Let's Talk About Death

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Attitudes toward death and dying are evolving, transforming the way people in Western society approach their final moments and how they celebrate life.

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By Blake Pinto

Everybody dies. Different people approach this fact of life very differently.

Traditionally in Western society, death and dying have remained taboo topics—despite their inevitability. They often conjure feelings of fear and terror, reinforced through frightful imagery, graphics, and art. Elena Gillespie, Ph.D., adjunct faculty in Saybrook’s School of Mind-Body Medicine knows this firsthand from her experience working in hospice care.

“We have a lot of families who don’t want us to talk about death or dying with their loved ones who are in our care,” says Dr. Gillespie, who was trained to work with the dying as a shamanic practitioner. Her academic research focuses on end-of-life issues and bringing back the spiritual aspect of indigenous people’s view of death and dying. “There are people I work with in some instances who are not even aware they’re dying. They’re terrified—absolutely terrified—and just wondering, ‘Why am I here? Why is everybody visiting me?’”

Life’s final moments—whether they span years as in the case of a terminal illness or seconds in the form of a traumatic event—don’t have to be terrifying. Those involved with the positive death movement, such as Dr. Gillespie and others at Saybrook University, are hoping to spread this message as a growing number of people reconsider Western society’s longstanding traditions, etiquette, and perspectives around death and dying.

There are people I work with in some instances who are not even aware they’re dying. They’re terrified—absolutely terrified—and just wondering, ‘Why am I here? Why is everybody visiting me?'

The positive death movement

In 2003, social worker and New Yorker Henry Fersko-Weiss created the first end-of-life doula training program with the goal of formally educating practitioners to assist with the nonmedical needs of dying patients—“anything from helping them review their lives to sitting quietly in witness,” according to the New York Times. Eight years later, in 2011, Jon Underwood held a special meeting in the basement of his London home. Attendees sipped tea, ate cake, and conversed with each other. The topic of discussion? Death and dying. And so the death cafe was born.

Today, a growing number of academic programs provide certifications for end-of-life doulas, and volunteer-organized death cafes are found in more than 70 countries around the world.

The rise in popularity of end-of-life doulas and death cafes—specifically within the U.S.—are symbolic of the positive death movement, a much larger cultural shift that is driving an evolution in the Western approach to thinking about death and dying.

“We’re witnessing what happens in the end-of-life relationship when the Western biomedical model intersects with the indigenous knowledge system,” says Gina Belton, Ph.D., adjunct faculty in Saybrook’s Humanistic Psychology program. She voluntarily runs a death cafe in a small Northern California town and says the “Silver Tsunami” of baby boomers has made discussions about death and dying a hot topic within many of today’s family circles. “The Western model’s commitment to rigidity and order has, historically, suppressed the very messy complexity and creative chaos that is death. Instead of focusing on the beauty of dying, it has worked to commodify the sacred.”

The foundation of the positive death movement is built on the desire to embrace this creative chaos through curiosity—a willingness to open oneself to the thought of dying, considering what that means for your life now and pondering how you want to be celebrated or remembered after death. With the recent COVID-19 pandemic, many people have been forced into talking about creating and updating their wills and end-of-life wishes when they might have avoided the topic otherwise. But the movement does not advocate waiting for a pandemic to become open to discussing death.

The movement doesn’t have a leader or official structure, rather it has been organically self-organized and is reflected through various means.

In addition to the growing prevalence of death cafes and end-of-life doulas, numerous blogs and YouTube channels offer guidance and facilitate discussion for the inquisitive. “Ask A Mortician” has nearly 1 million YouTube subscribers; the Art of Dying Institute at the Open Center in New York is dedicated to an interdisciplinary approach that will “address the need for a cultural awakening around the theme of death and our mortality, how we die, and the consequences for how we live”; and the Conversation Project was launched to encourage more people to talk about end-of-life care—its starter kit has more than 1 million downloads.

The internet and, of course, social media have played a role too. Increased interconnectivity means that more people than ever before have greater access to knowledge about alternative approaches and perspectives to death and dying.

“I think it’s one of the healthiest cultural phenomena that I’ve seen,” says Drake Spaeth, Ph.D., chair of Saybrook’s Department of Humanistic and Clinical Psychology. “I love the organic, self-organizing nature of death cafes, and what is happening in families and communities around the loss of people who die—the beautiful ceremonies they’re creating on their own for the loss of loved ones. I think that’s what this movement really brings to the table. And like any sort of cultural revolution or transformation, we need to be very careful and take an honest look at ourselves and our egos at all times, in terms of the secondary gain or the sort of euphoria we’re getting from doing something unique and special.”

