I’ve worked with enough families to know that EVERY family has baggage and complex dynamics (mine included!). Add in the stress and grief-inducing task of working with your family members as one is entering end of life and you likely have a recipe for disaster. What is already hard is made harder by things like your long standing bitterness towards your brother for being the favorite, or your mom leaving the room whenever conversations are hard…all this history just compounds on itself.
So when I had a conversation with Leigh Ann Roberts from the Dying Well Project on how she helps families work through these dynamics and history to come together and walk a family member through end of life productively and cohesively, I had to know more. Add on top of that that she also uses the Enneagram, a personality indicator, to facilitate these conversations, I was hooked. I am a self-proclaimed lover on the Ennegaram (I’m a 3!) and had never before considered using the known traits of a family member’s personality to help aid these hard conversations and avoid common pitfalls.
See my conversation with Leigh Ann on how you and your family can better come together in the incredibly difficult season of end of life.
In what ways do you see families struggling to make plans and prepare for death?
I often see families struggling to “team” well as they begin to communicate, plan and prepare for a loved one’s death and dying process. As a workplace mediator for over 20 years, I know first-hand how challenging teaming is for groups. There are very predictable pitfalls of group process, and companies and organizations routinely invest significant time and resources to help the people on their teams succeed and manage important projects skillfully. Some of these techniques are timeless truths blending ancient wisdom carried by indigenous lineages and historical teachers with modern best practices informed by emergent data in neuroscience and more. The approach I use has both “ancient roots and modern branches”, a term coined by one of my own teachers and mentors Kay Pranis, and one which I see offering a variety of entry and engagement points for family members that bring their own differences to these complex conversations.
What are some reasons you think families struggle to have these conversations? And how much do you think our family systems and knowledge of past experiences play into that?
First of all, I hope families will take great comfort knowing that teaming with relatives is what I call “advanced” teaming. Group dynamics are challenging enough for trained professionals with little to no history; throw in family dynamics, heightened stressors of life and death, trauma, codependency and that unique brand of disfunction that are special to family gatherings, you begin to see why this process thrives and flows with intentionality and skill. Another important reason families struggle teaming is often because we all fall into rote decision making patterns and roles we have played in our families. Teams work best when each person is confident to take risks, speak openly and share from their various intelligence centers each of which is helpful for various aspects of the work of family care teams. (Everyone has head, heart and gut intelligence centers; although some centers are more dominant or preferred than others.) Teams, especially family care teams, experience the most resilience and effectiveness when each person is contributing from their strengths. These teams experience less conflict and the process is often much more true to the wishes and best interests of the dying individual.
How do you think personality indicators like the Enneagram can be useful in end of life conversations? What are some ways of using personality information can lead to better conversations?
I love using assessments with families- they are such uplifting and affirming tools to “break the ice” and start the more challenging conversations needed to achieve the common vision, goals and/or values of the dying person. Assessments like Strengths Finder and Enneagram are some of my favorites and some group members may already have an affinity for another assessment like Myers-Briggs, DISC, True Colors or the Thomas Kilman Instrument (TKI for conflict style) they experienced in another setting like school, church/temple or work. Whatever the assessment, I find that families enjoy exploring more organic and positive ways of coordinating the tasks and functions of the dying persons death plan and process. These tools also provide a clear way to harness the cognitive diversity and perspectives of each family team member- all of which is needed to navigate the complexity, changing stages and varying speed of decision making that arise in the death and dying landscape. I also find that some families have a “culture” of learning and growing together. Weaving assessments into the process of dying well, can actually help the process be generative, resilience building and even, dare I say, enjoyable at a time when levity and hope are so needed and where learning and developing, whether individually or collectively, is particularly challenging.
What are some proactive and productive ways to get families to have these important end of life planning conversations?
My goal in working with families is to help them find the confidence and skill needed to have intentional conversation and partnering designed with supportive structures based on best practices. The beautiful part about these best practices and structures are that they are simple. They support and foster engagement and efficacy allowing even grandchildren and extended family to find their footing and contribute to the shared leadership. I should note, however, that just because something is simple does not mean it is easy or comfortable to do. Having just a modicum of support and guidance getting started in this teaming process enable family care teams to step confidently into the conversations that matter for their loved one’s dying process. Organizations and community groups invest in teaming support- why shouldn’t families. Participants develop greater skill for experiencing self-determination in their own death planning and the family system as a whole may enjoy more ease and competency around death and dying in the future. Together we explore some of the more challenging conversations that occur in this process and plan for realities like caregiver fatigue, grief and emotional intensity, uncertainty, uncomfortable dissonance-producing complexity, power dynamics and more.
How does working with you help families put all these different elements together? Why do families engage your services?
When I work with families, participants experience a process that restores, builds and deepens trust among participants. Because of my background in helping teams navigate conflict and challenging conversations, participants develop behavioral norms and agreements that help the group establish a tone of respect while also setting clear expectations for their partnering together. I often tell families “you can’t get to a good place in a bad way” and never is this truth more important than in honoring the wishes of the dying. When the dying see their family members partnering well and honoring the vision of a death plan, the dying person can relax a bit into their own work of dying trusting their family team to support their vision and plan. Sometimes family members are concerned about a certain family dynamic and how that will impact the dying person’s process. I work with families to create an appropriately inclusive process that helps participants define and maintain boundaries so that no one member over or under functions in the team. Families are able to practice using a process that cultivates a deep listening to not only the participants gathered but also to the dying family member and his or her vision for a self-determined dying process. These discussions equip the family team with the shared vision needed to champion and support the wishes of the dying member and to confidently partner with and guide palliative, hospice and other healthcare professionals. This fidelity to the wishes of dying family member is both essential for dying well and also for the living who often find a great deal of comfort in grief knowing that the autonomy and self-determination of the dying person was preserved and reflected in the dying process. This is real “legacy” work in my opinion. By providing space for family members to be with their own emerging experiences of the coming loss, the family team becomes a grounding place for each person to be reminded of the importance of attending to their own grief process and their growing capacity in grief. This decreases the likelihood there will disruptive crisis points in the execution of the death plan. Future generations see how the generation before them “be” about death and dying- positively shifting the norms and culture about death in that family and also giving family members more confidence to attend to partnering “knots” in the family system, heal areas of dissent that emerge and even to begin articulating their own end of life wishes.
All such great information! Thanks so much, Leigh Ann!
Learn more about Leigh Ann Roberts here and her work with the Circle Center and Dying Well Project and how she and her colleagues support family care teams and individuals looking for end of life partnering, training and facilitation support.
We are invited to join the growing community at the Dying Well Project where we can find resources to help families find the confidence and skill needed for critical conversation and partnering in end of life planning. Leigh Ann and her team provide family care team facilitation, end of life coaching and training for end of life professionals. The Dying Well Project is committed to supporting a death-competent culture by training professionals, family members and coaches to be end of life partners.
Friends of Sunny Care Services receive 50% off the next 90 minute Dying Well event with coupon code: DyingWell. To register: www.DyingWell.net