Pastoral Care

By David Pettett.

The concept of Pastoral Care springs from the understanding of the compassion of Christ. In Matthew 9:36 Jesus had compassion on the crowds because they were like sheep without a shepherd.

It is into this sense of “lostness” that the pastoral carer comes. Typically the place of lostness is a “hard place”, a place that is out of the ordinary for the person who has a sense of loss. It is a physical place such as a hospital, a jail, a nursing home. But it is also not a physical place but a place of mourning, grief, sadness or paradoxically, a place of happiness.

Jesus also expresses compassion when he sees suffering, for example when he heals the sick (Matthew 14:14), or comforts the bereaved (Luke 7:13).

The unique encounter that Jesus brings is one of restoration and reconciliation with God. He does not “cure” disease as a doctor or nurse might bring medical attention, but he heals. (The Greek word of the New Testament for “heal” is the same word for “save”.)

The unique encounter that the Christian Pastoral Carer brings to a person in a hard place is this same restoration and reconciliation. The Pastoral Carer therefore does not mix the roles of medical attention or other allied health roles with that of Pastoral Care. Pastoral Care compliments these other types of caring by adding the dimension of reconciliation with God.

Pastoral Carers need specific training so that these boundaries are clear and so that the Carer remains anchored in his or her own confidence in God while at the same time being able to sit with a person in a hard place that may be a place of great turmoil and anguish. Then, while being anchored with God in Christ and at the same time being with another in their place of turmoil, the Carer can, by the power of the Holy Spirit, help the person in turmoil to discover how Christ Himself is present in their suffering.

What does an Evangelical Theology of Chaplaincy Look Like?

Kate Bradford

An evangelical theology of Chaplaincy draws on both evangelical tradition and historical roots of chaplaincy. Theologically it must engage both with theologies from above and those from below. The theology must avoid reductionism but rather be open to contributions from other disciplines and allow them to both critique and contribute to theological positions held.

Chaplaincy is not parish based but institution based. The chaplaincy pastoral encounter does not always have faith or a church property providing common ground, but rather an institution (work place, hospital, armed forces, prison or school) or incidents (such as trauma, suffering, illness, and tragedy) provide the point of connection. Christian chaplaincy is not simply parish pastoral care ‘tweaked’.  The rules of engagement for a chaplaincy ministry are fundamentally different from parish based ministry, although, both parish and chaplaincy ministries engage in ‘cure’ of souls.

An evangelical theology of chaplaincy will:

·         Draw on the evangelical touchstones of Conversionism, Activism, Biblicism, and Crucicentricism.[i]

·         Engage with the historic traditions of Chaplaincy and Pastoral Care.

·         Draw on the reformed theologies of Calvin, Luther and Augustine that look at the world from above.

·         Draw on the Theological Anthropologies that consider faith from below: the perspective of humanity, and engage with the God/man Jesus Christ.

·         Draw on the theologies that engage with the narrative and drama of Scripture and philosophical concepts. 

·         Not lose focus that the primary concerns of Chaplaincy are: the pastoral encounter, the patient as person and the pastor as person. Attention must be paid to all three aspects. The discipline always has at its end, a practical purpose, a real visit. Clinical Pastoral Education is an action/reflection training module that aims to hone and sharpen skills in this area. 

·         Determine the theological frame that the chaplain brings into the encounter, if affects who the chaplain ‘is’ in the encounter, how they interpret the situation and the care plan that is formulated for the way forward.

·         Understand that contemporary terms Chaplaincy and Pastoral Care describe a broad discipline: one far wider than the traditional Christian meanings. This discipline is also called spiritual care and concerns itself primarily with issues of belief and meaning. This public meaning arises from  secular concepts that encompasses religion, ecumenicalism, multi-faith dialogue and psychology, sociology and spirituality. 

·         Enter a dialogue with the pastoral and practical theologians who are actively engaging with the broad definition of spiritual care and engaging with disciplines of psychology and sociology and issues of the infinite, ultimate concerns, suffering, pain, joy, peace, compassion and the limits of human finitude.

Three evangelical theologians who are writing in this area are Timothy Keller a former Professor of Practical Theology at Westminster, Eugene Peterson, Professor of Spiritual Theology at Regent College and Andrew Purves, Professor of Reformed Theology at Pittsburgh Theological Seminary.

