It's really about a cultural re-awakening and re discovering old wisdom; old wisdom in particular about the art of dying which I believe is the same thing as the art of living. That if you learn to as the title of my the subtitle of my book suggest if you learn how to die you are in fact learning how to live more fully. One of the piece I find offer, just to give you a flavor and the book by the way is first and foremost the story of Steven's dying. You cannot from my point of view, the way I do my work; I couldn't begin to convey who I am about and what it is I do without telling a very personal story. Because people die one at a time and in particular in this case Steven Foster died. And so if I wanted to convey the power of that experience it had to be a personal story. But I also knew from the beginning that there was this bigger historical story which I am alluding to already, about how we are as a people just re-discovering old ways and that became what I was from the beginning calling the in between chapters, in between the home visit chapters. And for the in the interest of time I am just going briefly sketch what those in between chapters are because what they have done capture for me is the essence of what the psycho spiritual work is involved with anyone who is preparing to die. Then again anyone preparing to die symbolically, anyone preparing to die physically. One of the places where I was able to get some good source material about old teachings was again, Stan's work around different books of the dead and in particular the teaching I am going to offer you is part for Mayan wisdom which was passed along orally for many centuries and then in particular it passed along orally by a Northern Cheyenne medicine teacher to Steven and Meredith about 25 years ago, Hyemeyohsts Storm, some of you may know the author of Seven Arrows. So in this teaching, if you are preparing to die symbolically or physically, four steps. Decision Road, you stop on to the road that you know consciously leads to your own death. In fact I would suggest any wisdom about how to die begins with some variation on what is how do you go ahead and declare, I want to do this as consciously as possible. And I would even suggest that people who sit and meditate every morning, people who have some desire to go ahead and show up as fully in their life as possible, all variations on this desire, to step on the decision road and do just dying which is just living as well as possible. And in this teaching if in fact it's a physical death as the Cheyenne people were using the teaching passed on to Meredith and Steven, if it's a physical death, the decision road leads next to the death lodge. And then the death lodge is the place where you go ahead and complete your relationships with the people that matters you most. In a symbolic death you could also suggest that if you really want to go ahead and die to an all the way of being in your life the only way you are going to do that is by making your relationships current, so death lodge work just as important around dying symbolically as it is dying physically. And here I borrow from a wonderful old teaching in the hospice world which I could refer to as an old nurse's tale, kind of like an old wife's tale and that no one knows where it comes from, but it's a wisdom that's so obvious in many ways that it has become part of the hospice lore. And its death lodge in its most essential form. And the wisdom is this, in order to complete a relationship you need to be able to say five things, and this is particularly true when someone is dying. Please forgive me, I forgive you, thank you, I love you, good bye. And in this very short version of what I am developing to say that you don't have to wait for people to be dying to do this work. And in fact I would strongly encourage you not to wait for someone to be dying to do this work. And that the way in which we keep our relationships current is the way we also prepare and hopefully not for many years to do the work on someone's death bed. One of the things I haven't mentioned yet is that six or seven months after Steven died Meredith approached me about becoming her teaching partner and the hand outs you have that were passed around earlier described the practice of living and dying, which is the work that she and I now do together. I am combining her 30 years of doing rites of passage work with my 20 years of hospice work and just like she and Steven we take people out into the desert. And what we do is we walk them through these different stages, decision road, death lodge purpose circle, ballcourt. And the experience we have had doing this, we have done this with about 20 different groups and about seven different countries, the experience we have had is that it's the death lodge work that's the most charged, most difficult and perhaps most important for people to be doing. So what we have done, just recently done for the first time in Austria, last year and then again in a couple of months in Death Valley, is take a whole week in the desert around the theme of just forgiveness and reconciliation. It's that important I believe. So in the teaching you make it good with the people who you love, who are important to you, you wrap up your human relationships, next phase is purpose circle. Purpose circle, this is the place to go ahead and wrap up your own life within yourself. Within my own life, within my own terms of what was important to me was the life that I lived, good. It was the way in which I sort out purpose and meaning what I wished that I would have done with my life. The very well known psychologist Eric Erickson, eight step model of how we walk through life and then tests of ego development beginning with trust versus mistrust as an infant, in his final stages integrity versus despair, which is purpose circle through and through. When you come to the end of your life or when you come to the end of a certain phase of your life, that you are dying to, do you step into the skin of who you are in that moment with a sense of integrity or do you despair of the things that you wished, you haven't done or things that you wished that you had done. Lots more to say in the hospice world about purpose circle, but just a brief version says that legacy and what we leave behind in this life, very big part of what purpose circle work is about, also