While reading Raymond Lawrence’s newest book, Nine Clinical Cases:The Soul of Pastoral Care and Counseling, I was aware of disturbing contrast.
Recently I was reviewing a number of websites conveying the services of the chaplain in various medical and other institutional centers across the country. Certainly not an exhaustive review on my part. I was struck, however, by how many of these chaplain websites tagged their top service was to provide prayer for the patient and their families. Equally true, they often used a photo of the chaplain at bedside holding the hand of a patient as a means to portray their service.
Of course chaplains pray and hold the hands of suffering patients and families. But prayer and holding hands is not the sine qua non activity of the clinical chaplain. After all, an untrained minister and layperson off the street can do so equally effectively.
These websites and language I hear from chaplains describing their services seemed to be limited in their effectiveness to stake-out the unique role of a clinical chaplain beyond that which a non-clinically trained pastor could offer. Chaplains provide “prayer”, chaplains provide “presence”, chaplains “show up”, chaplains provide “spiritual guidance” and help people with their “spiritual pain”, chaplains connect patients with their "faith resources", etc.
It might be that having a prayer, holding a hand and reminding people of their faith resources has now become so embedded in the practice of chaplains now offering “spiritual care” that the notion they are clinical chaplains has dropped from their awareness and commitment. I hope not but there is increased evidence this might be the case.
Only after a few pages into Nine Clinical Cases the reader cannot miss Lawrence’s challenge. The effectiveness of a chaplain, even the integrity of chaplaincy, he contends, resides in a genuine clinical approach when engaging people who face overwhelming life alternating/ending situations and human suffering.
The work of the clinical chaplain, Lawrence declares, must be informed by psychodynamic/psychoanalytical theory. In addition, the competent clinical chaplain makes creative use of the self. The latter typically means the clinical chaplain in addition to CPE training has also undergone their own psychotherapeutic investigation in order to gain a healthy degree of self awareness. From Lawrence’s viewpoint, even with all of this, which is necessary, a chaplain without a good dose of "humanity and humility" will only be a performer doing an “official duty”, not a curer of souls.
The bottom line: Raymond Lawrence calls all of us in clinical ministry to correct the drift from our historic roots which demand our being well trained and informed clinical practitioners. He directly and indirectly gives warning to the current lapse into the murky language and practice of “spiritual care”.
Nine Clinical Cases:The Soul of Pastoral Care and Counseling, stakes out the necessity that all practitioners of clinical ministry have a firm grounding in psychodynamic/psychoanalytical theory and have participated in a form of psychodynamic clinical supervision that invites depth of exploration; an integration of theory, theology with the person and their clinical practice. Failure to do so, in time, will become our undoing as chaplains and our place as a vital member of the health care team.
It could be that the health and well-being of the whole clinical pastoral movement will pivot on our re-consideration of our current emphases on “spiritual care” and its murkiness of definition and practice.
Lawrence calls for a more informed and effective clinical practice by returning to our historic roots as addressed in Nine Clinical Cases.This book represents a service, a dent, and possibly a disruption as he calling for a commitment to re-evaluate what it means to be a clinically trained chaplain/minister dedicated to the care of soul.
My strong impression is that our medical colleagues: physicians, nurses, social workers, psychiatrist, etc. will welcome such a reconsideration and a renewed commitment for chaplains to truly function as clinical members of the medical team. They want and need for us to be far more clinical and sophisticated in the knowledge and language of the social sciences we use with them as fellow consultants and members of the care team than we currently offer. They need us to have a deeper level of clinical acuity as providers of care and counseling for their patients and families who who are broken not only in body but in mind, spirit and in their relationships. Dr. Lawrence’s Nine Clinical Cases, reflects the same wish, even a plea.
Lawrence’s Nine Clinical Cases:The Soul of Pastoral Care and Counseling should be required reading for all clinical chaplains and ministers. Equally true, it is an absolute must read for CPE training supervisors and their trainees.
Perry Miller, Editor
NC State Board Certified Pastoral Psychotherapist/Clinical Supervisor
CPSP Diplomate, CPE Supervision and Psychotherapist