"Amid the Complex Entanglements of Actual Life": How Are Clinical Pastoral Chaplains to Gain Perspective? -- by Robert C. Powell, MD, PhD

25 Jan 2016 12:28 AM | Perry Miller, Editor (Administrator)

“Amid the Complex Entanglements of Actual Life”:
How Are Clinical Pastoral Chaplains to Gain Perspective?1

I seek not
     the ready-made formulations contained in books. 

I seek to make
     empirical studies – of 
          “living human documents” – particularly those who 
               are breaking or 
                    have broken – in the midst of 
                         moral crisis – the 
                         inner day of judgment.

I seek 
     the basis of spiritual healing in understanding the
          “living human documents” and their
          actual social conditions – in
                   all their complexity and in
                   all their elusiveness – respecting the
          tested insights of the wise and noble – of 
                   the past as well as of
                   the present.2

**********

     We lack perspective … [in] our knowledge... and
     [we] are confused in our concepts. [Yet]
     we know more than we know we know.3 

So, how are clinical pastoral chaplains to gain perspective? Both [Helen] Flanders Dunbar(1902-1959) and Anton Theophilus Boisen (1876-1965) gave similar answers – which is no great surprise since they worked as colleagues for a decade – and remained friends until the end. They said chaplains must study closely, intensely large numbers of people in both their social as well as in their psychological contexts

Dunbar defined religion as “a technique ... for the handling of emotional life, particularly those emotions involved in the relation[ship] of the individual to the group” – as well as those emotions involved in the “evaluation of the ideal and the real”.  She noted that chaplains “must work with” “bringing about alterations” in a man’s or woman’s “external world” of social involvement as well as with his or her “inner world of … emotions and … goals”. Dunbar viewed chaplains’ task as one of “guiding” those who are suffering, bewildered, and vulnerable “in their adjustment to their total environment, outer and inner …”.4

Similarly, Boisen defined religion as those experiences that promote “identification with … fellowship” that is “universal and abiding” – as well as those experiences that promote “unification with the finest potentialities of the human race”.5As far back as 1905, in forestry school, he picked up the notions of social ecology – of the mutual developmental relationships between a transitioning forest and its growing trees – between an environment and its organisms– between a society and what its individuals were trying to become. Around 1924, in the social work department at Worcester (MA) State Hospital, he further came to appreciate studying “the entire person in his [or her] social setting”.6One of the most arresting conclusions of Boisen’s research was that “crisis experiences … tend to set in motion forces which have the capacity to transform the personal and social life”.7Like the College of Pastoral Supervision and Psychotherapy, Boisen’s focus was not just on training or on education but on transformation – clinical pastoral transformation – on both the personal and social levels. As Boisen pointed out, “The end of … all vital religious experience” is “the transformation of the personality” – in the context of a “quickened sense of fellowship”.8 

Dunbar, as early as 1935, emphasized the public health aspect of clinical pastoral chaplaincy, noting that chaplains, like social workers, generally are welcomed into peoples’ homes – parts of their social contexts – “before illness has developed”.   That is, chaplains are able “to spot the first signs of incipient disease, physical or mental, before” these individuals have realized “even … the need of coming" for care.9 

By 1936, in his second book, Boisen stated explicitly his focus on dealing “with the living human documents and with actual social conditions in all their complexity”. His third book, ten years later, specifically carried the subtitle, “the Co-operative Study of Personal Experience in Social Situations”.10

This year’s Dunbar Awardee pointed out quite effectively, in a much quoted essay, that Boisen “had a two-fold objective for his case study method”.11 Boisen explicitly noted that he “sought to begin not with the ready-made formulations contained in books but with the living human documents and with actual social conditions in all their complexity”.12Let us repeat that yet again: “with the living human documents and with actual social conditions”. 