Theology of Chaplaincy is not a purely theoretical discipline. It does involve theory, but it is more like an apprenticeship. It involves a repeated, spiralling process of theological stretching. There are times without answers, other times of deconstruction and disengagement before a deeper theological reconstruction as we understand something new of Christ, or ourselves, or another: then there is a further re-engagement. All this is learned.  As the chaplain lowers themselves down into the abyss of another’s suffering, the chaplain themselves enters the sufferer’s suffering. Issues that surround human life emerge: pain, suffering, justice, the groaning creation, a fallen broken world, alienation and forsakenness. These can also exist alongside compassion, kindness, image of God, love, light, burden bearing, redemption, forgiveness, peace, joy and eternity. The issues all cut across our common humanity, frailty and flawed morality.

As a chaplain, we see into the brokenness of another’s world we too are confronted with our own brokenness. We understand again our own need of Jesus’ death for us on the cross. We do nothing in our own strength: we are not counsellors, or social workers but simply fellow travellers who have been shown mercy in Christ and, as such, we extend mercy to another. An evangelical chaplain will be concerned that the  ultimate need of any person is to see their story completed in Christ, and as such along with listening, silence, compassion and care will seek to share, at just the right time, saving words of Truth that illuminate true life.

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[i] D W Bebbington. Evangelical Christianity and the Enlightenment. Crux: December 1989/ Vol. XXV. No. 4. pp. 29-36. As quoted by D. Pettett in previous blog, 10 April, 2011

Evangelical Chaplaincy

by David Pettett

D W Bebbington has defined Evangelicalism as having four distinct features; Conversionism, Activism, Biblicism, and Crucicentricism.[1] These have become known as Bebbington’s Quadrilateral and refer to the belief among those who call themselves Evangelical that a person must turn to Christ, be active in evangelism and good works, acknowledge that the Bible is the authoritative source of knowledge of God, and believe in the atoning death of Jesus on the cross.

It was evangelicals who took the initiative in the eighteenth century in such areas as prison reform, an end to slave trading, and to supply a chaplain to the Colony of NSW. Curiously, in the 21^st century evangelical chaplains are somewhat marginalised in the Australian context. Needless to say, no hospital administration wants chaplains insensitively evangelising critically ill patients. Corrective Services NSW explicitly forbids its chaplains from proselytising. This does not, however, prevent a chaplain from believing that a person must be converted to Christ, nor prevent him or her from being active in good works (what is a chaplain doing if visiting the sick or those in prison is not good works?), and it does not prevent the chaplain from believing in the authority of the Bible nor the centrality of the death of Christ on the cross as a substitutionary atonement.

And yet I have heard a keynote speaker at a national conference of chaplains say that any person who held such beliefs should not be a chaplain. This statement received general applause. On another occasion the keynote speaker, leading studies in the book of Job, said, “we no-longer believe in such a “vindictive” God and we should repent of this God.” He then asked the delegates to participate in a liturgy of repentance for this vindictiveness of God.

It is time for Evangelicals to retake the ground and I am pleased to see some small signs of this happening. We believe in the uniqueness of Christ and that it is only through his atoning sacrifice as revealed in the Scriptures that a person can be saved by putting their trust in him. This is a simple message that can be shared sensitively even with the dying.

I was called to the bedside of a dying man at three o’clock one morning. He told me he was afraid and wanted to know how he could be sure of going to heaven. He told me he had lived a good life. He had even taught Sunday School when he was younger. But he wasn’t sure God would accept him. I talked with this man about the fact of Jesus taking the punishment we deserve. Jesus has paid the price for my sin. I need to put my trust in Him. My thoughts were based on the passage Ephesians 2:8-9 “For it is by grace you have been saved, through faith — and this not from yourselves, it is the gift of God — not by works, so that no one can boast.” As I talked I noticed tears well up in his eyes and he said to me, “I feel so much at peace.” This man suddenly realised Christ had paid the price for his sin. All his sin was forgiven and he was at peace with God.

Evangelical chaplains need to be aware of the dire circumstances people find themselves in and sensitively speak of the amazing grace of God which has given us a crucified Saviour who has paid the price for our sin and through whom we have full assurance of salvation by grace through faith alone.

