Conversation with Elena Sipán from Peru - thanatologist and founder of 'The elephant in the room'
Kasia - Your Facebook page is followed by more than 8000 people. Why did you call your project ‘The elephant in the room’ and how can your online grief community support people who have lost a loved one?
Elena - I am a thanatology teacher trained here in Peru and Mexico. When I began to study it, I noticed that the people I studied with, were very open to share their personal experiences, issues that had happened to them or people very close to them. It was when I realized that there was a tremendous need to talk things out and that there was no space to do it outside of our class.
'The elephant in the room' is basically a situation in which there is a problem. Imagine that you have an elephant in your room and I visit you and I don't ask you what this is, how it got here and what it is doing here. There are many people who live their lives with these kinds of problems. It's not that we don't notice other people's elephants but it requires a lot of work to ask the other if they want to talk about this. And to talk about this I first have to learn to talk about my elephants. .Of course, the more we all try to hide something so impossible to hide, it becomes a taboo. I started my project because I realised that there is no space where we all dare to say: yes, there is an elephant. At the beginning, on my Facebook page, I only shared reflections, images, tools on how to work with grief or books that I had read. Then people began to write to me telling me their stories. I was surprised that there was such a need to share personal things with a person they didn’t know.
Sometimes now, my followers leave comments telling what happened to them and how they feel knowing that no one is going to judge. So it is an inclusive space, without any philosophical or religious affiliation of any kind, where people share their grief and feel accompanied, especially now during the pandemic.
Kasia - I don't have much experience in talking to people at the end of their life. You spent many years visiting hospitals where you spoke to very sick, sometimes dying patients. It seems to me that although we know that people at the end of their life may have a need to talk about their life and death, there is so much fear in us that in the end, we choose not to start this topic. How to talk to a dying person and what is important in this conversation?
Elena - The art of speaking is to listen. People at the end of life have a need, if they are conscious, to share memories or things that have happened to them and are important to them. They just want those around them to pay them attention. The important thing is to sit next to each other as calmly as you can, facilitating this space. In a conversation like this, the accompaniment is horizontal - more than anything you guide me towards what you want. It has happened to me that people did not want to talk. Silence is also therapeutic when we accompany a dying person because the idea is that this person does not feel alone and that feels that there is someone who looks at them as a person. There are also conversations at the end of life in which one sometimes needs to put their voice to the things that have happened to them. Because there are things that they did not share with anyone before. This is all very moving.
Kasia - And are there any questions you ask to start this conversation?
Elena - When I was volunteering, I wasn't necessarily going to hospitals to talk about death, but it was a topic which often came up. I always told my patient: 'I'm here to talk about whatever you want'. Sometimes we didn't talk, we just painted together or talked about the news, nothing personal. When that bond became more personal, they felt more comfortable to open up. So, the principle is that to be able to talk to someone, you have to be present and not bring ideas to what you want to say about death or about what is going to happen after someone passes away, because you don't know, because you have never died.
Now I always tend to tell people what I do. I say: 'We can talk about everything but maybe there are some topics that you probably want to delve into'. A good way that I discovered working in the hospitals, was to talk about their places of origin, because most of the people that I visited here in the capital of Lima, came from other parts of the country. And now that they have told you all that, they are going to tell you other things. How they can connect their life with the things that have happened to them, what they miss, things that suddenly worry and hurt them right now. Sometimes they want things to be like before, but they know it won't be possible, or they realize what a great life they have had. Sometimes people just want to tell you things without expecting an answer. And you do not have to validate if what they say is right or wrong, they just share things and that's it. People at the end of their life have so many things to share, so much of what you as a human being had to learn. It is really a privilege and I really appreciate the times that I have the opportunity to accompany someone in that process.
Kasia - You also work in the area called a memory craft. What does this mean and how can we fondle our memories in the context of grief? I love this expression because it is so soft and it gives me a certain kind of reassurance.
Elena - I tried to use words that are more concrete, because the words ‘fondle’ and 'craft' have to do with the art that heals. And they also carry a certain degree of commitment because grief is a commitment to managing pain. No one can do it for you and it is not something you can stop doing so that the pain will resolve itself when time passes. It is as if you carried a memory locked in a drawer thinking that it will not hurt because you are not very aware of what is in this drawer. Again we talk here about this bad image of the elephant in the room. What we really have to do to manage pain is face it. Feel it, say here I am, this is happening to me and this is actually hurting me. Sometimes one confuses or believes that what they see is the absence, but within that absence there are other things that hurt us. And everything that hurts us in grief is something personal, which is totally selfish. It doesn't hurt that your grandmother died, it hurts you above all not to have her.
The pandemic has left us without places and the possibility of saying goodbye so what we need so much now is to go from the abstract to the concrete. We need the body to caress it, to honor it and to say goodbye to it with dignity. I do not promise anyone that I will heal them, what I can do is to give a place to the memories that someone wants to preserve. Grief cannot not be overcome because there are pains with which we live.
So during my memory craft workshops we evoke not only the memory but we also work on it, look for it and feel it. And we never allow anyone to invalidate your memories and tell you to forget about them. We work with objects, references to music, meals, and photographs to create healthy memories where that person, who you are missing, was alive because if you think about it they were alive all their life.
