Empathy, emotional clusters and the accurate identification of the functions of pastoral care

By Stuart Adamson

 

Empathy is a chaplain’s stock in trade. Combined with a pastoral presence that is focused on the client, and with the ability to do what I call triple listening (listening to the other, listening to self and listening to God in a dynamic internal/external process), the chaplain is equipped with some key skills to begin to care well for others pastorally.

 

There are a number of kinds of listening to the other, but for our current purposes, I want to focus on empathic listening, because of where it leads, namely: to the accurate identification of the felt need of the person being cared for, and consequently, the pastoral function.^[1]

 

Empathic listening involves listening to the heart of the other person as expressed by their words, but also by their body language, their demeanour and their facial expressions. This is because the person the chaplain is caring for pastorally does not just communicate verbally.

 

All of those messages, verbal and non-verbal, are being communicated to a chaplain, who in the best-case scenario, is fully focused on the person they are caring for, blocking out distractions, listening intently and watching closely. The chaplain employing empathic listening will seek to identify the main emotion, or range of emotions, and reflect them back to their client in a way that will communicate that the chaplain appreciates and is accurately assessing the emotional state of the client. In essence, that they are a good listener, and that they care about the person they are with. Such listening has the added effect of building trust very quickly.

 

Let me illustrate from a visit I had today with a patient in ICU.

 

Background: Joe identified as a Christian. When I arrived, he had a thick pipe supplying oxygen to his nostrils, which were plugged. He was sitting up with three pillows behind his back, his bed inclined to support this. His breathing was shallow, he could talk freely, but it was an effort, and from time to time, his eyes would roll back into his head.

 

S1 Hi Joe. (Pause) It’s a real struggle. 

J1 (Nods) It is … I’ve lost so much weight … But I just don’t feel like eating. 

S2 And it leaves you feeling so weak … 

J2 It’s so hard Stuart 

S3 One step at a time … 

 

Analysis: Joe had communicated so much to me without even saying a word, so using all that non-verbal information, I reflected back to him a summary emotion, “it’s a real struggle”.

 

Notice that he responds with a confirmation, both a nod and “it is”. This tells me that I am on the right track. That I am assessing the non-verbals accurately. At S2 I chose to reflect back what I was getting from him, his weakness. But notice he wanted me in J2 to understand that he was being pushed to his limits, “It is so hard”, he said. In other words, “I want you to know that I’m really struggling, and I don’t know how much I can take of this.” At S3 I was responding to this. I offered prayer (which for the sake of brevity is not recorded here) which he welcomed, and I prayed that the Lord would be his strength for the road ahead, and I gave thanks that Joe’s strength would be sustained as he looked to the Lord.

 

The cluster of presenting emotions is: feeling like it is a huge struggle (J1) weak (S2), exhausted, overwhelmed, doubtful about his capacity to persevere (J2).

 

When seen through this framework, it confirms the obvious primary function of sustaining.

 

Relating the above visit to the six functions in a more nuanced way, there are arguably other relevant functions. Joe feels trapped by his circumstance, so liberation is also indicated (Perhaps this is what the prayer addressed in some small way?). He was looking to me. “It’s so hard”. I’m at my limit. How long can I continue? There is a dimension of guidance here as well. “Those who hope in the Lord will renew their strength” might have been appropriate. But hoping in the Lord might sound to him like a lot of effort in his current circumstance. Hence I said Look to Him, (remember the event that John 3:14 refers? The Israelites were to just look at the bronze snake. Num. 21:9). The prayer addressed the wider issue of healing as well, but also mentioned the love of his children, which also reminded Joe of the resources available to him in those who love him. Nurturing comes into its own when people feel weak and need gentle, loving care. Reconciling is only hinted at here, not that Joe was out of relationship with His God, but, like the Psalmist who asks, ‘Will you forget me forever?” (Ps 13:1) Joe needed assurance that God cares for and loves him, truths that were reinforced to him via my presence.

 

Emotional clusters emerge on sustained reflection, and with practice, in the encounter, suggesting a pastoral response in line with the relevant function.

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^[1] In the interests of simplicity, I am treating the six “functions” of pastoral care as the following: guiding, healing, nurturing, reconciling, sustaining and liberating. I don’t think that this list of “functions” is by any means comprehensive, or really adequate, but it is a helpful framework to use for chaplains in training. You may like to see Part One of this short series at http://bloggingchaplains.blogspot.com/2016/09/the-six-functions-of-pastoral-care.html for my thoughts on the model, the six functions. My preference is to think of them more as “pastoral responses” to presenting needs rather than the somewhat mechanical, “functions”.