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  • 25 Apr 2018 3:34 PM | Anonymous


    Left to Right: David Roth, Pamela Cooper-White, Kerry Egan, and Raymond Lawrence.


    Lost Wisdom, Found Wisdom, Shared Wisdom:
                            You Can’t Pray Gibberish. You Can’t Write Gibberish Either.
                            The Importance of Writing for Clarifying Your Thoughts. 1

    by Robert Charles Powell, MD, PhD

    Finding “a point of effective intervention” –
    a phrase favored by Helen Flanders Dunbar, theologian, philosopher, and psychiatrist –
    spirals through wisdom
    even as we probably have needed to spiral through knowledge and understanding to get to wisdom.2

    In many ways, The College of Pastoral Supervision and Psychotherapy has been viewed as a “back to Boisen” movement – and it is. This year’s plenary, however, helps to clarify the ways in which CPSP also should be viewed as a “back to Dunbar” movement – for she wrote on many currently important themes between 1923 and 1959 – that is, some six to nine decades ago. Think about that for a moment.

    As early as at age 21, Helen Flanders Dunbar already was sorting out what now tends to be called “intersubjectivity” – the creation – and re-creation – of multiple simultaneous shared meanings through multiple layers of interrelationships.  Rather than focus on the “dynamics” or the “mechanismics” of relationships, Dunbar focused on what then was called the “organismics” – the constantly moving, mutually involving holism of the relationships going on within and between our minds – as well as within and between our environments – as we work with someone in a healing way. 3

    I spoke of this at the Chicago plenary in 2015 – of the psychological and the sociological as enmeshed in the Boisen-Dunbar “world” – as well as at the Salt Lake City plenary in 2016 – of “personal experiences in social situations” – and vice versa. Boisen and Dunbar did not view pastoral care, counseling, and psychotherapy as some kind of “method” in which one person “does” something to another, but as a complex evolving process of what goes on between “helper” and “helpee”. 4

    [quote:]

    through pushing both the
                psychodynamic and the
                crucial public health aspects

    of professional chaplaincy, …
    Dunbar was among the first to
    focus on both

                the personal body and
                the social body
                            simultaneously. 5

    [quote:]
    our internal relationships … mirror
    our external relationships.

    We are –
                each of us is –
    our brother’s and sister’s keeper.

    The goal is
                to reflect on all this –
                to carry out all this –
    with
                tolerance and
                encouragement. 6

    Years ago, mentors taught me that writing – like speaking – works best when one tries to answer a clearly formulated question. That is part of our topic today – how important it has been – and will be – for this field, that individuals wander through knowledge and understanding to wisdom – and that they communicate with their colleagues along the way. Speaking and writing are essential for clarifying your thoughts.

    I got into this whole world of Dunbar 50 years ago when I asked, “Why did the literal founder of the American psychosomatic movement pursue a Bachelor of Divinity degree first?” The budding psychiatrist part of me said that there had to be a reason why. 7

    Apparently, Dunbar got into the beginning stages of her life’s work when she wondered, “How do symbols work? – in religion, in medicine, in everything?  How is everything – the outer and inner environments, the personal and the social worlds – bound together – with everything constantly impacting everything else?” Dunbar’s Bachelor of Divinity thesis indeed focused on “the therapeutic values of the various forms of worship – liturgy and hymnody, the exercise of private devotions, and the contemplation of religious symbols and architecture”. 8

    Apparently, Boisen got into the final stages of his life’s work when he wondered, “What if some forms of mental disorder and some forms of religious experience attempt to work out similar issues? – what if serious “cooperative inquiry” by, so to speak, mentor and mentee, could assist both kinds of exploration? 9

    A Dunbar Awardee apparently asked, “What if the profound sometimes lies right in front of us – wisdom wanting to be found – if we can be patient enough to wait for it to become manifest in the healing presence?”

    A Dunbar Awardee apparently asked, “What if the complex layers of communication between helper and helpee evolve constantly as a shared wisdom? – as the two parties engage in a kind of Boisenesque “cooperative inquiry,” trying to ascertain a kind of Dunbaresque “point of effective intervention?” 10    

    Dunbar herself almost single-handedly reinvigorated a mostly lost font – and fountain – of wisdom – the “insight symbol” – as understood by the late medieval world’s deepest thinkers. In her first book – in a thinly veiled description of herself – Dunbar noted that “Had a medieval thinker of the first rank been equipped with modern psychological background and technique, he [or she] would no doubt have maintained that the deepest meaning behind each of the interpretations given was the attempt to make that adjustment to the Infinite which Dante represents fully accomplished in the last four lines of the Paradiso”. The individual’s relationship to his or her internal and external environments was a concern of the organismic approach to medicine; the individual's adjustment to his or her spiritual environment, the Infinite, was the same process on a different level. In either case, Dunbar considered an adequate handling of symbolism as “fundamental” to the “integration of the individual within … [him- or herself] and in his [or her] environment”.

    Dunbar spoke of the insight symbol as that which reaches “out toward the supersensible,” toward “a Reality ... greater and truer than the symbol in all its aspects”. A “true insight symbol,” she believed – and you need to understand – “depends on the continual re-creation and expansion of its meanings”. Therefore, with an insight symbol, “all meanings are true,” and they “are often all intended at once”. Dunbar considered insight symbols as mediators between a person's inner and outer worlds, and that much in the realm of healing and wholeness could be achieved through “careful handling of symbolism”. 11

    A Dunbar Awardee focused on
    “the wisdom to be found in stories” shared within a healing “peaceful presence,”
    as those dying try to rediscover the meaning of their living.

    Whatever story is told, whatever story is held, it may well be open to multiple meanings on multiple levels as insight evolves between supposed healer and supposed healee. One can be both. 12

    As a result of found wisdom – even some found in the awardee’s own life – the awardee learned to be “not so quick to reject ideas of what might be possible”. 13

    Can we be open to expanded meanings beyond our first impressions? “There is only becoming,” as this awardee phrased it. 14 Boisen said about the same thing. Boisen spoke of having faith in “the Love … in whose eyes no one is condemned who is in the process of becoming better”.  Again, as in the wisdom this awardee found, “We are becoming who we already are [ -- ] up until the moment we die”, 15

    Let us go back for a moment to that notion of healing “peaceful presence”. Dunbar spoke of something similar in terms of parenting. She wrote three books on the theme. 16 This awardee, in terms of chaplaincy, explained, “ ‘I take a deep breath before I enter the room, and I ask G-d for help. I remind myself why I am there, and I let go of everything else in my mind.” 17

    Hmm. That also sounds a little bit like the psychodynamic “free floating attention,” doesn’t it? It is an attitude – without presumptions – that is open to whatever meaning – or meanings – arise – in the supposed healer – in the supposed healee – and in the space between them.

