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  • 16 Jan 2006 10:16 PM | Perry Miller, Editor (Administrator)

    8th Asia-Pacific Congress on Pastoral Care & Counseling

    By Robert Charles Powell

    Opening address, The 8th Asia Pacific Congress on Pastoral Care and Counseling,

    Tsuen Wan, The New Territories, The Hong Kong Special Administrative Region, 

    The Peoples Republic of China, August 8, 2005.

    Honoring the 18th Anniversary of the Founding of the Pastoral Care & Counseling Association of Hong Kong.

    ABSTRACT: Anton Theophilus Boisens first major study, The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience (1936, 1952, 1962, 1966, 1971), and his last, his own case history, Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience (1960) are classics. Three other of his works, however, are not to be neglected: Religion in Crisis and Custom: A Sociological and Psychological Study (1955, 1973), Problems in Religion and Life: A Manual for Pastors, with Outlines for the Co-operative Study of Personal Experience in Social Situations (1946), and the hymnal he edited, Lift Up Your Hearts: A Service Book for Use in Hospitals (1926), later re-titled, Hymns of Hope and Courage (1932, 1937, 1950). Boisens research and teachings concerned how persons and societies reorganize  for the good or for the bad  in response to crisis. He used and encouraged theological reflection to generate hypotheses, then followed a patient stance of co-operative inquiry with those troubled in spirit or soul, toward finding a point of effective intervention that would promote constructive resolution. The current essay aims to demonstrate the special relevance of Religion in Crisis and Custom, a study of the formation and transformation of spirit and soul, to our turbulent times.   

    There exists today a great need for carrying forward the empirical study of human nature in its various aspects to  the higher reaches and broader perspectives with which religion is concerned. [p.190, Religion in Crisis and Custom ; italics mine]

    What is needed is the attitude of humility which is willing to put religious insight to the test. [p.202, RCC; italics mine] 

    I seek the basis of spiritual healing 
    in the living human documents 
    in all their complexity and 
    in all their elusiveness and 
    in the tested insights of the wise and noble 
    of the past as well as of the present. 

    [pp.248-9, The Exploration of the Inner World ; italics mine;
    while Boisen maintained some skepticism about the work of
    theologian Emmanuel Swedenborg, which he definitely studied,
    one has to wonder whether Swedenborgs notion of
    inner exploration influenced the title of this book; see p.71-2, EIW]
    we turn to the laboratory of life and examine the experiences of 
    those who are  under the strain of moral crisis. [p.41, RCC; italics mine]

    Without true understanding
    it is impossible to render effective service,
    only as one comes in the attitude of service 
    will the doors open into the sanctuaries of life. 
    [p.5, Problems in Religion and Life ; italics mine]

    The great opportunity comes not to those who live in cloistered academic seclusion but to those whose knowledge is being constantly tested and increased through actual service to human beings in need. [p.6, PRL; italics mine]

    A remarkable book from fifty years ago, Religion in Crisis and Custom , still speaks to us, across place and time. Having some two decades earlier examined personal crisis in depth, the studys author, the Rev. Dr. Anton Theophilus Boisen (1876-1965), now went on to tackle social crisis, observing that religious experience arises spontaneously when men and women are forced to think and feel intensely regarding the things that matter most. [p.xiii, RCC; italics mine]  Let me repeat that, that religious experience arises spontaneously when men and women are forced to think and feel intensely regarding the things that matter most.

    As your Congress President, the Rev. Dr. Ernest Y. Wu, noted in his letter of invitation, the recent global scenarios of drastic financial ebb and flow, of political bitterness and terrorism, and of wars and aftermath of wars  not to mention, of tsunamis and earthquakes  have troubled people throughout Asia  and indeed throughout the world. That these crises have troubled people must surely stand as understatement. Who among us can forget the chilling images of skyscraper towers crumbling to dust or of tsunami-hit villages swept to sea? Who among us was not forced to think and feel intensely regarding the things that matter most? We may not want to be reminded, but the fact remains that incidents of sudden, catastrophic terrorist and natural destruction  far too many of them in Asia  have become more frequent over the last five years. [US State Dept, Patterns of Global Terrorism, reports re 1985-2004; the 2004 tsunami rapidly killed about 300,000; the last times devastation of this magnitude and velocity had been encountered were the1976 earthquakes in China, the 1970 floods in Bangladesh, and the astounding 1959 floods in China  as noted by The Disaster Center, a private think-tank] Within  such context this Congress addresses President Wus question, of how we and our people can maintain our buoyancy  and lift up our spirit  so that we can continue to focus on a more abundant life of faith, hope, and love.

       Boisens research, spanning fifty years, argued that as one stands face to face with the ultimate realities of life and death, religion and theology tend to come alive. [p.3, RCC] By religion he meant not a system of beliefs and values, but, in its creative stages, those experiences that

    (1) are characterized by the sense of identification with a fellowship that has the capacity to be universal and abiding  and that

    (2) are preferentially promoting unification with the finest potentialities of the human race. [p.100, PRL; p.305, EIW] 

    By theology he meant the attempt  either individually or collectively  to organize and scrutinize these experiences and the associated beliefs regarding 

    (1)  the end and meaning of life, 

    (2)  the spiritual forces which operate within us, and 

    (3)  the relationships which exist between their various manifestations  . [p.306, EIW]

    Notice how, instead of speaking in terms of his own religion, an evangelical liberal version of Christianity, Boisen, viewing himself as an explorer and investigator, attempted to find objective terms that could apply to any religion and to any theology. Following St. Thomas Aquinas, he considered theology itself to be the queen of the sciences. [St. Thomas Aquinas, Summa Theologica, 1 question 44 article 2] Boisen further held that

    (1) by examining the beliefs of troubled individuals, each in its own context amid the complex entanglements of actual life, and 

    (2) by taking into account the consequences which have followed from particular choices and reaction patterns, it would be possible to arrive at some valid generalizations

    (1) regarding the nature and function of religion, and 

    (2) regarding the conditions under which maximum self-realization is 

    likely to be achieved. [p.191, EIW]

    In Religion in Crisis and Custom  , a masterpiece of extended theological reflection, Boisen tried, as empirically as possible, to delineate to what extent and under what conditions crisis experiences  standing face to face with the ultimate realities of life and death  are associated with religious awakening  maximum self-realization  and under what circumstances [crisis experiences are associated] withdisaster. He recognized that crises may break as well as make  both individuals and groups. [p.4, RCC; italics mine] That the impact of crisis could go either way he considered to be the price we have to pay for being human  with the power of choice and the capacity for growth. [p.5, RCC]   

    Religion in Crisis and Custom .  What did Boisen intend to imply by the juxtaposition of those words crisis and custom? Spirit and Soul. What do I intend to imply by the juxtaposition of the words spirit and soul? These issues are, I believe, connected. It might go without saying that neither term in the two pairs can easily stand alone: the recognition of crisis lies within the context of appreciating what has become custom, and the value of spiritual awakening may depend somewhat on having experienced soulful repose. While for most of us, let me hope, custom is normative and crisis unusual, we must strive hard to grasp that for some persons and some societies at some times unfortunately crisis has become normative and custom unusual. For the small child both of whose parents died from terrorism or a tsunami, which has become more real, the critical trauma or the customary life? In contrast, most of us, let me hope, have lived long enough in what Boisen would call the static phase, a time of habit and custom, that we are ready to be jolted into the creative phase, a time of reorganization albeit through crisis. [pp.33,38, RCC] He viewed, for example, established churches as products of custom and upstart sects as products of crisis, with the interaction between churches and sects as accounting for the development of religion. [p.239, RCC] While meeting and resolving crisis,assimilating lessons learned into custom, is ever a task of organized religion, Boisen pointed out that the door should always be left open for the prophet when he comes. Social crisis may provoke the prophetic, and the prophetic may provoke personal crisis. Perhaps we are fortunate that the troubles of the world have, as Dr. Wu noted, troubled people around us. Have you and I been troubled enough?

    Before examining the notions of spirit and soul, as well as their correlates, spiritual formation and pastoral care, let us take a closer look at the word crisis. In the medical sense  and indeed the concept originated in the era of the great physician Hippocrates  crisis is seen as the turning point in disease, a bad time that is coming, but whose coming is accepted, even encouraged, for, if the patient does get through this inevitable difficult period, health does lie ahead. [Epidemics, Prognosis, Regimen in Acute Diseases] It is in this sense that Boisen viewed crisis, whether personal or social: as an experience to be embraced. He considered that it is ever religions task to disturb the consciences of men and women  to induce crisis, if you will   regarding the quality of the life they are living, and regarding their failure thus far to achieve their true potentialities. [p.41, RCC] He observed that in periods of normality, men and women do their thinking in an accepted currency of ideas, and their attention is free to apply itself to the commonplace duties of life.  Boisen went on to explain that, and I quote,

    In time of crisis, however, when their fate is hanging in the balance,  [men and women]  are likely to think and feel intensely. 

    Under such conditions new ideas come flashing into the mind, often so vividly that they seem to come from an outside source. 

    Crisis periods have therefore creative possibilities. 
    They are also periods of danger. [pp.68-9, RCC]

    Whether it be terrorism or tsunami, the deep emotional stirring provoked may serve as a stimulus for either beneficial or malignant reorganization. According to Boisens studies, and I quote, when the process is induced within a social matrix  and follows accepted patterns, the danger of personality disorder is at a minimum.  

    When, however, the intense emotions generated in such experiences comes under wise leadership, then an important and vital religious movement is likely to result. 

    In either case a leveling process [eventually] takes place. 

    The eccentric and regressive movements are leveled up and become respectable, while the forward-looking prophetic movements are leveled down and become conventionalized. [pp.93-4, RCC; italics mine]

    That is, as Boisen noted, whether regressive or progressive, a sect, a new group, under a slightly new belief system, ultimately, under wise leadership, becomes or rejoins an established church, an established religion. The religiously quickened ultimately find words to instruct the next generation, and the new entity born of crisis becomes part of custom.

    Boisen's earlier research regarding personal crisis is far better known than his later research regarding social crisis, and our current task is to focus on the social response to sudden, catastrophic terrorist and natural destruction, but it may be worthwhile to review quickly his writings on disorganization  the discovery of special insight  and reorganization  the recovery of equilibrium. Crisis periods are characteristic of normal growth. [p.42, RCC] That must be accepted. Worldwide, the normal crises of personal development are integrated socially through religious ceremonies, such as weddings, funerals, etc. Personal character and social culture develop through the overcoming of difficulties. [p.43, RCC]  Boisen distinguished four main reactions to crisis. Ponder these, as they are reviewed, in terms of how this or that society might respond to the abnormal crises of sudden and catastrophic events:

    Surrender  an embracing of the unacceptable, leading to a loss of self respect; Withdrawal  seeking satisfaction in avoidant fantasy, leading to a loss of hope; Concealment  depreciation of others, substituting minor for major virtues, escape into beliefs unshared by others, and bids for undue attention; Frankness  accepting responsibility for ones shortcomings and for ones failures.

    Without naming specific societies  as all have erred at some point in time  it can be recognized that each of these responses  surrender, withdrawal, concealment, and frankness  has been employed at different stages of social crisis in recent years. To adopt Boisen's phrases, we are called upon to seek the tested insights of the wise and noble of the past as well as of the present. [pp.248-9, EIW, italics mine]  The challenge is to bring these social crises under wise leadership, such that an important and vital religious movement  [might be more] likely to result. [pp.93-4, RCC; italics mine]   

    Within chaplaincy, such leadership manifests itself, at times of custom rather than crisis, through everyday ministrations to parish congregants, but also through patient supervision of younger theologians.  In both cases there is a complex task at hand. Let us now examine the phrases spiritual formation andpastoral care. Across this last decade there has been an accelerating trend toward dropping the phrase pastoral care and counseling in favor of the phrase spiritual formation and care  as if the two notions could be either equal  just a change of words  or entirely opposed  the one being clearly not the other. [See the following caveat re spirituality; while spirituality is all too often viewed as unambiguously positive, one must recall that, as Boisen  would have admonished, there can also be negative manifestations in some people, in some societies, at some points in time. Raymond J. Lawrence, The Trouble with Spirituality.] Perhaps a not unreasonable solution was that of one chaplaincy group which renamed itself the Association of Pastoral and Spiritual Care and Counseling  supposedly toward satisfying both the primarily western contingency that identified with the pastoral, nurturing aspect, and the primarily eastern contingency that identified with the spiritual, awakening aspect of chaplaincy work. [Emmanuel Y. Lartey, Global views for Pastoral Care and Counseling ] While the stereotypes are more likely provocative than accurate, it may well be that the more chronically over-stimulated and scattered West is longing for a recovery of soul just as the more habitually calm and reserved East is seeking an invigoration of spirit. It would be easy enough to argue that all of us could benefit from both. Just as Boisen taught down to earth pastoral care to young clergy through their supervised encounter with living human documents, so that they might develop into mature living souls, one could also say that he encouraged transcendent spiritual formation through orchestrating their supervised encounter with the divine, so that they might experience the quickening spirit. [1st Corinthians 15:45 And so it is written, the first man Adam was made a living soul; the last Adam [was made] a quickening spirit. 1st Corinthians 15:47 The first man [is] of the earth, earthy: the second man [is] the Lord from heaven.]

       As I have discussed at length elsewhere, there is a vast literature regarding the spiritual in contrast to the soulful aspects of religious ministrations to those who are vulnerable or broken. [see Matthew Cohn, A Brief Review of Biblical Psychology, 2003, on the web at] Boisens student, colleague, and mentor, Dr. Helen Flanders Dunbar (1902-59), at the outset of the movement for a clinically trained chaplaincy, conducted a classic program of inpatient research on healing, comparing the invigorating role of spiritual stimulation, attempting to connect with the transcendent, to the quieting role of induced soulful repose, attempting to connect with ones own essence. She ultimately concluded that the spiritual and soulful approaches used together offered the most promise for mobilizing and restoring the healing processes as we know them. She recognized that there was a time for new insight and awareness just as there was a time for tranquility and equanimity. [compare the complementary Buddhist meditation techniques of Vipassana and Samatha]  Dunbar was herself most intrigued by the therapeutic values of the various forms of worship  liturgy and hymnody, the exercise of private devotions, and the contemplation of religious symbols and architecture, [her only manuscript regarding this, however, was lost in the flooding of the basement at Union Theological Seminary, New York, NY; see her classic volume, Symbolism in Medieval Thought . . . ; yes, this is the Flanders Dunbar, BD, PhD, MD, MedSciD who is generally considered the founder of the American Psychosomatic Movement  parallel to Boisens movement for clinical pastoral training, which she shepherded to its success; see Powell, Healing and Wholeness ] She also encouraged Boisen in the continued refinement of his chaplaincy hymnal, that first carried an inspiriting title, Lift Up Your Hearts . . . , but later reflected the merged  soulful plus spiritual  approach under the title, Hymns of Hope and Courage . . . . In one of his later books he spoke of the attitudes of  calm reassurance that  make it possible for the healing forces to operate, and of the message of  joy that triumphs over pain, of  life that springs eternal, which has untold power to help. [p.86, PRL]

    Again, while these distinctions between soulful and spiritual today may seem more provocative than entirely accurate, they were quite meaningful years ago, and they may help us grasp some otherwise unexplained trends in the worldwide responses to terrorism and the tsunami. After 9/11, the Western emphasis, it would seem, was on containing potentially retaliatory fervor. After the tsunami, the Eastern emphasis, it would seem, was on stimulating regional awareness of ones neighbors. One part of the world sought a reconnection with the depths of the ordinary; the other a contact with the heights of the extraordinary.  May their souls rest in peace was a prayer for those who died on 9/11. May our spirits seize the occasion was a hope of those who survived the tsunami. [pp.135-6, 157-8,196-8, RCC on East versus West; Thomas More, Soul Talk, 2003] The resting in peace being sought was not one of slumber but of the peace that passeth understanding, the sense of wholeness within. [Philippians 4:7] This seizing the occasion being sought was not one so much of action as of  seeing face to face interfaith relationship. [1st Corinthians 13:12] Those in the West, it would seem, were called upon to look inward, to consider the mote within ones own eye.[Jesus, as recorded in Matthew 7:1-5; compare this with the Buddhas similar admonition, as recorded in the Dhammapada 4 (50)] Those in the East, in would seem, were called upon to look outward, to consider the broader ramifications. This is a very complex area of thought, but it is clear that soul and spirit have very different implications, both in the scriptures of the various religions and in common usage. [According to the Jewish Kabbala, the ruach (literally, wind), the distinct personality, so to speak, is viewed as an intermediate entity, flitting back and forth between alliance with the nefesh (literally, rested), the earthy, soulful essence that keeps one physically alive, and alliance with the neshama (literally, breath), the transcendental, spiritual essence that pulls one toward God. During moments of specifically religious observance, while there is an aspect of rest (nefesh), there is predominantly spiritual expansion (neshama). Jews consider themselves spiritually connected to all peoples of the world, because they believe that all humans, whether they know it or not, share neshama, this potential for an awareness of God. Simcha H. Benyosef, The Additional Shabbat Soul] In either case, however, soulful and spiritual suggest purposeful, mindful engagement.

    Stepping outside what has become customary, uninvolved existence, allowing the challenge of potential crisis, and the time to engage, is a prerequisite for personal and societal growth. What do I intend to imply in the title of this essay by the juxtaposition of the words discovery and recovery, as well as of the wordsformation and transformation  all of which relate to this notion of growth?  These issues are, I believe, connected. It might once again go without saying that neither term in the two pairs can easily stand alone: the longing for recovery lies within the context of appreciating the past joy of discovery, and the nature oftransformation depends somewhat, quite obviously, upon the nature of ones original formation. Notice how both discovery and formation seem to hark back to an earlier time in life, while both recovery and transformation seem to speak to a later period. Most important for us is that we consider that societies as well as persons both form and transform -- discover new truths and recover old ones  sometimes through their own conscious intention and sometimes through being provoked.

    Getting involved, while appreciating the risk of rejection, is exactly what Boisen would advise and did. Viewing himself as a sociologist, he read widely about other cultures, and throughout his life he could strike up a conversation with anyone. More than read or talk, though, Boisen listened. Despite his many social anxieties, he had a way of helping individuals and communities to convey their real concerns. Let us take a quick look at some of the prompts that made up the clinical interview used by Boisen and his theological students with patients on the hospital wards. The right question  sincerely asked  might start someone thinking and feeling and talking for quite a while.  Imagine yourself having several days to engage with an individual or a community about even one of the following questions: 

    Have you been worrying about something? 

    Have you ever felt that you were different from others?         

    Have you been having any unusual experiences?   

    Have you felt that something strange was going on, 

    something you could not understand?   

    Did it seem to you that something was about to happen?                                            

    Have you ever felt that God was displeased with you? 

    What is your idea of why we are in the world?                                                

    Have you ever thought of dying?

    What is your idea of this universe in which we live?

    What reasons do you have for believing in God?

    There were other questions  and Boisen had no qualms about eliciting a complete sexual history  or asking about almost anything, for that matter  but you might admit that his questions were probably more interesting and more productive of meaningful conversation than those asked by the average physician, the average ward attendant, or maybe even the average minister. [Powell, 1977, ATBs Psychiatric Exam] Within this interactive process, Boisen tried to bring patients to that sense of social support which gives peace in the midst of conflict  that is, he tried to calm them down, but he also tried to reinforce those tendencies which make for progressive unification on a basis conceived as universal and abiding  that is, he tried to spur them onward. [p.268, EIW] He viewed this engaged rather than sterile interview as co-operative inquiry  beneficial to both parties, but also as part of an overall empirical theology, an effort to build up a body of organized and tested experience relating to the religious life and the laws that govern it.[p.157, The Present Status of William James ; Boisen always used the spelling co-operative rather than the spelling cooperative, and that convention will be followed in this manuscript]  He viewed this engaged, sincerely questioning approach as a means of helping patients carry through their attempts at reorganizing their lives in response to disintegrating crises, but also as ultimately advancing the cause of society and religion.

    What Boisen in his era would have called conversion or spiritual awakening, frequently sudden, via religious quickening, is perhaps what in this era would be called spiritual formation or spiritual transformation, frequently viewed as the endpoint of a process. In the best of all worlds, Boisen envisioned all of us  both personally and socially  as making an honest and thoroughgoing commitment to what he called the heroic way of life. [p.206-7, RCC] Notice that this is not a static but rather a dynamic notion  commitment to an ongoing way of life, to a becoming.This was a key concept in the theology he felt most useful to persons and societies in trouble  that they be viewed not as they are now but as what they are in process of becoming that they be honored for doing the best they can with the resources at their command. [p.51, RCC, referenced to John Dewey, Reconstruction in Philosophy. New York: Henry Holt, 1920, pp.176ff] The yesterdays demand attention only insofar as they are influencing the todays and determining the tomorrows.[p.99, PRL] Boisen, focusing on the becoming, viewed transformation of the personality as the end of all vital religious experience, and he viewed support for the re-creation of religious faith as a special task of the clergy. Thus he might set out to help the troubled in their formation of spirit and soul, but his real focus would be on their ongoing transformation across time. [p.178-9, RCC]

    Let us take a closer look at Boisens comment about the re-creation of religious faith. While usually we view this in terms of personal spiritual formation and transformation, is this not what has happened across millennia, centuries, decades, and even just a few years as different societies, different faith groups have struggled with their own internal crises? Despite the fact that we do not generally stop to think about it, there has been a continual, global re-creation of religion. In virtually all cases, the splinter sect has caused the original church todiscover new insights and to recover old ones, with a net benefit to society. That is, this re-creation of religious faith is both

    (1) the effect of men and women feeling forced to think and feel intensely regarding      the things that matter most, as well as 

         the things that matter most, as well as 

    (2) the cause of further personal and social spiritual transformation.

