Because of the heightened affective state around illness, uses the psalms, prayers, Christian poetry, and metaphorical language help communicate directly into the soul in this affective space
I was recently asked what guidelines we used in selecting Christian literature that was suitable for hospital patients. My ideas have been shaped by Christian patients who told us what they liked or had found helpful. We also knew what literature patients and families had selected themselves, and there was a high degree of agreement. It was one of those situations where I had to give words to implicitly held ideas.
The most commonly requested and chosen Christian literature are booklets containing a single Gospel, New Testaments containing Psalms and Proverbs, and complete Bibles. Many people take pocket copies with small print, but many others request large or giant print or easy English translations. There is also a need for a simple handbook to the Bible to assist new Bible readers.
Begin where the person is, not where we would like them to be – working from the real, not the ideal.
In addition, to Bibles, many patients choose other literature, and based on the patients’ selections, below are some considerations we attend to when selecting printed material for patients. A further crucial concern is that illness affects people’s ability to concentrate and form new abstract concepts but often opens people to deeper affective and emotional perspectives on realities.
Literature that speaks to patients and their families:
Places them in conversation with God through thoughtful words – allows them to notice, wonder and discover things about the triune God.
Begins where the person is, not where we would like them to be – working from the real, not the ideal.
Uses easy English, good sized font and pictures or illustrations designed for adults rather than teens or children.
Holds to Christian/scriptural theological perspectives that are agreed upon by most denominations.
Uses the first and second person I-Thou rather than third-person and addresses the reader as you rather than them, they, this person or that.
When speaking about God, talks to God, or of God, as if he is standing right next to a person longing that they might come to him, rather than distantly about God.
Because of the heightened affective state around illness, uses the psalms, prayers, Christian poetry, and metaphorical language help communicate directly into the soul in this affective space.
Uses gentle and gracious language that can accommodate the depth of suffering, helplessness, meaninglessness, pain and angst of a severe illness, leaving a door open for God’s transforming life in the situation.
Avoids offering answers without hearing the questions – this is particularly the danger with evangelist tracts – they are written for a general audience. They are not designed to attend to the specific needs of the other, attune to their situation and accompany them on their journey through suffering and death.
Seeks to build up, not to tear down – connect people to God’s love rather than trying to convince them of their sinfulness and or for forgiveness. Offers of God’s forgiveness make little sense if someone has no concept of the triune God, and this requires a scaffold to build between a person’s understanding and the obstacle between them and knowing God, which is highly individual.
Locate sin and redemption within the broader category of God’s good but broken creation.
In Christ, there is forgiveness that takes sin as far away as the east is from the west.
Bears witness to the faithful presence of God and his desire that all who are heavily laden might come to him.
In the background, a chaplain or soul carer carries many narrative patterns: encoded variously in melody and harmony, themes and variations, rhythms, textures tones and timbre.
One of the significant challenges with ministries such as chaplaincy, pastoral care, spiritual care is defining what soul care is and explaining what it looks like. A colleague and I were talking about this a few days ago, and he asked, “Well, for example, what would spiritual care look like if you were visiting a man who was a victim of a shark attack and had lost both feet?”
As a chaplain, I would meet such a patient on a regular ward round as I regularly visit some intensive care units and several surgical wards. I usually choose not to know the patient’s medical diagnosis before I visit for the first time as it tells you very little about the person or the relationship they have with their diagnosis. I also meet patients following a referral or a specific request for a visit from a chaplain. If the medical staff requests the visit, usually, the request is accompanied by a brief description of the patient’s medical condition.
All soul care begins with an offer to listen or attend to the other and be willing to attune to the matters on their soul and accompany them into their story, initially asking only questions that help the other clarify their thoughts or feelings. As we listen deeply to another, we also listen to ourselves while subconsciously being held within our more extensive webs of meaning. The sensitivity and stability of a more comprehensive web of meaning allow us to enter another person’s story and help bear the weight of their griefs and sorrows without merging them with our own or dissolving ours into theirs.
The carer’s attitude is crucial; it is not enough to be a safe person but to have the ability to engender a feeling of safety within the other that enables enough trust to share what is uppermost on their mind or troubling them in their heart. The skills to connect and listen deeply needs to be developed and honed. Deep listening helps bring forth the metaphors and words of feeling necessary to communicate that which is on the heart or mind.
In the background, a chaplain or soul carer carries many narrative patterns: encoded variously in melody and harmony, themes and variations, rhythms, textures tones and timbre. These narrative threads, in turn, resonate with themes from theology, philosophy, psychology, sociology, literature. They present as accounts of trauma, PTSD, grief and loss, abandonment, isolation, enmeshed or well-differentiated relationships, supportive community, physical, mental and emotional states and spirituality. Spirituality is also seen in feelings and beliefs around justice, guilt, shame and forgiveness, and existential experiences often beyond our control. Narrative threads of spirituality appear through all these themes, expressed through religious observance, practices, habits and the things in which they find peace.
As a chaplain listens with an open-handed curiosity to a person’s story, some aspects will resonate with one or more of the patterns mentioned above. These inklings cause us to notice certain things and wonder if the other is also aware of a link in their story. A point comes where we might respond to ask how something felt or how it seemed to them as we help them form connections from the things they have shared.
