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“In navigating this complex web of fact, fear, imagination and physiology, a palliative care doctor is a scientist with a hint of shaman.” Rachel Clarke is one of these scientist/shaman working with the living, who happen to be dying. In ‘Dear Life’, she manages to articulate the challenges of being a medical doctor with a big heart on the front line of end of life care. She takes us with her, on her journey to become a doctor, combined with the roles of mother and daughter. It is her warmth as a person that comes through in her writing and allows us to connect with her experience. She recognises the importance of fundamental values like kindness, listening, and as she puts it, “patient, not disease, centre stage”. She is a representative of an underfunded sector of an under-funded NHS, a pragmatic yet passionate doctor. She recognises how, “patients oblige, comply, obey; they cannot risk dissent when so much power is concentrated in medical hands.” She is a powerful advocate for “small acts of kindness, and simple touch to transcend primal fear.” She doesn’t shy away from facing issues of ‘desperation medicine’, which is a tempting treatment avenue to follow when including death in the conversation around life-limiting conditions is avoided. She is wise and understanding as she accompanies patients and their families, navigating hospice life together. “I forgot how much it hurts to love someone while losing them”, she admits. Her descriptions of the vibrant life on a hospice ward are inspiring and life affirming. She shows us what is possible in the face of difficulty. “In the absence of cure there is still love, joy, togetherness, smiles, tears, wonder, solace – all of life, only concentrated.” Her own grief unfolds through the narrative when her father is diagnosed with cancer. This becomes the lens which deepens her clinical practice and reminds us that “grief, like love, is non-negotiable”.

“You really look after your teeth”, were the muffled words from behind the mask. “I need to”, I think but don’t say, as I reflect on my complex dental history. I am extremely grateful to this unfamiliar dentist who is peering at the hole in my mouth where a crown has been dislodged. A sharp edge on the remaining fragment of tooth is lacerating my tongue. He wrestles to fit a metal clamp over my tooth in thick black latex gloves. I would smile if I could at the choice of pink dental dam. I am lucky. Not only does my dental practice have an emergency clinic during the ‘shut-down’, but this particular dental problem does not require an ‘aerosol generating procedure’, ie drilling. Tooth drilling is only to be carried out in the most extreme emergencies according to the latest government guidelines. I recommend spending the extra time to brush behind that wonky molar, to floss or use a tee pee. This dentist anticipates that routine dental care is unlikely to be available for months ahead. I shall be nibbling carefully next time I eat a piece of rustic toast, and will brush diligently afterwards.

I am devoted to connection face to face, through touch, heart to heart, and in community. Restricted from happening in person, meetings beyond our household now take place on line. From the vantage point of my childhood, we are now in Star Trek technology. I feel deeply conflicted about virtual engagement, but also see the advantages of connecting far and wide without leaving home. Those who can’t afford or can’t cope with the technology are penalised. I feel reluctant about holding space on line. Others lead as I join meetings, share feelings in this way. Communicating using both face and the sound of your voice hold me closer than a disembodied voice alone. Recently I have followed my Pilates class, while seeing the décor of each student’s home. I have lain under a blanket while others snuggle up elsewhere for a sound bath. I have breathed with a screen full of other open mouths and rising chests. I have attended work meetings with participants across the UK, and I have jiggled as a tiny form on a tessellated screen with dancers around the globe. I am curious to watch how our digital selves will evolve. Most of all I value the people I am lucky enough to be in proximity to. Opportunities for skin to skin connection, for conversations within two metres are highly prized.

Many things that are not essential have been foregone. Enough food is fundamental. Now each item on the shopping list must be considered and foraged for. I feel as though I am giving each provision due thought, attention and gratitude. A month ago, we had a surfeit of lemons. I froze a bag, and since then have been grating frozen lemon onto dishes and into mugs of hot water. Today we bought more lemons. Hygiene protocols mean that we wash each item that comes into the house. Tony efficiently presides over the sink as our ‘Supplies Operations Manager’. I admire the spectacle of sunlight playing on zest. Lemons, then broccoli and leeks jostle in soap suds. I cook supper. Ingredients are invited like favoured guests to join our culinary spread. Each flavour is a valued addition. Shades of green from roast fennel to avocado and spinach salad with pesto dressing decorate our plates. Mushroom and coconut sauce on pasta spirals completes the tableaux. ‘When life gives you lemons…’