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[1] D W Bebbington. Evangelical Christianity and the Enlightenment. Crux: December 1989/ Vol. XXV. No. 4. pp. 29-36.

‘They won’t hear a word you say unless it’s the wrong thing’ But how do we avoid saying the wrong thing?

This book review and thoughts are from Kate Bradford, a chaplain in a paediatric hospital.

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This searing quote from the book, Surviving the Death of a Child, by John Munday with Frances Wolenhaus-Munday, refers to those suffering from the deep pain of the loss of a child. 

For a chaplain, one of the most harrowing aspects of ministry in a paediatric hospital, is being called to support a family, with a child who is dying or has just died. To be called to stand on the edge of the abyss with the parents and walk with them through their valley of the shadow of death, is always confronting. The expected order of life is totally overturned every time a child predeceases a parent.

We are called to enter an alien landscape where children die, and parents are somehow expected to go on because the sun will still rise tomorrow on a new day. But, how are we ‘to be’ in this situation?

 Surviving the Death of a Child, is about enduring and surviving the most painful of all losses, the death of one’s own child. The authors write from their own painful experience, both as parents and as those seeking to support the bereaved. Frances’ eighteen year old daughter, Marlys, was brutally bashed at home one afternoon by an intruder. The murder remains unsolved.

The authors are theologically trained and offer clear insights, both for bereaved parents and those seeking to care for them spiritually. In the book they explore why bereaved parents often drop out of church, survival strategies, and the way in which comfort was found in the Bible and their faith in Christ.

Chapter 7, There Are No Easy Answers is particularly useful if you are able to absorb and internalise it before visiting recently bereaved parents. This short chapter distils advice and guides the visitor through this difficult terrain, the advice ‘on how to be’ is summarised below:

1)      Those in the deep pain of the death of a child won’t remember a word you say unless it is the wrong thing.

2)      Even if something is true there may be no reason to say it.

3)      The reason to spend time with the person must be founded on Christian love. Theology of Accompaniment means being there with the person in pain.

4)      Not a time for answers, words must be based on unconditional love, compassion not knowledge.

5)      What not to say:

i)             God wanted your child more than you did

ii)            You’ll get over it in a few weeks

iii)           You have or can have other children

vi)           God is punishing you for something

v)            Your child is better off with Jesus

vi)           We are only given what we can handle

vii)          God has a plan

viii)         Rejoice always and give thanks in all circumstances

6)      The wrong thing should not be said, especially if what you are about to say is either an easy or simple answer.

7)      What can we say? There are no easy answers only accompaniment.

8)      The person who needs to talk is the person experiencing the grief.  

9)      Offer love, not advice or opinions 

10)   ‘I am sorry’, if you have been there yourself ‘I understood’, or ‘I am here for you’.

These wise insights are invaluable as I visit families in similar situations. It is not leaving God out of the picture but rather takes into account the level of shock and unreality that surrounds such events. Words are so often just a blur but care is felt at another deeper level. To gently say that you are praying is  another way to care. 

The latter half of this concise book explores the authors’ journey with God, this section provides a helpful guide to conversations that the bereaved may have in a later stage of the grief as they begin to move towards healing and find hope in living for Christ and loving as they are loved by Christ.

Surviving the Death of a Child, John Munday with Frances Wolenhaus-Munday. (WJKP, Louisville), 1995.

Reflection on Natural Disasters

The article is presented by David Pettett who has been a Navy Chaplain, Hospital Chaplain and now is Chaplain at Lithgow Correctional Centre, west of Sydney.

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On 24 January 1798 George III of England, in response to the war with France, made a proclamation that on 7 March that year the people should observe a “public fast and humiliation” “to obtain pardon of our sins”, “tender the favour of Almighty God and … avoid his wrath and indignation”.

For this Fast Day the Rev. Charles Simeon published a sermon outline on the text, 2 Chronicles 29:10-11 which he entitled, “The use if covenanting with God”. In this outline Simeon argued that God normally sends calamities on his people as a warning that they should repent of sin and so avoid God’s anger and receive his blessing.

