Rose's Stone Soup

The Story of Procrustes

2011-04-17T09:48:00.000-07:00

Procrustes was the son of Poseidon whose house was located by the sacred road between Athens and Eleusis. He would invite passersby to spend the night in a special bed that fit everyone perfectly. Once inside he would place them on a rack and stretch them to fit the bed or amputate their limbs if they were too long. Our Medicare Hospice benefit can be experienced as this Procrustian bed in which a patient must fit certain criteria to qualify for the service, including a six month prognosis, and once on the program must give up certain treatments seemingly at the whim of the hospice thereby performing a similar feat in which the patient is either stretched or cut down to fit the program.

The Drowning Man

2011-02-26T13:56:00.000-08:00

David inspires me to write. Abandon if you will the ramblings of your reasoning mind asking why this tragedy should occur, did occur and what can be done to prevent it in the future. Just take the image as is. A man who is under the influence (unconscious) decides to take his canoe over a waterfall against the protests of the other memebrs of his party. He falls into the water and is immediately in the grips of a force created by the falling water and it is pulling hime under. He instictively tries to struggle against this natural force to reach the surface. But he cannot and eventually becomes passes out. As his body beocmes limp he is immediately pulled under and resurfaces a few seconds later down stream, the escape strategy revealed too late. If he had simply let go he would have survived. If he had thought counter to his intuition he would have survived.

This image has stayed with me from the first time I read it in Peter Senge's The Fifth Discipline many years ago. It taught me how natural systems can over take us if we do not understand them and are overtaken by them. It's the letting go that we must learn. Many years ago HBO produced a film called Letting Go about the hospice industry. It has been used in hospice to teach about how hospice can support the terminally ill and their loved ones through a diffuclt journey.

What exactly are we letting go of and what are we so resistant to. Where do these two approaches come from? What is the heroic stance we take against dying, something that is not only in our thinking but seems to be hardwired in our bioneurology. WE have been living and dying for millions of years yet we act as though it's never going to happen to us.

Ernest Becker investigated the source of war and violence and religious hatred and studied the origins of psychoanalysis settling on Otto Rank who offered him the most toward his eventual theories. He came to believe that we all walk around with an unconscious, deeply unconscious fear of death, and have evolved elaborate cultural mechanisms to convince us we are invulnerable. At the heart of this is our medical culture that has done much to convince us that we can live forever. As the longevity curve continues to move further out beyond 80 years it is not surprising we are allowed to wake up every day without the belief that at any moment we could be annhilated. It remains deeply rooted in our unconscious until something reminds us that we are vulbnerable. That could be a death of someone we know, an accident on the road, the world news any given day, bombs and terrorists and war oversees. It could be a new medical diagnsosis that makes us think about our own mortality.

The Fall -Memories of Rose

2010-09-26T09:24:00.000-07:00

As the Fall approaches I think of Rose and the chnages she experienced toward the end of her life. One of her final dreams she shared with me involved her with someone (Mercurius) instructing her to catch the large rats and place them in a burlap bag. Then he instructed her to eat them. I was not surprised to look up Roses birthyear in the Chinese Zodiac to discover she was born in the year of the Rat, 1924. She was quite turned off by the dream but i explained its meaning to her. She was incorporating her archetypal self into her consciousness and eating the rats demonstrated this. This is similar to the ancient symbol of the Uroborus, the snake that eats itself. Rose's bringing out her lost parts of herslef for review and confrontation is like the King carrying the corpses over the graveyard. Each corpse reveals a different story and ultimate paradox or riddle that must be resolved. Now we often offer up an easy answer to the corpse spirit to resolve the riddle but that is not what he is looking for. the ego can come up with many reasonable answers to riddles.

Remember my poem

I can swim a thousand miles
on one unswered question
and drown the moment
a meterologist explains the wind

It is not until the King is unable to resolve a riddle that the King is free to move on and the spirit is released from his corpse. As Rose worked through these riddles such as why did Sam betray me and what meaning did that have in my life? Why was that fruit presented to me and what gem lies inside?

Rose struggled with this part of herself that refused to forgive the perpetrator of betrayal and I think it crossed her mind that perhaps the way she lived her life-lockinh this aspect herslef away and holding the other person her girldfriend, Sam her husband all responsible for her her shame she realized there was another alternative life she could have lived. This part of her lied in shadow and it was the forgiving side of her, This was a hard pill to swallow that perhaps she wasted many years in resentment of these people and perhaps there was an aletrnative approach that may have changed her life.

I remember the day she told me she did not want to discuss these past issues anymore, they depressed her and caused her to dwell on them and she did not want to have me stop coming but it crossed her mind. So in the same way she blamed her betrayers for her shame, she blamed me for bringing it up. I told her I would not bring up anything that she did not want to talk about. I think the other meaning of the Rat dream which came around the same time as her not wanting to talk about past shame, was the rat represented her shame as well, something horrible to her, the part of her she felt was so reprehensible she required its banishment from conscious life. Her reaction to eating the rats was similar to the reaction to eating her grief in confonting her lost self, the self that never was born, the self that would have forgiven those who betrayed her. The lost opportunity many of us experience and must confront at the end of life.

Self-Betrayal and The Corpse

2010-08-15T09:19:00.001-07:00

Perhaps it is inevitable we confront betrayal of our self at the end of life. How do we batray ourself? The parts of our self we cut off because they are shamed into hiding, parts that we must place into shadow thinking it necessary in order to survive and move on. These parts of our self seem to require recognition and reintegration before we die. If we do not do this we can be overtaken by unconscious forces at the end of life that manifest as depression, various hallucination and dysphoria and exacerbated physicial symptoms such as pain and dyspnea. Our task is to carry the corpse of our dead selves to the magic circle, the arena of transformation, the alchemical vessel. But along the way we must extract from the corpse a lesson, a riddle that seems to be important more for the struggle it requires we go through than for the answer we give because just as we think we have the answer we must start all over.

