I FIRST CAME TO THE WEST at the beginning of the 1970s, and what disturbed me deeply, and has continued to disturb me, is the almost complete lack of spiritual help for the dying that exists in modern culture. In Tibet, as I have shown, everyone had some knowledge of the higher truths of Buddhism and some relationship with a master. No one died without being cared for, in both superficial and profound ways, by the community. I have been told many stories of people dying alone and in great distress and disillusion in the West without any spiritual help, and one of my main motivations in writing this book is to extend the healing wisdom of the world I was brought up in to all men and women. Do we not all have a right, as we are dying, not only to have our bodies treated with respect, but also, and perhaps even more important, our spirits? Shouldn’t one of the main rights of any civilized society, extended to everyone in that society, be the right to die surrounded by the best spiritual care? Can we really call ourselves a “civilization” until this becomes an accepted norm? What does it really mean to have the technology to send people to the moon, when we do not know how to help our fellow humans die with dignity and hope?
Spiritual care is not a luxury for a few; it is the essential right of every human being, as essential as political liberty, medical assistance, and equality of opportunity. A real democratic ideal would include knowledgeable spiritual care for everyone as one of its most essential truths.
Wherever I go in the West, I am struck by the great mental suffering that arises from the fear of dying, whether or not this fear is acknowledged. How reassuring it would be for people if they knew that when they lay dying they would be cared for with loving insight! As it is, our culture is so heartless in its expediency and its denial of any real spiritual value that people, when faced with terminal illness, feel terrified that they are simply going to be thrown away like useless goods. In Tibet it was a natural response to pray for the dying and to give them spiritual care; in the West the only spiritual attention that the majority pay to the dying is to go to their funeral.
At the moment of their greatest vulnerability, then, people in our world are abandoned and left almost totally without support or insight. This is a tragic and humiliating state of affairs, which must change. All of the modern world’s pretensions to power and success will ring hollow until everyone can die in this culture with some measure of true peace, and until at least some effort is made to ensure this is possible.
A friend of mine, who had just graduated from a famous medical school, started work at one of the larger London hospitals. On her very first day on the ward, four or five people died. It was a terrible shock for her; nothing in her training had equipped her to deal with it at all. Isn’t this astonishing, considering she was being trained to be a doctor? One old man was lying in his bed, staring at the wall. He was alone, with no family or friends to visit him, and he was desperate for someone to talk to. She went over to him. His eyes filled with tears and his voice trembled as he asked her the last question she expected to hear: “Do you think God will ever forgive me for my sins?” My friend had no idea at all how to respond; her training had left her completely unprepared for any spiritual questions. She had nothing to say; all she had to hide behind was her professional status as a doctor. There was no chaplain close by, so she just stood there, paralyzed, unable to answer her patient’s desperate call for help and for reassurance about the meaning of his life.
She asked me, in her pain and bewilderment: “What would you have done?” I said to her I would have sat by his side, held his hand, and let him talk. I have been amazed again and again by how, if you just let people talk, giving them your complete and compassionate attention, they will say things of a surprising spiritual depth, even when they think they don’t have any spiritual beliefs. Everyone has their own life wisdom, and when you let a person talk you allow this life wisdom to emerge. I have often been very moved by how you can help people to help themselves by helping them to discover their own truth, a truth whose richness, sweetness, and profundity they may never have suspected. The sources of healing and awareness are deep within each of us, and your task is never under any circumstances to impose your beliefs but to enable them to find these within themselves.
Believe as you sit by the dying person that you are sitting by someone who has the true potential to be a buddha. Imagine their buddha nature as a shining and stainless mirror, and all their pain and anxiety a thin, gray mist on it that can quickly clear. This will help you to see them as lovable and forgivable, and draw out of you your unconditional love; you will find this attitude will allow the dying person to open remarkably to you.
My master Dudjom Rinpoche used to say that to help a dying person is like holding out a hand to someone who is on the point of falling over, to lift them up. Through the strength and peace and deep compassionate attention of your presence, you will help them awaken their own strength. The quality of your presence at this most vulnerable and extreme moment is all-important. As Cicely Saunders wrote: “The dying have shed the masks and superficialities of everyday living and they are all the more open and sensitive because of this. They see through all unreality. I remember one man saying, ‘No, no reading. I only want what is in your mind and in your heart.’”1
I never go to the bedside of a dying person without practicing beforehand, without steeping myself in the sacred atmosphere of the nature of mind. Then I do not have to struggle to find compassion and authenticity, for they will be there and radiate naturally.
