Dignity Therapy: A treatment method for end-of-life.

Death, for obvious reasons, is a painful subject for many. Embracing the end of our lives is something most of us avoid thinking about. We hope - understandably - that we live to see our children's children's children, and die peacefully in our sleep. At 94, my grandmother often says she's "ready to go" after a life well-lived, and I can't think of a more ideal way to feel in those final years.

As we all know, many people enter the last stages of their lives well before this golden age. Terminal illnesses like cancer and ALS affect people of all ages, thrusting them into a stage of life they previously thought was decades away. Fear, sadness, confusion, a sense of peace and contentment, are just a few of the vast array of emotions one might experience during this time. While many people explore their feelings with family, friends, their healthcare team, or spiritual/religious leaders, others may experience a sense of loneliness and isolation, or perhaps filter their true feelings to protect loved ones. 

Psychotherapy for end-of-life issues can be profoundly impactful. Many people with terminal illness enter the stages of grief from the time of diagnosis - shock, denial, bargaining are all common and valid responses. A challenging dynamic of facing end-of-life is coping with the inherent uncertainty - since even the most experience healthcare professionals cannot predict when exactly life will end. Sitting with uncertainty can be terrifying and anxiety-provoking, and humans are experts at trying to avoid it. Being willing to simply be with it, can lead us from anxiety and suffering to acceptance and trust. A trained therapist may hold space, objectively, for feelings and thoughts to arise without judgment. 

​Dignity Therapy: What is is?
​Dr. Harvey Chochinov, a Canadian psychiatrist, developed a treatment method to reduce the distress experienced by hospice care patients. Dignity therapy is a brief, individualized, and clinically effective treatment method for end-of-life that was designed to promote a sense of purpose and autonomy. It was created to acknowledge the loss of personhood and dignity that can, but doesn't have to, occur during the end stages of life. It includes three components:
-Addressing and processing stressors that contribute to loss of sense of self, such as decline in functioning and symptom distress, with a goal of enhancing a person's sense of meaning.
-Conducting a "life review" including nine open-ended questions, reflecting on life's most important events as well as hopes and dreams for loved ones.
-Creating a legacy document; with permission from the client, the abovementioned interviews will be recorded and and then transcribed to a written document. The client will read this and request changes as needed. It will then be passed on to chosen loved ones and friends. 

Processing difficult and challenging emotions with a licensed therapist can increase quality of life.  I have completed the Dignity Therapy training through the Hospice Foundation of America. Feel free to schedule a phone consultation to determine if this service could benefit you or a loved one.