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The College of Pastoral Supervision & Psychotherapy is a theologically based covenant community, dedicated to "recovery of the soul" and promoting competency in the clinical pastoral field.

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December 8, 2014

“Spiritual Well-Being”—by Rev. William E. Alberts, Ph.D.


“Spiritual Well-Being”—by Rev. William E. Alberts, Ph.D.
The Theme of the 2014 Pastoral Care Week

(Condensation of presentation given at the annual Pastoral Care Week celebration at the University of Pittsburgh Medical Center, Pittsburgh, Pa on October 21, 2014, and at Neptune, NJ’s Jersey Shore University Medical Center’s first celebration on November 3, 2014. Photo by Chaplain Dianna S. Wentz, D.M., UPMC Mercy Hospital)

This year’s Pastoral Care Week theme is “Spiritual Well-Being.” If you Google the word “spiritual,” 18,100,000 references appear. Spirituality reveals not only the infiniteness of divinity, but the infinite varieties of humanity.

Spirituality can represent a wellspring, or a wastebasket. A wellspring of comfort and strength that enables coping and wellness and empowerment and direction and reflection and “love-your-neighbor-as-yourself” connectedness with other human beings.

Spirituality can also represent a wastebasket, in which insecurity may lead one to dumb down his or her god with absolutes that provide certainty, are dismissive of cause-and-affect understanding of human behavior and the natural order, can’t stand ambiguity, nurse “exceptionalism” that is intolerant of diversity, and lead one to act as if “loving your neighbor as yourself” actually means wanting your neighbor to be like yourself.

That said, my focus is that the “spiritual well-being” of patients and their families often depends on the emotional well-being of the chaplain. I see a hospital as a unique crossroads of humanity, which calls for pastoral/spiritual caregivers who are comfortable with and accepting of diversity of belief—and nonbelief—of patients. Thus, the pastoral/spiritual care and “well-being” of patients and their loved ones begins with the humanness of the chaplain-- beyond the outward calling, the inward emotional journey where one becomes self-aware, and is in touch with and accepting of oneself.

Chaplaincy is about empowering patients and their families, not imposing any belief or value system on them. It is about empathy, not evangelism. About connecting with, not converting. Respect for the patient’s beliefs and rights is fundamental.

Pastoral/spiritual care is not about the chaplain, but about the patient. It is about the chaplain in terms of his or her awareness that it is about the patient. That is where the chaplain’s emotional security comes into play.

This emphasis on the patient and his/her “spiritual well-being” is not meant to minimize the identity and faith of the chaplain. Rather, it is to stress the pastoral/spiritual care qualities of self-awareness and inner emotional security that enable the chaplain to affirm patients and their families to be who they are. It is the emotional “wholeness” of the chaplain that nourishes the chaplain’s “spiritual well-being”—and that of the patient as well.

Spiritual care-giving is determined by the expressed beliefs, wishes and spiritual and human needs of patients and their loved ones. It is about utilizing and reinforcing patients’ and families’ beliefs in their struggles to recover, or to cope with dying and grief.

And if a patient is comfortable with being a “non-believer,” that should not make the chaplain feel uncomfortable. That patient is neither less nor lost, but just as legitimate as a “believer,” and just as deserving of pastoral care—guided by that patient’s wishes.

Self-awareness and emotional security free the chaplain to participate in an interdisciplinary commitment to fulfil any hospital’s mission of individualizing patients, respecting their diversity and rights, and providing “Exceptional Care. Without exception”—which is Boston Medical Center’s stated mission.

I was privileged to work as a full-time hospital chaplain at Boston Medical Center, from 1992 to 2011, when I retired. And since then, I’m still privileged to work there as a chaplain consultant, covering on occasion for the two staff chaplains. I want to share BMC’s diversity statement with you, as It expresses most hospitals’ emphasis on diversity, which has implications for the emotional make-up of chaplains. BMC’s 2008 Diversity Statement says,

As part of its stated mission and values, the Medical Center
remains committed to creating and sustaining a work place and
a hospital where employees and patients, and patients’ families
are respected and valued not in spite of, but because of, the
differences in their backgrounds and cultures. We believe that
there is strength in diversity, not only of race, gender, age,
religion, and disability, but also of education, politics, family
status, national origin, sexual orientation, and all of the other
factors that make people individuals.

I’ve stressed the diversity of patients and the emotional integration that reality requires of us chaplains. The commonality of patients and their families is also to be emphasized.