    It could well be that a persons initial spiritual formation and later transformation are quite different  perhaps better, perhaps worse  according to whether that personsreligious tradition itself is in crisis or custom. Historically, as we have noted, the trend has tended to be positive, but that does not guarantee a positive outcome for the recent re-creation of religious faith occurring as Islamic Jihad. Surely this could bear a great deal of further study  now, and not in the distant future. In any case, Boisen viewed the guiding of this transformation of religion as a responsibility of the clergy. While it would be easy to argue that each faith group should tend its own garden, perhaps it is worth asking if the current religions have any responsibility for assisting all of the worlds people toward what Boisen spoke of as identification with a fellowship that has the capacity to be universal and abidingand toward what he spoke of as promoting unification with the finest potentialities of the human race. [p.305, EIW; italics mine]

    Let me give but two examples, while fully knowing that each is imperfect. When the United States government, after the liberation of Afghanistan, found itself with detained combatants who turned out to be underage, illiterate, and ignorant of the religious tradition that nominally provoked their carrying of arms, it accepted the responsibility to protect them as children, to teach them to read and write, plus to bring in Moslem clergy with whom they could study the Koran. Surely such outreach must be rare in the annals of history. Perhaps it may help build a bridge later between the religions of custom and this religion of crisis  this sect of a church in crisis. A second example would be the work of the Mennonites, a branch of Protestant Christianity. Before, during, and after the main thrust of the recent struggle in Iraq, this faith group, itself opposed to participation in all wars, has continued its valuable work helping Iraqi farmers. While the chance of Mennonite relief workers converting Muslims theologically is remote, their chance of having positive effect on the development of a Muslim sect is great. Chaplaincy work in general, of course, stands as one of the rare and notable situations in which practitioners of one religion might be called upon to assist the adherents of another religion in the practice and perhaps deeper understanding of their faith.

    While the initial tendency is to view growth and transformation, whether personal or societal, as uniformly positive, the fact is that growth does not always proceed steadily in one direction. Growth frequently involves taking two steps forward, then one step backward. Keeping this in mind, we need to allow ourselves and our religions some room for misunderstanding the true nature of things and for losing the intended path. To not allow this is to set up ourselves and our religions for a potentially devastating sense of failure if the choices made later turn out to need some correction. Boisen wrote extensively about this problem of disintegration in response to self-perceived failure and threatened isolation. [Personality Changes ]

    One of Boisens core observations was that the sense of personal failure was the driving force behind many crises. While he focused primarily on the personal, he recognized that this factor might also apply to the social. Boisen emphasized that the sense of personal failureis not necessarily an evil. When frankly recognized and intelligently handled, it becomes a precondition of growth. [p.46, RCC] Of course, frankly recognizing and intelligently handling it is most of the problem. We could say that the Western world failed to protect itself from terrorism or that the Eastern world failed to protect itself from the tsunami, but we could also ask, are these not worldwide responsibilities? Is it not now becoming clear that the West needs the help of the East and that the East needs the help of the West?  that the East can help the West dissipate the powers of terrorist destruction just as the West can help the East dissipate the powers of natural catastrophe? What if the East recognized the terrorist attacks of 9/11 as their problem to solve? What if the West recognized the washed away towns of 2004 as their problem to solve? What if the East and the West forgot which is East and which is West?  There is a need for all of us to begin thinking more globally. Boisen called for an effort at mutual understanding and helpfulness in the pursuit of a common goal. [p.260, RCC; italics mine]

    What if, however, no one or no group frankly and intelligently tried

    (a) to understand things as they really are and

    (b) to promote transformation of all toward their finest potentialities? 

    Whatever the actual personal or societal response to crisis, one of Boisens main concerns was that there might be no constructive response. Let me repeat that: one of his main concerns was that there might be no constructive response  thatno one and no group might get involved. He considered that the real evil for a person or a society would be the failure to grow, the failure to obtain ones true objectives in life. [p.207, RCC] He had no illusions about what he called the herculean task, but his approach was just to get started with the person or society at hand  which he did. Boisen assumed that everyone was capable of theological reflection, and that everyone had some kind of beliefs, perhaps not well formulated, regarding the end and meaning of life, the spiritual forces which operate within us  [as well as] the relationships which exist between their various manifestations, . . . . [p.306, EIW]  He had no qualms about arousing the sleeping conscience as long as one recognized that an individualized task of reconstruction must then begin. [p.281, EIW] While Boisens research used a standardized set of provocative questions that he and Dunbar devised, as noted above, he was quite adept in any case at just sitting down with someone and drawing out his or her views about the things that matter most  the ultimate realities of life and death. He did this within a respectful atmosphere of what he called, co-operative inquiry  a kind of blending of the two parties into a research team regarding the problem at hand. Boisen taught his students to try to get involved with others active or latent curiosity about their beliefs  amid the complex entanglements of actual life[pp.191,182, EIW; see, John Dewey, A Common Faith. New Haven: Yale University Press, 1934, p.32, "There is but one sure road of access to truth  the road of patient, cooperative inquiry operating by means of observation, experiment, record and controlled reflection"; perhaps also of interest: John Dewey, The Field of Value, in Raymond Lepley, Values: A Cooperative Inquiry. New York: Columbia Univ Press, 1949]

    The question is, can this drawing out of others views about the things that matter most  the ultimate realities of life and death  be carried out on a societal as well as on a personal level? Can one society or one religion successfully engage another society or religion within this atmosphere of co-operative inquiry? Boisen thoroughly believed that through suffering together, getting down to work on real problems, the strain is shared and social support is afforded, with the net result being steadying and constructive. Can this tried and true approach to persons be applied to societies and religions? Preliminary research on the recent incidents of sudden, catastrophic terrorist and natural destruction, shows that those persons immediately wrestling with the task have fared the best  which is exactly what Boisen would have predicted. Could this hold for societies or religions  that those immediately tackling the real problems, open to assistance among equals toward resolving the problems, would fare best in the near future? Crisis experiences, in Boisens view, reveal hidden elements of strength and of weakness. [p.45, RCC]

    Boisen maintained that cultures developed best through the overcoming of difficulties [p.43, RCC] Some of the difficulties currently facing the world, however, are of an unprecedented magnitude. Boisen observed that war, for example, as a personal and social calamity, seemed to be an exception to the rule that crisis could stimulate useful religious concern. [1945, What War Does to Religion]  As he asked, What important religious movements have grown out of a war  ? [p.5, RCC] He concluded, however, that religious growth of a personal and social nature might occur when the reaction to national disaster was self-blame rather than hating and blaming the enemy  that examining the beam in ones own eye had to precede considering the mote in the others. [p.6, RCC; see note above] In his view, war, like an acute psychosis in an individual  is an attempt at reorganization which may either make or break, depending on the honesty and fair-mindedness which we face and eradicate the long-standing evils  the complex forces common to us all  which have been responsible for the problem in the first place. [pp.7,97, RCC]  That is, we must strive to maintain perspective and a self-critical stance during the current global war on terrorism. Even a natural phenomenon, such as the 2004 tsunami, brings its own challenges  especially to the extent that there are contributing non-natural factors and complications. When the reaction to catastrophic terrorist and natural destruction brings excessive self-blame or excessive acceptance, that can derail useful religious concern, discouraging an engaged response.

  • 15 Jan 2006 10:15 PM | Perry Miller, Editor (Administrator)

    At the last Asia Pacific Congress on Pastoral Care and Counseling, in Perth, Australia, in July 2001, the Rev. Dr. Emmanuel Y. Lartey outlined prophetically some of these problems we now face. He spoke of  rapid change and flux in the social, economic, cultural, religious, political and personal spheres, producing confusion, uncertainty, fragility, and vulnerability. He emphasized that these conditions exist to different degrees all over the globe  simultaneously  that it was not the case that any one of these conditions exists in isolation in one geographical area or cultural context. While Lartey called for all of our assumptions to be critically appraised, he also cautioned that it was not true that the condition critiqued ceases to exist. What are we to do? Sounding very much like Boisens call for an empirical theology fifty years earlier, Lartey called for a post-modern, global view of pastoral care and counseling, encompassing both individuals and societies, focusing on the specific. He called for a return

    (1) from the general to the particular,

    (2) from the universal to the local and contextual, as well as

    (3) from the timeless to the timely.

    Lartey also spoke bluntly of the problem that not all approaches are positive  that developing religious beliefs can be sometimes creative and other times lethal. He raised the issue of universal responsibility  of chaplains as agents of respect for the whole-created order of the world. He noted that in response to the need for multi-faith initiatives some religions, just as Boisen would have predicted, are responding to the crisis courageously and innovatively, while others are frozen with fear, dread and anxiety. Lartey called upon chaplains to engage critically and empathically, encouraging and empowering others to work towards creative change of community-destroying structures. While not quite showing the appreciation of empirical method  the attitude of humility which is willing to put religious insight to the test  that characterized Boisens work, Lartey did call for collaborative work with disciplines outside of theology, toward achieving holistic health for the entire planet. [Lartey, Global Views for Pastoral Care and Counseling ; italics mine] The question becomes, can we step outside our own religion to engage all other religions?  Can we listen to the others, speak to the others, and nourish a reasonably objective appreciation from both sides as to what is working and what is not?

    We may need to begin closer to home, to gather strength for taking on the world. Boisen called for the recovery of zeal, inner experience, and faith [p.232, RCC]  for a living fellowship with a certain body of beliefs in which there is room for growth and for discovery. [p.237, RCC; italics mine] One organization, a theologically based  covenant community, has been trying to foster this nurturing environment by actively bringing together groups of chaplains who desire to grow richer in spirit and in soul. [The College of Pastoral Supervision and Psychotherapy, PO Box 162, New York, NY, 101098, USA; on the web at] Let me quote from their Covenant, but as I do so try to imagine these admonitions not as applying to individuals but as applying to societies and religions  indeed to all the societies and religions of the world.

    We  see ourselves as spiritual pilgrims 

    seeking a truly collegial  community. 

    We commit to being mutually responsible to one another for

    our  work and direction. 

    We commit ourselves to a galaxy of shared values 

    that are as deeply held as they are difficult to communicate. 

    Again, try to imagine these admonitions as applying to all the societies and religions of the world. Let me continue to quote:

    We place a premium on 

    the significance of the relationships among ourselves.

    We value personal authority and creativity.

    We believe we should make a space for one another and
    stand ready to midwife one another
    in our respective spiritual journeys. [italics mine]

    That is the phrase that most caught my attention: We  stand ready to midwife one another in our respective spiritual journeys.  That is, we, or our societies and religions, will help each other through our spiritual transformations, or, in Boisens terms, our re-creations of religious faith. Let me again continue to quote:

    Because we believe that life is best lived by grace, 

    we believe it essential to guard against becoming 

    invasive, aggressive, or predatory toward each other. 

    We believe that persons are always more important than institutions  .

    We are invested in offering a living experience 

    that reflects human life and faith within 

    a milieu of a supportive and challenging community of fellow pilgrims. [italics mine]

    Does not this covenant sound like Boisens living fellowship with a certain body of beliefs in which there is room for growth and for discovery? [p.237, RCC] Imagine the impact a loose worldwide network of such interfaith groups could have. Just two years ago this covenant community of chaplains underscored its conviction that a clinically trained person is one who is committed to continuing personal transformation. [see the General Secretary's report, 21 March 2003, The College of Pastoral Supervision and Psychotherapy.  Since these chaplains have already been very active in encouraging the formation of indigenous pastoral care and counseling associations throughout the world, it would not be much of a stretch to envision them as committed to working toward a continuing transformation of the world.

    As you will recall, Boisen observed that, worldwide, the normal crises of personaldevelopment are integrated socially through religious ceremonies, such as weddings, funerals, etc. Another of the questions facing us now is, what means do we have for integrating the normal crises of social development? Is each society and each religion left to struggle on its own? Remembering Boisens research on four main reactions to crisis, is there a way that part of the world community  perhaps a network of clinically trained chaplains  might help groups avoid

    surrendering to hatred,

    withdrawing into lust and greed, and

    concealing ones inadequacies through delusion,  

    but rather succeed in

    viewing frankly the true nature of the situation, 

    such that exceptional crisis might provoke insights that can be integrated into customary life?

    Eighty years ago, nowhere in the world did there exist a clinically trained chaplain. Now there are thousands. The movement for clinical pastoral and spiritual training, education, and transformation was ecumenical from the start, and began to spread worldwide within several decades. These programs, however, need to embrace clergy of even more faith groups and to be established in even more nations. Perhaps one of the most important projects to be tackled would be the translation in paraphrase of Boisens call for clinical work, A Challenge to the Seminaries, into as many languages as possible. [Boisen, 1926, in Christian Work 120: 110-112; reprinted in the Journal of Pastoral Care 5: 8-12, 1951]  Think of the potential impact on our current crises if there were clinically experienced chaplains attached to every  and I do mean every  theological school in the world, commited to nourishing the wisdom of perspective and a self-critical stance.[compare Larteys speech from the last Congress, 2001,cited above, in which he spoke of the post- modern approach, in which one attempts to maintain the stance of   being in critical vein or in questioning mode.]

    Religion in Crisis and Custom. Let us return to the title of Boisens last monograph, published fifty years ago this year. The first major thrust of this presentation outlined  religion during crisis and custom  the personal discovery and recovery of spirit and soul during extraordinary as well as ordinary times. The second major thrust, however, began a careful consideration of religion itself in crisis and custom the re-creation of religious faith in societies as new revelations and insights initially rest uncomfortably with older ones, during extraordinary as well as ordinary times. Boisens view of transformation  for both individuals and societies  focused on struggling together, on striving to maintain an honest and thoroughgoing commitment to a process of becoming  on becoming the best one can conceive. Boisen emphasized that failures were part of the price paid for attempting to grow  to become  but that daring efforts must be attempted nonetheless. The burden  the challenge  is large, but appears unavoidable.  We must indeed, as this Congress is charged, maintain our buoyancy  and lift up our spirit  as we shoulder the immediate worldwide task with which we are confronted. What is being asked now is whether we can come to view our religions, individually and collectively, as having universal responsibilities to promote what Boisen called  the finest potentialities of the human race. [p.305, EIW; italics mine]

    My questions, once again, are beginning to outnumber my answers. The conclusions from my several historical presentations to the clergy are, however, beginning to add up. A few years ago I noted a first challenge from the past, exemplified by the work of Boisen, that we

    (1) maintain the courage to espouse beliefs not initially shared by others. 

    [Powell, 1999, Whatever ] Somewhat later I noted a second challenge from the past, exemplified by the work of Boisens colleague, Dunbar, that we 

    (2) maintain the willingness to tackle the apparently impossible task. 

    [Powell, 1999, Emotionally ] Still later I noted a third challenge from the past, again exemplified by the work of Boisens colleague, Dunbar, that we 

    (3) maintain the continued ability to create and invent.

    [Powell, 2002] Before formulating  actually, resurrecting  a fourth challenge, let me note several things about the Rev. Dr. Anton Theophilus Boisen in the light of these first three challenges.

    He sized up a moral problem, putting insights into print for evaluation by colleagues, and stood strong by his convictions.

    He took charge of situations, overcoming the shyness induced by severe mental illness, and started what had to be done.

    He remained intrigued by situations, reflecting on complex confusion until finding clarity, and proposed a solution.

    I am sure that Boisen would have thoroughly enjoyed reflecting theologically upon recent world events and the ways in which the religious community has or has not engaged and responded. There is no question in my mind that we would be hearing his prophetic voice. In Boisens absence,

    (a)     can the suffering world  not just your region or your community  but the world  depend upon you to provide the wise leadership needed? 

    (b)     can the broader world depend upon you to size up problems, take on the tasks, and remain intrigued? 

    (c)     can those parts of the world that seem foreign depend upon you to stand strongly by your convictions, get to work without excuses, and encourage novel approaches?

    Each time I speak to the clinical pastoral community as an historian, so it seems, I discover and recover one more piece of wisdom from your past. During his latter years Boisen spoke of  the broader perspectives  with which true religion is concerned. [p.393, What War Does to Religion. this longer version of Chapter VI, RCC is strongly recommended.] He thought deeply about the hardships of the 1930s, the moral issues of World War II, and the worldwide aftermath of war, recognizing the temptation for each party involved to focus primarily on its own situation. Following the precedent of the prophets, Boisen saw the need for clergy to take the lead in expanding and questioning peoples views. This time, the challenge from the past, a fourth, is that the worldwide clinical pastoral and spiritual community

    (4) maintain the wisdom of perspective and a self-critical stance,

    as it takes seriously the call to transform the world, in times both of crisis and custom.

        Thank you for inviting me to share my thoughts on the formation and transformation discovery and recovery  of spirit and soul.  Shalom                                              

    Out of the depths have I cried unto to thee, O Lord.  Psalm 130:1 in the Protestant Bible; 129:1, De Profundis, in the Catholic Bible.

    A Book which We have revealed to you, in order that you might lead mankind out of the depths of darkness into light  . al-Qur'an 14:1.

    Endnote for the General Reader:

                    The Rev. Dr. Anton Theophilus Boisen (1876-1965) is generally credited as the founder, in 1925, of the trained chaplaincy, for hospitals, prisons, the military, and other institutions.  These specially trained ministers also now offer pastoral care, counseling, and psychotherapy within parish settings. What eventually became the worldwide movement for clinical pastoral education actually grew out of a delusion Boisen had in 1920  about having broken an opening in the wall which separated medicine and religion. Yes, this was initially a delusion, as Boisen was, at age forty-four, in the midst of his first of six periods of profound psychosis. What makes Boisen different from so many others who have suffered with schizophrenia is that he devoted the last half of his life to working out the practical implications of his delusional insight. The training program he developed for theological students in 1925 has since been copied by most American seminaries, has spread throughout Europe, and is now spreading throughout Asia. His best known book  his first  that has been republished five times  is The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience (1936), which is still widely cited in the literature of religion and psychology. A close runner-up would be his last book, Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience (1960). Each of his books  and he wrote three more  has become a classic in its own right.                                                                              


    Benyosef, Simcha H.:  The Additional Shabbat Soul, in Living the Kabbalah: A Guide to the Sabbath and Festivals in the Teachings of Rabbi Rafael Moshe Luria. New York: Continuum International Publishing Group, 1999. Chapter on the web:

    Boisen, Anton Theophilus, editor: Lift Up Your Hearts: A Service Book for Use in Hospitals. Boston: Pilgrim Press, 1926, later re-titled, Hymns of Hope and Courage, 1932, 1937; 4th edition, Chicago: Chicago Theological Seminary, 1950.

    Boisen, Anton Theophilus: Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience. New York: Harper & Brothers, 1960.

    Boisen, Anton Theophilus: Problems in Religion and Life: A Manual for Pastors, with Outlines for the Co-operative Study of Personal Experience in Social Situations. New York: Abingdon-Cokesbury Press, 1946; during World War II, a 1941 lithograph version was in circulation.

    Boisen, Anton Theophilus: Religion in Crisis and Custom: A Sociological and Psychological Study. New York: Harper & Brothers, 1955; reprinted, Westport, CT: Greenwood Press, 1973.

    Boisen, Anton Theophilus: 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.

    Boisen, Anton Theophilus: Personality Changes and Upheavals Arising Out of the Sense of Personal Failure. American Journal of Psychiatry 5: 531-551, 1926; reprinted, American Journal of Psychiatry 151(6 Supplement): 125-33, 1994 [reprint supplement also issued as a hard-cover book, Arlington, VA: APPI, 1994].

    Boisen, Anton Theophilus: The Present Status of William James Psychology of Religion. Journal of Pastoral Care Counseling 7:155-162, 1953.

    Boisen, Anton Theophilus: What War Does to Religion. Religion in Life 14:389-400, 1945.

    Dunbar, Helen Flanders: Symbolism in Medieval Thought and Its Consummation in the Divine Comedy. New Haven, CT: Yale University Press, 1929; reprinted, NY: Russell & Russell, 1961.

    Lartey, Emmanuel Y.:  Global views for Pastoral Care and Counseling: Post-modern, post-colonial, post-Christian, post-human, post-pastoral.  Address given at the 7th Asia Pacific Congress on Pastoral Care and Counseling, Perth, Western Australia, 15th July 2001; on the web at

    Lawrence, Raymond J.:  The Trouble with Spirituality. Contra Mundum: A Journal of Theological & Clinical Reflection, issue #91, January 12, 2001; hard copy: P. O. Box 2535, Times Square Station, New York, NY 10108; on the web: 

    More, Thomas: Soul Talk. Comments during an interview by Rachel Kohn, on the radio program, The Spirit of Things. 30 March 2003; on the web:

    Powell, Robert Charles: Anton T. Boisen (1876-1965): "Breaking an Opening in the Wall between Religion and Medicine, pp.47, special supplement to the AMHC Forum, 29(1), October 1976 [Association of Mental Health Chaplains > Association of Professional Chaplains].

