Reading: How do I cope with worsening heart condition?

Recently my symptoms have been a lot worse. I’m waiting to hear back from my cardiologist about the last lot of tests, but it is very – well – disheartening to find yourself lying on the sofa, week after week unable to get up.

What does my heart need? Is there something I can do? Some chemical that I’m lacking? Some habit I need to pursue?

This reading was full of intent.

I started, frankly, hoping there would be a medical answer in here somewhere. Even though I don’t believe tarot can do that! That is what I wanted to see. Note that desire. Tarot, for me, is about seeing what emotions and wants rise to the surface, of spotting what you are suppressing and assuming before it is suppressed or taken for granted.

I chose a layout of my own design. I give you…

The Ego Spread

“The ego attempts to mediate between id and reality, it is often obliged to cloak the (unconscious) commands of the id with its own preconscious rationalisations, to conceal the id’s conflicts with reality, to profess…to be taking notice of reality even when the id has remained rigid and unyielding.” – Sigmund Freud

On the left hand side are the two interests of the id: to seek pleasure (top left) and avoid pain (bottom left). These are the id cards.

You (“the ego”) have to manage the pleasure/pain drive in such a way that is realistic, pro-social, and brings long term benefits. The card to the right of the id cards relates to how you balance the need for pleasure and need to avoid pain.

On the right hand side are the two interests of the superego: your sense of right (upper right) and wrong and guilt (bottom right). It is your inner parent, teacher, the idealised role model from your culture. It is the voice that tells you that you should do or not do something.

The superego is concerned with social respectability, where as the id wants instant gratification no matter the consequences.

The card to the left of the superego cards is how the ego balances these two demands of the superego.

On top of the balancing cards (central and behind) is the last ego card, the card that brings together the two ego cards and unites the id and the ego into a single point.

Mine looked like this:


  • Pleasure: Knave of Swords
  • Pain: Nine of Pentacles
  • Ego’s understanding: Six of cups


  • Virtue: Ace of Pentacles
  • Vice: The Tower
  • Ego’s understanding: The Devil

Final ego card: Death

Finding Meaning

Before I interpret my scribbles, look at the “pain” card! It is blindly chosen from a deck of 78 cards. The card that ended up representing the visceral pain of my heart condition literally has a view inside the chest cavity.

I also shuffled the deck irrationally hoping to find a chemical answer to my problem. Don’t the pentacles look like tablets?

Here is how I read it…

The Id and The Ego

  • Knave of Swords: the pleasures of the inner life
  • Nine of Pentacles: the pain of exhaustion
  • Six of cups: your capacity to hold both pleasure and pain mindfully

The Six of Cups with the Knave of Swords could represent the inner life running away with itself, but it is the ego’s job to bring things back to reality. (The id is always impulsive and haphazard. Anything in the ego’s domain gets organised, and either expressed or suppressed.)

One way to bring things back to reality is by doing things with other human beings.

We share all sorts over a cup of tea or glass of wine. We have to fill our cup – not just randomly in the imagination, but in reality, in an organised, intentional and meaningful way.

The Six of Cups with the Nine of Pentacles puts me in mind of spilling my energy everywhere. Leaking, broken cups, all knocked over.

If we can’t fix them, we can be careful not to break them further.

Imagine six cups filled with nine coins each. They represent your energy budget. You need to get through the day or the week on what is in them. You can’t deal with your debts by ignoring them.

If the Six of Cups were to communicate a message from both cards, it could be to invest in a rich inner life. Be careful not to indulge exhausting and upsetting thoughts. Share this wealth of insight with others, but don’t spend your energy on those who cost you too much or charge you well over your budget.

Seek emotional and mental fulfilment from your dreams and relationships. Avoid those who leave you feeling empty. Save your energy and spend it on what brings the best out of your mind.

The Superego and Ego

  • The Ace of Pentacles: the virtue of getting things in order
  • The Tower: the vice of chaos
  • The Devil: your capacity for judgement and autonomy

I already felt like I was letting myself down when I reached over to turn the first card.

What virtue was I failing to live up to? What vice had I fallen into?

That’s the second thing to note: before even turning over the cards on this side, I was judging myself and telling myself that I had let myself down. It was my fault in some way.

Whatever I saw on the cards I would see through that lens and make it fit this prejudice.

This was almost all unconscious, and I almost missed it. Until I turned over The Devil card.

The Devil has a bad rap. He is seen by some as the embodiment of evil, and by others as a rebel against the tyranny of God. God tells Adam and Eve that they are forbidden to decide good and evil for themselves. The Devil gives them this knowledge. God never gave them freewill. Satan did. This knowledge was the first sin because it allowed humans to disagree with God, to come to different conclusions, to be disobedient even if they wanted to obey. From one point of view, this means humans cannot follow God’s plan and righteousness because we will always second guess it. From the Satanist point of view, it is better to be autonomous than the playthings of a deity. Richard Dawkins was of this opinion:

“The God of the Old Testament is arguably the most unpleasant character in all fiction: jealous and proud of it; a petty, unjust, unforgiving control-freak; a vindictive, bloodthirsty ethnic cleanser; a misogynistic, homophobic, racist, infanticidal, genocidal, filicidal, pestilential, megalomaniacal, sadomasochistic, capriciously malevolent bully.”