how we do life review, how we tell stories about all of what we have done in our life, also big part of how we see this play out in a hospice setting. In the final step in this four parts process, which I have to say is where Dr. Grof's wonderfully just breaks this open and and the richness that I couldn't pretend to offer you. It's the final crossing, the actual stepping across the threshold into whatever it's to come after we die. The allegory, I won't go into here for lack of time but the the main allegory of the great ballcourt, it's the place where you actually dance with death, perhaps winning another day so that you can stay on with the world of living or perhaps in that final dance you you pass over, you cross over into whatever is to come. For the work I do in as a hospice physician, briefly just to say, I have seen people in that in between worlds, of not really being part of the living anymore but yet not having actually physically died yet. You perhaps some of you had the experience of people in their final hours, the days, sometimes weeks to months, the classic example of this near death experience, but people crossing over in some sense having an experience but yet coming back and talking about it. I mean being able to say this is where I was, but now I am with you but that's where I was. Again, just a flavor for that, I think the last place I will go then and then the give the microphone to Stan is to say that this wonderful notion of the great ballcourt in our daily lives, the way to get that across for me and this is the process of really symbolically dying to the past so that you can step fully into the present moment. If you do the work of I am going to do this consciously, decision road, if you do the work of death lodge I am going to keep my relationships current, so I am not stuck in the old wounds, I am going to go ahead and live a life filled with purpose and meanings so that what I am giving myself over to right now is what I am supposedly doing, then the great task of the ballcourt is to step on to the court and surrender to the dance that you are called to do every step, in every day of your life. And just to say that there we perhaps don't always have that really magical present moment experience of dancing in our lives but for me when that really happens most is when I am going to someone's death bed. And I walk in the room and I everything I have ever known, I am no longer accessing it in any kind of direct way, I simply show up and I do the dance. Same thing with Meredith and I out in the desert, you simply show up and you do the dance. And the best way to do that, the way to learn how to die in order to live is to do the psycho spiritual work of decision road, death lodge purpose circle and then give yourself to that present moment. So I think I will stop there. Thank you. Good afternoon. Before I start talking I would like to join Scott in thanking Book Passage, not just for giving us this opportunity to to share with you our work but also for that wonderful work that they are doing, you know being this unique cultural center in Marine, organizing workshop and all kinds of special events, bringing interesting people so something to I feel very, very grateful for that. I have this task now to use 15 minutes to share with you something that is a very sort of comprehensive discussion of various aspects of death. Bringing in the psycho spiritual insights that came from where it was non ordinary states of consciousness extended really over a more than 50 years now. About half of this about half of the time psychedelic work and the clinical work with psychedelics, the second half work with Holotropic Breathwork which is a method that my wife Christina over there, developed jointly jointly with me. We have done also work with people who had spontaneous non ordinary states because of spiritual emergencies rather than psychotic breaks. And then connections with with Shamans, with anthropologists, with psychics, with parapsychologist, with the people who had UFO abduction experiences, various spiritual teachers you know Vipassana Buddhists and Buddhists Tibetan Buddhists, Christian you know, Benedictine Benedictine monks and so on. So this after an experience which I had over 50 years ago, when I volunteered for a LSD experience in Prague, the study of these non ordinary states became a passion of my life. I have done very little in the last 50 years than something that was in one way or another related to these non ordinary states. And one of the probably most interesting things that came out of it are very, very new and extraordinary insights into into death. So I start the book by expressing my surprise that considering how important death is you know, it cannot be anything more important for for each of us as we goes through our life we all lose relatives and friends and teachers and sooner or later will be confronted with that situation ourselves. So how little how little attention Western people have given to death until certainly the late 60's but we still have very, very long way to go. And I start by comparing this situation in western culture with basically the situation in all ancient and pre industrial societies where it was very, very different you know their in their mythology, in their cosmology, in their religion, rituals, spiritual practice, death you know plays a very, very central role. And I am comparing the situation of a person who is a dying in that kind of a situation as compared to people dying in a technological society. So person dying in our society very frequently is very isolated you know does not have sort of a full inter personal support system, there is much more emphasis on life support systems, sometimes beyond and a reasonable reasonable point. We who have not really developed any specific ways of supporting people in this ultimate crisis, we have crisis intervention just about for any other situation only not for the one that is the crisis of all all crisis. We have also until recently not paid much attention to about what's happening psychologically to people as they are coming close to death or what's happening in near death situations and so on. Now this is very, very different from these other cultures where people die in in matrix, the clan of an extended family. They have maps of these non ordinary experiences associated with death. They