    Powell, Robert Charles: Anton T. Boisen's Psychiatric Examination: Content of Thought (c. 1925-31): An Attempt to Grasp the Meaning of Mental Disorder. Psychiatry 40 (4): 369-75. 1977.

    Powell, Robert Charles: Healing and Wholeness: Helen Flanders Dunbar (1902-1959) and an Extra-Medical Origin of the American Psychosomatic Movement, 1906-1936. Ph.D. dissertation, Department of History, Medical Historian Training Program, Duke University, 1974.

    Powell, Robert Charles: "Questions from the Past (on the Future of Clinical Pastoral Education). Keynote address, presented before the 50th Anniversary Conference, Association for Clinical Pastoral Education, Minneapolis, October 1975. 1975 Conference Proceedings: 1-21, 1976.

    Powell, Robert Charles: Whatever Happened to CPE -- Clinical Pastoral Education?  Keynote address,  presented at the 9th Plenary Meeting, of the College of Pastoral Supervision and Psychotherapy, March 1999, Virginia Beach.                                                                                                                                                   


    Dr. Robert Powell is a renowned scholar in the field of the Clinical Pastoral Movement. The Pastoral Report is honored to have been given permission to publish Formation and Transformation  Discovery and Recovery  of Spirit and Soul: Religion in Crisis and Custom .

  • 15 Jan 2006 10:08 PM | Perry Miller, Editor (Administrator)

    Religion in Crisis:
    Am I my brothers keeper?
    a third report out of
    the 8th Asia Pacific Congress on Pastoral Care and Counseling,
    held 7-11 August 2005 in Hong Kong

    Dear Editor:

    When fate decreed that I should take Jim Gebharts place as lead speaker at The Asia Pacific Congress, the organizing committee, including our good friends, Chaplain Patty To, Sister Agnes Ho, the Rev.Dr. Ernest Wu, and the Rt.Rev.Dr. Thomas Soo, asked me to keep an eye on the conference theme about Spiritual Formation of the Human heart: Tested Models of Pastoral Care and Counseling, but also to speak directly about the reality of the 2004 tsunami and of the war on terrorism.

    Once again it did not hurt to consult the work of Anton Theophilus

    Boisen, who thought quite deeply and wrote extensively about the Depression and about the Second World War. My presentation drew heavily upon his insights. Sharing speaking duties with several Buddhist colleagues also forced me to think outside the confines of the Judeo-Christian tradition. I hope that the readers of the

    CPSP Pastoral Report will find this essay thought provoking.

    Let me jump to the crux of the argument:

    It could well be that a persons initial spiritual formation and
    later transformation are quite different  according to whether
    that persons religious tradition itself is in crisis or custom.
    Historically  the trend has tended to be positive, but that
    does not guarantee a positive outcome for the recent
    re-creation of religious faith occurring as Islamic Jihad.

    In any case, Boisen viewed the guiding of this
    transformation of religion as a responsibility of the clergy.
    While it would be easy to argue that each faith group should
    tend its own garden, perhaps it is worth asking if the current
    religions have any responsibility for assisting all of the worlds
    people toward what Boisen spoke of as identification with a
    fellowship that has the capacity to be universal and abiding
    and toward what he spoke of as promoting unification with
    the finest potentialities of the human race.

    The audience in Hong Kong seemed most touched by the power of one specific idea:

    that of embracing all of the worlds faiths within the CPSP Covenants pledge to
    stand ready to midwife one another in our respective spiritual journeys.
    Are we the keepers of our brothers or our sisters religion?

    Should we intervene  and, if so, in what way should we intervene 
    if we see our neighbors religion in crisis?

    Robert C. Powell, MD, PhD

  • 03 Jun 2003 12:54 AM | Perry Miller, Editor (Administrator)

    I have been thinking about leadership as a task: We are all leaders in particular contexts, or we would not be here. But I am thinking specifically about leadership in CPSP, undoubtedly related to thoughts about my own mortality.

    I am aware, with some nostalgia, that the founding generation, which was old to begin with, is passing on. That?s the way the world was created. We have threescore and ten, or four score, and some get a little extra, but not much. In twelve years I will have had my fourscore, if I make it that far. CPSP is not going to get much more out of me.

    I cannot think of anything more important than the emergence of strong, wise leadership for the decades to come. Without it, we will be a forlorn community. We see the crisis in our national life and on the international scene, the fruits of unwise leadership, overly cautious or incautious, bullying or indecisive. The whole world is anxious this week because of the flaws in the leadership of nations.

    Competent leadership consists of: 

    -strength that does not bully. 

    -a caution that is not afraid to act boldly.

    -a vision of what is up ahead that protects a community from too many bad surprises. 

    -and perhaps most importantly of all, empathy for the weakest among us.

    None of us exercise competent leadership consistently. Like our time on the baseball diamond or on the links, some times in the batter's box are better than others. Our batting average or golf score is just an average. Sometimes just showing up is an act of leadership.

    In 1990 fifteen persons showed up to create CPSP ex nihilo. Many others said they would come. We expected 30 to 40. Each one of those fifteen was very important. We knew we were contemplating a potentially dangerous course. Had we been fourteen instead of fifteen, we may have opted to withdraw from the field.

    Following the organizational meeting, five dropped out before a shot was fired. Two dropped out a couple of years later, two died, Al Anderson the year before last, and Don Gum last year. Two are in semi-retirement, still with us but not active, and four of the original fifteen are still active and present with us: Perry Miller, Bill Carr, David Moss, and I.

    Don Gum is second of the fifteen to die, after Al Anderson. The river of life takes us one by one. Don was a flawed and broken person. He also had a considerable energy and creativity. He accomplished more than some of us who have no discernable major flaws. And he showed up. Ninety percent, they say, is just showing up, and he showed up. You have to wonder, if he had not shown up, whether we would have this community that surrounds us. We were conscious of how few we were, and fourteen is a lot fewer than fifteen. Besides, Don was a strong leader in the wider community, and President of the College of Chaplains, which gave us some political cover. We needed it, particularly given some of the other characters we had aboard. Don was second president of CPSP. In his own idiosyncratic and sometimes disconcerting ways he contributed to our well-being. I think it appropriate that we stand for a minute of tribute to Don. May he rest in peace.

    The six of us who remain are mostly ?has-beens.? The sun is setting on us. As a tribute the six who are still with us, I read this poem which was sent to me by my friend Deryck Durstan, attributed, I think falsely, to Dr. Seuss:

    Dr. Seuss on Aging

    I cannot see.

    I cannot pee.

    I cannot chew.

    I cannot screw.

    Oh, my God, what can I do?

    My memory shrinks.

    My hearing stinks.

    No sense of smell.

    I look like hell.

    My mood is bad ? can you tell?

    My body?s drooping.

    Have trouble pooping.

    The Golden Years have come at last.

    The Golden Years can kiss my ass.

    I do not suggest we venerate the fifteen, or the remnant thereof. Many others who came into CPSP later have contributed even more to our prosperity. To name only a few, I point to Myron Madden, Ben Bogia, Richard Liew, and Ken Blank. George Hull, Beng Imm Low, and Henry Uy put this meeting together. Foy Richey has demonstrated considerable energy and leadership in his role as President. John deVelder negotiated our place now as a sponsoring organization of Journal of Pastoral Care and Counseling, and is Vice President of the JPCC's Board of Managers. All members of CPSP will now receive a subscription of the JPCC from this point on. I also want to commend Jim Gebhart, who has conducted in a highly effective manner a major revision and upgrading of our Standards and at the same time entered into conversations with the DOE on the subject of recognition of CPSP.

    CPSP is not just another organization. We represent specific values that should never be negotiated away: Three principal values called CPSP into being, values that remain central to our existence as a community: 

    1. A return to theology.

    2. The conviction that a clinically trained person is one who is committed to continuing personal transformation.

    3. A commitment to a communal, participatory political structure in our own organizational life.

    1. A return to theology.

    Recovery of soul is the metaphor that we have used to highlight this issue. The return to theology is not a cheap shot at psychology. A minister who is not broadly familiar with psychology, who is unaware of the significance of Freud and his revolution, is by definition unlearned and predictably incompetent. But psychology is not our home. Theology requires obedience to the requirements of love and justice, whereas psychology claims to be a science, and as a science has a tradition of relative non-commitment to specific values.

    Our knowledge of the human heart is deepened by the contribution of Freud and his heirs. It is in parsing the inner world of the human heart/soul where psychology and religion meet. But Solomon was psychoanalytically informed almost 3,000 years before Freud. He was called wise because he knew the workings of the human heart and its recesses. He knew that a woman who really loved a newborn child would rather see it raised by an abductor than slain, and thus he deciphered who the real mother was. He knew a woman who would allow the child to be put to the sword rather than have her aggressiveness thwarted was unlikely to be the mother.

    As David was dying Solomon's half brother, Adonijah, who thought he should be king instead, made an attempt to roll over Solomon. He lost. Solomon was merciful, and released him on good behavior. "If he proves to be a worthy man, not one of his hairs will fall; but if he is wicked, he will die." Shortly, however, Adonijah asked permission to marry Abishag. Abishag was the beautiful young maiden, sought for through all Israel, who was commissioned to minister to David's in his last days, in the hopes that she would revitalize him with more salutary effect than chicken soup. Abishag?s ministrations notwithstanding, David soon died. When Solomon heard of Adonijah's request, to take Abishag to wife, the merciful Solomon's response was swift and decisive. He summarily ordered Adonijah to be put to death. Solomon knew that the symbolic power of Adonijah's wish to have his father's last consort, and Solomon saw that Adonijah's political ambitions were still active, even after having been pardoned. Solomon was wise in the ways of the human heart.

    Theology as a discipline differs from psychology in that it deals in the question of what is commanded. In this regard we are informed by Karl Barth, for whom obedience was a central issue of attention in theologizing. The Talmudic tradition also emphasizes the matter of obedience in a dramatic way. But the truth is that all religion is built on one or another call to obey what is commanded. Anton Boisen himself gave a particular spin to the issue through his vision that he and we must break down the wall between medicine and religion, not that he thought that to be the only thing commanded, but rather a singular command in addition to other commandments. Every clinical case, therefore, should be examined under the auspices of the question of what is commanded, of the patient, the physician, the medical team, the family members, friends, and chaplain.

    Parenthetically, we know that people tend to think of what is commanded in terms of commandments, often prohibitory commandments. What has come clearer in recent years is that story and narrative are sometimes more effective bearers of what is commanded.

    This focus on what is commanded is not taking place in most clinical pastoral training. I know from my travels. What generally passes for theologizing is an embarrassment, or should be. What we typically observe under the label of theologizing in clinical pastoral training programs is free association on biblical texts. What biblical passage does this case bring to mind? The response of course is, nine times out of ten, the Good Samaritan or the Prodigal Son. This is the inflation of the value of free association beyond all reason.

    Another common gambit in launching into theologizing is to pose the question, ?Where is god in this case?? This could be called the search for the absent god. She is in the cafeteria, perhaps. Wondering where god is, say during the holocaust is a poignant undertaking, and not an unworthy venture. However, it is quite secondary to the primary theological question, "Adam, where art thou?" In other words, where are you in relation to what is commanded?

    Most theologizing is limited to the task of establishing contact with one's feelings, which is certainly a commendable enterprise. Not to be in touch with one's feelings is dangerous to oneself and others. However, contact with one?s feelings is not the alpha and omega of theological reflection. Serious theological reflection calls for examination of the context of feelings and the requirements of love and justice.

    Take, for example, the Iraq War: We may have feelings about the war. We may be filled with pride and patriotism, or have feelings of revulsion at the pretext for the war or the destruction and loss of life involved. Theological reflection on the war would mean an exploration of the requirements of the commands for love and justice, a process that goes beyond a simple exploration of feelings.

    Serious, disciplined theological reflection in clinical training is rare, replaced generally by a mix of 19th century piety, medieval catholicism, and pop psychology. (I refer you to a recent article in the Journal of Religion and Health that encourages patients to meditate on the 19th century hymn, "In the Garden.")

    A psychologically informed minister is a blessing to any community, and a minister uninformed psychologically is a potential menace. A minister who does not know how to think theologically is even more of a menace. Recovery of soul in CPSP means in part the recovery of a capacity to theologize.

    2. A revivified personal authority founded on the requirements of continuing personal transformation.

    The clinical training movement has been haunted from its beginning by the conflict between the exploration of the self and the development of pastoral skills, the one rather inward looking, and the other more outwardly oriented. Each is important in its own way. Each wishes to assert preeminence. Boisen and Dunbar were unequivocally on the side of person transformation and Cabot and Giles on the side of skill development. The movement has never really faced up to the conflict, but generally has sided with Cabot and Giles. They sell better in the marketplace. While Boisen lived the personal transformation agenda was preeminent. When he died the tide began to turn.

    A focus on personal transformation is quite problematic politically. Until a little past mid-century pastoral clinicians tended to be characters. They were wild. They defied convention. Smoked themselves into lung cancer, drank into alcoholism, and misbehaved generally. And how we miss them. The rough-hewn idiosyncratic and often obnoxious characters many of whom were still around mid-century were almost nowhere to be found, replaced by the politically correct and experts in public relation.

    I have been to a trainload of meetings of Boisen's followers in the past four decades, and 

    I have the impression that with more and more persons who are allegedly clinically trained, I have the distinct feeling that nobody is home. They have the appearance, in the wonderful words of Harold Bloom, of a "rabblement of lemmings." If you pretend to follow Boisen you are obliged to become so uniquely yourself that you become a distinctive and memorable person.

    In clinical pastoral training that is faithful to its origins, the question, "Who are you?" takes precedence over the question, "What skills do you possess?"

    Much foolish talk abounds of late deriding the notion of "outcomes" in clinical training. Of course we expect outcomes. Who can imagine a supervisor saying: "Come join my training program. We will have no expectations for what you will accomplish by so doing." However, because some of our colleagues have transformed outcomes into paint by numbers process does not invalidate the necessity of holding to a concept of desired outcomes. One of our desired outcomes is that of personal transformation, and more specifically, a transformation that penetrates the typical narcissism and grandiosity that seems inevitably to accompany a call to the ministry. The late Reuel Howe was a professor at Virginia Theological Seminary during the middle of the last century, and someone who appreciated the value of clinical pastoral training. He wrote in vivid language about his idea of desired outcomes in clinical training: 

    "I want [the students] "dunked" -plunged deeply into life, brought up gasping and dripping, and returned to us humble and ready to learn.  Until all students are faced with the tragedies, the contradictions, and the stark questions of life, they cannot understand the need for redemption or God's redemptive action. I want my students to lose, as soon as possible, their easy faith, their ready answer. I want them to lose their personal conceits and their illusions about themselves, their illusions about their fellow men and their illusions about God. I want their assumptions about the ministry and their assumptions about how they are going to conduct their ministry completely destroyed."

    Howe sought explicit outcomes, but the outcomes he sought are more difficult to codify than some of the more specific, concrete skill acquistions. A silly check list will not measure what Howe was seeking.

    3. A more communal political system in the clinical pastoral community itself

    Soon after CPSP appeared on the scene, one of our collegial organizations made an effort to replicate the Chapter model, and called for support groups among clinical supervisors. Such groups did in fact spring up in various quarters. Such groups will not accomplish much. They forgot what Paul Tillich wrote in Love, Power and Justice, that love and power must not be separated in a particular structure, or the structure is lame. Support groups with no power are effete. Chapters are not support groups, though they should have some of the marks of a support group. They have also the power and obligation to pass on the credentials of all its members annually, to guarantee the continuing education of all Chapter members, and to monitor the ethical conduct of all Chapter members. Chapters which are not performing all these tasks are not fulfilling their mandate and are subject to discipline by the Council.

    We should never evolve into a guild, (groups with exclusive rights of trading in a particular field) in the sense of creating a lock on the profession, so that anyone who wishes to work must come through us. Such guilds poison the well, are unbecoming to our calling. Such a lock on the right to work breeds strife and anxiety, domination. One of the main sources of antagonism toward CPSP was that we had breached the guild. DOE has a policy not to recognize only one organization in a given field.

    Paid bureaucracy is poisonous. A highly paid bureaucracy is highly poisonous. For thirteen years CPSP has not paid a dollar to any one of its leadership, not even for secretarial services. We do need to hire secretarial support. However, I urge the next generation not to salary its key leadership, but to pay only for administrative support, not for leadership. The minute you begin to pay my salary, the minute my own personal goals and ambitions become entangled with the objectives of the community. I have never had to consider implications for my personal income in making a leadership decision in 13 years.

    Chapters in CPSP place the balance of power close to home. We practice home rule.

    We believe power and authority belongs in the context of a community where we are known, not in the files of some bureaucratic official in a faraway city who may or may not know me, but certainly does not know me well.

    We convened this meeting under the dark shadow of a declaration of a new morality in our national leadership: the declaration of international martial law.

    The President disclosed in his State of the Union speech that he had assassinated in Yemen a significant international terrorist. Five others who were in the car that was targeted, and were also killed. The guilt of the alleged terrorist has not been documented, and certainly not vetted by accepted standards of due process. The guilt of the unidentified companions obviously has not been established, except by association perhaps. The President boasted in his speech that these people are no longer a problem to us. This is martial law, and it is a radical departure from national policy and morality. Covert assassinations by our government are not new. They have been staged by former Presidents. Eisenhower ordered the assassination of Patrice Lumumba of the Congo. Kennedy tried to do the same to Castro. The Diem brothers of Viet Nam were killed by the CIA, though Kennedy probably thought they would simply be removed from office. Chile's army chief of staff was kidnapped and murdered on directions by Nixon and Kissenger. The democratically elected President of Chile, Salvator Allende, was attacked and killed by forces in alliance with the CIA. All these covert assassinations, and others as well, have heretofore imputed shame to the perpetrators. The new policy is that there will be no shame. Assassinations will continue, and they will be shameless. The new claim of the ruler's right to execute without due process throws us back historically several hundred years. It has been thought for some time now that such action is an improper arrogation of power. The current President has dismantled enlightenment principles of justice and due process and has replaced them with brute force of American hegemony. By so doing he has made us citizens of a terrorist state.

    The character of our national life cannot but rub off on us. Ask any German who lived through the Nazi era what it meant to be a German in the 30s and 40s and subsequently. One did not have to support Hitler to be stained by his perversity and destructiveness. As Americans we will not escape the stain of George Bush's assassinations, or other forms of aggressiveness. Travelers abroad are already trying to distinguish between being American and supporting Bush. Such protestations go only so far.

    Self-awareness, examination of and reflection on our covert motives and unconscious agenda, deep self-scrutiny of the intricacies of what makes for a loving and just decision---these are the warp and woof of the clinical process. This process may be more difficult to parse in the immediate years ahead. They are inimical to all that we stand for in CPSP: self-deception, self-inflation, unreflective grandiosity, and more especially, to bullying of the weak by the strong. The former leads to the wisdom of King Solomon; the latter to the foolishness of King Herod.

    Under the Nazi regime in the 30s Karl Barth called on faithful people to go on doing theology as if nothing had happened. Of course, something was happening, and he knew it, but he stayed his course. What Barth was calling for was the importance of staying focused even though the world seemed to be collapsing around him. Indeed he was himself dismissed from his teaching position and driven out of Germany for his opposition to the Nazis.

    It is not clear how the new character of our national life under the current administration will impact CPSP as a community. It need not blur our vision. But the cost to us of remaining faithfully theological and clinical, of remained focused, may be significantly dearer in the time before us.

  • 04 Apr 2002 9:35 PM | Perry Miller, Editor (Administrator)

    The Helen Flanders Dunbar (1902-59) Memorial Lecture on Psychosomatic Medicine and Pastoral Care
    delivered 11/2/99, at Columbia Presbyterian Center of the
    New York Presbyterian Hospital, New York, New York


    ABSTRACT: This essay aims to stimulate rethinking about religious and medical "healing and wholeness." While psychiatrist (Helen) Flanders Dunbar is well known as a psychosomatic investigator and as "Medical Director" of the Council for Clinical Training, the initial home of Anton Boisen's ground-breaking movement for the clinical pastoral education of institutional chaplains and parish ministers, she is less appreciated as a theologically-trained scholar. This essay explores an earlier eras understanding of the "spiritual" and the more "soulful" components of healing and how Dunbar combined these to focus on helping all peoples become "free to think and act."

    "a magnetic, charismatic woman, with . . .

    an almost magical gift

    of insight and intuition."1  

    Now is the time -- no, it is long past time -- to begin honoring Helen Flanders Dunbar, BD, MD, PhD, MedSciD, psychoanalyst and Dantean scholar, for her contributions to religion as well as to medicine.2 As the practical theoretician, loving friend, and guiding force behind the Rev.Mr. Anton Theophilus Boisens ground-breaking movement for the clinical pastoral education of institutional chaplains and parish ministers, she was brilliant, realistic, and sincere. Just as Boisens work focused on breaking "an opening in the wall which separated religion and medicine," Dunbars work focused on that broad area of healing and wholeness, where religion and medicine overlap.3

    This memorial lecture can be seen as honoring the 70th anniversary of Dunbars first treatise, Symbolism in Medieval Thought . . ., which set the tone for all her subsequent work.4 It can be seen as honoring the 65th anniversary of her most beautiful and beguiling article, "What Happens at Lourdes? Psychic Forces in Health and Disease."5 It can be seen as honoring the 60th anniversary of her founding of the journal, Psychosomatic Medicine, and its associated society.6 It can be seen as honoring the 50th anniversary of Your Childs Mind and Body: A Practical Guide for Parents, the sequel to her best-seller, Mind and Body . . . .7 It can be seen as honoring the 45th anniversary of the fourth and final edition of Emotions and Bodily Changes . . . , which launched the mind-body movement.8 It can be seen as honoring the 40th anniversary of Psychiatry in the Medical Specialties, which was accepted for publication on the day of her death.9 From these standpoints and many others, "The Helen Flanders Dunbar Memorial Lecture" can be seen as an occasion well overdue.

