A fresh look at making New Year’s resolutions work…

Another year is beginning… We could just go with the flow, take life as it is, and be ourselves. 

But then, feeling completely at ease with ourselves, and with the way our lives are unfolding, may be a step or two away. There may well be things we would like to be different… 

Time for another New Year’s resolution? If so, how to make it stick? 

This week, a new approach that really does work, but first 

       Thought for the day

Taking life seriously does not mean spending our whole life meditating 

As if we were living in the Himalaya Mountains or in the old days in Tibet. 

In the modern world, we have to work to earn our living,

But we should not get entangled in a nine-to-five existence, 

Where we live without any view of the deeper meaning of life.

Our task is to strike a balance, 

To find a middle way, 

To learn not to overextend ourselves 

With extraneous activities and preoccupations, 

But to simplify our lives more and more. 

The key to finding a happy balance in modern life is simplicity.

                     Sogyal Rinpoche

 

The wonderful thing about New Year’s resolutions is they always seem so sound, so logical. 

This year I will meditate more. This year I will drink less, exercise more, be kinder, more tolerant, more aware, more forgiving… all so sound, so logical; how could we not take up on any of that? Yet for many, a week or two into January, not only has the change not been accomplished, it is probably even forgotten!

So… how to actually make personal change? How to work with our mind? 

Having helped people with this for decades, many readers will probably be familiar with the Three Principles of Positive Thinking. These Principles have helped many people to set goals, follow through and accomplish them. Changing habits, changing environments, changing ways of relating – these 3 steps really do work. But in this post, a new take; another way of making personal change. 

(You can check out the Three Principles in The Mind that Changes Everything or You Can Conquer Cancer).

The fresh approach? 

Answer these 5 questions: What?, Why?, How?, When?, and How much?

1. What - Set Your Goal. Three important points:

i) Goals can come to us courtesy of whims, emotions, rational thought, contrariness, contemplation – or because somebody tells us what to do! 

Best be clear where your goals are coming from, and make a deliberate choice. 

Experience is pretty clear here; the best goals come from combining the use of the intellect and contemplation. Details are in The Mind that Changes Everything.

ii) A goal can be focussed upon an outcome or an action. Both are valid, but quite different. 

An outcome might be catching a plane overseas and as such is quite time dependant and uncompromising. The actions required to purchase the ticket and get on the plane may change over time and benefit from a flexible approach, but the time of departure is fixed. 

Many goals are like that; the outcome is fixed, the actions required to accomplish the outcome may well need to change to adapt to evolving circumstances and as such, are best to be flexible. Here, the goal is uncompromising, the actions are flexible. 

An action might be to meditate daily – no wriggle room there – you either do it or you do not. You may relapse and need to recommit, but basically, the aim is to be doing the action as intended. Here, the goal is the action and as such it is inflexible.

iii) Aim to reduce your goal to a few words, and express it as an affirmation – in the first person, present tense, as if it has already happened. And in a way that is joyful!
Example? Not I hope to meditate daily and with a bit of luck maybe I will some time off in the future, but it seems a bit unlikely, I have tried it before and it was pretty difficult… ; rather I really enjoy meditating daily, now. The mind responds to hearing this - first person, present tense, as if it has already happened, not the previous vague waffle.

2. Why?

Why is it time for this change? 

Example? Maybe you have been meditating off and on… Very common… But maybe it is becoming even clearer: when I do meditate everything seems easier, everything seems to work out better. Funny that… 

Maybe you do need to heal something? Maybe you do aspire to becoming a better person? Maybe it is time to get to know yourself a little more deeply?

The stronger the Why, the easier the How.

3. How?

What will it take to accomplish this goal? 

What do I need to do? 

Example? Meditating daily. 

If you have good personal discipline, you probably do not need to read on; just do it. 

However, many I have helped over the years did have good, clear goals, and yet they struggled to accomplish them. 

If this is you, you need to plan.

