Creative Cocooning: A Process for Successful Change and Transition

by Pat McGuire


A cocoon is a safe place for dramatic change. Cultivating the courage to change is the purpose of cocooning. Personal losses, fears, and brokenness can then be used as catalysts for metamorphosis and growth. The concept of “cocooning” is important throughout the life cycle during times of transition: divorce, job change, entering/leaving the military, death, illness, mid-life changes, identity crises, aging, etc.

To achieve pervasive peace, we have to learn how to successfully navigate these changes — how to grow into deeper dimensions of ourselves so that we can accommodate new demands. These times of transition can be fraught with resistance and turmoil. Learning how to navigate transitions so we can let go of who we are and open up to who we are capable of becoming is invaluable. We call this process “cocooning.”

We spend much of our daily lives like caterpillars: mindlessly crawling along feeding habits that give us comfort, power, and security. Then, something (divorce, job change, death, illness, general disgruntlement, mid-life changes, identity crises, aging, etc.) interrupts our crawl, causing us to look beyond our horizons and long for butterflyness – a yearning that completes the destiny we were born to fulfill. The transformation from caterpillar to butterfly is largely ignored and avoided in the “feel good” culture that we live in. Yet, my experience has led me to realize that, paradoxically, the cocoon holds the secrets of healing. It is in the cocoon where successful transformation occurs.

Sadly, society feeds on false images that convince us that we can become butterflies without having to become cocooned. Advertisements and other cultural influences promote one of two approaches:

  • Continued caterpillaredness (“You don’t have to change anything. Keep doing what you’re doing. Just buy our product or do what we tell you.”)
  • Become a butterfly (“Buy our product and do what we tell you and you will magically transform without having to make any adjustments.”)

Neither of these approaches produces effective change. They only create frustration due to the repeated disappointment and guilt that is created! Thus, we don’t learn the cocooning process.

Yet, cocoons have much to teach us…
A crawling caterpillar spends most of its life devouring its food source, but when it is time to become an adult, it wanders away from food. It finds a sheltered, safe place to PUPATE, or transform, into an adult. It sheds its skin, revealing a protective shell known as a chrysalis, which protects the caterpillar while it transforms.

During this metamorphosis, much of the caterpillar’s body is broken down. It actually LIQUIFIES! During this liquified state, the cells are called IMAGINAL CELLS; they are like stem cells in humans. These cells become undifferentiated, developing the potential to become any type of needed cell. This transformation process is known as holometabolism and takes about two weeks for most species.

Thus, the “cocooning” process is a safe place for dramatic change. Change requires that we:

  • Shed our skin and liquefy old habits and attitudes that keep us stuck in “same.” This means letting go of something we’re grasping (attitude, belief, relationship, habit, expectation, or even life itself). This invokes fear and resistance because it takes us away from our comfort zones. And,
  • Build wing structures by listening to the Grace of our Being calling us into Butterflyness where we can redeem our destiny. This means opening up to something different, new, uncomfortable, uncertain. This, too, invokes fear and resistance because it takes us away from our comfort zones.


➣ Changing our Relationship to the Past

by Deborah Grassman


The process that precipitates pervasive inner peace is forgiveness. I have to forgive every disappointment and interruption that interferes with my experience of the moment. Every time I am told, “No” by God, another person, or life itself, I have to actively forgive the world for things not going the way I had hoped. Then I can reencounter the ever-present now; I reestablish peace in my world. I call this my journey from “Oh no!” to “Oh well…”.

One time, I asked my mother, “Who is your best friend?” She replied, “Whomever I’m with at the moment.” I liked that answer. I hope I can live out that wisdom. Similarly, I hope that I can answer the question, “What’s your favorite thing to do?” with “Whatever I’m doing right now.” Then, I’ll know that I’m living in the now, and the key for doing so is forgiveness; I will be able to forgive the world for everything that is not “now.”

Forgiveness can have very practical applications. I jog along a two-mile rural road. Trash litters the edge of the road, corrupting its beauty. I frequently complained about the litter with a tightness in my jaw and neck as I did so. Then I realized that I had a choice: I could forgive the litter for being there and enjoy the landscape anyway, or I could pick up the litter. I decided on the latter. My garbage bag in hand, I picked up each can and wrapper. Initially, I was thinking mean thoughts about the litterers. Then, I realized that I was littering my mind with resentment, robbing me of “now-ness.” I switched to blessing each litterer, and actually had great fun on the rest of my clean-up adventure. Forgiveness is like that; it transforms moments so I can live in the vitality of the now.

Desmond is a Vietnam veteran who knew how to maintain peace in the now. During a Quality of Life meeting with him, our team acknowledged his military service, which he appreciated. “’Nam vets never got their due,” he told us. We offered an apology for the way he had been treated when he returned from the war. When asked how he was doing spiritually, he told us, “I’m good in that department because I always keep my feet wiped.” He explained that some people don’t keep their “feet wiped” on a daily basis. Instead, dirt accumulates, surfacing as they approach death, which was the case with Jim.

Jim was a World War II vet. He was weak with a cancer that would take his life in a few days. After I introduced myself and we spoke quietly for several minutes about hospice care, I asked him if there was anything from the war that might still be troubling him. He said there was, but he was too ashamed to say it out loud. Motioning me to come down close to him, he whispered, “Do you have any idea how many men I’ve killed?”
I shook my head, remaining silent, steadily meeting his gaze with my own. He continued.

“Do you have any idea how many throats I’ve slit?”

Again I shook my head. The image was grim, and I felt my eyes begin to tear. Jim was tearful too. We sat silently together, sharing his suffering. No words needed to be said. This was a sacred moment that words would only corrupt.

After several minutes, I asked, “Would it be meaningful if I said a prayer asking for forgiveness?”

He nodded. I placed my hand on Jim’s chest, anchoring his flighty, anxious energy with the security of my relaxed palm. My prayer, like any praying I do with patients, reflected no particular religion. “Dear God: This man comes before you acknowledging the pain he has caused others. He has killed; he has maimed. He hurts with the pain of knowing what he did. He hurts with the pain of humanity. He comes before you now asking for forgiveness. He needs your mercy to restore his integrity. He comes before you saying, ‘Forgive me for the wrongs I have committed.’ Dear God, help him feel your saving grace. Restore this man to wholeness so he can come home to you soon. Amen.”

Jim kept his eyes closed for a moment, tears streaming down from unopened lids. Then he opened his eyes and smiled gratefully; his new sense of peace was almost palpable. It was a reminder to me of just how heavy guilt weighs.