A hospital especially reveals humanity’s commonality as well as its diversity. Illness confronts all people with their mortality, and hence their vulnerability, their humanness—their oneness and connectedness with each other. In a hospital, the common humanity people share comes to the fore and often transcends their differences. Some of the best pastoral care comes from the patient in the next bed—and from relatives and friends.

A metropolitan hospital is actually a global neighborhood, as it uniquely reveals the humanity everyone shares. Patients and families of different religions, races, nationalities, genders, sexual orientations, political ideologies, religious beliefs and economic classes bring their common mortality to the hospital’s crossroads of humanity and reveal what our global neighborhood looks and feels and is like—like everyone of us.

In the hospital’s radical humanizing setting, individuality discovers its commonality, diversity meets its connectedness, uniqueness is introduced to its oneness, illness offers class consciousness a lesson in equality. Everyone becomes ill, experiences fear, endures pain, sighs, laughs, cries, dies, and is grieved. Everyone bleeds human. And it is these very struggles that bring out the tremendous wisdom of patients and their loved ones. The spiritual/pastoral role of the chaplain is to give these common human struggles air and reverence.

Now to put some “flesh and blood” on “spiritual well-being. “ I recently encountered a patient in need of “spiritual well-being” before my day officially began-- upon entering the Admitting Office to pick up my patients’ list. She was sitting in the hospital’s Admitting Office-- along with a few other patients. As I sat down to wait for my patients’ list to be printed, a black woman called out to me from across the room: “Are you a doctor?” “No. I’m a hospital chaplain,” I replied. “Do you say prayers for people, and give the last rites?” “I say prayers for people, if they want me to,” I answered. “You say prayers,” she repeated. The man accompanying her, who turned out to be her brother, said, “He said that he says prayers, if people want him to.” She then said, “I’m having surgery today, and I’m a little nervous.” “I can appreciate that,” I said.

At that point the Admitting staff person told me the patients’ list was ready. Upon receiving it, I went over and sat down next to the woman, told her my name, and asked her name. After she introduced herself, I asked her religion, and she said that she is a Catholic. She then stated that she would appreciate receiving a prayer before her surgery, a hysterectomy operation.

I told her the name of the Catholic chaplain, and said that I would leave a message for him with her request, saying also that he may not be in as he had been ill. I said that if he doesn’t come in, I would find her and offer a prayer, which she appreciated.

I left the Admitting Office, climbed a flight of stairs, walked across a bridge toward my office, and stopped—thinking about her. She said that she wanted a prayer before her surgery. And it was unlikely that the Catholic chaplain would be in, and if he did come, he probably would not arrive in time. Also, the Admitting staff person told me that she would not be assigned a room until after her surgery, which meant that I might have difficulty reaching her beforehand.

So, I walked back to the Admitting Office, sat down next to her, and said, “Would you like me to offer a prayer for you now?” “Yes, I would,” she said. I took her hand and offered a prayer: it began with her “feeling a little anxious” about her surgery, and continued with Jesus who touched all kinds of lives to reveal God loves everyone, including her, gave thanks for the commitment of the medical staff attending her, called forth all that is loving to bless and renew her, and expressed gratitude for the love she and her brother share. When I finished, she said, “Thank you. I feel much better.”

She then told me a little about herself. She just turned 57, celebrating her birthday two days ago. She has four grown sons. And a supportive brother by her side. Before leaving, I shook her brother’s hand. He stated, “Thank you,” and added, “May you have a blessed day.” “Thank you,” I said.

You never know when someone may say to you, “I’m a little nervous.” That may be an invitation to pastoral care.

Much of pastoral care is unscripted. It is about ear and sight. Spontaneous responses to what is heard and seen. Becoming comfortable with silence, seen as natural not awkward. Feeling one does not have to fill it in with talk. Or perform a self-expected conventional ministerial role. Secure around strong emotional outbursts of loss, understood as human not as inappropriate or profane. Un-pressured by a fear of not saying the right words. Or of saying the wrong thing. Again, learning where one is coming from so that one may better know where other people are at. At ease with oneself, and therefore attuned to others. It is what I call the humanology of pastoral/spiritual care.

I continue to appreciate the power of prayer in the service of “spiritual well-being”—prayer that is on the wings of rapport having been established with a patient, rather than a substitute for it.

