Pastoral Report Articles 

  • 05 Jul 2013 9:46 AM | Perry Miller, Editor (Administrator)

    Palliative Chaplaincy at PACE

    In 2009, Palliative Chaplaincy had not yet emerged as a specialty to be certified. Chaplains in a variety of settings had some occasion to provide Palliative Chaplaincy. Some settings call primarily for Palliative Chaplaincy. One setting that requires only Palliative Chaplaincy is a program called “PACE” – “Program for All-inclusive Care for the Elderly.”

    PACE Centers work with people who are elderly, frail and poor. The goal is to keep them living in the community as long as possible. Besides spiritual support, PACE provides comprehensive care: medicine, social work, nutrition, transportation, and recreation.

    PACE attempts to create the kind of natural community in which people care for one another through natural bonds. A Cambodian community in San Francisco, On Loc, provided the model. People who feel a sense of community tend to live longer. People who live independently tend to need less costly care. PACE promotes caring that makes good sense to everyone involved.

    We call the people in the program “Participants.” The term “patient” implies passivity and denotes people to whom things happen. The term “participant” implies freedom of choice and denotes people in charge of their own lives. Our members participate in all phases of the program: d\Do I want to join? Do I want to come to the Center? How often? Do I want to join in any, some or all of the activities? 

    The National PACE Association describes the average PACE Participant in this way:

    In order to qualify for PACE, a person must be 55 years of age or older, live in a PACE service area, and be certified by the state to need nursing home-level care.

    The typical PACE participant is very similar to the average nursing home resident.  On average, she is 80 years old, has 7.9 medical conditions and is limited in approximately three activities of daily living.  Forty-nine percent of PACE participants have been diagnosed with dementia.  Despite a high level of care needs, more than 90% of PACE participants are able to continue to live in the community.

    http://www.npaonline.org/website/article.asp?id=50&title=Who_Does_PACE_Serve_

    The PACE Center where I was Chaplain served Participants ranging in age from 58 to 101. Most chose to stay in the program until they died. This gave us an average of about 2.8 years to work with each of them. It also required us to deal often with death and bereavement.

    The program was called “Finishing Well.”

    The frail elderly we serve tend to experience their lives as in retreat: physical health wanes, mental acuity dims, social relations fade. Even those with strong family support tend toward depression and are tempted to despair. They may feel they are losing slowly the last battle, with death. They could see themselves Finishing Well the last phase of life.

    PACE can help transform this worldview. Our colonial forebears called it Dying Well. I prefer “Finishing Well” to make clear to our generation what was obvious to theirs: the last phase of life is only partly something that happens to us, but also something we do, and can do well. The tasks of the last phase of life include:

    Cultivating gratitude resting from labor reflecting on what “is very good” savoring an inventory of memories Making peace forgiving oneself forgiving others asking forgiveness, directly or symbolically preparing to meet one’s Maker Providing legacy passing on property to do no harm passing on stories as heritage family stories community stories Passing on character as blessing dispensing wisdom reflecting on life lessons distilling wisdom in story or saying Offering wisdom to those who will hear dying well arranging the Family Vigil tradition expressing the Last Words tradition

    We may not help any Participant achieve all of these, but we can help every Participant achieve some of these.

    We look pro-actively for opportunities, and work as a team, to fulfill the spiritual/religious component of our “all-encompassing care for the elderly.” As your Chaplain, I will serve you any way I can.

    The Finishing Well program was well received by the Staff. National PACE Association selected it for presentation at the National Meeting in 2010.

    To implement Finishing Well, I developed four programs:

    I am like I AM – for individual spiritual care

    Songs and Stories – for corporate spiritual care

    Finding Meaning in Suffering- for end of life counseling

    We Remember – for bereavement

    While doing so, I began to wonder what programs in Palliative Chaplaincy were being developed at other PACE Centers across the nation. Were each of us trying independently to invent the wheel?

    From the National PACE Association I obtained a listing of all PACE Centers in the country. (There were then 77, and are now 92). I e-mailed “Chaplain” at each Center. Results were spotty. I then e-mailed the Director of each site requesting the name of the person in charge of spiritual care. After several rounds of correspondence, about half the PACE Centers were found to have chaplains. About a quarter had someone else – a social worker, the compliance director, whomever – tasked with handling spiritual care in addition to their full-time responsibility. About a quarter provided no spiritual care to speak of, or at least mentioned none.

    National PACE Association sponsors a Colloquy for each profession to promote collaboration and excellence. Through National PACE, I sent to all known PACE chaplains an invitation to share their best practices for palliative chaplaincy.

    Several dozen “best practices” arrived. Some seemed a little sketchy. From those chaplains, I requested a program description detailed enough that another chaplain who valued the program could replicate it. I offered this framework for presenting best practices:

    Dear Fellow PACE Chaplains:

    Thank you each for responding. Having read through your ideas, it seemed helpful to find a way to order them. The definition of spirituality published in The Journal of Palliative Medicine offers a foundation:

    “Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred.”

