This month, I’ve had the great joy of having a real conversation with Frank Ostaseski, the author of The Five Invitations, one of the wisest people I know. Frank was the cofounder director of the Zen Hospice Project and he is the founder and director of The Metta Institute and is considered a pioneer of endearing and compassionate end-of-life care. His perspective on life and death is full of revelations and talks about his work in a way that makes us seriously think about the matter.
Gáspár: The Five Invitations is one of the greatest love messages for life, ever. Thank you, Frank, for this book and for everything it has brought in my life. I would like to start our conversation with the beginning: What was your motivation behind this book and how was the process of writing it?
Frank Ostaseski: I had two primary motivations. First to honor the people who I had the honor of accompanying through their dying process. They generously shared their most intimate moments with me. I consider them my beloved teachers. In healthcare and the culture at large we often describe the way we meet the dying process as, „making the best of a bad situation“. This attitude robs death of its powerful significance in our lives. It leads to people dying in fear and distress. I thought I might be able to help change that attitude and help us all to discover how a reflection on death can be life affirming. Perhaps to illustrate how a contemplation on death can help us to live life with more wisdom and love.
Gáspár: The book is an invitation to sit down with death and have a cup of tea with her. The only member of my family that I can talk with openly about death is my grandmother, who is in her 80s. Still, I feel that we, humans, have a great hunger for this subject. How and when can we open up a conversation around death with one’s family and friends?
Frank Ostaseski: the vast majority of people in the USA die in a way they would not choose. Often in hospitals surrounded by strangers and machines instead of their loved ones.
Having a conversation about end of life planning is a meaningful and loving act. It may be awkward even difficult at first. the Conversation Project in the USA has some very good suggestions on starting this type ofdiscussion.
I suggest starting with open-ended questions around the dinner table or on a walk in the woods. An honest conversation can bring us closer together. Don’t give advice. Just listen. Begin with life affirming questions.
- What does a good day look like for you? What really matters to you in this life?
- What or who supports you during difficult times?
- If you had only a few months to live how would you like to spend them?
- Do you have anything left unsaid or that you would like to say again to your loved ones? If you couldn’t speak for yourself, who would you trust to make decisions for you?
- What do you think happens after you die?
Gáspár: There are many powerful stories in your book, that one can only be touched or resonate with. Many of the stories I read made me think and ask myself some key questions about life and death. When did your professional concern with this subject begin and what was the reaction of those around you?
Frank Ostaseski: The introduction to my book answers these questions. My professional work began with the AIDS epidemic in San Francisco Bay Area where almost 30,000 people eventually died of this disease. Many friends were dying or caring for their loved ones. I saw this outpouring of care as one of the greatest spiritual movements of the 20th century. In co-founding Zen Hospice Project, I thought there was a natural match between people cultivating what I would call the listening mind in meditation and people who need to be heard at least once in their life. People who were dying with little or no family or social support. My professional work was a natural response of the heart.
Gáspár: I read in your book that you worked closely with Elisabeth Kübler-Ross, probably one of the most influential voices in the psychology of loss. Yet your beliefs and teachings are Buddhist. What does Buddhist philosophy know about death and the Western world knows too little? What is the connection between what you have learned from Buddhism and what you have noticed about Dr. Kübler-Ross?
Frank Ostaseski: I did not work with Elisabeth Kübler-Ross, however, I did study with her and she was an important mentor in my life. I think Elizabeth was willing to face suffering directly without turning away. I believe the Buddhist teachings on compassion are rooted in this action. One way to heal the suffering in our lives is to turn toward the experience to see what it has to teach us. If we are continually avoiding the experience of our suffering, we won’t develop a capacity to effectively meet it in the future.
Empathy, the capacity to „feel with another’s suffering“ can be a doorway to compassion. But empathy alone is not enough. In fact, people can become easily empathetically overloaded. This occurs frequently in healthcare. Some professionals suggest treatments for their patients to manage their own personal distress from empathetic over arousal. This action is „me focused“. Compassion is an action to relieve suffering and that is „other focused“.
Gáspár: I loved the idea that death is not waiting for us at the end of a long road, that she is the secret teacher helping us to discover what matters most. What is different in the life of people who live with the consciousness of death and do not hide behind denial? How is the quality of their life?
Frank Ostaseski: I believe that when we acknowledge the precariousness of our life, we also come to appreciate is preciousness. Then we don’t want to waste a minute. We tell the people that we love, that we love them. I think this makes us kinder and gentler with one another. We learn to live with less fear and learn to embrace both the beauty and horror of this human life with more equanimity and integrity. Often, we misunderstand the term „denial“ and try to manipulate people into some semblance of acceptance. However, I think it is wiser to think of denial not as he fixed position but simply as an expression that articulates the idea „that I am not ready for this right now“. I believe that is kinder. Too often we are trying to impose our ideas on the others as a way of managing our own fear of dying. In my experience, dying is hard enough without our needing to accommodate other people standards about how we should die.
Gáspár: Honestly, I was also impressed by the fact that, at the end of life, we, humans, are looking for the answer to two questions: were we loved and have we loved? And your invitation is not to wait until we reach the end of life, but to act „here and now“. What do you think is blocking our actions and what can we do to fully embrace our lives?