What was the lesson of Rose's story of Sam, the interloper, who seduced her and betrayed her? We worked through this story as she carried the corpse of his memory for a few sessions. She was a young woman in her 20's still living at home in order to care for her parents but also because it was not accpetable for an Italian girl top leave home unless one was married. So Rose was courted by Sam, a man devoted to Rose, often jealous of how confident and gregarious she was. Rose hobnobbed with some of Chicago's politicians. She was a secretary but very in contact with many improtnat people and she had the confifence to negotiate these high society waters, but Sam did not like that and he courted her with a serious look toward marriage. He would often visit Rose with her family. But when she asked him about his family he wouild always say his mother was ill and he was caring for her and there was never a good time for her to meet his parents. She went out with him for 5 years and eventually could no longer tolerate his jeolousy and stalking. He would follow her home from work and park in front of her house. Then she recieves a call from a woman identfying herslef as Sam's wife and that she demanded she stop seeing her husband. Rose never knew he was married.

There was a part of Rose deeply ashamed of this experience and she was left with the feeling she had done something wrong and the part of her that was naive was cut off from her and the part of her that was more skeptical, less trusting, more critical, the Critic in her came out and became a predominate way of dealing with the world. This explained why Rose was perceived as such a witch, overcontrolling, hyprecritical of everyone and why she threw a podiatrist out of her room.

So how did Rose intergrate this part of her again or did she? Over the course of the 2 and 1/2 years I saw Rose she chnaged from being seen as a witch to the archetypal old crone, wise woman and all caring. The young workers in the facility would go to her for advice on matters of love and sex and motherhood. I believe the part of her that was cut off also contained that softer, more loving side of Rose that emerged again toward the end of her life. But we must carry that corpse many times before we can assimilate its lessons and finally bring it to the center of the circle.

The Necromancer

2010-08-01T08:43:00.001-07:00

The necromancer is the shadow side of the ascetic and represents the death instinct or thanatos principle of Freud. It is also the mother complex that we must confront and moving into the realm of the dead, the graveyard we come very close to the mother complex and constellate very strong feelings that try to overwhem us. The symbol of deference that is staged by the necromancer when he kneels down and bows his head is very interesting. A Christian version of this story might require a sacrificial act so this image would not make it into a more western story. We are reminded that the east does not believe in self-sacrifice so the ritual of kneeling and bowing is to be avoided. Yet the celebration comes from cutting off the head of the destroyer, defeating the mother complex and transforming the mother complex into the creative and ever-expanding mother archetype. It is the difference between drinking alcohol until unconscious and drinking herbal tea referring back to the fishing trip. It is using the fermentation of yeast in making bread vs making and drinking alcohol. It is transmuting mother nature into nurture rather than being destroyed by mother nature's byproducts. In fact a Christian version of the story is the story of Faust and requires a pact with the Devil. There is no good and evil in our Indian story just the visible and invisible worlds.

The necromancer is also the archetypal trickster setting us up for failure by telling us a lie. The king's response is to become the trickster himself and turn the tables on him. There is an internalization of the components of the story into the king. The king takes in the fruit that hides the gems for years. He takes in the corpse and his stories and teaching and finally he takes in the trickster and the trickster becomes part of him. He is now a complete person.

The Monkey

2010-08-01T08:42:00.001-07:00

The King represents that ego we know, the one that makes up our conscious attitude towards the world. This ego is in on autopilot mode that eventually becomes bored or unsettled. It takes the king ten years in the story to come to the realization that all the gifts he has been given by life he has thrown away not understanding their true value. Sometimes this can take a lot longer, maybe even 50 years. It is important to take note that it was the monkey that revealed to him the value in the fruit and the monkey resides in the female quarters. This is the unconscious parts of us, the lunar side, the realm of the feminine, the feeling function which most men repress most of their lives. Now the king's realization there is value here he had previously ignored seems an easy transition, perhaps because this is an Indian tale and Indians are much more in touch with their feeling function. In the west this would manifest as a complaint, depression, anxiety because the ego would resist such new knowledge. Or the person would act out in an affair or something that would force his stance with the world to change (once caught). The king feels indebted to the peasant who brought the fruit once he realized their value. This indebtedness we all experience when we come to the same realization often late in life that we have taken advantage of life all our lives and that it's real meaning was right in front of us. The peasant turns out to be something more than a peasant just as the fruit turned out to be something more than fruit. The peasant is actually a holy man, an ascetic, and the king offers the holy man a favor. The holy man requests the king as hero assist him in an enterpise of magic. The holy man's name is "Rich in Patience" which is quite befitting him. This is that part of us that intiates us into the realm of the imagination, the magical realm and he can wait many years before he is listened to.

