Pastoral Care in Context

An Introduction to Pastoral Care

John Patton

• Éditeur: Westminster John Knox Press
• Année: 2005
• ISBN:
  9781611644562
• Sujet: Theology & Religion
• Sous-sujet: Christian Ministry

An expert in the field of pastoral care, John Patton demonstrates that pastoral care is a ministry of the church. He focuses on the community of faith as an authorizer and source of care and upon the relationship between the pastor and a caring community. Patton identifies and compares three paradigms of pastoral care: the classical, the clinical pastoral, and the communal contextual. This third paradigm emphasizes the caring community and the various contexts for care rather than focusing on pastoral care as the work of the ordained pastor.

Part One

The Communal and the Contextual

1

The Communal: Care as Remembering

What are human beings that you are mindful of them, mortals, that you care for them?

—Psalm 8:4

Patient (after a visit from the hospital chaplain): “Remember me, Reverend. Remember me.”

The understanding of pastoral care in this book is based on the theological conviction that human care and community are possible because we are held in God’s memory; therefore, as members of caring communities, we express our caring analogically with the caring of God by hearing and remembering one another. God created human beings for relationship and continues in relationship with creation by hearing us, remembering us, and meeting us in our relationships with one another. The communal contextual paradigm views pastoral care as a ministry of the Christian community that takes place through remembering God’s action for us, remembering who we are as God’s own people, and hearing and remembering those to whom we minister. This chapter argues that thesis by examining the meanings of care, community, and memory and their relationship to one another.

The Meaning of Care

In an address to the Association for Clinical Pastoral Education, Parker Palmer used a quotation from Annie Dillard to affirm care as a fundamental part of the human spirit. “In the depths of the human being,” he said, “underneath the violence and terror of which psychology warned us, you find what our sciences cannot locate or name . . . the unified field, our complex and inexplicable caring for one another and for our life together here. This is given. This is not learned.”¹

Whether this “inexplicable caring for one another and for our life together here” is given or learned—I believe that it is learned in the first relationships of life—is less important than the affirmation of its fundamental nature. One can express the same affirmation biblically:

Then God said, “Let us make humankind in our image, according to our likeness; and let them have dominion over the fish of the sea, and over the birds of the air, and over the cattle, and over all the wild animals of the earth, and over every creeping thing that creeps upon the earth.”

So God created humankind in his image,

in the image of God he created them;

male and female he created them.

God blessed them, and God said to them, “Be fruitful and multiply . . . and have dominion over . . . every living thing that moves upon the earth.”

(Gen. 1:26–28)

A major conviction on which this book is based is that scripture reveals a God who cares and who creates a community with authority to interpret scripture in a way that empowers its life in the world. The material above from Genesis 1:26–28 has been the church’s classic text for the doctrine of the imago Dei, the image of God in human being, but it also provides an important biblical basis for pastoral care. It is the Bible’s earliest attempt to say what the human being is and does. The theological understanding of the human being created in the image of God has been conceptualized in a number of ways, but traditionally it has been seen as a capacity given by God to humankind, a capacity associated with power. More recent interpretations, however, have argued that humankind’s responsibility is not dominion or power over the earth but care for it.² According to one of my former professors of theology, Joseph Sittler, “The word dominion is a direct English effort to translate the Latin. In English dominion suggests domination, but that is an incorrect translation. The Hebrew statement is, ‘And God said you are to exercise care over the earth and hold it in its proper place.’”³ I think that this newer interpretation is not so much a more nearly correct translation as it is translation informed by a newer theological interpretation.

In another place Sittler insists that the “fundamental term imago Dei is not a term that points to a substance, an attribute, or a specifiable quality, but one which specifies a relation.”⁴ Humankind, according to this reinterpretation of the Genesis text (from dominion to care) has been given the vocation of caring for the earth.⁵

Considering the concept of care more broadly, the Oxford English Dictionary traces two basic views of care in the development of the English language. The first understanding involves the concept of anxiety; the second, of solicitude. To care is to be anxious, troubled, and even to grieve, but it also means to be concerned with, to regard, and even to love, in the sense of care for the other rather than for oneself. Both meanings are important in understanding pastoral care.

