Here is my contribution to a broader understanding of the various painful states of being, we humans may experience. To describe the mechanisms I will use the state we call Dementia. We are all in transient states of being, which we are the only one to experience no matter what others may say or think about us and our appearance. We may find ourselves healthy, when others call us sick, and we may find ourselves sick when others call us healthy and we can seemingly die and be in a completely different state, like the one many people have experienced through near death experiences and also returned from, and some day we will die. All states of being are in some way or another impermanent.

The reason for dementia is not known. We often say that it is genetic, but we could express this fact for any condition, it does not tell anything about the cause for a specific condition. It is not known what is activating the genes in our DNA, and what initiates the process of dementia. The genes are not the cause, they are just the templates that trigger the expression, the expression we call dementia. So we don’t know what in the surroundings that triggers the genes and by this the condition. When we say that something is inherited, it is not a final truth. It is not certain whether a genetic code will be expressed in a lifetime or ceases to express itself in a person's life. Think of a healthy curious child. We are born healthy with a potential to stay healthy and respond to life's many events also the loss and trauma and pleasures, and we have a choice consciously or unconsciously: to give up, give in, and go on.

Dementia can be described and approached from the following levels:

1) From a physical level: Dementia can be described in terms of the changes the physician observes through his investigation. This is a description of various structural changes which may be seen in the organ, at the cellular and biochemical level, and which is linked with the condition, without really knowing what started these structural changes at first hand. Based on the findings the physician add diagnoses like: Alzheimer dementia, alcoholic dementia, dementia parkinson, Lewi body dementia, vascular dementia, etc., with a theory of a chemical substitute, like a drug or another substance can correct, alleviate or perhaps cure the state dementia. As we may have realised an entirely structural approach is not sufficient to cure the state dementia. The structural and biochemical changes occur in virtually all conditions where we may experience discomfort and illness, they are not the reasons they are the response to the causes the different triggers.

2) From a functional level dementia can be described as loss of various functions the person's possessed before the state of dementia. It may be loss of memory, orientation, emotional control, balance, walking ability, presence, empathy, and more. Any of these losses of function can be found in other states and illnesses. Loss of functionality is something, which is experienced in most states of discomfort and illnesses.

3) From a level of personality: dementia can be described as if the personality is gradually dissolved. What usually characterized the person is difficult to discover and what was more unknown has become more obvious. Loss of function is also associated with loss at an emotional level, just as emotional loss also may lead to loss of function. It is quite obvious as in a severe state of depression where there are loss of function and emotional balance. Loss and grief and guilt and shame and powerlessness can show up in many ways, like anger frustration, anxiety, "Belle indifference" and also as forgetfulness, insecurity and confusion. It can be difficult to determine what occurred first: Loss and grief of something that maybe long forgotten by the intellect, or the loss and grief of a loss of function, which is visible right now, or both. Emotional imbalances are clearly present in the state of dementia. The personality is also formed, or perhaps entirely formed by our emotional loss and trauma all that might prevent us from being, all that we are or can be: colourful and multifaceted human beings. Changes in personality/emotional attitudes are something, which is experienced in all states of discomfort and distress for the person as well as the surroundings.

4) From a consciousness level: there is basically an observer to everything in our life also what we may call sick and healthy. There is a certainty and reason for everything that happens, the triggering causes, which initiates the genes, so the structural changes, functional loss and personality changes become visible. We are just not aware of it, because we are not aware right down to the cellular level, and our intellect and our defence mechanisms are mostly preventing us in being aware on the emotional / personality level.

We rarely achieve full awareness of the triggering causes, at best we can achieve awareness of the structural, functional and personality level and relate to it, without necessarily judging it as sick or healthy, as our own as well as others' judgments, which may be powerful reasons for maintaining ourselves in a state of being.

We can only deal with what is here right now. With the state of dementia as an example, it seems that a person will leave the world in this way. Conscious and unconsciously they gradually let go of control and their personality gradually dissolve. It is not know what led to the state dementia. Unfortunately we can’t communicate with severe states of dementia in trying to find the answers in them. We can only deal with what is: they are about to say goodbye or have already said goodbye to life, without being dead in our usual understanding of death. We may experience people in a state of dementia walking around and talking to themselves, or with invisible beings, they laugh, cry, rages, laugh, and in the midst of all they may fall or get sick and get closer to death, and yet they do not pass on. Perhaps because of the fear of dying, perhaps because of a deeper unspoken desire to continue to live, or perhaps the surroundings holds on to them because they cannot allow them to die. In other words, they are locked in the state and process of dementia.

5) On a spiritual level: We don't know the entire gift and meaning with our life. If we can't do anything better it may help to accept what is. It is often very painful for the environment to witness severe states of dementia, and the best we can do is to try to serve them the best as possible and let go of our own desires and expectations. It requires a lot of flexibility, in letting go of our own values and requirements in the sense of accepting that they walk around expressing strange words, look strange, angry, sad, happy, confused and forgetful, without necessarily offering medication, as we know a personality cannot be cured with medication. At best we may soothe their agitation and anxiety. The most straightforward way would be to examine and use the body's own endorphins and provide this to be release d to gain calmness. Some enjoy music memories, pets, quietness, caresses in fact simply holding hands, as they are obviously anxious and troubled by the process. It requires tranquility and spaciousness. However in the severe states of dementia it is about relieving the person utmost, and luckily there are synthetic endorphins to use among other choices of medications and treatments.

It requires tranquillity and spaciousness, and it may be difficult if there is people around them who takes the control and management out of some values and requirements, which not always are for the benefit of the person in the state of dementia.

The way the state of dementia is described and approached can be used for any disorder. No matter in which way a symptom shows up we could approach an illness from all five levels. Through dialogue and inquiry, an understanding of why the body produces a symptom we may become more wise. What does the body inclusive the personality defends itself from realising and doing? What does it want to achieve, which may not be directly expressed? What have we not yet awakened to realise and understand in our lives in the present contexts? No one has put the disease into our bodies, we have created it ourselves unconsciously. Whatever might be pushing us from outside or inside, the answer will always be in ourselves, as manifested through the way the body responds. If we are able to and if we ask for and receive the support that is truly needed, we have a possibility to change ourselves. There are different healing levels needed in this process as mentioned above. We can also choose to continue to relieve the physical and functional level in the way we already do. Everything is possible, it is a choice, hopefully in the future a more conscious choice out of our own needs, and the available options, also through accepting the unknown manifestations of spirit in our life.