Structures and Faith Aside: making space for spiritual conversation at the end of life
Erik Isaksson lives outside of Lund with his wife Ulrica and their three children. He loves music! He’s a minister in the Church of Sweden, and has spent many years within palliative care, both in Sweden and Botswana.
This interview took place on the 9th of April, 2018.
“So, I am an ordained minister in the Church of Sweden (Svenska Kyrkan) since 1995. And a big part of that working time has been in hospital chaplaincy — which has mostly been here in Lund, and in Botswana, as well. They are very different settings, but with a similar closeness to dying people and their families, obviously. And that has been a part of my work which has been one of the most meaningful and most rewarding. I would say even ‘happy,’ in a way. People ask sometimes, ‘is it not tough to be close to people who are dying? Isn’t it hard work?’ and in one way it is, but it’s also great to be allowed to come straight into the issues that seem to be really important to people. I think given the fact that I am a minister in that context — not necessarily because there’s a faith structure, or a dogmatic structure, but because there’s a kind of openness to existential issues and issues of spirituality — there is more space for being open about feelings and emotions.
And if you were to ask me about what kinds of conversations typically circle around with people who are dying and their families, I would say it’s 90% around their relationships in the here and now, not really the things that happen after dying — like whether or not there is a heaven or hell. What is here and now, what is most important to me at this time. And that’s what I mean when I say it’s a good experience, because it’s a privilege to be close to people in that way, at those times and have those conversations. So, to be very frank, I don’t know how much it effects the matter, the fact that I’m a minister in the Church of Sweden. Or what that exactly means in that context, other than that most of the time, it creates a room or a space that signals that there’s some kind of conversation that is possible or allowed.”
“And also, it’s been really encouraging to realise that for many patients, it’s not important which denomination the chaplain or counselor comes from. I’ve been meeting Muslims and I’ve asked them, ‘do you want me to call for an Imam,’ and they’ve asked me, ‘can you pray for me? Do you believe in God?’ And I say, ‘Well, yes I do,’ and then it’s fine. To me, that is also very hopeful — that, it’s not my belief, or the dogma, or that God is this and this and that, but rather that it’s the personal, and the longing for life, and the conversations about relationships and love that matter. That, I think, is the core.
That’s one thing I’m thankful for, having the profession that I have. To have intimacy with people at these very special times. I’m guessing that it can happen, in other ways, from other professions, and I think for example, DNS (De Nödvändiga Samtalen) at Palliativt Utvecklingscentrum, is an ambition to give doctors an opening to explore the emotions around death and dying. Emotions around getting a difficult diagnosis or test result. And also having an awareness of, or being sensitised to, the all the existential issues and questions that most of the time come with that.”
“Sweden and much of Northern Europe are quite secularlised. Having said that, I also want to say that my sense is that there is a big openness to talking about spirituality and spiritual longing, maybe not always with the terminology from the Christian structure. And Christian rituals around death — the funeral is one. It is not a must, but many people have a funeral. I would like to say that the funeral is still a very important ritual. And I do think it’s important to have a ritual for the process of grieving. I think it helps. Death is, in a way, a very bizarre thing to understand. If you are in a room with somebody who is one minute still breathing, and the next minute is not — the visual impression is just so similar, only that the stomach is no longer pumping out breath, but something is fundamentally changed. And funerals give us a chance to engage in this earthly context of relationships, to see when relationships are over. To ritualise that, I think, is important. I heard the other day that the numbers of people who attend funerals has gone down — and these days, there are more people who die and get buried without a burial or ritual. I haven’t been working in a congregation for many years, but when I did, I occasionally did have funerals where it was just me and a musician and the undertaker. No relatives or friends present.”
“I think in a few senses, I think there’s a huge poverty in the Swedish context when it comes to offering clearer structures or guidelines or social ways of grieving. I think people often get alarmed and don’t know what to do. People think, ‘Should I call the widow? What should I say? Or what if I say the wrong thing?’ I had been working in Botswana a couple of years with Palliative care. And in Botswana, I saw houses being emptied of all furniture, mats being laid out and people would sit down on the floor for three days just to share stories and tears and laughter and meals, just to be together.
I have a lot of experiences that I am reluctant to make any generalisations from because even in Africa, there is still a strong taboo to talk about death and dying. But having said that, there is arguably more acceptance. Death is not hidden away the same way it is in Swedish society. I mean, people there are often confronted with the person dying in the home — and funerals are massive. Often a hundred or more people, lasting many hours. And when someone dies you will notice on the street the huge funeral that follows. Sometimes it can be a burden for the family because there is an expectation for food being served, and it’s a lot of hard work to hold memorials, which can be financially and otherwise tiring for people. But on the other hand, I think we have too little of that here. I think it is helpful to get practically involved with the death of your loved one.”
“As I’ve said before, to be close to a person, and quickly come into something that is very essential – that is a huge privilege in my work as a chaplain. I would go home from work feeling enriched rather than exhausted or burdened. And thankful to come home to my family. And work in the chaplaincy does affect my experience of being alive as well. Today I am alive and well. What about death? What will I do about that? It provides gratitude and also adds a kind of sharpness to daily choices that I make. Not in a stressful way, of being constantly aware of the choices I make, but in a sort of profound way. It does matter what I do, and what I choose. Also, I like to use — because it provokes us a bit, the word ‘selfish.’ To assist myself and people I meet to make ‘selfish’ choices. And with that, I mean making choices that allow you to think that your life does matter. And to take myself seriously, and take my choices seriously, helps me to be more genuinely present in my relationships with other people.”