    This “sitting in the silence,” the awardee reminds us, prepares us
    to recognize when the moment arrives,” when,
    if we just wait in silence,
    if we just hold the line,
    “no matter how hard that is,
    somehow the patient will find the courage ….
    to say the unspeakable” –
    to acknowledge
    the “deep hole of meaninglessness” that he or she carries inside. 18

    Thank G-d, the awardee assures us, the supposed healer and the supposed healee always find their way out of the depths.

    Yes, these are the awardee’s own formulations – but I believe that echoes of Boisen’s and Dunbar’s writings can be heard.

    A Dunbar Awardee focused on
    “a shared wisdom that grows and is held between helper and helpee in the [clinical] pastoral relationship” –
    on a wisdom drawn “from the shared exploration of meanings that arise … [within “the intersubjective dyad”] and are co-created uniquely in … [that specific helping] relationship.” 19

    “The process of meaning-making is not … viewed as moving toward some single, incontrovertible truth or concrete certainty. The ‘truth’ of an experience … [is viewed as] usually become increasingly rich, complex, and multiple over time.” 20

    Indeed, as that awardee has suggested, “mental health may depend as much on … the ability to entertain multiple meanings as it does on unity, integration, and a capacity to synthesize.” 21

    Within this notion of a shared wisdom, “The role of the therapist … [is] as a companion in the patients’ efforts to tell the stories of their lives and to come to deeper contextural understandings of how these stories shape daily choices, relationships, and current behavior.” 22

    This notion of a shared wisdom also emphasizes the importance of the therapist’s ability “to maintain a consistently exploratory stance [,] … moving the … process from the realm of action back into symbolization, verbalization, and [,] ultimately, comprehension.” 23

    There are layers upon layers in a life – and this is even more so true within a healing relationship – as the layers upon layers of healer and healee interact.

    Yes, these are the awardee’s own formulations – but I believe that echoes of Boisen’s and Dunbar’s writings can be heard.

    On this 10th anniversary of the convening of “A Task Force to Assess CPSP and Its Future Direction,”
    please join me in welcoming the 17th recipient – and the other 17th recipient – both of them – of
    “The Helen Flanders Dunbar Award for Significant Contributions to the Clinical Pastoral Field,”
    Chaplain Kerry Egan and Doctor Pamela Cooper-White.



    **********

    Now, let me note that it is most unusual for us to bestow an award before the honoree gives his or her presentation – but just as you packed the audience for Doctor Cooper-White’s speech, I urge you to pack the audience tomorrow for Chaplain Egan’s speech. She has a fantastic way with words – which reinforces the subtitle and the sub-subtitle that I gave to this introduction:

                the subtitle: You Can’t Pray Gibberish. You Can’t Write Gibberish Either.”
                and
                the sub-subtitle: “The Importance of Writing for Clarifying Your Thoughts.”

    I hope that all three authors – Dunbar, Cooper-White, and Egan – will have inspired you to write your own essays, your own articles, and your own books.  

    #

    Endnotes:

    1. Twenty years ago – in 1998 – is when Raymond Lawrence first asked this author to speak at The College of Pastoral Supervision and Psychotherapy. “Whatever Happened to ‘CPE’ – Clinical Pastoral Education?” http://www.cpsp.org/pastoralreportarticles/3778818

    2.         “I have filled each with
                the spirit of G-d,
                in wisdom, and
                in understanding, and
                in knowledge … .”  [Exodus 31:3]
                “By wisdom the earth’s foundations were laid;
                by understanding the heavens were set in place;
                by knowledge the deeps were divided …. .”  [Proverbs 3:19-20]

                “Through wisdom a house is built;
                through understanding it is established; 
                 through knowledge its rooms are filled … .”  [Proverbs 24:3-4]

    3. Powell RC. “Helen Flanders Dunbar (1902-1959) and a Holistic Approach to Psychosomatic Problems. I. The Rise and Fall of a Medical Philosophy,” Psychiatric Quarterly 49: 133 -152, 1977. abstract on the internet at www.pubmed.gov ; a revised edition will be published soon.

    4. Powell RC. “ ‘Amid the Complex Entanglements of Actual Life’: How Are Clinical Pastoral Chaplains to Gain Perspective?” 2015; on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3779026 .

    Powell RC. “From Emotions and Bodily Changes … – in the Personal Body – to Bodily Changes and Emotions – in the Social Body: The Organism in Its Environments: Both Inner and Outer.” 2016; on the internet at http://www.cpsp.org/pastoralreportarticles/3929569 .

    5. Powell, 2016.

    6. Powell RC. “Religion in Crisis and Custom: Formation and Transformation – Discovery and Recovery – of Spirit and Soul.” 2005; on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3778881 ; translated [2011] by Chaplains Rafael Hiraldo Román & Jesús Rodríguez Sánchez, with the assistance of Chaplain R. Esteban Montilla, as “Religión en Crisis y en Costumbre: Formación y Transformación - Descubrimiento y Recuperación - de Espíritu y Alma”;  on the internet at   http://www.metro.inter.edu/facultad/esthumanisticos/coleccion_anton_boisen/case_study/Religion%20en%20Crisis%20y%20en%20Costumbre.pdf ; a revised edition will be published soon.

    Powell, 2016.

    7. Powell RC.  “Emotions, Bodily Changes, and Symbolism: The Early Writings, 1924-1936 of Helen Flanders Dunbar, BD, PhD, MD.” 1969; The Josiah C. Trent Prize Essay in the History of Medicine, 1970.