To place these carefully chosen reflections, we need to understand what we are hearing and our sense-making frameworks for linking and locating the expressed ideas and impressions.
I wish to return to the hospitalised patient suffering from a shark bite. If the patient had requested a chaplain to visit him, and after greetings, I enquire how I could help him. If I had met him in a surgical ward, I would have explained I was a chaplain doing a ward round and wondering how his hospital stay was going and if anything was on his mind or troubling him or he would like to chat?
A conversation with the patient could go as many different ways as there are people. But suppose I merged this patient who was bitten by a shark with a patient Joshua (identifying details changed for privacy). He was a road cyclist training for an international event when hit by a truck and suffered extensive damage to his legs, requiring amputation of one. In that case, I think it may provide a plausible possible encounter.
I met Joshua two and half weeks after his accident. He began speaking about his accident. He viewed himself as a survivor rather than a victim despite the truck driver being in the wrong. He expressed that he was looking forward to beginning rehab and moving some muscles again. Yet, as he spoke, it became more evident that the loses and griefs he was facing were huge. He was a schoolteacher and was grateful that the school understood and provided him with a leave of absence for an extended period and was eligible for third party insurance to cover many of his costs. As he continued, he then mentioned that he had been married for two years to his childhood girlfriend, and she was also an elite athlete. While she was amazing with the whole accident thing, he had gnawing insecurity voicing a fear that she might not want to live the rest of her life with a disabled person.
Joshua was not religious. He had a philosophical approach to life where he didn’t have a special pass to avoid tragedy. Joshua could not see anything he would have or could have done differently on the day of the accident as he followed his regular training routine.
I commented that he seemed to be carrying a very heavy load and was bearing many losses. He nodded and wiped away a tear with the heel of his hand. After a bit, he said, yeah, some days it’s all too much, then smiled and thanked me for listening. I replied, thank you for sharing; you certainly are going through a lot. I will keep you in my thoughts and prayers.
Following a chaplaincy visit, a chaplain reviews the visit through a spiritual assessment tool. One such tool is a simple and effective assessment developed by two nurses, Highfield and Cassons. It reviews the patient’s meaning and belief, their need to give love and receive love and their hopes and creativity which broadly corresponds to a description of a person’s faith, loves and hopes. I prefer to review the conversation using a framework of religious, moral, spiritual and existential concerns and the web of relationships in each domain. After listening to Joshua and reflecting on the conversation, my initial spiritual assessment was this.
Joshua was not religious, but his accident disrupted his patterns and habits and separated him from his training and work community. Morally, Joshua was not asking questions of justice around the accident but seemed to be attempting to absorb the impact within himself through the frame of ‘life happens.’ At this early stage, he was not dwelling on the deep wrong that had been committed against him, nor the severe assault against his person and body.
Spiritually, Joshua was experiencing disruption to all areas of his life that filled him up, his relationship with his wife, body, sport, and training teams expressed through absence and grief. Existentially, in an instant, he had lost his leg, his health, his work, his sport, yet he demonstrates a genuine desire to transcend his current sufferings.
As a chaplain, I was in internal prayer for Joshua and prayed that my visit would be helpful to him at this time. I endeavoured to accompany him, staying with his story and going at the same speed he was going. I drew on the stable and secure framework I have around me, working out of the depth of my faith, skills, and training to accompany and scaffold Joshua in his experiences.
The practice of prayer is perhaps the most future-orientated and therefore hopeful soul care practice of all, linking the present to eternity.
Pastoral theologian Eduard Thurneysen contended that there was no proper soul care without prayer. In many ways, the act of soul care is a lived prayer seeking as it does to bring hope into despair, light into the darkness, life into existence and grace to futility.
Prayer is tangible and hopeful. Desires expressed in prayer give voice to the hopes and longings of the future.
Thurneysen, a Chrisitan pastor, viewed his ministry of visiting with parishioners as an act of hospitality. His soul so extended into listening that it assumed the form of intercessory prayer. He drew upon Philippians 1:3-6: “Whenever I think of you, I offer to God my prayer and thanksgiving for you.”1 He describes a “full listening… without a single word passing our lips.” The type of hospitality that he spoke of accepts the speaker as they are and draws them into a kind of solidarity – neighbourly love – flowing out of the spiritual life in Christ back towards God-given life.
Thurneysen’s understanding of prayer in soul care had three aspects. Firstly, “it is a prayer for myself as a pastor, for purification and illumination of my spirit, a prayer that I may become the true instrument of the Spirit of God.” Secondly, it is a “prayer for my neighbour; it is intercession.” The third form is prayer with the other.2 Thurneysen noted that wisdom was required as to whether or not this third act of common or shared prayer was appropriate. Thurneysen explained that for God to be at work in this context was a work of his own free grace. In a sense, it is an act of daring on the pastoral carer’s part even to take initiative in the process of prayer. In Thurneysen’s words, “The circumstances will decide from case to case whether I may and ought to pray with another person.”3
Caring for another involves being wisely attuned to what might be taking place for themselves, the other, and the working of the Holy Spirit through the soul care process. “Prayer is therefore always a step that leads beyond all boundaries into the realm of eternity. For it is actually talking with God, really God, really being heard by God and listening to God. Hence prayer is the final destination of every way, the deliverance from every distress, the fulfilment of every petition.”4 From a human perspective, the carer facilitates a conversation between the other and the Heavenly Father in prayer, depending upon the Holy Spirit, in the name of Christ Jesus.5
Through prayer and faith, the soul carer foresees hope and a possible future through love and forgiveness through the power of a love that bears all things, suffers all things, believes all things. Thurneysen felt strongly that neither prayer nor hope were practices to be employed simply for therapeutic ends. Instead, these arise from the Christian faith and are anchored deeply in Christ within the soul of the carer. Prayer in this context is not a therapeutic practice but a radical act of hospitality whereby the horizons of the present have been opened out and are inviting the inbreaking work of the Heavenly Father.