The reason I prayed for Jim with my hand on his chest is because anxious energy usually rises. Think about when you get excited. Your voice usually gets higher; energy gets flighty. You might place your hand on your chest or near your throat, unconsciously anchoring yourself. A calm, centered person’s energy usually resides lower and deeper. If a calm person places his or her hand on an un-calm person’s sternum, it can often help this person feel secure, more weighted, less anxious. I often sit with my dying patients with my hand on their chest. I teach their loved ones to do the same. (See “Hand-Heart Connection” under tools.)


1-Day Workshop: Forgiveness & Healing

Would you like to recover the energy of pieces of self you may have knowingly or unknowingly lost through: self-disregard, heartache, neglect, abuse, trauma, death, or war so you can inhabit yourself more completely? Deborah Grassman joins forces with Dr. Abi Katz to provide an unforgettable day. E-mail to schedule them to come to your event.

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Integrative Letter Writing

Myths & Rituals

➣ Myths and Rituals: A Format for Healing Soul Injuries

by Deborah Grassman


The Power of Myth, a book by Joseph Campbell, awakened me to the value of myths and rituals and their relationship to the change and recovery process. To my scientific mind, myths were untruths. Yet, here this brilliant professor was showing me how myths spoke truths about personhood and humankind. Just as parables (stories that are not “factual”) are used because words cannot completely embody truth, so too do myths embody larger truths. Myths use symbols that access the energy of the unconscious. Campbell reminds us that truth is often hidden in symbols, requiring nonphysical eyes to see it.

Joseph Campbell spoke similarly about rituals. To me, the word “ritual” meant a habit that was empty of meaning; it meant actions that were robotical, automatic, habitual. However, Campbell writes that the rituals to which he speaks are just the opposite. They are filled with meanings that provide maps for navigating change. They provide order in the midst of chaos, helping things fit together. Their purpose is to transform the experience by bringing congruence to what was initially incongruent. The ritual does not fix the problem but rather opens us up to a deeper interior dimension that allows us to be at peace with the changes that have occurred. Just as myths speak a larger truth of the unconscious, so do rituals.

The term “ritual” often has a negative connotation; people sometime associate it with cults or gangs. Unsavory groups do take advantage of ritualized forums, but they also use forums such as speech and books to disseminate their message. Yet, the rest of us don’t stop speaking or reading for fear it might link us to something sinister; neither should we fear rituals. In fact, the more I learned about rituals, the more convinced I became of their therapeutic value. The more I let go of my preconceived ideas about what I thought rituals were, the more I became open to their effectiveness in reckoning with change. I realized that in times of uncertainty, loss, and change, therapeutic rituals provide a format for letting go of the old, integrating the uncertainty of change, and redefining a different, hopeful future. I became so convinced of the value of rituals that I designed my graduate school master’s thesis on the relationship between rituals and hope. I embarked carefully upon the study of designing therapeutic rituals that could be used clinically to provide support, guidance, and hope for hospice patients and families as they faced the uncertainty of changes that accompany death.

For healing to be complete and heartfelt, the unconscious mind must be engaged. Rituals provide access to the energy of the unconscious. Once these rituals are valued, I hope that people will learn how to develop them to navigate important changes in their lives. When combined with integrative letter-writing, it becomes a powerful tool for abiding hardships and reckoning with the changes needed to create peace and healing.

A gaping hole in our society exists that would benefit from a therapeutic ritual. This gap is left during war — when soldiers are killed. Their surviving comrades are given no time or format to grieve. Stopping to grieve would get you killed. Plus, “good” soldiers don’t cry. So where does their grief go? Mostly, the grief goes into the unconscious where it remains hidden until a later loss triggers its release. Currently, I have been challenging hospices and funeral homes (specialists in bereavement and grief recovery) to meet this societal need be offering an annual ceremony specifically for combat veterans so they can come forth to finally be able to honor their dead comrades and honor their own grief. Pat and I developed such a program. It originated when we were providing clinical consultation services to the staff so they would better understand how to care for the unique needs of veterans as they die. I asked a Vietnam Veteran, “Is there anything from the war that might still be troubling you now?” The veteran, hardly able to talk due to severe COPD, nodded his head. Then he said, “My brother and I both went to Vietnam, but I was the only one who came back.” Tears slowly ebbed down his cheeks while we waited in calm silence. Then, he added: “I didn’t even get to go to his funeral.”

We explained that we could design a ceremony to honor his brother and create space for his grief. We explained the value of unmasking unresolved grief. The veteran’s face visibly lightened and he eagerly participated in the designing of the service. That’s when we realized the gaping wound in many of the veterans at the State Veterans Home, so we invited all of them to the service to mourn their comrades fallen during battle. About 25 showed up! There were many tears as these veterans allowed themselves to confront their losses and begin moving through them.

The value of rituals cannot be underestimated, especially because ritual has been a successful aspect of military culture throughout the years. An effective ritual consists of three stages: separation, transition, and integration (see subpage on the 3 stages).

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Personal Healing

➣ Re-owning & Re-homing Pieces of Self

by Deborah Grassman



No one taught me how to fail. No one showed me how to lose, and because I never learned these things, I felt alone when they occurred. Sometimes, I felt more than alone. I felt incompetent if I didn’t win; I felt rejected if I wasn’t the chosen favorite. I felt worthless or guilty if I couldn’t please someone. As a result, pieces of myself got lost, like puzzle pieces that no longer fit into the big picture. I spent the first half of my life running from my losings and failings. I’ve spent the last half learning how to show up for the hidden treasures they contain. I discovered that, paradoxically, the things I had been so fearfully fleeing were the very things that would free me to grow into my larger self—the hero that lies within. The secret for growing into my larger self was that I needed to learn how to let go of who I was so I could open up to the person I was capable of becoming.

I have come to conceptualize a three-step process that facilitates access to the interior hero. The three steps are:
• Abiding: Showing up “openheartedly” to all of the emotional dimensions of life: the good, the bad, and the ugly, and more importantly, embracing the part of self that is generating that feeling.
• Reckoning: Changing our relationship to problematic situations, relationships, or aspects of self by cultivating the honesty, courage, and humility to face the source of distress.
• Beholding: Experiencing a newfound peace with the circumstance because the relationship to the problem has shifted. As a result, we feel at one with our soul.

I believe that we are born whole with an imprinted destiny we are designed to fulfill. Each time we close down to a feeling we don’t like, the part of self experiencing the feeling is disconnected from the whole; we lose our integrity by closing ourselves off from the message this silenced self is trying to tell us so it can be rejoined to the conscious self. We turn away from the very piece of self that we need to be facing. More importantly, we lose the energy of this exiled self. Failing to gather these pieces of self means we do not inhabit ourselves completely, distancing ourselves from our imprinted destiny. To the extent that we don’t completely inhabit ourselves, we live an unused life. The abiding, reckoning, and beholding processes facilitate gathering these aspects of self so they can be welcomed back home, and we can regain our integrity.

