TRANSITUS

I first met Therese Schroeder-Sheker at a conference on Death and Dying on the holy island of Iona in the autumn of 1987. It was an extraordinary week that produced many collaborative ventures that have lasted until this day. In the evening we would go at 9 p.m. to a service in the abbey, and a few of us gathered afterwards in a small chapel by candlelight to pray, chant and listen to the exquisite sound of Therese's harp and voice in that ancient Celtic sacred space. A similar atmosphere pervades this remarkable book that tells the story and explains the principles behind the Chalice of Repose Project: music-thanatology, accompanying the dying with 'prescriptive music'.

The religious roots of the project can be found in the monastic medicine from the famous mediaeval monastery of Cluny in Burgundy. Therese herself is a mediaeval scholar who has also been drawn to the work of Rhineland mystics like Hildegard von Bingen and Mechtild von Magdeburg. Deathbed healing without curing is called Musical-Sacramental-Midwifery that uses an alternating process of contraction (meditative silence) and expansion (sung prayer). The monks also left detailed accounts of how the dying were tended (care of the body, cure of the soul). They sought to alleviate various levels of suffering that might prevent the person entering that state of peace in which they could make a blessed transition. They also discovered that certain rhythms eased the passage or transitus, for this approach takes for granted that we move from one form of life and consciousness to another.

Therese tells the story of the Chalice of Repose Project as an intimate journey of souls who have come together to do special work in the modern world. They bring a new understanding of death and dying as well as a new training and practice that is demonstrably capable of enhancing the experience of the process of dying. The training includes many elements but at its root is a profound spiritual practice and nourishment without which the practitioners would be incapable of functioning at the required level. A metanoia or alchemical transformation of being forms an integral part of the clinical training, along with history, scriptural understanding and clinical skills. As Therese puts it, the vision has been concerned with 'living a contemplative practice with clinical applications'. Knowing what live music to 'prescribe' is a fine skill honed by experience of both 'processing vigils' and 'imminency vigils' - the latter when the patient is dying.

Therese comments that 'spiritual suffering is the experience that results when we are cut off from our deepest sources of meaning, which is a widespread affliction these days. The goal of a music-thanatology vigil is to relieve either physical pain or this spiritual suffering. Practitioners have to be able anoint the patient with sound by using texture, consonance and dissonance, harmony and rhythm clinically on the basis of a 'body-systems phenomenology'. Here there is a relationship between the harmonic content and the circulatory-respiratory system, and between metabolism and all uses of rhythm. Near the end, music-thanatologists will use non-metered music to assist what Therese calls 'the unbinding process' involving a process of self-emptying or kenosis. The dying person is unbinding not only from biological rhythms but also from layers of personal identity and cultural conditioning. Here an attitude of resistance serves only to intensify a struggle in a situation that requires surrender.

The book itself has been crafted with the same meticulous care that goes into the training and practice of music-thanatology. Sidebar quotations emphasise the message and are complemented by sensitive and evocative photos of people, nature and buildings. A good many photos depict music thanatologists at work with the dying, so that the process is vividly conjured up - we are only missing the music. The book can be read at a number of levels: for information alone, but more deeply as contemplative reading, as Therese has expressed her soul in the book as she does with her music. Her writing is precise and evocative at the same time, with many apercus into spiritual principles. The reader will appreciate that it really is possible to have a blessed death in the modern world.