With the End in Mind: Dying, Death, and Wisdom in an Age of Denial

by Kathryn Mannix

The success of a psychological intervention lies in how far the patient moves from unhelpful beliefs, thoughts and behaviours to new and more helpful ones, and therapy is most helpful when the patient perceives that they, and not the therapist, are the agent of change. This could be regarded as ‘not getting the credit’, but in fact it is perhaps the most rewarding outcome of all to watch someone fly high and proud on their own, because therapy has given them wings.

different ways in which people cope with difficulties: trying to keep control; avoiding the truth; sinking into helplessness; simply accepting whatever fate has in store; using resilience to adapt to events; and becoming anxiously preoccupied with the threat of the situation.

Allowing each other to discuss dying, rather than treating the D-words as magic ciphers that may cause harm merely by being spoken aloud, can support a dying person in anticipating the last part of their living, in planning ahead in order to prepare their loved ones for bereavement, and can bring the notion of death as the thing

Open discussion reduces superstition and fear, and allows us to be honest with each other at a time when pretence and well-intentioned lies

Some of these patients bravely offered to test new anti-cancer drugs, aware that they were unlikely to experience any personal benefit yet willing to help our research in order

‘He did that thing that so many people do. That “choose the moment” thing.

We don’t understand it, but we recognise that sometimes people can only relax into death when they are alone.

Today, in ED, Lisl’s skills focused not on saving life at any cost, but on enabling goodbye. Sometimes, in the end, it’s all we have to offer.