The abiding, reckoning, beholding process has practical applications in daily life. Although not as dramatic as stories in my book which highlights the abiding-reckoning-beholding process, the following example provides insight into the practical application.

On the first day of our vacation to the canyons in Utah, my friend Shaku said to me, “Teach me more about abiding.” She was participating in a book circle based on my book, The Hero Within. The group was studying the chapter on abiding.

“But you know how to abide already,” I responded. “You’re a good abider,” I laughingly said.

“I want to be better,” Shaku responded.

I didn’t think much more about it until a few days later. I had rented a bicycle for the day. I was told there were two routes I could consider: a tree-lined bike trail that meanders along the river or a trail that hugs the ridge at the city’s edge. I chose the former. I was sorely disappointed. Interstates and traffic noise abounded. The river was low and I was unable to see the water beneath the tall weeds that flourished on the banks. I never did find the “tree-lined” portion of the trail. Clearly, I had made the wrong decision. I returned to the Bed and Breakfast Inn where we were staying, reporting my disappointment to Shaku. She listened sympathetically before responding.

“That’s okay. At least you got to see the city,” Shaku said.

“I had no desire to see the city. I came out here to see the terrain so I feel like the day was wasted,” I replied.

“It’s not wasted if you learned from it,” Shaku persisted.

“I’ve invested a lot of time and money to be here. I’m just disappointed. That’s all,” I replied.

“You’ll be back. You’ll know where to go next time you come here,” Shaku said trying to reassure me. I didn’t feel reassured.

“Shaku. I’m not coming back here. This is a one-time deal.”

Shaku was at a loss for words. She wanted to console me and it wasn’t working. That’s when I remembered her desire to become more intimately acquainted with abiding.

“Shaku. I’m okay with my disappointment.  It’s not going to ruin my vacation. I’m not afraid of disappointment. What would be helpful is if you wouldn’t be afraid of it either. Stop trying to talk me out of it by trying to make me think positively. If you’ll just abide my disappointment with me, then I’ll be able to figure out apositive relationship with my disappointed self.”

Shaku looked at me with excitement in her eyes. “I get it! I get it! I get it!” she exclaimed. She was like a kid in a candy store who had just been given her long-awaited favorite flavor of gummy bear.

Reckoning – changing my relationship to my disappointed self…that came next. I decided to drive up to the canyon ridge at the edge of town to survey the bike trail there, considering the possibility of renting the bike an extra day. But, alas, although the trail was nice, it paralleled a busy street abuzz with traffic noise. We drove out past the edge of town and spotted a tell-tale brown sign indicating parks or points of interest. As soon as I turned into the state park, I felt like I had entered the gates of Paradise. This would be my dream bike ride. There was just one problem. It was 10 miles outside of town – 20 miles roundtrip plus biking the canyon, more than I wanted to do in half a day. An idea started formulating…

“Let’s see if the back seat goes down,” I told Shaku. Our rental car was tiny – so tiny that our large suitcase couldn’t even fit in the trunk. Shaku looked at me skeptically.

“Haven’t you always wondered what it feels like to be a sardine in a can?”

“Not really,” Shaku lauged, “but I’d like to now.”

With a little rearranging, grunting, and bicycle-chain oil on our hands, we maneuvered the bike into the back seat/trunk. We were ready for tomorrow’s canyon adventure!

“We can thank the disappointed part of Deborah for figuring this out,” I told Shaku.

“What do you mean?”

“If I would have tried to shut down my ‘disappointed self’ with positive thinking or ‘rising above’ the situation, I would have lost her energy – her vitality. By abidingwith my disappointment without fear and without trying to control the outcome, Iused my disappointment to expand me and get closer to my intentions – to what’sreally important to me. My ‘disappointed self’ gave me hope to stay open to alternative possibilities, which precipitated searching further. I can’t wait for our adventure tomorrow!”

“Yes! Yes!” Shaku says with excitement. (Shaku never turns down an opportunity for adventure.)

The next day proved beyond my wildest expectations. We arrived early in the day, climbing a canyon peak where Shaku would remain while I biked. When we reached the top, Shaku was in tears: “I can’t believe I did this. I can hardly walk; who would have ever thought I could get up here?” Pure joy exuded beyond her self-disbelief.

I headed back down to the canyon floor, disentangled my bike from the car’s interior, and pedaled toward the entrance of the bike trail. Little did I know the thrill that awaited me. Towering, red-cragged, canyon walls hauntingly surrounded me. I mounted my bike in awe. The bike path had a meandering, medium-grade, downward slope. Initially, I was undecided how fast to descend. I started out braking, but soon asked myself: “Can you risk no brakes? Can you play the edge of control?” I decided I could. Flying down the canyon at 30 miles/hour, wind whooshed into every pore of my face, my body, and my soul. I felt like I was flying. The tears in my eyes were the beholding evidence – a gift from my ‘disappointed’ self who had sought redemption.

A week after we returned from our trip, I saw Shaku again: “It was such a small thing, Deb, but such a BIG lesson.”

“What do you mean?” I replied.

“The abiding. It has made such a big difference.” She went on to tell me how she had applied the concept in some of her daily situations and relationships. “And to think it all started with a prayer before we left on vacation.”

“A prayer?” I queried. “You didn’t tell me about any prayers.”

“Before we left, I prayed, “God, show me how to abide.”

I don’t know which Shaku was more excited about: learning the value of abiding or rediscovering the power of prayer.

Opus Peace provides 1, 2, or 3-day healing retreats. The experience is designed to cultivate pervasive personal peace by learning how to re-own and then re-home pieces of self scattered by: self-disregard, heartache, neglect, abuse, trauma, death, or war. Commonly, we turn away from these pieces of self, banishing them into unconsciousness, losing the energy of these exiled selves. The re-owning and re-homing process can be used to increase self-regard, heal neglect and abuse, bring peace to broken relationships, lose weight, and face aging, death or any challenging situation. Therapeutic tools for soul-integration are used: therapeutic letter-writing, meditation, mythological stories, integrative music, shadow confrontation, and therapeutic rituals. You will achieve what Derek Walcott so eloquently describes: “The time will come when, with elation, you will greet yourself arriving at your own door, in your own mirror, and each will smile at the others’ welcome.” Within the sanctuary of a healing community, participants learn how to stop running away from the very things that will free them up, paradoxically, becoming more whole and empowered in the process. Each participant also receives an autographed book, The Hero Within: Redeeming the Destiny We Were Born to Fulfill, as a “Welcome your Self home” gift. If you are interested in participating in or hosting a retreat in your area, contact us

1-Day Workshop: Forgiveness & Healing

Would you like to recover the energy of pieces of self you may have knowingly or unknowingly lost through: self-disregard, heartache, neglect, abuse, trauma, death, or war so you can inhabit yourself more completely? Deborah Grassman joins forces with Dr. Abi Katz to provide an unforgettable day. E-mail to schedule them to come to your event.