    “Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference”

    The Journal of Palliative Medicine, Volume 12, Number 10, 2009

    This definition refers to meaning and belonging.

    PACE can benefit Participants as much spiritually as medically. Many of our folks spent their days mostly alone, watching TV. As one of them told me, “Those people on TV talk a lot, but they never listen.” Coming to PACE can help Participants to have friends, community, and encouragement. Some lost fifty or a hundred pounds that needed to be lost. Some learn to walk again. They get a life.

    Their experience in PACE can be described as

    Getting a life (joining)

    Living the life (participating), and 

    Finishing their life (dying).

    Combining this timeline with the definition of spirituality creates this structure for spiritual care:

    Getting a Life Living the Life Finishing their life

    Meaning: _____________ ______________ __________________

    Belonging: ____________ ______________ __________________

    In trying thus to organize the spiritual practices you so generously sent to me, I soon learned that I simply don’t understand them well enough to do this. Mostly, your responses listed spiritual practices without detail about how you do what you do.

    Would you be willing to send me your best practices in detail? You can use the format above. You don’t have to detail all you do, just pick the few you think you do the best.

    I will share the results with all known PACE chaplains.

    Thank you! I’m looking forward to seeing the specifics of your best practices.

    Blessings,

    Fred


    All submitted “Best Practices” were forwarded to all chaplains. Each chaplain could learn what wheels were rolling elsewhere, and innovate rather than invent to meet the need at their center.

    I asked for volunteers to serve on a Selection Committee to select the best practices from among the submissions. Several chaplains volunteered. They considered several means of recognizing Best Practices. The first option would select a first, second and third place winner. This would make the adoption of standards a matter of competition rather than achievement, so was rejected. The second option would select a winner in each of several categories, such as Spiritual Assessment or Bereavement. This had the appeal of specificity, but the danger of becoming too fragmented, like the Oscars – “best supporting actress in a black-and-white documentary.” The third option would be to honor each submission that had sufficient detail to be replicated as a Best Practice. The committee met by conference call and selected options two and three.

    St. Martin’s Cloak

    A vigorous discussion ensued about what to call the Best Practice Awards. Etymology lifted the winner: St. Martin’s Cloak. In the IVth Century, a young Roman cavalry officer named Martin was entering the gates of Tours when he saw a freezing beggar. Martin cut his heavy crimson cavalry cape in half for the poor man. His act gives us our title as Palliative Chaplains.

    He cloaks – Latin palliare – gives us the verb Palliate.

    His cloak – Latin capella – gives us the noun Chaplain.

    St. Martin’s Cloak was printed on tabloid paper (11x17). It looks like this.

    National PACE Association framed and sent the awards to the chaplains who had developed the Best Practices.

    The PACE Center where the chaplain worked usually arranged a formal presentation by a senior official, done in the presence of the Participants. This encouraged the Participants by knowing the spiritual care they were receiving was some of the best in the nation.

    Hopefully, this also may encourage the senior officials to appreciate the value of their own chaplain in particular and the need for full-time professional chaplaincy in general.

    Looking Ahead

    Lessons learned from this project might include the following:

    1. Collegial Collaboration improves the quality of palliative chaplaincy. Rather than inventing the wheel, we can innovate to adapt and improve proven designs. 

    2. The Analytic Grid combining a standard definition of spirituality with phases of care could be useful in any institution – hospice, for example – that involves joining, participating, and leaving.

    3. St. Martin’s Cloak could be extended to chaplains in other institutions or societies to recognize and encourage excellence in palliative chaplaincy. For example, the Virginia Chaplains’ Association is considering its use. Anyone interested is invited to contact me: fredpoorbaugh@stanfordalumni.org.

    Palliative Care has become the first Board Certified Specialty for chaplains. Various certifying bodies are developing programs to that end. The College of Pastoral Supervision and Psychotherapy has in 2013 allowed Board Certified Clinical Chaplains working primarily in palliative care to earn Board Certification as Fellows in Hospice and Hospital Palliative Care.

    As our population ages and technology improves, people will be living longer with chronic diseases. They will require palliative care. Palliative care was first recognized as a specialty for doctors only in 2006. Now, interdisciplinary teams of professionals certified as palliative doctors, nurses and social workers will need chaplains who are peers.

    ___________________________________________________

    Frederick Poorbaugh

    fredpoorbaugh@stanfordalumni.org

    Following education in Philosophy (Stanford), Theology (Yale) and training in Psychology (Jung Institute), he spent ten years serving a dirt-poor parish (Appalachia) where God made him into something usable. Current palliative care tries to help patients in crises and at End of Life find meaning in their suffering.

    He belongs to the Hampton Roads Chapter of CPSP, and is certified as Clinical Chaplain, Pastoral Counselor, and Fellow in Hospice and Hospital Palliative Care.


  • 30 Jun 2013 9:52 AM | Perry Miller, Editor (Administrator)

    The transcontinental flight home from our recent CPSP Plenary was an apt setting for immersing myself into the journey of Amy Glenn’s life: Birth, Death, & Breath. As I traveled across the continent back home to New Jersey I was also transported through Amy's heartfelt and heart-full life so far. 