For this reason, prayer must not be forced, manipulated or coerced by the soul carer. There is a complexity in the offering of prayer in soul care practice, and the practitioner must be alert to the possiblity of overreach when taking an initiative that may only belongs to God. Yet, prayer might be the very means to shift ordinary conversation beyond the breach into a truly divine-inspired soul conversation.
The soul carer is an agent of hope; there is no hope left even when humanly speaking. Such longings and prayers present the other with a glimpse of the eternal horizon of significance from which the soul carer ministers. Thurneysen believed, therefore, these qualities of wisdom, hope and prayer and needed to be cultivated. No matter how effective listening is, it can never “replace the decisive act of prayer.”6 Prayerfulness of the soul carer for the other is of such importance that it could almost be equated with soul care. In fact, as Thureysen expressed it, “The practice of soul care and prayer are actually one and the same. Soul care is prayer.”7
The attitude of prayer can move a conversation from the horizontal plane of human concerns to the vertical dimension of the inbreaking of the Word.
1 Eduard Thurneysen, (1946) Theology of Pastoral Care, 128, 197 2 Ibid, 195. 3 Ibid, 198 4 Ibid, 197 5 Ibid, 197 6 Ibid, 190 7 Ibid, 190 Image by Couleur Pixabay
The soul of every person comprises a multilayered, interconnected web of beliefs, values, experiences, emotions and relationships held together through a spiritual web with overlapping religious, moral, spiritual and existential dimensions.
A soul care conversation is an intermingling of hospitalities. The soul carer offers the hospitality of soul to attend to another’s soul. If the offer is accepted, the other extends hospitality by inviting the carer into their spiritual home.
The spiritual home is a metaphor for our spiritual self, comprising a constellation of spiritual connections.1 Or, as Louis Nieuwenhuizen explains, “The spiritual self is not separate from the physical, psychological or social self; it is simply a natural, interconnecting dimension.“
This concept is supported by an ever-expanding body of literature supporting the “idea of multiple complex connections between the psychological, physical and spiritual components of individuals.”2 The soul is an embodied and encultured entity that embraces the whole person and the whole of life. Spirituality of the soul focuses mainly on how a person makes sense of life or finds meaning in life and death. The soul of every person comprises a multilayered, interconnected web of beliefs, values, experiences, emotions and relationships held together through a spiritual web with overlapping religious, moral, spiritual and existential dimensions. We might consider the religious, moral, spiritual and existential dimensions of the spiritual as distinct yet interconnected domains within the concept of sense-making or spirituality.
These interconnected domains form the most profound and fundamental components of the spiritual self and cohere around the individual’s core beliefs.3 Soul care works within the multifaceted spirituality of an individual’s spiritual self. Each domain of spiritual the spiritual self represents a different dimension of the self and approaches questions around meaning, purpose and belonging from a different perceptive.
For the purposes of soul care and facilitating spiritual wholeness, or spiritual health, it is possible to think of the spiritual self as a spiritual home and the different domains as rooms or spaces. This spiritual home has four rooms or areas: religious, moral, existential, and spiritual. The spiritual home has a verandah or porch for the chatter that passes the time of day on the weather, other people or other things of a social or general nature. Not everyone who visits a spiritual house is invited to enter the spiritual home. To cross the threshold, one entered through a door that was opened for the inside.
The religious space within the spiritual home contains the personal and social connections and practices clearly defined by objective aspects of religion – such as shared beliefs and traditions, habits, patterns, liturgy, rituals, rites of passage, symbols and signs. Now, many people might be thinking about the people who identify themselves as spiritual or not religious. Philosopher James A K Smith observed, that to be human is to follow a set of cultural liturgies. We might find these rituals in malls, stadiums and universities, and these habits and liturgies, are shaped and in turn, shape what we love or desire.4
Symptoms of religious distress are exhibited through disbelief, dismay, a loss of faith or trust, or a sense that there is nothing behind the drama and theatre of the belief system. The believer has become disillusioned, believing that the rituals do not represent any larger reality, the signs do not signify anything more substantial, and the symbols are merely hollow trinkets. Yet, even in disbelief and loss of faith, there are other sets of liturgies and rites of passage such as the burning of books, desecration of sacred things, or the removal of wedding rings or the formal desacralisation of religious property or items.
The moral space contains the person’s internal compass, guided by their deeply held corresponding philosophical values, ethics and morality. Their moral space will be directed by their sense of fairness, justice, good and evil, ideas of retribution, forgiveness and grace. The overlap between religious and moral spaces will depend on how religious beliefs form and influence a person’s moral intent. Symptoms of moral distress arise when there is an inner conflict between one’s own values and what one is required to do or witness. Soul care will witness and attend to the other’s inability to reconcile their morality events with their belief about what should have happened.