Remember, you can do nothing to inspire the person in front of you if you do not inspire yourself first. So when you don’t know what to do, when you feel hardly able to do anything to help, then pray and meditate, invoke the Buddha or any other figure whose sacred power you believe in. When I’m faced with someone going through terrible suffering, I call down with fervor the help of all the buddhas and enlightened beings, with my heart completely open to the person dying in front of me, and compassion for their pain filling my being. I invoke as intensely as possible the presence of my masters, the buddhas, of those enlightened beings with whom I have a particular connection. Summoning all my powers of devotion and faith, I see them in glory above the dying person, gazing down at them with love, and pouring down light and blessing on them, purifying them of all their past karma and present agony. And as I do this, I keep praying that the person in front of me should be spared further suffering, and find peace and liberation.
I do this with the deepest concentration and earnestness, and then I try to rest in the nature of my mind and allow its peace and radiance to permeate the atmosphere of the room. Many, many times I have been awed by the sense of sacred presence that then establishes itself very naturally, and which in turn inspires the dying person.
I’m now going to say something that may surprise you. Death can be very inspiring. In my experiences with dying people, I have found that I have surprised myself by the way in which my prayer and invocation transformed the atmosphere, and I myself have had my faith deepened by seeing how effective this invocation and prayer and this presence of the buddhas are. I have found that being by the bedside of a dying person has made my own practice far more powerful.
Sometimes I see that the dying person also feels this atmosphere of deep inspiration, and is grateful to have provided the opportunity for our reaching, together, a moment of real and transformative rapture.
I would like to single out two points in giving spiritual help to the dying: giving hope, and finding forgiveness.
Always when you are with a dying person, dwell on what they have accomplished and done well. Help them to feel as constructive and as happy as possible about their lives. Concentrate on their virtues and not their failings. People who are dying are frequently extremely vulnerable to guilt, regret, and depression; allow them to express these freely, listen to the person and acknowledge what he or she says. At the same time, where appropriate, be sure to remind the person of his or her buddha nature, and encourage the person to try to rest in the nature of mind through the practice of meditation. Especially remind the person that pain and suffering are not all that he or she is. Find the most skillful and sensitive way possible to inspire the person and give him or her hope. So rather than dwelling on his or her mistakes, the person can die in a more peaceful frame of mind.
To the man who cried out: “Do you think God will ever forgive me for my sins?” I would say: “Forgiveness already exists in the nature of God; it is already there. God has already forgiven you, for God is forgiveness itself. ‘To err is human, and to forgive divine.’ But can you truly forgive yourself? That’s the real question.
“Your feeling of being unforgiven and unforgivable is what makes you suffer so. But it only exists in your heart or mind. Haven’t you read how in some of the near-death experiences a great golden presence of light arrives that is all-forgiving? And it is very often said that it is finally we who judge ourselves.
“In order to clear your guilt, ask for purification from the depths of your heart. If you really ask for purification, and go through it, forgiveness will be there. God will forgive you, just as the father in Christ’s beautiful parable forgives the prodigal son. To help yourself to forgive yourself, remember the good things you have done, forgive everyone else in your life, and ask for forgiveness from anyone you may have harmed.”
Not everyone believes in a formal religion, but I think nearly everyone believes in forgiveness. You can be of immeasurable help to the dying by enabling them to see the approach of death as the time for reconciliation and reckoning.
Encourage them to make up with friends or relatives, and to clear their heart, so as not to keep even a trace of hatred or the slightest grudge. If they cannot meet the person from whom they feel estranged, suggest they phone them or leave a taped message or letter and ask for forgiveness. If they suspect that the person they want to pardon them cannot do so, it is not wise to encourage them to confront the person directly; a negative response would only add to their already great distress. And sometimes people need time to forgive. Let them leave a message of some kind asking for forgiveness, and they will at least die knowing that they have done their best. They will have cleared the difficulty or anger from their heart. Time and time again, I have seen people whose hearts have been hardened by self-hatred and guilt find, through a simple act of asking for pardon, unsuspected strength and peace.
All religions stress the power of forgiveness, and this power is never more necessary, nor more deeply felt, than when someone is dying. Through forgiving and being forgiven, we purify ourselves of the darkness of what we have done, and prepare ourselves most completely for the journey through death.
If your dying friend or relative is familiar with some kind of meditation practice, encourage him or her to rest in meditation as much as possible, and meditate with the person as death approaches. If the dying person is at all open to the idea of spiritual practice, help the person find a suitable, simple practice, do it with him or her as often as possible, and keep reminding the person gently of it as death nears.
