Monday, September 28, 2015

Theology of Pastoral Care…an ever-evolving project

A.Hanson, Denver, 2015
At the start of my year of residency, I was quite timid in my pastoral caregiving.  I did not want to be too Lutheran or too Christian or not Christian enough or step on anyone’s toes or assert authority that I did not have.  I struggled a lot with the question, “what does a chaplain do that is different from a social worker or a particularly compassionate nurse?”

While still evolving, my pastoral theology centers around the conviction that pastoral care is an essential part of reuniting the whole person who is experiencing un-wellness with the social environment of which they are a part. Our discipline as chaplains is not concerned with treatment or therapeutic support, but rather, to meet another person where they are, using all of our humanity to meet their humanity. We have tasks that are therapeutic and we have tasks that are supportive of wellness, but our primary role is not wholly that. Perhaps more than anyone else in the hospital, chaplains are a link to the outside world and to a world of health and wholeness and a reminder of the hope that a person will rejoin that world outside the hospital. In the case of a patient’s death, we serve that function for family members.

Another core aspect of my pastoral theology is incarnational. I believe that God is in all people.  This might be seen as foolish, because it means that I tend to see people in the most affirming way but I think I will go on celebrating it because I would rather be foolish and see people as good than be suspicious and always be looking for evidence to the contrary. With this aspect of my pastoral theology, I do not think that I “bring God” to my patients, but rather, because God is in both of us, our time together is a fuller realization of the Kingdom of God. I view the hospital as a sort of communion table. We all bring ourselves to the table, we are broken and Christ is broken for us. The Lutheran understanding of the sacraments is that the most ordinary of things (such as water, wine, and bread) can carry the presence of God.  So the most ordinary of things in the hospital, one person sitting with another, already carries the presence of God.  Pastoral visits are sacramental and sacred.

One of the parts of my theology that has been challenged is my conviction that “God is always present.”  Because there are many, many times where I feel like this is not true. I have not found an answer for this question, and why my greatest discovery in my work as a chaplain has been the depth of mystery that exists in this work. Why bad things happen. Why patients with the same condition have vastly different outcomes. Why children die. Why parents die. Why sheer luck saves someone when all the knowledge in the world cannot. Why prayer seems to work. Why prayer does not seem to work. Why it is possible to feel the presence of God so clearly at times, and yet, at other times, God is so far away. I have no answers. When I started this residency I was searching for answers. I knew that explanations of faith healings and miracles and fervent prayers did not hold for me, but I was searching for the elusive answer that would somehow tie it all together.  And the answer has been revealed, and it is, “trust the mystery.” Patients frequently ask me what happens after death, and express their existential anxieties about what will happen to them, and the most truthful answer I have is “I have no idea.”  And I am settling into being okay with the mystery. My progressive Lutheran theology does not have the answers, neither does Christianity, nor does science. The only answer is, “I am willing to be with you in your suffering as you ask those questions.” Where I have landed in this particularly difficult part of my pastoral theology is to come back to Christ as seen on the cross, and God being willing to descend to hell and death, and I come away knowing, “There is no place that God is unwilling to go.” 

A final conviction that shapes my pastoral theology is that of, “I see your suffering and I am not repulsed by it.”  I do not take a medical model approach to suffering (diagnose and cure) or flee from suffering as the world is wont to do, but rather, an accompaniment model. I stand alongside my patients in their suffering and bear witness to it and provide a hand to hold and an ear to listen and a mirror to reflect.


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