The existential space relates to the experienced reality of when stuff happens. Our Existential spirituality is a closely related relationship with the external world through our body and mind and our physical and cognitive responses to the existence, and how we make sense of events and find meaning through the events. Philosopher Martin Heidegger coined a term to describe our experience of these events, and he called this our thrown-ness into life. This thrown-ness may be positive, negative or neutral, but is mainly beyond an individual’s control and includes birth and death, ethnicity and nationality, disease and heath, war or peace, poverty or prosperity. Existence includes all events of life and things that matter. These events include genetics, history, environment, culture, family and shared spaces. Our response to existential events is variously described as resilience, thriving or despondency, fatalism, survival or acceptance. Symptoms of existential distress include suffering, pain, anxiety, pain, loss, grief and soul care provided focused attention and awareness of the expressed losses and suffering.
The spiritual space relates to inwardness, subjectivity, and personal experiences that connect people to something beyond themselves. This space is experienced as a state of creativity, flow state or being in the zone where perceptions of focus and time are experienced differently. Spiritual experiences and practices include prayer, meditation, yoga, scripture reading, connectedness to nature, gratitude, thankfulness, sport, dance, and music. These are times we are functioning in a non-self-conscious way from our heart or soul. It could be said we are performing out of our spiritual self, not mediated through a persona.
In this state, we can be others who also are also relating as their selves and find harmony or symmetry felt as being on the “same wavelength” “in tune with” or “in step with.” Symptoms of spiritual distress exhibit disharmony, discordance, disproportion and may be exhibited variously as guilt, shame, fear, depression, being overwhelmed or feeling trapped.
Spiritual health is evident when a person’s spiritual self can predominantly participate in their regular liturgies, process, and grow through life’s challenges. They have a moral framework that can accommodate sin and tragedy and find comfort and peace even in trying circumstances, as described in Psalm 18. Conversely, Psalm 137 describes people experiencing religious, moral, spiritual and existential spiritual distress. Psalms 42 and 43 describe someone held by fragile threads of grace that hold in the face of distress. In the 23rd Psalm, we observe the spiritual health of someone who can place their religious, moral, existential and spiritual distress in the shepherd’s care and is restored to spiritual health even in the face of physical death.
Central to the Christian faith is the belief that the spirit of Christ dwells within the spiritual home of the believer, (Eph 3:17; James 4:5) experienced as the peace of Christ which passes all understanding (Phil 4:4-7).
This is not an easy place to sit. We are easily assailed by an overwhelming desire to restore that which was lost; to fill voids with solutions, and fix things up to stem the tide of our own overwhelming fear and anxiety – if this tragedy could befall one person it could befall anyone.
The alien landscape of suffering is a world that exists on the other side of a tissue-thin membrane. We are separated from this world of seemingly ‘untouchables’ by gossamer-thin fibres of favourable circumstances that isolate the wounded from the walking. Those who suffer are caught in this nightmare world: even in sleep, the craved for escape eludes them. In this alien world time warps ― it enters slow motion― people’s lips move soundlessly. This lonely and isolated landscape can be torturous solitary confinement.
When we sit awhile in the landscape of another’s existential crisis we begin to attend to their pain and attune to their utterances of loss. However, this is not an easy place to sit. We are easily assailed by an overwhelming desire to restore that which was lost; to fill voids with solutions, and fix things up to stem the tide of our own overwhelming fear and anxiety – if this tragedy could befall one person it could befall anyone. We are forced to choose a vantage point, for there is no view from nowhere. We might choose to soar above the situation, theorising and categorising: retreating into our systematic and biblical theology to understand this loss in the sweep of all of creation and redemption. Or we might observe events from a psychological or medical perspective trying to situate events within structure and frameworks of mental and physical health and disease orientating us to find a solution to the current distress.
These different viewpoints map onto Frame’s triperspectival framework. Each theological viewpoint is a different type of lens on reality. The Normative lens captures an overview of reality capturing themes and patterns. From this normative lens are principles, doctrines, typologies and the salient turning points of salvation history are seen theologically from the divine viewpoint. The Situational lens is a long lens that captures what can be observed and described from history, nature, culture, society, psychology ― the books of Ecclesiastes and Proverbs provide examples and the situational lens on reality. The Existential lens is limited to the depth of field to which a particular person in a particular place and circumstance can see. The Book of Job (excluding the divine speeches) provides a salient example of the Existential lens.
The normative and situational lens serve to orientate and stabilise the soul carer. These lenses provide anchor points from which the carer can descent down into the existential suffering of another. By differentiating between the purposes of the lens of Scripture, the carer avoids using Bible as a book of solutions or oughts, shoulds, and musts for people who in the present time are unable to will themselves to climb up on to the first rung. Psalm 137 poignantly captures feelings of the desolation of such a people, the exiles who are sitting, weeping and remembering. For the exiles, perceptions of reality are shaken. They need to find new categories to process the experience, this takes time.
