The Practice of Pastoral Care, Revised and Expanded Edition

A Postmodern Approach

Carrie Doehring

• Publisher: Westminster John Knox Press
• Year: 2015
• Print ISBN: 9780664238407
• eBook ISBN: 9781611645521
• Topic: Theology & Religion
• Subtopic: Christian Ministry

The Practice of Pastoral Care has become a popular seminary textbook for courses in pastoral care and a manual for clinical pastoral education. In it, Doehring encourages counselors to view their ministry through a trifocal lens that incorporates premodern, modern, and postmodern approaches to religious and psychological knowledge. Doehring describes the basic ingredients of a caregiving relationship, shows how to use the caregiver's life experience as a source of authority, and demonstrates how to develop the skill of listening and establishing the actual relationship. This new edition elaborates on and expands the author's previous work, adding an intercultural perspective that gives more attention to religious pluralism in the pastoral care setting. It offers a road map for using a step-by-step narrative, relational, embodied approach to spiritual care that respects the unique ways people live out their values and beliefs, especially in coping with stress, loss, and violence. Readers will be able to confidently and professionally offer pastoral care and counseling to members of their congregations or other places of ministry.

Chapter 1

Intercultural Care: Trust and Theological Accountability

The term intercultural, in preference to cross-cultural and transcultural, is used to attempt to capture the complex nature of the interaction between people who have been influenced by different cultures, social contexts and origins, and who themselves are enigmatic composites of various strands of ethnicity, race, geography, culture and socio-economic setting.

(Lartey, 2003, p. 13)

In the introduction I began to explore how pastoral and spiritual care is a two-part process that begins with trust and moves into cocreation of life-giving theologies. When care seekers trust that caregivers will respect what is unique about their religious beliefs, values, and spiritual practices then cocreation of meanings and practices can begin. The more caregivers respect the unique religious and spiritual worlds of care seekers, the more trust will deepen. Once the cocreative process begins, caregivers need to be theologically accountable for not imposing their theologies and for using their theological education to explore and assess beliefs and values collaboratively. Several key concepts lie at the heart of this process of intercultural spiritual care—trust/radical respect, theological accountability, and cocreation of life-giving theologies.

RADICAL RESPECT FOR ALTERITY

An intercultural approach builds trust when we as caregivers respect the unique religious beliefs, values, and practices of those seeking care. We enter into their story-making as those invited into their religious or spiritual homes. We step inside cautiously and with reverence, not assuming we know what is commonplace or sacred, ready to be surprised by the other and ourselves. We are guests whose welcome depends initially on the hospitality of our hosts—those receiving care. Hospitality is an apt metaphor for the challenges of intercultural care. One challenge is for us to not only accommodate but also respect religious meanings and spiritual practices that might be quite different from our own. Another challenge is to not assume commonalities when another’s religious world seems to be similar to our own.

Trust deepens when care seekers sense that caregivers will respect the mystery of who they are—their alterity.

Through pastoral encounter with others, participants will experience the paradox of familiarity and otherness which situates them within, and draws them beyond, the present and immediate . . . [to] an encounter with transcendence and authentic faith occurring at the very point of loss of certainty and self-possession: divine activity and presence encountered in the mystery of alterity. (E. Graham, 1996, pp. 206–7)

Alterity is an evocative term describing each person’s otherness: those aspects of an individual’s religious or spiritual world hidden by what seems similar or familiar to us. As intercultural spiritual caregivers we are responsible for monitoring the ways that our social location and privileges make us see others through our own experience, often eclipsing what is mysterious about them. Too easily we assimilate the differences of others into our own story-making, sometimes by imposing our religious beliefs and values on those seeking care. For example, when I as a Christian shaped by Catholic, Presbyterian, and Episcopalian traditions do not think critically about how I am comparing my religious faith to another’s religious faith, I risk subsuming the other’s idiosyncratic values, beliefs, and spiritual practices within my own.

