From depression can come spirituality and empathy

Curtis-Childs-depressionby Curtis Childs, as interviewed by Chelsea Odhner

I was raised in the New Church. Both of my parents are Swedenborgians. My education was split evenly, from elementary school through college, between Swedenborgian and non-Swedenborgian schools. I have been told that I talked and thought about religious ideas from a young age. I took it pretty seriously.

A good part of the way through my eighteenth year, I began a very distinct phase in my life. It was marked by the onset of major depression and obsessive compulsive disorder. I got overpowered by my internal world. This internal world was running everything in my life. It was horrible. I became unable to control what was going on in my mind. There was an immense gravity pulling me toward thinking about things that worried me. I would become trapped in looping thoughts and fears about a lot of things. This pattern hit its peak when I was about twenty-one or twenty-two. Eventually, I didn’t like Swedenborg’s teachings at all.

The Writings of Emanuel Swedenborg became hazardous to my health for a little while. Swedenborg’s teachings are awesome, but I found that they have the potential to be a little bit dangerous because they can give your fears a lot of ammunition. If you are open to spiritual concepts and to thinking deeply, your fears can become cosmic. A lot of my fears had Swedenborgian elements to them. The worldview was imprinted on the inside of me, and my thoughts would use this against me. When I would read the Writings, I would get into a bad mood. It was my understanding of them. I would think that Swedenborg was saying one thing, when now I take that same thing to mean something entirely different. I developed fears around concepts that really shouldn’t exist. It got to the point that reading the Writings wasn’t doing me any good, so I stopped.

During this time, I began reading other sorts of spiritual literature, some along the new age route. I read about near death experiences, which had a deep affect on me. I see now that exploring beyond the Writings of Swedenborg allowed an important expansion to my spirituality.

The lowest period I had was at Bryn Athyn College of the New Church. I was overwhelmed. I quit school because I was so depressed. It was just so hard. I was still getting good grades, but I couldn’t handle it mentally and emotionally. I moved back to my home-town in Michigan. After some time off, I decided to enroll in the communication program at nearby Oakland University.

An incredibly valuable lesson I learned during this period was that I wasn’t going to cure depression through religious thinking. I had to get everything else straight. You can’t out-think bad nutrition; you can’t out-think lack of exercise. I used to think that everything that was going on inside of me was either emotional or spiritual. I didn’t understand that our physical health affects our brains as much as it does. Part of what brought me out of my depression was physical exercise and antidepressants. I also made use of energy medicine and talk-therapy. I came to understand that I had to take care of myself holistically.

I also attribute the lessening of my depression in large part to growing older. It just takes time. I’m twenty-six now, and in some respect, I feel like I’ve beaten the depression, in other ways I feel like it has just slowed down. One thing I learned is how powerless I am, and that led me back to a search for God.

Over the course of my time at Oakland University, I came back to Swedenborg’s Writings and they became the core of my worldview. On account of my familiarity with Swedenborg’s teachings, I found myself able to contribute a lot of positive ideas to the conversations that took place in my courses. Swedenborg’s worldview is really kind in its essence, and I liked having that attitude towards everything. I liked the sense of identity that it gave me. At Oakland University, I would share my Swedenborgian worldview, and I found that people felt fed by it. At some point, I remember having the realization that I liked reading Swedenborg’s works again. I began to understand his Writings at a level that I had never known before.

I’d say the core of my spirituality is a deep level of empathy towards humans that was built up in me in part during my depression. I gained it through suffering. I know what humans shouldn’t have to go through. As I read Swedenborg’s Writings, I found that his teachings never were discordant with the empathy I felt in my heart.

It’s ironic, because at one time the problems I had were rooted in Swedenborgian concepts. But now, it is through Swedenborg’s teachings that I’ve gained a perspective that frees me from all of my fears. The reality of what he’s describing is an environment that a lot of my fears can’t survive in. The vision that he casts of what is in store for us and what is operating on our deeper levels provides hope.

Out of so much chaos have also come many gifts. One is the inspiration I’ve been given to make short, Swedenborgian-based videos. I publish them on YouTube and have had overwhelmingly positive responses from watchers, even from people well outside of the Swedenborgian realm. I want to make it possible for others to experience the relief that comes when it turns out that something that has been haunting you isn’t true, or when you hear about a reality that puts your fears to rest and awakens your greatest hopes. I see my involvement in this work as a convergence of my innate human desire to not want others to suffer and my fascination with Swedenborg’s revelation.