    8. Powell, 2005.

    9. Powell RC. “’Cooperative Inquiry’ in Pastoral Care: Some Thoughts on Dr. Rodney J. Hunter’s Article [“Spiritual Counsel: An Art in Transition.” Christian Century 118: 28, 2001].” 2001; on the internet at      http://www.cpspdirectory.org/pastoralreportarticles/3778829 ; a revised edition will be published soon. This author been intrigued by one of Boisen’s questions, “What does G-d think of you?” – as well as by the question, “For what does G-d pray for you?”

    10. Boisen AT. ““Cooperative Inquiry in Religion,” Relig. Ed. 40:290-297, 1945.
    Dunbar F. Psychosomatic Diagnosis. New York, Hoeber, 1943 [the whole book].

    11. Powell RC. “Helen Flanders Dunbar (1902-1959) and a Holistic Approach to Psychosomatic Problems. II. The Role of Dunbar's Nonmedical Background,” Psychiatric Quarterly 50:144-157, 1978; abstract on the internet at www.pubmed.gov ; a revised edition will be published soon.

    Powell RC. “Emotionally, Soulfully, Spiritually ‘Free to Think and Act’.” The Helen Flanders Dunbar Memorial Lecture on Psychosomatic Medicine and Pastoral Care, delivered November 1999, at the Columbia Presbyterian Center of the New York Presbyterian Hospital, New York, New York.  Journal of Religion & Health 40(1): 97-114, 2001. on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3778841 ; added, January 2016, to EthxWeb: Literature in Bioethics, a digital collection maintained by Georgetown University, Washington, DC:  https://repository.library.georgetown.edu/handle/10822/944171 . revised edition to be published soon.

    The following is a brief review what Dunbar meant by “insight symbol” – a phrase she introduced to academic literature. She drew a crucial distinction between three levels of symbolism: 
                (1) the association, extrinsic, or arbitrary symbol 
                            (this stands for that) – more properly called “the sign”; 

                (2) the comparison, intrinsic, or descriptive symbol    
                           (this resembles that) – more properly called “the simile”; and 

                (3) the semblance, interpretative, or insight symbol 
                            (this reveals many that’s) – the symbol proper, 
                upon which she was to place her attention.

    12. Egan K. On Living: Dancing More, Working Less and Other Last Thoughts from the Dying. New York: Riverhead Books, 2016; p.17. [London: Penguin Life, 2017]

    13. Egan, 2016, p.103.

    14. Egan, 2016, p.113.

    15. Egan, 2016, p.113.

    16. Dunbar F. Your Child’s Mind and Body: A Practical Guide for Parents. New York: Random House, 1949.
    Dunbar F. Your Pre-Teenager's Mind and Body. [edited by Benjamin Linder]. New York: Hawthorn Books, 1962.
    Dunbar F. Your Teenager’s Mind and Body. [edited by Benjamin Linder]. New York, Hawthorn Books, 1962.

    17. Egan, 2016, p.14.

    18. Egan, 2016, p.19. This phenomenon was described in neurologic terms in 1964 as “contingent negative variation” – a reference to a shift in the electroencephalograph (EEG) pattern – “response anticipation” – suggesting that the brain “knows” what a person wants to do some seconds or minutes before that person has any conscious awareness of intent to do something. This current author long has been aware of this phenomenon as part of countertransference during a psychotherapy session – as when the therapist, for example, has a definite internal sense of anxiety, depression, anger, or fear – and then waits silently some seconds or minutes longer for the patient’s upcoming verbalizations relating to that sensed emotion; in other words, in some ways the therapist knows through countertransference in the session what is coming before the patient knows what is coming. Walter WG, Cooper R, Aldridge VJ, McCallum WC, Winter AL. “Contingent Negative Variation [CNV]: an electric sign of sensorimotor association and expectancy in the human brain.” Nature. 25 Jul 1964;203(4943):380-384;

    19. Cooper-White P. Shared Wisdom: Use of the Self in Pastoral Care and Counseling. Minneapolis: Augsburg Fortress Publishing, 2004: p.vii.

    20. Cooper-White, 2004, p.52.

    21. Cooper-White, 2004, p.54.

    22. Cooper-White, 2004, p.159.

    23. Cooper-White, 2004, p.175.

    Also see Pastoral Report article: http://www.cpspoffice.org/the_archives/2012/01/

  • 14 Apr 2018 7:30 PM | Anonymous


    We had word this morning of the death of J. Harold (‘Hal’) Ellens yesterday at age 85. He had been suffering from congestive heart failure for some time but had remained active to the very end.
     
    Hal was the 2014 Helen Flanders Dunbar awardee, after which he requested to be certified as a CPSP Diplomate. He was a prolific writer and a supporter of many other writers. He had deep connections in the publishing world, especially at Praeger Press. Hal was also a large influence in the religious community, particularly Biblical studies, psychology, and the clinical pastoral field. Hal had some 180 books published under his name as author or co-author. He was a key leader in the Society for Biblical Literature, nationally and internationally.
     
    On a personal note, I heard from Hal last month. He reported that his heart was failing him more rapidly than he anticipated. He wrote in reference to his ongoing help for me with publishing. I was last with Hal at the Society for Biblical Literature meeting in Vienna in 2014, which he attended with his vivacious teen-age granddaughters and adopted son. Astonishingly, he was popping nitroglycerin pills at that time to keep his heart functioning and keeping up his usual fast pace.
     
    I had been introduced to Hal by Donald Capps some twenty years ago, who thought he could help me get published, as indeed he did. Hal will be greatly missed by me personally, both as a dear friend and as a theological ally. Our community has lost a strong advocate for the values to which we are committed.

    May he rest In peace.  


    ---------
    Raymond J. Lawrence
    General Secretary


  • 21 Feb 2018 9:27 PM | Anonymous


    On February 1 of this year, the Pastoral Report published my “A NEW PROPOSAL: THREE LEVELS OF CHAPLAINCY AND PASTORAL EXPERTISE.” The result was considerable serious conversation from several quarters that led to a significant rethinking of the issue that I had broached. Brian Childs was particularly helpful in these conversations. The result is a significant revision of the original document and the creation of what I believe is a more substantive and more accurate delineation of the varieties of clinical chaplaincy roles. Thus I offer for your consideration the following revision of the “Three Levels...”  RJL

    A NEW CONSTRUCT
    Raymond J. Lawrence

    THREE AXES OF CHAPLAINCY AND PASTORAL EXPERTISE IN THE PUBLIC ARENA

    I propose three axes of chaplaincy and pastoral work, but there is no absolute or fixed boundary between the three. Each axis defines a general emphasis rather than a clear distinction or separation.

