Buddhist Contemplative Care Training
“Do not close your eyes before suffering,” taught the Buddha. Not easy – especially during tough moments. The New York Zen Center for Contemplative Care is doing something about this to help alleviate the suffering of terminally ill patients.
A nine-month course introduces a Buddhist approach to mindful and compassionate care and gives those who participate the tools to sit with pain and emerge uplifted from the experience.
The participants also conduct clinical hours at facilities like Beth Israel Medical Center, Visiting Nurse Service of New York, or in their local communities. The course, called Foundations in Buddhist Contemplative Care, also offers continuing education and serves as a pre-requisite for the Zen Center’s Clinical Pastoral Education Buddhist Chaplaincy training program.
Koshin Paley Ellison, a Jew-turned-Buddhist who founded the program thanks to a suggestion from his grandmother -- who was initially very uncomfortable about her grandson's new-found Eastern religion -- talks to Lauren Tepper about how it all came about, who gets involved and how to stay present and fully alive in the face of death.
Lauren Tepper: How did you go from a Jewish upbringing to Buddhism?
Koshin Paley Ellison: We were more “Woody Allen Jewish” than religious. When I was eight, I declared to my family that I wanted to be a Zen Buddhist monk when I grew up. I was always taken with Asian art, and I remember a life-changing moment when I saw a photograph of a monk standing still on a street corner with a slight smile, in perfectly clear focus, while all the others rushing past were blurred. I was so drawn to that image of being still amidst busyness.
In middle school I took karate with a Zen practitioner. He had us start off meditating for the first 15 minutes. It was so difficult, sitting on that hardwood floor. I learned to quiet my mind within the discomfort.
LT: What inspired you to start this program?
KPE: I was the primary caregiver for my grandmother, and I lived with her in hospice for the last six weeks of her life. She had previously been resistant to my Buddhist perspective on life, but during this time she had a change of heart. “I never thought I’d say this,” I recall her saying, “but this Buddhist thing is just what’s needed for people in health care. They don’t know how to pay attention, to be really there with patients. You should train people about Buddhism and caregiving.”
LT: What type of people come to the program?
KPE: We’ve had yoga teachers, doctors, nurses, rabbis, chaplains, nuns, social workers – even acrobats! They’re all Buddhist-friendly or at least curious – but most don’t identify as religious. The common denominator is the foundation in a spiritual or contemplative practice.
LT: Is it difficult dealing with death and dying on a regular basis?
KPE: People think it must be depressing working with sick and dying people. I find it actually enlivening. When you’re with someone who’s in obvious pain, they can’t hide anymore. It’s actually just a more extreme reflection of what we’re all experiencing. Pain is part of every human life. In turning toward suffering, we turn it into an opportunity for growth.
Death is really a culmination of life. Through this work people not only help others, they are also learning to experience their own lives more fully.
LT: What do participants find most challenging and most rewarding about the program?
KPE: We must practice being with our own discomfort in order to help others. It’s not easy, at first, to stay with all your feelings; we are conditioned to seek escape. This program teaches participants the courage to be here. It’s powerful if we can be OK with our own discomfort, and it’s what allows us to be compassionately present for someone else.
There’s this weird sense of ‘waiting’ in our culture, where people feel like their life is not complete until some future event, which then only brings them to further wanting. This greed is actually a poison, and it causes people to miss out on their own lives. Being with people at the end of their lives changes people’s attitudes toward living. They become more content, and more engaged in their lives. It changes the way people relate to others. They have more intimacy, more meaningful conversations with their spouses, family, friends.
LT: Can you give me an example of an interaction between a trainee and a patient?
KPE: Doctors often tell patients to "Just relax.” Susan, one of our trainees, was working with a scared fifty three year old woman with end stage ovarian cancer who was just informed she was being transferred to hospice.
“What am I going to do?!" the patient fretted as the doctor left the room. Susan calmly asked "How have you experienced anxiety in the past?" The patient was silent for a moment. "Well, she said, "I have been always anxious in my life. I love gardening and yet when I garden, I garden with my anxiety. I love baths yet when I bathe I do it quickly.” After a pause Susan responded, "What would it be like to go to hospice with your anxiety and live with it just like when you garden or bathe?" The patient breathed a sigh of relief. "Can I do that? I thought the doctor said I had to relax."
This encounter taught me that contemplative care is about simply meeting the patient where they are without fixed ideas of where they should be. Openness and curiosity are the gateway to intimacy and care.