Clinical Supervision and Theology of Chaplaincy

Kate Bradford

In what way is Chaplaincy different for Clinical Supervision?

I have been participating in a workplace course, Clinical Supervision Training; the use of the term Clinical in this context relates to the discipline of Clinical Psychology rather than the medical/clinical work environment. The purpose of this course is to equip hospital staff members (nursing, allied health and others) with skills to clinically supervise and support other staff members in the hospital work environment.

Clinical supervision in this particular course encompasses skills to: empathically support; encourage reflection; help clarify; in order to aid the development of coping skills and build confidence in the other. The key skills focused on are active listening and reflective questioning. A method of Socratic questioning is used in the training. By drawing on Socrates’ belief that: people already have the truth within them and the questioner acts as a mid-wife helping to draw the answers out of people – they in effect discover what they already know.[1]

The clinical skills imparted during the course are both practical and insightful. But as a result of my participation I wish to ask; does Chaplaincy offer anything different from Clinical Supervision? And if so; in what way is Chaplaincy a distinct discipline? If it is not, then consequently, chaplaincy is essentially a form of Clinical Supervision dependant on a clinical psychology framework. Therefore if this is the case, then would it not be better to leave our work to those specifically trained in clinical psychology or counselling?

As Christian Chaplains our ministry is distinct from Clinical supervision is several ways. 1) Christian chaplains help prayerfully, to create a space where a patient may explore spiritual issues around meaning, purpose, hope and love. By listening and asking perceptive questions we help the patient discover what they know: how they think and feel about an issue or event. We are physically, emotionally and spiritually present with the person as they explore their issues. The chaplain is below, seeing events from the patient’s viewpoint; they are compassionately beside them and in their present.  2) As the chaplain spends time with the patient they help the patient to discover not only what they know but additionally help the patient discover the limits or edges of their knowledge. A Biblical perspective would critique the Socratic questioning at this point, as Socratic questioning cannot open up what someone truly does not know, or does even not know that they don’t know. The chaplain, beginning with the patient’s perspective, has a role to guide the patient beyond to deeper truths that lie outside themselves.

The chaplain must remain continually mindful that Socrates can only lead them so far and they must never place their ultimate confidence in him and his method. Socrates could observe true things about humanity; but not about humanity’s relationship with God, for this the Christian must follow the way of Jesus and his wisdom on these matters.

Soren Kierkegaard, a follower of Jesus’ way, addressed this issue in Philosophical Fragments, a book written pseudonymously by Johannes Climacus, who asks ‘How far does Truth admit of being learned?’[2]^,[i] Climacus observed that "one cannot seek for what he knows, and it seems equally impossible for him to seek for what he does not know. For what a man knows he cannot seek, since he knows it; and what he does not know he cannot seek, since he does not even know for what to seek."[3] Climacus underlines that with the Socratic Method "the Truth is not introduced into the individual from without, but was within him all the time"[4] that “all learning and inquiry is... a kind of remembering" and that "one who is ignorant needs only a reminder to help him come to himself in the consciousness of what he knows".[5] Such a view is at odds with the Biblical view: that are generally revealed truths that we may identify for ourselves however there are a greater set of divine/eternal truths that remain hidden until revealed. This Truth is external, residing in the triune God. The value and limits of the inward journey are that they may ultimately reveal the need for the outward journey.   

As chaplains we question, because if we do not hear the question how is it possible to know the answer, but if we have no answers beyond those things that patient can discover within themselves: how can we be ministers of the Gospel? Climacus describes a moment of departure from what is already know as of being of  "decisive significance,"[6] Thus, for the patient the moment of departure in time is more than just a realization of what one already has. It is the realisation of what one wholly lacks. The patient may not even possess the truth unknowingly or unwittingly. Prior to the moment of departure the patient does not know or possess the truth, and does not even know that they do not know the truth.

The chaplain is working with two patient’s horizons of significance.[7] One horizon is the immediate circumstance in which the patient finds themselves and as such has some self-knowledge and access to an understanding of these circumstances.  A second horizon of significance is the eternal horizon; access to this horizon is not inside but rather, outside the patient.  In the Christian worldview truth is revealed; truth is most clearly seen in the person of Jesus Christ who said, ‘I am the way, the truth and the life’ (John 14:1,6) and truth is comprehended through the revealed text of the Bible. The chaplain helps create an environment and conditions necessary for hearing this Truth. The chaplain reflectively introduces ideas or concepts from Biblical truth that connects with the patients and their situation and helps lead them to a new place.

Socratic questioning is an invaluable tool for the chaplain but not as an end in its own right. Jesus and the Apostle Paul were both masters of Socratic questions – not with the intent to reveal the truth within – but rather to illuminate contradictions in thought and to expose the limits of human reasoning. It is possible to assume that Jesus and Paul may have been drawing on contemporary Greek culture that surrounded their first century world, but we can be certain that they drew on their own Jewish culture’s reliance on the power of reflective questioning to show human limits, this is most clearly seen in the book of Job.

Chaplaincy as a discipline differs from Clinical Supervision. Clinical Supervision is concerned with changing perceptions and alleviating anxiety in the immediate context. Chaplaincy is concerned with engaging both the temporal and eternal horizons of significance. The chaplain listens attentively, and questions reflectively, in order to help guide the patient to what can be known about the current circumstances and to help the patient sense the limits of what cannot be known internally about eternity. This is a process that involves both illumination and revelation.

[1] Julius Tomin, ‘Socratic Midwifery’, The Classical Quarterly New Series, Vol. 37, No. 1 (1987), pp. 97-102
Cambridge: Cambridge University Press.  Article Stable URL: http://www.jstor.org/stable/639347

[2] Soren Kierkegaard, ‘Philosophical Fragments’, A Kierkegaard Anthology Robert Bretall, (ed) Princeton: Princeton University Press, 1946, 154.

[3] Fragments, 155.

[4] Fragments, 155.

[5] Fragments, 155.

[6] Fragments, 157.

[7] Horizon of Significance refers to Charles Taylor's claim that authentic identities ought to be constructed dialogically against 'horizons of significance’ The Ethics of Authenticity, 1991.

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[i] An essay on Kierkegaard’s discussion between Socrates and Climacus: "Greek and Christian Models of the Truth." <http://www.123HelpMe.com/view.asp?id=22042>. Accessed 20/April/2012

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