    AXIS 1: The Chaplain or Pastoral Clinician as Symbolic Figure

    A wide variety of institutions, organizations, and social clubs appoint or elect “a chaplain,” sometimes for cursory or ad hoc functioning and sometimes for long term and more significant functioning. Here the chaplain’s role represents a kind of liturgist. The death of a president or a natural catastrophe typically becomes the occasion for public memorials of some kind, and typically a religious or quasi-religious leader is summoned to preside over such grieving. The Axis 1 role is generally symbolic and dramatic rather than interpersonal. For an example of this from my own experience, when the World Trade Center was attacked, I was called on as director of chaplains at Columbia-Presbyterian Hospital, in New York, to preside over a memorial service for the entire medical community. It was the first and last time I was called upon to preside over a religious or quasi-religious gathering of the entire community, or at least the members of the community who elected to attend the memorialization of the World Trade Center attack. My burden as a chaplain at that moment was to represent the highest and broadest values of the culture in that context, and I certainly could not appear to represent any particular religion, ideological faction, or subgroup. Such is an Axis 1 role: to present as a religious functionary in the broadest, inclusive sense. Such inclusiveness must embrace even the non-religious, paradoxical as that may appear.

    Such a religious functionary provides the philosophical basis on which a variety of organizations and institutions, large and small, appoint chaplains. Such appointments are generally brief and quite limited in scope. For example, Congress has its own chaplain. Police departments typically have one or more chaplains. Social clubs often appoint or elect chaplains. Almost invariably, by necessity in such contexts, the role is detached from any particular religious tradition. The role is largely formal and temporary, certainly not extensive or with many defined tasks. Typically the duties consist of opening meetings with a prayer or some form of invocation. In some instances the role may extend to attending a crisis situation with the purpose of providing some kind of comfort, and in that limited context the role may border on the clinical. 

    Seldom if ever is there any sort of training for such a role. In those contexts the chaplaincy role is mostly symbolic, formal, and often impersonal.

    The burden in functioning at that level is to represent consensual elements of religion or quasi-religion without giving the appearance of lobbying for or endorsing a specific religious tradition or ideology. Chaplains in Axis 1, and pastoral work insofar as it is conducted in contemporary public contexts, must be universalist and non-sectarian.

    Axis 2: The Chaplain or Pastoral Clinician as a Therapeutic Presence

    A second axis of chaplaincy or clinician pastoral work posits that the chaplain or pastor assumes a therapeutic role, sometimes in relation to a group but more often in a one-to-one context. That role typically carries the additional label of “pastoral care” and/or more recently and with less clarity, “spiritual care.” The chaplain’s role should be a clinical one, that is attending to and focusing on the specific data at hand as distinct from any ideological concerns. The chaplain as clinician always begins and ends not from a position of ideology, religious or otherwise, but by responding specifically and dynamically to the presenting data.

    In this axis the chaplain or pastoral worker attends primarily to transferential data, that is data that gives evidence of unconscious as well as conscious material at play, in the patient, in the chaplain him/herself, and between the two of them. Transference, that is to say the insertion into relationships of unconscious material, can be observed both in the therapist-patient (or parishioner) relationship and in the clinical supervisor-trainee relationship. Both arenas invite, even command, reflection and exploration.

    Such clinical chaplaincy, and the clinical pastoral field generally, owns a large corpus of literature that typically includes a significant training regimen in the arena of attending to the unconscious life of persons and groups. The quality and intensity of training at that level will bear similarities to the clinical training for psychotherapy that psychologists and psychiatrists undergo.

    This approach to chaplaincy (this axis) follows the philosophy and practice of Anton T. Boisen, who inaugurated the clinical pastoral training movement early in the twentieth century. Boisen presented himself as a non-medical pastoral psychotherapist in the general tradition and practice of the psychoanalytic movement begun by Sigmund Freud. 

    Axis 3: The Undifferentiated Chaplain or Pastoral Clinician (The Blurring of Axes 1 and 2)

    A third axis of chaplaincy is a condition wherein the chaplain or pastoral clinician blurs the boundary between Axes 1 and 2. This blurring stems in part from harboring the illusion that the clinical chaplain can perform both functions with the same patient or patients at the same time. But a clinician cannot take the role of religious authority, teacher, and dispenser of religious rituals such as prayer without abdicating the therapeutic posture.

    For example, at the patient’s bedside the chaplain may abandon the therapeutic role and assume the role of a religious authority, teacher of religion, or a dispenser of religious rituals, like prayer. But such action renders the chaplain clinically ineffective. It is probably not a stretch to say that most currently functioning chaplains and pastoral clinicians in the U.S. fall into this trap most of the time.  

    The principal problem for the pastoral clinician is learning the demands of the agnostic posture requisite to competent pastoral counseling and psychotherapy. Most clergy strongly resist abandoning their roles as religious authorities. In congregational leadership such authority is useful to some extent. However, in the clinical setting such organizational religious authority is irrelevant and in fact corrupts the clinical pastoral role. This is abundantly clear in contemporary public institutions with their religiously diverse populations. But it is also true in institutions governed by particular religious organizations. The clinical chaplain cannot simultaneously promote any particular form of religion and at the same time remain clinical and therapeutic.

    In recent decades this issue has been blurred by a clever deception, that of presenting the pastoral clinician as an authority in the amorphous arena of spirituality that is alleged to incorporate all religions. In fact it embraces none. This ploy has been bankrupt from the start simply because “spirituality” as a category means most anything one wants it to mean, and therefore means actually nothing. Communication always breaks down when words lose their definition. Similarly prayer has been commodified in such a way as to give the appearance of being applicable to any god and any form of religion at any time. Most, but not all of this commodification has been promoted by non-theologians, a curious recent secular usurpation of theology by secular authorities. But if it matters not which of the many gods are being addressed, why pray at all?

