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A Phenomenological Research Study
Of The Human Experience Of The Finality Of Death
R. David San Filippo, M.A., LMHC
May 11, 1992
Abstract:
Individuals approach the death experience differently, dependent upon their past experience of death and dependent upon who is dying or has died. The person who is dying has a different perspective of death than a parent whose child is dying and/or dies, or child whose parent is dying and/or dies. Death is a universal experience that causes a sense of loss in the dying and the grieving. Even though human beings are consistently reminded of death, through life experiences, literature, and audio-visual media, the actual death event usually comes unexpectantly. This study will present the human experience of death as experienced by a dying woman, a grown woman who has lost her mother, and a young mother who has lost a young child.

Introduction:

History of the Problem
The finality of death and the questionable purpose of one's life and death are major fears associated with dying. In one's attempt to overcome the fear of the finality of death, he/she must look into the purpose of his/her life and death and extract an understanding of these events. Insight into to these facts of life help the individual who is dying and the ones that are grieving. In the dying and grieving process, the sense of the finality of death is tempered by a sense of understanding and/or faith in a life after death. This understanding and faith provides support and comfort to the dying person and the grieving family and friends.

The death of a child is one of the most tragic events that can strike any family. No other loss, with the possible exception of the death of a spouse, extracts the heavy outpouring of anguish that loss of a child elicits. The loss of a parent can leave an individual, whether an adult or child, with a sense of abandonment and a fear of loss of direction and stability.

According to Levine (1982), when we experience grief, we are not just experiencing the loss of a child, parent, or our own life. We are dropped into a pit of despair and longing. We are in touch with the reservoir of loss. We experience the long-held fear and doubt and grief that has always been there. It is not an experience that most would choose, though the confrontation with this area of deep holding seems to be an initiation often encountered along the fierce journey towards freedom, spoken of in the biographies of many saints and sages (p. 86).

Through the phenomenological analysis of how individuals deal with the finality of death, of either self or another, a psychological understanding of the essence of the dying experience can descriptively be reported.

Purpose
In order to confirm that a sense of purpose in life and a belief in a life after death is a strong human need, a small study was conducted, to examine the similarities and differences in how an individual responds to the finality of death, from his/her personal perspective of the dying and death experience, was conducted. The research question, "Describe a personal experience with the finality of death." This questions was presented to the Subjects during their interview.

Apparatus & Procedure:
The data collected in this study came from personal interviews and observations of the subjects, an analysis of their personal journal recollections regarding dying and death, and research articles on the subject of death, dying, and grief. The descriptive interviews and journal passages, used to examine the human phenomena of the finality of death, were analyzed using the descriptive phenomenological psychological method to identify the essence of the experience.

In this study, I examined the experiences of three individuals. A 50 year old woman who has been told she had one year to live, a 40 year old woman whose mother died almost one year earlier, and a 28 year old mother whose 5 year old son died about one year earlier. I reviewed the personal journals of the Subjects, performed personal interviews with the Subjects, and read various research articles on the topics of death, dying, and grief.

The phenomenological study required 8 procedural steps.

1. The Subjects were chosen from the researchers client base.
2. The Subjects were interviewed and asked the research question, "Describe a personal experience with the finality of death." The Subjects descriptive report was tape recorded and then transcribed for analysis.

3. The Subject's journal entries were examined after their interviews.

4. Literature research was performed in the subject area of death, dying, and grieving.

5. The interview data was qualitatively analyzed by identifying the meaning units within the Subject's report of the experience.

6. The meaning units were then interpreted for the psychological relevancies of each statements.

7. An individual general statement is derived from the phenomenological, psychological analysis of each experience.

8. At the completion of the analysis of all of the experiences, a general statement regarding the essence of the commonality and differences between the all the experiences are described.

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Results:
The essential structure of the 3 recorded experiences confirm that the human experience associated with the finality of death is a personal, private manner which is dealt with in individual manners, based upon the relationship to the dying individual, and the grieving individual's beliefs and expectations. Individual death experiences vary, dependent upon who is grieving. The individuals in this study viewed the purpose and meaning of life, belief in an after-life, and their involvement in death process in different ways. Their grieving process was aided or impeded based upon their personal expectations and belief systems.