    Dunbar considered becoming "free to think and act" -- she underscored the word "free" -- as a basic goal for all those seeking help.10 It was her admonition to physicians and ministers trying to heal as well as to patients and parishioners hoping to be healed. She held that becoming "free to think and act" was an accomplishment open to all -- one that could also be achieved by parents, then taught to children, heading off future problems.11 In various forms, this liberating sentiment -- becoming "free to think and act"  echoed throughout the era between the two world wars. In this essay I will lead you to explore the spiritual and the more soulful components of this admonition, how Columbia Presbyterian Hospital first became a font of knowledge on mind-body interactions, and how Flanders Dunbar became central to this ground-breaking enterprise, on both the religious and the medical sides. As a nonseminarian physician, I can only observe and hypothesize about theological matters, but I hope to stimulate your rethinking of what you thought you knew about religious and medical healing and wholeness.

    While the era opened with much confusion about healing efforts within the church, this quickly evolved into an implied distinction between what I will call

    (a) the "spiritual" [see definition below] and

    (b) the more "soulful" [see definition below] elements involved

    as well as an implied distinction between

    (a) the remedial stance of curing illness and

    (b) the more preventive stance of maintaining health. 12

    As Dunbar saw it, "The priest . . . speaks first of goal" -- the spiritual, that which maintains health and wholeness -- and "brings promise of external assistance." In contrast, without promising any such "reinforcing of strength," the general physician tries to set the soul at ease by removing "objects in the patients path," and the trained psychiatrist focuses on "straightening out . . . disharmony" in the patients path itself.13 Religion alone, she suggested, could add spiritual confidence -- "The Lord is my shepherd!" -- "Shema Israel!" -- to the soulful contentment and quiet that either religion or medicine might achieve. Clergy and physicians both could focus more on the present as it unfolds into the future -- prevention, and less on the past -- the etiology of an illness or disease. Together, the psychiatrist, the physician, and the pastor might guide the person seeking help toward becoming emotionally, soulfully, and spiritually free to think and act.

    Mrs. Ethel Phelps Stokes Hoyt, an intelligent, energetic laywoman, who wrote a remarkable little book called Spirit: A Study in the Relation of Religion to Health, and whose husband, industrialist John Sherman Hoyt, served on the Board of Columbia Presbyterian Medical Center, contributed greatly in the clarification of these issues.14 As early as 1923 she asked, "Will not those Churches which are interested in Spiritual Healing help the Cause more at present by emphasizing the Power of the Spirit in maintaining Health and Abundance of Life, rather than by putting the emphasis on 'Curing disease'?"15 On March 8 of that year she and her husband gathered "a small group of physicians and clergymen"

    (a) to discuss "the possibility of better cooperation between Religion and Medicine in maintaining health and curing disease,"

    (b) "to study the basic factors, physiological, mental, and spiritual, underlying the various healing cults," and

    (c) "to strengthen the work of those groups which were earnestly seeking scientific guidance."16

    As the Rev.Dr. Harry Emerson Fosdick is said to have phrased it at that meeting, "modern ministers are approaching this problem [of healing] in a scientific manner, trying to interpret spiritual laws with the same scientific spirit with which . . . doctors are working to interpret physical laws. We must work scientifically from both sides until the tunnel joins." Just as pastors might be taught a more careful, rigorous, clinical approach, it was suggested that physicians might be taught how to "rekindle latent faith in Patients." Overall, the controversies over religious healing were seen as an unfortunate stumbling block and as "only a small part of the greater problem of [obtaining] 'The Cooperation of the Church & the Medical Profession'."17 Mrs. Hoyt encouraged both sides to see that "the Church can do more in preventive & educational than in curative work" and that putting more emphasis on "religion as an aid in maintaining health" would make it "far easier for doctors and clergy to get together."18

    This "small group of physicians and clergymen," which eventually developed into the "Joint Committee on Religion and Medicine of the Federal Council of Churches of Christ in America and the New York Academy of Medicine," initially focused on the role of "spirit," only later getting around to recognizing the role of "soul." One of Mrs. Hoyt's close friends at the Academy spoke of "a veritable and potent force in these specific emotional states associated with religious experience," and of "the importance that its use in modifying bodily functions be intelligently guided."19 The medical chair of the Joint Committee spoke of "Expectant emotion" as favoring "'the healing power of Nature'."20 Mrs. Hoyt's notes for a presentation quote a Professor Pupin's view of the role of "Purpose" and "Partnership" as "Stimulants" as well as of "Symbols" as "Tonics"; the general thesis asserted that "the symbolism of faith and purpose may arouse latent possibilities of power."21 The Joint Commission on Christian Healing in the Episcopal Church, of which Dunbar became one of the thirteen members, no doubt through the intercession of Mrs. Hoyt, similarly declared that "Effective prayer has the effect of a potent tonic; it vitalizes and energizes the whole personality of man."22 That is, as the Joint Committee was being organized, the original emphasis was upon the more dynamic role of inspiring and inspiriting in the encouragement of health.23

    Once the Federal Council's "Subcommittee on the Relation of Religion to Health" had decided to join forces with the Academy's "Subcommittee on Religious Healing," the Joint Committee then found it hard to find "a clergyman with special interest in this field whose main emphasis in religious therapy was distinctly religious and not some form of amateur psychiatry."24 The irony, of course, is that what they did find was an unordained woman who was trained as a psychiatrist. As their official history tells the story: "In 1929 the [Joint] Committee became interested in Dr. Helen Flanders Dunbar, who had been working in the field of psychosomatic relationships for five years, first as a part of her studies for the degree of Doctor of Philosophy at Columbia University, then in connection with her Bachelor of Divinity degree from Union Theological Seminary and her . . . [Doctor of Medicine degree from] the Yale University School of Medicine."25 Now, it just happens that Dunbar had attended Brearley School and Bryn Mawr College with one of Mrs. Hoyt's daughters, and that both Dunbar's parish priest and one of her seminary professors were members of the Joint Committee.26 Returning now to their own narrative, "While she was continuing her work in Europe [in 1930, as her fourth year of medical school] she undertook to make certain studies at Lourdes and other healing centers for the [Joint] Committee [returning to Lourdes in 1933, again on behalf of the Joint Committee]."27 Let me interrupt again to note that, upon returning from Europe, she promptly became, in September 1930, "Medical Director," and later, "Executive Director," of the "Council for the Clinical Training of Theological Students," the program in pastoral education founded by her teacher, friend, and colleague, the Rev.Mr.Anton Theophilus Boisen. I should add that while Boisen was organizing his pastoral education program in the late 1920s, Mrs. Hoyt was attempting to place "certain Seminary students from Union [Theological]," where Boisen had trained and Dunbar was training, "at Stockbridge," that is, at the Austen Riggs Foundation, a private psychiatric hospital in Massachusetts.28 In addition, she was trying to get "the Human Welfare Group at Yale," where Dunbar was also studying, commuting between New York and New Haven, pulled in with the Academy of Medicine and the Federal Council of Churches as a third constituent of the Joint Committee.29 Returning again to the Joint Committee's own narrative, "In April, 1931, a year after her return, she [, Dunbar,] was appointed Director of the [Joint] Committee's work on a part-time basis."30 Actually she had already, during the opening months of 1931, been supervising the Joint Committee's preliminary "Study Project in Religious Healing" along side her own research on "physiological changes accompanying emotions."31 During the year between her studies in Europe, where she audited lectures at Vienna's Psychiatric-Neurological Hospital while serving as "Assistant" at Zurich's Burgholzli Clinic, meeting with Carl Jung nine times, and her assuming the leadership of both the Council for Clinical Training and the Joint Committee, Dunbar completed an internship in medicine, arranged by Mrs. Hoyt through the help of her husband and others, at Columbia Presbyterian.32

    So who was this amazing "Dr. Helen Flanders Dunbar," who earned two bachelor's degrees and ultimately three doctorates by her mid thirties? To begin with, she was someone who agreed with the Joint Committee's initial assumption about the preeminent role of stimulating the "spirit" in helping to maintain health. An early manuscript of hers speaks of religion as "giving man power for the accomplishment of his ideals," and she certainly managed to accomplish more of her ideals than the average mortal.33 There is no doubt, however, that she understood even this simple sentiment as having more complexity than the average Joint Committee member could have grasped. Every aspect of Dunbar's history thus far touched has turned out to be quite complex, and we await additional insights gleaned from materials gathered by her daughter and the Rev.Dr. Allison Stokes.34

    Thirty years ago I wrote, "Dunbar was a physician. She was also a woman with a mission . . . and with a mask, a persona progressively concealing her person."35 Five years later I wrote, "Who was Dunbar? That is a question even her closest colleagues asked and could not answer. No one knew . . . . [One] close associate has commented that 'after more than a generation of reflection,' Dunbar still remained to him basically an enigma. Some colleagues recall, without being able to account for it, the 'sense of mission' with which she inspired them, while others recall little but enmity toward her for reasons equally obscure."36

    In brief, Dunbar was born in Chicago to an electrical engineer/ mathematician/ patent expert and to an ardent feminist/ translator/ genealogist. Her father withdrew and retired at age forty-six, moving Helen and her younger brother back to the ancestral territory near Manchester, Vermont, where Helen's overprotective mother, her strong-willed maternal maiden aunt, and her deeply religious grandmother, set the tone. Dunbar grew up more at home with books than with people. Following an erratic early education peppered with tutors, she studied at Brearley and Bryn Mawr with mother and brother in tow. During her years at Bryn Mawr, the then shy, unsophisticated Dunbar came under the influence of her maternal uncle's wife, who taught her the basic social graces and made it a point to introduce her to those listed in the New York Social Register, of Professor James Henry Leuba, a psychologist of religion, who proposed systematic "collaboration of religious idealism with science," and of the writings of fourteenth century poet, Dante Aligheri, who argued that religion and science were not antagonistic but complementary.37 Dunbar's first doctoral thesis took Dante's notion of complementarity entirely seriously, seeing his Divine Comedy -- and the world -- as interpretable "at one and the same time on different levels," these interpretations being "so closely interrelated that each is corrected by the other and that all are blended into an harmonious whole."38 This Dantean viewpoint, embracing multiple, simultaneous, complementary interpretations, was to guide Dunbar's intertwined medical/religious approach to the study of emotions and bodily changes.

    So, Dunbar, finally graduating from her simultaneous enrollments at Union, Columbia, and Yale, became Director of the Joint Committee on Religion and Medicine in April 1931, but the committee itself had studied widely, spending eight years refining and expanding its grasp of the "religious healing" problem. The original meeting at the Hoyts' in 1923 had included plans for "Rest and Convalescent Homes," where "tired people" could go for "physical re-creation, mental re-education, and spiritual re-generation."39 While the Joint Committee did not take any such homes under its wing, leaving their private establishment to Mrs.Hoyt and her friends, it did endorse the idea of such so-called "preventoria."40 Similarly, Mrs. Hoyt's above cited notes for a presentation also quote a Professor Pupin's view of the role of "Peace" and "Trust" in providing "Sedative " effects as well as of "Faith" in providing a "Stabilizer" effect.41 The Joint Committee was beginning to recognize that, beyond examining the more dynamic inspiriting, stimulating "motives which will make life worth living," it needed to examine the more holistic, organismic rest, repose, and calming which go toward "modifying the fears" associated as either cause or effect of most illness or disease.42

    The Joint Committee commissioned a research psychologist, Alice E. Paulsen, PhD, to review the principles apparently operant in contemporary religious healing. Her original outline noted, among the "Techniques for making faith more effective," the "reinforcement of rest and relaxation through prayer, meditation, suggestion, and visualization."43 Her final report gave considerable space to the work of the Rev.Dr. William Thomas Walsh, who in early 1931 had worked on the wards under Dunbar's supervision.44 Walsh, Paulsen noted, "states that there is in the Bible abundant evidence of a very definite technic of healing used by Jesus," which was, in essence, creating the conditions that make rapport possible.45 Walsh saw prayer as "the means of getting yourself into the state where you can receive God," and he believed in working hand-in-hand with a patient's physician "in order to get the conditions requisite to the working of divine power."46 In the conclusion of her formal report, endorsed and disseminated widely by the Joint Committee, Dr. Paulsen noted that "Each [healing] system in some way introduces the idea of cure or health after preparing the mind through one means or another [-- generally, "rest and relaxation" --] to accept it . . . ."47 With this study in hand, about one year before Dunbar assumed control, the Joint Committee "proposed that a study shall be made . . . not only of the more specific treatment of disease by spiritual means, but of the therapeutic values of the various forms of worship -- liturgy and hymnody, the exercise of private devotions and the contemplation of religious symbols and architecture."48 The die was set that they would study both spiritual stimulation and soulful repose.

    Once Dunbar was officially in charge, she conducted, with four clergymen, "a preliminary study at Presbyterian Hospital, purely empirical in nature, based on the hypothesis that exposure to religion might prove valuable to the patient. . . ."49 The only restriction the Joint Committee placed upon her work was "that it should be carried on, as hitherto, without publicity of any kind."50 Whereas "isolated cases," primarily patients with cardiac and ulcer problems had been used earlier that year in her observations of the effects of the more soulful, rapport enhancing ministrations by the Rev.Dr. Walsh, Dunbar now proceeded systematically, adding, for what she and others thought would be a control group, "certain types of surgical patients, particularly those who are confined in hospitals for long periods of time, such as [patients with] fractures of the head of the femur."51 The patients were divided "into two groups of a more or less similar type, the one to be treated in the usual [medical] way, and the other with the aid of a clergyman's ministrations."52 Her plan was to determine "what contribution, if any, the stimulation of religious faith might make in . . . . [the] 62 patients treated simultaneously by clergymen and physicians."53 Those assigned to the clergy were seen an average of eight times, and one of the ministers involved suggested that while his inspiriting ministrations produced "no change in the process of getting well," they caused "an extraordinary acceleration of the process."54 Dunbar herself concluded that the clinical investigation of the effects of religious emotion, whether quieting, as in the first study, or invigorating, as in the second study, "was too complex for the present state of our knowledge," and that any further study "should be given background and perspective by a bibliographic survey."55

    In October 1931, Dunbar defined the aim henceforth of the Joint Committee. Whereas a draft forwarded to her suggested that the aim should be to determine "what contribution, if any, religious faith can make in the maintenance of health and the healing of disease" and "under what conditions cooperation between physicians and clergymen may be effectively carried on," she broadened yet focused the scope as follows: "This committee proposes to investigate the border territory between religion and medicine, in other words, to study the problem resulting from the dichotomy of psyche and soma [,] with a view to a better understanding of the integrating forces and of the psycho physiological organism as a whole."56 The original draft supplied to Dunbar suggested that the committee focus on what unique contribution the minister may "contribute as a clergyman," as one "who believes that through religious faith we are brought into contact with cosmic forces . . . , and who uses his contact with the patient to induce in him an attitude which may make the resources of this faith available."57 Dunbar, rephrasing this in her even more poetic language, proposed that they try "to distinguish by careful experiment and observation" the "influence of a personality, of an atmosphere, of a symbol," on "restoring, mobilizing, or accelerating the healing processes as we know them," and specifically the influence of these on "reinforcing . . . that most indispensable and unaccountable of all our therapeutic resources"[:] "rest itself."58 Thus, again, the juxtaposition -- albeit this time, via Dunbar, more of a melding -- of the invigorating and the calming, the spiritual and the soulful.

    "While the primary purpose of our Committee," suggested the draft, "is research, its ultimate purpose is education."59 Dunbar herself further asserted that progress required "both research in the sphere of relationship of psyche and body and actual experiment in cooperation between physicians and clergymen."60 Thus Dunbar's roles, as director of what she now called "psychosomatic research" at Columbia Presbyterian and as medical director of the Council for the Clinical Training of Theological Students, were subsumed under her directorship of the Joint Committee on Religion and Medicine.

    The two divisions of the Joint Committee -- research and education -- were held together by Dunbar's overarching Dantean vision. In the opening pages of her first doctoral thesis, the magisterial Symbolism in Medieval Thought . . . (1929), she suggested that "nothing is more needed by the student of disorders of the human mind" -- that is, the psychiatrist -- "than a thorough study of the development of insight symbolism."61 By "insight symbol" Dunbar meant those special symbols -- almost "alive" -- which invite "continual re-creation and expansion" of meanings, in which "all meanings are true" and "are often all intended at once" -- reaching "out toward the supersensible," toward "a reality . . . greater and truer than the symbol in all its aspects."62 She considered such symbols as mediators between a person's inner and outer worlds, both physical and psychological.63 In a letter dated September 21, 1929, she confirmed that she was, indeed, "writing the thing [, a new version of her dissertation,] in psychiatric terms."64 This, I asserted thirty years ago, essentially became "Part One" of Emotions and Bodily Changes . . . (1935), the book whose publication was arranged by the Joint Committee and that essentially launched the American psychosomatic movement.65 "Part One" can, indeed, be seen as addressing the object of symbolism; in medical/psychiatric terms, Dunbar called this the "working out of the individual's relationship to his [or her] particular environment and personal problems"; in religious terms, invoking Dante, she called this the working out of the individual's "adjustment to the Infinite."66 While "Part One" of her first psychiatric classic thus constitutes a carefully albeit subtly argued treatise on "the organism as a whole" -- the mind-body functioning as a symbol -- and "Part Two" is straightforwardly a bibliography, a ". . . Survey of Literature on Psychosomatic Interrelationships: 1910-1933," as the book's subtitle declared, "Part Three," mentioned frequently in the Joint Committee's minutes as a bibliography on "the relation of religion to health," as "a factor in directing and controlling emotion," did not appear.67

    As early as 1931 and as late as May 1934, two of Dunbar's secretaries were working on "the religious section of the bibliographical survey," and the Joint Committee employed the Rev.Dr. John W. Suter, a board member of the Council for Clinical Training, to produce the final manuscript, but "Part Three" never saw the light of day.68 As I have discussed in greater detail elsewhere, the missing religious, symbolistic part did appear later, in essence, as a volume by Boisen's successor at Worcester State Hospital, the Rev.Dr. Carrol A. Wise.69 When Emotions and Bodily Changes appeared in print in June 1935, hardly one word concerned religion.70 The following November, Dunbar reported to the Joint Committee her conclusion that "Religion itself, no matter how understood, is not a common element" in most "religious healing," and that religion, "So far as we have been able to determine," "is not essential to the healer, to the patient, nor to the setting."71 Nonetheless, she noted that "through the Council [for Clinical Training,] and through our clinical research projects we are accumulating relevant data" concerning "how religion fits into the psychosomatic regime . . . ."72

    Let me emphasize, at this point, that while Mrs. Hoyt, understandably, became as furious as such a genteel woman could upon digesting Dunbar's conclusion that religion was not essential to religious healing, we should not assume that Dunbar meant her conclusion in any negative way. Even the Rev.Dr. Edward E. Thornton, an earlier historian of the clinical pastoral education movement, who, overall, certainly does not idolize Dunbar, nonetheless notes his findings that those working side-by-side with Dunbar "were loyal to her because of her intense commitment to the cause of relating the clergy to physicians in a constructive way and because of her genuine religious interest."73

    Dunbar's religious -- or, perhaps, Dantean -- interest showed itself in a most peculiar way in late 1935. Mrs. Hoyt circulated a letter suggesting that, since "Helen Dunbar has so many extraordinary qualities and so much ability," perhaps "she should be released as far as possible from all the complications of administrative and directing activity and devote her time to the medical side of research . . . for which she is so uniquely well suited."74 Thus damned with praise, Dunbar was removed from her role as Director of the Joint Committee, which was itself dissolved into its original non-joint components. Then, much to Mrs. Hoyt's horror, the possibly infidel Dunbar managed to reconstruct her power base almost exactly as it had been before. Dunbar arranged to have representatives from the Academy of Medicine and the Federal Council of Churches appointed to her executive committee at the Council for Clinical Training, and arranged to have her personal secretaries accepted as representatives to the Academy and the Federal Council. Dunbar herself became "consultant" to the Academy's new "Subcommittee on Emotions, and her "executive secretary" within the Council for Clinical Training organized the Federal Council's new "Subcommittee on Religion and Health." Thus, within the space of only several weeks, Dunbar managed, as Mrs. Hoyt noted with alarm, to "again be virtually head of both Medical and Religious committees. . . ."75 The status quo was thus maintained, with both religious and medical aspects of the original project continuing to be run out of Dunbar's office. The primarily educational arm of her work, The Council for the Clinical Training of Theological Students, later renamed just "The Council for Clinical Training," expanded aggressively into new settings, and the primarily research arm of her work, the psychosomatic medicine division at Columbia, embarked on one of the world's first large scale studies, ultimately involving over 1,600 patients.76

    So, again, who was this amazing "Dr. Helen Flanders Dunbar," who felt driven to maintain complementary religious and medical programs side-by-side as she explored "emotions and bodily changes"? While she agreed, as we have noted, with the Joint Committee's initial assumption about the preeminent role of stimulating the "spirit" in helping maintain health, she came to place equal emphasis on the importance of quieting the "soul." A later manuscript of hers speaks of "creating an atmosphere of quiet concentration and rapport" and she certainly was a master at putting people at ease.77 There is no doubt, again, however, that she understood even this simple skill as having more complexity than the average Joint Committee member could have grasped. Every aspect of Dunbar's history thus far touched has turned out to be quite complex, and her consummate skill with patients, her "magnetic, charismatic" capacity for empathic connection, has been called seductive when its use with foundation heads and department chairs allowed her to get whatever she could want, as she pursued her far-ranging studies of emotional, soulful, spiritual integration.78

    Dunbar made at least three visits to the healing shrine in southern France at Lourdes. It was there that she seems to have had her first inkling of the complementarity of what I am calling the "spiritual" and more "soulful" aspects of religious emotion. Her 1934 article on Lourdes called these aspects "confidence" and "contentment".79 Taking her cue from the nurses and stretcher bearers at Lourdes, Dunbar noted that, of patients visiting the shrine, those overcome by hysterical excitement as well as those merely waiting for a miraculous cure were not the ones to return home feeling well. Patients achieving the most success were those who became able, with "deep confidence and quiet," to go about their day, helping themselves and others.80 That is, both spiritually and soulfully, they had become emotionally "free to think and act."81

    If Dunbar was what I have called a "practical theoretician," "a woman with a mission," her focus regarding illness was on prevention and effective intervention. As you may recall, the era's initial confusion about healing efforts within the church had quickly developed into an implied distinction between

    (a) the remedial stance of curing illness and

    (b) the more preventive stance of maintaining health.

