Lost Wisdom, Found Wisdom, Shared Wisdom -- by Robert Charles Powell, MD, PhD

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/