Consider supports like establishing a routine, setting up a good practice space, starting small and building, providing yourself with rewards once landmarks are passed, seeking contact with teachers and like-minded company you can learn from, share your goals and your progress with, consider writing a journal, record your practice and share your results with those close to you. What does it take?

4. When?

Some goals have a definite timing to them, like catching a plane; others are more flexible.

Unless the goal is time dependant – like the plane trip – it is preferable to keep the time for accomplishment open. This is not a cop out; some goals might take longer than planned, others be accomplished quicker. It works to keep the time open where possible.

5. How much?

This may well be the most important step to get clear. Is this goal, this new resolution, a matter of life and death? Will you do absolutely everything possible to accomplish this goal? Or is it a matter a little importance? If it works out, all to the good; but if not, who cares???

This question when answered brings the previous 4 together into an intention – that motivating force that can be casual or unstoppable depending upon how much you want it. 

I remember in my sporting days, training each day was a non-negotiable; it was what I did every day and all else needed to fit in around that. When I was really ill back in the 70’s, healing was my priority and all else needed to fit in around that.

When the goal is clear and the intention is strong, amazing things happen. “Miracles” happen. 

May 2023 be a year of personal miracles for you and all you care for and about…

 

RESOURCES

Allevi8 App – free meditation practice app with options for online group teaching/mentoring

 

Digital downloads – Mind training

 

The Mind that Changes Everything

 

You Can Conquer Cancer

Mindfulness as effective as an antidepressant for anxiety

If you have some anxiety, you are not alone. Whilst in 2022, 63.4% of adults were estimated to have no anxiety, 25.5% had low level anxiety, 7.1% medium anxiety, and 4.1% were claimed to have high anxiety.

So what to do? What does the evidence say? New research published just last month has shown a guided mindfulness-based stress reduction program was as effective for patients with anxiety disorders as the gold-standard drug - the common antidepressant escitalopram. So this week, how to apply this knowledge and details of the study itself, but first

         Thought for the day

   One forgets the self, 

   Zen teachers say, 

   By becoming one with the task at hand. 

   At such moments, 

   Released from the burdens of selfhood, 

   One glimpses, however briefly, 

   A state of spiritual wholeness that underlies 

   And supports one’s everyday consciousness.



                         Andrew Cooper

Common side effects of escitalopram are listed to include trouble sleeping, nausea, sexual dysfunction, drowsiness and feeling tired. More serious side effects may include suicidal thoughts in people up to the age of 24 years.  It is unclear if use during pregnancy or breastfeeding is safe.

Research establishes common effects of mindfulness include better sleep, good digestion (and with use of our Allwevi8 app, a specific and significant drop in nausea for those affected by it), sexual satisfaction and increased energy levels. When used during pregnancy, there is likely to be increased calm and ease in both mother and baby, and breastfeeding is likely to be facilitated for the better due to this increased calm and ease.

Of note, approximately 15% of the U.S. population tried some form of meditation in 2017.

This said, anxiety disorders can be very tough. Anxiety disorders include generalized anxiety, social anxiety, panic disorder and fear of certain places or situations, including crowds and public transportation, all of which can lead to an increased risk for suicide, disability and distress. Therefore, these disorders when severe are commonly treated in psychiatric clinics. 

In October this year, the United States Preventive Services Task Force for the first time, recommended screening for anxiety disorders due to the high prevalence of these disorders.

Drugs that are currently prescribed for the disorders can be very effective, but many patients either have difficulty getting them, do not respond to them, or find the side effects as a barrier to consistent treatment.

Elizabeth Hoge, MD, director of the Anxiety Disorders Research Program, associate professor of psychiatry at Georgetown and lead author commented:

"Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers." 

"A big advantage of mindfulness meditation is that it doesn't require a clinical degree to train someone to
become a mindfulness facilitator. 

Additionally, sessions can be done outside of a medical setting, such as at a school or community center."