As our awardee observed, many chaplaincy supervisors picked up on Boisen’s study of individuals’ internal experiences but missed his study of their important social external experiences.13Perhaps part of the problem has been that the notion of studying “the living human documents” – actually listening to those who were suffering, bewildered, or vulnerable – instead of just preaching at them – was so extraordinary that chaplaincy supervisors missed the second part of Boisen and Dunbar’s message, that attention must be paid to the social situation of those who are suffering, bewildered, and vulnerable.

Perhaps another part of the problem has been that Boisen’s The Exploration of the Inner World …– including both its 1936 and 1952 editions – was read by far more pastors than hisReligion in Crisis and Custom …, published in 1955 – which was clearly subtitled, “A Sociological and Psychological Study”. I strongly urge you to read both books – both of which will be coming out in new editions. Both books concern the relationships between mental disorder and religious experience – as does Boisen’s autobiography,Out of the Depths …– which also will be coming out in a new edition.14

Today’s Dunbar Awardee noted that  
     “unless … [a] pastor has done some serious reflection on 
     the meaning of his or her own experience” 
     “it is impossible for a pastor to meet fully 
     human beings at the point of their growth and pain”.15 

Our awardee also emphasized that the 
     “in-depth case study method, 
     with attention to theological issues” 

– a point upon which both Boisen and Dunbar insisted – 
     “has the potential of increasing 
     the pastor’s skill in relation to others”.16

What starts as a personal experience leads to an improved social experience. Boisen indeed noted this in most of his writings – and as did Dunbar in at least one of hers. Rather than focus on just training or education per se, The College of Pastoral Supervision and Psychotherapy, now 25 years old, dedicates itself to “searching for the meaning of human experience and human relationships” – the meaning of personal and social experience.17

Normally this introduction to the Dunbar Awardee focuses, understandably, on Dunbar. I will note that, as a child, she lived in Hyde Park, Chicago – at what became 5210 Harper Avenue and at 5109 Kimbark Avenue – only blocks away from where Boisen taught, at Chicago Theological Seminary. Today, for the Chicago Boisen Conference, however, it seems quite reasonable to yield the focus to Boisen. 

Thus, let me begin pulling this introduction to a close by noting several more anniversaries. We meet today

– on the 110th anniversary of Boisen’s first call to the ministry –
     followed by a collapse of faith –  
     followed by the entry instead of this instructor of French into a forestry school – anécole du bois.

– on the 95th anniversary of Boisen’s consequential delusional 
     discovery that he had “broken an opening in the wall 
     which separated religion and medicine” – his first 
     encounter with “valid religious experience which was at 
     the same time madness of the most profound and unmistakable variety”.18

– on the 90th anniversary of Boisen’s founding of professional 
     chaplaincy – which began at Worcester (MA) State Hospital and 
     eventually moved worldwide – as well as of Boisen’s first becoming 
     a “research associate” (1925>), then a lecturer on “practical theology” (1930>),
     then a lecturer on “pastoral psychology” (1935>1942) 
     at Chicago Theological Seminary.

– on the 80thanniversary of Boisen’s classic comment to his psychiatrists, 
     “I started in despair and began to sing and then felt better ... . 
     When I began to sing I began to get some hold of myself ...”.19

– on the 75th anniversary of the first “Standards for Chaplains”
     – that included specialized clinical pastoral training, functioning in a clearly clergical role, and close interaction with other professions.20

– on the 70th anniversary of Boisen’s “Co-operative Inquiry in Religion”.21

 – on the 60th anniversary of Boisen’s Religion in Crisis and Custom:
     A Sociological and Psychological Study.

– on the 55th anniversary of Boisen’s Out of the Depths: 
     An Autobiographical Study of Mental Disorder and Religious Experience.

– on the 50th anniversary of Boisen’s having left this earthly abode.22

**********

So, how are clinical pastoral chaplains to gain perspective “amid the complex entanglements of actual life”? Our clinical pastoral ancestors suggested that chaplains must study closely, intensely large numbers of people in both their social as well as in their psychological contexts.