The human experience associated with the finality of death is experienced in a personal, private manner. Individual death experiences vary, dependent upon who is grieving. The sense of loss, however, is a universal to all grieving. The levels of emotions are effected by the grieving individual's belief in life after death. Positive memories and tangible artifacts, such as a family heritage, pictures, and a grave, help with the individual grieving process.

 

Discussion of Results:
a.) INTRINSIC ELABORATION OF THE RESULTS
The analysis of the research data supports the claim that death affects each individual differently based upon her relationship to the dying person and the value and belief systems of the griever. The research looked at 3 woman's response to dying. One woman was terminally ill with cancer, and expected to die shortly. Another was a grown daughter whose mother had recently died of cancer but had only been ill for a short period of time. The last subject was a young mother who had lost her 5 year old son as a result of drowning while she was within 15 feet of him.

The woman who was dying looked at her life and feared the loss of control, a faith in an after-life, and a sense of accomplishment knowing that she was leaving a heritage in her children. The daughter whose mother had died, felt a sense of loneliness at the loss of her mother and a positive sense for life and life-after death. The third subject, whose interview reflected a consistent focus on her self, could not accept the loss of her son and felt that his loss of life was a result of her misdeeds. As a result, she feels her life has been significantly changed and that the memory of her child will always remain. A sense of loss is universal to all death grieving. The levels of emotions, that express the sense of loss, are affected by the grieving individual's belief in life after death and her assessment to the value of the lost life.

The research supports the concept that there are different structures to the human reaction to dying and death. In this research, the Subjects demonstrated 3 different structures of dying and death:

1. Death of self.

2. Death of another - accepted.

3. Death of another - not accepted.

The woman who was dying accepted the inevitability of her death. She associated her own death with her sense of loss of control, as she died, and a need for faith in a life after death. She felt a sense of accomplishment associated with the knowledge that she had had children and that she would live on, in this life, through them and their memories.

The daughter who lost her mother felt alone but had positive memories of her mother to reflect upon and to be comforted with in her grief. Her strong faith in a life after death made the loss of her mother easier and she was able to accept her death.

The loss of her son was an added consequences to the life of a young mother subject. She demonstrated a lack of control over her life by always placing blame for events in her life on other people. Even in the loss of her son, she focused on the affect it has had on her life and not on the loss of her child's life and future. She states that she will never forget her son and that she will never be the same. She essentially immobilizes her self by connecting her future to the lack of understanding and acceptance of her son's death.

 

b.) LITERATURE REVIEW ASSOCIATED WITH THE RESEARCH
Individuals approach the death experience differently, dependent upon their passed experience of death and who is dying or dead. The person who is dying has a different perspective of death than a parent whose child is dying and/or dies, or child whose parent is dying and/or dies.

The finality of death effects different people different ways. For the individual who is dying there may be a sense of fear, expectation, and/or remorse at the discovery that he/she is dying. For the individual who has lost a parent the sense of loss can be accented by a feeling of aloneness and missing the parent in times that were customarily a shared experience. The death of a child is one of the most tragic events that can strike any family. Death is a natural experience of life and the ability to deal with death is directly associated with the individual's attitude towards death and his/her belief in life after death.

In order to deal with the grief associated with the loss of a loved one, Stephen Levine (1982) states that the death experience, either from the dying individual's or the grieving family and friends perspective, should be experienced as an enriching, growing experience for all affected by the dying process. To acknowledge the moment, to live fully in this instant, participating in one's life moment to moment, compassionately observing what is felt, seen, heard. Not in the analytical mind of why, where, or how it relates to some self-image, some model of the universe. But with the keen light of investigation, with a new wonderment at each unfolding (p. 34).

In this research study, the Subjects all reflected on the dying process and responded to the associated grief in different ways. One subject accepted death and found peace in the heritage of a family and the hope for life after death. Another accepted death and recalled the positive moments in shared lives between the Subject and the "missing other." The final Subject has difficulty accepting the death and immobilizing her self by believing that her life will never be complete as a result of her loss. The first two subjects support the comments of Levine. The discomfort of the third subject reflects her inability to look beyond her life and see the "wonderments" of each event in her life.

According to Levine (1982), grief can have a quality of profound healing because we are forced to a depth of feeling that is usually below the threshold of awareness. The three subjects used their grieving process to attempt to heal the pain of dying and death. Each subject became aware of her own depth of feelings and dealt with them in different manners. The first subject was able to accept her death and die consciously and peacefully. She was able to live her life to the fullest until its end. The second subject accepted her mother's death and the depth of her feelings by leaning on her faith in a life after death and on the positive memories of her mother's life. The third subject could not successfully accept her son's death and therefore was immobilizing her personal growth.

