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