Please join me in welcoming our 14th recipient of the Helen Flanders Dunbar Award for Significant Contributions to Clinical Pastoral Training – a chaplain who appreciated the social as well as the psychological aspects of Boisen’s work: the Rev. Dr. Glenn Hackney Asquith.23

#

Endnotes:

     1. Anton T. Boisen. The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience. Chicago: Willet, Clark & Co, 1936; reprinted, NY: Harper & Brothers, 1941, 1952, 1962, 1966; Philadelphia: University of Pennsylvania Press, 1971; p.191. A fresh edition of Anton Theophilus Boisen, The Exploration of the Inner World …is to be published, by Benicia, CA: VerbumIcon, with an introduction by Robert Charles Powell, a foreword by Raymond J. Lawrence, Jr., and an afterword by Pamela Cooper-White; VerbumIcon@gmail.com;http://newhost.boisenbooks.com/

     2. This is an amalgamated paraphrase of Boisen’s clinical approach as enunciated in his second book,The Exploration of the Inner World ..., pp.10, 185, 248-249, and in his last book,Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience. New York: Harper & Brothers, 1960, p.187. A fresh edition of Anton Theophilus Boisen,Out of the Depths …is to be published, by Benicia, CA: VerbumIcon, with an introduction by Robert Charles Powell. This formulation first appeared in Robert Charles Powell, “Anton Theophilus Boisen (1876-1965), Clinician. I. Assessment: Persistent and Provocative “Cooperative Inquiry”: Empathic and Enlightening “Exploration of the Inner World”; II. Therapy: Patient and Creative “Co-operative Interpretation”: “Thinking and Feeling [Strongly] Together about Things that Matter Most”; two lectures delivered in Malibu, CA, on 8 & 9 October 2012 at the National Clinical Training Seminar – West, of The College of Pastoral Supervision & Psychotherapy, in Robert Charles Powell,Anton T. Boisen (1876-1965): Clinician: A Guide to Clinical Pastoral Assessment & Therapy, revised and updated essays, to be published.

     3. H. Flanders Dunbar,Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships: 1910-1933. New York, Columbia University Press, 1935, for the Josiah Macy, Jr. Foundation; “Introduction,” p.xi; appeared on the same page in revised editions published in 1938, 1946, and 1954.

     4. H. Flanders Dunbar, “Fifth Annual Report of The Council for the Clinical Training of Theological Students [September 21, 1934].” New York, Union Theological Seminary Library, pp.12,13,14; Italics mine.

     H. Flanders Dunbar, "Mental Hygiene and Religious Teaching," Mental Hygiene, 1935, 19:353-372, pp.361,362,369,370; Italics mine.

     5. Anton T. Boisen,Problems in Religion and Life: A Manual for Pastors: With Outlines for the Cooperative Study of Personal Experience in Social Situations.New York: Abingdon-Cokesbury Press, 1946; p.100.The Exploration ..., p.305.

     6.Out of the Depths ..., pp.60,180,148; Italics mine.

     7. Anton T. Boisen.Religion in Crisis and Custom: A Sociological and Psychological Study. New York: Harper & Brothers, 1955; reprinted, Westport, CT: Greenwood Press, 1973; pp.41-42; Italics mine. A fresh edition of Anton Theophilus Boisen,Religion in Crisis and Custom …is to be published, by Benicia, CA: VerbumIcon, with an introduction by Robert Charles Powell.

     8.Religion in Crisis ..., p.209; Italics mine.

     9. H. Flanders Dunbar, “The Clinical Training of Theological Students,” Religion in Life, 1935, 4:376-383, pp.380,379.

     10.The Exploration ..., p.185; the third book wasProblems in Religion and Life ....