Standardized mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR), can decrease anxiety, but prior to this study, the interventions had not been studied in comparison to effective anti-anxiety drugs. 

The clinicians recruited 276 patients between June 2018 and February 2020 from three hospitals in Boston, New York City and Washington, D.C., and randomly assigned people to either MBSR or escitalopram. MBSR was offered weekly for eight weeks via two and a half-hour in-person classes, a day-long retreat weekend class during the 5th or 6th week, and 45-minute daily home practice exercises. 

Patients' anxiety symptoms were assessed upon enrolment and again at completion of the intervention at 8 weeks, along with post-treatment assessments at 12 and 24 weeks after enrolment. The assessments were conducted in a blinded manner -- the trained clinical evaluators did not know whether the patients they were assessing received the drug or MBSR.

At the end of the trial, 102 patients had completed MBSR and 106 had completed their medication course. The patients were relatively young, with a mean age of 33 and included 156 women, which comprised 75% of the enrolees, mirroring the disease prevalence in the U.S.

The researchers used a validated assessment measure to rate the severity of symptoms of anxiety across all of the disorders using a scale of 1 to 7 (with 7 being severe anxiety). Both groups saw a reduction in their anxiety symptoms (a 1.35 point mean reduction for MBSR and 1.43 point mean reduction for the drug, which was a statistically equivalent outcome), dropping from a mean of about 4.5 for both, which translates to a significant 30% or so drop in the severity of peoples' anxiety.

"It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect," Hoge said. 

"Also, virtual delivery via videoconference is likely to be effective, so long as the 'live' components are retained, such as question-and-answer periods and group discussion."

Trial enrolment was wrapping up as the COVID pandemic started in early 2020 but most enrolees completed their eight-week course of treatment before the pandemic started. 

The researchers conducted a second phase of the study during the pandemic that involved moving the treatments to an online, videoconference, and that will be the focus of future analyses. The researchers also hope to explore the effects of MBSR on sleep and depression.

Reference: Hoge AE et al. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults with Anxiety Disorders. JAMA Psychiatry, 2022; DOI: 10.1001/jamapsychiatry.2022.3679

NOTE The Allevi8 app with its attendant online personalised, live mentor/teaching sessions, includes mindfulness techniques as well as meditation, contemplation, guided imagery and deep relaxation.

The MYRIAD trial. World’s largest mindfulness trial, early adolescence, mostly negative results… What can we make of it?

The MYRIAD study, the largest mindfulness study ever, and just published, has trialled a particular approach to mindfulness training as a universal intervention. It was a very large, well-designed English study that included over 8,300 children between the ages of 11 and 13. It was run by a high-quality research team with a big budget. 

The results were mostly negative.

Therefore, the MYRIAD trial results pose a clear challenge to the generally high levels of confidence and enthusiasm for using mindfulness practices in school programs—which often bring with them strong claims of being ‘evidence- based’. In this study, the mindfulness intervention did not do any better than Treatment as Usual (established social and emotional learning training).

The study’s authors concluded: Universal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.

So how do we interpret the results? This week we take a deep dive, and also include recently published studies examining mindfulness in schools programs that did record positive findings. My own limited experience with young children in schools has been very positive, so it would be good to hear comments from any teachers or parents with their own direct experiences, but first

  

 Thought for the day

     Acquire inner peace 

     And a thousand persons around you 

     Will find peace.

St. Seraphim of Sarov, 18th Century Russian Hermit

 

Clearly, we cannot ignore the MYRIAD study; its results do fly in the face of a good body of research attesting to the positive benefits of school-based mindfulness programs for adolescent mental health and behaviour problems (see the results of three evidence-based review papers below). So, what conclusion are we to take from the MYRIAD study? Is it that mindfulness does not work, or that mindfulness works but not for people of this age group, or that mindfulness works but the program delivered was not a good program, or that the research was poorly done and therefore delivered a false finding? Well, the research team were high quality and it was a thoroughly designed and well thought through study, so it is unlikely to be the latter. Then let us explore the other possibilities.

