Book Review: Reflecting On the Inevitable: Mortality at the crossroads of psychology, philosophy and health

"Whenever I try to think of my own death I end up muddled and confused" is the first sentence the author writes in the preface of the book Reflecting On the Inevitable. The exploration of 'my-death' as opposed to 'other-death' is the main subject matter the author has dedicated this book to. Presumably the intention of the author was to get to a more clarified place by the end of the book and assist the reader in that journey of clarification in turn.

Clearly the topic is an important one, maybe more so at this time, when the global pandemic of the coronavirus has meant a confrontation with death in a way unknown for a long time in the West. For over a year there have been extended and intermittent lockdowns in order to 'keep safe' and 'save lives', and the virus has been a relentless media subject. Bombarded with the daily chronicle of death figures, stories emerged of those who have lost someone dear or had a brush with death with recoveries that sometimes included long-COVID.

What better time to think afresh about our relationship with death? The book has certainly kept my-death close by, perhaps more in the form of a background hum of uncomfortableness residing quietly in the shadows, always tinged with the pandemic and lockdown blues chugging by now faithfully alongside the uneventfulness of the collective mundaneness of COVID existence.

Sadly, the book has not added much to what I might already know, or at least sense I know, about death, nor has it managed to bring me closer to a clarified place of my-death. Perhaps, as the author alludes to, this is an impossibility. And yet, I feel this is a missed opportunity. The author seems to have tackled the subject in an uninspiring manner. Both the title (exasperatingly not containing the word death) and the structure of the book have felt muddled and confusing throughout, so that I had to keep checking and re-checking what the argument at hand was and what the author was trying to get at.

Completing my read of the book, I must admit with relief, I will try to summarise in three points what I think the author was grappling with and trying to convey. First, our focus on other-death is much easier than focusing on my-death, and research and conversations around death are generally conducted with other-death in mind. Next, given the elusive nature of my-death, it is almost impossible to get a handle on it, but the focus of the exploration can be greatly helped and enhanced by seeking conversations with others about death that touch on topics such as fears, beliefs, cultural background, actual experiences of illnesses, accidents or death of loved ones and so on. Clarifying your particular framework of death contributes to finding more peace with the inevitability of it. Third, he suggests a need to widen conversations around my-death to all domains of life as it enhances people's engagement with life itself. It is enriching, it lessens the fear of death and it can give a sense of serenity, and brings people closer together in the contemplation of this profound phenomenon.

There was a strange back-to-front sensation with the book. Firstly, before embarking on his journey, I wanted to know why the author had chosen this topic and how his views might have changed in the process of researching and writing. He gives us a glimpse in the conclusion where his first sentence starts "I found this book difficult to write and did not anticipate it being so challenging". I found that interesting. But it would have helped to set the scene if he had shared this in a comprehensive way with the reader at the beginning. It would also have achieved the all-important naming of the context. I wished that the author would have started the book with (my previously mentioned) point three, rather than build the argument up throughout the book to reach his conclusion at the end. It was a frustrating and long-drawn-out ride.

Instead he chose to introduce the reader to four invented characters, Stan, Leo, Mandy and Brenda, who take us through a journey of discussions and conversations with each other and chart their change in thinking around my-death to reach the conclusion that culminates in a special three-course dinner they share. I feel this was not done successfully.

The characters often lacked credibility and the way they related to each other and discussed the topic was rather unlikely. This would have been okay if the author would have made an explicit point of that at the beginning, explaining why he chose to incorporate these people into the book and to what end. Annoyingly, the author mentions some of this at the end of the book, by which point my exasperation about this stylistic choice had reached exhaustion point.

Moreover, palliative care is a well-documented movement that has helped death conversations greatly, as have death cafés, both of which the author talks about insufficiently towards the end of the book. Again, this could have been a really useful starting point in order to illustrate his view that other-death is initially easier to think about than my-death.

Unfortunately, the above points of criticism have seriously gotten in the way of my ability to take the finer points of the book on board. I shall try to briefly summarise as best as I can, as I wish to honour the hard work the author no doubt has put into writing this book. As far as I understand the author identified what he called four enabling frames: Essential Structures; Passionate Suffusio; Point-of-Transition; and Self-Generative Process. These frames are meant to assist a person (or the academic?) to clarify their views and their relationship to my-death presumably, but I remain baffled as to what exactly these frames mean so that I can only describe them in a limited way.