    While Dunbar's early patroness, Mrs. Hoyt, saw a preventive rather than a curative focus as helping physicians feel more comfortable with the clergy, and while a Joint Committee document encouraged "affirmative . . . thinking and praying . . . as a preventive measure" counteracting "early tendencies to disease," it was Dunbar herself who carried this distinction the farthest.82 She saw this "public health" approach of maintaining health in order to prevent disease as one of the major reasons for encouraging cooperation between religion and medicine. She considered her research on mind-body interaction and integration as highly practical, as providing knowledge relevant to physicians' practice albeit disseminated through the clergy. The pastor, she noted, "has the opportunity to spot the first signs of incipient disease, physical or mental, before the parishioner has even realized the need of coming" to anyone for care.83 The pastor "should not forget," she admonished, that he or she "is the one officer of health who is welcome in these homes before illness has developed."84 While acknowledging the glamour of trying to cure, she hoped to impress upon the clergy that "an important part" of their mission is "to prevent disease of body and spirit."85 Clinically trained clergy, she envisioned, could "fill an important part in preventive medicine."86

    Dunbar considered the clergy's "public health function" as extending beyond the mere finding of "cases." She saw belief, perhaps especially religious belief, as "the unifying power in personal life," "mediating relationships of our internal physiological world to the external world at large," and clergy as uniquely qualified to focus upon and clarify beliefs.87 Notice, by the way, her careful combination of words -- "unifying power" -- suggesting the amalgam of soulful and spiritual elements in one concept -- which she had spoken of elsewhere as the almost living, breathing, -- organismic -- "insight symbol." The pastoral task, as she viewed it, was in helping men and women "in their adjustment to their total environment, outer and inner."88 To carry out this role, clergy had to gain an appreciation of scientific method and study firsthand what her colleague, Boisen, called "living human documents," the actual stories of men and women in triumph and in distress.89 She insisted on calling the programs they developed "clinical" rather than "pastoral" training because then existing courses in "pastoral theology" focused on telling the theologue "what to do" rather than "giving the student opportunity for adequate contact with the human being whose problems he [or she] is discussing."90 Dunbar viewed the Council for Clinical Training "not only as a movement in education" but "as a laboratory . . . from which guidance may be expected."91

    Above I spoke of the Council for Clinical Training as primarily the educational arm of Dunbar's work, and of her large scale studies of psychosomatic illness as primarily the research arm of her work. I said "primarily" in each case because each had a second, complementary, function. Just as she saw clinical pastoral education as a research environment exploring how clergy might best interact with their parishioners, she saw psychosomatic research as an educational opportunity for teaching patients and doctors about mind-body interaction. Dunbar, driven by her overarching Dantean vision, can be seen as a major stimulus in the development of the entire combined field. Her focus on "the border territory between religion and medicine," on "the problem resulting from the dichotomy of psyche and soma," led us all to "a better understanding of the integrating forces and of the . . . organism as a whole."92 The evolving, crisscrossing spirals of education/ research/ education/ research and religion/ medicine/ religion/ medicine, which finally led to the current rediscovery of mind-body interaction in medicine, initially had far more impact on religion, creating the clinically-based pastoral disciplines that we know today.

    As author of a history of clinical pastoral education, I am well aware of and have worked with several of the national associations that have developed across the last seventy years. Within the fields of professional chaplaincy, pastoral counseling, and pastoral psychotherapy, however, the College of Pastoral Supervision and Psychotherapy has uniquely chosen specifically to encourage a return to the fields' roots in the work of Anton Boisen and Flanders Dunbar. Trying to retrieve something that once was lost but now is found, the CPSP Diplomates see themselves as "spiritual pilgrims," and the CPSP Covenant speaks of them as specifically dedicated to the "recovery of soul."93 Just as these serious men and women might find it hard to pin down exact definitions of their phrases "spiritual pilgrims" and "recovery of soul" -- which may be why they chose these phrases -- I, too, am perfectly aware that my reification in this essay of an era's and Dunbar's implied distinction between "spiritual" and "soulful" is a bit stretched and certainly not perfect. Nonetheless, there is a distinction to be made. Perhaps it is the distinction between a more active stance and a more passive stance -- a "doing" and a "being" -- without any implication that one is better than the other. If the "spiritual" suggests, at least to me, the more inspiriting, as in "Onward Christian Soldiers!" and most Hanukkah music, then the more "soulful" suggests, at least to me, solitude, rest, and receptivity, as in "Rock of Ages," and most High Holidays' music.

    As I have noted elsewhere, it may be time for the College of Pastoral Supervision and Psychotherapy -- and the broader pastoral fields in general -- to rediscover the inspiriting virtues of remaining "Still Crazy After All These Years," adding these to their ongoing "recovery of soul."94 The true legacy of the Rev.Mr. Anton Theophilus Boisen, I have suggested, may be the courage to espouse beliefs not initially shared by others.95 The founding years of CPSP will most likely be remembered for their insistence that a soul was a terrible thing to waste. A legacy of Dr. Dunbar --BD, MD, PhD, MedSciD -- let me propose, may well be the willingness to tackle the apparently impossible task, of integrating the spiritual and the more soulful. Remembering Dunbar is to remember that much work lies ahead.

    Without being explicit about it, CPSP members seem to have adopted Dunbar's liberating emphasis on becoming "free to think and act," applying it as much to their colleagues as to their patients and parishioners. Dunbar's basic approach was to try to set the person's mind at ease, "to help the patient get into condition to think for him[or her]self," and only then to give the person encouragement in solving his or her own problems.96 A recurrent theme throughout Dunbar's writings is that "few patients need to be given advice as to what to do when once they are emotionally free to think."97 In her master's thesis, seventy-five years ago, she noted that the true reformer must be "like the man in Plato's Allegory of the Cave who knew that his chief task was to turn the prisoners [watching shadows on the back of the cave] around [,] so that they could face in the direction of the sun" and the real-world sources of the shadows.98 We need only, she believed, to show patients or parishioners "the way out"; once they see the path "clearly before them," she believed, "they can be trusted to take it . . . ." "The ideal patient," in her view, was "the one who can proceed down the road to health on his [or her] own two feet -- with guidance but without having to be dragged or carried."99 You do not have to change many words to see this as, in essence, the approach to helping "spiritual pilgrims" in their "recovery of soul" that CPSP has tried to bring to the clinical pastoral fields. There are here, too, however, complementary, potentially crisscrossing spirals of soulful thought and inspiring action as we enter the new century.

    The year 2000 will mark the seventy-fifth anniversary of clinical pastoral education and the tenth anniversary of the College of Pastoral Supervision and Psychotherapy. What began in 1925 with three students -- Boisen always called Dunbar "the first" -- expanded within Dunbar's overarching vision to become an epoch making movement worldwide in theological education and religious practice.100 In closing, let us stop for a moment and try to imagine a world without professional chaplains, pastoral counselors, or pastoral psychotherapists. Let us try to imagine a field of clinical pastoral education without the "return to Boisen and Dunbar" that CPSP has tried to provide. In the fascinating area of healing and wholeness, where religion and medicine overlap, we have now begun honoring Helen Flanders Dunbar, psychoanalyst and Dantean scholar, for her contributions to religion as well as to medicine.


    Robert Charles Powell, M.D., Ph.D., a psychiatrist and historian, gratefully acknowledges that much of the research herein reported was conducted under the tenure of a fellowship from the Josiah Macy, Jr. Foundation and under US-PHS Training Grant TO 2 MH 05972-17. He may be contacted at 847/ 441-8283; 1520 Tower Road, Winnetka, Illinois, 60093-1627.


  • 04 Apr 2002 9:20 PM | Perry Miller, Editor (Administrator)


    1. Marcia Dunbar-Soule Dobson, Dr. Dunbars daughter, quoted in G. Allison Stokes, "Dunbar, Helen Flanders," Notable American Women: The Modern Period, Barbara Sicherman, and Carol Hurd Green, editors, Cambridge, MA: Harvard University Press, 1980, pp.210-212, p.211. Ms. Dobson is Professor of Classics at Colorado College, Colorado Springs, Colorado.

    2. She went by the purposely ambiguous name "H.Flanders Dunbar" between July 1929 and December 1939, and then changed her name legally to "Flanders Dunbar."

    3. Robert Charles Powell, Anton T. Boisen (1876-1965): "Breaking an Opening in the Wall between Religion and Medicine," pp.47, special supplement to the AMHC Forum 29(1), October 1976 (The Association of Mental Health Clergy is now part of the Association of Professional Chaplains since merger in May 1998 with the College of Chaplains.)

    Robert Charles Powell, Healing and Wholeness: Helen Flanders Dunbar (1902-59) and an Extra-Medical Origin of the American Psychosomatic Movement, 1906-36, PhD dissertation, Department of History (Medical Historian Training Program) Durham, North Carolina: Duke University, 1974, [reprint available via University Microfilms, order # 75-2415, on the internet at]

    Robert C. Powell, "Helen Flanders Dunbar (1902-1959) and a Holistic Approach to Psychosomatic Problems. II. The Role of Dunbar's Nonmedical Background," Psychiatric Quarterly, Summer 1978, Vol.50, No.2, pp.144-57.

    4. H. Flanders Dunbar, Symbolism in Medieval Thought and Its Consummation in the Divine Comedy. New Haven: Yale University Press,1929; equals her PhD dissertation, New York: Columbia University,1929; reprinted, New York: Russell and Russell, 1961; reprinted again, Atlanta, GA: SOLINET,1994.

    5. "What Happens at Lourdes? Psychic Forces in Health and Disease." Forum, 1934, Vol.91, pp.226-231. The word "free" is italicized in the title of this essay because Dunbar italicized it in the phrase "free to think and act" on page 1 of this article.

    6. Psychosomatic Medicine was founded by Dunbar in 1939 with the assistance of the Josiah C. Macy, Jr. Foundation and the National Research Council; she remained editor-in-chief until 1947; in 1942 the advisory board of the journal voted to form a sponsoring organization, the "American Society for Research on Psychosomatic Problems," which in 1948 was renamed the "American Psychosomatic Society."

    7. Flanders Dunbar, Your Childs Mind and Body: A Practical Guide for Parents. New York: Random House, 1949.

    Flanders Dunbar, Mind and Body: Psychosomatic Medicine. New York: Random House, 1947; as a "Book-of-the-Month Club" selection, this had numerous printings; a "new, enlarged" edition was issued in 1955.

    8. H. Flanders Dunbar, Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships: 1910-1953, 4th edition. New York: Columbia University Press, 1955; reprinted, New York: Arno Press, 1976; the 1st edition, 1935, covered 1910-1933; the 2nd edition, 1938, had some additional editorial material; the 3rd edition, 1946, covered 1910- 1945.

    9. Flanders Dunbar, Psychiatry in the Medical Specialties. New York: The Blakiston Division, McGraw-Hill Book Company, 1959.

    10. Dunbar, "What Happens at Lourdes?," p.226.

    11. Flanders Dunbar, Your Pre-Teenagers Mind and Body, edited by Benjamin Linder. New York: Hawthorn, 1962.

    Flanders Dunbar, Your Teenager's Mind and Body, edited by Benjamin Linder. New York: Hawthorn, 1962.

    12. Definitions:

    Spirit - [Hebrew, "ruach"] - "the animating or lifegiving power of which persons are the recipient"; "Gods dynamic and creative activity."

    Soul - [Greek, "psyche"; compare to the Hebrew, "nephesh"] - "a divine substance within the human construct"; "an intrinsic part of personhood"; "it embraces the whole of [a persons] existence."

    When I first drafted this manuscript I was dealing exclusively with materials from the 1920s and 1930s. Only later did I properly appreciate the need to ensure a correspondence between how these terms were used in that earlier era and how they would be appreciated today. The definitions here quoted are from Raymond J. Lawrence, Jr., The Poisoning of Eros: Sexual Values in Conflict, New York: Augustine Moore Press, 1989, pp.7, 6 (on the internet at Chaplain Lawrence, too, had to deal with the problem of consistency of meanings across many years, and, having checked with three theological dictionaries, I believe his careful definitions would be comfortable with Dunbar and her colleagues as well as current readers.

    After completion of this manuscript, a brochure came in the mail describing a course on "Spirituality & Healing in Medicine," to be given 19-21 March 2000, "Under the Direction of Herbert Benson, MD." The "Course Description" notes research establishing "that when a person engages in repetitive prayer, word, sound or phrase and when intrusive thoughts are passively disregarded, a specific set of physiologic changes ensue. . . . These changes . . . have been labeled the relaxation response." The description then goes on to note later research establishing "that people experience increased spirituality as a result of eliciting this state [-- the relaxation response --] regardless of whether or not they used a religious focus. Spirituality was expressed as experiencing the presence of a power, a force, an energy, or what was perceived of as God and this presence was close to the person. Furthermore, spirituality was associated with fewer medical symptoms." (italics mine)

    As you will note, Benson uses the term "spirituality" much the same as did Dunbar and her colleagues of the 1920s-1930s. However, whereas the earlier group saw soulfulness/ relaxation as enhancing ones receptiveness to the spiritual, Benson and colleagues apparently see it the other way around, with the spiritual enhancing ones potential for achieving soulfulness/ relaxation. Dunbar herself seems to have seen these as going hand-in-hand, with, if anything, the soulful encompassing the spiritual, which, one could argue, comes closest to the more classical theological view.

    13. H.Flanders Dunbar, "Medicine, Religion, and the Infirmities of Mankind," 1934, Mental Hygiene, Vol.18: 16-25, pp.19-20.

    14. Robert C. Powell, "Mrs. Ethel Phelps Stokes Hoyt (1877-1952) and the Joint Committee on Religion and Medicine (1923-1936): A Brief Sketch." Journal of Pastoral Care, 1975, Vol.29, No.2, pp.99-105.

    15. Ethel P.S.Hoyt, letter to Dr. Slattery, 5 September 1922, in folder "Religious Healing, 1923," File A, Drawer 1, Association for Clinical Pastoral Education Archives.

    Since I did my original research in the 1970s, the ACPE Archives have moved at least twice. As best I can tell, the files to which my notes refer are now housed as follows: "Records, 1930-1986 - Series VIII: Related organizations. Record Group No.001 (Formerly Yale Divinity Library MSS 71) F. Miscellaneous Other Organizations, 226 3409 through 226 3416," Archives and Manuscripts Department, Pitt Theology Library, Emory University, Atlanta, GA; these are indexed on the internet at

    16. Helen Van Voast and Ethel P.S. Hoyt, "History of the [Joint] Committee on Religion and Medicine of The Federal Council of Churches of Christ in America and The New York Academy of Medicine, 1923-1936," ?1936, p.1, in folder "Religious Healing, 1923," ACPE Archives.

    17. Van Voast and Hoyt, p.2

    18. Ethel P.S.Hoyt, letter to Dr. E.H. Lewinski Corwin, 23 July 1923, in folder "Religious Healing, 1923," File A, Drawer 1, ACPE Archives, p.2.

    Ethel P.S.Hoyt, letter to Dr. E.H. Lewinski Corwin, 24 October 1924, in folder "Religious Healing, 1923," File A, Drawer 1, ACPE Archives.

    19. E.H. Lewinski Corwin, October, 1923, quoted in Van Voast and Hoyt, p.3.

    20. Frederick Peterson, "Mind, Religion, and Medicine," in Contributions to Psychiatry, Neurology, and Sociology Dedicated to the Late Sir Frederick Mutt, J.R. Lord, editor. London: H.K. Lewis, 1929, pp.37-44, p.38.

    21. Ethel P.S. Hoyt, "Points of Contact: Notes on Religion as a Factor in Maintaining Health and Curing Disease," p.1, 27 December 1925, in folder "Religious Healing, 1923," ACPE Archives.

    22. "Report of the Joint Commission on Christian Healing in the Episcopal Church," Journal of the General Convention of the Episcopal Church, 1931, pp.557-558.

    23. Just before presenting this lecture that I realized that the contrast here proposed between "spiritual" and "soulful" notions in Dunbar's religious thought paralleled the contrast between "dynamic" and "organismic/ wholistic" notions I had documented twenty years earlier in her medical thought.

    Robert C. Powell, "Helen Flanders Dunbar (1902-1959) and a Holistic Approach to Psychosomatic Problems. I. The Rise and Fall of a Medical Philosophy," Psychiatric Quarterly, Summer 1977, Vol.49, No.2, pp.133-52, p.136: "during the 1930s the dynamic mode [of psychosomatic theory] . . . emphasized psychical forces, etiology, specificity, and a focus on the past, e.g., psychogenesis; . . . the organismic, correlational mode . . . emphasized functions, meanings, and wholes -- such as character and constitution -- plus a focus on the future, e.g., purpose, prognosis, and prevention. It might not be too simplistic to say that the . . . [one] focused on the mind, . . . and the . . .[other] on the patient as a whole." Just after finishing my talk, a gentleman from the audience suggested that many disciplines were exploring this kind of contrast during the era between the two world wars.

    24. Van Voast and Hoyt, p.7.

    25. Van Voast and Hoyt, p.7

    26.Powell, Healing and Wholeness, pp.117-118, 88, 114; she majored in mathematics and psychology, but took most of the premedical curriculum; the Rev.Dr. W. Russell Bowie was rector of Grace Church in New York, an outpost of the "Emmanuel Movement" for "medically supervised religious psychotherapy." (See also, Robert Charles Powell, review of Sanford Gifford, The Emmanuel Movement (Boston, 1904-1929): The Origins of Group Treatment and The Assault on Lay Psychotherapy. Boston: Francis A Countway Library of Medicine/ Harvard University Press, 1997. in Bulletin of the History of Medicine, 1999, Vol.73, No.2, pp.345-346.); the Rev.Dr. William Adams Brown had her in at least two courses and one tutorial.

    27. Van Voast and Hoyt, pp.7, 10.

    See, also, Robert Charles Powell, C.P.E.: Fifty Years of Learning, through Supervised Encounter with "Living Human Documents." booklet, 32pp. New York: Association for Clinical Pastoral Education, 1975, reprinted, 1987; reviewed in J.Pastoral Care, 1982, Vol.36, No.4, p.210.

    28.Harrison Elliot [Professor, Union Theological Seminary], letter to Mrs. J.S. Hoyt, 10 March 1925, in folder "Religious Healing, 1923," ACPE Archives.

    29. [?J.A.Hartwell?], letter to Mrs. John Sherman Hoyt, 13 December 1929, in folder "Religious Healing, 1923," ACPE Archives

    30. Van Voast and Hoyt, p.7

    31.[Joint Committee on Religion and Medicine] "Notes on Plan and Procedure of a Study Project in Religious Healing to be Conducted under the Auspices of the Joint Committee on Religion and Medicine" [1930-31], in Seward Hiltner, "Commission on Religion and Health -- Notes from 1923- materials to 1935," 1939, ["Notebook"] in the Federal Council of the Churches of Christ in America Archives, held by the National Council of the Churches of Christ in the U.S.A., New York, New York. H. Flanders Dunbar, "Presentation of the History and Accomplishments of the Committee on Religion and Medicine to the Public Health Relations Committee of the New York Academy of Medicine," 1935, in Hiltner Notebook.