Many of the psalms of lamentation and Psalm 88 in particular paint a harrowing picture of a person who feels desolate, destitute and utterly abandoned by God. The sufferer is unable to come out to us we must enter into the alien landscape. For a sufferer undergoing a Psalm 88 experience, we also must descend into the dark regions below, sustained by the normative and situational knowledge that God is not absent even in Sheol or the pit, or beneath the overwhelming waves. We sit beside, we weep with those who weep, we pray, we wait and stay in the present, enduring how it is now for the sufferer.
It is an act of grace to stand with the sufferer and share their existential lens limiting our vista to their vista, trying to see things from their perspective – below where they are – not from God’s global perspective. To feel the events from their perspective – beside – this is not a time for putting things into perspective. Severe trauma and stress place a person in a continual present: the only starting point. We must stay beside the sufferer and ‘be now‘ in their present, being careful not to run ahead of them or pull them back, it is a dance where we must learn the sufferer’s dance steps.
Only by being in their present is there any possibility of scaffolding them into the future. There are times for remembering the past and times for looking forward and providing a reason to go on, but not at the expense of denying someone the opportunity to express the pain they are feeling now, today.
Once we are able to abide in the landscape, we have to learn to stand with the sufferer and allow our eyes to adjust to the surrounding darkness we also can accompany them. If we listen carefully we might hear the predawn birdsong as we wait for the predawn light, a thread of hope of a home where there is no more crying, no more pain – a quiet whisper; a plea that there must be more to life than this. We enter the chaos as one of Christ’s people and stand with the sufferer and turn our face towards the light.
Some of the content of this post was first published as “The Alien Landscape of Suffering,” by Kate Bradford, edited by Margaret Wesley, Loss and Discovery: Responding to Grief with the Compassion of Christ and the Skills of All God’s People. (Wipf & Stock Publishers) 2013. pp 166 -174. Frame and Poythress Triperspectivalism Image by Bertsz from Pixabay
Grief and loss are experienced as anguish within the soul, they are not as dilemmas to be solved.
Loss and its accompanying grief fragment and shatter our reality. Familiar paths of life and meaning are ruptured or dissolved by a rising tide of events we have little control over. Soul care, at its best, is a ministry that provides a balm to the seeping wounds of grief. It scaffolds and holds the sufferer through the unfamiliar tangle of grief when the familiar paths are overgrown, moving only at the pace that the sufferer can manage.
Yet, anyone who has spent much time with people grieving the loss of someone they love will have heard on more than one occasion examples of people’s rather clumsy attempts at words of comfort. These attempts might include phrases such as “they’re in a better place,” or “you’ll be fine,” or “stay strong.” They may offer explanations: “everything happens for a reason,” or suggestions that the sufferer sees things from a different perspective that begins with “at least you still/or can …” Sentiments such as these very often require a commitment to an image or idea that further burdens the sufferer.
Similar attempts to quote the Bible or express a biblical sentiment place similar burdens on the sufferer.
There are several verses so repeatedly misapplied they bear outlining them here.
God is faithful. He will not allow you to be tested beyond your ability (1 Cor 10:13)
Do not be anxious about anything (Phi 4:6)
God intended this suffering for good to accomplish his work (Gen 50:20)
Give thanks in all circumstances, for this is God’s will for you in Christ Jesus. (1 Thes 5:18)
The Lord gives, the Lord takes away, blessed be the Lord (Job 1:21)
And we know that for those who love God, all things work together for good. (Rom 8:28)
We may plan all we want, but it is still the Lord’s plan that will reign. (Proverbs 19:21)
The critical issue is, will this verse resonate with the sufferer in the midst of their present suffering? Are they able physically and mentally to integrate this concept into their world now, or does it simply become another overlay that prevents genuine integration? Such verses were written for a specific context and are a helpful but generalised touchstone of faith. There are inherent dangers in applying extracted and globalised wisdom to highly specific local situations which risk exacerbating and intensifying the sufferer’s grief. As with the words of Job’s comforters, these attempts minimise, or worse still, deny the reality of the suffering of the bereaved. In a previous post, we observed that suffering is nuanced, and context always matters. To this, we could add another truism – grief and loss are experienced as anguish within the soul, not as dilemmas to be solved.
There are many reasons why these words further injure the bereaved. Such causes include misunderstanding the nature of the losses that people grieve, poor skills at communicating sympathy and compassion, and a lack of differentiation between the comforter’s unease and the care needed for the sufferer, leading to an unfortunate consequence that their own discomfort is inadvertently projected onto the sufferer.
Their actions exhibit a faulty theology, such as the theology of Job’s comforters for which they God critiqued them, “You have not spoken truly about me, as my servant Job has.” (Job 43:8)
John Frame’s Triperspectival ethical model offers a framework that helps avoid the failure of Job’s friends. Frame contends that errors in interpretation stem from misunderstanding our finitude and not sufficiently grasping our limited perspective and that we do not see reality from a Divine perspective. Frame’s triperspectival ethic accentuates three perspectives from which events can be viewed: 1) a normative perspective where events can be understood from a divine vantage point; 2) a situational perspective from the point-of-view of information and that which can be gained by observation, and 3) an existential perceptive which represents the internal experience of the people involved in the event under observation.
