"In spite of the staunchest, most venerable of our defences, death anxiety is always there, lurking in the hidden ravines of our minds"
Staring at the Sun, inside cover blurb
Our Mortal Wound refers to our knowledge that we humans have, that ultimately, we will die. This book examines our fear of death, conscious and unconscious, and the ways we find to deal with that fear, in particular through therapeutic exploration.
When I first heard about this book, when it was released in 2008, I was very keen to read it. However, due to my being in the middle of counselling training, I decided that I wanted to get a better grip on my own relationship with death before I explored Yalom's work. I wanted to make my own journey and come to my own conclusions, rather than taking on somebody else's construct.
So, a few years later and I have completed counselling training, had extensive personal therapy, life events and a particular confrontation with the concept of the ceasing of my own existence, and I feel in a good place to read Staring at the Sun. I read Yalom's Existential Psychotherapy a month or so prior (my review for which can be found here) which had a huge section on Death Anxiety.
I was ready for the full weight of a book dedicated to facing the fear of death, written by somebody who at (then) age 70 was facing his own fear of death.
I needn't have stressed. I actually found the book quite untraumatic compared to my personal explorations. It was probably something to do with reading Existential Psychotherapy beforehand and I think that, ideally, the best order would be to read Staring at the Sun first.
Rather than review the book I would like to share some snippets that I bookmarked whilst reading. These are useful to me as a therapist and resonate with my way of being in the therapy room.
Chapter 1 - The Mortal Wound
"Death, however, does itch. It itches all the time; it is always with us, scratching at some inner door, whirring softly, barely audibly, just under the membrane of consciousness. Hidden and disguised, leaking out in a variety of symptoms, it is the wellspring of many of our worries, stresses, and conflicts."
"I feel strongly - as a man who will himself die one day in the not-too-distant future and as a psychiatrist who has spent decades dealing with death anxiety - that confronting death allows us, not to open some noisome Pandora's box, but to reenter life in a richer, more compassionate manner."
Chapter 4 - The Power of Ideas
On Schopenhauer's triplet of essays: What a Man Is, What a Man Has, What a Man Represents:
"1. What we have. Material goods are a will-o'-the-wisp. Schopenhauer argues elegantly that the accumulation of wealth and goods is endless and unsatisfying; the more we possess, the more our claims multiply. Wealth is like seawater: the more we drink, the thirstier we become. In the end, we don't have our goods - they have us.
2. What we represent in the eyes of others. Reputation is as evanescent as material wealth. Schopenhauer writes "Half our worries and anxieties have arisen from our concern about the opinions of others...we must extract this thorn from our flesh."....Opinions hang by a thread and make us slaves to what others think or, worse, to what they appear to think - for we can never know what they actually think.
3. What we are. It is only what we are that truly matters. A good conscience, Schopenhauer says, means more than a good reputation....Inner equanimity stems from knowing that it is not things that disturb us, but our interpretations of things."
Chapter 5 - Overcoming Death Terror Through Connection
"The task, then, is not to offer answers, but to find a way to help others discover their own answers. The same principle operated in the treatment of Julia, a psychotherapist and painter, whose death anxiety stemmed from her not having fully realized herself and neglecting her art in order to compete with her husband in earning money. I applied the same strategy in our work when I asked her to assume a distant perspective by suggesting she imagine how she'd respond to a client who behaved as she did. Julia's instantaneous comment - "I'd say to her, you are living a life of absurdity!" - signalled that she needed only the slightest guidance to discover her own wisdom. Therapists have always operated under the assumption that the truth that one discovers for oneself has far greater power than a truth delivered by others."
Chapter 6 - Death Awareness: A Memoir
"In my practice, I've worked with several psychotherapists who, having just finished a graduate program consisting almost entirely of cognitive-behavioural therapy, feel despair at the prospect of working mechanically with patients in a behavioural prescriptive mode. And I wonder, too, where therapists trained to treat patients in this impersonal behavioural mode will turn when they themselves need help. Not to colleagues of their own school, I would wager."
Chapter 7 - Addressing Death Anxiety
"Terence's Maxim and Therapist Self-Disclosure - Terence, a second-century Roman playwright, offers an aphorism that is extraordinarily important in the inner work of a therapist:
I am human, and nothing human is alien to me.
Beginning therapists would do well to use Terence's axiom as a mantra, helping them to empathise with their patients by locating their own similar experiences. This aphorism is particulalry apt to work in patients with death anxiety. If you are to be truly present with such patients, you must be open yourself to your own death anxiety...no training program prepares therapists for this type of work."
"...why is the here and now important? A fundamental catechism of psychotherapy training is that the therapy situation is a social microcosm; that is, patients will sooner or later exhibit in the therapy situation the same behaviour they exhibit in the life outside.....This is the first step in helping a patient assume responsibility for his or her life predicament."
"...the positive therapeutic alliance is a prerequisite for the effectiveness of any therapy. It is not the end, but a means to an end. A major internal shift can occur when patients form a genuine, trusting relationship with the therapist, disclose everything and still be accepted and supported. Such pateints experience new parts of themselves, parts previously denied or distorted. They begin to value themselves and their own perceptions rather than over-valuing the perceptions of others....The intimacy with the therapist serves as an internal reference point. Knowing that they have the ability to form relationships they develop the confidence and willingness to form similarly good relationships in the future."
"I never tire of telling student therapists that their most vital instrument is their own self, and that, consequently, the instrument must be finely honed. Therapists must have a great deal of self-knowledge, must trust their observations, and must relate to their clients in a caring and professional manner. It is precisely for this reason that personal therapy is (or should be) at the core of every therapy training program...they should return to therapy as they progress through life."
These selected snippets do not reflect the content of this book, more, my ideals on the therapeutic relationship.
The book itself is a useful accompaniment to a personal journey in exploring one's relationship with death. However, I already had gone deeper and further than this book took me, and I wish I had read it earlier. It is ideal for those dabbling with the concept, and wondering about therapy's place in such a journey. Referring to my fears expressed above before reading this book, there are no "constructs" to take on. Staring at the Sun is respectful of all the ways we find to deal with our mortal wounds.