    32. Powell, Healing and Wholeness, pp.100, 102, 118.

    33.Helen F. Dunbar, "The Medieval Mass in the West," typescript, n.d. [?1923-4?], Box 4, Folder 2, Mary Anita Ewer Papers, Cornell University Library, p.13.

    34. Allison Stokes, Ministry After Freud. New York: Pilgrim Press, 1985.

    35.Robert C. Powell, "Emotions, Bodily Changes, and Symbolism: A Study of the Major Influence upon Doctor Helen Flanders Dunbar's Early Medical Writings, 1932-1936," 1969, Trent Prize Essay in the History of Medicine, Duke University, Durham, North Carolina, p.2.

    36. Powell, Healing and Wholeness, p.79.

    37. Robert Charles Powell, "Dunbar, (Helen) Flanders," Dictionary of American Biography, Supplement Six, John A. Garraty, editor, New York: Charles Scribner's Sons, 1980 ,pp.180-181. See also, Powell, Healing and Wholeness, pp.79-105.

    James H. Leuba, The Psychology of Religious Mysticism. New York: Harcourt, Brace & Co., 1926, p.332.

    38. Dunbar, Symbolism in Medieval Thought, p.xi.

    39. Van Voast and Hoyt, p.2.

    40. Powell, Healing and Wholeness, p.217.

    41. Hoyt, "Points of Contact," p.1.

    42. Anton T. Boisen, "A Project for the Study of Certain Types of Mental Disorder from the Religious Standpoint," memo from Boisen to Galen M. Fisher, Executive Secretary, Institute for Social and Religious Research, 1923, in "Dunbar Materials," a box of manuscripts and other items deposited by the Dunbar Estate, Union Theological Seminary Library, New York, New York. While the quotes are from Boisen, they are characteristic of comments by Hoyt and Dunbar during the period.

    43.[?Alice Paulsen? Ethel Phelps Stokes Hoyt?] "A Suggestive Outline of Principles and Techniques to Promote Spiritual Health and Healing," not dated, but internal dating of this revision to at least 1939, catalogued in 1944 and filed under "Paulsen" in the pamphlet files of Union Theological Seminary Library, New York, New York.

    44. Alice E. Paulsen, "Religious Healing: Preliminary Report," Journal of the American Medical Association, 1926, Vol.86, No.20, pp.1519-1524, 1617-1623, 1692-97, p. 1621-1622; while called "preliminary," it was not revised and was distributed as a pamphlet.

    Dunbar, "Presentation," p.7; also the Rev.Drs. Thaddeus A. Cheatham, John A. Gardner, and Lyman R. Hartley.

    45.Paulsen, p.1621. William T. Walsh, Scientific Spiritual Healing. New York: D. Appleton, 1926, Chapter II.

    46. Walsh, pp.71, 105.

    47. Paulsen, p.1693.

    48."Trinity Dean [Percy . Kammerer] Seen as Faith Clinic Head: Academy of Medicine, Federal Church Council Unite in New York Project: Pittsburgh Divine Talked as Leader: Scientific Religious Center to Result from Study of Mind-Body Kinship," The Pittsburgh Press, clipping attached to telegram dated 3 March 1930, in Box 34, Federal Council Archives.

    49. Dunbar, "Presentation," p.7.

    50. [Joint Committee on Religion and Medicine] Minutes, Committee on Religion and Medicine, Medical Section, Committee on Public Health Relations, New York Academy of Medicine, New York, New York, 17 April 1931, p.48.

    51. [Joint Committee on Religion and Medicine], p.47.

    52. [?Committee on Public Health Relations?] Minutes, Executive Committee Meeting, New York Academy of Medicine, 21 November 1932, p.1.

    53. Van Voast and Hoyt, p.8.

    54. Dunbar, "Presentation," p.8.

    Thaddeus A. Cheatham, "Report to the Committee on Religion and Medicine: of the Religious Work at the Presbyterian Hospital and in the Vanderbilt Clinic: from July 3 through Sept.12, 1931," 1931, p.2, in Hiltner Notebook.

    55. Dunbar, "Presentation," pp.8-9.

    56.William Adams Brown, "Statement of Aim of The Committee on Religion and Medicine: prepared for clergymen and laymen," 1 December 1931, p. 1, Union Theological Seminary Library.

    H. Flanders Dunbar, "Prospectus (being a statement of the aim, scope, and work to date): Committee on Religion and Medicine, p.1, in Hiltner Notebook.

    57. Brown, p.1.

    58. Dunbar, "Prospectus," pp.1-2.

    59. Brown, p.2.

    60.H. Flanders Dunbar, "Aim and Scope: Committee on Religion and Medicine," File A, Drawer 1, ACPE Archives, p.2.

    61. Dunbar, Symbolism in Medieval Thought, p.10, fn.19.

    62. Dunbar, Symbolism in Medieval Thought, p.14, 11, 4.

    Helen Flanders Dunbar, "The Sun Symbol in Medieval Thought," Master's Thesis. New York: Columbia University, p.65.

    As an example of how insight symbolism gives "a glimpse of a beyond," Dunbar speaks of a "rock": "A geologist, or navigator charting a channel, will note on the map the conventional sign, thus using an arbitrary[-extrinsic] association symbol as a shorthand representation of the datum. The artist on the other hand may sketch the rock, or write a poem describing it in terms of other sense experience [,i.e., as a simile], which then becomes a descriptive[ intrinsic-comparison] symbol of the rock. Finally, the philosopher or the artist gifted with insight may look through the object to one or more deeper meanings, such as the stability of eternal law, and so use the rock itself as [a symbol proper, that is, as] an [interpretive, semblance or] insight symbol." Later, she adds even more possible deeper meanings: "It [the rock] may stand for Christ, as in the familiar hymn Rock of Ages; or it may exemplify that which each soul should be to its fellows, as Christ himself used the symbol with reference to Peter; or finally, the rock may mean the foundation of the heavenly kingdom." (The italicized and bracketed items are here added so that the passage may serve as a summary statement of Dunbar's comments on symbolism.) Symbolism, pp.8-9, 19-20, 11; "The Sun Symbol," p.4.

    63.H. Flanders Dunbar, "The Faith and the New Psychology," Living Church, 13 January 1934, pp.333-336, p.11.

    64.Helen [Dunbar], 21 September 1929, personal letter to Ted [Theodora Land], from Vienna, in the possession of Mrs. Theodora Land Wilson.

    65. Powell,"Emotions," p.11-22.

    66. Dunbar, Symbolism in Medieval Thought, p.10, fn.19.

    67. Van Voast and Hoyt, p.9. Powell, Healing and Wholeness, pp.239-241.

    Robert Charles Powell, "Whatever Happened to 'CPE' -- Clinical Pastoral Education?" keynote address honoring Anton Theophilus Boisen, delivered 18 March 1999, at the Ninth Plenary Meeting of the College of Pastoral Supervision and Psychotherapy, paragraph 7 (on the internet at

    68. H. Flanders Dunbar, "Confidential Report of the Director to the Committee on Religion and Medicine," 1 May 1934, p.5, in Hiltner Notebook.

    69. Powell, "Whatever Happened to 'CPE'," paragraph 7.

    The late Rev.Dr.Seward Hiltner, one-time secretary to Dunbar, later head of the successor to the Joint Committee, before becoming a statesman in pastoral theology, called the late Rev.Dr. Caroll A.Wise's book, Religion in Illness and Health (New York: Harper's Brothers, 1942),"the best and most complete description in print for the non-medical reader about psychosomatic interrelationships." Religion and Health. New York: Macmillan, 1943, p.276. Both books -- both authors -- are recommended to those enjoying the current essay.

    70. The word "religion" does appear three times and the words "religious" and "clergyman" each appear once on page 58, but without any great significance. The Joint Committee is alluded to very inadequately on page xv as "a subcommittee of the Committee on Public Health Relations of the New York Academy of Medicine." A footnote on page xxvi of the "Second Edition," 1938, did provide a little more credit to the Joint Committee, but not much: "'(1930-31) as the Committee on Religion and Medicine assisted in the initiation of this volume . . . . The work of this subcommittee led to the formation of a joint committee representing the Academy of Medicine and the Federal Council of Churches'"

    71. Dunbar, "Presentation," pp.19-20.

    72. Dunbar, "Presentation," p.21.

    73.Edward E. Thornton, Professional Education for Ministry: A History of Clinical Pastoral Education. Nashville: Abingdon Press, 1970, p.77.

    74. Mrs. John Sherman Hoyt, personal letter to Dr. William Adams Brown, 13 December 1935, in Hiltner Notebook.

    75. Powell, Healing and Wholeness, pp.243-244.

    [Mrs, John Sherman Hoyt], "Notes to talk over with Dr. Brown - December 12th, 1935," in Hiltner Notebook.

    76. Dunbar kept control of her whirlwind empire through the end of 1939, at which time complications arose in her personal life -- a divorce from her husband followed by her father's death -- and she was herself ready for a rest. She withdrew to an only slightly quieter, less complicated life. A second marriage brought her the joy of a daughter, and she published seven more books plus twice as many articles between 1939 and 1959. Overall, however, her last twenty years would have tried the patience of a saint.

    77. Dunbar, Psychiatry in the Medical Specialties, p.16.

    78.Stokes, Ministry After Freud, p.84, quoting from my 18 April 1973 interview with yet another of Dunbar's executive secretaries.

    79. Dunbar, "What Happens at Lourdes?" p.228.

    80. Dunbar, "What Happens at Lourdes?" pp.229-230.

    81. Dunbar, "What Happens at Lourdes?" p.226.

    82. [?Paulsen?] "A Suggestive Outline," p.[i].

    83.H. Flanders Dunbar, "The Clinical Training of Theological Students," Religion in Life, 1935, Vol.4, pp.376-383, p.379.

    84. Dunbar, "The Clinical Training," p.380.

    85.H. Flanders Dunbar, "Standards for Clinical Training of Theological Students," Bulletin of the American Association of Theological Schools, 1934, Vol.9, pp.68-80, p.80.

    86. Dunbar, "Confidential Report," p.11.

    87.H. Flanders Dunbar, "Mental Hygiene and Religious Teaching," Mental Hygiene, 1935, Vol.19, pp.353-372, p.370.

    88. Dunbar, "Mental Hygiene," p.370.

    89. For the oft-used phrase "living human documents" see Anton T. Boisen, The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience (Chicago: Willet, Clark & Co., 1936. reprinted, New York: Harper & Brothers, 1952, and Philadelphia: Univ.of Pennsylvania Press, 1971), p.185:

    ". . . I have 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."

    90.H. Flanders Dunbar, "Fifth Annual Report of The Council for the Clinical Training of Theological Students," p.4, in "Dunbar Materials."

    91. H. Flanders Dunbar, "Fourth Annual Report of The Council for the Clinical Training of Theological Students," p.4, in "Dunbar Materials."

    92. Dunbar, "Prospectus," p.7.

    93. On the internet at

    94. Robert C. Powell, "Anton Boisen and Theological Reflection: The Importance of Being 'Still Crazy After All These Years'," delivered at Chicago Theological Seminary, 1987.

    95. Powell, "Whatever Happened to 'CPE'," next to the last paragraph.

    96. Dunbar, Mind and Body, p.49.

    97.Flanders Dunbar, Psychosomatic Diagnosis. New York: Paul B. Hoebner, 1943; reprinted, New York: Johnson Reprint Corporation, 1968, p.116.

    98. Dunbar, "The Sun Symbol," p.72.

    99. Dunbar, Mind and Body, p.73.

    100. Anton T. Boisen, note on the flyleaf of a portfolio of his photographs of the training program at Worcester

    (Massachusetts) State Hospital, "Christmas 1928," in "Dunbar Materials": "To Helen Flanders Dunbar[,] who as the first of my theological students has had much to do with this under taking."

    Robert Charles Powell, M.D., Ph.D., a psychiatrist and historian, gratefully acknowledges that much of the research herein reported was conducted under the tenure of a fellowship from the Josiah Macy, Jr. Foundation and under US-PHS Training Grant TO 2 MH-05972-17. He may be contacted at 847/ 441-8283; 1520 Tower Road, Winnetka, Illinois, 60093-1627.

  • 21 Mar 2002 9:26 PM | Perry Miller, Editor (Administrator)

    Robert Charles Powell, MD, PhD

    The First Annual Helen Flanders Dunbar (1902-1959) Award
    for Significant Contributions to the Field of Clinical Pastoral Training
    3/21/02, Virginia Beach, Virginia, at the Plenary Meeting, of the
    College of Pastoral Supervision and Psychotherapy

    When we've been there ten thousand years.1 Actually, while many have made the collegial, spiritual pilgrimage back to Virginia Beach year after year, this is only the tenth  not the ten thousandth  plenary session of the College of Pastoral Supervision and Psychotherapy. The organizing meeting of what was to become CPSP occurred on St. Patricks Day 1990, with the first plenary session  the first full gathering of the community  occurring from March 12th to the 15th, 1992.

    While ten thousand years may overwhelm contemplation, ten years worth of plenaries has been within our grasp. What about one hundred years  this award being based on a centenary anniversary  can we appreciate that? This group speaks of Anton Theophilus Boisen and of Helen Flanders Dunbar. Can we take a moment to ponder the importance of the year 1902  one hundred years ago  to these two founders of the movement for clinical pastoral transformation? Boisen felt he owed whatever measure of success he was enabled to achieve, exploring the inner world of mental disorder and religious experience, to the compassion, wisdom, courage, and steadfast fidelity of the good woman, Alice Batchelder, whom he met in 1902  one hundred years ago  the year Helen Dunbar was born. Alices death precipitated, as Boisen completed his first book, his final psychotic episode, out of which he was led by Helens rekindling of that Dantean love that moves the sun and  other stars.2 Thus the bedrock of this organization lies in the year 1902  and in love.

    Again, what about one hundred years? This award celebrates the 100th anniversary of the birth of Helen Flanders Dunbar, psychoanalyst, theologian, and Dantean scholar, who herself did not get to see that age, but whose last book, Psychiatry in the Medical Specialties, noted her research on those who did, the so-called centenarians. Dunbar knew she would not be among those who would live that long. While I can not prove it, I suspect that the following words, sent to her in publishers galley proofs the day of her death, describe her own personality cohort, and she knew it:

    These are people who have attained some degree of maturity or at least recognition through achievement. No matter at what point one may find

    them on the ladder, they appear to be live-wires, going somewhere and

    with a tremendous amount of energy to go on. They must go, they must

    grow and sometimes they run head on into a stone wall, a blind alley or

    perhaps a luring adventure that becomes a point of no return. This kind

    of frustration is intolerable,  as it is to [one] who explores  confines 

    and [who] wants to go beyond.  They feel stifled. They feel themselves

    like withering plants growing in the basement without sunshine and they

    [have an]  almost physical pain of having to grow with no space to

    grow in.  In this group one finds  those who have achieved

    everything anyone could hope to achieve in the line of their endeavor

    but  [who] feel there is no further place to go. All of a sudden the walls

    come closing in and they smother.3

    As most of us know, she indeed smothered, drowning in the midst of apparent coronary spasm while briefly alone in the basement swimming pool of her home.

    Could the College of Pastoral Supervision and Psychotherapy have helped her  to live a full one hundred years as brilliantly as she lived her first fifty-seven? As stated in the Covenant, it is essential that members

     guard against becoming

    o invasive,

    o aggressive,

    o predatory toward each other,

     make space for one another and

     stand ready to midwife one another in their respective spiritual journeys.

    It is not by accident that this terse admonition appears in the Covenant. Dunbar could have used a little love. As most of us know, when this titan  all 411 of her  slipped, as all of us must do at some points in our lives, she was attacked and struggled to regain her poise. With more supportive colleagues, perhaps Dunbar could have felt there was some further place to go. Fortunately for the clinical pastoral movement, her best years, even though only part time, belonged to it. Even Dunbars somewhat second-best years, though, provided more than most of us could offer. Just imagine if we had her here today!

    Once again, what about one hundred years? Dunbar knew she could not, would not live that long, but she noted attributes of those who did. Based on her study of a series of about 100 patients followed from 10 to 25 or more years, Dunbar noted that the continued ability to create and invent [her italics] marks potential centenarians. While this continued ability to create and invent is the point to emphasize, a number of Dunbars lesser but unique findings are worth reviewing quite rapidly. She observed that the centenarian appears to have been throughout his lifetime a person different  from the majority of his contemporaries. The pre-centenarian responds creatively to change. She considers this enthusiastic, unfrightened response to change and to the unknown as among the outstanding characteristics of the long-lived. Centenarians have taken catastrophe in their stride and almost automatically mobilized their forces to do quickly whatever could be done to cope with disaster. They seem not to have reacted with shock to personal injury. In brief, these people avoid frustration where possible. When avoidance is impossible, instead of calling themselves failures they make a fresh start. Dunbar also noted that centenarians are honest, giving a straight answer except when they are kidding. She believed this indicated an unusual capacity to be honest with themselves  to observe and face squarely that which is observed. Other noteworthy traits of centenarians, she suggested, are the following: they are religious, but avoid the extremes of orthodoxy; they are disciplined, but are more interested in being creative than in being perfect. They are interested in the development of new ideas, and are never at a loss about what to do with their leisure time. They enjoy conversations with others, increasing their store of information and developing new projects. They express themselves well and keep their lines of communication open. They are more interested in the new than afraid of it. They combat entropy by remaining curious.4

    So, while ten thousand years may overwhelm contemplation, and ten years worth of plenaries has been within our grasp, for the trained chaplaincy to become centenarian, as it soon can become, in only twenty-three more years, certain preventive health measures may have to be in place. If we can apply, perhaps, individual research data to an organization, Dunbars study suggests that, to make it to one hundred years, the clinical pastoral community will have to

     nourish inventiveness,

     embrace change and unknowns,

     take catastrophe in stride,

     avoid frustration in life,

     not avoid making fresh starts, and

     foster self-observation, while


    o religious,

    o disciplined,

    o creative,

    o expressive,

    o straightforward, and

    o curious.

    Thats a tall but doable order. The CPSP Covenant already speaks of valuing creativity. That CPSP grasped the need for parish-based programs speaks to inventiveness. CPSP may wish to broaden its view explicitly to include both recovery and discovery of soul, refocusing constantly away from institutions that exist to facilitate and toward the needs of persons trying to maintain serious pastoral relationship.

    While clinical pastoral training implied imparting knowledge with hands-on experience, and clinical pastoral education implied specific exercises for the mind, clinical pastoral creation/invention implies the development of something new. As Edward Thornton pointed out twenty years ago, the best clinical supervisors generally aimed toward neither training nor education but toward transformation  transformation of themselves  and ultimately of their students. Through what Thornton referred to as the central mythic enactment  the so-called mystery of the laying on of CPE hands  the hope was that pastoral theologians, beyond just being trained and educated, would in fact emerge as something new  would be created and invented  re-entering their calling transformed.5

    Again, it is not by accident that clinical pastoral transformation sounds suspiciously like the outcome of intimate hours such as were discussed earlier today. Susan Baur wrote five years ago of psychotherapy as an intense, intimate, and affectionate relationship, one intended  to call two people into existence and revitalize them, as it heightens the relevance of the existential dilemmas they address.6 Is that not akin to what your group refers to as the restoration of soul? Is that not what should occur in supervision, or in local Chapter Meetings? Perhaps similar intimate hours of these plenaries can help ensure that the College of Pastoral Supervision and Psychotherapy will maintain continued ability to re-create and re-invent itself  pastorally transform itself -- into its centenary year and beyond.

    Let me begin to close. Several years ago I proposed that it may be time for the College of Pastoral Supervision and Psychotherapy  to rediscover the inspiriting values of remaining Still Crazy After All These Years, adding these to their ongoing recovery of soul. The true legacy of Boisen, Dunbars colleague, I suggested, may be the courage to espouse beliefs not initially shared by others, with the founding years of CPSP most likely to be remembered for their insistence that a soul was a terrible thing to waste. I further proposed that the true legacy of Dunbar may well be the willingness to tackle the apparently impossible task, integrating the spiritual and the more soulful. Without being explicit about it, CPSP members, it also seemed to me, had already adopted Dunbars liberating emphasis on becoming free to think and act, applying it as much to their colleagues as to their patients and parishioners.7 This time I propose that CPSP take to heart one of Dunbars final observations, that centenarians  perhaps movements as much as people  maintain the continued ability to create and invent. Thus among the challenges facing the College of Pastoral Supervision and Psychotherapy are the following:

     to maintain the courage to espouse beliefs not initially shared by others,

     to maintain the willingness to tackle the apparently impossible task, and

     to maintain the continued ability to create and invent.

    (Each time I speak to you as an historian, I discover and recover one more challenge from your distant past. One of these days you may learn not to invite me!)

    I once was lost, but now am found.8 I am honored to be with you. The phone call from Chaplain Raymond Lawrence, pulling my work out of oblivion, pulling together pieces of my life, has revitalized me as a person. I also hope and trust that benefits accrued to others here tonight. I am thankful to be alive, sustained, and enabled to be with you this day. I value your friendship in coming years.



    1,868 words


    1 added stanza, mid 19th c, to Amazing Grace, late 18th c.

