Preparing for Death and Planning to Live: an interview with Marianne Pomeroy

I first met Marianne Pomeroy in August, 1987, when I was a new student of Process Work. I was drawn to her good humor and warmth, and I remember she helped me work on a symptom I had at the time, a lump in my breast which turned out to be a fluid-filled cyst. Marianne had already had a mastectomy, and my mother had recently died of breast cancer. We had a lot of common ground. Later, in California, Marianne came with me to visit my first client, a young woman who was dying of a massive brain tumor. We made several trips together to visit my client in the hospital and then at the friends' home where she was staying. During this time, we became firm friends.

Although death has been in the background of our friendship from the beginning, I was still amazed to see Marianne, as a member of a support group for women with advanced breast cancer, on Bill Moyers' public television series about mind-body healing. Thaf s how I found out that her cancer had returned. When Marianne came to the Lava Rock Clinic in Waldport last spring, I was so happy to see her again. The seriousness of her physical condition somehow seemed to fade beside the warmth of her laugh. We resumed our old friendship immediately.

After listening to some of the things Marianne had to say about her illness and her dying process, I asked if she would let me interview her for the Journal. She agreed, thinking as I did that the interview might be of interest to other women working with breast cancer, as well as to therapists and Process Work students.

My focus is on Marianne's experience of breast cancer and the ways she relates that experience to her thoughts about life and death. This has been a theme at the bi-annual Lava Rock Clinics on chronic illness, where a number of people with serious illness have begun by working on a symptom, and the work has moved into the realm of life/death issues. Looking back on my own symptom work, I realize that I hope, through living my symptoms and connecting them with my fears and fantasies of death, to live more fully. Another aspect of this theme are my relationships with dying friends. These relationships, I have discovered, do not end at death, but continue to be part of my life, as my friends' courage and intensity at the edge of life and death continue to inspire me.

Marianne, in the process of working on issues of identity and awareness in relation to her thoughts and feelings about living and dying,

has developed a teaching side which she was shy to bring out in the past. In addition to the Moyers' series, Marianne has appeared on other television shows, speaking about her cancer and its effect on her life. Cancer, Marianne told me, is "an epidemic/' She said it kills one in nine women, in some areas one in eight women.

When I sent her the transcript of our interview, she asked me to add the following:

"I feel extremely vulnerable having some of the deepest parts of myself out in public. I wish that people who read this please not criticize or analyze me or my process—but please hold me in unconditional love. If they can do that—then I am open to any questions or communications they may wish to pose.

I am opening myself in the spirit of service. I hope my life and work can be useful."

Following Marianne's wish, I have edited our conversation minimally in order to offer a record of her thoughts about life as she prepares for her death.

Lava Rock Clinic, Waldport, Oregon, April 7,1993

Sara: Marianne, can you start with a history of your experience with breast cancer?

Marianne: Eleven years ago I discovered a lump in my breast. I got out of the bathtub and a light came and shone on my right breast. A voice came into my ear and said, "Check your breast." So I did, of course, and I found a tumor, a large lump about the size of a plum, firm but not hard. Within a week I had a mastectomy. They removed my right breast and took the lymph nodes out of my armpit. I had two positive nodes, which is not great. If s not a really bad thing in the medical world, but it was enough that they advised me to have a year of chemotherapy.

So I started on chemotherapy, moved to California, and completed my chemotherapy while I finished my master's degree in tran-spersonal psychology. A year after I finished the chemotherapy, I was again guided to check my incision site. I discovered a garbanzo bean size lump at the site. I went and had it removed and had six weeks of radiation therapy because that lump was also cancerous. Then I did pretty good.

About three and a half years ago, my regular bone scan showed a little shadow on my rib, and the doctor said it was nothing, or that it was an old fracture, or that it was radiation damage or something like that—it didn't look like cancer. But I felt it was something important. It looked to me like a star, and I felt that I needed to go inside and follow my own star. At that time I made a lot of changes in my life. I dropped out of the Process Work program and stopped working on my dissertation, and I rescheduled my therapy practice so I'd have more time off. I started to be a little more inward.

