Where Psychotherapy & Yoga Meet

Is this common?

Many cultures and spiritual traditions embrace this last phase of life and go on to incorporate it into daily life. The Buddha, for instance, encouraged his disciples--young and old--to meditate on the three heavenly messengers: aging, illness, and death. Western culture is currently infatuated with conquering the declining phases of life so as to sustain eternal youth.

Can anyone do this sort of work?

No. There are some that I would discourage from participating, and some I would not advise until certain factors have been adequately treated. Major Depressive Disorder, severe anxiety disorders, Personality disorders, and trauma are a few examples. 

Do you do any workshops?

I conduct the following workshops:

  • An Introductory CD Course
  • The Advanced Course on how to apply CD to therapy
  • Developing a Personal CD Practice
  • How to combine CD and yoga for spiritual growth
  • Using CD to cultivate self-care

Also, click here to see books available on the subject.

What is the reason behind the caution?

Like some spiritual (i.e. meditation, Chakra work , Kundalini, yoga, etc.) and psychotherapy (i.e. EMDR, Prolonged Exposure Therapy, various grief methods, etc.) approaches, CD can awaken (not create) mild and temporary levels of anxiety and sadness. Existential work includes attention on our upcoming phases of decline--aging, a terminal illness, and death. These topics naturally stir unease no matter if done therapeutically or talking about it while in line at the grocery store. Thus, the ability to regulate emotions is important, which for some diagnoses (treated or untreated) could prove challenging.

Fortunately, some research exists around simulated death work. Two articles to read are "To Die or Not to Die: A Review on Simulated Death" by Marcia A. Corvetto, MD and Jeffrey M. Taekman, MD, and "Use of High Fidelity Simulation to Teach End-of-Life Care to Pharmacy Students in an Interdisciplinary Course" by Irene Gilliland, PHD. 

Currently, no research has been done on CD. This isn't to say that I haven't asked. I do take surveys, though, during and after workshops. In general, the majority who have attended report a moderate level of one or more emotions: sadness, anxiety, joy, and peace. A fair number who responded to a week follow-up reported moving more into a reflective state and/or conversation with family about end-of-life care, which confirms the transient nature of feelings.

Isn't caution the same as denial?

No. Anything of significance carries steps for proper application. This goes for medication, yoga, and styles of therapy. When developing the practice of death awareness, you want to take into account many things: personality (i.e. composed of various conditioning factors), current situations, methods of relating to self and other, patterns of breathing and energy that influence our pace, attitude, thinking, and attachment themes. Denial is looking away from not only the truth of an impending last breath but how such subtle awareness influences our every day lives.

You refer to Conversing with Death as spiritual. Why?

I often refer to CD as existential, which could sound as if the work is purely psychological. However, CD is primarily spiritual work. The reason for this is that certain movements need to take place for the work to progress. First, there needs to be an understanding of the illusions we personally use to create a feeling of longevity and why. This involves themes of attachment and aversion. Second, there needs to be a deep curiosity and meaning-making intention around our own existential makeup that supersede sole logical inquiry.

What has been your observation while facilitating Conversing with Death?

In my years of facilitating CD, many reported feelings of sadness, mild anxiety, and joy. No one reported a threatened level of anxiety. Upon a one week follow up, those who responded stated that their initial feelings during the workshop dissipated and was replaced by fruitful reflections with self and conversations with one or more family members.

​What's the benefit of Conversing with Death?

CD practice has a number of existential benefits that can't often be attained by other methods. By courageously tuning into reflections around our last breath, we can: (1) think ahead enough to possibly reduce elements of surprise. Many unwanted surprises occur around end of life, in spite of one's wishes. Last breath reflections can soften this even a little; (2) befriend those feelings and mental states that come during end of life. There is a difference between how we feel when we are vibrant and how we feel during phases of decline. CD encourages a mindful approach that seems to best address internal experiences; (3) open dialogues with family early on. All too often families wait as long as they can before "bringing up the subject." Sometimes it is too late. Last breath awareness encourages discussions early on so that when the time does come family members are all on the same page and conflict remains at a minimum; and (4) create a more intentional, gratuitous life NOW. We often do take things for granted, thinking we have many tomorrows. Knowing that we don't have long can generate a greater moment-to-moment appreciation for living.

How can you use death awareness for self-care?

When we have a felt-sense that we are not here forever, the temptation to put off personal importance lessens. We recognize that time is a gift and that our bodies are temples to be honored. The thought of putting our bodies through grueling months and years of stress and unrest for some seemingly reasonable goal becomes intolerable.

How do you apply yoga to Conversing with Death?

The method can vary but I sometimes begin by lying down with a prayer mudra. This emphasizes a type of surrender. Then I move into Shavasana. Here, I can move into lying meditation or repeat a mantra. At times, and if I need courage, I use the Warrior Pose or the Triangle Pose or both. Asanas that open the heart and help expand the lungs for deep breathing are helpful as well. If I become slightly anxious, I employ a set of poses to create momentum. If I find myself in need of validation or assurance, I resort to kind poses like Child Pose. In many of my asanas, I use the ujjayi breath. However, depending on what I need for the moment determines the type of pranayama I use.

Dying is an art, like everything else. I do it exceptionally well. I do it so it feels like hell. I do it so it feels real. I guess you can say I've a call. --Sylvia Path

What exactly is Conversing with Death?

​Conversing with Death (CD) is a carefully constructed method that attends to our existential awareness. At times, we wonder about our end. "How will I die?" Where?"" "From what?" While we don't know the answers, CD believes that such questions are natural and should receive some attention. While this varies, in CD work specifically the attention involves facing and embracing the deep awareness in us all around our last breath. 

Do I have to be in the dying stages to apply this exercise?

No. Many methods surrounding death are applied when someone is in their dying stages. CD encourages us to cultivate a relationship with our last breath way before the time does come. Why? By addressing all our fears and worries now we stand greater chance to design a more peaceful transition later.