The Corpse

2010-08-01T08:41:00.000-07:00

The King and The Corpse

2010-08-01T08:40:00.000-07:00

This very old story from India has not had the shake and bake handling of a jungian analyst as I can find and except for Heinrich Zimmer, an Indologist not an analyst, I can find no other attempt to interpret. It is a rather long story so I will leave out much in a synopsis. A king was quite content in his office and would meet daily with the people of the kingdom to give them access to him for a short time each day. A peasant shows up and begins offering him fruit everyday which the king politely accepts and then gives to his treasurer who tosses them through a window into a treasure room. This went on for ten years until one day the peasant gives the fruit to a monkey that escaped from the women's quarters in the castle. The monkey takes a bite and throws it down revealing a large gem in the center of the fruit. Now the king is interested and has the treasurer check on all the other fruit in the room only to find many gems with fruit in some state of decomposition, The king is intrigued with the peasant and the next day asks the peasant what he, the king, could do for him. The peasant tells him he could be a hero and directs him to a sorcerer. The necromancer tells the king he must go to the graveyard and cut a corpse down from the large tree on which the criminal was hanged. The king finds the corpse and cuts him down and carries him on his back to the sorcerer but on the way a voice from the corpse begins to tell the king a riddle and if the king knew the answer he must tell it or his head would explode in many pieces. The king asnwers the first riddle and the corpse flies back to the tree. The king trudges back to cut him down again and begins the trek back to the sorcerer but along the way the corpse tells him another riddle that the king, if he knows, must answer or else his head will explode in many pieces. The king answers the next riddle and the corpse flies back to the tree. This goes on all night with the king answering 24 riddles. Then the 25th riddle the king could not find an answer and with that the corpse is impressed and reveals to the king a secret. That when he brings the corpse back to the necromancer he will try to kill the king by instructing him to kneel down and lower his head so that the king can be given power over the world of souls and spirits but the necromancer will cut off the king's head instead and he will become the ruler over all the world visible and invisible so the corpse spirit told the king when the necromancer tells him to do this to ask the sorcerer to show the king how it is done and when the sorcerer bows his head the king would cut it off with the same sword and that is what is done. The corpse spirit in gratitude offers the king power over all the visible world and when he dies over the spirit world as well. The corpse spirit, in gratitude for the king completing the journey offers the king whatever his heart desires and the king simlpy asks that the 24 tales and his own story be handed down through the ages for all mankind and this is done.

Work this story around for a while and we will discuss next posting.

Story of Stone Soup

2010-06-24T16:35:00.000-07:00

"According to the story, some travelers come to a village, carrying nothing more than an empty pot. Upon their arrival, the villagers are unwilling to share any of their food stores with the hungry travelers. The travelers fill the pot with water, drop a large stone in it, and place it over a fire in the village square. One of the villagers becomes curious and asks what they are doing. The travelers answer that they are making "stone soup", which tastes wonderful, although it still needs a little bit of garnish to improve the flavor, which they are missing. The villager doesn't mind parting with just a little bit of flour to help them out, so it gets added to the soup. Another villager walks by, inquiring about the pot, and the travelers again mention their stone soup which hasn't reached its full potential yet. The villager hands them a little bit of seasoning to help them out. More and more villagers walk by, each adding another ingredient. Finally, a delicious and nourishing pot of soup is enjoyed by all."
(Wikipedia at...http://en.wikipedia.org/wiki/Stone_soup

There is other internet chatter that Stone Soup is a Grimm's Story though I have not yet found that nor able to verify Grimm's Brothers as a source. However it has been called a folk tale and for its revelation of the unconscious it is valuable. Another version casts the travelers as soldiers which adds a different dimension to the story, one relevant for our times. When three soldiers are returning from the Napoleonic wars they stop off in a town and ask the townspeople for some food and shelter. The townpeople all close their doors and windows. So the soldiers set up a large pot in the center of town and the story continues pretty much as above.

In the story in the context of my relationship with Rose I am taken by the added detail of the soldiers. What do soldiers bring back with them from war? They bring back death, the experience of premature death and its aftermath, it lingers about them and the townspeople sense its presence and they close the doors and windows. The soldiers realize the townspeople cannot bear dealing with death at such close proximity so they use the ritual of preparing soup for the purpose of sharing the positive aspects of their death experience with the townspeople without scaring them. They did this by using the stone to sybolize death and creating a wonderful nourishing soup around the experience, a soup the townspeople helped create. It is this nourishment that paradoxically is created around death, the stone, the one immutable force of nature that we cannot excape and its pedogogy if we choose to listen. It can be undrestood that what the townspeople bring are their unconscious material to the death experience thereby enriching the broth for all.

I remember Rose struggling with the staff in the facility, everyone afraid of her and tiptoeing around her, getting angry at her when she scolded them, then avaoiding her. Then after months of therapy she began to soften and she became their mentor. Many of the aides were young girls who were pregnant or with children who were being manipualted by men because they lacked the self-confidence to make it the world on their own. She would tell them you can make it on your own. You don't need a man to give you self-respect. They would all flock around her for advice.

The last time I saw Rose awake she was sitting up in bed and was being fed by one of those aides who cared for her like a mother carefully feeding her very slowly. I remember that image of her being nurtured by those who a year or so before would go out of their way to avoid her. This was the stone soup she created while we were together and we all were nurished by it.

Parsifal and the Grail King

2010-06-20T06:23:00.000-07:00

The story of Parsifal is the story of the differentiation of the real father for the archetypal father. On Father's Day it is appropriate to return to it. When a young man Parsifal, who is living with his widowed mther, sees five knights ride past him he is smitten with the desire to join them in their journey. So he leaves his mother whose name is Heart Sorrow and goes off to find the 5 knights. He has many adventures but never finds the knights. He does find a great knight living in the castle of Gournamond. The mentor teaches him to become a knight and instructs him if he were to ever find the Grail Castle he muct ask, "Who does the Grail serve?". After a time Parsifal meets a fisherman who invites him to stay the night in his home down the road. When Parsifal gets there he realizes he is in the Grail Castle. The Fisher King in in charge of the castle but the castle and its kingdom are poor and without food and in is in illrepair. The Fisher King got his name as a child when wandering the woods he came upon a spit upon which salmon was cooking and he touched the fish and ate of it. He never tasted anything so good but he suufered a wound in the tasting and the wound was in his thigh. He suffered greatly all his life but the wound would neither heal nor kill him. The King oversees the Grail which is kept in the castle but the power of the grail does him no good. He cannot touch it. The king and kingdom cannot be healed until an innocent fool (origin of Parsifal's name) eneters the castle and asks the right question, "Whom does the Grail serve?" Parsifal is bathed and brought to a banquet room wherein lies the Grail and a sword dripping blood but he forgets to ask the question and the next morning all, the castle, the king and Grail have disappeared. It is many years before Parsifal again finds the castle and is brought through the same experience to the Grail and this time he asks the question, "Whom does the Grail serve?" and he is given the answer,"The Grail serves the Grail King." The Grail King is the archetypal king or father and the Fisher King only the lord of the castle. When Parsifal understands the difference the Fisher King is healed and the kingdom becomes productive and nourished once again.