After about a year of knowing I had this star on my rib, I was still not feeling good about my private practice. I felt burned out and needed a lot of time away. I didn't want to go to work. One day I was sitting with a client, and a voice came into my ear and said, "You've got two drops left, what are you going to do with it?" I immediately started the pro cess of closing my practice.

I finished my practice two years ago, in March, and I thought, "I'll change professions. I'll go back into nursing, I can do that part-time. If 11 be easy compared to psychotherapy" (laughs). So I took a couple of refresher courses—I loved studying the body. That was really exciting. While I was doing that, I discovered from a scan that the spot on my ribs

June Jordan recently pointed out, as other feminists have, that while roughly four times as many deaths have been caused in the last ten years by breast cancer as by AIDS, AIDS research has been targeted as a major concern by the U.S. government, but not breast cancer. "Of course," Jordan comments, "breast cancer kills women/' See "Seeking an attitude/' Women's Review of Books X(8), May 1993.

had grown. This seemed more serious, and the doctors were getting more interested. They debated for a couple of months about whether it was or wasn't cancer.

I didn't have any symptoms. My blood tests were all normal, and my surgeon even said, "I just don't believe this is cancer. It doesn't look like it." Two years ago in September I had a biopsy on my rib and the surgeon said the rib was complete mush; there was no structure left at all. I had a tumor in my chest wall, and that had gone in deeper, through the chest wall and into the pleura, the lining of the lung. But it wasn't in the lung. So last year I spent about seven months in chemotherapy and six weeks in radiation to try and stop the tumor growth. It hasn't stopped. It is continuing to grow. Now I'm only taking some tamoxifen to try to interfere with the growth of the tumor. I'm hoping the drug will help slow it down. I think it's interesting that this tumor is considered to be an indolent tumor (laughs).

I identify myself with being rather indolent, but I'm discovering I'm not as indolent as maybe I should be. The tumor is slow-growing, and it doesn't go distances. It stays in the same place and just goes deeper. So thaf s what I'm trying to do (laughs).

Sara: You're picking up on what your tumor is doing?

Marianne: Yes, you know, there's something about the qualities of my tumor that I really identify with. I think if s funny that I fought against indolence all my life. I thought I was lazy and had to push myself so hard. And now all of a sudden I'm given a symptom that says, "You'd better be more indolent!" I like that. I mean, I like having permission to stay still for a while, and go deeper.

Sara: What do you think it has taken for you to give yourself that permission?

Marianne: Oh, God! A lot of internal and external battles. I had to really work on myself, and on my critic that says I'm lazy, I'm not useful and I have no value as a human being unless I'm working. I didn't even get that until last year. For the first time in my life I had severe

bronchitis and asthma for three months. I couldn't do anything but lie in bed and breathe. And I just pondered that question/What good am I? What use am I? I can do nothing." I realized that if s enough just to lie here and breathe (tears in eyes). If s a profound teaching for me. And it took more than cancer for me to get that. The asthma taught me. It took something to really put me in bed, make me still, make me quiet er and make me go more deeply.

I think this is a common thing, at least with other women I've talked to who have breast cancer. It's like, "I'll just keep on with my life, I'll just keep giving, I'll keep doing, you just tell me what to do, I'll do it." We have a lot of identification with being valuable because we're helpers. I'm saying "we" now. I'm thinking especially of the women from my support group for metastatic breast cancer, and I think for all of us, saying that we are needy is almost impossible. I see these women struggle with this issue at every meeting. And I think I've come a long way in that struggle. I'm more willing now to just be. And I don't give much (laughs). I don't give as much, and it makes me feel really good. I feel almost like a bad little kid; I'm not going to give. I'm not going to give, I gave at the office and every place else in my life.