My life has been so intense and miserable at times, but it has definitely softened up my will. I have had the mixed blessing of constantly being under assault internally. This experience has kept me vibrantly interested in spirituality and in God. It’s funny, but hell has added so much to my spirituality.


Curtis Childs is an active contributor to Kidslive at kidslive.newchurchlive.tv. You can check out some of his YouTube videos at www.youtube.com/user/offTheLeftEye.

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DAILY INSPIRATION

“Just as light devoid of warmth is totally unproductive, so is faith devoid of love.”

Arcana Coelestia 3146

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Celestial

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In some ways, the Lord is simplicity itself. Taken in His essence, He is love. His attitude toward us is also simplicity itself: He loves us. And He expresses that love in an unending stream that works completely and constantly to get us to freely accept and return His love. When you start looking at how that process works, it can start to seem complicated. But in essence, it could hardly be more simple.

It makes sense, then, that the best state we can achieve as humans is to receive the Lord’s love and love Him back. That’s the state Swedenborg means by “celestial”: It is the highest, best, most pure, most innocent and most joyful state human beings can experience, one powered by love of the Lord. It is also the state of the highest, inmost heaven, and is in some degree present in everyone as the recipient of the Lord’s love.

Not all of us receive and manifest the Lord’s love in the same way, though (in fact, none of us do), so the pure simplicity of the celestial state gets complicated as people open themselves up only partway to the Lord and redirect His love toward lesser things. Swedenborg’s works tell us that this results in three distinct “levels” of existence, based on what people love. The celestial is the highest of these levels, based on love of the Lord; the “spiritual” is based on love of other people, and the “natural” is based on the delight we feel in being good. The spiritual is more external and less pure then the celestial, and the natural is more external and less pure than the spiritual.

Each of those levels is further divided, however, between those who are led directly by the level’s defining love and those who are led by the ideas that spring from that love. Some celestial angels, then, are led by the love of the Lord itself, while others are led by the exquisite concepts that express love to the Lord. Unfortunately, Swedenborg also uses the words “celestial” and “spiritual” to identify that division, with “celestial” representing the love of each level and “spiritual” representing the truth and wisdom of each level. So the celestial level – centered on love of the Lord – has a celestial aspect and a spiritual aspect. The spiritual level – centered on love of other people – also has a celestial aspect and a spiritual aspect. And the natural level – centered on the delight of being good – has a celestial aspect and a spiritual aspect.

That might sound awfuly complicated – maybe even unnecessarily complicated – but it makes sense if you think about it. We all know people who are simply motivated by the desire to be good and to do things the “right” way. That’s an example of the natural level of existence, focused largely on external things, but aligned with the Lord’s wishes. Within that group, there are those who do what’s right pretty much by instinct, following their good affections; they would be the celestial natural. There are also those who like to know the rules and think about the instructions, so they can know intellectually that they are doing things right; they would be the spiritual natural. There are similar distinctions on the spiritual level and the celestial level.

One other thing is worth noting: Swedenborg’s works say that very few in the modern world are capable of reaching the celestial level, due to the amount of knowledge we have, the external nature of our lives and the need we have to use our minds to advance spiritually. The celestial heavens are largely populated by people from ancient times, who were able to live in closer, more direct communion with the Lord. As we understand the Lord’s wishes on a deeper and deeper level, though, we can open up greater possibilities for ourselves and for future generations.

(References: Arcana Coelestia 162, 1470, 1824, 3887, 9868; Arcana Coelestia 4286 [2]; Arcana Coelestia 9915 [2]; Arcana Coelestia 9993 [1-2]; Heaven and Hell 23, 31)

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Using Swedenborg to Understand the Quantum World II: Desire and Energy

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By Ian Thompson, PhD, Nuclear Physicist at the Lawrence Livermore National Laboratory

In the previous post of this series, we saw how Swedenborg’s theory of correspondences could help us to better understand the physical world from a quantum perspective. If our mental processes consist of desire acting by means of thoughts and intentions to produce physical effects, then these physical actions should manifest themselves according to a corresponding pattern. More specifically, if the components of our mental processes occur at variable finite intervals, so too should the expected physical events.

