Table Of ContentDying
a transition
Monika Renz
Translated by Mark Kyburz with John Peck
DYING
END-OF-LIFE CARE: A SERIES
END-OF-LIFE CARE: A SERIES
Series editor: Keith Anderson
We all confront end-of-life issues. As people live longer and suffer from
more chronic illnesses, all of us face difficult decisions about death, dying,
and terminal care. This series aspires to articulate the issues surrounding end-
of-life care in the twenty-first century. It will be a resource for practitioners
and scholars who seek information about advance directives, hospice, pallia-
tive care, bereavement, and other death-related topics. The interdisciplinary
approach makes the series invaluable for social workers, physicians, nurses,
attorneys, and pastoral counselors.
The press seeks manuscripts that reflect the interdisciplinary, biopsychosocial
essence of end-of-life care. We welcome manuscripts that address specific
topics on ethical dilemmas in end-of-life care, death, and dying among mar-
ginalized groups; palliative care; spirituality; and end-of-life care in special
medical areas, such as oncology, AIDS, diabetes, and transplantation. While
writers should integrate theory and practice, the series is open to diverse
methodologies and perspectives. Manuscript submissions should be sent to
series editor Keith Anderson at [email protected].
Joan Berzoff and Phyllis R. Silverman, Living with Dying: A Handbook
for End-of-Life Healthcare Practitioners
Virginia E. Richardson and Amanda S. Barusch, Gerontological Practice
for the Twenty-first Century: A Social Work Perspective
Ruth Ray, Endnotes: An Intimate Look at the End of Life
Terry Wolfer and Vicki Runnion, eds., Dying, Death, and Bereavement
in Social Work Practice: Decision Cases for Advanced Practice
Mercedes Bern-Klug, ed., Transforming End-of-Life Care
in the Nursing Home: The Social Work Role
Dona J. Reese, Hospice Social Work
Allan Kellehear, The Inner Life of the Dying Person
DY ING
A TRANSITION
MONIKA RENZ
TRANSLATED BY
MARK KYBURZ
WITH JOHN PECK
Columbia University Press New York
Columbia University Press
Publishers Since 1893
New York Chichester, West Sussex
cup.columbia.edu
Originally published as Hinübergehen: Was beim Sterben geschieht ©
(2011) 2015 Kreuz Verlag
Translation copyright © 2015 Columbia University Press
All rights reserved
Library of Congress Cataloging-in-Publication Data
Renz, Monika, 1961– , auhor.
[Hinübergehen. English]
Dying : a transition / Monika Renz ; translated
by Mark Kyburz with John Peck.
p. ; cm. — (End-of-life care : a series)
Translation from German.
Translation of: Hinübergehen : was beim Sterben geschieht. 2014.
Includes bibliographical references and index.
ISBN 978-0-231-17088-8 (cloth : alk. paper)
ISBN 978-0-231-54023-0 (e-book)
I. Title. II. Series: End-of-life care.
[DNLM: 1. Attitude to Death. 2. Terminally Ill—psychology.
3. Adaptation, Psychological. 4. Palliative Care—psychology.
5. Terminal Care—psychology. BF 789.D4]
R726.8
616.02'9—dc23
2015008493
Columbia University Press books are printed on permanent
and durable acid-free paper.
This book is printed on paper with recycled content.
Printed in the United States of America
c 10 9 8 7 6 5 4 3 2 1
cover image: © Borut Trdina/Getty Images
cover design: Diane Luger
References to websites (URLs) were accurate at the time
of writing. Neither the author nor Columbia University Press
is responsible for URLs that may have expired or changed since
the manuscript was prepared.
CONTENTS
Acknowledgments vii
Introduction: In Search of Inner Experiences of Dying 1
1 Dying and the Transformation of Perception 17
2 The Three Stages of Transition and Dignity 23
3 What Is Primordial Fear? “The ‘I’ Dies into a ‘Thou’ ” 47
4 Other Hearing: Beyond Space and Time 63
5 Metaphors of Transition 70
6 The Sites of Transition: Fear, Struggle, Acceptance,
Family Processes, Maturation 83
7 Dying with Dignity: Indication-Oriented
End-of-Life Care 107
Epilogue 129
Appendix 131
Notes 137
References 141
Index 149
ACKNOWLEDGMENTS
I AM DEEPLY GRATEFUL to everyone who has assisted me
in bringing to publication the English edition of this book.
My warm thanks to Dr. Keith Anderson, whose enthu-
siastic response to “Dying Is a Transition” (American Journal of
Hospice and Palliative Medicine 30 [3]: 283–290) made this book
possible in the first place. I owe many thanks to Columbia Uni-
versity Press, especially to my translators, Dr. Mark Kyburz and
Dr. John Peck; to Dr. Rudolf Walter, the editor of the original
German edition of this book (Hinübergehen [Freiburg: Kreuz
Verlag, 2011, 2015]); and to Dr. Miriam Schütt Mao, my research
assistant, who supported and encouraged me time and again. I am
most grateful to the following medical staff for their outstanding
cooperation in the service of the patients in our care: Dr. Thomas
Cerny, Department of Oncology, St. Gallen Cantonal Hospital;
the palliative care physicians Drs. Florian Strasser and Daniel
Büche; my fellow psychotherapist Michael Peus; and the palliative
care teams St. Gallen and Münsterlingen. I am indebted to the
following individuals: Dr. Gisela Leyting, a practicing supervisor,
psychiatrist, and psychoanalyst; Dr. Ursula Renz, Department
of Philosophy, Klagenfurt University; Dr. Roman Siebenrock,
viii 4 acknowledgments
Department of Theology, Innsbruck University; and Dr. Pim van
Lommel, The Netherlands. I also extend my sincere thanks to
my former teachers and colleagues, who were always prepared
to discuss delicate questions in the areas of psychology and psy-
chotherapy, theology, and spirituality. I owe special thanks to the
many patients and relatives who shared their experiences with me.
I wish to thank my family, my parents, my brothers and sisters.
I would like to mention especially my mother for her critical
comments and her unfailing support. My most personal heartfelt
thanks go to my husband, Jürg!
DYING