To discern the archetypal father and to access him within heals the wounding of the literal father, the lord of the castle. Until we can do that the king and the kingdom remain blighted in our eyes. Happy Father's Day

The Dream of The Dead Physician

2010-06-12T13:25:00.000-07:00

Around the time I had read Godfather Death to Rose and we discussed its meaning Rose brought me a dream in which she is in her room in the nursing home and the nurse comes to her to tell her her physician had dies. Rose remembers feeling very sad when she hears this news but also not surprised. The physician in the dream is not any physician she knows but she really likes this physician. It reminded her of the physician she had to give up to go to her current nursing home.

At the time Rose was struggling with her physicians the oncologist and attending who were not comminicating effectively. Rose had complained about not having an appetite and the oncologist ordered Megace. The attending physician did not think this was a good plan, there were side effects and she did not belive it worked effectively but Rose wanted to do as she was told and she listened to and trusted the oncologist. The relationship with the oncologist was unlike and in some ways very opposite to the relationship with her other physicians. She accepted what he had to say and whatever treatments he orders she will comply with.. She was not so obsequious with her other physicians. In fact she was quite oppositional asking questions about their choices and if not satisfied with the answers she would refuse the treatment or diagnostic. When I first started seeing Rose I was told by the staff of the nursing home how she had thrown a podiatrist out of her room becuase he would not listen to her. She was giving him instructions on how to cut her husbands nails and the physician said, "I am the doctor and I will do as I please". Rose told him to get out and not to let the door hit him in the ass. These two Roses were manifesting side by side for the next several months.

When she returned from the oncologist with an order for Megace I was irritated because of the amount of discussion we had in which appetite was not a big issue for her. She did want to take another pill though the option to take an appetite enhancer was always there. I was irritated because she argued against it then when she sees the oncologist he simply orders it and she takes. It occurred to me the old Rose, fighting mad, demanding respect and don't you dare treat me like these other rag dolls sitting around in wheelchairs, Rose was giving way to a Rose that was more accepting and willing to be taken care of. And perhaps the old image of the physician was dying or had died inside her.

The Final Transformation

2010-05-31T05:13:00.000-07:00

The last phase of the alchemical process involves the servants pleading the heavens for divine intervention which comes in the form of an angel who combines the bones into a new king. The new king then sits before the five servants who each now wear a diadem symbolizing their transformation as well.

The new and the old must lie together incubating for a period of time. It is extraordinary to think about how little respect we pay to this process of transformation when we expect new ways of looking at the world to come about with a simple intellectual exercise. In my practice I often observe the change that occurs when one is told he or she has a terminal disease or one's loved one is dying. The change that occurs is very deep and cannot be made abruptly yet discharge planners in hospitals often try to speed this process up not understanding the psychological shift that must take place when the old world and the new collide. Some do not let go of the old very easily and these people become stuck in that part of the process.

I remember giving a talk on hospice and a man in the audience recounted his experience with his brother dying and how he still hadn't forgiven the hospice for not providing IV hydration at a time in which he thought it would have made his brother more comfortable. We know in the field of end of life care that IV hydration can cause serious complications but applying a broad stroke to circumstances like this does not take into account the psychological impact of denying a loved one such a request. The fact that a year later this man is still ruminating about being denied this request speaks to the depth of this process and how one can be stuck in one phase by lack of attention or recognition of what this process is.

Eating the Rats

2010-05-24T16:53:00.000-07:00

Rose had a dream in which someone was instructing her how to catch rats and place them in a burlap bag. If I wanted to invent a more perfect image it would be impossible. This was at a point in her life in which death was approaching and we had worked for two years becoming acquainted with her shadow. I sometimes felt like Mephistopheles with her. And as He was transformed so was I. One wonders who the teacher in the dream was, Mephistopheles or Hermes or Mercurius. After she collected the rats she was instructed to eat them. Large dirty rats. Rose was disgusted but reported the dream to me because she knew it was significant. And she knew I would know its significance. To my knowledge she never told anyone else that dream. So what does it mean? At the end of life we must incorporate the shadow into consciousness. She had been doing this all along but the dream made it clear and invited her to eat, as ritual, to incorporate soemthing that was loathesome to her, those parts of herslef she had made loathesome, shameful.

The rat is an animal that lives off the decay of other matter, a bottom feeder. In a way the parts of herself Rose cut off were decaying, apart from her core self. In nature nothing is wasted , nor in the psyche. The rats were transmuting decaying parts of the self back into available energy. Its when these decaying aspects of ourselves our not broken down that they weigh us down, keep us from moving on. I asked Rose what symbol represented her in the Chinese zodiac and of course it was the Rat.

Hamlet was unable to move to the heroic realm, so he could not incorporate the shadow. He was unfinished. See the alchemical plate in which the king's son takes his father's blood and puts it on his own shirt, He is owning his responsibility for the death of the king. This is required to go on to the next phase which involves entombing the king. But the son "falls" into the tomb himself and dies with his father. The alchemist text tells us that this part of the process required the alchemist's artistic influence because the son was reluctant to join his father. Following this the father and son remain in a period of incubation and after a period of time the bones are removed and placed in a certain configuration.

