29 Nov 2022

Self-awareness when working with people at the end of life

From Nine To Noon, 11:30 am on 29 November 2022

"If you want to deal with the dying, deal with your own shit first," is the key piece of advice that shaped palliative care nurse Susan Marsden's career. 

It was given to her back in 1978 by the eminent psychiatrist and author of On Death and Dying Elisabeth Kübler-Ross.

In the new book Thank You, Elisabeth, Marsden reflects on the healing power of self-awareness and some of the amazing people she's connected with.

Portrait of Sue Marsden, plus book cover

Photo: Supplied

Marsden tells Kathryn Ryan that at the time she had no idea what Kubler-Ross was getting at, but eventually recognised that to be able to do the best work, first some of her own issues had to be acknowledged and dealt with.

Anybody tasked with supporting someone who is suffering will soon find that any unresolved grief from their own past can be easily triggered, she says.

"If [the other person's emotion] is suddenly triggering or evoking in me a whole lot of unlooked-at griefs from the past then that will come to the fore.

"[My past emotional experience] is going to be projected into the situation so I'm less able to be present and really focus on what this person's needs are and really hear them."

The other important aspect of caring for the dying is learning how to take enough care of yourself, Marsden says, not just as a healthcare professional but as a human being.

In the book, she writes of an awful knot that would appear in her stomach every time she had to visit the room of a patient named Anna.

"I thought 'what the hell is this about?' ... What I realised was seeing Anna lying in this room - it was a four-bed room and she just looked so lonely - was evoking in me the loneliness of my own life."

Marsden was going through a "very acrimonious" divorce at the time and also carried painful memories of leaving behind her toys and friends in England aged 5, when her family moved to New Zealand.

"Once I'd worked through some of this stuff and realised what this knot was about. I still remember going to Anna's room … and sitting on her bed and feeling that I could actually create some safety for her or be there for her.

"She looked up at me, sat up and threw her arms around me and said 'Oh, you look better today!' From then on, I was able to support her and not have my issues get in the way."

Old woman's hands clasped.

Photo: Timothy K Hamilton/Flickr