Human growth can be measured by the gentleness and awareness with which we once again pick ourselves up, the lightness which with we dust ourselves off, the openness with which we continue and take the next unknown step, beyond the edge, beyond our holding, into the remarkable mystery of being. Going beyond the mind, we go beyond death. In the heart lies, the deathless (Levine, 1982, p. xiv).

This study and the Stephen Levine research article support each other. Levine speaks of the consciousness and acceptance of death as a healing and growth experience. The research study supports the literature that expresses the opinion that there is a healing quality in accepting death and that there is human personal growth as a result of this awareness and acceptance. The 2 subjects that stepped beyond their fears and sense of loss and looked towards the positives in life and death, found peace in their loss. The subject that would not accept the her loss and her son's loss has immobilized her self in her grief and belief that life will never be the same.

 

VI. References

Cordes, H. (1991, September/October). Facing death. Utne Reader, p. 65.

Dawson, G. (1991, February 22). When death stalks prime-time TV. The Orlando Sentinel, pp. E1, E5.

Jaffe, D. (1980). Healing from within. Simon & Schuster: New York.

Knapp, R. (1987, July). When a child dies. Psychology Today, pp. 60-67.

Levine, S. (1982). Who dies? New York: Anchor Books.

Levine, S. (1991, September/October). Conscious dying. Utne Reader, p. 66-74.

Silver, M. (1989, May 22). Confronting the death of a parent. U. S. News & World Report, pp. 74-75.

 

Appendix:

1.) Carol F., 50 year old terminally ill woman -

I am tired and suddenly realize that I have been on the go much too much. My concentration on meditation and prayer is poor. I am immersed in living and can't seem to focus on anything else. I am not afraid of dying, although I fear pain and weakness. I have hope still, but reality takes over and I know from all facts and figures that I am dying. I know that miracles do happen, but I don't think I am capable of creating one. At times I feel guilty about not being able to do better -- meditate more effectively and cast out doubts. The living seems more important to me. I think about my life and wonder about its purpose for 50 years. I think about my purpose today. I have no answers. Sure I leave the heritage of a loving family but, what do I leave them for? What is the meaning of life? What is the meaning of death?

Is there any meaning? Why hasn't even one person returned from the dead to give us some clues? (Except for Jesus and other Biblical references). I want to believe beyond a doubt that my soul will live forever but how can one believe without doubt? I know that that is the substance of faith -- to not question but to know. It is all such a mystery -- life and death.

 

QUALITATIVE ANALYSIS
 

Meaning Units 

 

Psychological Relevancy 

 

The S realizes that she has been immersed in living and not thinking about the finality of her death. She is tired as a result of not using her time to meditate and pray. 

 

There is an awareness that she is avoiding/ignoring her situation of her approaching death and focusing on short term decision making, which has resulted in her being fatigued. 

 

 

The S indicates that she fears pain and the lack of control in her life, not the fact of dying. She knows she is dying, by the facts presented, but still has hope for life. 

 

The finality of the death experience is not what is feared but the loss of control over one's life. Yet hope is used to attempt to deal with the inevitability of the finality of death, due to her unrealized fear of dying. 

 

The S believes in miracles but does not feel she has the power to create one. She feels guilty for not working on her treatment more because she is busy working in her present life. 

 

The S looks towards an outside influence to save her life due to her lack of confidence in her ability to save herself. Guilt is sensed with the realization that she is not working to save her self and creating her own miracle. 

 

The S reflects back over her 50 years and wonders about its purpose. She questions the meaning of life and death. She finds no precise answers but realizes that she is leaving a heritage through her family. 

 

Through reflection, the S ponders the essential meaning of one's life and death and finds her meaning in the knowledge that she is leaving a heritage. This gives her some purpose for her life but does not lessen the finality of her death. 

 

The S continues to wonder about life and death and wants to believe that she will live on beyond the finality of this life. She realizes that to believe in life forever requires faith, which she questions she has enough faith to overcome her doubt.  A faith in something outside of the self, which will exist beyond this existence, is required to overcome the sense of death's finality. Doubt is expressed by some ambivalence about life after death which may given some insight into how the S experiences death.
 

