Addressing the Psychospiritual Distress of Death as Reality: A Transpersonal Approach

Considering the exponential growth in knowledge today, both the physical and social sciences are increasingly re-examining the philosophies of knowledge development undergirding their clinical and research practices. More and more, accepted knowledge bases, established perspectives on truth, and traditionally held belief systems are being called into question and re-evaluated in light of dramatic new understandings of the universe. Social work scholars are calling for a reconceptualization of the reductionistic and dichotomizing thought of empiricism that social work has inherited from the classic sciences (Canda, 1988; Cowley, 1993; Hartman, 1990; Imre, 1984; Weick, 1987). Empiricism is defined as knowledge acquired by sensory experience or knowledge capable of detection by the five human senses (Wilber, 1983). These scholars are requesting that the profession move beyond empiricism and view social work as the holistic system of activity that it is. In doing so, they are laying the philosophical groundwork for the reconciliation of science and religion and are moving toward a transpersonal perspective, that is, a perspective beyond the person or beyond ego. According to Washburn (1988), the primary objective of transpersonal theory is the integration of spiritual experiences into the larger understanding of the development of the human psyche. He further asserted that transpersonal theory assumes that the ultimate aim of human development is spiritual fulfillment, and thus it is only from the spiritual perspective that human nature can be fully understood. Transpersonal development, then, is the genuine synthesis of psychological and spiritual perspectives in relation to the nature of the human psyche. The transpersonal position assumes that everyone has impulses toward an ultimate state and that these impulses are continuous whether or not an individual is aware of them at any given time (Sutich, 1980). Reed (1987) described these impulses as "a human propensity toward transcendence" (p. 335) and indicated that this phenomenon is particularly evident as an individual moves closer to death. Problem Statement Many traditional Western psychologies fail to recognize spirituality and transcendental needs as intrinsic aspects of human nature (Walsh & Vaughan, 1980; Welwood, 1983) and therefore may not be meeting the needs of terminally ill people or those in the process of confronting their mortality. To confront one's mortality is to come to the acute awareness, sometimes for the first time, of the vulnerability of the body ego. The transpersonal perspective is based on the principle that there are powerful forces within the psyche propelling individuals toward greater wholeness and integration beyond the ego (Bodian, 1989). However, traditional theories of psychology, on which some social work interventions are based, are highly ego identified in their focus and have heretofore lacked a theoretical framework for an ego-transcending phenomenon such as death. Thus, terminally ill patients, those facing a life-threatening illness, or individuals in the process of confronting their mortality often are reduced to approaching their illness, their dying, and their eventual death from a fearful and reactive stance. Although death is an integral part of human existence and is in fact the final stage in the life cycle, the ultimate opportunity for growth it may provide if explored is often missed when confined within the parameters of the ego. However, more recent theories of holistic social work practice based on the interactional perspective (Shulman, 1991, 1993) promote the principle of the mediating transaction of person and environment, a perspective unique to social work (Germain & Gitterman, 1980). This mediating transaction allows for a dialectical synthesis and the possibility of the redefinition of experience beyond the limits of ego. Redefining one's attitude toward death to formulate a personal death perspective that serves as a comfort rather than a threat often requires the individual to move beyond his or her commonly held beliefs. …