What is End-of-Life Counseling? An Interview with Kathy Jacobson

Kathy Jacobson is a body worker and life coach in San Francisco, who also works as an end-of-life counselor. I sat with her to discuss her entry into this burgeoning, and much needed, field of therapy. Most people do not know what end-of-life counseling is. Kathy’s integrative therapy addresses both the mind and body of her clientele, where she has training in a ranging from Transformational Bodywork, to Voice Dialogue, and Reiki. She also speaks about death with a refreshingly direct fluency and ease, effectively counseling through a versatile approach that tailors to the client’s level of comfort, and openness, in discussing their spirituality.

Julia: How did you discover end-of-life counseling?

Kathy: It was a natural progression for me after working with this one client specifically. She had seen me for many years, and I worked with her husband as well. Unfortunately, she developed Parkinson’s disease, and she began losing control of her motor skills and speech. She was a person who was very much ‘in her head,’ and related to people on an intellectual level, so it came as a big blow to her when she began losing her ability to speak. She had never been a happy woman; she held a lot of tension in her body, bad arthritis in her fingers.

She had a hard time being open to intimacy; she and her husband couldn’t discuss things very easily together and kept many affairs around the household separate. For example, their finances were kept totally separate, where they kept  jar in the kitchen so that both of them could put their own money in to use for buying the joint supplies. The distance between them was palpable, though when she started to get ill and I asked him what he was most grateful for, he would only talk about her. There was a strong love there, and I would work on encouraging this as a dialogue.

The distance between them was palpable, though when she started to get ill, and I asked him what he was most grateful for, he would only talk about her.

After suffering for many years, she began to not do the simplest things, like feed herself, and wanted desperately to end her life. I helped her research how to facilitate a dignified death for when her illness would render her incapable of having any sort of life worth living. I found The Peaceful Pill on the Internet, and through this she discovered a clinic in Switzerland called Dignitas that specialized in euthanasia.

Five days before she and her husband left for Europe I performed a ritual for their family. She always believed that when you die, that’s it, it just goes black. I shared with her what I believe – that the material world is just the tip of the iceberg, and that your spiritual body is tenuously encased in your physical form – though I held a space for her own beliefs and didn’t push mine onto her. In the middle of the ritual, among her husband and daughter, she was able to write on a white-board something that deeply affected me. It said “I felt the spirit of God, and it felt good.” She was then ready for her journey to Dignitas.

Julia: Tell me what went on in the counseling you provided for them?

Kathy: I have always had the ability to discuss difficult subjects blatantly, so it’s very easy for me to engage [in] a dialogue on death. Initially I worked [out] some technical details, such as helping her get her affairs in order, and being able to discuss what she wanted with her husband. I worked with them both separately, and then together.

 Kathy Jacobson is a body worker and life coach in San Francisco, who also works as an end-of-life counselor. I sat with her to discuss her entry into this burgeoning, and much needed, field of therapy. Most people do not know what end-of-life counseling is. Kathy’s integrative therapy addresses both the mind and body of her clientele, where she has training in a ranging from Transformational Bodywork, to Voice Dialogue, and Reiki. She also speaks about death with a refreshingly direct fluency and ease, effectively counseling through a versatile approach that tailors to the client’s level of comfort, and openness, in discussing their spirituality.

Julia: How did you discover end-of-life counseling?

Kathy: It was a natural progression for me after working with this one client specifically. She had seen me for many years, and I worked with her husband as well. Unfortunately, she developed Parkinson’s disease, and she began losing control of her motor skills and speech. She was a person who was very much ‘in her head,’ and related to people on an intellectual level, so it came as a big blow to her when she began losing her ability to speak. She had never been a happy woman; she held a lot of tension in her body, and even had really bad arthritis in her fingers. She also had a hard time being open to intimacy; she and her husband couldn’t discuss things very easily together and kept many affairs around the household separate. For example, their finances were kept totally separate, except where they kept a jar in the kitchen so that both of them could put their own money in to use for buying the joint supplies. The distance between them was palpable, though when she started to get ill, and I asked him what he was most grateful for, he would only talk about her. There was a strong love there, and I would work on encouraging this as a dialogue.

After suffering for many years, she began to not even do the simplest things, like feed herself, and she wanted desperately to end her life. I helped her do some research to facilitate a dignified death for her when her illness rendered her incapable of having any sort of life worth living. I found ‘The Peaceful Pill’ on the Internet, and through this she discovered a clinic in Switzerland called Dignitas that specialized in euthanasia.

Five days before she and her husband left for Europe I performed a ritual for their family. She has always believed that when you die, that’s it, it just goes black. I shared with her what I believe — that the material world is just the tip of the iceberg, and that your spiritual body is tenuously encased in your physical form — though I held a space for her own beliefs and didn’t push mine onto her. In the middle of the ritual, among her husband and daughter, she was able to write on a white-board something that deeply affected me. It said “I felt the spirit of God, and it felt good.” She was then ready for her journey to Dignitas.

Julia: Tell me what went on in the counseling you provided for them?

Kathy: I have always been able to discuss difficult subjects blatantly, so it’s very easy for me to initiate a dialogue on death. At first I worked with some technical details, such as helping her get her affairs in order by finding them an estate’s lawyer, and then helped her to articulate what she wanted with her husband. I worked with them both separately, and then together. They finally were able to collaborate for the first time, since they had spent most of their marriage not sharing the most fundamental things. And their communication needed some work, too. For example, while she was getting worse, her husband was offered a new job that would take him away from home. It was hard for her to ask him to refuse this opportunity, but she really wanted him to stay at home with her. When she confessed this to me, I helped by providing a space for her to express this to him. She was finally able to, and he was happy to comply with her wish.

Of course, I also provided bodywork for her, in an effort to help her be mindful of what her body was telling her. I believe we are a mixture of spirit and body and mind — it all goes together. So there is a sequence between what you think, and how that affects how you feel. If you think differently, then you feel differently — and things begin to change. I believe that breath is a very important tool in working with people’s bodies. Your body holds memories and experiences, and with a conscious application of breathwork, the body can be just as capable of releasing these things as well.

Julia: What is important in addressing someone who has been dealing with a dying loved one?

Kathy: I would ask them some questions regarding how they are feeling, if they have any regrets, and what they have left to say to the person who is dying.

Julia: What key issues do you focus on with the person who is dying?

Kathy: I spend a lot of time helping the person get in touch with their inner wisdom. Not everyone believes that something ‘happens’ after you die. However, anyone who has ever quested, been on some higher journey, or searched for something greater than themselves can access their inner wisdom. I also think it’s important to ask them what’s on their bucket list — if there is anything that they feel is incomplete in their lives. And equally important, I ask them if there is anything they would like to let go of. The things that we wish to let go of are just as significant as what we wish to attain. I also try to help them envision what they would like for a memorial, and to find a way for them to personalize the experience.

Overall, the methodology behind my work focuses on love and connection between the groups of people — made up of the person who is dying and their family and friends. No matter what we believe in spiritually, this is the place where anything can happen, and everything is possible. My goal as an end-of-life counselor is to open this dialogue, by helping people express themselves, and to align everyone’s focus on what really matters.

Julia: Is there any literature you would recommend to people going through this trying process?

Kathy: I’m a fan of Abraham Hicks who writes about how we are partly physical, but mostly spiritual beings. I also enjoyed the book Dying to Be Me by Anita Moorjani — a woman who had a fascinating near-death experience.

Julia: Thanks, Kathy!