General Description:
The finality of one's own death is associated with a sense of a need for faith in a life after death and a fear of a loss of control during the dying process. The S is aware that she is not directing her attention to her current condition and therefore feels a sense of guilt at not being in control of herself. A sense of accomplishment is associated with the knowledge that she leaves the heritage of a family, in this life.

2. Lynn S., 40 year old woman whose mother died -

I've really missed momma this year. I've had to prepare Thanksgiving and Christmas all alone. I've had to remember details to handle that she handled. I've had to shop all alone. I've cried a lot this month. It's so hard to believe 10 months have gone by. We bought a camcorder this year. I have wanted one for a long time. I wish we had done it while mom was still alive.

We watched slides this past weekend from before Thanksgiving 1987 through Rachel's birthday in 1988. It was hard, sad because those slides of mom at Christmas was the last ever taken of her. There were slides of her grave, the memorial plaque, the family who came for the funeral. I know that the pain will go away. It takes time but God does heal our wounds. I can still see her last few days as if it was yesterday. I can remember her last breath. I remember how just before she died she looked at each one of us. It was her way of saying goodbye to us. I have so many good memories and yet there are so many things I wish I could change in our relationship. But, I know we had a good relationship. I've grown up to understand so much more now than I ever did before.

 

QUALITATIVE ANALYSIS
 
Meaning Units 

 

Psychological Relevancy 

 

The S misses her mother particularly at Thanksgiving and Christmas of the first year after her death. The S has had to due a number of activities her mother used to help her or do with, alone. 

 

The finality and sense of loss, as a result of death, is experienced as the individual senses being alone during a holiday time when she had not previously been alone and found that she lacked knowing how to do some of the details that the "missing other" generally did. 

 

The S finds it hard to believe that 10 months have gone by since the death of her mother. She finds that she is crying more during the holidays. 

 

The loneliness is expressed by tears, especially at the holiday time, and a sense of disbelief at the period of time that has gone by since the death experience.
The S watched slides of times her mother was alive, just prior to her death, and scenes of her mother's funeral. It reinforced her grief at the loss of her mother. She expresses regret in not buying a video camera before her mother's death, in order to have memories of her mother on video. 

 

Remorse, over the finality of the experience, is expressed when viewing slides of before and after the death experience, especially of the "missing other", when she was alive. The S expresses a desire to have been able to save memories of her mother by using a video tape in order to produce a more vivid, dynamic memory of the "missing other".
She expresses her knowledge that time will help the pain to go away and that God does heal the wounds of sorrow. 

 

The S freely expresses the essence of her faith, that overtime and with the belief that God heals the pain, that the pain of the finality of death will be overcome. 

 

The S remembers her mother's last breath and how she died. She is comforted by the belief that her mother looked at her, to say good bye, before she died. 

 

The finality of the experience is expressed by the memories of the dying individual's last days and breath and especially what appeared to be an expression of a personal "good-bye". 

 

The S has good and bad memories of her relationship with her mother. There are some things that she wishes she could have changed but feels the relationship was good. The S accepts and learns about the finality of the death and recalls the good memories even though there is some desire to be able to change some of the pre-death relationship but the finality reveals itself as the S realizes she can no longer change the relationship.
 
 
The S feels she has grown as a result of the finality of her mother's death. The S has grown in understanding of life and the finality of death. 

 

GENERAL DESCRIPTION

The finality of death is experienced when the S feels she is alone. The memories of the deceased keeps the person alive in the memories of family and friends. The S' faith in a higher power offers hope in a life after death for the deceased. This attitude provides a positive outlook towards life in the presence of the finality of death.

 

3. Delanie E., 28 year old mother whose 5 year old son died -

Q: How are things going?

A: I'm worried, you name it and I'm worried about it.

This job isn't good for my health. The guys are all chocolate fiends. They buy me brownies and give me orange chocolate bunnies. I'm drinking 2-3 diet Pepsi's a day just to keep a buzz on. I think this medication is slowing me down and I want or feel I need to be faster. At any rate I feel like crap, but I look good, so all is not lost.