    In practice, patients and clients will themselves tempt chaplains to confuse and violate the boundary between Axes 1 and 2. But it is the responsibility of the pastoral clinician to be alert to such temptation. The temptation is an intrinsic fruit of resistance to the therapeutic opportunity, and resistance is universal. How many are there among the patient population who would prefer to avoid dealing with their own personal reality? And how many chaplains prefer not to do the therapeutic work? It is quite easy to tempt the chaplain to recite a prayer and go away, not only entirely voiding the work of reflecting on inner turmoil and interpersonal discomfort but also avoiding the benefit of the chaplain’s potential therapeutic role. Chaplains insofar as they are clinicians must understand resistance and be attentive to it, an essential part of clinical practice. To grasp this temptation the chaplain must of course be disciplined in the art of declining the pedestal of religious authority, that most temptingly irresistible plum.

    Contemporary pastoral clinicians must decide whether they seek to function as administrators of whatever religion or cult pays their salary, including the newly created “spirituality cult,”  or whether they are going to function as theologically informed and psychoanalytically informed therapists in the tradition of the clinical pastoral training movement.

    -----------------

    Raymond J. Lawrence, General Secretary
    lawrence@cpsp.org





  • 01 Feb 2018 7:17 PM | Anonymous


    At the recent meeting of COMISS in Washington, DC, David Roth and I discussed at length the signs of strife amongst the various chaplaincy organizations, and attempted to imagine together what new constructs might be introduced that would have some prospect of assuaging some of the rivalry and animus that attended the differences among the various chaplaincy and pastoral care and counseling groups. David and I came to the conclusion that a way to begin might be to recognize that each tradition has its own way of functioning, and its own idiosyncratic goals and values. Furthermore, we concluded that such differing goals should be acknowledged and accepted without derogation. In the broad field of chaplaincy, pastoral care and counseling there should be no “one size fits all” approach. After reflecting on our COMISS conversations, I present the following proposal for a possible reframing of the ways we think about the respective work of the various chaplaincy, pastoral care and counseling traditions. I invite others to join this conversation. 

    ***

    Level 1:

    A wide variety of institutions, organizations and clubs appoint or elect “chaplains.” For example, Congress has its own Chaplain. Police departments typically have one or more chaplains. Social clubs often appoint or elect chaplains. Generally in such contexts, the role is detached from any particular religious tradition. The role is largely a formal one, but not extensive nor with many defined tasks. Typically the duties consist only of opening meetings with a prayer or some form of invocation. In rare instances the role may extend to attending a crisis situation with the purpose of providing some kind of comfort. Seldom if ever is there any sort of training for such a role. 

    Level 2:

    A second level of chaplaincy, typically more finely defined as pastoral functioning, posits that the chaplain or pastor assumes a professional role. That role typically carries the additional label of “pastoral care” and/or more recently, “spiritual care.” In many but not all instances this role is considered a clinical one, that is, attending to and focusing on the data at hand as distinct from ideological concerns. The clinician as clinician always begins not from a position of theory or ideology, but by responding to the presenting data.

    Such clinical chaplaincy and the clinical pastoral arena generally owns a large corpus of literature and typically includes a significant training regimen. The quality of training at this level may or may not have some

    resemblance to social work training and/or psychotherapy training, depending on the focus and intensity of the training itself. 

    As distinct from the clinical posture, this level of training may also involve training in specific religious practices and doctrines to be introduced into the work of caring for persons. For example, there are Jewish, Catholic, Hindu, Buddhist and Muslim associations for pastoral care and/or chaplaincy. While there is or should be a clear disconnect between the clinical and the promotion of specific religious practices, this distinction is not always adhered to in practice. Some chaplains attempt to straddle the clinical and the specifically programmatically religious agenda. 

    At this level of chaplaincy the role of the chaplain is typically a broad spectrum one, and may involve a complex mix of clinical care and  counseling along side religious rites and rituals. In specifically religious hospitals, for example, we will find a predominance of chaplains from the religious group that owns the hospital. Chaplaincy at this level is generally seen as promoting religion of one sort or another and consequently tends to dilute or even nullify the clinical dimension of care. Such chaplaincy becomes complicated when, as often occurs, the patient and chaplain subscribe to widely differing religious traditions from that of the institution itself. This level of chaplaincy is exemplified generally in certifying organizations such as Neshama: Association of Jewish Chaplains (NAJC) and the National Association of Catholic Chaplains (NACC). The Association of Professional Chaplains (APC) sees itself as a proponent of this perspective.

    In this level of chaplaincy, the training regimen for chaplains is generally seen as “education” for “students.” The largest training institution for this level of training at present is the Association for Clinical Pastoral Education (ACPE).

    Level 3:

    A third level of chaplaincy is a specialization level extending beyond level 2. This level of chaplaincy posits the chaplain as a religiously-based - generically speaking - pastoral counselor and/or pastoral psychotherapist, but one who does not promote any particular religious sect. In this philosophy of chaplaincy the overt religious doctrines and various religious philosophies fall into the background, and the chaplain assumes a universalist posture. In this approach to chaplaincy the patient will not be aware, optimally, of what particular religious tradition the chaplain subscribes to, if any. This approach to chaplaincy, or pastoral care, gives attention solely to the patient and the patient’s predicament. Listening to the patient and attempting to reach a pastoral diagnosis, and to offer a therapeutic relationship is the principle burden of the chaplain. Such a pastoral diagnosis will transcend the doctrines of any particular religious tradition and function on a universalist level. The focus of attention is entirely on the patient. The training of chaplains in this modality is generally referred to as “clinical pastoral training,” following the medical model, as opposed to “education,” following the academic model.

    This approach to chaplaincy follows the philosophy and practice of Anton T. Boisen, who instituted clinical pastoral training early in the twentieth century. Boisen presented himself as a non-medical pastoral psychotherapist in the general tradition of Sigmund Freud. This level of chaplaincy is generally represented by the College of Pastoral Supervision and Psychotherapy (CPSP).

    ----------

    Raymond J. Lawrence
    CPSP General Secretary
    lawrence@cpsp.org

  • 29 Jan 2018 9:18 PM | Anonymous



    Editor's Note: As we remember Dr. Martin Luther King, Jr., who with great courage, dignity and wisdom, fought against racism and its destructive forces on humanity, I encourage you to listen to this interview with Isabel Wilkerson, author of The Warmth of Other Suns: The Epic Story of America’s Great Migration. Listening to this interview, I hope will warm your heart with human compassion, as well as pierce your heart knowing the pain racism has inflicted. 