Faust and Integration of Shadow

2010-05-22T08:07:00.000-07:00

Goethe's brilliant work Faust is an excellent depiction how part of our life task before we die is to integrate our shadow life with our conscious life, and to do this before we die. In Rose's case it became clear to me there was much about her life that she tried to keep cut off from consciousness either because it caused her shame or simply made her uncomfortable. Those shameful episodes in her life became the focus of our discussions. Over time I believed they were the key to her attachment to life, perhaps what was keeping her from moving on. It raises the question what role shame may play in the transformative aspects of the transition from the heroic stance. Are we tied to the mundus realitas because of shame and resolution or transformation of shame is necessary to the dying process? Rose shared with me an experience as a teenager. She felt she did not fit in because she did not have a boyfriend while all of her girlfriends did. She had her heart set on a particular boy for her prom. Her best girlfriend, a friend she said she was so close to, they sometimes went to the batheroom together, betrayed her. Her girlfriend went behind her back to ask her boyfriend to the prom. Rose was devastated. Her response was to cut herself from both her girlfriend and her boyfriend. She later found out that he did not go with her to the prom. But her response was interesting. She simply cut off all contact with them and cut off that part of herself in which shame was embedded. As we discussed in the story of Sedna, the cut off part of herself continued to influence her conscious life from deep within her ocean, her unconscious. She did not discuss this aspect of her life for many years. She told me she did not want to dwell on such things so she developed a personae strong enough to withstand the influence of these cut off parts of herself. Sometimes in our sessions that part of her, the hurt and feelings of betrayal seemed very close. I could almost see the little girl in the old woman.

Hamlet

2010-05-17T17:07:00.000-07:00

Hamlet was caught between the heroic realm and the transformed. He could not accept his responsibility as being heir to the throne. Even if he did not literally kill his father, he contributed to his father's death by not preventing it. The burden of this particpation is too much for him. In the following alchemical plates from Janus Lacinius Therapas depicting the transformative sequence to the “lapis”, the philosopher’s stone, we see the son and five servants representing the potentialities of life seeking recognition of a “sleeping” emperor.

The king is sleeping because he is no longer conscious and his time is over. The image suggests the servants are beseching him for change and he is unresponsive. It falls on the son, as pharmakon, to initiate the transformation.

So he kills the king, the old order, the cultural world view (Becker) the status quo. Change requires the sacrifice. The king in Hamlet could not accept his fate and still haunts the moors looking to avenge his death. Hamlet picks up on the projection and becomes the avenger, though he is unable to follow through. Hence he is caught inbetween worlds in which he fulfills the role of hero and the role in which he is transformed. He resists the transformation-that is his tragedy. He becomes victom of the process. Next post we will explore what Hamlet would have needed to be able to do to become transformed.

Betrayal in the Story of Sedna

2010-05-15T09:00:00.000-07:00

The Artic story of Sedna, Princess of the Sea, is a wonderful story that begins with a betrayal. Sedna is a beautiful young girl who rejects all her suitors while her father wants to marry her off. There is an Electra complex within this part of the story. Sedna is not willing to leave the father which is a necessary part of her growth and maturation. While traveling a storm develops that threatens their lives and the father fearing for his own life and in order to appease the gods sacrifices his daughter by throwing her into the ocean and when she holds on to the boat, he cuts off her fingers. She continues to cling to the boat and he cuts off her arms and legs. Finally her dismembered body falls to the bottom of the ocean and is encapsulated and goes through a process of transformation in which her missing limbs are replaced with fish of various forms which replenishes the ocean (mermaid image). Sedna influences the world above from this place below. The mediator between Sedna and the outerworld is a shaman who is callled upon during times of famine to descend to Sedna and soothe her by combing the lice from her hair. The shaman must travail dangerous seascape including burning cauldrons in which dolphins were being boiled to reach Sedna. Try this website for this wonderful story.

http://www.google.com/imgres?imgurl=http://www.orderwhitemoon.org/goddess/sedna-1%2520mirror.jpg&imgrefurl=http://www.orderwhitemoon.org/goddess/Sedna.html&h=235&w=235&sz=11&tbnid=WrV2lgSBqumDSM:&tbnh=109&tbnw=109&prev=/images%3Fq%3Dsedna%2Bgoddess&hl=en&usg=__TDFq15JCt0p8FfbFDwjtu240ulk=&ei=AcfuS827Go-6NovSrOQP&sa=X&oi=image_result&resnum=8&ct=image&ved=0CC8Q9QEwBw

Pedagogy of Death

2010-04-22T18:02:00.000-07:00

Over the last few years I have been able to incorporate into my trainings of clinians the ideas presented in this blog and they seem to have an impact on their view of things as if a door opens that was not noticed before. We can see our clients a little differently when those doors are openned. Death and the anxiety it provokes is a big blind spot for most clinians. Often we do not venture into the darkness that is theirs because we are afraid of annhilation but there is the possibility of transformation also. Again we confront the Pharmakon, the remedy and the poison. It is as if that which we fear the most offers us the greatest gold. When I guide a group of people through an exercise in which they symbolically experience loss the individuals in the group respond in two ways. Some will become introspective and experience grief and begin crying. Others get angry and blame the exercie or the facilitator for the pain of their loss. AS a country on September 11th 2001, many of us came together in our grief, our fear, our sense of community by raising flags etc. Others of us were angry and took our frustration out on those who looked threatening to us and in some cases murdered them. Our patients respond to the possibility of death similarly, some by external projection and others by introjection.