It seems to me that the author loosely mapped the four enabling frames onto the four characters, perhaps at the service of clarification, but to me this muddled the subject matter further. Or perhaps this is me trying to organise the material by doing this mapping, in which case I ask to be forgiven if that is not what the intention of the author was. However, this is what I understood. The frame of essential structures seems to be mapped onto Leo (a young man, son of Mandy, age unspecified); the passionate suffusion frame was mapped onto Stan (living on his own with his dog, in his eighties, a neighbour); the point-of-transition frame was mapped onto Mandy (Leo's mother, widowed, age unspecified); and the self-generative process frame onto Brenda (Mandy's lodger, a health professional working in palliative care, age unspecified).

As the youngest, Leo believed staunchly until the end that there is total annihilation and nothingness after death, and grappled on and off with why there was any point in living at all if that was the end result. He was fascinated by Heidegger and his concept of finitude.

Stan, the oldest, changed his perhaps un-reflected position to embracing life wholeheartedly after suffering a heart attack that almost killed him. This re-oriented him towards an idea that life and death are on a continuum, held together through some sort of electrical charge. His life thereon felt very much worth living, as death was a continuous reminder of the validity of life. He was also intrigued by Heidegger and the concept of finitude and seemed to take it further than Leo, having life experience on his side.

Mandy was the most resistant character to talking about my-death. She worried greatly that Leo, her son, was too morbid and or too negative about life/death, but resolved this by re-affirming her belief in an after-life in the process of the many conversations. Finding this position comforted her a great deal as it was linked to her Catholic upbringing, which still appealed to her as a framework; this was not shared by the other three characters.

Lastly, Brenda who worked in palliative care, thought that she had a good grasp on death, but realised through their conversations that it was other-death rather than my-death she was focusing on. This threw her into crisis, but she finally came to the conclusion that my-death was a process, negotiated continuously through the ups and downs of life.

When the four of them meet at the end of the book for the special dinner celebrating Stan's recovery, they appreciate their process of sticking it out thinking me-death through with each other, getting to a place of acceptance that everybody has their own take on my-death influenced by their lives and background, and that this was okay. Each one was happy with the conclusions that they had drawn for themselves for now and felt enriched by, and more bonded through, their conversations.

The characters – and this is presumably the author's view – wondered how such conversations could be facilitated in other domains, so that others could benefit from this positive outcome too.

I agree with this conclusion. It seems that people would benefit from talking more in-depth with others about their own death and deepen their beliefs and frameworks of understanding. If not, we are ruled by fear which has the ability to shrink one's world, limit one's ability to explore and shuts down new possibilities. Existential-phenomenological psychotherapy would be well-placed to facilitate such conversations both for individuals as well as groups. The author, however, does not make a leap from Heidegger, who gets explored but in quite a confusing way, to existential-phenomenological psychotherapy as a way of opening up these conversations, which I find a little surprising.

I also got the impression that the author secretly belittled the idea of an after-life, which he seemed to link to religion. That would have been alright as a stance had he declared at the start of the book his own beliefs and how these might have changed through this process. Alas, this remains unknown. Given that I personally feel comfortable with the idea of re-incarnation and believe that death is a passing into a different realm as real as earthly-physical life, I did not feel represented in the book.

My long-standing meditation practice informs my views and provides me with reassurance, something of a calm place. Buddhists in palliative care, for example, have an interesting approach to my-death where the willingness to meet death as consciously and mindfully as possible is part of their philosophy of both life and death. There is a famous Zen Buddhism saying that goes "Doing zazen is like entering your own coffin". I understand this statement. Meditation can feel at points like dying, or the confrontation with something dark, or life suddenly seems a little insignificant…perhaps meditating on a regular basis is some form of rehearsal for my-death?

The explorations of the author feel a bit limited in their scope and could have included many more interesting practices or philosophies that meet my-death quite deliberately. The assisted suicide movement is another example that meets square my-death and many fascinating documentaries have been made about that. There is a beautiful and moving film called Griefwalker (https://www.youtube.com/watch?v=xLQWM2j3AVg) that talks about embracing and choosing death in order to be able to embrace and choose life (and vice versa). Watching it re-affirmed a sense of peace, a feeling held and reassured that death is not horrible or out of the ordinary, but rather extraordinary in its ordinariness in its partnership with life.

The topic of my-death is fascinating and the main concern of the book to have facilitated conversations with others is a really worthwhile project. I am not sure it achieves that in any successful way but it has certainly encouraged me to want to look further. The death cafés are mentioned just in passing, yet I feel they represent a practical way to have conversations about my-death. These cafés are run in a non-expert way, where people from all walks of life share views and beliefs about death, no doubt coming away richer than before they entered that process.

Sara Angelini