As a therapist, I am always struck by the recognition of “the moment” in which a shift happens. Some call this an “aha moment,” when a client has been working on uncovering something deep, something forgotten, something feared. In those moments, there is both catharsis (release of emotions – a letting go) and a mental shift from the “before” to the “after.”

Before this acknowledgement, clients may be withdrawn or disconnected from their own personal reality. I am not referring here to delusion but rather not allowing themselves to identify what they are holding in, that which is not allowing them to move on with their life.  Some clients call it a wall. Some describe it as feeling submerged, like drowning. Some call it walking through a heaviness.  Some feel it is hard to catch their breath. The feelings that go along with this sensation of being stuck can be anxiety or depression or trauma.  And the fear is that to connect with these feelings may bring tears, or anger, confusion or regret, that will never end.

But after this shift, emotions are freed, sometimes seemingly unattached to a specific thought, there is a physical sensation of letting go.  And it is usually visible not only in the body, perhaps relaxing, crying, a scream, and sometimes, even laughter, but there can be a mental clearing as the body begins to release what it has been carrying. We are able to access the thoughts and the emotions we have been using as protection. Sometimes this allows us to take new ownership.  In those moments, I will often simply witness what is happening and encourage the client to describe the shift they feel.

In medicine, there are many such moments, many shifts in our understanding - “before” and “after.”  Palliative conversations are a place of witness and an opportunity for your committee of support to begin to make a plan.