have powerful rituals that support them in the situation of dying and they were they have particularly something that we can call experiential training for dying. It is possible to experience death before we die. So the book itself has basically four parts. In the first part I discuss the different methods that we can use or that these cultures have used as practicing dying. So certainly you find it in Shaman as in where the initial crisis of the Shaman is a powerful spontaneous death-rebirth experience in the Shamans and it become familiar with the with the the Tibetans call the bardo realm they can sort of travel back and forth and they can they can become what's called psychopomps, they can guide people sort of in and out and use it for healing. That another major major category would be a rites of passage that Scott mentioned, something that's function I will describe. They are basically rites that were developed in all major cultures that are enacted at some at the time of important biological or social transitions and most importantly during puberty, where again people are exposed to some powerful technologies, mind altering technologies that involve the experience of deaths and reverse. And in these rites of passage it's interpreted as dying in the old role and being born into the new one. Let's say dying as a boy or a girl and emerging out of the rite of passage as an adult and having a very profound personal and convincing experience that the old died and that something really new emerged. The next institution that I discuss at some length are the ancient mysteries of death-rebirth you know in Egypt, Eleusis you know the Bacchanalia, the Mayans had similar kinds of rites of passage, the there were Nordic mysteries of Watan and so on. Again those were institutions where the initiates could come and be exposed to some powerful technologies, changing consciousness and the focus again is on dying and being born. And there is also there are also techniques that were developed by the great religions of the world. There were the Hesychasts or the people who are doing Jesus prayer or Ignatius of Loyola had those kinds of exercises, the Kabuli's certainly, the Sufis a very powerful mind altering procedures where it is possible to experience dying and being born. It's a very, very important phenomenon of dying before dying. Abraham of Santa Clara who was a German Augustinian monk said, "A man who dies before he dies does not die when he dies." He meant sure he women as well but that's that's how it was done. So any way so these are all these different institutions and what what we have now is various possibilities of either using psychoactive substances, at least when it was still allowed to us we are we are slowly returning to that to that whole realm. But also a powerful non drug technique, certainly the Holotropic Breathwork that we developed would be one of them. That can actually help people you know, to experience the death rebirth experience, it means to lose fear of death and as a result of it have their have their life the quality of their life changed. So that's the first part of the book. The second part shows how modern consciousness research expanded somehow the cartography of the psyche that we had. The current understanding of our psyche in psychology is that it's limited to post-natal biography and to - what Freud called the individual unconscious. Now that's a very superficial you know, almost pitifully small model of the psyche. And the image that emerged from the work with consciousness, with non ordinary sub consciousness brings the image of the psyche close to those of you find in the great eastern philosophies were actually the psyche of each of us is to measure it with with all there is. Our individual psyche is kind of teased out of that cosmic matrix. And once you have that kind of model then it's much more plausible that it is possible that consciousness survives after death. Then the third part of the book actually summarizes the different findings from the modern consciousness research that brings some supportive evidence or at least suggestion that consciousness might survive death. And this is the whole [0:27:08] ____ research, people who are in near death experiences and their consciousness while they are resuscitating, then their consciousness goes out of the body and they observe the body from from ceiling and then they decide to go for all trip and goes through the walls and check what's happening in other parts of the building and may be experience something 1000 miles away. And we have even research now that shows that this can happen to people who are congenitally blind, they have never seen any thing in their life for organic reasons and unconsciously their consciousness goes out of the body, they can actually see. And then lose the ability to see when consciousness comes back. The other area where we have now extensive research is the whole ground of reincarnation, both the kinds of experiences that people have in psychedelic sessions and the breathwork sessions in spiritual emergencies, but also the amazing research that was done by Ian Stevenson on little children remembering he studied over 3000 cases when little children were remembering their previous lifetimes. And he was able to go there and in some instances take the children to the place where they supposedly lived and the child would know the geography of the town, would know people by name and they could identify you know, where they lived. So that's another area and then finally the last part of the book is description of the research that we did in the in the 60s and in the 70s which was using psychedelic substances particularly LSD and MDA at that time, with dying cancer patients, and finding out that if they have powerful mystical experiences that they tended to lose fear of death, that the whole process of dying is transformed. So this is particularly interesting because this is now returning there is a renaissance of it there are three projects where where psychedelics are now again used with cancer patients in you know, in respectable facilities including including Harvard that actually was this is the fact that there was a chance to return to this research was one of the motives why I decided to to write this book. It became relevant now. So I have used all my time. Thank you very much.