I've got a careers exam next week and Tim forgot to teach us anything until today so we're all pissed off about it. We've been doing these silly exercises to help us find our "true vocation" and today we covered four theories on career counseling and all it did was show everyone how little we understood about them. We could have used the last three classes to cover this but we didn't. This is typical of Tim's classes. He doesn't know how to communicate what he wants from us and the time frame. He doesn't seem to like to allow people to prepare - like he doesn't. After the third group session he finally hands out an outline of the steps the group leader should go through. Thanks! That didn't help me a damn bit. Supposedly he'll take it into consideration when he grades us. Its just additional pressure for me when I don't need it right now.

Q: What do you mean by that?

A: Prioritize! It something I must do. This something Fred (recent ex-husband) and JB (boy friend) would agree on. When I get to feeling overwhelmed and start to freak-out they both say the same thing - get your priorities straight and do what you can. It sounds so simple.

I just hope everything turns out OK. When I just thought that, I thought to myself, it will somehow. But then I realize that it doesn't always turn out OK. It didn't with Evan. That was one of the strangest feelings associated with that whole experience. That no matter what, Evan's death would never be OK with me. You just can't justify that its over and forget it. You can't say it will get better, because better means he'd not be dead and that won't happen. Its just something that I can't put away until another day, cause it won't be any better. Nothing new can come along and change these circumstances.

Q: How has the finality of Evan's death effected you?

A: I think of Evan a lot more than I did. I confuse his name with other men's/boy's when I talk. I've cried after a few times and tears come to my eyes more often. I used to lay on my bed and cry my heart about him. I don't know what is different now. Maybe it is the feeling that I should be getting over it and not to cry. I actually feel guilty about not crying enough. I know I love him. I always will. I wish I could go to the cemetery in Indianapolis. To see his name on the marker - I just want to.

I don't like the feeling of having this shoved down my throat. I guess I didn't realize how much I chose to avoid unpleasantness and all the ways I do it. It makes me very angry that I can't get away from this. The farther you run the worse it gets. If you don't look at it, it hurts you more. There is nothing like it. Amputation is the only thing I can compare it to. Arms and legs don't grow back. You just have to face it. Its gone.

Why me? Not why poor me, but why in my life? The first thing I said to my father at the hospital that day was, "What lesson is so important that they had to take Evan?" Couldn't have taken less to teach me this, and what in the hell is it? I believe life is for learning and everything that happens is to learn from, but I get real frustrated when I don't know what is expected from me. Just tell me what you want.

 

QUALITATIVE ANALYSIS
 
Meaning Units 

 

Psychological Relevancy 

 

Q: How are things going?  

 

A: The S expresses she is worried about everything. The S reveals her sense of free floating anxiety of being worried about everything.
 
 
The S states that her job isn't good for her health because her male coworkers buy chocolate and buy her brownies and chocolate. She is also drinking a number of diet soda, with caffeine, to give her a lift. She feels her medication is slowing her down and the caffeine will keep her up. The S blames others for her job not being good for her. She accepts food that is not good for her health, uses caffeine to get some feeling into her life and then blames her medication, in part, for the fact that life is not what she feels it should be. She does not express any responsibility for her actions in the way she feels and is currently living.
 
 
She states that she feels terrible but is looking good. The S notes the contradiction that she is looking good but feeling terrible.
 
 
The S states that she has an exam the following week and that the professor has not taught the material that is expected to be on the exam and she and her classmates are upset. The S expresses being upset over not being prepared for an exam. The S places blame for not being prepared on someone else instead of accepting responsibility for her unpreparedness. In order to lend creditability to her claim of blame as a result of someone else, she groups herself with others in the same predicament.
 
 
The class has been doing exercises to teach part of the subject and they have been taught 4 theories that are going to be on the exam. After learning about the theories it showed the students how much they didn't know. The S learns how much she and others do not know about the subject by learning the theory of the subject and then by using practice exercises.
 
 
The S states that this is typical of her instructor's classes. She feels he doesn't know how to communicate what he wants and the time frame to complete the assignments. She feels that he doesn't seem to like to allow people to prepare - like he doesn't. The S feels that there is a lack of communication between her instructor and her, and she reinforces this belief by using the support of her fellow students discontent with the instructor. She blames her unpreparedness on her professor, and believes that this other person wants her to fail.
 
