By Rev. Craig Rennebohm, PhD
As chaplains, we are daily witnesses to the importance of faith and the power of spiritual practice in healing and recovery. We share our experience largely through narrative, through parable and personal story. We mine verbatim accounts of our conversations with patients for insight. We bring to bear a phenomenological approach, richly describing moments of the soul, drawing on the wide range of human knowledge to help us understand and explain, moving toward ultimate wisdom and theological truth. At our best a constant qualitative reflection guides our pastoral work. The practices of contemplation, meditation and discernment, individual and collective, help us shape the body of knowledge in spiritual care.
Researchers bring the tools of scientific method to explore the role of faith, religious practice and spiritual community in promoting human well being. Studies suggest a correlation between church attendance and health, or between prayer and health outcomes. Brain imaging studies have begun to illuminate areas of brain function involved in such spiritual practices as deep meditation. Researchers have found that a spiritual orientation is of strong importance to individuals in their recovery from the combination of mental illness and chemical dependency.
Research in spirituality and healing is in its relative infancy. There are a handful of academic centers devoted to the study of healing, spirituality and theology. As this field grows, what is our role as chaplains with respect to research being done by our science colleagues? Let me suggest that we have two basic responsibilities.
1. We have a responsibility to help define the terms of the discussion.
What is meant by “spirituality?” I accompanied a mentally ill homeless patient to an initial appointment at a local clinic. Going through the medical history and screening process, a practitioner asked the patient, “What is your spiritual orientation?” The patient asked “What do you mean?” “I guess,” said the practitioner, “it means are you ‘new age’ or something.” “No,” said the patient. The patient was a baptized and practicing Catholic, but the way the question was asked and the term defined, data about the patient’s spirituality was not entered on her chart at intake. She was charted as having “no” spiritual orientation. Our task is to help give meaning to
spirituality, faith, religion, soul, and other key terms, both in the context of our particular traditions, and in multi-faith and secular settings. Seeking clarity of language is important not only in our pastoral care conversations, but crucial to interfaith dialogue and to discussions with our care colleagues in other fields. When data collection or research on spirituality and healing is proposed, religious leaders serving in health care have a role to play in reviewing and shaping the terms of the discussion.
2. We have a responsibility for developing and sharing with one another our own lines of inquiry as spiritual caregivers.
I work on the streets, at various survival services, and in clinical settings with individuals who face serious mental illness, profound trauma and abuse, and chemical dependency issues. As a chaplain, I have developed four lines of pastoral inquiry in exploring spirituality with deeply troubled individuals.
I am interested in how a person experiences the holy, the sacred, the movement of the spirit in his or her life. This is for me, the most fundamental line of pastoral inquiry, creating a baseline of spiritual information. I bring to the moments of our relationship, my own particular understanding of “spirit” as a creative, informing and loving presence in our lives, and am open to how each person I meet experiences the spiritual in their lives. I use a “holistic model of spirituality” developed by Ed Canda and Leola Furman (Canda and Furman, 1999), which explores spirituality as the center of a person, a dimension of a person’s life, and as the wholeness of a person in relation to all. I track and record the person’s faith narrative, the accounts of each individual’s fresh and immediate experience of the spirit over time. As the spiritual story is told and unfolds, I attend to the beliefs and practices that have helped shaped this person in their faith – the effect and influence of religious history, culture and community. I begin to appreciate and comprehend the soul, this person’s unique and particular spiritual identity.
As a spiritual caregiver, I am interested in how a person’s faith experience and religious background shape the way the individual names, describes and understands their symptoms and disease. This is a second line of pastoral inquiry, providing valuable insight into an individual’s current spirituality. While providers may be clear about the medical condition and the biological roots of an illness, patients may draw on their particular cultural and social framework in discussing and describing their illness experience, using a wide range of spiritual notions, faith terms and religious ideas. Such language may be foreign to the clinician, but it is an important signal to the pastoral caregiver. I listen especially for how the patient explains his or illness from a spiritual perspective. I am alert for confusion or conflict between the medical explanatory model and the patient’s personal spiritual understanding of the illness. As I begin to see how a patient interprets his or her illness and treatment through the eyes of faith, I am better able to support both the patient and care team in a collaborative healing process.
In order to provide maximum support for healing, I am interested in what spiritual practices and religious resources contribute to a patient’s recovery and well-being. This is a third line of pastoral inquiry, gaining us prescriptive spiritual wisdom. In the field of mental health care, we don’t have much in the way of data. Is prayer helpful to a person struggling with depression? A doctor colleague confided that in his depressive episodes, he simply cannot pray. He must rely on the prayers of another. That is important information, the beginning perhaps of some useful research.
I worked with a young man who was admitted to the hospital for two years in a row just after Christmas and just after Easter. He reported stopping his medications for bi-polar illness as the holy seasons progressed and became increasingly caught up in the rituals of Advent and Lent, and finally the glories, Christmas Eve and Easter morning. A pastoral prescription encouraging him to become part of a low-key, mission church community with the simplest of liturgies and a small, personally supportive congregation understanding of his illness vulnerability helped this patient steer a healthier life course.
As a chaplain who will be part of a person’s life for a comparatively short time and most often during a period of crisis, I am interested in how a person’s spiritual experience and orientation contribute to becoming part of a faith community, supportive of long-term stability, meaning and purpose. This final line of inquiry emerges most fully as we complete the caregiving journey together. What may block a patient from returning fully to his or her parish church? What steps are helpful in making connection with the congregation and new spiritual resources? What has changed in the life of the soul in the course of illness? Where does a person freshly in touch with their mortality and vulnerability, and perhaps new limits, now find hope, meaning and purpose?
I recall a refugee from Ethiopia. He was scheduled to be discharged from the hospital’s mental health unit at 11 a.m., after two weeks of successful treatment for a severe and paralyzing depression. At 11, his bag was packed and he sat on the edge of the bed, but refused to leave the hospital or even exit his room. He insisted on seeing a priest. As the unit chaplain, I was called, and visited quietly with the patient. He was a Coptic Christian, and we agreed that I would ask an Orthodox priest colleague to come as soon as possible to attend the man. The priest came, talked briefly with the patient. They stood face to face as the priest chanted a prayer and anointed the man with holy oil. The priest finished. The man picked up his suitcase and left. I asked Father Steven to help me understand.
“It was a prayer of blessing,” he said, “which reassures the patient and the community of God’s healing presence. The prayer signals that whatever of contagion, quarantine, or stigma may have been associated with this person’s disease, such conditions no longer pertain. There is no need for fear or distance. This blessing is a trigger for welcome and return to the community. It is a sign of hope.”
Over the years, following our own lines of pastoral inquiry, we accumulate valuable insights and information in our spiritual care records and notebooks. This raw data, drawn from what Anton Boisen called the “living human document,” provides content for reflection and the development of theory and practice in contemporary spiritual care. Pastoral inquiry also has heuristic value, helping inform the questions posed and the research done by our colleagues. Keeping our own accounts of discovery, we can help shape the questions worth asking and determine what studies might be most meaningful for us and those we serve.
Rev. Craig Rennebohm retired last June as chaplain of the Mental Health Chaplaincy in Seattle, WA, which he founded. Read about his work there at www.thefigtree.org/march11/030111rennebohm.html. Since retiring, he has served as the executive director of Pathways to Promise, a national mental health ministry resource based in St. Louis, MO. He is the author of “Souls in the Hands of a Tender God,” (Beacon Press, 2008) which goes into depth on the issues raised in this Vision article.