In the midst of restrictions, here is beauty. Nature is unfurling full steam ahead, ripe with life. Blue sky and fat white blossom at its most open. Each day more petals fall like confetti. The cherry tree in South Millfields has no regard for pandemic regulations. Leaves are coming, blossom showers in celebration of spring. I walk the dogs, gulp in fresh air, blue sky, sunshine and trees. At night I pad across the carpet to the bathroom where moonlight illuminates the toilet. I feel my cells respond to larger forces. Sweat, then cool keeps me awake at 2am, in my new day by day existence. Walking the dogs, anchored by nature’s disregard for anxiety holds me steady. This is my spiritual practice. I delight in watching noses twitch in the breeze, feel grounded by capturing shit in small green plastic bags. This cherry tree is now a place of pilgrimage. I breathe it all in, stand less than two metres from its trunk.

The Corvid family are smart. The genus includes Carrion Crows, Hooded Crows, Rooks, Jackdaws, Magpies, Ravens, Jays and Choughs. People are surprised that the crows on Hackney Marshes know me…but it’s not hard. Every day they spot a curious caravan of humans with bright plumage, dogs and a pram. They call out and land nearby. All winter they come, a regular crowd, more when it’s cold. They arrive for elevenses with eager hops to see what I have brought them – peanuts, suet or scraps. Despite our familiarity, they remain camera shy (strange black object). I feel their indignation when anything disturbs their feed – bicycles that stray from the path, dogs that race out of nowhere. I feel annoyed on their behalf when raucous toddlers, that want to watch them flap, run into their circle. I stand while they swoop towards me, then they circle overhead. They wait for me to stand back, give the dogs a treat, before they approach. Beaks on sunflower seeds have the most delightful popping sound. I tried to record their voices this week, not very successfully. The RSPB have done a better job. Now that warmth has arrived, they will feast on insects and forage until autumn. I cried this morning as their numbers dwindled to nineteen plus, already missing crow chatter. They will ignore me over the summer, despite my enticing conversational openers. I shall listen to this recording to remind me of their intelligent company, and well mannered, generous society.

www.rspb.org.uk/birds-and-wildlife/wildlife-guides/bird-a-z/carrion-crow/

We gathered, the damp and determined, in an upstairs room at the Roebuck in SE1 on a rainy Wednesday night. It was not so long ago, in a different era. We went to hear Emma Purshouse and Steve Pottinger. Also known as two out of three ‘Poets, Prattlers and Pandemonialists’. Love and loss are currency for the grist of poets. They notice the small changes and gestures that show love like Pottinger’s ‘Impulse’, or Purshouse’s love letter, ‘Wolverhampton – a Winning City’. They both speak passionately about change. Be heartened by Pottinger’s letter to Café Nero. Emma Purshouse brings her irreverent eyes to the back waters and cul-de-sacs of town. She stands to read, as though recently uncrumpled from the sofa. She is astute, wrapped in humility plus woolly hat. I want to hug her. Her wit is sharp enough to hide in the spaces between words. Her voice lingers, leaving a sigh after her dead-pan face has left the room. If you need cheering up, or fancy a trip to the everyday life of the Black Country, there’s stuff to read, watch, and some silliness on-line.

www.emmapurshouse.co.uk/wolverhampton-a-winning-city/
www.stevepottinger.co.uk/coffee

Before the theatres went ‘dark’, I was lucky enough to spend seven hours immersed in Robert Lepage’s visionary epic, ‘The Seven Streams of the River Ota’ at the National Theatre. This is a revised production of the work, created by Ex Machina – Lepage’s multidisciplinary company. Robert Lepage is an extraordinary magician, with a creative team who bring together performing with recorded arts to make extraordinary theatre. Seven scenarios take place within the piece, from 1945-1995. There are elements of overlapping narrative. “Hiroshima, city of pain,” is where the arc begins and ends. One after another clever and beautiful image takes us through the different scenarios. The action depicts Hiroshima post nuclear explosion, close proximity of relations in an American boarding house, life in Theresienstadt concentration camp in Czech, a farce in Osaka, (shown both from the inside and outside), diplomatic life in Osaka, an assisted suicide as a result of HIV Aids in Amsterdam, and Hiroshima again. Sometimes the narrative is more obscure, but ultimately the whole piece is devised to show Hiroshima as a symbol of rebirth. Within the play there is also an exploration of theatre itself, and its ability to transform details of history into a felt understanding. With his usual inventive flair, physical performances blend with lighting, video and sound to summon atmosphere and emotions. These draw me in to each character’s different history of trauma and grief. Looking back to a day when there were only 163 confirmed cases of Covid-19 in the UK, the few empty seats appearing in sold out shows offered bargain theatre-going opportunities. My elbow touched a stranger. Recalling breath-taking tableaux summoned up with light, silhouette, colour, mirrors, dance, humour, story, sound and silence, conjures up illusions within what now seems an illusory time. A garden of stones creates a walkway to be kicked up with butoh, or walked on through the opening sequence. Percussion adds to the crunch. One and sometimes two drummers keep the show moving. I notice the cymbal “Made in Wuhan China”. It reverberates, calling our attention to find meaning in a sea of grief.