Frank Ostaseski: This is a complicated question. However, I might suggest that the number one obstacle to opening more fully to love is fear. And the single greatest cause of suffering is the belief need to be separate in order to be an individual. This belief is particularly prevalent in western culture. Each of us is unique and individual but not separate from the whole. No more than the waves are separate from the ocean. The wise archbishop Desmond Tutu introduced the world to the term „Ubuntu“ from his native South Africa. The term is generally translated as „We are because we belong“. That is just not an ancient spiritual idea. Modern science validates this truth.
Interconnectedness is a central tenant in Buddhist teaching. Everything is entirely dependent on other things. And an apple seed cannot be a fruit. The right conditions, a suitable climate, adequate sunshine, moisture, and nutrients from the
soil in order to grow into a tree and bear fruit. Without relying on other factors. Feeding the fire of separation leads to so much unnecessary suffering in our world.
We are not separate, but we are also not the same. When we recognize this to be true the way we care for each other fundamentally shifts. This understanding of our mutual belonging is at the heart of my work.
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The world has never been more connected, yet people are lonelier than ever. We live in the existential trance of separation. The absence of belonging may be the great silent wound of our times.
Gáspár: Your life experience has brought you close to death not only as a professional who helps the dying, but also as a man who has had a heart attack. How much did this experience influence your perspective on death and in what sense?
The experiences related to my own illness give me a greater sense of empathy for others who are ill. My firsthand experience of helplessness, dependency on others and contact with my human vulnerability give rise to natural compassion which enables me to stay present for the suffering of others.
For years I have carried with me a quote from the humanistic psychologist Carl Rogers that speaks to the healing power of human presence, that was strengthened through my life-threatening illnesses.
„Before every session, I take a moment to remember my humanity. There is no experience that this man has, that I cannot share with him, no fear that I cannot understand, no suffering that I cannot care about, because I too am human. No matter how deep his wound, He does not need to be ashamed in front of me. I too am vulnerable. And because of this, I am enough. Whatever his story, he no longer needs to be alone with it. This is what will allow the healing to begin.“
My areas of therapeutic interest include dream analysis. This is why I take the liberty of asking you a more personal question.
Gáspár: You are so in touch and aware that death is inevitable, but also extremely intimate. Did you ever have a dream regarding death that made a strong impression on you?
Frank Ostaseski: Yes, I have had many such dreams about my own dying.
After my heart attacks I had dreams of the patients that I had cared for coming to be with me. Sometimes, they would offer advice, other times they expressed gratitude, and other times they simply sat with me in silence. These dreams continued for several months during my recovery. The dreams were vivid, almost like visions and I woke from them with a great sense of belonging and that I was never alone in the challenges of my illness.
When I teach meditation I often say to students, „you are never just sitting for yourself“. We are always sitting for and with all beings.
Gáspár: Of the five invitations in the book, the second one, „Welcome Everything, Push Away Nothing“ is the most difficult for me. It is difficult for me to be receptive to whatever presents itself too me, without opposition or rejection. And I imagine that this can bring more peace in my soul and in my existence. And the question is: What sacred connection did you find between suffering – healing – love?
Frank Ostaseski: To „welcome everything and push away nothing“ doesn’t mean that we must like or agree with what we are presented with in this life. It just means that we are willing to meet it. To see what it has to teach us, to learn from the experience rather than only rejecting it. This cannot be done with only a cognitive understanding. It does not condone unskillful behavior, nor does it excuse the evil actions in our world. It is the beginning of a process of discovery. One that will require courage and flexibility. It engenders in us a willingness to learn, to be open, to take risks, and to forgive constantly. It is not an act of will. It is an act of love.
Gáspár: Our conversation comes to a close and I still have many questions for you, but I select only one: What does it mean to find the truth and how do we know that it is the truth we have found, and not something else?
Frank Ostaseski: Truth is a subject over which there is much debate. In my tradition we speak of the „paradox of two truths“. For example, about belonging. There is the absolute truth, of our connection with everything and the truth that we are not separate. And, there is also the relative truth that we each come into the world with different conditions and histories and those differences shape our individual identities. As I said earlier, we are not separate, but we are also not the same. Embracing this paradox is crucial to our freedom.
Sorry, there is not one single, ultimate truth. That is why the invitation „Cultivate a Don’t Know Mind“ is so important. It speaks to a mind that is curious, not fixed on a single solution or belief. It is a mind that is open rather than closed.
Our intelligence and clear minds can help us discern. However, it is our wise heart (not emotional heart) that reveals what is true in our life.
We need to bring this discerning mind at wise heart the situations of inner and outer conflict. Some degree of stillness is useful so that we can observe the minds old opinions and allow us to understand things in a fresh new way.
In the Buddhist tradition there are five things to consider before speaking it may be useful in discerning right action in this area.
- Is what we are about to say factual and true?
- Will what we say be helpful?
- Are we speaking with kindness and good will that is hoping for the best for all involved?
- Is it endearing? Spoken gently in a way the other person can hear?
- Is this the right time to speak? Can it be heard now by the other?
All of these are interdependent and determined if what we were about to say is beneficial.
I hope that my words have been beneficial. I hope this interview will be of some small service to your readers.
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