If we consider the verses listed above, they tend towards a normative viewpoint, where all the intertwining threads of existence can be seen from above across time. Similarly, we might consider the sufferer’s limited perspective on events they are experiencing, yet, seeing only through a glass darkly viewed from below, shrouded in mist. If the carer assumes a theological perspective above, it distances the carer from the sufferer rather than moving towards them. The ministry becomes commentary rather than sympathy. Comfort, intercession and accompaniment are lost while the other passes alone through their valley of the shadow of death.
There are rich streams of comfort through Scripture that speak into shadowy and fragmentary experiences of pain, loss, suffering, and evil. Scriptures that are written from the view below, verses that intercede for broken hearts and crushed souls. Frame’s Triperspectival model provides an integrated theological framework for making sense of God and reality and provides a well-defined explanation for why the above comments fail to offer the comfort the carer intended.
A critical task of pastoral theology is to cultivate the ability to act appropriately at particular times. This includes understanding why some pastoral interventions help in some circumstances but cause harm in other contexts and identifying the multiple variables in a situation. Theology, in essence, is wisdom, a sense-making framework from the standpoint of Scripture.
To be continued in the next post The Existential Frame of Soul Care
As an art, conversation is more than simply two people speaking together. Instead, it is a cooperative sharing and exploration of thought, enabling two souls to move into a sympathetic rhythm with each other.
I have spent several years in the company of one of pastoral theology’s most eminent practitioner theologians. My companion has been Swiss Pastoral Theologian Eduard Thurneysen while studying his theory and practice of soul care which took the form of a soul conversation. This blog post is the first of several occasional posts where I will share some valuable insights gained from my time in Thureysen’s company.
Thurneysen (1888-1974) was a minister in the Swiss Reformed denomination at the Minister in the Swiss city of Basel for over 30 years together. During this time, he also lectured in Pastoral Theology at Basel University. The emphasis in his ministry was pastoral care to his Basel parishioners combined with training theological students.
Thurneysen understood the ministry of the Word of God to be a multifaceted ministry that, alongside preaching, teaching, and administration of the sacraments, included a conversational ministry with parishioners and community members. He called his conversational ministry soul care. For Thurneysen, soul care was a ministry that belonged to all Christians. Still, he believed those set apart for ministry – ministers – had a particular obligation to cultivate the attitudes and skills needed for the ministry of soul care.
For Thurneysen, the ministry of soul care centred around understanding the nature of communication, speech and conversation. The centrality of the conversation was based on several theological principles, the first being that God himself is a communicating God who speaks through his Word. Secondly, the human ability to communicate and converse reflects God’s image and nature, and it is speech that breaks our human isolation and brings us into fellowship with others. Thirdly, speech is the human vehicle that conveys the revelation of God, where the Spirit of God is at work in the souls of both the speaker and the hearer. The proclamation of God was central to Thurneysen’s theology. However, he was careful to distinguish the soul conversation from attempts at evangelism or proselytisation that did not connect, or co-opted the conversation to the speaker’s own ends, such could not be considered a soul conversation. Indeed, if we were to regard him as someone who reduced pastoral conversations to what might be called evangelism, much of his nuance has been lost, and we would be somewhat mistaken.
In Thureneysen’s thought, speech was the primary conduit of the communication between souls, which happened through the interchange of conversation. Thurneysen drew upon the biblical witness to conversation and the expressive importance of speech and the art of conversation as exemplified by Jesus in the Gospel, of which the conversation with Nicodemus is a salient example. As an art, conversation is more that simply two people speaking together. Instead, it is a cooperative sharing and exploration of thought, enabling two souls to move into a sympathetic rhythm with each other. Furthermore, there is a communal dimension to this form of conversation. It is the co-creative sharing and exploring of ideas, emotions and thoughts, requiring the help of other people, which leads to realisations that otherwise would not be available.
Such a conversation was more than simply words or speech; it was a deep level of embodied communication and connection. Such communication includes speaking and hearing but has other senses. It included perceptions and intuitions drawn from what is seen and felt, in the form of gestures, breath, falling into step together, mirroring, modulation, and tone of voice, and the ability to hear both that which is said and that which is left unsaid.
From the perspective of the soul carer, the conversation is entered into prayerfully and attends to the other person with their whole attention, attempting to catch their full meaning and perceiving what was on their hearts. There is a deep acceptance of the humanity of the other and a genuine interest in them and their world. Yet, the carer maintains a level of differentiation, neither merging with them nor presuming to know their thoughts. In a soul conversation, matters of concern become a little different when given voice. A good conversationalist helps the other figure out what they mean by helping them explore, reflect and enquire. The soul carer holds conversation under the universal and eternal truths within the love of God. Any observation or comment is made in the best interests of the other person. A comment arises from that which has been spoken of without minimising, denying or catastrophising the events. If the other has spoken of dire circumstances, it might be that a soul carer observes gently, “It sounds like you are walking through the valley or the shadow of death.”
All of human life is contextualised. It is embodied, enculturated and held in a complex web of beliefs and experiences, which format the way we, and others, see the world and faith.
Two second-grade boys each broke their arms. Alex had broken his arm in a spectacular fall at soccer training, and he wore his plaster cast conspicuously, collecting as many signatures as possible. On the other hand, Jamie tried to hide his plaster cast and broken wrist inside his jumper sleeve. Everyone was sure Jamie’s cast had something to do with his Dad, but no one wanted to know, let alone sign his cast. Alex wore his plaster cast as a badge of honour, but Jamie’s clung to him as a mark of shame.