Ex Machina, the company of Robert Lepage

We stride out to take our daily walk. Two humans, two dogs; one in a pram, the other on four legs. We navigate a careful two metres around other pedestrians. I smile, say “morning”, try not to appear rude at this shunning. Spring and winter yoyo from day to day, sometimes from hour to hour. The wind buffets the crows as they circle above me. A sharp chill this morning brings a sudden rattling shower of hail. Gigi endures me taking a photo of the small white meteors of ice on her back. They land on her black fur, chime with the increasing strands of grey. I continue to observe the daily miracles of weather, nature and season, despite the topsy-turvy world we now inhabit.

Butterfly emerging symbol of changeHow to use embracing change as a Grief Tending practice

‘Embracing Change in Uncertain Times’ is designed to be read in different ways. If you have time and space, you could leave it open, meander through it, pausing to feel. This article is written in the form of a Grief Tending Practice, as a framework for embracing change, giving time and attention to grief.

“The best and most beautiful things in the world cannot be seen or even touched. They must be felt with the heart” 
Helen Keller

Who supports me?

In order to be with painful feelings we need support. We need to feel safe in order to contact feelings. Grief Tending is something that is usually done with the support of a group of people. Connecting with another, taking turns to witness might be helpful, perhaps on-line if not in person. If we are not able to spend time with others during this period of restrictions, and you would like to give time to grief tending as a practice, perhaps there is someone you trust that you could check in with before and after?

Setting up a space for Grief Tending

In order to tend to your grief, it’s good to find a space where you feel safe and comfortable. I like to set up a special table with images or things that inspire me on it. You can also include objects or images that connect you to your grief. If you have a dedicated space already, is there something you would like to add to it today? I like to add something seasonal – from the garden, park or fruit bowl. Prepare anything else you need, in order to support you on a personal journey towards observing change and tending to grief.

Elements to include

Grief Tending in Community was brought to the UK from the Dagara people of Burkino Faso by Sobonfu and Malidoma Somé. My teachers Sophy Banks and Jeremy Thres have passed on some of the practices that have come from this tradition, some of which I share here. Working with water to balance fire comes from the Dagara people. In addition to lighting a candle, water is an important element to include when working with grief. We include a jug of water, and an empty bowl to pour into.

Pause and reflect

When I spend time attending to my inner experience, it helps if I stop and pause to feel into any sensations or reflections. You might choose to pause, to pour a little water, perhaps naming whatever you are feeling in acknowledgement. Staying as grounded as possible helps me to stay present during uncertainty. I regularly return to ‘Dropping into the Body’ (see below), as well as pausing to feel, and pouring water during grief tending.

Change in these uncertain times

As I write Covid-19 is sweeping the globe. But the information presented here is just one way to respond to the uncomfortable feelings of grief in relation to other circumstances. Many changes are happening now. The level of risk we face, will depend on our underlying health, our financial and food resources, our location, our relational support systems, our national governance and our luck. Giving space to feel these changes in our bodies will allow us more choice in how we respond.

It is likely that most people will be affected in some way. Many people will experience dramatic changes in their circumstances. Fear or anxiety may be present for you. You may angry, overwhelmed, or facing loss. We will each have different stresses to deal with. Many people will already have challenges in their daily lives, and Coronavirus circumstances will add to the load they carry. The pressures of homes that contain many people, compared to those living alone may be very different. Some may be overloaded by too much work, for others, not enough.

What we are coping with, how we feel and the way we express it will be different for everyone. It may be too soon to feel anything, so please approach your emotional wellbeing with care.

How we respond to changes that happen to us, that we cannot do anything about, may give us some agency in these times. I’m not talking about change as a result of the kind of unfair treatment that needs to be challenged and protested.