There seem to be several issues:
1. The results could be accurate and a warning signal.

2. The study focused upon children 11 – 13. So it really says nothing clear about younger children or adolescents aged 15 – 16 etc. It may be children in primary school could usefully be grouped together, and be considered separately from those in secondary or tertiary education, but this remains to be seen.

3. The real challenge for running mindfulness programs for children is to make them interesting, relevant and to contextualise them to their lives and what is important to them. It seems many children in this study did not like the practice and did not spend time doing it. 

It appears, those who did like it, and did practice, did gain significant benefits. Perhaps they needed to be engaged better, or the children will need an opt out clause, or maybe mindfulness interventions are particularly challenging to deliver successfully to whole cohorts of students rather than just those who self-select to do it.

4. This study taught one style of mindfulness to over 8,000 children. Previous studies, where results were positive, were much smaller and may have adapted more to their limited audiences. It may be one learning from this study is the need for more prior consultation and then to adapt promotion and methodology to fit individual schools, communities and children. This is a need experienced in most public health initiatives. In other words, if mindfulness is to be adopted widely, there may be a need to be flexible with delivery and teaching styles.

5. The training provided for teachers in this study was comprehensive. Many current programs have much lighter trainings. It seems likely a high level of training is likely to be important. Some studies have shown results are better when programs are presented by external experts, rather than internal teachers. 

6. There was a small increase in some negative outcomes (e.g. more reporting of attentional problems, more obsessional traits, becoming less mindful) for some participants in the mindfulness group. Whether that is a negative outcome of the mindfulness intervention or simply an outcome of students being more aware of something they were previously not noticing is a question that is hard to answer. If the children are becoming more aware of what they were previously not noticing, then the solution is not necessarily to stop teaching them mindfulness but rather to help them to gently but mindfully work with these challenges. Possible responses to this observation might be to include better support for those students who are really struggling, and that the way we work with children be adapted to different needs.

Finally, whether this paper answers all the questions or whether it raises more questions than answers (e.g. why this program did not work, what kinds of school-based programs do work for adolescents and why?) is hard to say. It certainly cannot be ignored, but it is likely to provide a lot of impetus to naysayers, and at the same time be a challenge to people delivering whole of school mindfulness programs to reflect long and hard on what they are delivering and how they do it. 

It is clear much more research is needed – soon.

ACKNOWLEDGEMENTS

Gratitude to Professor Craig Hassed of Monash University’s Centre for Consciousness and Mindfulness Studies, and Assoc-Professor Nicholas Van Dam of the University of Melbourne’s Contemplative Studies Centre for their assistance in collating and reviewing this post.

RECENT RESEARCH

Here are recently published studies examining mindfulness in schools programs that did record positive findings.

Meta-analysis of Randomized Controlled Studies (RCTs) shows Mindfulness-Based Interventions improve the mental health and wellbeing of youth – 2019.

Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. 

In this study, a systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included.  Across all RCTs the research found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen's d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only. 

Conclusions: This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. 

Dunning DL et al. Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents - a meta-analysis of randomized controlled trials. J Child Psychol Psychiatry. 2019 Mar;60(3):244-258. 

Update for the Dunning meta-analysis – 2022

The previous meta-analysis from this team (2019), suggested that MBPs show promising effectiveness, but highlighted a lack of high-quality, adequately powered randomised controlled trials (RCTs). This updated meta-analysis assesses the-state-of the-art of MBPs for young people in light of new studies.

Sixty-six RCTs, involving 20 138 participants (9552 receiving an MBP and 10 586 controls), were identified. Compared with passive controls, MBPs were effective in improving anxiety/stress, attention, executive functioning, and negative and social behaviour. Compared against active controls, MBPs were more effective in reducing anxiety/stress and improving mindfulness. In studies with a follow-up, there were no significant positive effects of MBPs. No consistent pattern favoured MBPs as a universal versus selective intervention.