In November 1815, when the Colony of New South Wales was in the grip of a server drought, with cattle dying and crops failing, and following the untimely death of a prominent citizen in his mid 30’s, the Rev. Samuel Marsden used Simeon’s outline in one of his Sunday sermons. Marsden exhorted his congregation to examine themselves, to see what sin might be lying within, to repent, and to seek God’s favour that he might turn away his wrath, of which these disasters were indicative, and shower blessing upon the people. (The Sydney Gazette reported the drought broke that same month.)

In January and February 2011 Australia and New Zealand have faced a series of unprecedented disasters. We live in different times so we do not expect our Head of State nor our politicians to recognise God’s hand in the ordering of the world. And we don’t expect anyone to call us to a national day of fasting. Also, most Australians would not expect the clergy to have anything much relevant to say about these disasters.

Never the less, the thrust of Jesus’ teaching, and the teaching of the whole of the Old and New Testaments, is that calamites are warnings that life is fragile and we will all face judgment. A natural disaster reminds us that we will face judgement and that therefore we should now repent of sin and seek God’s favour.

As a chaplain approaches a hospital bedside and listens to the story of the person in that bed, the chaplain must remain open to the possibility of encouraging the patient to reflect upon the warnings God has graciously sent to them in their life, to repent of sin and seek God’s favour so that they will receive his ultimate blessing of salvation in the Lord Jesus Christ.

Praying Globally within Chaplaincy

Here is a book review by Lindsay Johnstone, a Chaplain at Royal Prince Alfred Hospital

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I recommend:  Don Carson, A Call to Spiritual Reformation (Baker, Grand Rapids, Michigan 1992). However, some of these perspectives are mine and should not be read onto anyone else.

Everything must be bathed in prayer.

The major impact of Carson’s book is the all-pervasive need of prayer with regard to every part of our lives and ministries, its passionate commitment to unselfish compassion, and the global dimensions of prayer to a living Father who is deeply committed to us personally and also to all others of his children.

“We become fruitful by grace; we persevere by grace; we mature by grace; by grace we grow to love one another more, and by grace we cherish holiness and a deepening knowledge of God.” (p.60)

We are not left by God just to use the propositions of the Bible and our native intellect and abilities to work it all out through our programs and stereotyped impressions of what is meant by our job descriptions. In Paul, prayer “is not made up of petty petitions, isolated requests that are to be answered by a God who, rather exceptionally, intervenes in our lives and does something remarkable. We are not to think of ourselves as basically independent and on the right tack, but occasionally in need of a little input from the Deity, a little blessing called down by an appropriately formulated prayer. That sort of view is almost akin to pagan magic.”(Carson p.61)

Our prayers are central within God’s sovereignty.

We should not think that our prayers move the contingent hand of God, nor that he does not really need our prayers at all for his will to be done.

Read Genesis 15: 19-20; 2 Samuel 24; Isaiah 10: 5-19; John 6: 37-40; Philippians 2: 12-13; Acts 18: 9-10;

Acts 4: 23-40(p.150-156)

Intercession is part of the invasion of the kingdoms of this world by the Kingdom of God

Whether your institution had a Christian element in its foundation or was entirely secular, never underestimate the purposes of God within it.

Our record and experience matters nothing if the Holy Spirit accompanies us not, and we rely mainly upon our native gifting or acquired skills.

An emergency call-out is an opportunity for compassionate and penetrating intercession.

Our assistance is desired in the most dire circumstances. Travel time between receiving the call and seeing the patient can be prayer preparation time.

We are in a spiritual warfare.

Do our prayers have passion and militancy?  Do we exercise our God-given authority in our prayers? Do we believe that the Devil roams around like a roaring lion, seeking someone to devour? (1 Peter 1: 5), or is he just a “headless chicken”?

“Shine, Jesus shine! Blaze, Spirit blaze!”

Is it alright to direct some prayers straight to Christ or to the Holy Spirit?  Many hymns do this, but some say it is preferable not to pray direct to the Holy Spirit (and perhaps not much to Christ). The Christian is free to do whatever is not ruled out by the Scriptures. 1662 BCP contains such prayers. “Come Holy Ghost our souls inspire...” for many decades was sung daily at meetings of the Sydney Diocesan Synod.  “I believe in the Holy Spirit... who with the Father and the Son is worshipped and glorified” (Nicene Creed)!

