The Physical, Psychological,
and Spiritual Process of Death
To be prepared for death … life shall thereby be the sweeter.
—William Shakespeare
The view of many religious, philosophical, spiritual, and mystical traditions is that death is one of the most precious experiences you will ever have in this life. You and I may dread death because we don’t have the knowledge, experience, understanding, or cultural support that would help us to view it differently as we face this great unknown. We still have a choice, however. We can either live in dark fear or turn on the light. To choose to turn on the light and explore the process of your dying can bring you the greatest personal discovery of your life. The traditions say that you will discover that the moment of your death will be like the moment of birth. Your dying will be a time of your greatest need and uncertainty as well as your greatest joy and fulfillment because you will be moving through the doorway into an incomprehensible life experience.
What I discovered in myself and in working with dying individuals is that conscious preparation, like what we will be doing in this book by focusing on a positive death, can actually help us in our dying. Yet there are still unconscious wants and desires that muddy our mind and emotions. You may have had thoughts like the following or heard others say: “I only want to die in my sleep.” “I want to be instantly killed in an accident.” “I want a lot of drugs so I don’t feel any pain when I die.” “I want all my friends and family telling me, ‘Don’t worry, everything will be okay, you won’t go to hell.’” Or finally, “Because of my disease I’ll commit suicide so I don’t have a prolonged death.” If these types of “death plans” don’t go as they are supposed to go, then it creates undo fear and uncertainty.
Wanting your dying to be different from what it actually is will create resistance and pain for you as you move through the outer separation from your normal life, and then enter the inner chaotic changes and fear that the final letting go of your physical life will bring to you. I give you this caution as you begin this book with the hopes that you will realize that you can and need to prepare many things before you enter the final stages of dying. This is the work we each must do in order to let go of our resistance to death.
The lesson is learning that we are dying in some way every day. To die into your living now is the true gift of preparing for your final death. Many people have told me that as they confronted the future of their own death and prepared for it, they became more alive and vital in living their lives now. Opening to a new inner life now—what we were born to be—is the same as going through the portal of our death.
What Dies in Us Physically?
Let us begin by understanding the physical part of the dying process. Later in the book, we will look specifically at what happens just before death, at the actual moment of physical death, and after you die. But to introduce the question of what happens at physical death, we will consider for now what goes on in your nervous system, in your brain, and in the rest of your body when you die.
The Nervous System and Death
Our nervous system plays a critical function in how we will approach our death. Death is about letting go. Our autonomic nervous system is responsible for regulating the body’s unconscious actions. When we move through the dying process, we shift into one of the two divisions of our autonomic nervous system. The two divisions are the parasympathetic nervous system and the sympathetic nervous system. The parasympathetic nervous system is often considered the “rest and digest” or “feed and breed” system. The sympathetic system is responsible for the “fight, flight, or freeze” response to outward threat.
An older simplification of the parasympathetic and sympathetic nervous systems describes the autonomic nervous system as the inhibitory (parasympathetic) and excitatory (sympathetic) responses. It is the parasympathetic nervous system that takes over during the dying process. Being the inhibitor, the parasympathetic is a slowly activated dampening system of the body. You need this “damping down” as you move into the final stages of dying. The two branches of the nervous system have opposite actions. One system activates a physiological response and the other inhibits it. You can experience this oscillating movement of high activity and then deep sleep as you are in the process of letting go to your death. It is the parasympathetic nervous system that kicks in when you let go in the final stage of dying. When letting go happens in any aspect of life, it results in a relaxed state of mind and body.
The Brain and Death
The growing body of research into the functioning of the brain is revealing new insights about what occurs in the brain when we are dying. One of the areas of research is related to our various brain-wave patterns. When you get close to death, the brain activity settles into a period of slower delta wave frequency.
Delta frequency is the slowest of the four major brain waves (beta, alpha, theta, delta). Delta is the brain frequency that we are in during sleep. The brain frequencies can be recorded to observe the fluctuating electrical changes in the brain as we approach death and afterward. A seminal research study with mammalian brains at the University of Michigan, published in the Proceedings of the National Academy of Sciences in 2013, reported that after clinical death, the brain enters a brief state of heightened activity normally associated with wakeful consciousness or so-called gamma brain-wave activity.