The power of prayer is seen in the surprising response of a 70-year-old black Protestant patient. Since she looked familiar, I asked if we had met before. She replied, “Yes,” then said, “I still remember when you visited me 8 years ago. I was near death, and you prayed for me, and lifted my spirits. I’ll never forget that.” She reveals that it is not just what a chaplain’s prayer may bring to a patient, but what a patient’s belief in her god may bring to a chaplain’s prayer.

Not that a patient’s “well-being” requires prayer or being “spiritual.” I believe that a primary role of a chaplain is to enable a patient to tell his/her story—which in itself nourishes the patient’s health, connectedness , and thus well-being.

One of my responsibilities is to visit patients whose religion is unknown, to determine if they are affiliated, and if so, that information goes to the appropriate chaplain for follow-up. When patients say they are unaffiliated, I wish them a good day and good progress in their treatment. I have no desire to market religion. I have an aversion to conversion, as the desire to convert people to one’s religious belief violates their right to be who they are. I take my cue from patients. If they want to interact, they let me know in different ways, and I respond.

Like the 64 year-old white man who told me that he was not affiliated with a religion, and continued-- and I listened. He said, “I believe in God, but not in organized religion.” He explained: “Picture the world as a puzzle, and each of the religions a piece of the puzzle. If I had the power and wanted to make the world be at war against itself, I would tell each group that its religion was the true one. All the groups,” he continued, “would be trying to convert each other and fighting would ensue. And the pieces of the puzzle could not be put together to reunite the world.”

The patient then stated, “Power corrupts.” He then quoted English historian, Lord Acton, who said, “Power tends to corrupt, and absolute power corrupts absolutely.” The patient said that organized Christianity, Catholic and Protestant, “is the anti-Christ.” Their aim, he believes, is to gain power over people, not empower them. It is not about “love your neighbor as yourself” as Jesus taught, but about which has the biggest miracle and thus the biggest piece of “the puzzle.”

The patient retired early from a professional position, and began tutoring children in English and Math. He said, “I have no children of my own, so my aim was to help other children to learn and obtain knowledge.” He said it was a challenging task, and involved teaching lessons for 10 minutes, then playing Scrabble or Chinese Checkers with the children for a period of time, then back to the lessons. He discovered that this technique enabled the children to better grasp and integrate material.

The patient then went to the heart of his story. One of the students he tutored grew up and became a state representative. He went to his former student’s election victory party. He jokingly told the state representative that he wanted to look at his victory speech to see the influence of his tutoring years ago. He said, “The state representative replied, ‘You gave me my humanity.’” The patient then choked up, and added, “At that moment the world stood still for me. His words led me to feel that I could have died right then and life would have been fulfilled for me.”

Pastoral care is about enabling patients to tell their stories, the sharing of which affirms and empowers the teller and often provides wisdom for the listener—a precious form of “well-being” for both.

Different patients have different definitions of what “well-being” means to them. Like the 80-year-old white man in an intensive care unit with a serious medical condition, which, understandably, led him to be “grumpy,” his nurse said, as she sought to prepare the way for a visit from me.

At that moment “Dexter,” the dog, “a 100% Boxer,” came into the Intensive Care Unit with Mike, his master. “Dexter” is one of 8 dogs that form a special program at Boston Medical Center, called, “Hounds Making Rounds.” The nurse invited “Dexter” and Mike into the “grumpy” male patient’s room, and asked me to follow, which I did. And as the nurse introduced me, the patient waved me off, indicating he did not want to see me. So, I wished him a good day and left. But he sure wanted to see “Dexter,” who proceeded to put his front paws on the top of the patient’s bed and wag his tail—and the patient petted “Dexter”-- with a smile on his face. Spell “dog” backwards, and you will see the power of “Dexter’s” presence.

For another patient, it was about his needing access to a loving god. An older, terminally ill black man, the patient told a palliative care nurse that soon he would be “shoveling coal.” The concerned nurse shared his troubling words of self-condemnation with me, said he was dying of cancer, had difficulty speaking because of his weakened condition, and asked that I visit him. His doctor also told me “We’re in a muddle about his saying he’s going to shovel coal in the next life, not knowing how to handle it.”

The patient confirmed that he was “going to be shoveling a lot of coal” when he died. I asked, “Why?” “Because of the number of bad things I have done in my life,” he said in a weakened tone. I did not pursue the “bad things” he said he did because of his difficulty speaking. Instead, being a black man, led me to ask if anyone had ever done “bad things” to him “growing up and in your life?” “Yes, a lot,” he replied.