The history of that goes back to my relationship with my mother at birth and shortly after birth. She had a really hard time with me. I wasn't breathing, I was choking a lot, and she freaked out and treated me like a farm animal. I had trouble eating because she didn't have breast milk. I was also born low birth weight. And so when I would nurse she would only have blood. I would spit up blood and she, well the story is, she ran three miles with me to the doctor's, and he put me on formula and I would choke. So she would put her finger down my throat and put me under the cold water faucet to make me breathe. As a result of that, I very early split off from a place that says, "I need." Very early.

Sara: You have a lot of feelings when you tell this story.

Marianne: Yes. I split off from a place that says, "My experience is valid/' I split off from any kind of assertion or aggression. Those are still really hard things I'm dealing with.

Sara: Thaf s an incredible story you just told, it's so painful. What happens now when you feel some need to be assertive or aggressive?

Marianne: Right now I'm seeing it in relationships. It comes up in my relationship with my husband. I have to deal with my neediness. I've had to tell him I'm really needy and I'm scared, and I've had to teach him how to respond to me.

Sara: In the past, before you felt any pressure to deal with this, what would you have done?

Marianne: I just stayed busy. If my needs weren't met I got mad and felt abandoned. Then I'd go away to a workshop or something.

Sara: How does this issue come up for you now?

Marianne: Being aware of dependency and neediness? I've had various thoughts with it. The first stuff I worked on was the split-off aggressive part of myself. My first dream figure was a hairy monster who lived in the basement and ate rats. She was wonderful!

That was my first work with Amy [Mindell]. It was the first work I ever did around the cancer. The work gave me courage, since this was a dream figure that was extremely primitive— it had been kept in the dark all my life, all its life. Somehow that work cleared up any fear I had about what was inside of me. I knew that whatever I was scared of and wasn't able to bring into awareness would come from this hairy monster.

I had a dream when one of the women in my group died that her mother was arrested for homicide. And in a sense it wasn't a dream of my own mother, I mean I know if s true in my own personal work, but I have a sense that it may also be the collective work. In my group many of the women often talk about troubles with their mothers. I think it's mother work. Beyond that I think if s repression of the wild

woman, repression of the feeling aspect in our culture and the denigration of that aspect.

Sara: It sounds as if the hairy monster has been a great ally for you.

Marianne: I think if s helped me stand up for myself as a feeling person. Learning to value myself has been one of most important aspects of this illness for me. I have learned from a community that showed me if s okay to value myself and that feelings are valuable and necessary. And I learned it in the process community, I learned it in Zurich. I remember exactly when it happened. Jean-Claude [ Audergon] had a huge feeling and he completely supported himself in it. I'd never seen this before. The whole atmosphere in the group had come about because people weren't saying their feelings. I felt really ashamed at that moment. Ashamed, and also happy at the same time, to know that if I had brought my feeling into the group it would have made a difference.

Sara: Do you think there's been any value to the experience of having breast cancer?

Marianne: Yes. If s the other side of the indolence. It's a funny thing, I've never thought about this before, but if I'm really indolent in the right way then I'm more awake to something else that needs to happen.

Sara: Whaf s the right way of being indolent? (Both laugh).

Marianne: Well the right way of being indolent is to really support oneself in indolence. I mean to get behind it and really allow it. For me it means having a room to myself here, pulling up chairs and resting when I'm tired, walking away when I need to and just being one hundred percent behind myself doing that. Because there's also a message to hurry up. Hurry up and be alive! (laughs). Be alive to everything that you have.

I think I've been on automatic for most of my life. I have lived in a sleepy way, but the wrong kind of sleep. That makes me think of fairy tales. I don't know which one.. .You would know a fairy tale, but if s something like, "I've been indolent but if s been the wrong kind of indolence. I've been lazy about,

no, I don't want to say lazy Well, okay, I've been a little lazy."

Sara: Once upon a time there was a lazy...

Marianne: Once upon a time there was a very lazy woman and she just slept all the time. She didn't want to do any work. She originally just liked to smell the flowers and stuff like that, but life sort of came in the front door one day and said, "No no no no, you have to do this and that and the other thing!..."

