Thursday, March 17, 2016

The work of chaplaincy and "emotional labor"

A. Kumm-Hanson Minneapolis 2016
I stumbled across something the other day comparing the physical labor to what is called "emotional labor." This idea resonated with me, because of the emotional intensity of chaplaincy. Work of this nature has ramifications for the chaplain's personal life and perhaps an honest appraisal of the toll of emotional labor can contribute to resiliency and health for the chaplain.

Chaplains dwell in the realm of the not-quite-tangible. Our practice involves spiritual and emotional concerns, not physical or social issues to be addressed. Our tools of assessment are not stethoscopes or CT scans, but our ability to listen deeply, our intuition, and our own emotions. In order to assess our patients, we literally use our own souls. We check in with what we are feeling to "take the temperature of the room" (to quote a CPE supervisor). We reflect back the emotions of our patients using mirroring techniques. We do not feel in full the trauma or death or pain of our patients, but we do go into those spaces with them and surround ourselves with that suffering.

Chaplaincy does not involve physical labor like industry, but it involves labor. One of my wise colleagues mentioned that the main difference between a healthcare chaplain and a parish pastor is that while pastors can and do enter into spaces of suffering and dying, they may only do so a few times a year. Chaplains go into the places of deep suffering many times per day. It is emotional labor to center one's self again and set aside whatever might be happening in the next hospital room over or the ER or whatever the chaplain witnessed already that day to be FULLY present with each patient.

It is tremendous emotional labor to be able to walk into a trauma room (I have the privilege of working in a level 1 trauma center) and exude calm. It is human nature to react to extremely stressful situations with "fight or flight" responses. It is a matter of training and experience to be able to observe calmly what is happening, with heightened senses, and be a source of calm and steadiness for others.  Instead of "fight or flight"chaplains "focus and feel." One of my favorite ER nurses said about chaplaincy, "Your physical presence in a trauma room is a rock for the patient, but also for the staff. We know you are going to be calm and we look to you for that strength." It is not physically possible to hold onto all the pain that we take in, but it takes emotional labor to release that pain also. When we come home from that night shift or that day of visiting nursing homes, we often just want to eat and turn our brains off. And in our sleeping or our reading or our netflix binge watching, that pain seeps out slowly like sap from a tree. It hurts a little, but it is necessary to relieve the pressure.

Our conversations with patients are deep. We talk about the sorts of things that many of us would rather ignore. Death and suffering and aging and tough decisions. We are called into ethical dilemmas and to bear witness to patients gasping for air and to offer comfort to family members. We are called to sit with patients so they do not die alone. Sometimes we forget how to have light conversation, because so many conversations in chaplaincy are serious. We might have little tolerance for small talk in our personal lives because we bear witness to the most sacred and painful moments of the human experience. But we want you to know that nothing you might say will scare us, because honestly, we have heard it all before.

We might not want to be social butterflies during our off time or we might want to surround ourselves with a close network of people who "get it." Because it is so hard to explain what we do, why we do it, and how we can possibly continue to do it day in and day out for years. We love our work, but it changes us. We think way more than the average person about the ravages of cancer or the slow death of dementia or the violent randomness of trauma. We are constantly thinking about the lives (and deaths) of our loved ones and we are constantly faced with our own mortality.

We might not always have the emotional energy to be fully present to our own spouses, families and friends at the end of the day. This is the greatest consequence of emotional labor for me. I am an introvert and sometimes I just do not have the emotional reserves to be a wife and family member without time to recharge.

For me, the most important tool in managing the toll of emotional labor is ritual. I symbolically put aside the day by changing out of my work clothes immediately upon returning home. I pray silently in my car that God would hold the concerns of those whom I serve in my work, so that I can let go of them. I visualize all of the trauma and suffering that I hold in my body draining out of me and into the earth. Sometimes I literally lay on the ground and do this. I worship in a faith community that sings its prayers and holds hands together, and I derive strength from the great cloud of witnesses each week. I cry when I need to, because sometimes it is all too much to bear.

Another important part of my resiliency is self-care. I relax HARD on my days off. I sleep a lot. I work out. I eat good food and enjoy good coffee. I try to do creative, generative activities like art and knitting, that allow me to create something tangible. I derive enjoyment from physical activities like yard work and cleaning, because it allows me to use my body instead of my mind. I ask for help when I need it. I love my spouse deeply and enjoy the company of my dogs and their enjoyment of the present moment.

I am not perfect at any of these things, and I still find myself getting worn down at times, but they are disciplines and they get better with time.

Fellow caretakers and chaplains, how do you counteract the toll of emotional labor?

1 comment:

Doug Koop said...

Thank you for this fine description of the spiritual care provider's task. Like you, I work in a trauma hospital and engage many people in their darkest hours. The language of "emotional labour" was particularly helpful.