Judas

2010-04-02T04:32:00.000-07:00

Reading Otto Rank's work on The Myth of the Birth of the Hero I am really excited about the realization that the Judas mythology from the point of view of the church is lacking. That originally Judas had a background that resembled Oedipus. He was born in Scariot of parents who were told by an angel that he was going to be the ruination of his people, so the parents "exposed" him by putting him in a bsasket and sending hom down a river or some such method. This exposure is very similar in story line as Moses and other heroes. Hercules was placed in a field as an infant and thereby exposed. The idea that this original abandonment by parents connects back to betrayal as an archetypal aspect of the story. Also the child is saved and that saving has a transformational impact on the life of the hero. Moses raised by the Pharoah, Hercules suckling the milk of Hera and becoming immortal, and Judas being rescued and raised by a childless woman. When the parents do have a child Judas kills his step brother and is banished form his country and goes to live under Pilate and work in his house but gets into a fight with his next door neighbor and kills him and then marries his wife later to find out it was his original father he killed and mother he married. The story then goes on to tell us that Judas found Jesus and followed himn until he betrayed him and the rest of the story we know from Christian mythology.

The fact that this back story was not advertised is intersting to me. Oedipus is the universal hero, Freud aside. He builds his heroic structure which always has a shadow which is either projected or swaollowed. His shadow was of course the killing of the father and marrying the mother. When he confronts this shadow he is able to come to peace with it after he has blinded himself and he is able to see with a different "sight". This is required of the hero when he has to abandon his heroic structure. That structure eventually betrays us. Recall the "Shirt of Nessus" in the Hercule myth. Hercules was given a shirt by his wife who did not know it was cursed by the foe that Hercules killed, Nessus, and before he died gave Hercules' wife a shirt as a gift for him. The shirt cause Hercules to burst into flames and cause immense pain and suffering that was so intolerable Hercules killed himself. Hercules was immortal remember so could only die of his own hand. Hercules could not abandon the heroic structure he created. Hercules was all about hero and overcoming all enemies. He could not withdraw his shadow projections, he could only literally kill that which he projected his shadow upon. Eventually the structure that held him betrayed him in the form of the shirt of Nessus.

Back to Judas. Judas could not handle his shadow so he projected onto Jesus the heroic stance he himself could not carry and when that heroic pathway was not going in the direction he expected he betrayed that hero and had him killed, then of course he killed himself according to the most accepted version of Christian mythology. There was no opportunity for self reflection and trnasformation because he could not own his projections. This is a very modern look at how we come to terms with the end of our life. You would think this story is a cautionary tale about not owning your own shadow but I am afraid the story of Judas allows the Christian the opportunity to project shadow onto Judas and use him a scapegoat. And if Christ is a scapegoat, you have two scapegoats in the same story and we understand how some of the mythology behind these two figures gets intermingled even to the suggestion that Judas really was the Christ. What practical value was served by the Oedipal heroic structure being transformed into the Jesus heroic structure or the "scapegoat" structure. Perhaps the belief in an afterlife was offered in the latter story and in Oedipu there is coming to consciousness.

The Cloaking of Death

2010-03-30T19:40:00.000-07:00

The term palliative is used freely in the hospice industry and now throughout healthcare. It's root words are the Latin ,palliare, meaning to cloak. Palliate also means to alleviate suffering and symptoms causing suffering without curing the disease. But what is being cloaked? If we return to our story the physician must make it very clear to the patient when Death has taken a stance at the foot of the bed that there is no remedy that can save him and no physician that can heal him. We cannot seem to say these words today. If the heroic pathway is a denial of death then the palliative pathway is the cloaking of death. Kubler-Ross challenged the medical status quo in 1969 with the publication of On Death and Dying. In one brief moment she empowered the dying with a voice and a choice in how they want to die. While our fairy tale physician was turning the bodies of those marked for death around and saving them, Dr. Kubler-Ross was telling the patients there was no more that can be done and now is time to die. We are not good at these conversations. We cloak these conversations in euphemisms and tell the patient we will focus on symptoms now rather than living longer.

What else are we cloaking? Perhaps we are also cloaking the cost of healthcare and palliative care is designed to save healthcare dollars so expensive treatments are not wasted on those who are dying anyway. This healthcare rationing can be cloaked in the Hospice benefit as well as palliative care and it is largely because the rest of the industry has not modulated the addiction to the heroic pathway.

So all this turing of bodies around and betraying Death has had a toll on us but where is this manifested? In our story the physician pays the price with his life. Perhaps the sacrifice in our historical or I should say archetypal drama is the relationship of the physician to the patient, a relationship in which the physician assists the patient in making decisions based on the values of the patient as perceived by the physician. That relationship has died. Now the physician offers choices because he cannot bear the burden of being the betrayer. We are cloaking the betrayer as well as the betrayal.

Betrayal

2010-03-26T17:54:00.000-07:00

James Hillman's classic analysis of betrayal in archetypal psychology teaches us that in mythology betrayal seems to be a component of transformation. We recall the myth of Samson and his betrayer Delilah. The story of Jesus is rich with betrayal symbology. Peter denies Jesus three times and Judas himself becomes the betrayer. In Christian myhthology Juads, as one of the apostles, betrays Jesus and then commits suicide. There is however more to the Judas story that we need to explore.