    Perry Miller, Editor
    perrymiller@gmail.com 


  • 28 Dec 2017 11:55 AM | Anonymous
    During this holiday season, don't forget to give yourself the gift of attending the 2018 CPSP Plenary!


    This will be a CPSP gathering unlike any before! AND we have just extended the special, low Early Bird and Justice Initiative rates one more week so you can take advantage of these savings. 


    Here are just 10 reasons to attend:


    1. Located between Berkeley and Oakland, Emeryville, California, is on the shores of San Francisco Bay. We have a special rate of $139/night (single or double) at the Hilton Garden Inn if you book by March 3. Oakland International Airport and San Francisco International Airport are both close by and both have affordable public transportation to the hotel. 


    2. Dynamic Speakers and Authors including Pamela Cooper-White, Kerry Egan, and Gordon Hilsman.

    Pamela Cooper-White is the widely-published Professor of Psychology and Religion at Union Theological Seminary. She will be talking about "Shared Wisdom" on Sunday afternoon. 



    Hospice chaplain Kerry Egan's  book, On Living, was published last year to wide acclaim. She will be speaking on Monday afternoon.  



    Gordon J. Hilsman is a board certified chaplain and CPE supervisor with over 40 years' experience in hospital, addiction treatment, mental health and hospice settings. The author of Spiritual Care in Common Terms, he will conduct a practical workshop on charting for clinical chaplains.  



         

         

    3. Book signings by Cooper-White, Egan, Hilsman, and also Raymond Lawrence whose new book Recovery of Soul is a history and memoir of the clinical pastoral movement. (Click on the book covers, above, for more information.)



    4. Music by The Threshold Choir, an international organization of choral performers who sing for those at the thresholds of life. 



    5.  NBA champion Golden State Warriors play the Sacramento Kings on Friday, March 16, the evening before Plenary. Tickets are limited but still available.



    6. Two-time Grammy-nominated bluesman and gospel artist (and chaplain) John Lee Hooker, Jr, and his band will perform for us on Tuesday night.



     7.  On the evening of St. Patrick's Day, March 17th, there will be an hourly shuttle between the hotel and historic Bill McNally's, Oakland's hottest Irish pub


    8.  Saturday sightseeing will include the San Francisco Bay Ferry from Fisherman's Wharf to tour Alcatraz Island the Maritime National Historical Park at Hyde Street Pier, and other attractions. Also, Plenary staff will be available to assist attendees who wish to meet as a chapter or want to take in the local sights. 


    9. Workshop topics include Ethics for CPSP Chaplains, Trauma Chaplaincy, The Chaplain's Role in the Physician-assisted "End of Life Option," and more.




    10. An opportunity to meet and get to know colleagues from around the country and the world, to rekindle old friendships, and to participate in small group sessions with case supervision are always Plenary highlights!

    Don't wait. Register NOW.


  • 25 Dec 2017 9:02 PM | Anonymous
    A friend spoke of her husband's battle with kidney disease and her fighting red tape to get help. The process sounded mechanical. They told her if his papers were in order he would be  eligible for medical assistance; if not, then he would need to met their criteria. Sounded to me like starting a car in cold weather. You need an good battery or a tow. 

    How much of healthcare has become that way? And perhaps getting other types of assistance? We need the right paperwork to get the wheels moving. Those of us needing help must wait for a computer output that will be forthcoming only if every dot and tittle's correct on the input. Meanwhile, my friend scrambles to get the right input as her husband suffers. 

    She is intelligent, tenacious, and resourceful, and so I'm confident she'll get it right. Let's hope that others less endowed with these qualities can obtain the expert help they need with their paperwork. 

    As chaplains, we do advocate for those in need where we can. In a larger sense, we can also 1) assure those we cannot help that humans are still in charge, 2) loosen the criteria that deny help where we can, and thereby 3) keep the machines in their place. Those three objectives would be fine holiday gifts that will last all year long. 



    ______

    Dominic Fuccillo is a retired Clinical Chaplain who lives in Littleton, Colorado.


  • 12 Dec 2017 11:49 PM | Anonymous

    “The century-long clinical pastoral movement sparked by Anton Boisen was and continues to be a long struggle to implement ethical and effective therapeutic approaches for working with suffering people, particularly those suffering mostly in their minds. Boisen himself learned from Freud … that a disordered mind, at least in some cases, was the result of a struggle to find integration in the face of powerful internal conflicts.”1

     “Any reader might be puzzled by the recurring centrality of sexual issues in the history of the century-old clinical pastoral movement. …

    The clinical pastoral movement, like Sigmund Freud, simply brought the issue out of the closet and into the light of day, at least in its early decades. …

    Therefore, let it be said loud and clear, that the clinical pastoral movement is not an outlier in its peculiar helter-skelter history of attempting to sort out virtue from vice in the sexual arena.” 2

    Recovery of Soul … merits inclusion in “The Great Books of Clinical Pastoral Chaplaincy”. You need to read it – along with Raymond’s other three books.3 Some years ago, Perry Miller, Raymond Lawrence, and I co-authored “Discrete Varieties of Care in the Clinical Pastoral Tradition”.4 That, too, still makes for good reading. In our editing, Perry and I were wise enough to retain Raymond’s unique verbiage, as he has a great way with words. That’s a point I want to emphasize – that Raymond’s rhetorical/ pedagogical style connects with the reader. He makes a fairly objective assessment of a situation – then adds a last phrase that tells us his real opinion about what he just wrote. Yes, the book is Pure Raymond. It is sort of like there is a “snarky Raymond” rendering the last word about what “academic Raymond” wrote. The method works.

    Classic guidance for preachers says, “Tell ‘em what you’re gonna tell ‘em, tell ‘em, then tell ‘em what you told ‘em”. A colleague’s foreword to Recovery of Soul … warns that Raymond “pulls no punches,” “acknowledges all our brokenness,” yet “points out the redemptive power of love” – and that he “does not suffer fools lightly” but “acknowledges that he, too, has worn the foolscap”. Raymond himself provides a preface about his main trusted historical sources plus a prologue about grasping the clinical pastoral task. Thirty-one pithy chapters either set stages or ruminate over the works and quirks of Anton Boisen, Helen Flanders Dunbar, Seward Hiltner, Russell Dicks, Wilhelm Reich, Armen Jorjorian, George Buck, Joan Hemingway, Donald Capps, Myron Madden, and Wayne Oates – with Raymond’s own story tossed in – weaving the history of professional chaplaincy around these bits of real lives in real contexts.