     11. Glenn H. Asquith, Jr., “The Case Study Method of Anton T. Bosien,” Journal of Pastoral Care, June 1980, 34(2):84-94; p.86; reprinted in his edited volume,Vision from a Little Known Country: A Boisen Reader. Decatur, GA: Journal of Pastoral Care Publications, 1992, pp.199-211, p.202. I strongly recommend 93% of Dr. Asquith’s collection of articles by and about Boisen. My only caveat concerns the chapter by North and Clements regarding Boisen’s diagnosis. Theirs is a carefully considered study, but, as a psychiatrist myself, I do not believe their analysis supports their conclusion. As I have documented extensively elsewhere, including clinicians’ direct observations across the course of his life, I believe that Boisen’s self-diagnosis of “catatonic schizophrenia” was accurate;  see,Anton T. Boisen (1876-1965): “Breaking an Opening in the Wall between Religion and Medicine,” New York: Association of Mental Health Clergy, 1976 [revised & updated edition, to be published].

     12.The Exploration ..., p.185.

     13.Asquith, “The Case Study Method ...,” p.86; crediting Robert Charles Powell, "Questions from the Past (on the future of Clinical Pastoral Education)," speech given at the 1975 annual conference of the Association for Clinical Pastoral Education, Inc., October 17, 1975, p.4; revised and updated version of “Questions ...” inClinical Pastoral Training. Education, and Transformation: The First Fifty Years of Learning through Supervised Encounter with “Living Human Documents” (1925-1975) & Some Thoughts about the Second Fifty Years(1975-2025), to be published.

     14. A number of items by and about Boisen are to be expected via Benicia, CA: VerbumIcon;  VerbumIcon@gmail.com;http://newhost.boisenbooks.com/ 

     15. Asquith,Visions ... , p.236; Italics mine.

     16. Asquith,Visions ... , p.236; Italics mine.

     17. Raymond Lawrence; “Psychology, Sexuality, and the Clinical Pastoral Movement”; pp.257-272, in J.Harold Ellens, ed.,Psychological Hermeneutics for Biblical Themes and Texts: A Festschrift in Honor of Wayne G. Rollins, London: T&T Clark, 2012; p.271.

     18.Out of the Depths ..., pp.91,196.

     19. “Staff Conference” “for diagnosis,” chart note, the Sheppard-Enoch Pratt Hospital, Towson, MD, November 11, 1935; re Boisen’s last psychiatric hospitalization.

     20. Seward Hiltner, “A Descriptive Appraisal, 1935-1980,” Theology Today. July 1980;37(2):210-20, p.213; http://theologytoday.ptsem.edu/jul1980/v37-2-article6.html

     21. Anton T. Boisen, “Cooperative Inquiry in Religion,” Relig. Ed.1945;40: 290-297.     

     22. Boisen died on October 1, 1965; half of his ashes were scattered over the cemetery at Elgin (IL) State Hospital and half were interred at Chicago Theological Seminary.

     23. The Helen Flanders Dunbar Award for Significant Contributions to Clinical Pastoral Training is notable in that the recipient (a) must be alive, (b) must not (yet) be a member of The College of Pastoral Supervision and Psychotherapy, and (c) must have made “significant contributions” to the field; CPSP did not want the award to be viewed as “patting its own on the back”. The past recipients have been myself (2002), G. Allison Stokes (2003), Myron C. Madden (2004), Robert C. Dykstra (2005), A. Patrick L. Prest (2006), Henry G. Heffernan (2007), Edward Everett Thornton (2008), Rodney J. Hunter (2009), John Edwin Harris (2010),Orlo C. Strunk, Jr. (2011), Kenneth Holt Pohly (2012), Donald E. Capps (2013).J. Harold Ellens (2014). Glenn H. Asquith, Jr. (2015); since 2007, an educational introduction of each has been published on the web atwww.pastoralreport.com; as of December 2015 these are available at http://cpsp.org/Sys/Search?q=powell&types=7&page=1
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Robert C. Powell, M.D., Ph.D., is the leading historian of the clinical pastoral movement. Many of his published writings are posted on the Pastoral Report. Readers can search the PR's archives to locate his articles. As a practicing psychiatrist, his writings reflect his daily investment in his clinical practice of providing psychotherapy and care to his patients. Contact Dr. Powell by clicking here