Companioning: A Compassionate Approach to End of Life Care Giving
The work of the doulas in the Pacific Death Doula Collaborative (PDDC) is grounded in the soulful practice of companioning. We are guided by the Gaelic phrase, “anam cara,” which loosely translates to ‘soul friend.’ This phrase acknowledges the unique depth, perhaps even mystical quality of the relationship that exists between a caregiver and client navigating significant life events.
What is a companion?
The word companion has etymological roots from Latin com- which refers to “with” and panis- which relates to “bread or food.” It is defined by the Merriam-Webster dictionary as one that accompanies or keeps company with another. (“Companion,” 2024)
Companioning is a term that has been applied to many different fields over the years, but has gained significant traction within the deathcare landscape at present nodding to the therapeutic benefits this approach has offered the bereaved.
Expert Dr. Alan Wolfelt, has developed a comprehensive approach to assisting those who are bereaved through the practice of companioning. Wolfelt advocates moving beyond the medical model’s approach to care, which prioritizes the assessment, analyzation, and resolution of other’s grief. Instead, companioning offers caregivers the opportunity to act as a witness, a soul guardian to those who are mourning.
Hospitality is a primary component at the core of companioning. When we provide hospitality, we bring comfort to another by being fully present and thus developing a sense of familiarity with the personal stories, needs, desires of another.
In his book, Companioning the Bereaved: A Soulful Guide for Caregivers, Dr. Wolfelt lays the foundation for the practice of companioning in the eleven tenets found below:
First Tenet:
Companioning is about being present to another person’s pain; it is not about taking away the pain.
Second Tenet:
Companioning is about going to the wilderness of the soul with another human being; it is not about thinking you are responsible for finding the way out.
Third Tenet:
Companioning is about honoring the spirit; it is not about analyzing with the head.
Fourth Tenet:
Companioning is about listening with the heart; it is not about analyzing with the head.
Fifth Tenet:
Companioning is about bearing witness to the struggles of others; it is not about judging or directing these struggles.
Sixth Tenet:
Companioning is about walking alongside; it is not about leading.
Seventh Tenet:
Companioning is about discovering the gifts of sacred silence; it does not mean filling up every moment with words.
Eighth Tenet:
Companioning is about being still; it is not about frantic movement forward.
Ninth Tenet:
Companioning is about respecting disorder and confusion; it is not about imposing order and logic.
Tenth Tenet:
Companioning is about learning from others; it is not about teaching them.
Eleventh Tenet:
Companioning is about compassionate curiosity; it is not about expertise.
What might companioning look like in a death doula’s practice?
The great thing about companioning is that it is fairly easy to implement at any moment. It requires that we listen with more than our ears and that we allow clients to lead as our teachers. As doulas, we acknowledge and trust the inherent wisdom that our clients possess, which ultimately acts as a guide for a good death. Although doulas may have knowledge about the typical manifestations of the dying and bereavement process, we also respect that uniqueness of each person’s journey. For doulas, companioning for a client might resemble old friends who are well acquainted sitting in silence together and at other times, sharing hearty laughs, or shedding tears with one another. Rather than turning away from or numbing feelings, death doulas seek to sit with the full spectrum of human emotion from pain, pleasure, anxiety, ecstasy, and everything in between.
Companioning is an accessible practice that is not limited to only end of life care; rather this approach can be applied as a measure to enhance the soulful and intimate quality of our interpersonal relationships.
Interested in learning more about the concepts and terms presented in this article? Check out the sources below for more information.
Sources:
Popova, M. (2023, December 5). Anam Cara and the essence of True friendship: poet and philosopher John O’Donohue on the beautiful ancient Celtic notion of Soul-Friend. The Marginalian. https://www.themarginalian.org/2015/08/12/anam-cara-john-o-donohue-soul-friend/
Wolfelt, A. & Massachusetts Funeral Director s Association. (n.d.-b). Companioning vs. Treating: Beyond The Medical Model of Bereavement Caregiving. Association of Death Education and Counseling Conference. https://www.massfda.org/Files/Griefwords%20-%20Caregivers%20Hospice/Companioning%20vs%20Treating%20Beyond%20The%20Medical%20Model%20of%20Bereavement%20Caregiving.pdf
Wolfelt, A. D. (2005). Companioning the bereaved: A Soulful Guide for Counselors & Caregivers. Companion Press.
Wolfelt, A., Ph. D. (2016, January 12). The companioning philosophy of grief care: being present to pain. https://www.taps.org/articles/2016/companioningphilosophy
Wolfelt, A. (n.d.). Foundations of “Companioning.” Pollock-Randall & Marysville Funeral Homes - Port Huron, MI. https://pollockrandall.com/healing/new-leaf/helping-others-grieve/foundations-of-companioning#:~:text=The%20companioning%20philosophy%20empathizes%20with,without%20any%20sense%20of%20shame.