The background of Judas parallel's that of Oedipus which suggests the influence of Greek mythology on Christian mythology. However, the background of Judas was stripped from the story of Jesus over the centuries and the extinction of this background demands some notice. If the Oedipal story is the story of the human condition then a comparison of the two is worth looking at. After Oedipus discovered what he done he blinded himself and spent his remaining days coming to terms with who he was and what he had done. This period of self-reflection and forgiveness is the pathway we all take at the end of life. The blinding of Oedipus is symbolic of the change of "sight" required at the end of life. This is also reminiscent of the change in attitude by the father in the Godfather Death story. But there is no such reflection and coming to terms by Judas; he commits suicide. Also the presence of the hero as Jesus in this story suggests that the transformation of hero as man from one stage of life to the next, as seen in Oedipus, is short-circuited in the Judas story to hero as God. The cloaking of the Oedipal background in the Judas story is significant and relevant for undertsanding our view of the world today.

In our culture betrayal is experienced by patients and families when the medical system decides the heroic approach is no longer effective. More on betrayal next time.

The Pharmakon

2010-03-26T15:17:00.000-07:00

The physician plays a unique role in this very ancient ritual that somehow our culture has shortcircuited. In our Grimm's story the physician is instructed to be very clear to the patient when he is expected to die and he must use the words, "there is no remedy that can save you and no physician in the world can cure you". These words are deliberately very clear. Yet few physicians can say these words to his patient even when it is most obvious the words are correct.

In alchemy the term pharmakon is the mercurial agent that gets the reaction going. It is the change agent. It also has a paradoxical meaning;at once meaning remedy and at the same time poison. In homeopathy often the remedy is through treatment with what at larger dose would be a poison. Arsenic is sometimes used to treat like symptoms that resemble arsenic poisoning. In our story the physician is the pharmakon, both the poison and the remedy. The poison is of course the news that there is no cure; the remedy is the same news. But how is this perceived as a remedy?

We need to look at the process of dying from a particular standpoint. If we look at the heroic structure that is collapsing because the person is ill unto death at what point is the transition from heroic battle to acceptance. What does it look like? When I worked in a hospice inpatient unit a family was with the father who was dying of liver failure. He was brought there to die but the family was in between acceptance of this reality and the heroic pathway. As the father's breathing became labored and it was clear the man was dying the wife panicked and asked if she should send him to the hospital to be treated. This last minute doubt is very common and in this day and age much could be done to drag out the dying process without substantively change the underlying disease. In this situation the medical director was nearby and was asked to speak with the family. I was very aware the physician was assuming an archetypoal role. Perhaps it was as palpable to her. She proceeded to tell the family she could send their loved one to the hospital and they would engage heroic measures to save his life but it would cause more suffering while not likely changing the outcome. He would still die only on machines and involving invasive procedures and more pain. The family chose to keep him in the unit and provide only comfort measures.

I watched carefully the wife's reaction when told by the physician that there was no more that can be done to save her husband. At first she broke down into tears as did the rest of the family and then she gathered her strength and moved close to her husband's side and sat with him. She then called the rest of her family to come to the unit to say their goodbyes. In a short time she abandoned the heroic stance that was no longer serving herself, her husband or her family. So in that sense the physician as pharmakon became the catalyst for the transformation away from the heroic pathway. The physician was the poison (the bitter news) and the remedy (the transformation to acceptance).

Rose's Shadow

2010-03-21T14:50:00.000-07:00

In Depth Psychology it is understood whatever the ego does not accomodate is placed in shadow (personal unconscious)and in hospice I believe this shadow material tries to reach the light of day.

In Rose's life she deeply regretted not having a boyfriend when she was growing up. She felt she was fat and unattractive and this caused her to feel out of place and unable to fit in whith her peers. On top of this feeling of inadequacy she revealed to her best girlfriend thatshe had a crush on a particular boy and she was planning on asking him to her prom. Behind Rose's back her grilfriend batrayed her by asking the boy first and then telling Rose she had no good reason to do that accept to win him over because she knew Rose liked him. From that point on she cut off her relationship with the girlfriend and the boy and went on with her life never looking back.

These aspects of Rose's life were particularly shaming to her and she saw no need to delve into them. It was many months into our therapy that aspects of her life that were cast into shadow started coming forth. If these memories were placed into her uncosncious so too were her feels of anger, betrayal and desire for revenge. On the surface Rose proclaimed that her life would be free of such negative thoughts and that she saw herself as a good person. She would often tell me she believed in thinking about only the good things that happened to her, not the bad. This also was one of Rose's predominant attitude's toward the world and herself. She did not want to think about what was in her shadow including the betrayal of her best friend.

As the story of Godfather Death teaches us one's "king" or principle attitude toward the world must die to give way to the new. If we try to save it, as the physician in the story does, we disrupt the balance of the underworld and the physician must pay the ultimate price, death. But before this will occur the king's daughter, representing the feelings attached to the world view, is presented for death and she too is saved. These images remind us that we grieve the loss of the "status quo", literally meaning "what was before".

Another way of looking at the figures in the story is the king is the old world view and the daughter is the new. If the old is not allowed to die then the new must die because it was not given a chance to live. So the healer in us, represented by the physician, must let this death ensue for change to occur. Can you recall a new idea that you did not bring to fruition because it would require the demise of the old way?

Tomorrow I will discuss how Rose struggled with her world view and with letting it die so that the new perspective toward the world could help her die comfortably.

Opioids and Control

2010-03-20T10:56:00.001-07:00

Given Rose's diagnosis of cancer and widespread metastasis to the bone I knew pain would eventually become an issue for her. But one of the fundamental needs was to maintain control. It was the predominant value she clung to for all the time I knew her. If we look at Godfather Death from the standpoint of the king we need to pull from alchemical imagery to understand what is happening. The king represents the status quo, the predominant world view. In the fairy tale the king is expected to die. Death has proclaimed it. Our world view is forever destined for extinction as it gives way to a new way of approaching the world, a new stance, a new attitude toward the world.