So she said,"oh, okay, I'll do it." She didn't even ask herself. She just did it. Thaf s the lazy part. She just did it. She didn't know how to fight it.

Sara: What did life look like?

Marianne: When it walked in the front door it looked like the world saying, "You! Get married and have kids and go to school and..."

Sara: That kind of life. Conventional life.

Marianne: Conventional life walked in. And she was probably an unconventional person. She could have been more of an unconventional person most of her life if she'd only been able to live more of the hairy monster. So then she lived this conventional life and did everything really well. She had five children in five years, went to school and got her master's degree, had a love affair and a twenty hour a week job all at the same time, lived on diet pills, it was wild. Then it all fell apart. The conventional life fell apart.

Sara: How?

Marianne: Well, she divorced her husband and she decided she didn't want any more conventional life. Somehow she knew that it was either get out or die.

Sara: How did she know that?

Marianne: She was up against the wall. She knew, it was either do it or die!

Sara: How did she know? Who said that?

Marianne: She had that feeling inside. Must have been a voice! I think it was a voice. It must have been this wonderful teacher inside that saved me, you know, in the nick of time.

If s a male voice, if s very clear, and it doesn't come very often. I've never asked for it, if s just something inside of me that seems to be in my best interests. If s like an inner teacher. If s almost impersonal. It says things like, "check your breasts now." If s just like my own special guardian angel inside (laughs). It comes in at the nick of time and says,"Whoa!" You know, I have a rather impersonal feeling myself that says I will die from this thing.

Sara: From this breast cancer?

Marianne: Yes, it does say that. And I have lots of feelings about it! There's a whole part of me that doesn't want to have anything to do with it, you know, "Forget it, I want to live forever!" I know that part. If s this little kid in me that says, "I will live forever! And I'm not ever gonna die— don't talk to me about going out into space and going to the sun, forget that! I want to have fun! (laughs). I'll never go in a little box, you're not gonna put me in a box, I'm not ever going to die!" She's incredible. My life force comes from her. And thaf s a neat part of me.

Then there's this detached, light self that says, "You're in a group of people with the same disease you have, they're dying, nobody goes out of this life alive, you're going to die. If s logical to expect that you will die from this." Since I am there in this group and facing this process, it has meaning for me, that I need to face my death. I don't want to, you know.

There are different ways that I do it. If I do it impersonally it's fine. I'm willing to go and if s okay (laughs). We keep talking about this other part of ourselves. Right now my little girl is saying, "No way! You know, no way!" But I know, of course, that I will die and I don't know when. Nobody knows when. I think thaf s one of the mysteries of life. I'm willing to be with the mystery too.

Sara: It looks like there's also a more maternal part in you, who pats the little kid-Marianne: Yes, thaf s the part thaf s escorting me through all this. She's the one who takes me in for the treatments and helps me through the medical stuff. She also helps me when I

need her, when I'm scared about relationship stuff and things like that. She'll give me hugs. So I feel thaf s a good mother. Thaf s important, I'm glad you saw that.

Another part is a little different, and thaf s when I go into the actual feeling mode of dying. It doesn't happen very often. But when I do that if s really scary. I get veiy frightened, and I don't know exactly what I'm frightened of, but I'm very anxious and very afraid and that seems extremely important for me to experience. I notice if s not a simple thing to let go. When I think about that part and ponder its usefulness, I see all the times that I go through a dying process in my life. Which is more often than we think, more often than I think. When something has to die, or I have to let go of something.

I'm thinking of when I started to have pain in my body a few months ago. Here I was, a person who had cancer but didn't have any pain. So my identity was as a person who had cancer, and it was a serious thing and I needed to deal with it, tadadadada. Then, all of a sudden, I started to get this pain in my body. When I first experienced the pain, I felt the fear that I was telling you about, the fear about dying and the hanging on to what I was before. If s like in slow motion, actually, I can see it. If s that fear. "No I don't have pain, no, no!" Then moving into this place of, "I do have pain." This is a new thing. This is me with pain; this is a new identity. It took me several days to integrate that information into the new body. This is me, I'm having symptoms in my body and this is how I'm working with it. This is whaf s happening. Now I have a new identity. I'm seeing it in macro, in slow motion. I'm a lot in the middle of the process of moving from one identity to another.