“I think it’s one of the healthiest cultural phenomena that I’ve seen ... And like any sort of cultural revolution or transformation, we need to be very careful and take an honest look at ourselves and our egos at all times, in terms of the secondary gain or the sort of euphoria we’re getting from doing something unique and special.”

Dr. Spaeth is also quick to mention that a more positive outlook does not entail the absence of grief. It is just a different way to understand our heartbreak after a loved one has passed. For someone facing a terminal illness, it can help them better comprehend the sorrow they feel.

“I like to say that grief illuminates us,” Dr. Spaeth says. “It is actually a beautiful process, even as it is the most painful type of experience we can undergo. It reveals our deepest humanity and reveals what we care about most. I would never want to take that human experience away from anyone.”

As increasing numbers of people open themselves to a more liberating relationship with death and dying, this cultural shift is having effects well beyond the collective psyche—it’s also impacting the bottom line of one of the most profitable industries in America.

The changing death care business

In 1960, roughly 3% of people who died in the U.S. were cremated. By 2019, the number had jumped to more than 50%. It’s projected to skyrocket to nearly 80% by 2040, according to the annual Cremation and Burial Report released by the National Funeral Directors Association.

Cremation trends since 1960

Percentage of U.S. cremations in 1960
Percentage of U.S. cremations in 2019
Percentage of U.S. cremations projected in 2040

The dramatic shift, in part, is a reflection of growing discontent surrounding the astounding price tags associated with traditional funerals—caskets alone can range from $2,000 to $10,000.

“The funeral industry has become far too commodified,” Dr. Gillespie says. “A patient dies in a hospital and turns into this alien lifeform that’s whisked off to the funeral home. It’s remade, waxed and polished, dressed, and laid out in an expensive casket. It’s turned into a McDonald’s assembly line.”

She adds the values in capitalist societies tend to prioritize profits over everything else, and in the funeral industry it’s no different.

Frustration with high price tags combined with the growing positive death movement is driving people to explore a wide range of alternatives for celebrating the deceased and disposing of their bodies.

In addition to cremation, which has soared in popularity, a diverse array of creative and more ecofriendly options are now available. For example, more people are choosing natural burials, which negate the cost and environmental impact of embalming. The company Eternal Reefs offers to use a mixture of concrete and your cremains to create new ecosystems for aquatic wildlife. And the process of promession creates a freeze-dried body before using vibration to break it down into an ecofriendly powder—perfect for those who may want their “ashes spread” but aren’t comfortable with the carbon footprint left by cremation.

“From a business perspective, there is opportunity,” says Tom Hayashi, Ph.D., Saybrook University’s program director for the Department of Leadership & Management. “I think, generally speaking, there’s more companies now being founded to help us all deal with death and dying. Companies are very much interested in the sustainability aspect of it. And because more people are open to discussing the taboo topic of death, it leads to new business opportunities, and opportunities to bring greater sustainability and social responsibility to this specific industry.”

A pillar of existential psychology

Saybrook’s legacy is forever intertwined with existential traditions. The current cultural and economic shift around the topic of death and dying has brought greater awareness to the field of existential psychology.

“One of the things that dying can teach us is to bring our whole selves to every experience,” Dr. Belton says. “This naturally brings us back to the legacy of Saybrook, right? When you talk about existentialism, and those core components of why finitude is so important to consciousness, it’s because it reminds us that life is short.”

The community has even discussed launching an end-of-life doula certification program. However, for now, many at Saybrook are happy to see a greater collective desire to face death with a new mindset.

“It is one of the things that gives me great hope amidst a lot of things that give me concern, because this idea of talking about death and the fears attendant to it, coupled with the advisability of facing it with courage, has been a mainstay in existential psychology,” Dr. Spaeth says. “It’s the awareness that one day we will die, which is the source of all our potential greatness. Either we can find the courage to face the fact that we have a limited span of time—and then use that time to create and leave some type of legacy—or we can neurotically avoid it and hide behind phobias, fears, and addictions. But we haven’t seen the reality of these ideas enter into mainstream discussion until very recently. And I hope that this movement can continue to move this conversation forward.”

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