 
The S continues to complain that after the third group session the professor finally handed out an outline of the steps the group leader should go through to be prepared for the exam. She doesn't feel that these instructions have helped her. She hopes he will take the lateness of receiving the assignment into consideration when grading the exam. The S rationalizes why she was a victim to her own unpreparedness by placing the blame on her professor instead of taking control of her learning and begin to prepare for her exam before some else did the work for her. She maintains a hope that the professor will accept the blame for the lateness of the preparation and therefore feel guilty and give the students a break on the grading of the examination.
 
 
The S states that the additional pressure of school is not what she needs at this time. S felt additional pressure from the way the her class was conducted, along with the job pressure, was not what she needed at this point in her life the pressure she now feels.
 

Q: What do you mean by that?

 

 

 
 
A: The S states that she must prioritize her activities. She has been told this by 2 primary people in her life, when she seems to get overwhelmed. She states that it sounds simpler than it is. S knows what action she must take in order to gain a sense of control over her life but appears to lack the confidence to take control because she believes that the action, to improve her self, is more difficult then the theory of the action.
 
 
The S hopes that things will be alright but then realizes that this doesn't happen. It did not happen in the case of her son's death. S hopes that things will be better but then assesses that she has no control over her situations and uses her son's death as an example of this lack of control. 

 

 
 
The S reflects the strange feeling associated with her son's death. The S learns, through realization, that things do not always turn out the way one wishes them to. The S capitulates her control over any situation by associating her lack of control over her son's death with the same lack of control she feels she has over anything else in her life
 
 
She states that her son's death will never be all right and that even with the finality of death, he will not be forgotten. She feels that things will not get better because to be better would mean that her son had not died. She feels nothing new can come along to change the fact that her son is dead. S is aware had, and continues to have the strangest feelings about her son's death, such as it will never be acceptable to her. She states that she will always retain a presence of her son but things will never get better for her if her son is not present in her life, the way she wishes it to be. Since she can not make that a fact, then her status in life cannot change. 

 

The S expresses that she is thinking and crying more often about her son and is confusing his name with other male names.  The S's increased recollection of her dead son causes her to confuse his name with others and to becomes emotional with these increased memories. The S's emotional investment in her dead son is apparent by her emotions and confusion.
 
 
The S remembers that she used to lay on her bed and cry her heart out about her son's death. She notes that she feels different now and does not cry as much as she used to. She feels guilty about not showing more emotion now. The S recalls memories of being immobilized by the finality of the experience. There is a sense that something is different now and that the S should be more emotionally in control, however, this same sense of lack of control, causes the S to also feel a sense of guilt by not showing enough remorse for the finality of the experience.
 
 
The S reinforces her feelings of undying love for her son by wanting to visit his grave. The S wants to confirm her loss by visiting the tangible proof of her loss. By doing this she will be outwardly expressing her grief and her inability to have controlled the situation.
 
 
The S states that she doesn't like the feeling of having her emotions shoved down her throat.
She realizes that she has avoided unpleasantness in the past but can't do so this time with her son's death.
 
The S states that it makes her very angry that she can't get away from her son's death. She realizes that the farther she tries to avoid the situation, the worse it gets. She states that if you don't look at it, it hurts you more. There is nothing like it. Learning continues with the S realizing that the finality of death is not something that can be avoided or blamed on another. The S realizes that even if you attempt to avoid the situation the pain does not leave but grows. She cannot equate any other human experience with the loss of her child.
 
 
The S use the analogy of an amputation as the way to compare how she feels about her son's death. She states, you just have to face it. Its gone. The S bemoans her situation, by stating, Why me? Not why poor me, but why in my life? S summarizes her interpretation of the finality of death by using a tangible, vivid analogy. She understands intellectually what needs to be done but she has not taken action. She still has not taken complete control of her situation. She seeks a tangible answer for her loss not for her son's loss of his life. 

 

 
 
The S relates what her first statement was to her father, the day her son died. "What lesson is so important that they had to take Evan?" The S questions if her life lesson could have cost less than her son's life In response to the finality of death, the S continues to focus on her self and her loss instead of her son's loss of life. She does place possible blame on herself for failing to learn a lesson.
 
 
The S states her belief that life is for learning and everything that happens in life is to learn from. However, she is frustrated when she doesn't know what is expected from her. She makes a plea to anyone that is listening to tell her what she is to do. The S expresses an understanding of life but feels that she doesn't have control because she doesn't know what is expected. She demonstrates conflicting needs when