In today's society, we are witnessing an increase in average life expectancy, made possible by technical and scientific progress and the development of health care. This provides a longer life, with better health and possibilities for self-fulfillment, less subject to the misfortunes of life. On the other hand, we are also witnessing an exponential increase in conditions of prolonged illness/death associated with extremely painful ends of life for the elderly and their families. Life is often prolonged without providing dignified conditions, without the person feeling that it still has meaning/purpose and that the suffering is tolerable – suffering and pain that persist despite medication. We are increasingly faced with extreme and prolonged suffering. For example, in people who can no longer walk, are dependent for everything, and suffer permanent pain – the bones wear out, the body withers, the muscles disappear until they no longer have the strength to hold their head up or open their eyes, the person becomes bedridden; it is a slow and painful process, death in life – dying is not for children!
For caregivers, it is very difficult, it is very painful to see our parents in this state, people who are central to our existence, our inner world, our blood. In their loss, we see their loss and our own, which is present and painfully conscious. The patient feels our sadness and we feel theirs, an emotional resonance that screams in the depths of our somatopsychiatry.
For the patient, pain occurs at all levels, physical and mental, and the end approaches with each breath – death, a source of intense anxiety and simultaneously, relief/liberation, terror and pain that are difficult to conceive. It is, however, possible for a feeling of peace to coexist with agony. Peace is not the absence of suffering, but the result of its acceptance. These extreme states imply an immeasurable capacity to accept suffering and the end, a detachment and a detachment from everything, even one’s own identity. There is only the moment, there are no more concepts and prejudices of social class, of success or failure, only the deepest and purest of Being in the naked here and now. For a terminally ill patient who receives a visit from a child they have not seen for years, old disagreements, wealth or poverty, the wrinkles that have creased their faces, the time that remains mean nothing (time no longer matters to those who have no time). It doesn't matter what clothes you're wearing, or what old disappointments you're wearing, because there are no illusions anymore, only Presence. Often there are no words, only Being, the peace of shared pain - the pain of saying goodbye, the pain of those who leave and, by going, come back, become more present within us and transform us; of those who, upon dying, give birth again.
Professional support can be essential in providing support and developing the skills and abilities required to deal with the challenges of these extreme situations, in which we can also learn and find purpose.
Daniel Figueiredo, Psicólogo, Psicoterapeuta, membro da SPPC