According to many thinkers throughout history, mental and physical are not identical but instead are two different kinds of substances that relate with each other. Swedenborg describes the mental (spiritual) and physical (natural) as distinct but says that they interact by discrete degrees:

A knowledge of degrees is like a key to lay open the causes of things, and to give entrance into them. . . . For things exterior advance to things interior and through these to things inmost, by means of degrees; not by continuous degrees but by discrete degrees. “Continuous degrees” is a term applied to the gradual lessenings or decreasings from grosser to finer . . . or . . . to growths and increasings from finer to grosser . . . precisely like the gradations of light to shade, or of heat to cold. But discrete degrees are entirely different: they are like things prior, subsequent and final; or like end, cause, and effect. These degrees are called discrete, because the prior is by itself; the subsequent by itself; and the final by itself; and yet taken together they make one. (Divine Love and Wisdom §184)

The mental can never be continuously transformed into something physical, nor can the physical be continuously transformed into something mental. They are connected, however, by virtue of their causal relationship: all physical processes are produced, or generated, by something mental. As described in my previous post, this relationship is what gives rise to our correspondences in the first place.

Most of us can realize that the mental and the physical are distinct, even though this may be denied by materialists (for whom the mental is merely an emerging product of the physical) and also by monistic idealists (for whom the physical universe is merely a representation in the mind). The latter view is common in many New Age circles today, and it is even thought to be implied by quantum physics. In this series of posts, by contrast, I want to show how Swedenborg’s ideas give us a new understanding of how mental and physical things can both exist in fully-fledged ways and with serious connections between them that are not deflating or reductionist.

Mental and physical things can both be substances but, they have very different characteristics:

  • Mental things are conscious, whereas physical things are unconscious.
  • Mental beings can think and make deductions using reason, whereas physical beings can only make logical deductions if they are designed that way.
  • Mental beings can use symbols and language to refer to objects and ideas outside themselves, whereas physical beings have no intrinsic ability to refer to anything.
  • Mental processes are motivated by purposes and intentions, whereas physical processes are determined by physical causes that supposedly exclude purposes and intentions.
  • Mental processes tend to produce results according to some conception of what is good, whereas physical processes have no need for any such concept.

As already discussed in the previous post, desire is a component of all mental processes, and we recognize “something physical like desire” as energy or propensity. Swedenborg sees desire, or affection, as a specific kind of love:

That love and wisdom from the Lord is life can be seen also from this, that man grows torpid as love recedes from him, and stupid as wisdom recedes from him, and that were they to recede altogether he would become extinct. There are many things pertaining to love which have received other names because they are derivatives, such as affections, desires, appetites, and their pleasures and enjoyments. (Divine Love and Wisdom §363)

For desire and energy to correspond to each other in the sense that Swedenborg describes, the function of desire as a cause must be similar to the function of energy as a cause. That is, the way in which desire causes mental processes must be similar to the way in which energy causes physical processes. This is not to say that desire is the same as energy but only that desire’s pattern of operation is similar to that of energy. The common pattern is that desire (energy) persists between events, then explores multiple possibilities for those events by means of thoughts (fields of energy), and finally becomes manifest in the physical events produced.

Up until now, the idea of substance has been rather obscure in both physics and philosophy, and it has not been developed significantly. From an ontological perspective, substance is that which endures between events. It is what individuates and bears the intrinsic properties of those events. We are not necessarily talking about a substance that endures forever or about a substance that exists independently of everything else. Based on the common pattern described above, we can arrive at the idea of a created substance that persists, or endures, as a thing at least for some finite time between events. And such a substance would be the capability, or disposition, for action or interaction in that time interval.

This relates to the idea of “dispositional essentialism” that has been put forth by philosophers in recent years.[1] Dispositional essentialism is the notion that some kind of power or disposition (such as a cause or energy) must be an essential part of something. Some philosophers take this idea even further, saying that disposition must be the individual essence of something. In much the same way, I am saying that disposition is what constitutes the substance of something.[2] So if the main similarity between desire and energy is that they both persist between events, then both desire and energy are substances.

By using ideas from Swedenborg to understand the world, we have a new way of grasping the mental and physical and perhaps of understanding quantum physics. Either one of these results would be very useful; to have both is to be extremely fortunate.

In the next post of this series, I will discuss how and in what form both desire and energy persist between events.