Having researched and written about America’s white-controlled hierarchy of access to economic, political and legal power, I assumed he probably had at least two racial strikes waiting for him when he was born. One invisible strike could be seen in a study that found, “Blacks Suffer Heart Failure More Than Whites . . . at a rate 20 times higher than did whites, even dying of it decades before the condition typically strikes whites . . . researchers reported.” (The New York Times, Mar. 19, 2009)

The second unseen strike against this patient may be found in another study that showed, “Chronic stress from growing up poor appears to have a direct impact on the brain, leaving children with impairment in at least one key area—working memory.” The “bad things” here: “Children raised in poverty suffer many ill effects: They often have health problems and tend to struggle in school, which can create a cycle of poverty across generations.” (The Boston Globe, Apr. 7, 2009).

In other words, a full stomach feeds a hungry mind. Whereas an empty stomach can fuel despair and destructive behavior.

Sadly the patient had a self-loathing heart. A white-dominated hierarchy, with him at the bottom where “bad” economic, social, political and legal “things” happen to people of color especially—and also to economically strapped white persons. “Bad things” legitimized by a theology of self-hatred, which was the third strike that apparently led this patient to believe he would be “shoveling coal” in hell when he died. A theology of self-hatred internalized through identification with parental and other religious authorities, many of whom themselves possibly struggling with their own marginalization at the bottom of society.

A theology of self-hatred born of oppressed and oppressive human relationships. A theology in which all persons, black and white alike, are born in sin, and will be “shoveling coal” unless they renounce their sinful nature and accept “Jesus Christ as the only Son of God and their Lord and Savior,” who is portrayed as having died on the cross for their sins.

The citing of this substitutionary atonement theology is not meant to disregard the model of Jesus as liberator. The civil rights movement in America in black churches has found much empowerment in Jesus’ words, “The spirit of the Lord is upon me, because he has anointed me to preach good news to the poor . . . and to set at liberty those who are oppressed.” (Luke 4: 18)

Certainly, also, there are many patients who believe that Jesus died for their sins, whose lives have been transformed in admirable personal ways.

Concerning this patient, what seemed to reassure him was not so much that I said Jesus revealed a “god of love who especially loves you.” Nor my statement that all of us are human and in need of grace. Nor the fact that a lot of “bad things” had happened to him already. Nor even the prayer that I offered, though prayer is often a powerful way to affirm and reassure a patient.

What seemed to especially connect with this patient was my telling him, “Wherever you are I will see you there.” “You will?,” he asked. “Yes, I’ll be there. And neither of us will be shoveling coal.” “I hope you’re right,” he said. Before his discharge to a hospice I saw him again and repeated: “Wherever you go, I’ll be there. I’ll look for you until I find you.” He replied, “Okay. That’s a promise.” “That’s a promise,” I said. The patient seemed to find reassurance in hearing someone not only voice caring about whether he lived or died, but caring about him even after he died. The bottom line of pastoral/spiritual care is caring.

For me, “spiritual well-being” contains a prophetic or social justice dimension, i.e. addressing the economic, political and legal determinants of health and illness. In an essay on “Community Health Centers in US inner Cities: From Cultural Competency to Community Competence,” published in Ethnicity and Race in a Changing World: A Review Journal, Winter 2009, Tufts University Professor of Urban Environmental Policy Professor James Jennings makes this point:

. . . The idea of multiculturalism or cultural diversity in the delivery
of health services is limited and incomplete in responding to health
challenges in US low income urban communities. In these places, where
problems of poverty, unemployment, bad housing, toxic air, and dirty
streets are found in greater levels than other places, community
health centers must move beyond simply being culturally sensitive
or reflective of local groups. Rather, they must enhance their
organizational role as community actors and become involved in
working with other non-health organizations seeking to challenge
the local and spatial manifestations of inequality. . . . Community health
centers in low-income communities represent a key venue for linking better
health for all people with a more just society.