    2 Boisen, Anton T., The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience, Chicago: Willett, Clark & Co, 1936. p.v;

    Boisen, Anton T., Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience, New York: Harper & Brothers, 1960, pp.47, 52;

    Powell, Robert Charles, Whatever Happened to CPE  Clinical Pastoral Education?1999, published on the web at

    3 Dunbar, Flanders, Psychiatry in the Medical Specialties, New York: McGraw-Hill, 1959, p.374.

    4 Ibid, pp.465, 461, 464, 153, 459, 460.

    5 Thornton, Edward, "The 'Secret' of Clinical Pastoral Education" [editorial], Journal of Pastoral Care, 36 (3): 145-146, 1982, p.146.

    6 Baur, Susan, The Intimate Hour: Love and Sex in Psychotherapy, Boston: Houghton Mifflin, 1997, p.273.

    7 Powell, Robert Charles, Emotionally, Soulfully, Spiritually Free to Think and Act: The Helen Flanders Dunbar (1902-59) Memorial Lecture on Psychosomatic Medicine and Pastoral Care, Journal of Religion and Health, 40 (1): 97-114, spring 2001, pp.108-109.

    8 Amazing Grace, late 18th c.

  • 04 Apr 2001 9:17 PM | Perry Miller, Editor (Administrator)

    In pastoral care, counseling, and psychotherapy, has there been a paradigm "shift," as suggested by Hunter (Christian Century October 17, 2001), following Patton (1993), following Kuhn (1962)? Or has there been, rather, a "wandering," across the last thirty or more years, of the core working assumption? I would like to suggest the latter. Most authorities  and thoughtful non-authorities  would agree that the movement for specifically clinical pastoral training of the clergy indeed broke new ground between 1925 and 1930, first in the United States, with steady spread to religious communities worldwide. To be sure, "pastoral care," of a generally dry, intellectualized, universalized variety, existed sparsely much earlier, but few would confuse exhortations and visitations with the richness of what is considered the best of pastoral care today.

    After Anton Theophilus Boisen's sudden, creative insight, however initially delusional, about "breaking a hole in the wall separating religion and medicine," pastoral care could never be the same. Boisen's arresting consideration of suffering souls as the "living human documents" of theology forced a true paradigm shift. All roads in clinical pastoral education, no matter how much some may wish to deny it, lead back to Boisen's "Challenge to Our Seminaries" (1926), his Exploration of the Inner World (1936), and his notion of "cooperative inquiry." All else is commentary.

    Boisen knew he was leading a revolution. "What is involved is a thoroughgoing shift of attention and a new method of attack and then, in the end, a new authority [for the clergy], grounded not in tradition but in experience." Boisen called for an "internship" year of supervised field training during which young clergy might deal with "living human documents and with actual social conditions in all their complexity" (1926). That shift  from books to the nitty-gritty world  had something intrinsically compelling about it, sparked by a patient turned clinician on behalf of suffering patients. Subsequent wanderings  however valuable and well intentioned  have had a tone of forced embellishment, prompted more by social maneuvers on behalf of those offering than on behalf of those receiving care. "Applying" family systems theory and narrative theory sounds all well and good, but Boisen simply knew he was working side-by-side with a person, an individual "text." Moving toward "communal-contextural" concerns (Patton, 1993)  eg, of "gender, race, ethnicity [and] aging, together with their associated forms of oppression, abuse and violence" (Hunter, 2001) may have helped clergy broaden their vision toward actually seeing more suffering persons, but it is debatable as to whether it offered anything further for the suffering persons themselves.

    Boisen tossed his students into the fray, the "communal context," asking them to join with another person's nascent curiosity about his or her "beliefs  amid the complex entanglements of actual life" (1936). His later  Outlines for the Co-operative Study of Personal Experience in Social Situations (1946) emphasized that "actual service to human beings in need," getting close enough to view life through their individual eyes, was what held out the hope of "true understanding" that could allow even more specifically "effective service." The image was not of preaching to, ministering to, shepherding, or showing concern. The image was of two sincerely curious investigators  the one with specialized clinical pastoral training  sitting side by side, struggling to comprehend, to repeat, their "beliefs  amid the complex entanglements of actual life" (1936). This was "cooperative inquiry"  neither "too personal" nor "too impersonal"  as firmly embedded in the social milieu as one could imagine. Boisen's colleague, Helen Flanders Dunbar, later spoke of this as avoiding fancy theories of cause or purpose and of simply working closely, intelligently with the person in need, toward discerning "a point of effective intervention" for the problem at hand (1943).

    Remembering Boisen's work helps illuminate Hunter's comments, wherein he calls for an "integrative, praxis-oriented, theological form of inquiry," and for "plumbing the depths of meaning involved in caring, [as well as] in the humanity . . . and in the divinity" "thus disclosed"(2001). Boisen proposed dealing "at first hand with the raw material of some definite segment of human life," so that "we may be able to arrive at some valid generalizations regarding the meaning of the idea of God, the nature and function of religion, and the conditions under which maximum self-realization is likely to be achieved" (1936). Like Hunter, Boisen would grieve that a "generation of pastoral counselors has been theologically educated but not clinically formed in theologically based, pastorally defined programs." He would second the call for "a distinctly pastoral, therapeutically informed art of spiritual and moral counsel" (2001). Hunter's overview of the current confusion allows us to follow the "wandering paradigm" back to its origins: Boisen's vision of "cooperative inquiry."


    Robert Charles Powell, M.D., Ph.D., a psychiatrist and historian is one of the leading authorities on Anton Boisen, Flanders Dunbar and the early beginnings of the pastoral care movement.

  • 08 Mar 1999 8:50 PM | Perry Miller, Editor (Administrator)

    Entire draft manuscript: copyright, 1999, Robert Charles Powell.
    webpage circulation.

    Whatever Happened to "CPE" -- Clinical Pastoral Education? 

    Robert Charles Powell, MD, PhD 
    keynote address honoring 
    Anton Theophilus Boisen 
    3/18/99, Virginia Beach, Virginia, at the Ninth Plenary Meeting, of the 
    College of Pastoral Supervision and Psychotherapy

    Whatever happened to CPE? Good question. Let me enunciate several other good questions up front. Whatever possessed you, such that the College of Pastoral Supervision and Psychotherapy decided to invite an MD-psychiatrist/PhD-historian to address a room full of theologues? Were you out of your minds? Whatever possessed me, such that I decided to accept? Surely you've handed me an impossible task with which I am doomed to fail. That being the case, in the manner of the Rev.Mr. Anton Theophilus Boisen (1876-1965), the spiritual progenitor of CPE, I have opted to embrace failure, to fail openly with, as he would say, "hope and courage."1 I do not, however, want to fail alone. Nor would he. [Please -- if you will -- please find a pencil or pen and some paper, to jot down notes -- not about what I say, but about what thoughts and associations you have about what I say. The CPSP "Covenant" asks you to "make a space for one another and stand ready to midwife one another. . . ." Please hear me out -- but not passively. Stand ready to expand my presentation.] I accept responsibility for tossing out "half-baked" ideas, but, as I lead you "down the garden path" in this essay, I ask you to commit yourselves to helping me get these ideas "more fully-baked."

    In 1976 I addressed what was then the Association of Mental Health Clergy 2 on Boisen's 100th birthday, exploring in depth his delusion about "breaking a hole in the wall between religion and medicine." 3 As delusions, beliefs not initially shared by others, go, that was an easy one for the chronically sane to absorb, and the AMHC distributed or sold about 2,000 copies of my "Boisen Booklet" on this theme. Just as Boisen exhorted us to attend to the whole of a human being, as a "living human document" of theology, some twenty years ago I challenged those working in pastoral care to take Boisen himself entirely seriously, delusions and all. No one that I know of, however, took the bait when I outlined, in the voluminous footnotes of the "Boisen Booklet," a second of Boisen's key delusions. 4

    Throughout the latter half of his life Boisen puzzled over a delusion about the "family of four." Five days before having the insight about religion and medicine, Boisen sat down to revise his theological "statement of belief." He first alluded to the death of Jesus on the cross, "where he died, . . . the perfect for the imperfect, the strong for the weak," then felt suddenly compelled to conclude that the weak and the imperfect should no longer accept this sacrifice and that they should be willing to give their lives, the imperfect for the perfect and the weak for the strong, that the divine may be freed from its prison house of infirmity and be able to come into the world in beauty and power. . . . He envisioned these types of people, the perfect, the imperfect, the strong, and the weak, as a forever intertwined, unified "family of four." He later added that "the essence of this idea was that of . . . setting the best types free from the appeal of those whose love was based on need." 5

    On the theological level and on the strictly personal level, Boisen considered many interpretations of this idea across time. On the practical level, this delusion determined Boisen's mission within the CPE movement from 1930 until his death in 1965. The "family of four," on one level, included both Helen Flanders Dunbar, BD, PhD, MD, MedSciD, Medical Director of the Council for the Clinical Training of Theological Students, and Austin Philip Guiles, BD, PhD, Field Secretary of the CCTTS and later supervisor in the rival Institute for Pastoral Care. Boisen interpreted the delusion, on one level, as instructing him to "give Dunbar over to Guiles" -- that is, that he, Boisen, was to keep fostering a relationship between the so-called "New York" and "Boston" poles of the movement, despite their natural tendency to mix like water and oil. 6 As outlined in his classic sociology treatise, Religion in Crisis and Custom . . . (1955), Boisen considered the splitting and unifying of groups to be a non accidental significant norm. 7 While he did not want the factions of CPE to be antagonistic or assimilated, he did want them to be productively confronting of each other and engaged in dialogue.

    For those of you who read footnotes, the cryptic footnote number 151 in my "Boisen Booklet" concerns one consequence of this second key delusion alluding to but not mentioning the rumor that Dunbar asked and Boisen told Guiles to accompany her, Dunbar, on a tour of the healing center in southern France at Lourdes -- a research trip that led to one of Dunbar's most poetic, beguiling articles. Whether the rumor was true or false, the point is that Mrs. Guiles believed it and became furious, which added, shall we say, to creative tension within the movement. As much as anything else, this rumor, driven by Boisen's delusion, led to the break between the "New York" and "Boston" camps. At a crucial juncture Mrs. Guiles, backed by the wealth of her father's "Earhart Foundation," encouraged Guiles to seize hold of the training centers he had supervised, while Dunbar literally seized hold of the Council, snatching its charter off the table at a board meeting and whisking it to New York. 8

    You may have noted how I keep using phrases like, "the theological level," "the strictly personal level," "the practical level," etc. Both Boisen and Dunbar had this notion of multiple levels of meaning constantly on their minds. Boisen believed that patients' symptoms "are not merely the results of past causes," but "also attempts at a new synthesis" -- attempts at reconciliation -- attempts at cure. 9 These attempts at synthesis, reconciliation, and cure -- at achieving healing and wholeness -- are, he and Dunbar believed, powerfully mediated through symbols. Dunbar, still world renowned for her first book, Symbolism in Medieval Thought . . . (1929), drew a crucial distinction between three levels of symbolism:

    (1) the association, extrinsic, or arbitrary symbol 
    (this stands for that) -- more properly called "the sign";

    (2) the comparison, intrinsic, or descriptive symbol 
    (this resembles that) -- more properly called "the simile"; and

    (3) the semblance, interpretative, or insight symbol 
    (this reveals many thats) -- the symbol proper, 
    upon which she was to place her attention. 10

    Dunbar spoke of the insight symbol as that which reaches "out toward the supersensible," toward "a Reality . . . greater and truer than the symbol in all its aspects." A "true insight symbol," she believed and you need to understand, "depends on the continual re-creation and expansion of its meanings." Therefore, with an insight symbol, "all meanings are true," and they "are often all intended at once." Dunbar considered insight symbols as mediators between a person's inner and outer worlds, and that much in the realm of healing and wholeness could be achieved through "careful handling of symbolism." 11

    Many know of Dunbar's epoch-making volume in psychosomatic medicine, Emotions and Bodily Changes . . . (1935), whose "Part One" constitutes a subtle philosophic essay on the integrative aspects of the human organism, specifically on the unifying power of emotion. 12 Few realize, however, that another volume was funded to explore these integrative, unifying powers from the religious rather than the medical point of view. The companion volume supposedly never appeared -- yet it did. In 1971, following the money trail, and noting the brilliance with which he had developed his own understanding of the role of religious symbolism, I asked the Rev.Dr. Carroll A. Wise, Boisen's assistant then successor in the original CPE program, if the first of his books, Religion in Illness and Health (1942) was perhaps the missing text. He answered, "Yes." He went on to add that Dunbar, ever aware of political realities, was "reticent in having too much recognition of her influence . . . " upon his work.13

    Let us go back now to Boisen's intriguing notion about the "family of four," made up of forever intertwined weak, strong, imperfect, and perfect people. I emphasize this delusion because it both defines my predicament -- the necessity of sacrificing myself, the theologic weakling, such that you, the stronger ones, may thrive -- and defines what I see as CPE's challenge -- the necessity of speaking with authority and presence from a position of accepted vulnerability. This is also a stance some of us have become increasingly clear about encouraging our patients to consider. I call this notion "acceptance without surrender" -- the acknowledgement of one's imperfection without allowing that as an excuse -- the acknowledgment of one's imperfection while searching there for insights and understandings of potential value to both oneself and those outside. 14 Take, for example again, the crucifixion of Jesus. If there ever was a classic case of someone getting little but lemons yet still managing to make lemonade -- of speaking with authority and presence from a position of accepted vulnerability -- the story of Jesus has got to be it. Not far behind would be the thought-provoking story told by Andre Schwarz-Bart in The Last of the Just (1959)--of doomed Jews conveying redemptive power through their personally unexpected courage in the face of unsought death. 15

    So whatever did happen to CPE? That was the question you posed to me primarily, I suspect, because at the 50th anniversary conference of the Association for Clinical Pastoral Education in 1975 I delivered an address entitled, "Questions from the Past (on the Future of CPE)," in which my narrative explored eight questions I thought Boisen would have asked were he there. 16 These questions, which I encourage you to ponder as I note them, were:

    "Whatever happened to pastoral social work?"
    ". . . to religious diagnosis?"
    ". . . to preventive pastoral care?"
    ". . . to 'everyday,' or 'maintenance,' pastoral care?"
    ". . . to the theology of pastoral care?"
    ". . . to religious rituals and symbolism?"
    ". . . to religious research within CPE?" and
    ". . . to the development of a critical tradition within CPE?"

    Perhaps you quite reasonably hoped for a reprise and update of that presentation. The question, however, "Whatever Happened to CPE?" can still be taken several different ways. Do we mean

    (a) "How has CPE developed since its 50-year mark in 1975?" or

    (b) "Where did it go? To where did CPE disappear?" or

    (c) "Whatever happened to Boisen's vision within CPE?"

    I will spend a minuscule amount of time noting how CPE developed over the last almost twenty-five years, reassuring us in passing that it did not disappear, but I will devote the remainder of my comments to evaluating "Whatever happened to Boisen's vision?" as suggested by the Boisenesque questions above.

    Overall reaction to my presentation in 1975 was polite but defensive. Respondents implied that CPE had moved beyond the "old myths," the original concerns, and that the cutting edge of CPE thought was to be found in full-length books, not in the shorter articles upon which I had focused my review. 17 Others, however, had apparently already keyed into my concerns, as within only several years a number of publications appeared speaking to themes I had raised. Without attempting to be comprehensive, I nonetheless want to draw your attention to the following:

    Paul Pruyser's The Minister as Diagnostician (1976); 18

    Donald Denton's Religious Diagnosis in a Secular Society (1997); 19

    George Fitchett's Spiritual Assessment . . . (1993); 20

    Kenneth Pargament's edited Religion and Prevention in Mental Health (1992); 21

    Thomas Moore's Care of Soul . . . (1992) 22

    Paul Holinger's Pastoral Care of the Severe Emotional Disorders . . . (1985); 23

    Charles Gerkin's The Living Human Document . . . (1984); 24

    John Patton's From Ministry to Theology . . . (1990); 25

    Charles Lopez's dissertation on developments in CPE from 1950 to 1985 (1986); 26

    My own article which serves as a preface to empirical theology (1976); 27;

    I also recommend several recent articles:

    Joanne Greer's "Linkages between Theological Reflection and Empirical Research" (1995) (envisions "empirical research as . . . ongoing self-reflection" and reminds that "after the data has been coded and its impact assessed, the last step is to reflect upon and try to appreciate what God has wrought"); 28

    Robert Duffett's "The Intellectual Foundations of Pastoral Counseling: A Perspective on the Future of the Profession" (1995) (re maintaining integrity in the so-called "managed care" environment); 29 and

    Rodney Hunter's ". . . Postmodernism and the Future of Pastoral Care" (1997) (calling for a "psychologically informed turn to committed religious practice" within a "covenant community"). 30

    One of the main reactions possibly to my presentation was a concerted effort to nourish in-house investigators and historians, an effort that brought scattered success. The annual Abstracts of Research in Pastoral Care and Counseling, begun in 1971, was really flying by 1982. Two award programs arose, in 1982 and 1983, honoring original investigations. The ACPE published a Research Primer . . . 31 in 1988, and launched the ACPE Research Network Newsletter in 1989. Nonetheless, "A Systematic Review of the Quantity and Quality of Empirical Research Published in Four Pastoral Counseling Journals" observed that while pastoral counseling had "integrated the clinical skills of the other mental health disciplines," it had been "far less successful in adopting the scientific method." 32 In stark contrast is the fact, discovered while preparing this paper, that Boisen's now ancient research is cited ubiquitously, with appreciation and serious analysis, in texts on the psychology of religion.

    On the historical side, while Allison Stokes' Ministry After Freud . . . (1985), builds cleanly upon my earlier work, almost as if adding extra chapters, several other attempts at historical commentary stand as detriments to understanding. Without noting the culprits' names, let me bluntly set straight the record:

    (1) Boisen's diagnosis was NOT of manic-depressive disorder; despite the article by a medical student, later psychiatrist, who had suffered psychosis; observations by Wise and Pruyser, among others, make it quite clear that Boisen definitely had schizophrenia. The article cited seemed to want to diminish the magnitude of Boisen's illness and his attempts to overcome it. The wonder is that he lived so long, and through so many episodes, with the mortality rate for acute agitated catatonic states being as high as it is. 33

    (2) Milton Erickson, MD, talented therapist that he later became, was NOT the "grandfather" of CPE as one author alleged, especially if the grounds for this claim are that he, as Boisen's assigned ward psychiatrist supposedly enabled Boisen's recovery and further work; both Boisen and Wise made it clear that Erickson, at that phase of his career, was clueless regarding how to approach psychosis, and that it was Dunbar who, by means not specifically known, popped Boisen out of his 1930 episode of psychosis. The article cited seemed to want to extract some of Boisen's glory as "father" to the CPE movement and place it one step back, somehow allied to magical therapy.

    The far more important point is that it was something about the power of pure and simple love -- "the love that moves the sun and the other stars," he tells us via a cryptic reference to Dante -- that revived and steadied Boisen. While we know that Dunbar flirted, not necessarily on a conscious level, and we know from the apparently ever-truthful Boisen that he got only to the brink of physical intimacy, it adds to the poignancy of his accomplishment that he did not shy away from struggling with the nature of love even from within the essential loneliness of schizophrenia. 34

    (3) Dunbar did NOT commit suicide, despite a reviewer's comments upon Stokes' words and others' suggesting that. Coroners' data support a diagnosis of coronary arterial spasm, leading Dunbar to drown in her private pool; Dunbar's daughter had been with her minutes before and found her minutes after, which underscores the happenstance nature of the death. The article cited seemed to want to suggest some aura of failure at the end of Dunbar's career. On the contrary, while she indeed suffered from others' mischaracterization of her theories in psychosomatic medicine, one of her best-written volumes, Psychiatry in the Medical Specialties (1959), came out on the eve of her death. 35

    Am I the only one who finds it disturbing that a disproportionately large sample of the CPE movement's so-called historical commentary over the last twenty years is not only just plain wrong but also denigratingly biased? As noted in the first issue of the infamous ACPE Underground Report, which arrived in various mailboxes around Christmas week of 1987, "There seems not much more left of Boisen in ACPE than his cane." 36 It was at the 50th anniversary celebration in 1975 that the custom began of handing down "Pappy's" cane to the Association's incoming president. At that very time it had struck me as odd, for, as I had noted in my keynote address earlier that day, Boisen's name appeared nowhere on the program. So, yes, by the time CPSP was getting itself founded some fifteen years later, that cane seemed to have become a spiritless artifact, an empty symbol that, much to what should have been everyone's horror, was whittled down, emasculated in 1991 into, heaven help us, a magical wand! 37

    While reviewing the literature I came across another "smoking gun," displayed without embarrassment or chagrin, as a 1982 editorial in the Journal of Pastoral Care. 38 Revealing, supposedly for the first time publicly and in writing, the "secret" of CPE, the editor noted that the soul of CPE had been in that supervisors' goal was "not education but transformation -- transformation of themselves first of all and ultimately of their students." The editor then went on to opine that the "central mythic enactment," "the mystery of the laying on of CPE hands," the secret soul of traditional CPE was dead -- that the field had matured, moving on toward "objectification, quantification, and verification," a more rigorous albeit soul-less existence! While that editor subsequently rediscovered a personal spiritual life, the editorial stood unchallenged, as far as can be seen, as a most curious proclamation in the movement's flagship publication. Can one do other than cry out in paraphrase, "Father, forgive them, for they know not what they say"?