Ian Thompson is also the author of Starting Science from Godas well as Nuclear Reactions in Astrophysics (Univ. of Cambridge Press) and more than two hundred refereed professional articles in nuclear physics.
[1] B. Ellis and C. Lierse, “Dispositional Essentialism,” Australasian Journal of Philosophy (72, 1994): 27–45.

[2] See Ian J. Thompson, “Power and Substance,” http://www.generativescience.org/ph-papers/pas.htm.

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Is free-market capitalism unethical?

Spiritual Questions & Answers

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Free-market capitalism
Rana Plaza building

When things go badly wrong in the world of commerce, we ask about the ethics of free-market capitalism.

Dangerous cracks had been spotted in the walls of the Rana Plaza building — a factory complex in Bangladesh — but the staff had been ordered to continue working, making clothes for lucrative export to the West. Now over 900 people are dead in the ruins of the building which has collapsed. In the last eight years alone, more than 1,000 workers had died in similar incidents, owing to the negligence of factory owners.  The Bangladesh Government has failed to regulate the garment industry by enforcing proper safety standards.

Given this tragedy, we might wonder whether unregulated free-market capitalism is a good thing. How can its advocates be correct when they say that the profit motive, property rights, divisions of labour, and competition, actually lead to prosperity for all? Is it really the case that market regulation reduces the entrepreneurial spirit?

For free-market capitalism

Those in favour of free-market capitalism maintain that self-interested individuals would mostly engage in win-win transactions: self-interest is natural and beneficial in making untrammelled free markets work well.

“The most important single central fact about a free market is that no exchange takes place unless both parties benefit.”
(Milton Friedman)

The pursuing of profits by self-interested companies competing in the market economy is said to cause trickle down benefits even to the poorest: thus an unintended consequence of individual gain is prosperity for all. And competitive markets are said to drive down prices and increase business efficiency.

Against free-market capitalism

If the biblical message about the love of money being the root of all evil is true, then perhaps maximising profits is undesirable. One can get carried away with free-market competition for the sake of making money. In 19th century America, a lot of people were against outlawing child labour, because to do so would be against the very foundations of a free market economy.

Free-market capitalism results in huge differences in wealth. For example according to Ha-Joon Chang:

“The top 10 per cent of the US population appropriated 91 per cent of income growth between 1989 and 2006, while the top 1 per cent took 59 per cent.”

One of the obvious recent social trends in Britain has been the huge and still widening gap between the poor and the rich. One can wonder whether even if free-market capitalism reduces the absolute level of poverty in a country, the gross inequality of relative poverty might lead to a divided rather than cohesive society.

Maximising profits

Writing nearly three centuries ago before the growth of free-market capitalism as we know it today, spiritual philosopher, Emanuel Swedenborg, suggests it is not ethically wrong to make profits. How else can one provide for oneself, and one’s family?  Today, like the past, any business that focuses on turnover without profits does not survive.

However, Swedenborg says there is an important difference between on the one hand gaining profit through providing a commercial service and on the other hand exploiting customers to maximize profits.

For example the ethical cobbler charges customers what he thinks is fair and reasonable for his skill and labour and not necessarily the higher price that the market would bear. He needs to cover his costs and provide for the needs of himself and his family but his focus is on being of help to his community.

There is a central spiritual principle here. It is that all spiritual  life is the life of wanting what is useful. In other words the inner experience of deep happiness and contentment comes not from material gain but rather from being of service to others and enjoying their fellowship.

Working for oneself, one can adopt one’s own rules. However, economies of scale in production mean that large companies operate in large markets which are impersonal and traders operate anonymously. For instance, one might wonder about a manager’s attitude towards sales staff who fail to get the best price by only charging what they feel is a fair price rather than the highest possible price they can get away with. Companies have codes of ethics but we might ask whether the ethical issue of non-exploitation — something that  perhaps transcends common commercial practice — could be defined by companies whose investors expect the maximisation of profit.

In some parts of the world it is thought that capturing limited resources by greedy exploitation of the weak and uneducated means that many remain hungry and homeless.

‘There is enough for everyone’s need, but not for everyone’s greed’, (Gandhi)

Moderating free-market capitalism

Here are a few suggestions that come to mind.

Curtailing privatisation of natural monopolies (e.g. water supplies) encouraging ownership by the population being served or strengthening the powers of regulators such as in Britain Ofgas, Ofgen etc.

