184 THE TIBETAN BOOK OF LIVING AND DYING Being aware of your own fears about dying will help you immeasurably to be aware of the fears of the dying person. Just imagine deeply what those might be: fear of increasing, uncontrolled pain, fear of suffering, fear of indignity, fear of dependence, fear that the lives we have led have been meaningless, fear of separation from all we love, fear of losing control, fear of losing respect; perhaps our greatest fear of all is fear of fear itself, which grows more and more powerful the more we evade it. Usually when you feel fear, you feel isolated and alone, and without company. But when somebody keeps company with you and talks of his or her own fears, then you realize fear is universal and the edge, the personal pain, is taken off it. Your fears are brought back to the human and universal context. Then you are able to understand, be more compassionate, and deal with your own fears in a much more positive and inspiring way. As you grow to confront and accept your own fears, you will become increasingly sensitive to those of the person before you, and you will find you develop the intelligence and insight to help that person to bring his or her fears out into the open, deal with them, and begin skillfully to dispel them. For facing your fears, you will find, will not only make you more compassionate and braver and clearer; it will also make you more skillful, and that skillfulness will open to you all kinds of ways of enabling the dying to understandand face themselves. One of the fears that we can most easily dispel is the anxiety we all have about unmitigated pain in the process of dying. I would like to think that everyone in the world could know that this is now unnecessary. Physical suffering should be kept to a minimum; there is enough suffering in death anyway. A study at St. Christopher's Hospice in London, which I know well and where my students have died, has shown that given the right care, 98 percent of patients can have a peaceful death. The hospice movement has developed a variety of ways of managing pain by using various combinations of drugs, and not simply narcotics. The Buddhist masters speak of the need to die consciously with as lucid, unblurred, and serene a mental mastery as possible. Keeping pain under control without clouding the dying person's consciousness is the first prerequisite for this, and now it can be done: Everyone should be entitled to that simple help at this most demanding moment of passage.
UNFINISHED BUSINESS HEART ADVICE ON HELPING THE DYING 185 Another anxiety of the dying is often that of leaving unfinished business. The masters tell us that we should die peacefully, "without grasping, yearning, and attachment." This cannot fully happen if the unfinished business of a lifetime, as far as possible, is not cleared. Sometimes you will find that people hold onto life and are afraid to let go and die, because they have not come to terms with what they have been and done. And when a person dies harboring guilt or bad feelings toward others, those who survive him suffer even more deeply in their grief. Sometimes people ask me: "Isn't it too late to heal the pain of the past? Hasn't there been too much suffering between me and my dying friend or relative for healing to be possible?" It is my belief, and has been my experience, that it is never too late; even after enormous pain and abuse, people can find a way to forgive each other. The moment of death has a grandeur, solemnity, and finality that can make people reexamine all their attitudes, and be more open and ready to forgive, when before they could not bear to. Even at the very end of a life, the mistakes of a life can be undone. There is a method for helping to complete unfinished business that I and my students who work with the dying find very helpful. It was formulated from the Buddhist practice of equalizing and exchanging the self with others, and from the Gestalt technique, by Christine Longaker, one of my earliest students, who came to the field of death and dying after the death of her husband from leukemia. 5 Usually unfinished business is the result of blocked communication; when we have been wounded, we often become very defensive, always arguing from a position of being in the right and blindly refusing to see the other person's point of view. This is not only unhelpful, it freezes any possibility of real exchange. So when you do this exercise, begin it with the strong motivation that you are bringing up all your negative thoughts and feelings to try and understand them, to work with them and resolve them, and finally now to let go of them. Then visualize in front of you the person with whom you have the problem. See this person in your mind's eye, exactly as he or she has always looked to you. Consider now that a real change takes place, so the person is far more open and receptive to listen to what you have to say, more willing than ever before to share honestly, and