    While that editor, without sorrow, tried to consign CPE to a soul less existence, he nonetheless provoked at least two important questions about the enterprise. First, how are we actually preparing the next generation in this clinical pastoral field? Second, how does what we call this enterprise shape our vision? Boisen and Dunbar clearly thought in terms of "facts first" -- that the novice needed to gain a knowledge base, needed to learn something, know something, specifically, about a few specific human beings -- that the novice had to do some original "research," so to speak, and be "trained," before he or she could move on to the more interactive processes of education and supervision. 39 During the 1970s and somewhat subsequently, most CPE appeared to have thought it could skip over the "training phase," in which both sacrosanct human documents, real people in crisis, and experts spoke with authority, to an interactive "education and supervision phase" that soon overshadowed the "transformation phase" that should come next, the never ending phase of growth. Beginning with the 1970s, most CPE appeared to have become preoccupied with producing an educated and supervised product. While the literature became overflowing with admonitions about theological reflection, this, too, appeared to be envisioned as an add-on, as in "Oh, yes, this certificate attests that I theologically reflected on January 13, 1983," etc., etc. Although the specter of so-called "managed care" and decimated budgets initially accelerated this focus on "the theologue as product," it eventually encouraged re-focus on "the pastoral service as product," which once again allowed consideration of the unique theologue delivering the service. It is well worth asking the degrees to which we want this pastor to be trained, then educated and supervised, and then transformed. Should we be calling this clinical pastoral training? clinical pastoral education and supervision? or clinical pastoral transformation ? I have argued elsewhere that mature theological reflection does not come early, and that many students are not ready for it. 40 While the seminary student tends to focus on his or her own internal problems and theological identity, the more established pastor or chaplain might be more able to endure the emotional discomfort of working with the distressed, and more free to participate in exploring the theological issues involved. The CPSP seems to grasp this, and perhaps its programs, let me suggest -- especially its latest one for established pastors and chaplains -- might best be characterized as programs supporting ongoing "clinical pastoral transformation." 41

    So, getting back on track, whatever happened to CPE? After an initial fifty years of development, whatever happened to clinical pastoral education? You know the awful answer: By 1980, if not before, clinical pastoral education had lost its soul. That is my conclusion, just as it was yours. Through the Underground Report, however, supervisors called a spade a spade and tried to get that soul back. It is no wonder, then, that the "Covenant" of the College of Pastoral Supervison and Psychotherapy focuses, front and center, on the "recovery of soul."

    Allow me to quote in mere chronological order some of the "cries in the wilderness" recorded in early issues of the Underground Report. A lot of wisdom appeared in those letters to the editor, as the writers called out for

    that something that "feeds and fosters growth"; 42

    "the discernment-of-spirits model of decision-making instead of the majority-rules model . . ., engaging in prophesy instead of strategic planning"; 43

    "a fecund movement. . . . viable, creative, growing, fertile, surrounded by semen or manure and life-giving"; 44

    something "life-giving and energizing"; 45

    the "values of 'chaos and faith' "; 46

    "more of a small group/ tribal atmosphere"; 47

    "a better way to be theologically serious"; 48

    "the awareness that we are a peculiar people, in desperate need of generous professional peers who can be a professional resource for our living and loving in the practice of our ministry"; 49

    "attention to the larger communal issues of value"; 50

    "a redemptive community"; 51

    "a supportive and challenging community of fellow pilgrims." 52

    Out of such sentiments grew the eventual College of Pastoral Supervision and Psychotherapy in March 1990, nine years ago this week. 53

    The CPSP and its members almost immediately had to tackle, even embrace, the necessity of speaking with authority and presence from a position of admitted vulnerability. One could argue that what you had to do as a community powerfully and positively transformed your lives and your pastoral care. The challenge is how to continue the "recovery of soul." I have been leading you "down the garden path" -- a long and winding one through the past -- because I believe that rediscovery of some of the old notions as you revitalize CPE.

    Along with other writings thus far noted, I recommend that you take another look at Wise's magnum opus, Pastoral Psychotherapy . . . (1980). 54 Wise seems to suggest that pastors be firm, yet humble, to listen and to be there. The pastor, he believes, "is called upon not to do but to be." He reminds us that the "religious ideas of a person, if listened to carefully, become a form of symbolic communication" and "are more than ideas in the abtract." In language similar to that used fifty years earlier by Boisen and Dunbar, Wise reminds us that the parishioner's religious ideas "have a vital relationship to the inner life . . . and to his interpersonal experiences," and "are symbolic in form since they express intangibles like meaning, value, and relationships." Without mentioning per se the concept of the insight symbol, that true symbol that reaches "out toward the supersensible," and that "depends on . . . continual re-creation," Wise nonetheless notes that "religious symbols pick up . . . goals from deep, instinctive dimensions . . . and transform them into higher, creative goals." "Growth requires the constant expansion of the meaning of religious symbols. . . ." Through appreciating the depths and potential heights of the "living human document" in front of him or her, the pastoral therapist "faces the experience of learning, unlearning, and relearning theology." 55 That whole thought bears repeating: "religious symbols pick up . . . goals from deep, instinctive dimensions . . . and transform them into higher, creative goals." "Growth requires the constant expansion of the meaning of religious symbols. . . ." Through appreciating the depths and potential heights of the "living human document" in front of him or her, the pastoral therapist "faces the experience of learning, unlearning, and relearning theology." The CPSP, let me suggest, has much to gain from assuming a stance that has authority and presence yet is open and humble, constantly eager for rebirth.

    Ending somewhat as I began, but by now on what I hope you perceive as a more affirmative tone, let me again ask: Whatever did possess you, such that you decided to invite a non-theologian to address a room full of theologues? Were you out of your minds? Maybe you were. Then again, perhaps it is now clear that maybe you should try being out of your minds a bit more often -- as long as you have trusted colleagues to help you find your way back. Boisen would probably argue the importance of being comfortable with madness and open to its potential insights, theological and otherwise. Whatever did possess me, such that I decided to accept this impossible task? Heaven only knows, but I'm glad that I did. Preparing this essay has been an important, reflective experience for me. Possibly I, too, have had some "recovery of soul." Possibly you, too, with "hope and courage," will not shy away from tackling the apparently impossible task. Since I am a physician, let me leave you with two images relating to this theme from "my side of the tracks":

    (1) During medical school, I once at 3am, because I could not get an i.v. into a patient's arm, woke up an intern. With wisdom not anger he sleepily gave me a crucial bit of insight that has served me well. He said, "If the task is impossible, what makes you think I can do it any better than you?" Remember that. I went back to the patient, and somehow he and I got the i.v. into his arm.

    (2) Early in my career, I developed a knack for working with psychotic patients and normal adolescents -- sometimes it's hard to tell the difference -- essentially by entering into the person's system with an open mind, admitting my ignorance, but refusing to entertain unsupported conclusions. This approach irritated one of my colleagues. Not with wisdom but anger he unknowingly gave another bit of insight that has served me well. He said, "Your patients get better because you have the delusional belief that they will!" Think about that one: my patients get better because I'm willing to be considered deluded. I can live with that. Can you? Perhaps CPE will recover its soul precisely because you are willing to tackle the apparently impossible task and not worry about being considered deluded, espousing beliefs not initially shared by others. Is this not the true legacy of the Rev.Mr. Anton Theophilus Boisen? Thank goodness he undertook the exploration of the inner world, leading us out of the depths, insisting that even the weak and the imperfect had a forever intertwined role to play, assisting the strong and the perfect, "breaking a hole in the wall between religion and medicine." 56

    It is now long past time for me to stop talking. I did ask you up front to commit yourselves to helping get some of my "half-baked" ideas "more fully-baked," to "make a space" for me yet to "stand ready to midwife" my nascent thoughts. Now it is your turn to talk, even to argue a bit, about what has become of CPE, and especially about your progress in recovering its soul.


    + See "Afterword" regarding others' valuable contributions to this manuscript after suggestions and comments were solicited at the CPSP webpage. Dr. Powell may be contacted at 847/ 441-8283; 1520 Tower Road, Winnetka, Illinois, 60093-1627. __________ 


    This is an allusion to Boisen's hymnal for use in mental hospitals. It was initially called Lift Up Your Hearts . . . , Boston: Pilgrim Press,1926, but was reissued in three revised, enlarged editions as Hymns of Hope and Courage, Boston: Pilgrim Press,1932, 1937, and Chicago: Chicago Theological Seminary, 1950. [Back to text]

    Now part of the Association of Professional Chaplains since merger in May 1998 with the College of Chaplains. The address was published as: Robert Charles Powell, Anton T. Boisen (1876-1965): "Breaking an Opening in the Wall between Religion and Medicine" , pp.47, special supplement to the AMHC Forum, 29(1), October 1976 [Back to text]

    Anton T. Boisen, Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience, New York: Harper & Brothers, 1960, p. 91. 

    For review of the history of the clinical pastoral training/education movement, see: Robert Charles Powell, C.P.E.: Fifty Years of Learning, through Supervised Encounter with "Living Human Documents." booklet, 32pp. New York: Association for Clinical Pastoral Education, 1975, reprinted, 1987; reviewed in J. Pastoral Care 36(4): 210, 1982. 

    Edward E. Thornton, Professional Education for Ministry: A History of Clinical Pastoral Education. Nashville: Abingdon Press, 1970. Allison Stokes, Ministry After Freud. New York: The Pilgrim Press, 1985. [Back to text]

    See Powell, Anton T. Boisen (1876-1965): "Breaking . . .," pp. 27-28. 

    For the phrase "living human documents" see Anton T. Boisen, The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience, Chicago: Willet, Clark & Co., 1936. reprinted, New York: Harper & Brothers, 1952, and Philadelphia: Univ.of Pennsylvania Press, 1971. p.185: ". . . I have 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." [Back to text]

    Boisen, Out of the Depths . . . , pp. 88, 89,104, 106, 115, 118-119. [Back to text]

    See Powell, Anton T. Boisen . . ., pp. 35- 36. [Back to text]

    Anton T. Boisen, Religion in Crisis and Custom: A Sociological and Psychological Study, New York: Harper & Brothers. 1955. [Back to text]

    See Powell, Anton T. Boisen . . ., p. 36. H. Flanders Dunbar, "What Happens at Lourdes? Psychic Forces in Health and Disease," Forum 91: 226-231, 1934. 

    Robert Charles Powell, Healing and Wholeness: Helen Flanders Dunbar (1902-59) and an Extra-Medical Origin of the American Psychosomatic Movement, 1906-36 , PhD dissertation, Durham, NC: Duke Univ., 1974, [reprint available via University Microfilms, order # 75-2415, on the "web" at] p. 224, fn. 4. The Council's charter was among Dunbar's papers at the time of her death. [Back to text]

    Anton T. Boisen, "Personality Changes and Upheavals Arising Out of the Sense of Personal Failure," Amer.J.Psychiat.5: 531-551, p. 559

    H. Flanders Dunbar, "The Sun Symbol in Medieval Thought," Master's Thesis, New York: Columbia Univ., 1923 

    H. Flanders Dunbar, Symbolism in Medieval Thought and Its Consummation in the Divine Comedy, New Haven: Yale Univ.Press, 1929 [= PhD dissertation, New York: Columbia Univ., 1929] reprinted New York: Russell and Russell, 1961, and again by Atlanta, GA: SOLINET, 1994.

    Dunbar, Symbolism . . . , p.11. Dunbar, "The Sun . . .," p. 4. Dunbar, Symbolism . . . , p.14. H. Flanders Dunbar, "Mental Hygiene and Religious Teaching," Ment.Hyg. 19: 353-372, 362.

    H. Flanders Dunbar, Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships: 1910-1933. New York: Columbia Univ. Press, for the Josiah Macy, Jr. Foundation, 1935. revised and enlarged in 1938, 1946, and 1954.

    Powell, Healing and Wholeness . . . ,pp. 240-241, fn. 4; Carroll A. Wise, Religion in Illness and Health. New York: Harper's Brothers, 1942.


    Robert Charles Powell, "Acceptance without Surrender: An Attitude within which We -- the Mentally Ill, the Family, and the Psychiatrist -- Might Work Together." invited address presented before the 3rd Annual Conference on Family Support & Advocacy, Alliance for the Mentally Ill - Northwest Suburban, Arlington Heights, Il., October 1993.


    Andre Schwarz-Bart, The Last of the Just. original French, 1959; translation, New York: Atheneum Publishers, 1960.


    Robert Charles Powell, "Questions from the Past (on the Future of Clinical Pastoral Education). Invited keynote address, presented before the 50th Anniversary Conference, Association for Clinical Pastoral Education, Minneapolis, October 1975. 1975 Conference Proceedings: 1-21, 1976.


    Edward E. Thornton, "The Meaning of History for Today and the Future: A Response to Robert C. Powell," 1975 Conference Proceedings: 22 27, 1976 

    Robert A. Preston, "Watch Out How You Are Listening. Consider What You Are Hearing," 1975 Conference Proceedings: 28-32, 1976


    Paul W. Pruyser, The Minister as Diagnostician. Philadelphia: Westminster Press, 1976. Pruyser's questions concern "communion," "awareness of the holy," "providence," "faith," "repentance of sin," "grace," and "sense of vocation"; they must be compared to Boisen's on "sense of the mysterious and the uncanny," "sense of peril," "sense of personal responsibility," "erotic involvement," "philosophy of life" (about God), " religious concern," and "plans for the future." See Robert Charles Powell, "Anton T. Boisen's 'Psychiatric Examination: Content of Thought' (c.1925-31): An Attempt to Grasp the Meaning of Mental Disorder," Psychiatry 40: 369-375, 1977. Boisen refers to these questions in his The Exploration . . ., but this is the first publication other than by mimeograph of the original full set. See note 19 below.


    Donald Denton, Religious Diagnosis in a Secular Society: A Staff for the Journey. Lantham, MD: Univ. Press of America, 1997. He uses three axes, "the concrete feeling of guilt," "the religious concept of sin," and the cosmic theme of defilement." see note 18 above.


    George Fitchett, Spiritual Assessment in Pastoral Care: A Guide to Selected Resources. Decatur, GA: J. Pastoral Care Publications, 1993.


    Kenneth I. Pargament, Kenneth I. Maton, and Robert E. Hess, eds., Religion and Prevention in Mental Health: Research, Vision, and Action. New York: The Haworth Press, 1992.


    Thomas Moore, Care of Soul: A Guide for Cultivating Depth and Sacredness in Everyday Life. New York: HarperCollins, 1992.


    Paul C. Holinger, Pastoral Care of the Severe Emotional Disorders: Principles of Diagnosis and Treatment. New York: Irvington Press, 1985. This is a revision of two meaty articles; see Pastoral Psychology 27: 136-150, 1979, and J.Pastoral Care 34 (3): 177-189, 1980. Holinger is a psychiatrist with a Master of Divinity degree.


    Charles V. Gerkin, The Living Human Document: Revisioning Pastoral Counseling in a Hermeneutical Mode. Nashville: Abingdon Press, 1984.


    John Patton, From Ministry to Theology: Pastoral Action & Reflection. 

    Nashville: Abingdon Press, 1990.


    Charles J. Lopez, Jr., Pastoral Counseling: Changes and Development, 1950-Present. ??PhD dissertation, Columbia Pacific Univ., ?1986.


    Robert Charles Powell, "Empirical Theology, 1916-1946: A Note on the Contribution of Anton T. Boisen." invited address, presented before the Autumn Convocation, Chicago Theological Seminary, September 1976. Chicago Theological Seminary Register 67: 1-11, 1977.


    Joanne Greer, "Linkages between Theological Reflection and Empirical Research." Abstracts of Research in Pastoral Care and Counseling. Columbia, MD: Congress on Ministry in Specialized Settings, 1995. pp. [xii-xiii]


    Robert Duffett, "The Intellectual Foundations of Pastoral Counseling : A Perspective on the Future of the Profession." J. Pastoral Care 49 (3): 255-263, 1995.


    Rodney Hunter, "Guest Editorial: A Bird's Eye View: Postmodernism and the Future of Pastoral Care." J.Pastoral Care 51(4): 373-375, 1997.


    Larry Vande Creek, A Research Primer for Pastoral Care and Counseling. Decatur, GA: Journal of Pastoral Care Publications. 1988.


    John Gartner, David B. Larson, and Carole D. Vachar-Mayberry, "A Systematic Review of the Quantity and Quality of Empirical Research Published in Four Pastoral Counseling Journals." J. Pastoral Care 44 (2): 115-129, 1990, p.123.


    Carol North and William M. Clements, "The Psychiatric Diagnosis of Anton Boisen: From Schizophrenia to Bipolar Affective Disorder." J.Pastoral Care 35 (4): 265-275, 1981. Dr. North's autobiography, focusing on her successful treatment by dialysis, is of interest even if her diagnosis of Boisen is incorrect. See Carol North, Welcome Silence. New York: Simon & Shuster, 1987. 

    Chaplain L. George Buck, just after my oral presentation of this manuscript told me of, then later supplied copies of, two documents concerning Boisen's admission in late 1935 to the Sheppard-Enoch Pratt Hospital, Maryland: the "Abstract" of his medical record (slightly over two typed pages, single-spaced) and the verbatim minutes of the "Staff Conference" "for Diagnosis" dated 11 November 1935 (slightly over 3 typed pages single-spaced). Let me note that when I sought permission in 1975 to quote from the case records concerning Boisen's hospitalizations in Massachusetts permission was denied because his one remaining relative would not provide consent; that impediment no longer remains.

    From the "Abstract": "His present illness is similar to his previous ones, except that in his relationship this time he believes himself to be on top, whereas formerly he was on the bottom. His ideas center about the family of four  weak accepting from the strong. Time for the weak to do something for the strong -- classifying himself as the weak one. He thought the informant was a Jewess betraying him and then believed he was John the Baptist. . . . He identified himself with Mary Magdalene, referred to Dr. Cabot as being the 'dead Center' of things. . . . He talked about changes going on in the moon, thought the world cold be saved if twins were born every birth because Christ lost his life everytime someone was born."

    From the "Staff Conference": [Boisen:] "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 . . . ." [Physicians:] "Diagnosis -- schizophrenia. Good outlook for this attack. He has recovered from his previous attacks, and this is exactly the same, with the one difference, and that is, when he described the relationship between himself and other people of always putting himself at the bottom and the other people on top, and this time he puts himself on top, which may be a better prognostic significance than the former ones. . . . I try to be optimistic about the outcome, but I am afraid it may not work out that way."


    [Helen Flanders Dunbar] "Certificate of Death [August 21, 1959]." Hartford: Connecticut State Department of Health, August 22, 1959. 

    Flanders Dunbar, Psychiatry in the Medical Specialties. New York: McGraw-Hill, 1959.


    Underground Report 1


    "Male Bashing at Breckenridge [the Association for Clinical Pastoral Education annual conference, 1991]," Underground Report 29 : 1-4, 1992, p.3.


    Edward E. Thornton, "The 'Secret' of Clinical Pastoral Education" [editorial], J. Pastoral Care 36 (3): 145-146, 1982, p.146


    Anton T. Boisen, "Clinical Pastoral Training in Retrospect and Prospect: Remarks at Faculty Luncheon -- Union Theological Seminary. October 30, 1957. 5 pp, lithographed. copy in Boisen's case record at Worcester [Massachusetts] State Hospital; other copies have been seen, and a copy is probably in the ACPE archives.


    Robert C. Powell, "Anton Boisen and Theological Reflection: The Importance of Being 'Still Crazy After All These Years." presentation at Chicago Theological Seminary, 1987


    For more regarding the CPSP program for mature pastors and institutional chaplains, see the "web" at


    Underground Report 1 (5): 2, 1988.


    Leonard I. Sweet, Underground Report 1 (6): 4, 1989.


    Robert M. Claytor, Underground Report 1 (6): 4, 1989.


    Lyle Grainer, Underground Report 1 (8): 2, 1989.


    Nick Ristad, Underground Report 1 (8): 3, 1989.


    Carl Brand, Underground Report 1 (9): 4, 1989.


    Raymond Lawrence, Underground Report 1 (17): 2, 1991.


    Perry N. Miller, Underground Report 20: 2, 1991.


    Charles Gerkin's book quoted, Underground Report 23: 3, 1991.


    Raymond Lawrence, Underground Report 22: 2, 1991.


    Perry N. Miller, Underground Report 35: 1, 1992.


    As best I can tell, the meeting that led to the birth of the CPSP opened on March 17, 1990, as the "College of Pastoral Counselors and Supervisors," and closed on March 19, 1990, as the "College of Pastoral Educators and Psychotherapists." Seven months later, on October 19, 1990, it became the "College of Pastoral Supervision and Psychotherapists," later, at some date unclear to me, becoming the "College of Pastoral Supervision and Psychotherapy." The March 1991 issue of ACPE News finally acknowledged the existence of the Underground Report and its offspring. The first plenary meeting of the CPSP occurred March 12-15, 1992.


    Carroll A. Wise, Pastoral Psychotherapy: Theory and Practice. New York: Jason Aronson, 1980.


    Wise, Pastoral Psychotherapy. . . , pp. 27, 16, 17, 276, 57, 62.


    These are allusions, of course, to Boisen, The Exploration of the Inner World. . . and Boisen, Out of the Depths . . . , etc.

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