Ensuring free competition by restricting the hike in prices that comes about as companies try to corner the market by forming cartels and restricting the company take-overs (e.g. in Britain by its Monopoly Commission)

Reducing the size and thus locality of savings banks along the lines of the previous mutual building societies before they were allowed to become private banks.

Encouraging local markets where business people draw income from activities in which they have some vestige of personal involvement. Admittedly, in the modern global, interconnected world, the ability to do this is limited.

Further developing markets in “Fair Trade” products.

Creating opportunities for share-ownership of companies. For example the John Lewis Partnership, which owns a chain of department stores and supermarkets, seems to have a good scheme; the company is owned by a trust on behalf of all its employees — known as Partners — who have a say in the running of the business and receive a share of annual profits, which is usually a significant addition to their salary.

Conclusion

Whilst the desires reflected in markets remain predominantly materialistic, I believe that an alternative economic pattern will be hard to grow. Therefore, it seems that the best ethical solution is for government not to de-regulate the markets but continue to exercise close control of health and safety, prevention of monopolies and ensuring there is fair competition.

Copyright 2013 Stephen Russell-Lacy
Author of Heart, Head & Hands Swedenborg’s perspective on emotional problems

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Posted on9th May 2013CategoriesEthics, Ethics & PoliticsTags, , , , , , , , , , , , , , , , , ,  Leave a comment

Causes

HR90 The Science Of Correspondence

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Ca784That natural things represent spiritual things, and that they correspond, may also be known from the fact that what is natural cannot possibly come forth except  from a  cause prior to itself. Its cause is from what is spiritual; and there is nothing natural which does not thence derive its cause. Natural forms are effects; nor can they appear as causes, still less as causes of causes, or beginnings; but they receive their forms according to the use in the place where they are; and yet the forms of the effects represent the things which are of the causes; and indeed these latter things represent those which are of the beginnings. Thus all natural things represent those which are of the spiritual things to which they correspond; and in fact the spiritual things also represent those which are of the celestial things from which they are. [AC2991]

The correspondence of the will and understanding with the heart and lungs cannot be abstractly proved, that is, by mere reasonings, but it may be proved by effects. It is much the same as it is with the causes of things which can be seen rationally, yet not clearly except by means of effects; for causes are in effects, and by means of effects make themselves visible; and until causes are thus made visible, the mind is not assured respecting them. In what follows, the effects of this correspondence will be described. But lest any one should fall into ideas of this correspondence imbibed from hypotheses about the soul, let him first read over carefully the propositions in the preceding chapter, as follows: Love and wisdom, and the will and understanding therefrom, make the very life of man (n. 363, 365). The life of man is in first principles in the brains, and in derivatives in the body (n. 365). Such as life is in first principles, such it is in the whole and in every part (n. 366).  By means of these first principles life is in the whole from every part, and in every part from the whole (n. 367). Such as the love is, such is the wisdom, consequently such is the man (n. 368). [DLW375]

Ends are in the first degree, causes in the second, and effects in the third.

Ends   Who does not see that the end is not the cause, but that it produces the cause, and that the cause is not the effect, but that it produces the effect; consequently that they are three distinct things which follow in order? The end with man is the love of his will, for what a man loves, this he proposes to himself and intends; the cause with him is the reason of his understanding, for by means of it the end seeks for mediate or efficient causes; and the effect is the operation of the body from them and according to them. Thus there are three things in man, which follow each other in order, in like manner as the degrees of altitude follow each other. When these three things appear in act, then the end is inwardly in the cause, and the end through the cause is in the effect, wherefore the three coexist in the effect. On this account it is said in the Word, that everyone shall be judged according to his works; for the end, or the love of his will, and the cause, or the reason of his understanding, are together in the effects, which are the works of his body; thus the quality of the whole man is in them.