Fasting

Matthew 6 assumes fasting is normal. It is least appropriate when we are celebrating the presence of the Bridegroom (e.g. Holy Communion!) Fasting is most appropriate in a context where the Bridegroom is experienced as absent. It may sometimes be needed to cast out a demon, or to receive a breakthrough such as guidance and empowerment for ministry, or for the breaking of a bondage that blocks the reception of some of God’s blessings.

Non-rational prayer?

Prayer consists sometimes partly of sighing, weeping, groaning, and tongues. In private they can be expressions of inner praise or grief, a broken heart, a passionate compassion for the lost or wounded. It is a sin to discourage people from the private use of such forms of these! Also they have nothing to do with some second stage process! Some “ talk more, others less; some are constantly vocal, others cultivate silence before God as their way of adoration; some slip into glossalalia, others make a point of not slipping into it; yet we may all be praying as God wants us to. The only rules are, stay within Biblical guidelines... ” (Carson, p. 38)

All For Jesus

“Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen” (Ephesians 3: 20 -21).

Copyright: J. H. Lindsay Johnstone

Book Review, Christopher Swift, Hospital Chaplaincy in the Twenty-first Century: The Crisis of Spiritual Care on the NHS

A Reflection by Kate Bradford, a Chaplain in a Paediatric Hospital.

This reflection focuses on the summary history of chaplaincy contained within the first section of Christopher Swift’s book. 

Christopher Swift presents a comprehensive guide to the major issues surrounding hospital chaplaincy conducted within a public health system. The context of the book is British but there are many parallels that could be drawn with the chaplaincy system we have inherited within the NSW health system.

Swift, as a chaplain, held a senior hospital position within a NHS Trust. He writes as an insider with a clear understanding of what it is to be a chaplain, negotiating simultaneously the expectations placed on a chaplain by a secular government and the institutional church.

Swift places chaplaincy within its historical context by providing a brief but fascinating history of chaplaincy and hospitals. During medieval times hospitals were initially within the monasteries. Illness and spirituality were regarded as intimately connected, concern for the body together with care of the soul, the hospitaller/chaplain  played a central role within these institutions. The role of doctor and chaplain merged. The surgeon was enjoined to ‘warn and persuade’ the patient and to call in the physician of the soul.

The care of the sick underwent major changes with the Reformation as hospitals came under government control. The role of the chaplain changed significantly and accountability for the institution was primarily to the Government. Previously the role of the chaplain involved ritual and sacraments but as the church reformed,  the role changed to the  more verbal ministries of teaching of Scripture, instructing and providing words of comfort.

Over time religion remained central to hospitals, but the focus on eternal salvation diminished and concern for the cure of souls subtly shifted to cure of bodies. The doctor was expected to play a role in the moral improvement of the patient expecting the patient to offer thanksgiving and prayer. As science and medicine advanced the public role of chaplain further declined and then ultimately retreated to the private world of the bedside.   

The historical context of chaplaincy was located very much within the area of Christian life and faith. Chaplaincy was primarily concerned with matters relating to spiritual health and the revelation of God rather than psychological health. 

It is interesting to note that this historical view of chaplaincy has some significant differences from the modern Clinical Pastoral Education (CPE) movement that began with Anton Boisen in the 1920’s in the Worcester State Hospital, Massachusetts. Anton Boisen was a liberal clergyman who suffered a number of distinct periods of severe psychosis. Boisen observed that a crisis could precipitate religious quickening, and that when a person’s fate hangs in the balance, people think and feel intensely about the things that matter most. The CPE model focuses on these issues in its care, drawing heavily on counselling models for its method.

Drawing on the perceptive insights provided by Anton Boisen, we need to hear the patient as a living document. But Christopher Swift has done us a great favour by reminding us of the rich Christian heritage we have as chaplains. On wider reflection if we, as chaplains, hear only the patient but do not listen to the true and living document that is the Word of Life and submit to the Spirit of Christ, we have done great disservice to the patient, and as such our care has not been Chaplaincy. 

Copyright Kate Bradford 2011

Swift, C., Hospital Chaplaincy in the Twenty-first Century: the Crisis of Spiritual Care on the NHS. (Ashgate, Surrey), 2009.