Rose's world view was no longer useful for her and was destined to give way to something else. Her world view included the need to maintain control at all cost. Most of us have this view, this need. In Rose's case it kept her from taking medication that would manager her pain but for her there was a cost she was not willing to pay;there was a perception that the medication would limit her control. Let me clarify here that opioids such as morphine are used very successfully for pain management and there are side effects that can cause sedation and some cognitive changes that are temporary until the body develops a tolerance. So initiation of opioid therapy involves confronting these side effects, most of which will go away, and which patients experience to lesser or great degree. Despite my attempts to educate Rose, she continued to hold on to the belief that she was going to go through this dying process in as much control as possible.

I supported her in this belief system knowing it would eventually collapse as all heroic approaches must but I did not anticiapte my role in augmenting its collapse.

Rose had started a more rapid decline the few weeks before she died. Her appetite faded, she seemed to be in more pain, more often and getting her out of bed was becoming more painful as her bones became more brittle. I was called by her physician and was told Rose would not let her put her in hospice or start her on appropriate analgesics which in Rose's would include opioids. On top of that the doctor had her sent to the hospital when Rose's pain was out of control one night. The doctor wanted her back radiated because she suspected spinal cord compression due to the cancer. I was angry the doctor had not consulted with Rose. When Rose got to the emergency room she threw a fit and demanded to be sent back to the nursing home. The doctor accused me of enabling Rose to maintian this heroic stance and the time now was for her to let go and let us do our job. The doctor's accusation hit me hard and made me think. I told the doctor I would talk with her.

When I saw Rose she was weak but glad to see me. She told me she was angry with the doctor, but I did not see the fire in her eyes I had seen in past discussions about doctors and control issues. I told Rose the doctor had called me and told me her pain was worse and will be gtting worse. I reminded Rose of all our discussions about opioids and when the time was right and Rose letting go. I then told Rose, "that time is now Rose, now is the time to let go and let hospice in and let the doctor order opioids for your pain" and then I said, "I need you to do this Rose. I need you you to accept hospice now and let them take care of your pain. You can relax now." I did not know where those words came from, " I need you...". It was not my clinical personae which respected her decision to make choices and respected her need to remain in control. The part of me that told Rose I needed her to let go was that part of me that cared for Rose. Rose amazingly agreed. "You're right" she said and she almost started crying, " ...let hosice come and do what they need to; I will let them."

After all that time it was our relationship that helped move Rose from the heroic pathway to acceptance and letting go. After all that it was not my clinical role, or clinical education; it was my caring about her. Perhaps she just needed a nudge and was already at the precipice of abandoning the heroic stance. I don't know.

When I think about the hard decisions patients and families make and the role of the clinician I am thinking the primary physician has an important role in helping the patient/family abandon the heroic pathway at the right moment and maybe it is not their clinical approach, the medical options they offer and the manner in which they offer them, maybe it is simply our caring that can nudge them in that direction and it is in the context of that sacred and very ancient relationship that these decisions are made not in some waiting room where the family is simply told their options.

Grimm's Fairy Tale

2010-03-07T20:23:00.000-08:00

As the Grimm's story goes...a man becomes the father of his 13th child, a son. Realizing he is depleted of resources he goes out onto the road to find a godfather for his son but the first person he comes upon is the Lord God and the man rejects him as godfather because the man does not like how God proportions wealth, leaving some very poor. The next he also rejects, the devil, because he leads man astray. He finally settles on the third person he sees and that is Death. He likes Death because he "makes all things equal". Noone escapes death.

So when the young godson reaches an appropriate age, the godfather tells him he will make him a famous physician and he will be quite successful if only he does as he is told. When he is called to see a patient, death will be there. If death is at the head of the bed then the physician may give the patient this herb that grows in the forrest and he will be healed. If however death is at the foot of the bed, the physcian must tell the patient that all remedies will be useless and no physician in the world can heal him. So the physician agrees and becomes very famous.

So famous that when the king gets ill, the physician is called to his bedside. Death is already there at the foot of the bed. The physician thinks if he can save the king he can become rich and inherit the kingdom so he turns the king around in bed and gives him the herb. The king lives. The godfather is furious and warns him never to betray him again.

But then the king's daughter becomes ill and the king pleads with kingdom that whoever should heal his daughter will inherit her hand in marriage and the kingdom. When the physician arrives he sees death at the foot of the bed. Without thinking he picks up the princess , turns her around and gives her the herb and saves her life.

With that the godfather takes him down to the underworld where there are many candles buring of all sizes. These candles represent the lives of everyone. The small candles are those of newborns and the very old and the large candles are of those in middlle years who are married. Which one am I, asks the phsyciian. Godfather shows him a very small candle ready to burn out. The physician panics and pleads with his godfather to have mercy and put his light onto a larger candle. I cannot do that says death; I cannot burn a new candle without another going out. But death pretends to move the physician's light to another candle but lets it fall to the ground and the physician drops dead.

The Heroic Pathway

2010-03-07T19:59:00.000-08:00

In exploring the heroic journey and its psychological strucure I have come to understand more deeply how that structure breaks down at the end of life. The more one clings to the personal heroic structure one has created, the more difficult one's death is. I will be using methods of analytic psychology and Jung's concept of active imagination to explore more fully this transformation at the end of life based on my experience as a nurse and a psychotherapist.

Denial of Death

2010-03-07T19:12:00.000-08:00

The 1974 book Denial of Death by Ernest Becker is the culmination of years of study into the psychological impact of death on our lives. Working in hospice one is allowed the opportunity to see both the destructive and transfomative influences of death.

Carl Jung once wrote, "Death is psychologically as important as birth and, like it, is an integral part of life...For seen in psychological perspective, death is not an end but a goal" (Jung, CW 13, par. 68).