Both boys had suffered a similar physical injury. A broken bone which required a plaster cast to immobilise their arm for six weeks; while their broken bones knitted back together the similarities end here. How will each boy make sense of what has happened to them? What meaning will they make as a result of these events? Leo Tolstoy began his novel Anna Karenina, “Happy families are all alike; every unhappy family is unhappy in its own way,” there is parallel truth – every suffering person is suffering in their own way.
Suffering is nuanced, and context matters. Always.
The circumstances of each of the boy’s injury took a different form. Soul care to each of these boys will look different, how a connection is established, the information required to attempt to understand the situation and the necessary degree of caution in responding appropriately.
The basis for any soul care ministry is the connection established by carefully attending and attuning to the other with the offer to accompany them for a time on their journey. Yet while soul care is never less than this, it is rarely limited to this as our care is accompanied by a desire to understand and appropriately respond. As we listen to the other, begin to locate and link some of the connections and relationships in the other’s web of meaning, this information forms the basis of a spiritual assessment. 
All of human life is contextualised. It is embodied, enculturated and held in a complex web of beliefs and experiences, which format the way we, and others, see the world and faith. This is an inescapable reality, which is also mirrored in our Scriptures. The Bible comes to us also clothed in language, narratives, poetry, letters, covenants, aphorisms, through different personalities, cultures, and specific circumstances.
As the carer reflects on the contextual web, a broader system around the pastoral encounter will appear. On the one hand, some webs of relationships and events will be orderly enough to accommodate or integrate new information or circumstances. However, on the other hand, if the encounter is not happening in a stable or settled mode, many indicators will point to a significant degree of disorder and disintegration. The soul care that is offered will need to hold space for a high degree of confusion and ambiguity.
As with all of life, suffering does not exist in a decontextualised zone, nor is there any decontextualised, prefabricated soul care. Walter Brueggemann, an Old Testament theologian, observed in God’s prayer book, the book of Psalms, some Psalms represent a state of order, others – disorder, and still others, a state of reordering after a time of turmoil and conflict.
To illustrate, we might observe that Alex’s situation seems pretty ordered, he has suffered a sporting injury. With the proper medical intervention, his arm should heal well. The fracture itself may have been complicated but, with good x-rays and proper medical procedure being followed it also should resolve satisfactorily.
Jamie’s situation is much more ambiguous. His broken arm seems to be a symptom of a more significant issue and the break may have served to bring to light a chaotic and unsafe domestic situation, requiring mandatory reporting to authorities. As more information comes to light about Jamie’s home situation, it reveals a complex web of relationships and circumstances with no easy solutions or resolutions. But if the pastoral carer has been able to identify that Jamie exists in a chaotic situation they may aims to help scaffold him and his family towards a more stable condition while recognising that this situation will remain challenging and far from ideal.
Soul care responses to Alex and Jamie, will be different indeed what might be accurate for one may not be valid for the other. Soul care for Alex may include thankfulness that the injury was not more severe, prayer for sound healing and complete restoration of health. However, for Jamie, we grieve that he was injured, we fear that the injuries to his arm are only the tip of the iceberg of his injuries, we lament for breach of trust that has been Jamie’s experience and in our soul and prayers we weep for him.
 I was introduced to this example and the phrase of ‘suffering is nuanced’ by spiritual director, Susan S Phillips, PhD, “Issues of Suffering and Theodicy in Patient Care.” lecture given for NSW College of CPE at St. Joseph’s Hospital, Auburn, Sydney, Australia. March 2010.
In Scripture, pastoral care imagery most often connotes corporate care of the flock, whereas scriptural references to the soul to denote the innermost being of a person or a person’s relationship with the triune God.
Why are you cast down, O my soul?
And why are you in turmoil within me? (Ps 42:5a ESV)
Have you ever puzzled over why some people maintain that the primary form of pastoral ministry for a congregation is preaching and teaching? Or, that the task of pastoral ministry was related to admonition? Have you ever wondered how this conclusion was reached?
The term pastoral care has a rich heritage that traces its origins back to Church Father, Gregory the Great (540– 604) a bishop who wrote The Book of Pastoral Rule, as a guide for the ministry of bishops and clergy. Two later writers who wrote on pastoral ministry were the Reformer Martin Bucer (1491 – 1551), Concerning the Care of Soul and Puritan, Richard Baxter (1615 – 1691) The Reformed Pastor. Bucer and Baxters’ books became classic guides to pastoral ministry in the Protestant church and were manuals for clergy and elders visiting their congregational members in order to know them and perceive the states of their souls and to instruct and pray for these parishioners.
In addition to the traditional use of the term, the term pastoral care rose to prominence again in a new context. Various sectors of the progressive mid-C20th American protestant church reinvigorated the term pastoral care for a style of ministry based on language drawn from the Twenty-third Psalm combined with on non-directive counselling. Since the mid-C20th the term pastoral care entered our vocabulary to refer to the various activities of ranging from church ministry, chaplaincy, Christian soul care, through to any form of multifaith and secular spiritual care. Following this broadening and inevitable shallowing of the term, pastoral care, became the accepted nomenclature for a large range of both Christian and secular roles that focus on the care of individuals with regard to individual well-being and issues of meaning and purpose.