In one of its meanings, care expresses the basic human concern with control and predictability. It is concerned with preserving the present and/or controlling the future. To be “care-full” is to be anxious. It involves the restless waiting for the future to unfold. But care also has the meaning of solicitude and concern for the needs of the other, based not on the subjective needs of the caregiver but on the objective perception of the other’s needs. The classic image of the shepherd still usefully illustrates the meaning of care. The shepherd tends the whole flock but is ever vigilant about the needs of the individual member of the flock while being concerned for the needs of the whole.

One of the names strongly associated with the meaning of care is that of Martin Heidegger. As in the definitional views noted above, Heidegger affirmed the importance of understanding care both as the anxiety that we feel about our own lives and also as the solicitude we direct toward others. He views care as “the basic constitutive phenomenon of human existence, and the clue to its interpretation.”⁶ Care is what makes the human being human. If we do not care, we lose our humanity.⁷ Yet, our finitude and our temporality are what make care possible. We are limited by time and, therefore, challenged to care both for ourselves and for others in order to deal creatively with the limits that time imposes. Heidegger is helpful in reminding the pastoral carer that care is more than what we feel or think or do. As “constitutive of our being,” it is what we in fact are—caring.

A useful recent interpretation of care comes from ethicist Nel Noddings, who identified caring as the moral virtue necessary for reducing alienation and guiding moral action. She argues that the “highest” stage of moral judgment is “not so much concerned with the rearrangement of priorities among principles,” but “with maintaining and enhancing caring.” Finding an ethical norm in what women do rather than in what men do, she argues that women “do not abstract away from the concrete situation those elements that allow a formulation or deductive argument; rather, they remain in the situation as sensitive, receptive, and responsible agents.”⁸

To care “is to act not by fixed rule but by affection and regard.” Thus, the actions of caring will be varied rather than rule-bound, and, while predictable in a global sense, will be unpredictable in detail. What is important for Noddings is that “the rational-objective,” which is so much a part of ethical thinking today, be reestablished and redirected from a fresh base of care and commitment. If this does not happen, the caring person can become “inextricably enmeshed in procedures that somehow serve only themselves” and her thoughts “separated, completely detached, from the original objects of caring.”⁹

Noddings reminds us that the caring attitude has as its prototype the mother-child relationship. That attitude “which expresses our earliest memories of being cared for and our growing store of memories of both caring and being cared for, is universally accessible.”¹⁰ Ethical caring is based developmentally in that original relationship, but it differs in being intentional. It may be accompanied by love, but it always involves responsibility for the other—the cared-for. “As we care, we hear the ‘I ought’—direct and primitive—and the potential for suffering guilt is ever present.” Guilt is most likely, however, in caring that is sustained over time. Although the one caring affirms responsibility for the other, she also insists on “a deep and steady caring for self.”¹¹

Commenting on Noddings’s work, a recent interpreter has offered a useful addendum, namely, that the successful use of an ethics of care requires a moral agent who is clear “about the boundaries of the self so that she can practice the demanding task of engrossment without the loss of self being a problem for her.” Furthermore, a care ethic also presupposes “an agent who has a realistic sense of her own competencies and a sense of that which she can reasonably take responsibility for so that she can separate from situations in which caring is not effective.”¹²

Many of the things that Noddings has presented in her view of care resonate strongly with pastoral care as it has developed within the clinical pastoral paradigm. The development of those sensitivities to relationships that have been identified as feminine is, in fact, a quality essential to becoming a good pastor of either gender. Noddings’s emphasis on being aware of one’s own involvement in what one does and the impossibility of evaluating thoughts and acts apart from the one who has them and does them is a central feature of what is best in the clinical pastoral paradigm. Learning to deal with one’s responsibilities for caring and the necessary guilt that accompanies the impossibility of fully carrying out those responsibilities is one of the most important things that supervised clinical experience has offered.