Be resourceful and inventive in how you help at this crucial moment, for a great deal depends on it: The whole atmosphere of dying can be transformed if people find a practice they can do wholeheartedly before and as they die. There are so many aspects of spiritual practice; use your acumen and sensitivity to find the one they might be most connected with: it could be forgiveness, purification, dedication, or feeling the presence of light or love. And as you help them begin, pray for the success of their practice with all your heart and mind; pray for them to be given every energy and faith to follow the path they choose. I have known people even at the latest stages of dying make the most startling spiritual progress by using one prayer or one mantra or one simple visualization with which they really made a connection in their heart.
Stephen Levine tells the story of a woman he was counseling who was dying of cancer.2 She felt lost because, although she had a natural devotion to Jesus Christ, she had left the church. Together they explored what she might do to strengthen that faith and devotion. She came to the realization that what would help her renew her connection with Christ, and find some trust and confidence while dying, would be to repeat continuously the prayer, “Lord Jesus Christ, have mercy on me.” Saying this prayer opened her heart, and she began to feel Christ’s presence with her at all times.
The most valuable and powerful of all practices I have found in caring for the dying, one which I have seen an astonishing number of people take to with enthusiasm, is a practice from the Tibetan tradition called phowa (pronounced “po-wa”), which means the transference of consciousness.
Phowa for dying people has been performed by friends, relatives, or masters, quite simply and naturally, all over the modern world—in Australia, America, and Europe. Thousands of people have been given the chance to die serenely because of its power. It gives me joy to make the heart of the phowa practice now available to anyone who wishes to use it.
I want to emphasize that this is a practice that anyone at all can do. It is simple, but it is also the most essential practice we can do to prepare for our own death, and it is the main practice I teach my students for helping their dying friends and relatives, and their loved ones who have already died.
Practice One
First make sure you are comfortable, and assume the meditative posture. If you are doing this practice as you are coming close to death, just sit as comfortably as you are able, or practice lying down.
Then bring your mind home, release, and relax completely.
1. In the sky in front of you, invoke the embodiment of whatever truth you believe in, in the form of radiant light. Choose whichever divine being or saint you feel close to. If you are a Buddhist, invoke a buddha with whom you feel an intimate connection. If you are a practicing Christian, feel with all your heart the vivid, immediate presence of God, the Holy Spirit, Jesus, or the Virgin Mary. If you don’t feel linked with any particular spiritual figure, simply imagine a form of pure golden light in the sky before you. The important point is that you consider the being you are visualizing or whose presence you feel is the embodiment of the truth, wisdom, and compassion of all the buddhas, saints, masters, and enlightened beings. Don’t worry if you cannot visualize them very clearly, just fill your heart with their presence and trust that they are there.
2. Then focus your mind, heart, and soul on the presence you have invoked, and pray:
Through your blessing, grace, and guidance, through the power of the light that streams from you:
May all my negative karma, destructive emotions, obscurations, and blockages be purified and removed,
May I know myself forgiven for all the harm I may have thought and done,
May I accomplish this profound practice of phowa, and die a good and peaceful death,
And through the triumph of my death, may I be able to benefit all other beings, living or dead.
3. Now imagine that the presence of light you have invoked is so moved by your sincere and heartfelt prayer that he or she responds with a loving smile and sends out love and compassion in a stream of rays of light from his or her heart. As these touch and penetrate you, they cleanse and purify all your negative karma, destructive emotions, and obscurations, which are the causes of suffering. You see and feel that you are totally immersed in light.
4. You are now completely purified and completely healed by the light streaming from the presence. Consider that your very body, itself created by karma, now dissolves completely into light.
5. The body of light you are now soars up into the sky and merges, inseparably, with the blissful presence of light.
6. Remain in that state of oneness with the presence for as long as possible.
Practice Two
1. To do this practice even more simply, begin as before by resting quietly, and then invoke the presence of the embodiment of truth.
2. Imagine your consciousness as a sphere of light at your heart, which flashes out from you like a shooting star, and flies into the heart of the presence in front of you.
3. It dissolves and merges with the presence.
Through this practice you are investing your mind in the wisdom mind of the Buddha or enlightened being, which is the same as surrendering your soul into the nature of God. Dilgo Khyentse Rinpoche says this is like casting a pebble into a lake; think of it plummeting down into the water, deeper and deeper. Imagine that through the blessing your mind is transformed into the wisdom mind of this enlightened presence.
Practice Three
The most essential way to do the practice is this: Simply merge your mind with the wisdom mind of the pure presence. Consider: “My mind and the mind of the Buddha are one.”