Many comparative approaches to religion used by Christians search for similarities within other religious practices and worldviews, replicating the historical ways that Christians in various contexts have defined other religious practices and worldviews through the lens of Christianity. Think, for example, of the comparative metaphor of the elephant that supposedly represents all kinds of religions, with sight-impaired believers describing the part of the elephant they experience through their particular religious tradition. Christians assume that there is one elephant and not a variety of beasts. This search for similarities is a search for one God (Prothero, 2010), which historically has been the Christian God found lurking in what seems to be the deep grammar at the core of all religions.¹

When Christians see all other religious practices and worldviews as essentially relating to the same God then their God becomes the norm used to define religion.² It’s no wonder that “non-Christian” religions/worldviews like Buddhism end up resembling Christianity. This imposition of their Christian religious world onto others goes hand in hand with other kinds of assimilation, discrimination, and oppression based on ethnic, racial, sexist, economic, and all kinds of difference. Think, for example, of the Roman Catholic missionary presence on a Chippewa reservation portrayed in the novels of Louise Erdrich. In a chapter from Love Medicine, Lipsha laments that the sense of the pervasive presence of the Chippewa Gods was lost when the “Roman Catholics gained ground” (Erdrich, 1997, p. 201). The Old Testament God of his experience of Catholicism has “been deafening up on us.” He can’t rely on a God “whose ears are stopped … just like the government.” He concludes “we got nothing but ourselves” (p. 202). In other words, he has been assimilated into an individualistic self-reliant Anglo culture whose deafened God has eclipsed tribal spiritual practices. In this example, the imposition of Catholic beliefs goes hand in hand with governmental racist and economic oppression. Lipsha’s portrayal of alliances between government and church is one illustration of how Christian missions have been part of a cultural process of colonialization. Christian colonialism intersects with racism and classism in Lipsha’s experience of social oppression. Intercultural spiritual care must begin to take into account the violence of colonialism as it continues to be played out in each and every spiritual care encounter (Lartey, 2012; McGarrah Sharp, 2013).

Searching for similarities often forecloses startling and sometimes jarring revelations of mystery in another’s religious world. “No interreligious encounter and learning is possible without a fundamental ethical respect for the irreducible and unique alterity of the other, defined as ‘the irreducible uniqueness of the other’” (Burggraeve, 2007, p. 232). Radical respect for alterity describes the quality of relationship that awaits the emergence of mystery. Trusting in the ultimate goodness of alterity, we are more likely to welcome de-centering and jarring moments that could become epiphanies. Intercultural spiritual caregivers draw on their theological education, clinical training, and ongoing relationships with peers, mentors, and supervisors to reflect theologically and psychologically on these decentering encounters with otherness. In her description of lifelong learning, Ward notes that “much of the learning that is formative of self and identity will be as a result of the engagement with alterity or difference, an engagement that is at the heart of ministry” (2005, p. 103). Such learning fosters a “sense of identity that is dialogical, willing to share oneself with others and to be open to the (sometimes radical) otherness, or ‘alterity,’ of different viewpoints” (Ward, 2005, p. 17).

EXPLORING EMBODIED LIVED THEOLOGIES

Once trust is established through this respect for alterity, those seeking care will invite us further into their religious or spiritual world. Together we will explore their lived religion: “the ever-changing, multifaceted, often messy—even contradictory—amalgam of beliefs and practices that are not necessarily those religious institutions consider important” (McGuire, 2008, p. 4). Sociological research on “religions-as-practiced” highlights the idiosyncratic ways persons and communities practice values and beliefs in complex and dynamic ways (Ammerman, 2013; Hall, 1997, 2010; McGuire, 2008; Orsi, 1985, 1996, 2003, 2005).

In exploring the unique features of a care seeker’s religion-as-practiced, caregivers can listen for the embodied emotional/spiritual logic that connects a set of core values, foundational beliefs, and practices for coping with stress and connecting with God/the goodness of life. For example, guilt may energize an experience of religion that includes

• beliefs about suffering as a consequence of personal wrong-doing,

• values of self-reliance and individual responsibility, and

• spiritual struggles that alienate care seekers from God and communities of faith.

I propose using the term lived theology to describe this emotionally charged constellation of values, beliefs, and practices that ‘make sense’ emotionally and spiritually.³ I have derived the notion of lived theologies from sociological research on lived religions, defined as the enacted values, beliefs, and practices that are evident in personal and communal everyday life. These lived theologies are not fixed or unitary but are always shifting, depending on energizing sets of emotions. These shifting lived theologies have their own inherent ‘logic’—a practical coherence that makes sense of personal or communal everyday life but is not necessarily rationally unified (McGuire, 2008, p. 15). For example, a care seeker who is both hopeful and fearful about cancer treatment might embrace a modern scientific approach to cancer treatment while praying for and believing in a miracle. Pargament (2013) uses the image of an onion to describe these layers of beliefs. “Purposeful practices are the bearers of value: cultural norms are reproduced and handed down but there is also scope for creative re-rendering” (E. Graham, 2000, p. 110). The term lived theology points to the embodied, emotionally charged inner logic of values, beliefs, and practices that constitutes this lived theology.⁴

