By James J. Castello, MBA, MA, BCC (Ret.)
In January 2008, I was hired to be a chaplain/director of pastoral care of a small, community hospital in New York State. Being a former corporate marketing executive, I have been trained to look for the largest needs in the environment I serve. In this case, I was quickly led to provide the most spiritual care to the patients and staff of the hospital’s detox/rehab unit. While feeling called to this unit, I was apprehensive about being able to meet patient’s spiritual needs since I had no training on how to relate to and work with mental health patients. This article is about what I learned in this marvelous unit.
Thankfully, the Lord provided consistently strong connections with many of these beautiful, troubled and vulnerable people. After a few months in this unit, I discovered these patients had a lot in common: total unawareness of the spiritual warfare they faced; high percentage of childhood abuse; raised in highly dysfunctional families; definite control issues; perfectionism; extremely low self-esteem; guilt and shame; clinical depression; around half are bipolar; and most have real problems with forgiveness – i.e., trouble in forgiving others, in receiving God’s forgiveness and, most of all, an inability to forgive themselves.
Spiritual Warfare: Very few people in this unit are aware of the battle within themselves between good and evil, God and Satan. They are unaware that their addiction to drugs, alcohol or both may be an attempt to self-medicate their emotional pain or an attempt to “fill the hole in their soul,” a hole that only God can fill. They also may be unaware that Satan, the great deceiver, may keep playing the same old negative tapes in their heads. These tapes need to be erased and removed via prayer for healing and replaced by the grace of the Holy Spirit.
Childhood Abuse: We can never discount the tragedy of childhood abuse, whether it is emotional, physical or sexual. People need to know their pain has been heard, and that the reality of their pain has been validated and listened to with compassion and empathy. However, holding onto the victim role for an inordinate length of time only continues to hurt the victim, not the abuser. At an appropriate point in the grieving process, a person may be ready to pray for the strength and grace to forgive the abuser. This is usually quite hard to do but can lead to substantial healing in the abused.
Dysfunctional Families: The prevalence of these was not surprising since the rate of abuse was so high. We all have dysfunction in our families, but most of these souls were raised in “off the chart” levels of dysfunction. A ritual that helped some patients was to ask them to write out all the things that they were angry, hurt, and resentful about. We would review the list (sometimes four to six pages long) and then pray over them and burn them. A lot of the rage was able to be released in the smoke of the burning paper.
Control: Almost all of us have a strong desire to control situations in our life. I often asked patients this question, “In the play of your life, who is the creator, writer, producer, director, actor, music director, etc.?” Before entering this ministry, I am sure I would have answered “Me” for all of those roles, “After all, it’s my life, my play.” I have since discovered that I am only the actor in the play of my life – and God gives me the stage, the audience and even the script. All I have to do is show up and be open to the Holy Spirit. This is my only role but it is not my play; it is God’s play I am making a brief appearance in. When I realized that I was not responsible for every detail in my life and that I needed to trust God to care for me, it felt like a 500-lb. albatross was lifted from my shoulders. The point is: who is in control?
Perfectionism: Just like many of us, patients in addiction treatment centers are “perfectionists.” I would suggest their definition of “perfect” may be an “international standard without any flaws, anytime, anyplace.” If so, they are bound to be disappointed and frustrated since there is no way they can live up to that standard. A more realistic definition of “perfect” is – “I did the best I could with what I had on that day.” That is all you can reasonably expect of yourself.
Self-esteem: The pervasive issue we need to address in our lives is one of self-identity, “who we are.” The answer is we are God’s beloved children whom he loves unconditionally no matter what we have done or have not done. The tape of our failures and low self-worth playing in our heads must be ejected and destroyed so our esteem can be fully restored.
Guilt and Shame: God cannot live in our dark caverns of shame and guilt, for God is pure love, pure light and, as light, cannot dwell in darkness. He calls us out of the darkness of guilt and shame and into the light, so we can live in joy and be a light to others.
Forgiveness (others, self and receiving God’s forgiveness): In my limited experience, the most common and the hardest to let go of is forgiveness of self. Most people will admit that God has forgiven them, but they cannot forgive themselves. Well, if God has forgiven us and we don’t forgive ourselves, what does that say about our relationship to God – perhaps we think we are “better or tougher” than God? Not!
Depression and Bipolar: I have firsthand experience with both of these in my family. One definition of “depression” I shared was “anger turned inward,” when we are actually angry at ourselves but are unable to process this anger in a healthy manner so we swallow it. Manic depression/bipolar is a chemical imbalance which occurs in some of us and requires a lifelong commitment to faithfully taking medication to keep it under control. As a chaplain, I have learned that these conditions can become a gift, as sharing about them with those you minister to almost always creates an instant bond.
As with all pastoral interventions, a primary goal is to listen to the person with your heart and try to love them as Jesus loves them. If they feel the love, they usually connect with you as being sent to them by God, who cares for them deeply, and that makes a difference.
Jim Castello worked 35 years in executive marketing positions for two global manufacturers before becoming a chaplain in 1998. He is a member of the NACC Board of Directors as well as a member of the NACC’s Editorial Advisory Panel. Much of his time is devoted to his family, which consists of his wife, Frances, a retired hospice chaplain, their five adult daughters and 16 grandchildren.
