Counseling Psychology


Becky's Legacy: More Lessons

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Taylor & Francis


In this commentary on Werth's (this issue) article, the author attempts to continue the work of “meaning making” by describing 10 lessons that were evident to him, based on 25 years of experience as an end-of-life researcher and clinician. He highlights the impact of stress, the importance of communication, the idiosyncratic definition of a “good death,” the role of patient-centered care, the power of self-efficacy, the need to integrate theory and experience, the use of interdisciplinary teams, the impact of altruism and having a sense of purpose, the need to listen, and the healing effects of communicating about loss.

At the conclusion of Becky's Legacy: Personal and Professional Reflections on Loss and Hope, Jim Werth lists the lessons he learned from his love—and loss—of Becky. One of these lessons, to “find or make meaning in your life,” was certainly a guiding force spurring him to assemble his reflections on loss and hope. Reflecting on these general kinds of experiences is not new to Jim Werth, an end-of-life specialist. However, perhaps new to him is carefully examining how his own intensely lived experiences correspond to the findings and conclusions of contemporary end-of-life research and theory. Werth's efforts to make meaning for himself and to expand on that meaning by sharing his insights with others, are a gift to us all. He tells his and Becky's story and then draws our attention to the many topics in the end-of-life arena with which the story intersects, including the nature of the “good death”; issues arising in the transition from curative to palliative care; orchestrating good pain management; implementing advance directives; weaknesses in the DSM-IV (American Psychiatric Association, 2000) treatment of grief and depression; the role of resilience, spirituality, and altruism as coping resources; and the myth of stages in dying.

In my role as commentator on this essay, I want to continue the work of “meaning making” (Neimeyer, Prigerson, & Davies, Citation2002) that Werth has begun and to highlight some other lessons that I see in his reflections on loss and hope. I will do this by connecting Jim's and Becky's experiences to more general issues I am concerned with as an end-of-life clinician and academician. Along the way, I will share some of my clinical experiences and the learnings I took away from them. I hope these contributions are useful additions to Jim Werth's remarkable essay on love, loss, and hope.