Gamma waves are the fastest brain waves and are associated with high levels of concentration. In a variety of other brain research labs, gamma brain waves have been demonstrated and recorded in Tibetan monks and others in deep states of meditation. Using cardiac arrest on animal subjects, the Michigan researchers demonstrated that this “afterlife” brain activity is also highly coordinated across brain areas and different brain wavelengths. Gamma waves are the neural hallmarks of high-level cognitive activity. This activity not only resembles the waking state, it might even reflect a heightened state of conscious awareness similar to what the researchers describe as “the highly lucid and realer-than-real mental experiences reported by near-death survivors.” 5 This is a pretty bold claim that critically depends on a person’s quality of consciousness to be able to report after-death experience.
The researchers argue that at the final stage of brain death there is actually more evidence for consciousness-related activity than during normal wakeful consciousness. At this point, it is difficult to quantify “consciousness-related activity,” but it does support the notion that the more conscious or lucid you are at the time of death, the more you remain in that lucid state to be liberated or freed to experience another state of reality. This corroborates what Tibetan and other religious and spiritual traditions describe as the awareness we have after our physical death and when the brain no longer appears to be functioning.
The Body and Death
As you approach physical death, your body undergoes a variety of metabolic changes. As metabolism slows, your body has more difficulty turning food into energy to keep everything going. A clear sign that you are approaching death is your wanting little or no food or drink. If caregivers try to give it to you, you may become agitated and resistant to being fed.
One of the noticeable changes is the slowness of breathing. There will be periods where there is no breathing for more than a minute and then a surge of fast breathing. The erratic breathing may last several days before you die. Coughing fits can happen as fluid builds up in the lungs. The fluid in the lungs is what often causes the rattling sounds in the breathing.
Body temperature can fluctuate between being very high one moment and then very cold the next. Along with the temperature variations, the skin will begin to change and will feel cold to the touch, followed by the appearance of blotchy patches on the skin. The skin can also change color, moving from pink to a grayish tone.
As you get closer to the moment of death, you will enter into a sleeplike coma. You will become increasingly weaker and lack bowel and bladder control. The kidneys will release urine that is brown or dark red. You will stop producing urine when you are very close to dying.
Vision and hearing become less and less, and hallucinations are common at this point before death. Restlessness may also increase, and often even the weakest person attempts to get out of bed.
All these physical indicators reveal that the body is shutting down. How long your body takes to go through the final stage of physical shutdown will depend on your unique physical and medical conditions.
Psychological and Spiritual Aspects of Our Dying
Throughout history, philosophers and religious persons have reported that how you respond to the moment of your physical death is mirrored by the life you have lived. If you are always on the go, busy, independent, and with a strong identity in the world, then dying will be an abrupt change of lifestyle! If this is your pattern, you may resist the shift of your body to slow down and resist letting go of the body as you approach death. Likewise, if you are a lethargic couch potato and have difficulty concentrating your energy on challenges, you may resist the shift to focus on a deeper awareness within you as your body begins to shut down. The struggle to hold on to your life pattern will determine the struggle that will ensue with your dying.
Death has a process of its own. It is a journey where you are not in control. Out of control is scary when you are used to being in control. Control is the hallmark challenge of the letting-go process. Letting go of your mind and body does not have to be terrifying. But rather, understanding what you will experience and having loving support around you will let your passage of death be both peaceful and transformative to you and others.
Let’s begin to explore your resistance to being both alive and dying. We begin with a journey of three steps. The following five chapters are divided into three steps. Each step lays out the journey of your dying process. Everyone may not go through these steps, but knowing each step will give you guidance into reducing the fear of facing your own death.
• The first step describes what happens when death is inevitable and there is no further treatment possible. The first step explores the general resistance you probably have facing your death. Most of us will try to push away or find some rationale or means to run away from dealing with the issue of death and our resistance to avoid it both mentally and emotionally.
• The second step is letting go when you can no longer use every means medical or otherwise to hold on to life and realize you can no longer resist or push away from death. At this step, you finally begin to let go and accept what is inevitable.
• The third step is the process of transcendence. This is the experience of our actual death or ending of the body breathing, the heart and mind ceasing, and the journey (whatever it may be) beyond life. In each step on this journey, there are exercises to personalize and explore more deeply how to reduce the fear of dying.
5. Jimo Borjigin et al., “Surge of neurophysiological coherence and connectivity in the dying brain,” Proceedings of the National Academy of Sciences 110, no. 35 (2013): 14432–14437.