I want to conclude by going a step further. In my 22 years as a hospital chaplain, I have been present, as you have, with families, at the bedside deaths of many religiously, culturally, politically and economically diverse people. “Don’t go, Mamma. Don’t leave me. I love you, Mamma” “Don’t leave me, mother! I will be all alone! I won’t know what to do without you! I love you so.” “You were always here for me, dad. I will never forget what you’ve done for me.” “You are the best mother in the world. Whether we were right or wrong, you protected us. Always.” “God damn it! I love her so!“ “Wherever you are in the afterlife, I shall find you, my darling.” “Momma, Daddy is waiting for you up there, and wondering what is taking you so long,” a tearful son said, chuckling sadly, at his dying mother’s bedside.

So many human expressions of love’s universal grieving aftershocks: anguish and anger, crying and cursing, screaming and shaking, silent and solemn, stroking and hugging and comforting. Human love transcends culture and color, religious belief and political ideology, poverty and wealth, straight and lesbian and gay and bisexual and transgender. People with less love as deeply as people with more. As with birth, death reveals the humanness everyone shares, and love is at the heart of that humanness. To hear each other’s laughter and to see each other’s tears is to experience each other’s humanness.

Iraq, Syria, Afghanistan, Israel, the West Bank and the Gaza Strip, Pittsburgh, New Jersey, all over America and the world: “spiritual well-being” is about empathy—toward ourselves and others-- that is at the heart of The Golden Rule.

Appreciation is expressed to CPE supervisors Revs. Charlie Starr and Joan Alevras and staffs at UPMC and JSUMC respectively for their care in planning the Pastoral Care Week celebrations and warm hospitality.
Bill Alberts is a member of CPSP’s Concord, New Hampshire Chapter. His book, A Hospital Chaplain at the Crossroads of Humanity, “demonstrates what top-notch pastoral care looks like, feels like, maybe even smells like,” states the review in the Journal of Pastoral Care & Counseling. His new book, The Counterpunching Minister (who couldn’t be “preyed” away), will be available shortly.


Posted by Perry Miller, Editor at 7:46 PM

December 4, 2014

2015 CPSP PLENARY.--Gathering of the Community-- A Celebration of Life Together After 25 Years


Gathering of the Community


Still Learning From Boisen
50 Years After His Death

We cordially invite you to join us
from March 15 – 18, in Chicago, IL.
We will meet for informative speakers,
dynamic group process,
and to celebrate our successes.

The CPSP Community will gather in Chicago March 15 - 18, 2015 to celebrate our 25 years together as a vibrant and innovative certifying and accrediting community dedicated to excellence in the clinical pastoral field. The theme of the conference is "Still Learning From Boisen 50 Years After His Death".

The schedule is as follows:

Sunday, March 15 – Thinking and Feeling Together About The Things That Matter Most - Anton Theophilus Boisen (1876-1965)
Workshops and gatherings will take place during the day.

The Presentation of the Helen Flanders Dunbar Award will be made by Robert C. Powell, Ph.D., M.D..
The Keynote Speaker is Glenn H. Asquith, Jr.
The event is scheduled for 6:00 p.m. that evening.

This will be a very special day - please be sure to join us!

Monday, March 16
Opening Session, Small Groups, and Presidential Luncheon.

Tuesday, March 17 –
Tavistock, Small Groups, Presentation of Certificates, and live entertainment.

Wednesday, March 18 –
Governing Council Meeting, closing.


The gathering will be held at the Embassy Suites Chicago - Downtown

Just steps from Magnificent Mile, and one block from the subway station, this newly renovated hotel has a dramatic 11-story atrium, filled with blooming foliage and a rushing waterfall.

Every guest room is a two-room suite, with a separate living room and bedroom, equipped with a microwave, mini-refrigerator, coffeemaker, and two telephones. Complimentary cooked-to-order breakfast is available every morning. PURE allergy friendly rooms and non-smoking suites are available.

We have reserved a block of rooms at the special rate of $159 per night for the single rate (one king bed) and $159 for the double rate (two double beds), and the separate living room includes a queen-size sofa bed, so three guests can easily share one room. There is a charge of $30 per person/per night, for more than two in a room. This rate is good for the Saturday night before the event, and the Wednesday night that our event ends.

Embassy Suites Chicago –Downtown
600 North State Street, Chicago, IL 60654
Tel: 312.943.3800
Event Code: CPS

More information and online registration: 015 Plenary - Gathering of the Community

A brochure will be posted on the Pastoral Report and emailed to all members in mid-December, and it will include a more specific schedule, as we finalize our plans for the very special event!

UPDATE: DOWNLOAD: 2015 CPSP Plenary Brochure

Posted by Perry Miller, Editor at 1:16 PM