Meeting my needs first

First we must attend to our needs for safety and survival. Until our physical needs for shelter, water, food and safety are met, everything else is a luxury. It’s important to feel safe and supported in order to touch into uncomfortable feelings. I can feel more grounded and safe with a hot water bottle, or wrapped in a blanket.

Taking care of yourself does not mean you are selfish or uncaring. It is necessary. We must ‘put on our oxygen mask before helping someone else to put on theirs.’ Your body needs to know that you are listening to its needs. I try to keep checking in with myself. Is there anything that my body needs or that I need to do now in order to be more present?

Dropping Into the Body

I stop for a moment. Give myself a little space for reflection. Allow the ground to take my weight. Can I feel my feet on the floor? Notice the quality of my breathing. What is my body feeling like right now? Is there any pain or tension that needs the touch of my hand or my attention? Are there any sensations calling my awareness? Can I sense an emotion surfacing or bubbling underneath? Perhaps my body has a message or some feedback for me?

Gratitude

When things feel as though they are falling apart, internally or externally, it’s easy to get lost. I used to dismiss the practice of offering gratitudes as hippy nonsense, but I’ve discovered it actually helps me. When times are tough it can be really hard to think of things that I am grateful for. Identifying what we love can help us to recognise our resources. Feeling gratitude can also be a support so that we are able to dip into feelings that may be more difficult. Ask what am I grateful for? If this is a struggle, it can help to start with something really small.

A global pause

Whatever your circumstances, there is probably an element of pause in normal activity as a result of Covid-19. This may involve the sudden end of something for you, or a temporary cessation. Are you able to allow this moment of pause to happen? What happens if we stop our busyness for a moment to be with the change? How does it feel to stop for a moment? What is surfacing in this moment of stillness?

Slowing down as a resource

Slowing down is a way to help embrace change. You may have more time, but be under more pressure than previously. I am relishing spending some time in activities that support me to live at a slower pace. Perhaps being restricted to spending more time at home can encourage us to embrace a slower way of life? Are there things you enjoy that might become resources as you flow with the changes? I am looking for new opportunities opening up to cook from scratch, grow vegetables, sort my paperwork, read a book, write poetry, send a letter, mend a jumper, draw the view from my window? What do you love doing, when you give it the time, that makes you feel good?

Some may have much less time. Perhaps you are working harder, longer hours, or have to give more care and attention to those around you. In this case, is there something slow that you want to prioritise as soon as it is possible? Are you able to allow yourself a moment now to pause, within the rush?

Re-calibrating

Our ability to recalibrate, affects our success at responding to change, particularly in these uncertain times. This requires being flexible both mentally and in practical ways. What will help me to recalibrate, in order to embrace the current changes?

If some of the changes you are facing are sudden, you may be feeling a range of emotions. I have been experiencing the familiar sensation of shock. Allow yourself time to pause, to feel into how you are, to listen to your body. How are you feeling right now? Are there physical sensations? Be curious about what lies beneath the mental chatter?

Mindfulness as a resource

Anything can be a mindfulness practice. Many people choose to meditate sitting on a cushion, but this may not be what works for you. Being mindful means being present now in whatever you are doing. It might involve paying attention to the washing up, looking out of the window and noticing my breath, being ‘in the zone’ when I am doing something creative, or listening to music.

Repeatedly returning my awareness to the present can help me to manage change. Rather than going over what happened or worrying about what will happen, being present can help me to function better. Being present allows us to take one manageable step at a time. I can practice being mindful any time, anywhere. It is normal to find this difficult to remember. But even a moment or two of focussing my awareness in the present can help me to create more inner space.

Feeling the changes

Changes stir up feelings. In the current pandemic you may be experiencing multiple simultaneous changes in your life. It is normal to respond to changes in the same way we respond to any loss or ending. Approach feelings very gently, especially if they are big or overwhelming. If you feel safe and supported enough, ask how am I feeling? Is my body giving me any symptoms as clues? Am I experiencing layers of different feelings? Grief includes a wide range of flavours including relief, anger, joy, fear, disconnection, shame, yearning and sadness. Old sorrows or emotions may also be touched by more current losses. It is normal to feel grief in your own unique way.

Expressing feelings

We can welcome in change by allowing our feelings to be felt, and heard rather than looking for distraction. In dealing with the uncomfortable feelings of grief, we need enough time and space to feel. What are the ways that help you to express your feelings?

Sounding

I find it helpful to articulate how I’m feeling by letting out sounds. Even when I am alone, I often speak how I am out loud, “I feel…” What happens when you drop your mouth open and gently allow sounds that long for release? Are you holding back a tone, a grumble, a sigh or a wail? Is there a song to sing which touches your heart?

