Yoga Therapy and End of Life Transition

At the age of 47 and merely 28 days after his diagnosis, Andrew, my husband of nearly 18 years, passed away. He was diagnosed with colon cancer; a cancer that, for individuals of his age, often goes undetected and unnoticed until it is well-advanced. After the initial onset of his primary symptons of pronounced abdominal discomfort, an ultrasound revealed masses in his colon with pronounced liver involvement. Andrew’s prognosis was soon determined terminal.

As the days followed, so too, did his pain. Even with a prescribed mix of high-level medications, his pain persisted. It became all-consuming. Coupled with this was the rapid decline of his cognitive function: Andrew’s ability to articulate his needs or express himself deteriorated as the cancer rapidly ravaged his body.

With this awareness, I became his voice and I assumed the role of primary caregiver. I assessed what was most needed and essential as the days drew on. I was faced with having to watch the love of my life, my best friend, and the father of our three children slip away: His weight decline, his pallor wane, the light in his eyes fade. I was watching a man die right before my eyes. I think it was then that I harnessed every bit of knowledge and wisdom I had cultivated during my studies in Yoga Therapy to tap into my intuitive sense of empathy to discern how to best serve him. It was then that I discovered that this is where the true gift of yoga therapy exists. It is this sense of awareness that enables us to be completely present for those we serve. As it relates to end-of-life care, the most poignant and powerful aspect of our practice is to retain and honor our abilities to maintain present moment awareness. The vehicle through which I was able to foster this was through the breath: The pranayama. I didn’t jot-down a protocol. I breathed into my lungs, allowing my diaphragm to descend, my belly to expand, and I listened to what my heart was telling me. And I suggested to Andrew that he do the same.

It was then that I began to share my breath with Andrew. We matched breath-to-breath. In this manner, Andrew, I could sense, felt that we were together, unified. His breath was just as capable as mine at that point. During this very delicate time, I shared the idea with him that although he could not control what was happening to his body, nor could he control his cancer, he still had the capacity to control his breathing. I invited him to use his breath as a vehicle in which to help his body ‘transition.’ As in yoga, our highest aim is to align the Individual Spirit with the Universal Spirit, and so with each breath, I knew my husband now understood that his breathing was a metaphor for the unfolding of his path forward.

I still use this same breath practice to help me stay present as I work through my grief. To that end, and in our work as yoga therapists, I would offer the simple, yet essential, tool to hold space via the breath for our clients as well as for ourselves. In our work, we can’t always offer someone a ‘tool box’ of asanas, mantras, and mudras, but we can offer the power of the breath to liberate one from their own suffering. Despite their present condition or prognosis, every person has some ability and capacity to control the in-and-out breath, to invite in the spirit and essence of prana, until it is no more. For however long this lasts, the individual still has control over the most basic and profound function of life. In his final days, Andrew had the wherewithal to, at one point, take my hand, look me in the eyes, and thank me for sharing in this most precious of gifts.

As the profound invocation presented in the opening of B.K.S. Iyengar’s Light on Pranayama suggests,

Who re-united Prakrti (nature) with Purusa (Self)-

May He bless the practitioner

By uniting his vital energy-prana-

With the Divine Spirit within.

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