    Raymond devotes a specific chapter to “The Creation of The College of Supervision and Psychotherapy (CPSP)” in 1990. “Creation” indeed is the right word. The chapter includes a copy of the short but powerful CPSP “Covenant”—which is well worth digesting. Take a close look at it. CPSP, as “a theologically based covenant community, dedicated to ‘Recovery of Soul’,” took a shape and form that definitely was something new in the clinical pastoral world. As Raymond notes, “unbeknownst to us at the time, we were reenacting history. By the seat of our pants we were reasserting the philosophy and values of Anton Boisen and Helen Flanders Dunbar”. All became clearer starting around 1999.

    Another chapter lists “10 axioms … for guidance in assessing and adjudicating alleged sexual violations by clergy”.

    Raymond’s final chapter – “Last Words” – provides a clear, logical, and convincing summary of his wide-ranging argument about the conflicting forces that drove the field to where it is now. If nothing else, read the last chapter – but you really should read the whole book. Actually, let me suggest a course of reading that honors the “complex, accursed, and redemptive” story, as Raymond phrases it, of how clinical pastoral chaplaincy developed over the last 100 years. 7

    Read Recover of Soul … now, but, if you get the chance, go back and read, in order,
    first my writings (with the story starting around 1906),
    then Allison Stokes’ book (focusing on the 1940s and 1950s),
    then Edward Thornton’s book (overviewing all through the 1960s), then Raymond’s new book again plus maybe his three previous books. 8

    Powell’s, Stokes’s, and Thornton’s studies of the movement are more academic, by design, but Raymond’s is both more insightful and more of a joy to read.

    As soon as the planned new editions of Boisen’s books come out, read those, too. You won’t at all regret that decision. You will be amazed at the depth of Boisen’s thinking.

    The Exploration of the Inner World: A Study of Mental Disorder and Religious Experience (1936);
    Religion in Crisis and Custom {A Sociological Study of Mental Disorder and Religious Experience} (1955);
    Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience (1960). 9

    Let me repeat: “If nothing else, read the last chapter” of Recovery of Soul …. It should become a common reading for anyone involved in clinical pastoral chaplaincy. “That [Freud-Boisen-Dunbar] thesis asserts that healing comes when an intelligent and informed pastoral person listens carefully and mostly silently to the accounts of a suffering person. And in that listening always keeping the unconscious and its perverse and unpredictable ways clearly in view – at least in the corner of the eye – and observing whatever connections can be made that might promote healing. … And we must add, supplemented by attention to community building, a calling in which religious communities have historically demonstrated some expertise.” 10



    Endnotes:
    1. Recovery of Soul …, p.176. It should be noted that Boisen himself called for the recovery of zeal, inner experience, and faith – for a “living fellowship with a certain body of beliefs in which there is room for growth and for discovery”. Boisen AT. Religion in Crisis and Custom …. (1955); pp.232, 237.

    2. Recovery of Soul …, pp.175-176.

    3. Lawrence RJ. Nine Clinical Cases: The Soul of Pastoral Care and Counseling (2015).
    Lawrence RJ. Sexual Liberation: The Scandal of Christendom. (2007).
    Lawrence RJ. The Poisoning of Eros: Sexual Values in Conflict. (1989). All are available on Amazon. If possible, read the books in the order of their publication.

    4. Miller PN, Lawrence RJ, Powell RC. “Discrete Varieties of Care in the Clinical Pastoral Tradition.” J Pastoral Care Counsel. 2003 Summer;57(2):111-6; re pastoral care, counseling, & psychotherapy; abstract: https://www.ncbi.nlm.nih.gov/pubmed/12875119; full text:  http://www.cpspoffice.org/the_archives/2005/07/discrete_variet_1.html

    5. Taking a look at the following examples of “academic” comments followed by “snarky” comments, note that they almost constitute a concise summary of the entire book.

    p.6. “… he abandoned French [literature] altogether and began majoring in forestry. The sexuality of trees would not disturb his psyche.”

    p.8. “… Boisen never had any psychoanalytic treatment subsequently. (Of course, neither did Freud have any psychoanalytic treatment! It seems that the only real treatment for either man was what he gave himself.)”

    p.22. “… the battle was over the question of the role of the pastor, whether pastors were going to be psychoanalytically oriented therapists in their own rights or adjuncts to the real therapists, the physicians. This ongoing dispute could by now be called another Hundred Years War.”

    p.31. “Kinsey could have walked over to Boisen’s childhood home. The ghosts there might have told him a lot about sex.”

    p.31. “… Hiltner deserves great credit for a willingness to face the sexual music publicly as a prominent religious leader and scholar. Apparently, no one else had such nerve.”

    p.48. “… he could talk for hours about the wonder of dialogue but was completely inept at engaging in it.”

    p.69. “The following pages will elaborate on some of the evidence of this developing state of affairs – or should we say, this developing crisis.”

    p.81. “My colleagues seemed quite delighted with the change [toward diversity] …. After all, what could be more boring than working exclusively with Protestant heterosexual males?”

    p.83. “… now that they [women] were included they found passivity at the helm. Passivity is worse than hostility.”

    pp.88-89. “… some of the most vicious women in their dealings with strong heterosexual males were themselves proponents of a liberated sexuality ….  The times were crazy-making.”

    p.112. “They had found something life giving in this connection to Anton Boisen and Sigmund Freud. But while they were followers of Boisen, he was not leading.”

    p.140. “Their hearts were in the right place, but their brains were obviously in neutral.”

    p.170. “… she too is theologically untrained, and it shows.”
    My point, again, is a “snarky” comment seems to help one to remember the more “academic” comment.

    6. Recovery of Soul …, pp.155-156.

    7. Recovery of Soul …, p.xx.

    8. Revised and updated editions of my main writings – each with extensive new documentation – are to be published in the next year or so.
    Powell RC. C.P.E. [Clinical Pastoral Education]: Fifty Years of Learning, through Supervised Encounter with “Living Human Documents” (1975); the initial print run was for 10,000 copies; reviewed in J. Pastoral Care. 1982;36(3):210; reprinted, 1987; translated into Spanish, 2009, by Chaplain [Maria] Magdalena Garcia [Orozco], at the request of Chaplain [Romulo] Esteban Montilla as Clinical Pastoral Education (CPE): Cincuenta Años de Aprendizaje: A través del Encuentro Supervisado con Documentos Humanos Vivos.