This focus on lived theology is a natural extension of a narrative approach to spiritual care. Narratives illustrate the ways that people embody values and beliefs in daily practices. In exploring these narratives, caregivers can listen for underlying emotions that might point to a constellation of values, beliefs, and practices that make emotional/spiritual sense. Emotions like tenderness and affection might well connect values like belonging, beliefs in God’s incarnational compassion with all humanity, and coping through social support. In contrast, emotions like fear could hold together values like self-reliance, beliefs that harm will come when one is not vigilant, and coping through addictive substances. Learning to identify these lived theologies is the collaborative work of intercultural spiritual care. The caregiver is the respectful guest who steps into the lived and intentional theologies of the care seeker’s stories. Together they can dwell in and begin to trace the outlines of these lived and intentional theologies in a collaborative way.⁵ They will deliberate over lived theologies—whether they are still relevant, meaningful, and life-giving or whether they have become irrelevant and perhaps life-limiting. They will compassionately understand their origins in childhood family and social systems. For example, a young Hispanic woman’s embedded theology of fear might originate in experiences of sexual abuse that reinforce social systems of sexism and racism. She and her caregiver will begin to identify and perhaps cocreate intentional theologies—meanings and spiritual practices that reflect the particularities of each care seeker and that care seeker’s experience of God or the sacred.⁶ Intercultural spiritual care, then, is about, first, trusting that the mystery and sacredness of the care seeker’s religious world will be respected and, second, constructing life-giving spiritual meanings and practices while being theologically accountable and self-reflexive, as I will now describe.

THEOLOGICAL ACCOUNTABILITY AND REFLEXIVITY

Spiritual and pastoral care is not just about being spiritually present as respectful guests; it is more than being open to the mystery of the other. It involves theological reflexivity (a term I will fully define), which makes pastoral and spiritual care distinct from other kinds of helping relationships. Just as health professionals draw on the health sciences and clinical training to identify, assess, and explore aspects of a person’s health, so, too, spiritual caregivers are responsible for exploring, assessing, and helping people create religious meanings and spiritual practices that are life-giving for them. I use the term life-giving to describe the goals of spiritual integration and relational justice that go beyond individual goals of healing and health.

It is challenging for spiritual caregivers to draw explicitly on their theological education in the practice of care. Biblical, historical, systematic, and comparative theological studies are highly specialized conversation partners that may not seem directly relevant in spiritual care conversations. One’s own beliefs and practices are more immediately meaningful than abstract theologies. It is also easier to default to one’s own religious tradition than to engage what is different and even foreign about another’s worldview, beliefs, and spiritual practices. Comparative studies of religion are especially important conversation partners for intercultural spiritual care, as I noted in describing radical respect. What roles do these theological and comparative conversation partners play in pastoral and spiritual care? The answer takes us into the third-order language of methodologies: What methods can be used to bring the practice of care into dialogue with relevant knowledge, like theological, religious, and psychological studies? Before taking up this question, I will consider a more basic methodological question related to theories of change: How does intercultural spiritual care help people change?

THE PROCESS OF CHANGE

How do pastoral and spiritual care conversations help people change? The process of change is complex and organic with many interacting factors. In a narrative sense, change can be described in terms of the elements of a story: who, when, how, what, and why.

Who Changes?

Those seeking care—persons, families, organizations—change in the process of spiritual care, and so do caregivers. In a relational sense, the ripple effects of change spread throughout webs of relationships—families, communities, and social systems change. When, for example, a community of faith offers a service of healing that is personally and communally empowering, the effects reverberate throughout the persons, couples, families, religious leaders, communities of faith, and even beyond. Depending on one’s understanding of God, some would say that God changes.

When Is Change Most Likely?

People change when they are ready (Miller & Rollnick, 2012; Prochaska, 2012).⁷ Emotions, values, beliefs, and spiritual practices play an important role in ambivalence about and readin...

Table of contents

• Cover Page
• Praise
• Halftitle
• Title
• Copyright
• Dedication
• Contents
• Acknowledgments
• Introducing an Intercultural Approach
• 1 Intercultural Care: Trust and Theological Accountability
• 2 Basic Ingredients of Caregiving Relationships
• 3 Embodied Listening
• 4 Establishing a Caregiving Relationship
• 5 Theological Themes and Reflexivity
• 6 Narrative Themes of Loss, Violence, and Coping
• 7 Systemic Assessment
• 8 Planning Care: Liberative Spiritual Integration
• Glossary
• References
• Index of Subjects