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➣ Re-owning & Re-homing Scattered Pieces of Lost Self

by Deborah Grassman


PTSD is not limited to those who’ve been traumatized by combat. Victims of crime, abuse, natural disasters, serious motor vehicle accidents, marital affairs, life-threatening illnesses, etc. might suffer PTSD; policeman, firefighters, emergency room responders, and other people who witness trauma are also vulnerable for experiencing PTSD symptoms. These traumatic experiences are sometimes not integrated into a person’s consciousness. Instead, the trauma is left compartmentalized, stored in unconscious experience, sabotaging personal peace.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the fundamental reference for defining mental health. It identifies a constellation of symptoms that must be present for the diagnosis of Post-traumatic Stress Disorder. These include: exposure to a traumatic event experienced with fear, helplessness, or horror; after the original trauma is over, the trauma is re-experienced through recollections, dreams, flashbacks, hallucinations, illusions, distress at cues that symbolize the trauma, or physiologic responses when confronted with cues reminiscent of the trauma. The distress of the re-experienced trauma causes people to exhibit avoidance behaviors and utilize emotional numbing in order to block out the trauma. But in spite of their best efforts, there are times when the trauma is re-experienced anyway and the person exhibits symptoms of arousal such as: difficult sleep patterns, irritability or outbursts of anger, difficulty concentrating, hypervigilance (staying on guard and unable to calm down or relax), exaggerated startle response to noises, being touched, etc. When this constellation of symptoms lasts for at least a month and causes significant impairment, a diagnosis of PTSD is made.

Many people with PTSD have successfully suffered their traumatic experiences by learning lessons that help them live their lives, deal with trauma, and reckon with PTSD. If they have received PTSD treatment, they can often say what helps them feel better. They might already have a PTSD network of friends who can provide support. Family members usually know how to respond to breakthrough episodes of PTSD because it’s familiar territory.

Other people with PTSD have not had this experience. They’ve compartmentalized the trauma, banishing it into unconsciousness. They might have increased difficulty as death approaches – haunted by residual memories or corroding guilts. Others seem less affected.

When patients with PTSD are admitted to a Hospice unit, they are sometimes anxious, suspicious, or angry. Leaving their home to enter an unknown hospital environment is threatening, increasing their feelings of danger. The hospital environment itself can act as a trigger with its militarized processes. Their own anticipated death can act as a PTSD trigger. PTSD, especially when combined with alcohol abuse, has often taken its toll on their relationships, leaving much unfinished business to be resolved so a peaceful death can ensue. Sometimes they arrive at the end of their lives broken, bitterness poisoning their souls. However, it is never too late. Opportunities for growth abound when death approaches and many people – even those who are bitter – avail themselves of the lessons.

Raymond was a veteran in a local hospital with end-stage liver disease, the result of excessive alcohol usage used to self-medicate his PTSD he sustained with the Vietnam War. His doctor phoned me, requesting admission for the patient to our Hospice and Palliative Care unit.

I had a mental image of what Raymond probably looked like based on his diagnosis: swollen abdomen due to accumulated fluid, mentally dull from built-up toxins, and the ruddy, disheveled appearance of a man who no longer took pride in himself.

That night, I dreamed I went to meet Raymond, and he arose from his hospital bed, tall, handsome and well-groomed, in a three-piece business suit. Then I awoke, puzzled by my dream. Raymond arrived later that day; he looked sick and ungroomed like I had expected.

The Hospice team held a meeting at his bedside to learn more about Raymond. He told us he had PTSD and had been a drifter since Vietnam, finding it difficult to establish relationships or maintain a job for long periods. “I don’t know what got into me. I wasn’t raised like that. I should have done something with my life,” he told us. I asked him if there was anything from the war that might still be troubling him.

“I try not to think about it,” he said. “But what keeps coming back is the eyes of my comrades. I saw peace in the eyes of the dead; I saw fear in the eyes of the living.” Our team sat in stunned silence as we let ourselves experience war vicariously.

Later in my office, I kept reflecting on the profundity of this casual comment and the detachedness with which it was said. I let its chilling truth penetrate my illusory, warless world. Now I understood the meaning of my dream. It was not this Raymond I had seen, but the Raymond he might have been. I had met the Raymond who had not gone to Vietnam. That’s when I realized that war robs people of many things; but possibly the most significant is a young person’s hope and dreams.


If you would like to help heal our nation of the aftermath of war, please consider sponsoring a Soul Injury Ceremonial Workshop community event that invites combat veterans to come mourn their fallen brethren. Contact us and we will come help you. Don’t miss this opportunity to heal the aftermath of war in your community. E-mail for more information. We will help you!


Peace at Last

While caring for thousands of veterans over a 25-year career in a hospice setting at a VA hospital, Deborah Grassman gathered stories of pain,redemption, personal awakening and peace. She’s built these stories into an unforgettable book, taking the reader on a journey of understanding and growth. Her pioneering work in identifying the unique needs of veterans has changed how this nation honors, respects, and treats veterans at the end of life. Already, her book has become a classic on the topic.

See all books.

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Wounded Warriors Video

Iceberg Feelings Display

Emotional Pain Scale

Integrative Letter Writing

Interactive Story Display

Quality of Life Meetings

Native American Talking Stick Forum



➣ Unique Needs at the End of Life

by Deborah Grassman


Many people do not realize that military service influences soldiers in ways that can sometimes complicate peaceful dying, even though their death may not occur until many years after they leave military service. Deborah was the first person to identify the influence that the military sometimes exerts on dying Veterans. Peace at Last: Stories of Hope and Healing for Veterans and Their Families was subsequently published and is now a recognized authority on how the military impacts veterans and their families as they experience the dying process.

These influences include:

  • The value of stoicism so earnestly and necessarily indoctrinated in young soldiers might interfere with peaceful deaths for all veterans, depending on the degree to which stoicism permeated their later lives;
  • Veterans who served in dangerous duty assignments might have their deaths complicated by traumatic memories or paralyzing guilt, depending on the extent to which they were able to integrate and heal traumatic or guilt-inducing memories;
  • There is a high incidence of alcohol abuse or other “flight”-type behaviors used either to avoid confronting locked-up feelings or to numb traumatic memories. These factors might contribute to “unfinished business” as veterans face the end of their lives;
  • Veterans often acquire wisdom because they have reckoned with trauma, stoicism, and addictions. Understanding these three elements helps access their wisdom and has been referred to as “post-traumatic growth.”
  • Veterans and their families have unique bereavement needs to consider when providing care.