Kasia - I know that you work with employers teaching them what they can do to support their employees in grief. Why is this all so important, and what steps can employers take to create a safe space for everyone to feel good at their job place while going through a loss?
Elena - To begin with, I would like to say that because of the pandemic, all of us lost not only our loved ones, but also spaces and places. Your office is also the place where you have friends, you spend time, you share many things, it is a group of people who support you. The fact that we had to lock ourselves at home has created a kind of loss.
At the very beginning I organized some talks around this topic at universities, not so much for students but for administrators who began to work remotely. Then before Christmas, 3-4 companies hired me to do grief talks because they realized that the spirit of celebration was not felt because there were many people missing within the company or the family. They basically wanted to learn how to handle it. Now I also work for a bank organizing grief pedagogy workshops for a group of leaders and we talk about how to facilitate a space for conversation where we talk about what has happened. Because it happens often in a workplace that when something serious happens, like the death of a colleague, nobody explains things well and a rumor is created. People get distracted, make more mistakes. We also talked about how to accompany the communication of bad news by working with the memory craft. You can say: 'He was not my friend, but I am sorry that he died'. Of course, because he was a person with whom you have shared time and there are probably things that you remember and above all that you value about him and you never told him. I recommend to all who have been affected by that to write, to make a place where they can hang their messages or a photograph of this person, without taking their place but slowly start to perform their responsibilities because the work has to carry on. Employers have to realize that their employees have to work, but they cannot work with pain, so they should start facilitating difficult conversations because if we do not do that, we will fill ourselves with elephants.
We all have to remember that in any job we are people. It has happened to all of us to work in pain because for example your mother has gotten sick, because they have to hospitalize your brother or because you are sick and you are afraid of losing your job because no one can cover you. All this is terrible but there are ways to accompany this process of humanization. As an employer I have to know that my employee is a person to whom things happen. I help them to grow economically but this money also helps them to study, meet goals, travel, and dreams.
Kasia - Could you tell me a bit about your cultural approach to death? Do people in Peru talk about dying and grieving?
Elena - I'm doing a bit of research around this topic and it seems to me that today's society denies death. There is no room for death, everyone wants to see you well because the bad is no longer shared. Pre-Columbian cultures, like mine in Peru, have a way of grieving, shaping pain and celebrating life. But it is something that we are losing, probably through migrations. I am from Lima, my parents are too, but my grandparents are not. It is not known how many rituals we have already lost because the migrant community could not preserve them because they were discriminated against. There are people who migrate from the Andes, the region here in Peru, who preserve deeply healing rituals of celebration. The rituals that allow you to talk about life, death and pain, as a community and provide support at that time. But in general I would say that here in Peru there is an ambivalence and a struggle between the new generations that do not contribute to that legacy and the older people who do. This is perhaps because of ignorance and the fact that death is not something that is shared, hence a taboo is created. People do not talk about pain, despite the fact that we are a very resilient society which has experienced a deep and eternal grief due to terrorism, people who disappeared and so many other situations that also create a community grief.
Kasia - You said that accompanying and talking to people who are dying is a privilege because you can learn so much from them. What did you learn from your conversations and what do you remember most about them?
Elena - I think the most I can remember is when people I speak to review their life and are left with the idea that we have to be grateful for everything that happens to us. There is no bad experience from which we cannot learn or get something positive that has connected you with a part of you that you did not know. When people tell me about their life in which so many difficult things have happened to them, I sometimes ask: 'but what pushed you to keep going?', because I see that sometimes they don't realize how strong they had been.
It also seems to me, I don't know exactly why or by whom, that we are all connected. All emotions, no matter how hard they seem or how emotional you are, we all deal with them in the same way. Pain is a unique experience for everyone and at the end of life a kind of special lucidity about your life reaches you as if you recently realized the experience of being alive. But not only to go through your life, but to be aware that life is here and that we do not know how long it will last. I also believe that there are things that we should always say when we say goodbye. We cannot expect to be in a difficult situation because at the end of our life it really matters how much you have loved and have been loved. And it is what people stay with. Sure, the fear of death appears in these conversations but it is definitely worth doing this work of gratitude.
Kasia - I realize by running this project that talking about death is actually talking about life.
Elena - Actually, the thanatologist's job has not so much to do with death, but rather what a person ends up being at the end of life. It is a process of reconciling with a biography. Do you know what the hardest thing is at the end of life? That someone has never asked themselves who they were and what they were here for. They spent their life working but never knew what they liked to do and what they were good at.
Translated from Spanish by Kasia Borowczak
Corrected by Jen Fearnley
Elena Sipan Moscoso
I am a publicist, communicator, humanistic counselor working in Carl Rogers's person-centered approach, thanatologist, and grief therapist. I work as Director of Thanatology, Grief and Mourning at the Elisabeth Kübler-Ross Peru Foundation.
I am also a teacher, workshop leader and blogger of the Facebook page 'The elephant in the room', where I share tools and reflections on everyday thanatology. This project also aims to be an online space, in times when we are physically separated but need to be heard.
The main definition of my profession is communication. My job is to facilitate people's communication with themselves and with others.