Conclusions The enthusiasm for MBPs in youth has arguably run ahead of the evidence. While MBPs show promising results for some outcomes, in general, the evidence is of low quality and inconclusive. We discuss a conceptual model and the theory-driven innovation required to realise the potential of MBPs in supporting youth mental health.

Dunning D, Tudor K, Radley L, et al. Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials. Evidence-Based Mental Health 2022;25:135-142.

Mindfulness leads to less disruptive behaviour - 2017

The purpose of this meta-analytic review was to add to the literature by synthesizing single-case research on Mindfulness-Based Interventions (MBIs) with children and adolescents. Specifically, the effect of MBIs on youths’ disruptive behaviour was examined in 10 studies published between 2006 and 2014. Results indicated that, on average, MBIs had a medium effect on disruptive behaviour during treatment. The average effect of MBIs during maintenance phases was larger. Potential moderators of intervention effects were also explored. Implications for future research and practice regarding MBIs with youth and in schools are discussed.

Klingbeil D et al. (2017). Effects of Mindfulness-Based Interventions on Disruptive Behavior: A Meta-Analysis of Single-Case Research. Psychology in the Schools. 54. 10.1002/pits.21982.

How well do Mindfulness-Based Interventions work for school children? - 2022

This systematic review published in 2022 set out to assess the current literature on mindfulness-based school interventions (MBSIs) by evaluating evidence across specific outcomes for youth. 

The researchers evaluated 77 studies with a total sample of 12,358 students across five continents, assessing the quality of each study through a robust coding system for evidence-based guidelines. The highest quality evidence ('A Grade') across outcomes indicated that MBSIs increased prosocial behaviour, resilience, executive function, attention and mindfulness, and decreased anxiety, attention problems/ADHD behaviours and conduct behaviours. 

The highest quality evidence for well-being was split, with some studies showing increased well-being and some showing no improvements. The highest quality evidence suggests MBSIs have a null effect on depression symptoms. 

Conclusion: This review demonstrates the promise of incorporating mindfulness interventions in school settings for improving certain youth outcomes. The authors urge researchers interested in MBSIs to study their effectiveness using more rigorous designs (e.g., RCTs with active control groups, multi-method outcome assessment, and follow-up evaluation), to minimize bias and promote higher quality - not just increased quantity - evidence that can be relied upon to guide school-based practice. 

Phan ML et al. Mindfulness-based school interventions: A systematic review of outcome evidence quality by study design. Mindfulness (N Y). 2022 Jul;13(7):1591-1613. 

Discriminating Awareness

Everyone loves a good story. What follows is one of the best, that is then garnished with a particularly fine piece of political spin. But is comes too with a caveat that is worth pondering, so this week, enjoy a great story and what it has to offer, but first

Thought for the day

The teachings of the Buddha are skilful means; 

They are not absolute truth. 

The Buddha said,

“My teachings are a finger pointing to the moon. 

Do not get caught in thinking that the finger is the moon. 

It is because of the finger that you can see the moon.”

JUDY Rudd, is an amateur genealogy researcher in southern Queensland and has been doing some personal work on her own family tree. She discovered that Prime Minister Kevin Rudd's great-great uncle, Remus Rudd, was hanged for horse stealing and train robbery in Melbourne in 1889.

The only known photograph of Remus shows him standing on the gallows at the Melbourne Gaol.

On the back of the picture Judy obtained during her research is an inscription: 

Remus Rudd, horse thief, sent to Melbourne Gaol 1885, escaped 1887, robbed the Melbourne-Geelong train six times. 

Caught by Victoria Police Force, convicted and hanged in 1889.

So Judy emailed Prime Minister Rudd for information about their great-great uncle.

Believe it or not, Kevin Rudd's staff sent back the following biographical sketch for her genealogy research:

Remus Rudd was famous in Victoria during the mid to late 1800s. 