When people learn that I work with dying veterans, they will often say, “I can’t imagine working in hospice.” To help you imagine my everyday world, let me tell you the stories of the nine patients on the Hospice and Palliative Care unit at the time of this writing. Then, you can understand the context from which my lessons are derived. You will also understand the privilege that it is to care for veterans. Military experiences changed them in fundamental ways that shape, mold, destroy, and redeem the rest of their lives. Many are able to confront their sufferings successfully. In one aspect of their lives or another, they have been able to redeem portions of their suffering so that it can be used for healing as they face the end of their lives. You will notice that in many ways, they die the same way civilians do. You will also notice that they experience some unique distinctions.

Mark is dying of liver failure from alcohol abuse, his skin yellow as a low-glowing lamp. He came to the Hospice and Palliative Care unit semi-comatose; we won’t get to know him except through his brother’s eyes. I comment on his brother’s devotion. The brother responds, “I look at Mark and know why I’m in Alcoholic’s Anonymous.” I behold one brother willingly serving the suffering of the other.

Donnie is 50 years old and has lung cancer. He’s been a quadriplegic since he was 27 when an automobile accident derailed his career as a professional football player. “I spent three years in despair. Then I found God and salvation,” he tells me. He says he is thankful for his suffering: “I never would have found Jesus if the accident hadn’t happened.” Twenty-three years of redeemed suffering is a story worth beholding.

In the next room, an embittered, lonely man sits sullenly. Alcohol has estranged Zachary from his family. At 82, he’s angry at his body for failing him. He’s been afraid of death since he was 10 years old when a neighbor died falling through a skylight. Bitterly, he tells me, “My only solace is in knowing that someday all the rest of you are going to be in this bed too.” A gathering of team members provided a turning point as Zachary experiences the concern of the four staff members who were willing to love him. “Why aren’t we talking about my breathing, and the 16 pills I’m taking?” he asks us. “Because you are more than just your breathing, and we are more than just pill-givers,” I reply, leaning in and daring to touch him tenderly. A tear forms; his features soften for the first time. “I can’t argue with that,” he says quietly. I can’t tell you the ending of his story, but once the crack starts hope emerges.

In the room next to Zachary is Marvin. He was a photographer to a general in World War II. He has been a physician, sailboat racer, and builder of piers, driveways, and roofs “made with my own hands.” Marvin’s wife and four children sit at his bedside supporting his journey into the next world and supporting one other. Near death, he says little except the Lord’s Prayer. There’s no need for us to intervene. We just get out of the way and behold a life well lived.

In the adjoining bed is Jim, a Vietnam War veteran who has lived a colorful life. He’s intermittently confused; sometimes he’s argumentative. He has no family; a few close friends are his source of comfort. His first days on the unit were filled with agitation. He was convinced the Vietcong had put a bomb in the stereo. Nurse Suzanne responded creatively. She called the security officer and said, “I want you to inspect the stereo and declare it bomb-proof. Tell the patient you’re pulling guard so you’ve got his back and the perimeter is safe. Let him know that another guard will be on patrol when you leave duty.” The police officer responded convincingly, and Jim’s agitation subsided.

Then there’s Bruce, a 67-year-old man who came for pain control. He hadn’t wanted to come to our Hospice unit because, he said, “I’m afraid I’ll never get out.” His early days of anxiety and impatience were manifested with frequent summons on the call light. Probably because he realizes he’s in a safe, loving environment his spirit is now emerging bright and full. He simply needed a little time and a little love to know that he need not fear. He has grown closer to his family as he approaches death and tells us, “I wouldn’t trade these last few weeks in my life for anything.”

Bruce’s roommate, Richard, suffers respiratory distress from a tumor encroaching on his breathing tube. He awaits his daughter’s arrival from Indiana tomorrow. He says his suffering will be redeemed when he can rejoin his wife who died two years ago. “That will be a happy day,” Richard says with tears. We share his anticipated joy.

Ben has a history of drug use and actively continues with alcohol abuse. He identifies himself as a loner who has witnessed much violence. “My family doesn’t care about me,” he told me. We’ve had some difficult sessions confronting his suffering. He’s going to be discharged next week. I don’t know what’s going to happen with him. What I can tell you is that his brow unfurls after prayer, he plans to go to Alcoholic Anonymous meetings, and he wants to reach out to a faith community. Seeds planted and good intentions, however, are still not enough to withstand the ravages of alcohol. Ben’s redemption awaits a courageous decision that only he can make every day for the rest of his life.

The last patient, Edwin, has severe chronic respiratory disease and is ready to die but he worries about his wife of 54 years. His needs are increasing rapidly but he doesn’t acknowledge them because he doesn’t want to worry her. “I can’t hold on much longer though,” Edwin says while making plans to hold on for his wife’s sake. We talk about the advantage of letting go so he can prepare himself and his wife for his death; we talk about the damage his denial is causing them both. Edwin cries as his grieving begins. Stories of sacrifice in the name of love are always worth beholding.

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Family Care

➣ Creative Cocooning: A Caregiver’s Journey

by Patricia McGuire

You may have heard that death is like the birth of the butterfly. What a peaceful thought that is. It brings images of delicate, colorfully-winged, creatures flitting from flower to flower. What it does not even hint at is the dramatic process of “cocooning” that happens between caterpillarness and butterflydom. More importantly we don’t get sick alone (if we are lucky). We will need a caregiver. Most of us know little about cocooning or caregiving. The furry little caterpillar pictured above looks so cute and harmless. And it is…until it begins to transform into a cocoon. Notice that as it spins its cocoon, it entangles those around it. Using the cocoon as a metaphor for the end of life and death processes can be very instructive. Transformation from “well and healthy,” to death is the most profound change we experience in life. (See “Cocooning” under topics for more information.) Not only that, but the caregiver can get so consumed with caregiving that they might lose their own sense of self, becoming immobilized in the cocoon (see picture below).


The average life expectancy twenty or thirty years ago was much shorter than it is today and many people died suddenly and unexpectedly. Today just 15% of us will die quickly. Medical advances allows the other 85% to spend longer and longer time in transition and caring for those in transition.