Choose whichever one of these versions of the phowa feels most comfortable, or has most appeal for you at any particular moment. Sometimes the most powerful practices can be the most simple. But whichever one you choose, remember that it is essential to take the time now to become familiar with this practice. How else will you have the confidence to do it for yourself or others at the moment of death? My master Jamyang Khyentse wrote, “If you meditate and practice in this manner always, at the moment of death it will come easier.”3
In fact you should be so familiar with the practice of phowa that it becomes a natural reflex, your second nature. If you have seen the film Gandhi, you know that when he was shot, his immediate response was to call out: “Ram . . . Ram!” which is, in the Hindu tradition, the sacred name of God. Remember that we never know how we will die, or if we will be given the time to recall any kind of practice at all. What time will we have, for example, if we smash our car into a truck at 100 mph on the freeway? There won’t be a second then to think about how to do phowa, or to check the instructions in this book. Either we are familiar with the phowa or we are not. There is a simple way to gauge this: Just look at your reactions when you are in a critical situation or in a moment of crisis, such as an earthquake, or a nightmare. Do you respond with the practice or don’t you? And if you do, how stable and confident is your practice?
I remember a student of mine in America who went out riding one day. The horse threw her; her foot got stuck in the stirrup, and she was dragged along the ground. Her mind went blank. She tried desperately to recall some practice, but nothing at all would come. She grew terrified. What was good about that terror was that it made her realize that her practice had to become her second nature. This was the lesson she had to learn; it is the lesson, in fact, we all have to learn. Practice phowa as intensively as you can, until you can be sure you will react with it to any unforeseen event. This will make certain that whenever death comes, you will be as ready as you can be.
How can we use this practice to help someone who is dying?
The principle and the sequence of the practice are exactly the same; the only difference is that you visualize the Buddha or spiritual presence above the head of the dying person:
Imagine that the rays of light pour down onto the dying person, purifying his or her whole being, and then he or she dissolves into light and merges into the spiritual presence.
Do this practice throughout your loved one’s illness, and especially (and most important) when the person is breathing the last breath, or as soon as possible after breathing stops and before the body is touched or disturbed in any way. If the dying person knows you are going to do this practice for them, and knows what it is, it can be a great source of inspiration and comfort.
Sit quietly with the dying person, and offer a candle or light in front of a picture or statue of Buddha or Christ or the Virgin Mary. Then do the practice for them. You can be doing the practice quietly, and the person need not even know about it; on the other hand, if he or she is open to it, as sometimes dying people are, share the practice and explain how to do it.
People often ask me: “If my dying relative or friend is a practicing Christian and I am a Buddhist, is there any conflict?” How could there be? I tell them: You are invoking the truth, and Christ and Buddha are both compassionate manifestations of truth, appearing in different ways to help beings.
I strongly suggest to doctors and nurses that they can also do phowa for their dying patients. Imagine how marvelously it could change the atmosphere in a hospital if those who were ministering to the dying were also doing this practice. I remember the death of Samten in my childhood, when my master and the monks were all practicing for him. How powerful and uplifting it was! My deepest prayer is for everyone to die with the same grace and peace that he did.
I have formulated this essential phowa specially from the traditional Tibetan practice for dying, and it incorporates all the most important principles. So it is not only a practice for dying, but it can also be used both to purify and to heal; it is important for the living, and for the sick as well. If a person is going to be healed, it will assist that healing; if a person is dying, it will help them and heal their spirit in death; and if the person has died, it will continue to purify them.
If you are not sure whether a person who is seriously ill is going to live or die, then whenever you visit them you can do this phowa practice for them. And when you go home, do it again. The more you do it, the more your dying friend will be purified. You never know if you will see your friend again, or if you will be present when he or she actually dies. So seal each visit with this practice, just as a preparation, and go on doing the practice in whatever spare moments you have.4
From the Tibetan Book of the Dead:
O son/daughter of an enlightened family,5 what is called “death” has now arrived, so adopt this attitude: “I have arrived at the time of death, so now, by means of this death, I will adopt only the attitude of the enlightened state of mind, loving kindness and compassion, and attain perfect enlightenment for the sake of all sentient beings who are as limitless as space . . .”
Recently one of my students came to me and said: “My friend is only twenty-five. He’s in pain and dying of leukemia. He is already frighteningly bitter; I’m terrified that he’ll drown in bitterness. He keeps asking me: ‘What can I do with all this useless, horrible suffering?’”
My heart went out to her and her friend. Perhaps nothing is as painful as believing that there is no use to the pain you are going through. I told my student there was a way her friend could transform his death even now, and even in the great pain he was enduring: to dedicate, with all his heart, the suffering of his dying, and his death itself, to the benefit and ultimate happiness of others.