They who do not know these things, and do not thus distinguish the objects of reason, cannot avoid terminating the ideas of their thought in the atoms of Epicurus, the monads of Leibnitz, or in the simple substances of Wolff, and thus they close up their understandings as with a bolt, so that they cannot even think from reason concerning spiritual influx, because they cannot think concerning any progression; for the author says concerning his simple substance, that if it is divided it falls into nothing. Thus the understanding stands still in its first light, which is merely from the senses of the body, and does not advance a step further. Hence it is not known but that the spiritual is a subtile natural, and that beasts have a rational as well as men, and that the son is a breath of wind such as is breathed forth from the breast when a person dies; besides many things which are not of light but of thick darkness. Since all things in the spiritual world and all things in the natural world proceed according to these degrees, as was shown in the preceding article, it is evident that intelligence properly consists in knowing and extinguishing them, and seeing them in their order. By means of these degrees, also, every man is known as to his quality, when his love is known; for, as was said above, the end which is of the will, and the causes which are of the understanding, and the effects which are of the body, follow from his love, as a tree from its seed, and as fruit from the tree. There are three kinds of loves, the love of heaven, the love of the world, and the love of self; the love of heaven is spiritual, the love of the world is material, and the love of self is corporeal. When the love is spiritual, all the things which follow from it, as forms from their essence, derive their spiritual nature; similarly if the principal love is the love of the world or of wealth, and thus is material, all the things which follow from it, as derivatives from their principle derive their material nature; likewise if the principal love is the love of self, or of eminence above all others, and thus is corporeal, all the things which follow from it derive their corporeal nature. The reason is, because the man who is in this love regards himself alone, and thus immerses the thoughts of his mind in his body. Wherefore, as was just now said, he who knows the ruling love of anyone, and at the same time the progression of ends to causes and of causes to effects, which three things follow in order according to the degrees of altitude, knows the whole man. Thus the angels of heaven know everyone with whom they speak; they perceive his love from the tone of his speech; and they see his image from his face, and his character from the gestures of his body. [ISB17]

Author: EMANUEL SWEDENBORG (1688-1772)

http://www.scienceofcorrespondences.com/causes.htm

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There Are Three Heavens

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HEAVEN >> Divine Order >> Divine Form >> Divine Human

THERE ARE THREE HEAVENS

There are three heavens, entirely distinct from each other, an inmost or third, a middle or second, and an outmost or first. These have a like order and relation to each other as the highest part of man, or his head, the middle part, or body, and the lowest, or feet; or as the upper, the middle, and the lower stories of a house. In the same order is the Divine that goes forth and descends from the Lord; consequently heaven, from the necessity of order, is threefold.[HH29]

The interiors of man, which belong to his mind and disposition, are also in like order. He has an inmost, a middle, and an outmost part; for when man was created all things of Divine order were brought together in him, so that he became Divine order in form, and consequently a heaven in miniature.{1} For this reason also man, as regards his interiors, has communication with the heavens and comes after death among the angels, either among those of the inmost, or of the middle, or of the outmost heaven, in accordance with his reception of Divine good and truth from the Lord during his life in the world. [HH30]

The Divine that flows in from the Lord and is received in the third or inmost heaven is called celestial, and in consequence the angels there are called celestial angels; the Divine that flows in from the Lord and is received in the second or middle heaven is called spiritual, and in consequence the angels there are called spiritual angels; while the Divine that flows in from the Lord and is received in the outmost or first heaven is called natural; but as the natural of that heaven is not like the natural of the world, but has the spiritual and the celestial within it, that heaven is called the spiritual-natural and the celestial-natural, and in consequence the angels there are called spiritual-natural and celestial-natural.{1} Those who receive influx from the middle or second heaven, which is the spiritual heaven, are called spiritual-natural; and those who receive influx from the third or inmost heaven, which is the celestial heaven, are called celestial-natural. The spiritual-natural angels and the celestial-natural angels are distinct from each other; nevertheless they constitute one heaven, because they are in one degree. [HH31]

In each heaven there is an internal and an external; those in the internal are called there internal angels, while those in the external are called external angels. The internal and the external in the heavens, or in each heaven, hold the same relation as the voluntary and intellectual in man-the internal corresponding to the voluntary, and the external to the intellectual. Everything voluntary has its intellectual; one cannot exist without the other. The voluntary may be compared to a flame and the intellectual to the light therefrom. [HH32]

Author: EMANUEL SWEDENBORG  (1688-1772)

http://www.scienceofcorrespondences.com/white-horse.htm

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Prolonging life — How far should we go?

Spiritual Questions & Answers

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Prolonging lifeWhen you are young prolonging life seems a great idea. But when you get old things seem a bit different.

Emily aged 85 went into hospital. Her home is a nursing care home. She cannot support her own weight and needs a hoist and wheelchair to get her to the toilet and dining room. She is able to sit in an armchair and watches television. She has several diseases necessitating a good deal of staff time and medication. These are Alzheimer’s, rheumatoid arthritis, chronic pain, diabetes, and chronic obstructive pulmonary disease. Her mood is okay and she is able to converse in a limited way with staff and her visitors.