So let’s consider that we are all a bunch of caterpillars. 15% of us will emerge from our caterpillars suddenly and unexpectedly and be released to our new lives as butterflies. That may seem a lovely thought, but what about the other 85%? Some will have short illnesses, some will have a couple of years of decline, and still others will enter the place between “life as we knew it” and “living loss.” For example, consider Carol and Bob. They met when they were quite young, married, raised a family and had a good life together for many years. Then Bob got Alzheimer’s disease and the next fifteen years of their lives was filled with chronic sorrow and living loss. Carol told me, “He would get so agitated and yell at me to get out of the house.” Bob didn’t recognize Carol as his wife anymore. Thinking that she was an intruder in the house, Carol would have to go out the front door, change clothes, and “come home” through the front door. She would then be accepted as his wife once more, and Bob would tell her about “the strange woman” who had been there. Imagine the chronic sorrow of lengthy cocooning!

I made the furry caterpillar you see in the picture above. When I showed it to Carol, she became animated, excitedly taking it from my hands and wrapping it around her neck like a shawl. “This is exactly what taking care of Bob has been like!” she exclaimed. The following week, Carol returned with a treasure she wanted to share with me: a hand-made book about her cocooning process. The book was beautifully illustrated with her artful drawings. I was so impressed that when she finished reading it to me, I declared that I would dub my furry frined “Bob” in honor of her and her husband.

Here is Carol’s eloquent version of her cocooning journey:

The Journey

I was a bush, bright and green
Covered with shimmering leaves upon which butterflies did preen.

Then one day along came this funny, furry little thing,
That climbed right up on a branch of mine!

Oh, Caterpillar, Caterpillar so furry and cute,
All dressed up in your Caterpillar suit.

I loved you true and you loved me too.
We used to laugh and play and throw away each day.

He took a bite here, and a little crunch there,
But I had so many leaves, I really didn’t care.

Caterpillar, you munch and crunch on me all through the day and night.
My life has become an agonizing fight.

Our memories fly away like dead leaves before autumn’s cold breeze
One by one my leaves do fall, one by one, you devour them all.

Like stiff-legged mice, across the frozen pond they fly.
Searching for comfort…they hopelessly try.

In your mindless advance,
You crunch and munch, as onward you prance.

Oh, Caterpillar, Caterpillar can’t you see,
You’re draining the life out of me?

Stripping away my last shred of dignity,
Only death can set me free.

Illness often precipitates the cocooning process. One woman who had been debilitated by Lymes Disease and was no longer able to practice her profession described the cocooning process beautifully when she told me, “I’m in a place between ‘I don’t fit like everyone else’ and ‘those in the main stream who can’t understand the life I live’.” She went on to say, “A friend asks me to lunch, and I really want to go. I say ‘Yes’ because I know going to lunch will allow me to feel normal for a little while… but if I’m having a bad day that day and can’t go…people don’t get it when I cancel at the last moment. They don’t invite me again.”

This is true for caregivers as well. Caregiving can be very lonely because most often it is done in isolation. When you are tangled in a cocoon, you are not free to pick up and go on a whim. You also may find yourself cancelling plans at the last minute when your loved one is “not having a good day.” Your friends may be concerned for you, but they go on with their lives.

Many people are frightened by the cocoons of people with disabilities. One woman told me, “If I was bitten by a shark, I might not be so scary because people don’t think a shark will ever bit them as long as they stay out of the ocean. But, I have a disease and if that could happen to me, it could happen to you too. That’s why people are afraid of me.”

Albert Schweitzer said, “Depersonalization is worse than death.” A man told me, “Smiling for the chronically ill is what they do instead of crying.” A caregiver may notice that when you take your loved one out in a wheelchair that the people around you speak to you rather than your loved one: ”I feel invisible,” wheelchair-bound people have told me. Make a point of including them in the conversation. Modeling comfort with those who are cocooning may reduce their sense of isolation.

Consider the following for peace-making and tool building:


Feelings: Anger, hope, fear, guilt, jealousy, helplessness, sadness. When a loved one is ill, we are forced into strange and unfamiliar situations. This threatens our security and may cause many emotions. Having a safe place and understanding people to talk with about these emotions is very important. A community of supportive people can keep you from losing “you” in the caregiving process. Then, you will have a “you” to grow into your changed life. Supportive people can “cocoon” YOU. Afterall, a cocoon is a safe place for dramatic change.

Self-care: If you don’t take care of yourself, you will not be able to care for anyone else. Physical exercise, eating healthy food, drinking plenty of fluids, maintaining adequate rest, seeking medical care for your own health issues, and having sources of fun are all important self-care needs to build into your daily routine. Find people to talk with. Set realistic goals and arrange time for yourself. When someone says, “What can I do to help?”, tell them to sit with your loved one so you can have some respite to take care of your own needs. Don’t let your pride interfere with receiving help and support.

Advocating for your loved one: When your loved one has unmet needs, speak up. Let the doctors and health care professionals know. The caregiver knows the patient better than anyone else. Your voice is important for the healthcare team to hear. The healthcare team relies on you to make your loved one’s needs known. You may have to speak your need repeatedly to numerous people. Until the need is met or you understand why it is not, keep asking until you are satisfied.

Communicating with medical staff: Frequently families say, “I don’t know what is going on with________”. You have a right to understand what is happening. You can schedule an appointment with the doctor. Write your questions down to help you remember. If you don’t understand what the physician tells you, ask for clarification.

Advance directives: These documents explain to the medical staff what medical care or treatments the patient wants if they are no longer able to make decisions for themselves. Do you have advance directives complete for yourself and your loved one? If not, we can help you complete one.

Health care surrogate: This is a trusted person appointed by the patient to make decisions for them in the event that they cannot make them for themselves. Because someone told you that they want you to make decisions for them, does not necessarily mean that legally the medical staff will be able to follow your directives. This must be written and witnessed to make it legal. Without such documentation, the legal next of kin is responsible to make decisions. Health Care Surrogate is no longer valid once the patient has died and in no way affects the patient’s last will and testament.

Legal next of kin (NOK): Legally, next of kin does not necessarily mean the person closest to the patient. We refer to the person who is close to the patients and not legally the NOK as the next of heart (NOH). The NOH has no legal rights. Unless you are related by marriage or blood, you are not the legal next of kin. An estranged wife who hasn’t seen the patient in twenty years could be legally the NOK. An estranged son or daughter who never remembers meeting the patient may be the legal NOK. If the patient wants you to be the one acting for him/her, this must be done legally.

Wills: A will is a legally binding document which one completes prior to death to direct the distribution of one’s earthly possessions after death. A person must be of “sound mind” to create a will, so it is important to complete before mental deterioration starts. This can be done with a lawyer, by completing a standard will available in office supply stores, or by simply writing out your wishes. This must be notarized and witnessed to be legal. In the will, a personal representative/executor is named. This person insures that the wishes in the will are completed. If no will is left, the legal NOK will assume this responsibility. Many people make their wishes for funerals, burial, etc. known in their will.