His business empire grew to include acquisition of valuable equestrian assets and intimate dealings with the Melbourne-Geelong Railroad.

Beginning in 1883, he devoted several years of his life to government service, finally taking leave to resume his dealings with the railroad.

In 1887, he was a key player in a vital investigation run by the Victoria Police Force. 

In 1889, Remus passed away during an important civic function held in his honour, when the platform upon which he was standing collapsed.

Sounds believable; almost appealing...

But then, there is truth, there is political spin, and there is fake news.

Sad to say, this story comes under the heading of fake news. Much as we might like to think dear Mr Rudd would spin a story about an errant ancestor, it just ain’t true.

Although the man in the picture was indeed a train robber, his name was not Remus, nor was he Australian. Thomas “Black Jack” Ketchum was a train robber in America, hanged in 1901 in Clayton, in the US state of New Mexico. 

The photo became famous partly because, according to a Colorado Encyclopedia entry none of his executioners were experienced at hangings, which led to Ketchum’s decapitation when his body fell through the gallows.

While Ketchum did have siblings it is unlikely he is related to any of the politicians that this long-running internet hoax has linked to the photo of his hanging.

So a great story. Not a true story, but a great story; and all the better as it can provoke us to reflect upon how readily we might take a story to be true, to be spun or to be false. 

Separating fact from fiction... Discriminating awareness.

 

Contemplating death can bring you more alive

Consider this an odd title? Maybe… However, we all know that one day we will die; and that leaves us all with a fundamental choice. Do we live our life in fear and denial of death, or do we live a life informed by death? It is obvious our attitude to death heavily informs how we live.

The basic proposition is that while the first option has more immediate appeal, the latter will actually serve us much, much better. 

Contemplating death can bring you more alive. 

Contemplating death can change your life for the better...

So this week, how to contemplate death constructively? How to plan for a good death? All prompted by me speaking on this theme for the Vajrayana Institute’s free online conference Dharma in Daily Life on Saturday the 8th October, but first

     Thought for the day

         What a beautiful and what a healing mystery it is 

         That from contemplating, continually and fearlessly, 

         The truth of change and impermanence, 

         We come slowly to find ourselves face to face, 

         In gratitude and joy, 

         With the truth of the changeless, 

         With the truth of the deathless, unending nature of mind!

                                             Sogyal Rinpoche

Reflect for a moment… 

It is clear… Fear and denial of death lead to either a defensive life, or a cavalier one. To withdrawal, to holding back, to anxiety and instability. Or to extravagance, bravado, risk taking, to the eat, drink and be merry for tomorrow we die style of living.

By contrast, a life informed by death means we take nothing for granted, we appreciate all we have, we make the most of relationships, we leave as little undone as possible. We are more present, more engaged, more grateful. More truly alive.

Most of us reach adulthood with little real reflection upon death. If, and when, we do realise the merit of doing so, then the question arises, how do we do it? 

Having worked with thousands of people facing life-threatening illness over 4 decades, what follows is a summary of the guidelines we shared in our self-help, lifestyle-based programs, and is reproduced from my book You Can Conquer Cancer - available as an audio book or in hard copy. 

May this checklist be of use for you, and if you follow through, you may well come to experience how contemplating death can bring you more alive.

END OF LIFE CHECKLIST                           

i) The practical matters - “getting your affairs in order”  

·            Prepare or update your will.

·            Attend to your financial affairs and ensure your partner can access joint accounts and other key financial and legal matters if necessary.

·            Create an Enduring Power of Attorney (a simple Power of Attorney ceases if you become incapacitated).

·            Consider establishing a Living Will or Enduring Power of Attorney – Medical Treatment form. This will set out your preferences and directions for end of life treatment options. These directions would provide guidance to medical staff and family if you become incapacitated, are not likely to recover, and choices need to be made regarding being left to die naturally or to have major interventions. You can also mention the levels of pain medication desired (maximum or minimal) and whether you would elect to have CPR (cardiopulmonary resuscitation) if your heart were to stop in this end stage of life. You could also nominate who you might want present (or absent) at the end of life and indicate a preference for being at home, in hospital or a hospice.