So, for many of us, whose introduction to the term pastoral care was formed through contact with the C20th pastoral care movement, the idea that pastoral care as instruction may sound discordant. But if we were to trace back to the origins of the biblical pastoral imagery and its relation to shepherds and sheep, the pieces of the puzzle may become clearer. Scripture refers to shepherds and sheep hundreds of times within the Old and New Testaments. From the book of Psalm and the prophecies of Isaiah, Ezekiel and Jeremiah and the other prophets, most references to shepherds are metaphors for God himself or the leaders of his people, who in turn are referred to as a flock, or as sheep.
Scripture certainly contains images of the tender shepherd scooping up his lost sheep, but many more references focus around the duties and responsibilities of the shepherd, and the dire consequences when shepherds neglect their sheep or even fleece and slaughter them for the shepherd’s own gain. The shepherds are instructed to guard the sheep and to teach them.
The image of a flock, or even sheep, are collective images that correspond closely to the corporate nature of a congregation. In the C16th, Martin Bucer chose another more fruitful term to refer to the individual state of a person’s faith, an intimate and richly textured image, the soul. The concept of the soul provides a rich stream of thought that flows through the length of scripture from Genesis to Revelation.
Our soul is the part of us that loves God, rejoices at God’s goodness, pants for streams of water, grieves, is downcast, can be bitter or sweet. Our soul may be awake or asleep, alert or dull, at peace or in anguish, rejoicing or in deep sorrow, alive or destroyed. Our soul is our very being, it is embodied yet it is more than our physical body. In the final analysis, it can transcend death entering eternity, or yet may be destroyed, everlastingly.
In Scripture, pastoral care imagery most often connotes corporate care of the flock, whereas scriptural references to the soul to denote the innermost being of a person or a person’s relationship with the triune God.
Soul care is a particular concern for the soul of another. It is to take the time to attend to and enquire of another’s soul; to listen, to allow another’s soul to speak honestly, and also for our soul to respond to the words of that other soul. We weep and rejoice with them and share in their anguish and joy with prayer and hope of connecting them to a deeper well of wisdom found in Christ Jesus. Finally, we connect their soul and its concern to Christ in prayer.
Image: Interior of a grotto with a rock-pool, frogs, salamanders and a bird’s nest by German-Dutch botanical illustrator and painter, Abraham Mignon 1640- 1679. In the Public Domain.
Soul care is a ministry where knowledge of God and the fruit of our faith bears fruit in the lives of those we encounter pastorally.
This week in Sydney we have two high profile speakers. An evangelist and the other a psychologist which has led to lots of discussion about God.
What sort of God are they preaching? Why are people drawn to attend their events? What are people searching for? How do members of the audiences think and feel about the message they heard? And how do we accompany people as they explore what they think, feel and believe? Conversations such as these lie at the heart of all soul care ministries.
Christian soul-care ministry covers a broad range of ministries in different contexts: pastoral ministries in churches, pastoral care in Christian organisations and institutions, ordained chaplains in the defence forces, chaplains to prisons, emergency services, sports teams and spiritual care to a vast range of secular institutions, but each of these pastoral encounters have one thing in common, each involves a conversation.
Christian soul care has two aspects. One aspect is helping Christians find a deeper faith in Christ rather than walking away and the other is helping non-Christians towards a deeper spirituality. Now it may not always be clear where someone is in their spirituality – whether they are seeking meaning or indeed, fleeing from it, but our task is not to determine where they stand so much, as to guide them to ask their own questions around meaning, belonging, identity, faith and existence.
Let me give an example. When we talk with someone who has heard one of these high-profile speakers, rather than asking them what was said by the speaker, enquire what was heard by the hearer? How did that make them feel? Or what did it have them thinking over or puzzling about? Does this indicate a next step that is needed for them or is the best just to continue mulling over points that are on their mind?
Soul care in its essence provides a space where people can unpack spiritually significant events with a desire to find deeper meaning.
I have heard soul care referred to as a ministry of listening – this is perhaps ninety per cent true, but I would want to suggest that it is not just listening but guided listening that lies at the heart of soul-care. And it is wisdom which provides guidance for this listening. It is wisdom that guides the listener as to when to remain silent and when to speak and the choice of those words imparted.
And from where do we get this wisdom? It is the wisdom of our Christian faith, wisdom tethered to the depth of our confessional faith, brought into conversation with the reality of another person’s life. Wisdom is a combination of depth of insight with a breadth of understanding. And Scripture tells us that this wisdom comes as a gift from the Holy Spirit filling us with the knowledge of the God’s will through all the wisdom and understanding, and it is given in order that we live a consistent with our faith as followers of Jesus Christ.
Soul care is a ministry where knowledge of God and the fruit of our faith bears fruit in the lives of those we encounter pastorally.
 1 Kings 4:29 (NIVUK) God gave Solomon wisdom and very great insight, and a breadth of understanding as measureless as the sand on the seashore. Cf Daniel 5;11 In the time of your father he was found to have insight and intelligence and wisdom like that of the gods.