It is hard to overemphasize the importance of care in human life. It may be a painful or a satisfying part of the most important human relationships. One of the earliest feelings and some of the earliest words in our experience have to do with whether the person most important to us cares or does not seem to care. Negatively expressed, the words “You don’t care” are, perhaps, the most painful ones that we hear or say. To care is central to being human, from the perspective of theology, philosophy, or ethics.

What care means and some of the implications of that meaning may be summarized as follows:

1. The image of God may be seen in relationality and responsibility—one’s response to God expressed through care for self and others. Care’s two meanings, anxiety and solicitude, express the self and other foci and exist in relationship to each other in a way similar to the individuality and relationality discussed in the section on community that follows.

2. Care as anxiety, or Heidegger’s “care for being,” expresses finitude, one’s own and the finitude of others. Those for whom we care most may die and leave us without relationship to them.

3. Care of the other—which cannot be separated from care of self—is based not only on our relation to God and our God-given vocation to care, but also on the fundamental relationship between parent and child, usually between mother and child. All other relationships emerge out of that basic relationship, and disappointment and denial of that relationship results in distortion of all our relationships.

4. Because of our relationality and our call to care, guilt is inescapable as a result of our failure to care fully and adequately. Thus, to be human is also to be guilty and to find ways of dealing with that guilt.

5. Care is fundamental for humanity and, as Tillich has suggested, an unconscious expression of who we are. However, ways of caring and caring more effectively can and should be learned by those called to a ministry of pastoral caring.

The Meaning of Community

In reflecting upon the meaning of community as I had experienced it and discussed it with caring communities involved in ministry, I recalled a lecture by theologian Daniel Day Williams in which he spoke personally of his experience of Christian community.

What was most important was the experience itself . . . this sense of being in an unfriendly world, a world full of all kinds of threats—the struggle to adjust to the group, of being alone—and then discovering that there is a group in which there is real love. In the church there is a community which truly cares about you. There is the sense of sin, of being involved in evil that you cannot overcome and being estranged from what is essentially right in life. And then the discovery of grace—that the sinner is still within the circle of the care of God—that there is a possible restoration of life. There is the experience of a new kind of life itself, a life beginning to be restored to what it ought to be. . . . Whatever philosophy or world view or general knowledge about the world comes along, it must help interpret this most important thing of all.¹³

I also remembered talking about the meaning of community with one of the elderly church members in a small church on the South Side of Chicago, where I was pastor during my days as a graduate student. Dr. Matthies had grown up in a German community in South Dakota. When I asked her how she happened to be a Methodist instead of a Lutheran, her simple answer was: “The Methodists called me ‘little sister Mabel.’” That community had named her as belonging to them.

Much more recently, when I was interviewing a group of lay ministers in a large Presbyterian church in the Southwest about how they understood themselves as ministers, one of the women, whom I will call Natalie, said:

I grew up in this church. A lot of these people were here when I lost my father, and they gave me something I didn’t even know I needed. I guess you could call it a sense of being part of a group that cared. When I visit people I want to give them the same kind of thing, a feeling that there is something important that they are a part of.

Natalie wanted people to feel “that there is something important that they are a part of.” She remembers being cared for herself, and wants others to experience care as she has. Her loss will help her be sensitive to the losses of others, but what she has to offer is not only what her life experience has been, but what she has experienced as a member of a caring community. Professor Williams, Dr. Matthies, and Natalie all remember being cared for and experiencing community. In sharing these reflections I am underscoring the importance of community as a basis for ministry, not attempting to develop a singular way of describing it.

One way of describing community has been suggested by William Willimon, who has identified five characteristics that are applicable to most of the caring communities that I have studied and experienced. Those characteristics are: common identity, common authority, common memory, common vision, common shared life together, an...