I told her to tell him: “I know how much pain you’re in. Imagine now all the others in the world who are in a pain like yours, or even greater. Fill your heart with compassion for them. And pray to whomever you believe in and ask that your suffering should help alleviate theirs. Again and again dedicate your pain to the alleviation of their pain. And you will quickly discover in yourself a new source of strength, a compassion you’ll hardly be able now to imagine, and a certainty, beyond any shadow of a doubt, that your suffering is not only not being wasted, but has now a marvelous meaning.”
What I was describing to my student was in fact the practice of Tonglen, which I have already shared with you, but which takes on a very special significance when someone is terminally ill or dying.
If you have an illness like cancer or AIDS, try as intensely as you can to imagine every other person in the world who has the same disease as you.
Say to yourself with deep compassion: “May I take on the suffering of everyone who has this terrible illness. May they be free from this affliction and from all their suffering.”
Then imagine that their illness and tumors leave their body in the form of smoke, and dissolve into your illness and tumors. When you breathe in, you breathe in all their suffering, and when you breathe out, you breathe out total healing and well-being. Each time you do this practice, believe, with complete conviction, that they are now healed.
As you approach death, think continually to yourself: “May I take on the suffering, the fear, and loneliness of all others all over the world who are dying or will die. May they be all freed from pain and confusion; may they all find comfort and peace of mind. May whatever suffering I am enduring now and will endure in the future help them toward a good rebirth and ultimate enlightenment.”
I knew an artist in New York who was dying from AIDS. He was a sardonic character and hated institutional religion, although secretly some of us suspected he had more spiritual curiosity than he admitted. Friends persuaded him to see a Tibetan master, who immediately understood that the greatest source of his frustration and suffering was that he felt his pain was of no use to himself or to anyone else. So he taught him one thing, and one thing only: the Tonglen practice. Despite some initial skepticism, he did practice it; and all his friends saw he went through an extraordinary change. He told many of them that, through Tonglen, the pain that before had been pointless and horrific was now infused with an almost glorious purpose. Everyone who knew him experienced firsthand how this new sense of meaning transformed his dying. He died in peace, reconciled to himself and his suffering.
If the practice of taking on the suffering of others can transform someone who has little experience of practice before, then imagine what power it has in the hands of a great master. When Gyalwang Karmapa died in Chicago in 1981, one of his Tibetan disciples wrote:
By the time that I saw him, His Holiness had already had many operations, some parts of his body removed, things put inside him, his blood transfused, and so on. Every day the doctors discovered the symptoms of some new disease, only to find them gone the next day and replaced by another illness, as if all the diseases in the world were finding room in his flesh. For two months he had taken no solid food, and finally his doctors gave up hope. It was impossible for him to live, and the doctors thought the life-supporting systems should be disconnected.
But the Karmapa said, “No, I’m going to live. Leave them in place.” And he did live, astonishing the doctors, and remaining seemingly at ease in his situation—humorous, playful, smiling, as if he were rejoicing at everything his body suffered. Then I thought, with the clearest possible conviction, that the Karmapa had submitted himself to all this cutting, to the manifestation of all those diseases in his body, to the lack of food, in a quite intentional and voluntary way: He was deliberately suffering all of these diseases to help minimize the coming pains of war, disease, and famine, and in this way he was deliberately working to avert the terrible suffering of this dark age. For those of us present, his death was an unforgettable inspiration. It profoundly revealed the efficacy of the Dharma,6 and the fact that enlightenment for the sake of others can actually be achieved.7
I know and I firmly believe that there is no need for anyone on earth to die in resentment and bitterness. No suffering, however dreadful, is or can be meaningless if it is dedicated to the alleviation of the suffering of others.
We have before us the noble and exalting examples of the supreme masters of compassion, who, it is said, live and die in the practice of Tonglen, taking on the pain of all sentient beings while they breathe in, and pouring out healing to the whole world when they breathe out, all their lives long, and right up until their very last breath. So boundless and powerful is their compassion, the teachings say, that at the moment of their death, it carries them immediately to rebirth in a buddha realm.
How transformed the world and our experience of it would be if each of us, while we live and as we die, could say this prayer, along with Shantideva and all the masters of compassion:
May I be a protector to those without protection,
A leader for those who journey,
And a boat, a bridge, a passage
For those desiring the further shore.
May the pain of every living creature
Be completely cleared away.
May I be the doctor and the medicine
And may I be the nurse
For all sick beings in the world
Until everyone is healed.
And the great elements such as earth,
May I always support the life
Of all the boundless creatures.
And until they pass away from pain
May I also be the source of life
For all the realms of varied beings
That reach unto the ends of space.8