Movement

Music can help me to access feelings. Nina Simone can really help me to find the spot. Movement, dancing, stretching can enable me to express my mood. What are the moves that will help you to open, that are longing to be expressed? What is the soundtrack to express what you are feeling right now?

Creativity

Writing or drawing is a way in for me too. Sometimes I pick up a pen or art materials and allow whatever is inside to flow onto the page uncensored. Take a sentence for a walk, starting here, “I long for…”

Breath

Simply spending time with your own breath can be really powerful. By allowing my jaw to loosen, breathing into the belly, and concentrating on my out breath, I can connect more with feelings.

Touch

I often find I can contact my feelings through self-massage, especially rubbing around my breast bone. Is there somewhere in your body that aches for touch?

Letting go

Change brings grief, and all the messy emotions that may come with it. Resisting change, avoiding pain can make life more difficult and for longer. Embracing change can be empowering. Facing our feelings can allow us to move through them. In order to embrace the changes, we need to be willing to let go. Moving forward involves being ready to surrender, to give up what we had before. Facing, rather than ignoring change can help us to ride the waves.

Welcoming change

Is the system disruption caused by this pandemic bringing opportunities to do and experience things differently? I am noticing new possibilities because of the changes, as well as restrictions. Are there changes that I need to make but haven’t get round to? We may be experiencing a real mix of emotions and responses.

By embracing change, we may discover opportunities for something new to come into our lives. We may discover that a change that has been imposed upon us, has benefits. By connecting with our feelings we can ‘make friends with change’.

What connects us?

The global influence of this pandemic brings both changes and reminds us that we are connected. Is this a shift that will be part of ‘The Great Turning’ as Joanna Macy calls it? This virus currently reminds me that we share the web of life. How do we look after one another in this time? What measures will help us to live fairly, despite the difference in how change lands in our lives? Can we recognise our inter-connection? Will we all come to value nature, fresh air, being able to walk freely outside more? I am aware of leaning into something greater than myself to guide me through the changes we face.

Soothing

After going inward I take time to stroke, or hug myself. Grief is hard to bear, and being witnessed helps. I need to connect with someone I trust after working with feelings. I will be especially kind to myself. Is there anything I need to complete this journey of tending to my grief? I might play some music, give my feet a salt bath, go into nature, open the window to breathe fresh air or make a cup of tea. I love to sing along to this version of the Hawaiian Ho’oponopono prayer sung by Trina Brunk.

Resources

In response to the current changes caused by Coronavirus, I am digging into my own toolbox to see what resources I have in place. What are the activities that support me? Where are the places I feel safe? What things remind me of connection? Who is there for me? This is more important in a time where we are being asked to ‘self-isolate’ or ‘social distance’. Am I finding enough outlets for self-expression with people who support me? I am finding new ways to weave threads of community on-line, in order to find more support during this period of change.

What matters most?

We all need enough food, water, shelter, health and resources to survive. Building on these, we need other things – to feel valued and able to contribute in our lives. This feels like a great time to re-evaluate my life. I am considering what are the things that matter to me most? I am pondering what is meaningful to me? Asking what do I value? I am noticing what I enjoy doing. And what gifts do I have to offer? Where and what makes me feel comfortable? Of the things I take in, what nourishes me? Who do I love?

For me, this is a great moment to cherish what matters most. When everything else is stripped away, love, relatedness and connection to the web of life can support us to embrace change.

‘Grief hygiene’

In Grief Tending we pay attention to the space after doing this practice. If I have poured water to connect to my grief, I pour it away, asking the land or sink to receive it as a blessing. Taking down any temporary special table, I might add something to my permanent one, to remind me of the things that support me. Burning sage, spraying an essential oil or cleaning the room clears the space. If something moved in me, I take a shower and change my clothes to shift into a different gear.

Moving On

If there is one thing we can be sure about, there will be more loss, and more change. Embracing change is a practice to return to again, and again. The skills of feeling and expressing grief can help us to live with uncertainty.

“What a caterpillar calls the end of the world we call a butterfly.” 
Eckhart Tolle

Links:

Join the Love and Loss mailing list or contact Sarah Pletts here
Grief Tending events on line with Sophy Banks and Jeremy Thres
Sobonfu Somé
Malidoma Somé
Joanna Macy
Helen Keller
Trina Brunk
Eckhart Tolle