In tarot, the meaning is up to you. It connects to all of your unique and common cultural associations.

You can see what I associated with it on the page: laziness.

The Tower and The Devil represented all of my worst traits. Letting myself down. All of my sins causing my health and opportunities, meaning and purpose to crumble.

Bad health because I am bad, bad, bad.

The Ace of Pentacles stood in for virtue. I see it as outer order. You exchange coins for goods. You save them and spend them building up your world. Coins are much like energy: you spend them on activities if you have it, and you can’t access activities if you don’t.

Order and chaos. And The Devil.

Am I throwing my energy into chaos? Is this about wasting my time? My life? The consequences of a bad routine falling down around me?

I turn over the last card.

Ego Integration


The Tower, The Devil, and Death. Three of the most stigmatised cards!

But… what if…

Death is transformation. Loss. A change. Grief. But also a valuable perspective.

The Buddha said those who remember that they are all going to die do not stir up trouble with each other or themselves. Those who forget that they and everyone else is going to die argue constantly.

Forgetting death means that we take much for granted. We treat ourselves and each other so badly because we think we are immortal. We think we have all the time in this world or the next. We don’t.

Looking at The Devil and The Tower in this light, what does it tell us? Why am I judging myself? In the light of Death, The Devil, to me, can only mean forgiveness.

Forgive yourself for not being able to stop the tower from falling. You don’t have to suppress the chaos. You can mindfully acknowledge it.

Buddhist nun Pema Chödrön writes that, “Chaos is part of our home ground. Instead of looking for something higher or purer, work with it just as it is.”

And, “To stay with that shakiness—to stay with a broken heart, with a rumbling stomach, with the feeling of hopelessness and wanting to get revenge—that is the path of true awakening. Sticking with that uncertainty, getting the knack of relaxing in the midst of chaos, learning not to panic—this is the spiritual path.”

We cannot control illness anymore than we can control death.

What might Death say about The Devil and The Ace of Pentacles?

In the spread, The Devil is in the place of the ego considering how to realistically handle one of the superego’s most highest aspirations.

The Devil, who prizes his autonomy and his right to decide what is right and wrong for himself above all else, might say this: I choose where to spend my time and energy. I decide how to order my life. I will decide how to live my life and weigh up the costs before I die. I decide what to time and effort to exchange, not even God will decide for me!

I always worry what other people will think of my decisions. I trade off my wants for theirs. I devalue my autonomy and perhaps overvalue their perceptions. My ego, like all good egos do, hides this decision from me. That is one of its key roles: suppression. You must believe that you are not doing things you don’t really believe in. It is like an accountant, in a way. It can calculate the risks, and make things look like they add up by fiddling around with the numbers.

The Final Meaning

The last ego card united the unrealistic pleasure impulses of the id with the unrealistic moral and ethical demands of the superego.

Traditionally, the Major Arcana show what we must prioritise in a reading. In this case they are The Tower, Satan, and Death. They all speak to one area in this reading: chaos, and what to do about it.

The second priority is The Ace of Pentacles, Satan, and Death. The Ace of Pentacles relates to the Nine of Pentacles, and so lends that slightly more weight, too.


In order of priority:

  • First, death makes self-forgiveness and acceptance of the chaos of the pain of fatigue the main focus. It is where we should begin. Do not suppress your knowledge of death or chaos. They will lead to forgiveness. Similarly, to forgive yourself you need to know when and how you judge yourself. Be mindful of it all.
  • Second, through self-forgiveness and awareness of death, we can seize our autonomy. You cannot truly feel autonomous if you do not accept yourself, your situation, or the consequences (the chaos) of your actions or inactions. With autonomy comes the need for self-forgiveness. It always goes back to that.
  • Third, a lack of energy can feel painful and chaotic. More energy is more control over your life. It feels more orderly and less painful. Energy is autonomy. However, don’t judge yourself for losing energy. Judging yourself is a further waste of energy and a rejection of reality. Autonomy relies on self-acceptance and energy together. When one is low, be careful not to deplete the other.
  • Fourth, look inwards and share your dreams with others. Creativity is key, here, but opening that door before you have forgiven yourself will not benefit you at all. What is self expression without self acceptance? This is an important pleasure in life, especially now, but it only truly starts once The Devil has taken you out of the dark.

It boils down to this:

What is it that you want to do and share with others before you die? And how can you possibly do that if you are not present in your life first?

That is something to ponder…

“Death represents the ultimate and inevitable destruction of that to which we are most attached: ourselves.”

Sogyal Rinpoche


Terry Pratchett

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