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Abiding in liminal space(s) : inscribing mindful living/dying with(in) end-of-life care Bruce, Winifred Anne

Abstract

Mind-body approaches such as mindfulness meditation are increasingly incorporated into health care. Despite a growing interest in mindfulness, its Buddhist philosophical underpinnings remain unexplored in nursing. Without an awareness o f the nondualistic assumptions embedded in mindfulness and Buddhism, interpretations of this Eastern practice are limited. This inquiry engages Buddhist philosophical thought and the experiences of meditation practitioners. The purpose of this study was to explore mindfulness by those who regularly practiced mindfulness meditation and were caregivers in a Zen hospice or living with a life threatening illness. Approximately ten weeks of residency in a Zen monastery, and participation in day-to-day volunteer caregiving in the Zen hospice were undertaken. Indepth unstructured conversations were conducted; mindful, open-ended reflexivity (Varela, Thompson, & Rosch, 1991) and koan construction were used in ongoing analyses and interpretation. Theoretical explorations in this inquiry constitute and reflect knowledge(s) about that which is unknowable, indistinct, and ambiguous. The inquiry addresses how we may point to 'that' which is beyond words with attention given to language and what happens with/in language as we write and are written through texts. Unconventional forms and writing are used to question conventional privileging of representational binaries that value words over silence, life over death, clarity over paradox, and knowing over unknowing. Death, re-interpreted in the Buddhist sense of the participants, is constructed as momentary experience occurring each mind-moment. Life is not necessarily privileged over death, but rather is seen as a doubling o f living/dying intertwining within momentary awareness. A re-configuring of living/dying is suggested that differs from Western perspectives where 'living' holds hegemony over 'dying'. Death is situated in the midst o/:—liminal space(s) of being/not being and ubiquitous change while mindfulness meditation is seen as a parallel process providing an embodied realization of this transience. These perspectives may help nurses and health care professionals go beyond dualistic views and provide guidance for abiding in the midst of suffering that may be beyond words. Further inquiry into non-conceptual awareness and its relationship with health and wellness is needed.

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