Durable power of attorney (DPOA): This is a legal document, which allows a designated person to act on behalf of another. If you are unable to act in your own behalf, you may designate a trusted person to take care of your personal business, banking, bill paying, etc. DPOA ceases upon the patient’s death.

Details office: This office at the Veteran’s Administration handles the care of the patient’s bodily remains after death. When someone is getting close to the end of life, it is helpful to visit the details office before he/she dies. There, you will get information about what parts of the final arrangements are your responsibilities and which are the VA’s. They can also provide information about funeral homes and types of burial. You might be surprised at how much better you will feel after this is accomplished.

Autopsy: An autopsy can be done at the request of the family. This may be helpful in determining the cause of death, assist with research, or identify genetic risks for other family members. Limited autopsies can also be specified, if you prefer. Limited autopsies only examine the part of the body suspected of causing the death. You can also specify that certain body parts (such as the brain) not be examined.

Organ donation: Discussing organ donation with your loved one prior to death can help you to know their wishes about donating organs. Even if the patient requests organ donation, the legal NOK will have the final say about donating organs after the death because all patient rights cease upon death.

Florida Department of Veterans’ Affairs: Many questions arise about eligibility for benefits when a veteran is sick. There are Veteran’s Service Officers can help you with these concerns.

Children and grandchildren: Community hospices have special camps and programs to assist with children’s grief. Ask for a referral. Schools can arrange for grief support for your child through their guidance department.

Consider the following websites to help:
The National Family Caregivers Association and the National Alliance for Caregiving or

“Caregiving is one way for humans to learn about humanity. It is not only about simply doing for others. It is also about self-acceptance and honest intentions.”
-Daniel Warner


➣ Good Grief: Those Who Grieve Well, Heal Well

by Deborah Grassman

Life is dramatically altered as people learn how to live in the world without their loved one in it. During the period after a death, little peace can be found initially.

The following letter is written by a woman who had avoided grief with the many deaths she had experienced. As a result, she became overwhelmed when her husband died. Luckily, she was amenable to learning how to grieve so that she could be transformed, finding peace. Here is the letter that she wrote describing the healing process:

Dear Grief,
How many times you have come with your black shroud wrapping your darkness around me. But I would only let your blackness be seen for a little while because as I looked into the eyes of others, I saw their pain so I quickly folded you and hid you within myself. As life went along, you came to me with each loss, but I always was quick to fold your black shroud and hide you away – thinking I was protecting those who could see your dark arms folding in around me.Then, I lost my husband, my dear love. You descended upon me, but I didn’t resist you this time. I let you wrap me in your black shrouded arms. As my tears flowed non-stop from my eyes and my spirit, it was as though you were inviting me on a journey with you, with places to stop along the way. I allowed you to take control, and like a little train, our journey began.The first stop was guilt. Could I have done more? Did I do enough? Did I give enough? I wish I had held my tongue. Could I have shown more understanding? This was a hard stop, but I let myself stay here long enough to examine these doubts. By doing that, I came to the satisfaction that I could have done no more than I could at the time with the strength I had. I had done the best I could with the circumstances I was dealing with.
The next stop the little train made was anger. Why was I so angry? Why wouldn’t people stop acting as if I had not experienced a great loss? Why was I being urged to get on with my life? Couldn’t they see I was locked into a place that had not been my choosing? As I lingered at this stop, I came to realize that FORGIVENESS made it possible for me to get back on that little train and continue my journey.Next we stopped at loneliness. It was difficult to see how I might get past this stop. It felt like I had been thrown off a mountain and I was left trying to crawl back up in total darkness having only jagged edges to hold onto. I let myself feel all the deep emotions of loneliness and with time, I decided to get back on the little train.The next stop surprised me with pleasantness. I started feeling the sun and its warmth. I saw blue sky and noticed the colors of flowers, birds, and leaves. They had been lost to me during my journey of grief. I reflected back on the other stops and realized that having let myself get off at each stop, I no longer felt lost any more.But there was another stop. This was the stop of New Life…a new way to live in the world without my loved one in it. I really hadn’t thought it possible. If anyone would have told me that I could now be so vitally alive without him, I never would have believed them. But my journey of grief had yielded many lessons. Lessons like: not to take life or people for granted, to give love freely and unconditionally, deciding to forgive, taking steps to heal anger, and living each day so that it has worth and meaning.

So, Grief, I no longer fear you. I no longer feel I should hide you. You are my friend who leads me through my pain so that I can make the necessary and healing stops along the way to that place where new life is possible.



➣ Spiritual Care: The Paradoxical Dimension

by Deborah Grassman


Peace that lies beyond human understanding is derived from the spiritual dimension. This dimension creates energy — that spark of life that powers the soul. During times of trouble or sorrow, people often contemplate deeper and more serious issues of the soul; they may even encounter despair. This time of darkness can be beneficial because it cultivates humility; humility accesses the soul. In the soul’s dimension, lies pervasive peace where energy beyond the material world is generated.

A word that might capture the spirit of energy is “vitality.” When I stop denying feelings and instead open up to them, I experience vitality; I become more alive. When I reckon with hardships rather than cope with them, I become vitally alive; my soul is engaged. This soul is important because it’s the most authentic and enduring part of me.

The National Consensus Project Guidelines for spiritual practice defines spirituality as “the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.” Teilhard de Chardin offers yet another perspective: “We are all spiritual beings here for a human experience.” These definitions capture the nature of our soulful beingness where energy and vitality are generated.

It’s easy to confuse religion and spirituality. Sometimes I conceptualize that their relationship is like trees and forests. Religion is the trees of beliefs that we create to understand the spiritual forest of our existence. We all live our religion (the values and beliefs that underlie our actions); even atheists live out their “religion.” Beliefs, however, sometime interfere with understanding existence because “we can’t see the forest for the trees.” Many people discount the value of religion because of this distortion of perspective. Yet, forests can’t exist without trees; and the quality of the forest is dependent on each tree’s contribution. Forests and trees are not mutually exclusive; in fact, they might be mutually inclusive. I learned this from a rabbi on National Public Radio. He was on a panel of religious leaders of different faiths discussing religion and spirituality. All of them agreed that not all spirituality is religious. Almost all panelists agreed that all religions are spiritual. A rabbi disagreed. He said that any religion that teaches exclusivity is not spiritual because spirituality is based on humility not arrogance. I liked his distinction.

As death approaches, people start contemplating deeper issues. Their perspectives shift, and frequently they undertake a spiritual quest.

“Tell me how you are doing spiritually,” I’ll say to a patient.

Often the response is, “Oh, I don’t go to church.”