    Powell RC. “Questions from the Past (on the Future of Clinical Pastoral Education)”. [ACPE] Conference Proceedings: 1-21, 1976.

    Powell RC. Anton T. Boisen (1876-1965): “Breaking an Opening in the Wall between Religion and Medicine”. AMHC Forum 29(1), supplement, 1976; the initial print run was for 2,000 copies; reviewed in J. Pastoral Care. 1982;36(3):209.

    Powell RC. “Anton T. Boisen's ‘Psychiatric Examination: Content of Thought’ (c.1925-31): An Attempt to Grasp the Meaning of Mental Disorder.” original version: Psychiatry 40: 369-375, 1977; abstract on the internet at www.pubmed.gov

    Powell RC. “Empirical Theology, 1916-1946: A Note on the Contribution of Anton T. Boisen.” original version: Chicago Theological Seminary Register 67: 1-11, 1977.

    Powell RC. “Whatever Happened to ‘CPE’ – Clinical Pastoral Education?” 1999; original version on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3778818 (an update on “Questions ….”)

    Powell RC. “Emotionally, Soulfully, Spiritually ‘Free to Think and Act’.” original version: Journal of Religion& Health 40(1): 97-114, 2001; original version on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3778841 .

    Powell RC. “Religion in Crisis and Custom: Formation and Transformation – Discovery and Recovery – of Spirit and Soul.” original version on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3778881 ; translated into Spanish, 2011, by Chaplains Rafael Hiraldo Román & Jesús Rodríguez Sánchez, with the assistance of Chaplain R. Esteban Montilla, as “Religión en Crisis y en Costumbre: Formación y Transformación - Descubrimiento y Recuperación - de Espíritu y Alma”; on the internet at http://www.metro.inter.edu/facultad/esthumanisticos/coleccion_anton_boisen/case_study/Religion%20en%20Crisis%20y%20en%20Costumbre.pdf  .)

    Powell RC. “Anton Theophilus Boisen (1987-1965), Clinician.
    I.   Assessment:  Persistent and Provocative ‘Co-operative Inquiry’: Empathic and Enlightening ‘Exploration of the Inner World’.

    II. Therapy:  Patient and Creative ‘Co-operative Interpretation’: ‘Thinking and Feeling Strongly Together about Things that Matter Most’.” 2012. to be published.

    Stokes A. Ministry After Freud (1985). A new edition is forthcoming.  https://www.boisenbooks.com/pages/about-the-books

    Thornton E. Professional Education for Ministry: A History of Clinical Pastoral Education (1970). For an appreciation of how Thornton’s insightfully conflicted thinking about the primacy of “clinical pastoral transformation” presaged, in a way, the controversy leading to the founding of the College of Pastoral Supervision and Psychotherapy, see Powell RC. “Discerning Spirituality in Everyday Life – and Allowing Oneself to Be Transformed.” 2008; on the internet at http://www.cpspdirectory.org/pastoralreportarticles/3778941

    9. See https://www.boisenbooks.com . Each of these will be cleanly composed editions, with scholarly introductions, forewords, and afterwords.

    10. Recovery of Soul …, pp.181-182.



    Robert Charles Powell, MD, PhD

    Editor's Note: Robert Charles Powell, MD, PhD, is the leading historian of the clinical pastoral movement. Many of his published writings are posted on the Pastoral Report. Readers can use the search field, located in the upper right corner of the website, to locate his articles. As a practicing psychiatrist, his writings reflect his daily investment in his clinical practice of providing psychotherapy and care to his patients. Contact Dr. Powell by clicking his name, above. -- Perry Miller, Editor



  • 05 Dec 2017 3:05 PM | Anonymous

    The current campaign to denigrate Muslims on the grounds that some Muslims have turned violent is reminiscent of the Nazi pogrom against the Jews. We must do all in our power to neutralize this perverse and irrational campaign. In fact Islam is a religion of peace just as is Christianity. 

    At times in history Muslims have shown themselves to be even more generous and peaceable than Christians. In the time of  the Crusades, for example, Muslims often responded more peaceably under stress than the thuggish Crusaders who were invading the Middle East. 

    The fact is that every religion harbors murderously violent persons such as those Muslims who brought down the World Trade Center. Christianity is no exception to such aberrations. 

    Current attacks on Islam itself and on Muslims in general must be neutralized by us by every means possible. Every Muslim in this country surely now feels like the United States is increasingly an inhospitable place to live. We are called upon to reassert hospitality to our Muslim brothers and sisters in our respective communities.

    And we are called upon do all in our power to embrace our Muslim colleagues in the CPSP community, and to express our solidarity with them. Anything less would be a betrayal of all that we stand for. 

    This incipient war of Christians against Muslims is a despicable development in our country that must be neutralized to the extent that we are able by compassion and support of the Muslim communities in our midst from all members of the CPSP community.

    Raymond J. Lawrence
    General Secretary 


  • 01 Dec 2017 11:04 AM | Anonymous

    A history and memoir of the clinical pastoral movement by a key leader is the first book published by the newly launched CPSP Press.

    "Recovery of Soul" by CPSP founder and general secretary Raymond Lawrence offers a critical and often personal take on the movement that has given us modern day chaplaincy and clinical pastoral education. Written from the vantage point of an insider with a half-century of experience, the book offers an unvarnished and penetrating look at the movement from its beginning by Anton T. Boisen in the early 20th century.

    The book is available now on Amazon.com and will soon be available at CPSPPress.org.​

    CPSP Press is committed to bringing into print a small list of significant new books as well as reprints of out-of-print titles of importance in the clinical pastoral field. David Roth serves as its general editor and publisher.

    "For many years we talked about creating a CPSP publishing house. At long last it has become a reality," said CPSP founding member and leader Perry Miller. 

    The announcement of future CPSP Press titles is expected at the CPSP Plenary in Oakland, CA, in March 2018, when two books by Boisen will appear in new editions under the Verbum Icon imprint.


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