·            Consider your possessions. Do you prefer for some items to go to particular people? If so, make sure this is clear; maybe consider giving some things away while you are alive.

·            Designate who you wish to look after any children, parents or other dependants if you and / or your partner were to die. Make sure the designated people know and agree.

·            Complete as many of the tasks in your life as possible. Give priority to your “Bucket List”. Aim to die free of regret for things left undone – either do them or let them go.

ii) Communicate. Do not die leaving people wondering!

·            Express your love. You may think they know, maybe they are psychic, but tell them anyway!

·            Consider leaving messages for significant people to be read or viewed at significant times. This can be particularly useful and comforting if you have young children now. Ideally, your write or record your messages and deliver them in person on the 18th birthday or at the wedding; but if you are not there, the message will have real meaning.

·            Consider documenting your life. You could simply create a photo album from childhood on, or collate any old videos or DVD’s. Or you could be more personal and specifically record your insights, reflections, regrets, passions etc.

·            Forgive. Forgive. Forgive. Resentment is like a cancer in itself. Forgiveness heals the heart and sets us free. Review the forgiveness section in the Healthy Emotions chapter and do it! Forgive others. Forgive yourself.

iii) Immediately after death

·            What preferences do you have for your body? Should it be left undisturbed for a while, and if so, for how long? In hospitals especially, there is often a need to clear beds for the next person (a tough reality), but family and friends may find great value in being able to sit quietly with the body after death. Also some spiritual traditions indicate there is real benefit for the person who has died if the body is left undisturbed for even up to 3 days after death. This length of time may not be practical, but you may choose to indicate your own preference.

·            What procedures do you want carried out with your body? Have you registered for organ donation? Embalming is a highly invasive procedure and only legally required if the body is being transported internationally. Have you a preference for who should wash the body and what clothes it will be dressed in?

·            Have you a preference for a particular type of coffin or casket?

·            Burial or cremation? Where?

iv) Funeral Service

·            Do you want one? If so, will it be closed to include only the immediate family, or open for everyone who wishes to attend? Be reminded a funeral can help those left behind a great deal and consider wherever possible what will help them.

·            Where will the service be held and who will officiate – a civil celebrant or a member of your religious tradition?

·            What style of service? Traditional according to your religion? Themed such as New Orleans Jazz? What emphasis will there be on the celebration of life and the grief of loss?

·            What music, poems, readings to include? 

·            Who will speak? Who gives the main eulogy? Will others reflect on your life, offer readings etc?

·            Are there particular interest groups to include and feature such as sporting or service clubs?

·            What about after the funeral? Will there be a wake? If so where, who organizes it and how will it be financed and provided?

v) Anything else important?

If so add it to your list.

A healthy lifestyle makes for a good death

A surprising number of people make the mistake of approaching death in an unhealthy way. Some people tell me “I tried the diet and the meditation. It helped for a while, but now I am approaching death I am going back to my old way”. This is a crucial point. Eating well makes it easier to die well. Why? 

Because heavy foods and junk foods add a burden to your system. High fat diets make for sticky blood and lead to higher risks of embolism, stroke and heart failure. Bad diets promote inflammation that is both uncomfortable and is likely to aggravate any health issues you have. Bad diets are degenerative, whereas our healthy diet is regenerative and anti-inflammatory. Meditation is also anti-inflammatory and regenerative, whilst it also clears the mind, reduces anxiety and pain and helps us connect with who we really are.

If I thought I was really closer to dying rather than just the fact of knowing I could die any day, I would be even more particular about what I ate and drank, and I would meditate even more than the average one hour per day I do currently.

Be gentle on yourself. 

Live well and die well.

Contemplating death can bring you more alive.