Pastoral Care: A Toolbox
What is "pastoral care"?
"I would define the basic, fundamental role of
pastoral care as the attempt to help others, through words, acts,
and relationships, to experience as fully as possible the reality
of God's presence and love in their lives."
Lawrence Holst, Hospital Ministry: The Role of the Chaplain Today
"I want everything I come in contact with to be affected by the presence of God in my life." Sr. Alice Potts, Chaplain - M. D. Anderson Cancer Center
Pastoral care is also often referred to as Spiritual care.
Crisis
"I've heard crisis defined this way: something of consequence which arises unexpectedly, demanding immediate attention, accompanied by intense feelings." Virgil Fry, Disrupted
How We React to Loss and Crisis
Physically, we become acquainted with the 'fight or flight' response. Emotionally, one might experience a wide range of emotions such as anger, fright, anxiety, etc. Psychologically, dysfunctions such as depression, feeling disoriented or irritation may arise. We ask, "Why me?"
People experiencing a loss or crisis find them selves existing between an "old normal" and a "new normal." We see a continuum of what was, what is, and what can be. The pastoral relationship can be sustaining during this period of uncertainty. A skilled listener can make a difference when a person is in the midst of a faith crisis - not by providing answers, but by providing a caring presence and being there for the person as he or she wrestles with important issues in moving from an "old normal" to a "new normal."
Emotions are an integral part of one's reaction to loss and crisis. Emotion is defined as, "A conscious mental reaction (as anger or fear) subjectively experienced as strong feeling usually directed toward a specific object and typically accompanied by physiological and behavioral changes in the body."
Four "primary" or "core" emotions are: mad, sad glad and afraid. These can be blended and vary in their intensity. See "Plutchik"s Theory of Emotions (1980) as presented by Think Quest.
Here are four underpinning understandings about listening and emotions:
1. Behavior is driven by our emotions.
2. Emotions are driven by thoughts.
3. Thoughts are underpinned by beliefs.
4. The human mind can believe anything.
Effective providers of pastoral care are tuned in to each of these
aspects.
From Social to Spiritual Visit
The "pastoral visit" is not the same as a "social visit." The chaplain's primary purpose is to connect on a spiritual level. This involves being present, identifying areas of spiritual distress and offering a response that will reduce the level of spiritual distress.
Spiritual distress is defined by the North American Nursing Diagnosis Association as, "a disruption in the life principle that pervades a person's entire being and that integrates and transcends one's biological and psychological nature." Spiritual distress is often precipitated by a significant loss, crisis, medical emergency, or by physical or psychological stress.
Here is an introductory way of moving from "chit-chat"
to "spiritua." It is called "FICA."
F Do you
have a FAITH?
I Is it
IMPORTANT to you as you deal
with ...?
C Do
you have a spiritual COMMUNITY
or CHURCH?
A How
would you like me to ACCOMPANY
you on a spiritual level?
The process flow of a visit is described in what is called the G.R.E.A.T. prayer model. The visit flows through five distinct steps: Greet, establish Rapport, experience the Encounter, Assess the situation, and Thank the other for allowing you to enter their space. Prayer can be offered at any point along this process. Before praying, ask the other what they want to pray for. This often elicits their deepest felt needs. Then the REAL visit begins after the prayer, when the chaplain knows what is on the other's heart.
Remember: You never get a second chance to make a first impression.
Basic Listening and Communication Skills*
"What is the secret of spiritual pastoral care? To me, the real quality of what makes spiritual pastoral care is engaged listening - learning to listen really to what's going on with that person, rather than walking in and feeling like you've got to do all the talking.
It's more joining them where they are, in their path, and asking how God comes into that. So, it's a relationship deal. It's much more important than any magic words or running errands and doing the things that are very important." Virgil Fry, "Dialogue: A Conversation With Virgil Fry", The Christian Chronicle, December 2006
"Perhaps there is no greater love than for a man or woman to close his or her mouth and open his or her ears and eyes, so that another may express himself or herself completely and freely." The Unwanted Gift of Grief, A Ministry Approach, Tim Van Duivendyk
"The first order of love is to listen." Paul Tillich
Listening and caring skills include:
Silence: When in doubt, listen.
Building Rapport: People like people who like them and are
like them.
Paraphrase: "What I hear you saying is…"
Productive Questions: Questions based on the speaker's incomplete
content.
Behavior Description: Describing the speaker's actions without
making inferences.
Perception Check: A guess about what the speaker is experiencing.
"Is that right?"
Fogging: Naming the truth in another person's critical statements.
Negative Inquiry: Asking the critic to identify what is upsetting
to him or her.
Life Commandments: Deep-seated beliefs that drive our behavior.
Story Listening: Listening for repeated themes and metaphors.
Why this story? Why now?
Note: Each of these skills is detailed in the book by Dr. John Savage, Listening and Caring Skills, Nashville: Abingdon Press, 1996; John Savage, Tom Billings and Margaret Slusher, Skills for Calling and Caring Ministries, Revised copyright 2007 by LeadPlus, Inc.
Caring for the Caregiver
Caring for the caregiver (the chaplain) is a vital aspect of pastoral care because you can't take care of others if you don't first take care of yourself! If you don't care for yourself physically, emotionally, and spiritually, then eventually there will not be enough of you left to care for anyone else.
Here are seven underpinning concepts:
1. Spiritual hygiene is important.
2. Clearing the clutter of an over stimulated life is an ongoing
exercise.
3. Caregiving is a way of life that begins with caring for the caregiver!
4. Caregiving to others is fueled by the care we give to and receive
ourselves.
5. We can comfort others no more than we have been comforted ourselves
(II Corinthians 1:3-4).
6. One cannot give what one does not have. "I want everything
I come in contact with to be affected by the presence of God in
my life" (Alice Potts).
7. It is impossible to experience the presence of God in a life
that is too busy to pray.
Stress: Stress is defined as the flexing of emotional, physical, or spiritual resources. Some degree of stress is necessary for motivation and stimulation; however, when stress is constant and unresolved, resources are depleted. Stress causes a loss of centeredness that undermines our sense of joy and effectiveness.
Burnout: Burnout is a state of fatigue or frustration brought about by devotion to a cause, a way of life, or relationship that failed to meet one's expectations. In burnout, one's resources are utterly depleted, there is no energy to meet the demands, and the caregiver is no longer able to perform his or her intended purpose.
Compassion Fatigue: Compassion fatigue is a unique form of burnout that affects people in caregiving professions when they become overly involved with the people they are serving. When compassion fatigue leaves, the joy of caring returns!
Mental Wellness: The motivation and resources to deal successfully with whatever is going on.
Notes:
1. Much of the preceding "toolbox" is based on teaching
material used by Lifeline Chaplaincy, (www.lifelinechaplaincy.org).
Chaplain Thyssen was integrally involved in the design of Lifeline's
core workshop, "Ministry In Times of Illness and Loss"
which is presented several times a year by Lifeline's staff in the
state of Texas.
2. For Hospital Visitors: Jim Hughes has written an excellent primer
for visiting patients in a hospital environment. It may be found
at: Making Hospital Visits, Jim Hughes, www.DifficultSeasons.com,
© 2009 (available by permission)
3. Visit the "Resources" tab on this website for additional
information on pastoral care.
So, Let the Journey Begin!
The First Step >>
Professional Chaplaincy >>
Pastoral Care: A Toolbox >>
Am I Fit To Be a Chaplain >>
Spiritual Assessment >>