I'm thinking of this in process terms; I'm spending a lot of time around the edges (laughs). And in that edge place I'm disintegrating. If s like a dying process at the edge. Then, in two or three days, I'm in a new form. Am I making sense?

Sara: It sounds as if you're letting go of your old identity and opening yourself up to a dif-

ferent sense of identity, to what is happening moment by moment?

Marianne: I think thaf s my dying work. Thaf s what dying is. And I'm doing it without physically dying. I'm hoping, you know, my intelligence says, "maybe if I do it really well, do it enough and get enough awareness around it, my own death will be more familiar for me."

If s learning about,"how am I as an individual, how am I with transition?" This process, the transition between one form and another, has let me slow it down so that I can see it and feel it, more clearly.

Sara: Between having a body that doesn't hurt to having...

Marianne:.. .a body that does hurt. Or between having a body, and not having a body.

Sara: You can conceive of not having a body?

Marianne: Yes, I think so. I think I can do that. The part of me that wants to die is really... I can't find it right now. I don't think I have any part that wants to die. I think that I am taking care of my needs really well. And I'll still die.

Sara: But it doesn't look like this moment is the right moment.

Marianne: No, I'm very alive now. I tell people I'm preparing for my death and planning to live! (laughs).

In June, Marianne sent me an addition to her interview

"I do not know what caused my cancer or anyone else's for that matter. The important thing for me is to find some meaning in my illness, to somehow bring my entire life and self into some sense of cohesion.

My mother is not the cause of my illness. We had some difficulties and that helped form my personality. She also gave me lots of good nurturing and was brave enough to share my early history with me without excusing or hiding her participation. I respect her for that. I feel that the abusive mother is inside me and

also in the collective. My real personal mother is larger than my issues."

In June Marianne spent a month in Zagreb, Yugoslavia, with her Sufi group, working with peer support groups of Bosnian women who have been in rape camps. She says her ongoing work with the Bosnian women makes her "feel that just being who I am is useful. It's a way to serve people who are worse off than I am." She continues, "I've also had to face the shadow side of being useful—giving beyond my body's capacity. Ifs sort of a razor's edge."

I realize that Marianne has taken her work on her early sense of abuse and dependency into the world channel. She is working compassionately with some very grave abuse issues for other women, and at the same time modeling a sustainable way of being a good mother, by paying attention to her own body and her own needs. She said, in a videotaped session of her support group which she sent me, that the work with Bosnian women has put her own struggle with breast cancer in a larger perspective. Marianne's issues are world issues. They are larger than her own personal history.

Marianne's image of the hairy monster who lives inside of her, her ally in standing up for

her feelings, is very touching and revelatory for me. Dreaming into her image, I see a very unfeminine monster, but a very female creature who is hairy, feeling, lazy, persistent, ready to fight for women's survival everywhere, and in touch with pain and with love.

At the time of writing (September 25,1993), Marianne reports that she's feeling well. Chinese herbs have helped with her pain and she's almost entirely off painkillers. Her Sufi group has just succeeded in bringing six women to California from Bosnia, and she feels a great sense of completion in having helped do that. As we spoke I felt completely at ease with her, in the presence of this woman who knows herself very well and is living life deeply in each moment.

Sara Halprin, Ph.D., lives in Portland, Oregon, where she writes, practices and teaches Process Work and Tai Chi, and lives a complex and unpredictable life. She has a diploma in Process Work, a Ph.D. in literature, and background in university teaching, film making, and video production. Her book, "Look At My Ugly Face: Myths and Musings on Beauty and Other Perilous Aspects of Women's Appearance," will be published by Viking in 1994.