“Sounds like you’re not a religious person, but I’m wondering if spirituality has any meaning to you,” I’ll reply. “Do you receive strength or comfort from a source of energy or power beyond your own?”

Many will say they believe in God; others talk about nature or their family; some say spirituality has no relevance in their lives. I distinguish between religion and spirituality because I want patients to know I have no interest in trying to convert them to a religion, impose my personal beliefs, or urge them toward any specific beliefs at all. My attitude is important because many patients have had experiences where others had an agenda to change or impose religious ideas; sometimes this kind of imposition was done in a manner that did not respect the patient’s personal beliefs or his or her need to doubt and question.

I usually try to provide nonreligious spiritual care. It takes time to assess a person’s beliefs, time I don’t usually have. Also, there are many different faiths, even divisions within the same faith. It requires time to discern the particular meaning of a patient’s religion. Instead, I provide open-ended “generic” spirituality so the patient can infuse his own personal meanings. I let the patient lead and I follow. I’m secure enough in my own religion that I don’t worry about differing beliefs sabotaging my own. Neither do I think it’s my business to convince them of my beliefs. Sometimes, we explore spiritual ideas together. I proceed cautiously though, always mindful that the patient could be vulnerable to my authority as the healthcare provider. I’m also aware that I might unconsciously want him to think like me.

I’ve learned a lot by watching other people provide religious and spiritual care. Shaku, one of the nurses on our Hospice unit, is Hindu, a religion not shared by many of our patients. She has learned prayers and practices of other religions so she can respond to patients’ varying needs. It’s not unusual to hear her reciting the Lord’s Prayer or the rosary with patients. Patients frequently tell me what a comfort Shaku is to them. (Contact Shaku at

I had an encounter with a nursing assistant who reminded me of Shaku when I, myself, was a patient. I had abdominal surgery and afterwards a small artery began bleeding. I lost many pints of blood, and all my clotting factors were consumed. I not only needed several blood transfusions but a second surgery to control the bleeding. I was left weak and debilitated. I also had severe diarrhea. Too weak to quickly get to the bathroom, I was incontinent. Embarrassedly, I activated my call light. When the nursing assistant came to the room, I told her apologetically about the mess awaiting her under the sheets.

“Oh, that’s okay. That’s why I’m here,” she said cheerfully. “You don’t worry about a thing. Your job is to just let me help you.”

Long after she left, I thought about this woman who made me feel like there was nothing more she wanted than to have the opportunity to clean up my stinky mess. She gave me graciousness, and that was a gift of the spirit that remains with me to this day. “God” was never mentioned, but she helped me realize that tenderly emptying a bedpan for a patient is one of the most spiritual things I can do.

This nursing assistant’s act made me reflect on an adage that sometimes circulates in healthcare circles: “Nursing assistants aspire to be nurses; nurses aspire to be physicians; and physicians aspire to be God.” I sometimes ask myself, “To what role in a hospital does God aspire?” I wonder if the answer is that God aspires to be a patient whose suffering is redeemed through the love of a compassionate care provider like that nursing assistant who knows how to empty bedpans spiritually.


1-Day Workshop: Soul Restoration: Revitalizing the Weary, Wary Heart

Caregiving, whether personal or professional, takes a toll! Caregivers encounter emotional pain on a regular basis. Understandably, we often disconnect from the pain. By disconnecting from the part of self carrying the pain, we unwittingly contribute to the loss of energy, emptiness, and compassion fatigue that can ensue. This 4-8 hour ceremonial workshop provides a restorative experience of self by re-owning and re-homing parts of self that may still be carrying unmourned grief.

1-Day Workshop: Forgiveness & Healing.

Would you like to recover the energy of pieces of self you may have knowingly or unknowingly lost through: self-disregard, heartache, neglect, abuse, trauma, death, or war so you can inhabit yourself more completely? Deborah Grassman joins forces with Dr. Abi Katz to provide an unforgettable day. to schedule them to come to your event.


The Opus Peace Prayer

Cultivate in me, Oh God, the willingness to re-own and re-home scattered pieces of myself so that I might be restored to Your wholeness. Grow in me the honesty, courage, and humility to release my fears of who I am and who I am not. Fuel me with your Grace. Amen

More Information

Quality of Life Meetings



➣ Dying Healed: A Shared Quest to Wholeness

by Deborah Grassman

The time surrounding death is fraught with fear and uncertainty. Few of us have developed an “exit strategy” for the end of our lives. Yet, exit strategies are essential if we want to die healed. We wouldn’t even consider leaving on a trans-continental adventure without seeking a map, guide, and advice. Yet, we often embark on our inevitable trip into the mystery of death all the while denying that we’re even leaving. We seldom stop to ask ourselves: “Could there be some advantages to preparing for the trip we’re destined to take? Would facing death rather than running from it reveal any secrets about living more fully?”

Not preparing for death has practical consequences: we might receive treatments we don’t want or need. Our family may be placed in the uncomfortable position of advocating on our behalf. This happened to Sheila Lozier, a hospice colleague of mine, when her father was dying of cancer. The following poem was written on a napkin in an airport as she was returning from her father’s funeral in Nebraska. She had just been through the unfortunate experience of having to advocate for his peaceful dying by preventing Tube Feedings from being initiated. Her poem helps families understand their role in helping loved ones die healed:

DEATH is Like the Birth of a Butterfly…


We walk along life’s path feeling the warmth
from the sunshine on our faces and
eating the leaves of life to fuel our bodies.

Then one day,
without warning,
our body is invaded
by sickness or by time itself.
A change begins to happen.

Slowly the foods that gave us great joy
lose their interest.
Friends and family can’t understand.
They insist we are starving to death.
The journey becomes more difficult for a time.

Now, eating is done to please others.
It’s ironic that in the end,
the very ones who love us the most,
make our lives more difficult by not understanding. Nevertheless, little by little we stop eating.
Meats, then vegetables, then
anything which requires energy to chew.

Finally all our palate wants
are the sweets of the earth:
puddings, ice cream and juices.
As our energy wanes,
we embark on a new phase of the journey-
the caterpillar stage.

In this slowing down and shutting down process,
the body does not require the fuel it once did.
Like a caterpillar, the body is drawing inward
as if spinning a cocoon,
waiting silently for the dawn of a new existence.

Slowly the muffled cries from the outside world
grow further and further away.
One day a miracle happens.
The broken and damaged shell that once housed
the spirit during its journey here on earth,
begins to break away.
First the hands and feet become cold.
Breathing slows down until it is no longer needed.

Now, as in the birth of the butterfly,
a new energy emerges that is headed
on a wonderful journey on a different dimension.

Perhaps if you listen very quietly
you will hear the gentle beating
of wings as they catch the wind
on their final journey to touch the face of God.