Prolonging life of patients like Emily

However the quality of life changes when she gets a chest or urinary tract infection to which she is vulnerable. At these times she has breathing problems and becomes uncommunicative. These problems have resulted in several hospital admissions in recent months.  Only in hospital can adequate treatment be provided eg monitoring machines, scans, medical expertise on hand, adequate amounts of needed oxygen and so on. When in hospital at first she becomes agitated and more confused and then later fed up not being in her own room at the care home where she sees familiar faces.

The question arises: how many times should a very ill and infirm person near the end of life be given repeated inpatient episodes of hospital treatment. When is prolonging life inappropriate?

It used to be said that pneumonia was the old person’s friend because, although it resulted in death, it took away suffering caused by other serious ailments such as from advanced dementia, cancer, or kidney disease.

Even if physician assisted suicide and euthanasia are rejected, end-of-life care for elderly people with chronic diseases involves difficult clinical and ethical judgments. Such conditions won’t easily go away despite the best that medicine can offer. Palliative care means doctors and nurses do their best to reduce discomfort and pain and improve the quality of the patient’s life whether or not there is hope of a cure by other means.

Prolonging life within the context of professional ethics

Doctors and nurses practice within a framework of professional ethics for example principles of informed patient choice, maximising good, not causing harm, and providing what is thought the patient has a right to receive. All medical treatments involve risks and benefits. Health staff try to get the best balance between interventionist treatment that directly tackles disease and palliative care. These however have different goals and sometimes suggest opposing clinical plans.

Good end of life care means neither hastening death nor unnecessarily prolonging life. Unfortunately it seems that sometimes inevitably one of these consequences will result.

Should one decline to give emergency resuscitation to someone where no improvement in their suffering is likely to result from further living? Should hydration and nutrition not be forced via tubes into the body when the patient is unwilling to drink or eat? Should more effective higher levels of sedative be given to patients in pain although this increases the risk of death? This seems suspiciously like inappropriately prolonging life.

To my way of thinking, the trouble is health professionals are expected to try to cure us. Those health care staff practicing palliative care do not always receive support from family members, other healthcare professionals, or their social peers for their work to reduce suffering and follow patients’ wishes for end-of-life care.

Negative attitudes towards palliative care

N.E. Goldstein and colleagues did a survey and found that more than half of doctors who practice palliative care report that a patient’s family members, or another health care professional had characterized their work as being “euthanasia”, “murder”, or “killing” during the previous five years. And so I do wonder if inadvertently doctors err on the side of prolonging life unnecessarily for fear of being criticised for harming patients by not being interventionist.

They practice in a world where anxiety about death is common and where medicine cannot sanitize dying. Fear of death is pretty widespread and so no wonder it exerts a powerful effect on attitudes to end of life care. Does acceptance of death mean one is able to lean towards palliative care rather than towards interventionist treatment?

Psychological research has found that the fear of death is made up of a number of different fears. For example a study by James Diggory and Doreen Rothman found that the following are common fears about death in descending order of importance:

  • My death would cause grief to my relatives and friends
  • All my plans and projects would come to an end
  • The process of dying might be painful
  • I could no longer have any experiences
  • I would no longer be able to care for my dependents
  • I am afraid of what might happen to me if there is a life after death
  • I am afraid of what might happen to my body after death.

Understanding death

Emanuel Swedenborg has given a vivid account of life after death from his personal experiences in the eighteenth century. What he says is often echoed since in the accounts of mediums, those having near death experiences (NDE’s), and those receiving brief communications from the other side (ADC’s). All show a continuation of life similar to what we are familiar in the physical world, albeit in a world of spirit where one’s inner life of experience and character are more apparent.

There is plenty of information that can greatly reassure people if they would take the trouble to find out more. For example for ADC’s click here and for NDE’s click here.

Is difficulty in confronting attitudes to death in Western culture affecting the way hospitals actively treat elderly people with serious illness at the end of their useful life in the world?

Copyright 2011 Stephen Russell-Lacy
Author of  Heart, Head & Hands  Swedenborg’s perspective on emotional problem

http://www.spiritualquestions.org.uk/

Posted on29th November 2012CategoriesEthics, Ethics & LifeTags,, , , , , , , ,  Leave a comment