From Rehuno Salud and in a joint work with the organisation Al final de la Vida we talked with Dr. Enric Benito about the humanisation of the end-of-life process. On the taboos that exist, what is the good death, palliative care and other issues that make the accompaniment of these significant moments in the lives of all people and their loved ones.

This is a series of Dialogues that we will be publishing periodically and in which we want to disseminate a vision of the process of dying that is full of humanity and meaning.

Enric Benito is a Doctor of Medicine, Specialist in Oncology and Honorary Member of the Spanish Society of Palliative Care (SECPAL). His experience and teachings are a true reference for the world of palliative care and for the accompaniment and humanisation of the process of dying well.

In this second interview we talked about Presence and asked Enric Benito to define it: Presence is the capacity we all have to inhabit the present, to be fully connected with the consciousness that sustains us, he replied.

And he continued: There is a phrase from the master Nath Hanh, who passed away this year, that says: “the best gift you can give someone is your presence. When you offer your presence to another, they can blossom, unfold, connect with themselves. It would be the capacity we human beings have to be connected with what we really are, with our essential being, our ontological foundation. There is no word for it”.

Dr. Benito explains that we spend a lot of time in our mental discourse: there is a narrative, biographical “I” that is constantly thinking about what I have to do, what to say, etc…. All this discourse is clouding and clouding the essential. At important moments, I have to stop this discourse and be very attentive because there is a situation that demands my attention. I can voluntarily promote this attitude of being connected with myself, present, without judgement, without interpretations, without adding content.

When you accompany someone who is suffering and you propose to help them, presence would be the basis, the foundation or the platform of the helping relationship.

To help someone I have to be very present and very connected to myself. This promotes in the other person trust, silence, peace, connection and a very favourable relationship begins to flow.

Marcus Aurelius says: we have to be like a promontory in the sea, where the waves, the tempest, the noise, collide and are softened, calmed… This concept in the therapeutic relationship is fundamental. If you are worried, anxious, restless, nervous, the patient’s anxiety and yours mix, there is a conflict and the situation becomes complicated, added Enric Benito.

We asked him about the indicators that a professional can observe to know that he or she is in Presence, and he told us: “This is cultivated over time, you need the mind to act, but it has to be planted in a peace, in a serenity. Imagine a heart surgeon, he has to be connected and present. It is something we can all do, as we have experience and have learned to be serene.

The indicators

  • A sense of openness. Being open, interested, wanting to know what I can do, non-judgemental, the other feels trusting, welcoming.
  • There is clarity, you see beyond the immediate circumstances, broader vision of the immediate reality, of appearances, I see with greater profundity.
    Equanimity, being serene, without being infected by the suffering, the anxiety of the other or the circumstances.
  • Energy. There is a point of vitality, creativity. It is not an amorphous presence, there is a capacity to generate creative responses.

(Video of the full interview from which we have extracted what we have published here)

REHUNO Salud asked Enric Benito how to strengthen these characteristics. How professionals can cultivate this presence, doctors, nurses, companions, etc. and this was his response.

There are some specific practices

  • Cultivation of mindfulness, attending to what is happening, any regular practice of mindfulness (meditation, breathing, consciousness, vipassana, contemplative prayer, chamata, etc) established regularly over time, as mental hygiene.

Those people who practice develop a capacity for “metacognition”, I “notice”, I observe myself and what is going on in the environment. I can interpret all this in a new way. This whole capacity for emotional regulation depends on the cultivation of mindfulness.

  • Reflection, when something has happened to you, analyse and learn. There are no mistakes but there are experiences. Be responsible in analysing when something has not gone so well, without blaming yourself.
    This can also be done as a team (nurses, doctors, therapists, volunteers…) talk, ask ourselves objectively, without blame: what happened, what did we learn, what could we have done better… This is how the team grows and learns.

There are examples of how to cultivate attention

  • Taking breaks during the day, for example when I wash my hands, taking the opportunity to breathe, to connect with our inner self… Not running from one place to another all day long.
  • When there is a complicated situation, a sick person in a difficult situation, a family in need of help, etc. Slow down, breathe, get ready and connect!
  • The invocation: I am an instrument of life who will help this patient, I will not enter the room alone. I ask for the most sacred to accompany me… it has no name (the energy of the Universe, the holy spirit, atman, Allah… no matter the name) and I ask so that I can serve these people with my best attitude. You go open, connected, present!

I invite the practitioners (with the scientific method) to do this, and try how it works for them. If it doesn’t work for you, forget it. But, if it works for you, you know that you are not alone and that life inspires us to be of service to others.

We asked Enric Benito for a final recommendation and he told us: We are tools to serve others.

Presence arises from humility (I know what I know and I know no more) and from courage. To invoke that presence and cultivate the connection with the essential is an itinerary that we can cultivate.

I believe that accompanying and caring for others is one of the most powerful spiritual paths to develop as a person, not only as a professional, but as a human being.

Cultivating Presence is a path we can take every day, throughout our lives, to develop the best version of ourselves.

Rehuno Health

At the end of Life