Working with the dying: Compassion, shame, and the illusion of loss.

摘要

This is a phenomenological inquiry into the work of caring for the dying. The primary focus is on the influence of experiences of loss on the daily compassionate activity of hospice volunteers. The study begins with a review of literature suggesting positive outcomes after experiences of loss. It then examines the nature of altruism and empathy from the perspectives of evolutionary psychology, neuropsychology, developmental psychology, and object relations theory, especially the writings of Melanie Klein. There is a review of the entirely different approach of Zen Buddhism to the question of compassion, where it is seen as an ontological characteristic of consciousness. I suggest a relationship between shame and loss and show how this relationship is an aspect of the connection between self and other, as well as the Zen Buddhist notion of no-self. I conducted a series of interviews of long-term volunteers working with the Zen Hospice Project. The semi-structured interviews illustrated the importance of loss and shame for hospice volunteers, as well as how these volunteers care for self and other, and go about the ordinary activities of being with the dying. I analyzed the interviews phenomenologically with important modifications: there was a focus on the psychoanalytic and Zen Buddhist elements of the conversation between the researcher and the co-researcher subjects.