    I met Amy over 5 years ago, as a Supervisor in Training at RWJ University Hospital in New Brunswick, NJ. As a new supervisor, I was blessed to have Amy under my care; the sharing of insight and wisdom was reciprocal. In the years after our work together at RWJ University Hospital we continue a relationship as fellow journeyers on the path of personal and professional growth. And she now offers others the opportunity to share in her reflective process by publishing this memoir.

    Amy has a poet's heart and voice. She integrates this lyric voice into a moving memoir of life experiences: her own and those she has witnessed in her work as mother, wife, doula, teacher, and chaplain. I resonate with so much of her story, having made my own path out of constrictive religious bonds, and through my own passages of self-exploration and growth. I also resonate with Amy's ability to integrate head and heart in her reflective process.

    The practice of reflective engagement is a hallmark of the clinical learning process. As a pastoral training supervisor I invite trainees to incorporate this process into their clinical practice. Amy's narrative is a clear and moving example of how transformative the experience of learning in the midst of ministry can be. It is so moving that I now give this book as a gift to my trainees upon the completion of a unit of training.

    Birth, Death, & Breath is available at Amazon.com.

    __________________________________

    Chaplain Tedford J. Taylor, MDiv, BCCC
    Diplomate in Pastoral Supervision, CPSP
    Director of Pastoral Care & Training
    RWJ University Hospital Hamilton
    One Hamilton Health Place
    Hamilton, New Jersey 08690
    TTaylor@rwjuhh.edu

  • 24 Jun 2013 9:54 AM | Perry Miller, Editor (Administrator)

    The grounds of the Loyola House in Morristown were ever so inviting, as we gathered this spring for NCTS, to hear fresh information, gaze upon new and familiar faces and break bread together.

    I was invited to delve into the work of my colleagues as they expressed victories and short-comings in their work of pastoral care and counseling. What a privilege to be entrusted with the vulnerabilities of my peers. There were moments of joy, sadness, disbelief and absolute silence at times, but in that we were able to hold the space sacred and build one another up with support and constructive feedback.

    The focus lecture of NCTS: Hospice and Palliative care was timely. There is such a shift in the way institutions deliver care at the end of life especially hospitals and long term care facilities that it was a pleasure to know we are staying current by developing and strengthening pastoral competencies in the area of hospice and palliative care. I am hopeful moving forward we will look at the populations who are underserved in the delivery of hospice and palliative care services and discover our role as pastoral care givers.

    As always meal time were wonderful. Breaking delicious bread with life giving folks is always a bit of heaven and quite energizing for relational people like me. What is Tavistock? It is freedom. As always, Tavistock never disappoints. Here’s to Rice Pudding! Once again, a gathering well done. There was something to be gained by all who dared to venture within and a bit outside of their comfort zone.

    _____________________________________

    Rev Martisha Dwyer, BS MA
    martisha.dwyer@rwjuh.edu
    Chaplain Emergency Department & Community Liaison
    Robert Wood Johnson University Hospital
    Pastoral Care Department


  • 19 Jun 2013 9:59 AM | Perry Miller, Editor (Administrator)

    Know
    whence you have come,
    wither you go, and
    Whom before you must stand.
    Whom before you must stand.

    Let us try, for a moment, to take the spirit of this admonition to heart – to keep realistic focus on 

    (a) whence we have come – what hard-won progress seems to have been made
    (b) wither we go – what potential progress seems to remain, and 
    (c) Whom before we must stand – that we are held accountable.

    Yes, the ultimate “whence” and “wither” is “dust” to “dust,” but we are called upon to make a “difference that makes a difference” along the way. That is the problem – and it is not as simple as it might sound.

    We will be judged. In advocating for a cause, in formulating a purpose, we, too, must make judgments. We must try, however, to avoid assuming that the ultimate standard by which the world will be judged is known. Some have sought to see “the judgment of G-d.” Talk about an elusive goal. The prophet Jonah, too, had sought to see the judgment of G-d – upon Nineveh – but, as a mere mortal, he was unable to anticipate – or appreciate – the breadth – and depth – of that divine judgment. Seeking theological insight is important. Fostering others’ seeking may be even more important. Knowing with certainty that you or I have found and understand the answers may be something else.

    We are called upon to act in the face of uncertainty, knowing that we are inadequate – but probably the best available – knowing that we do not know the end of the story – or even where it lies. All too often religious organizations have marched confidently forward, under-appreciating that mortals might not have all the answers – let alone even know all the questions. The world is complex – especially once we get down to working side-by-side with individual people – and we need gadflies from all sides to remind us, about what we do and do not know.

    That, to me, seems to be a recurring, underlying theme of the College of Pastoral Supervision and Psychotherapy plenaries: our need for gadflies – preferably humble ones. Anton Theophilus Boisen, who founded the movement for professional chaplaincy, considered it

    ever the task of the church to
    disturb the consciences of men [and women] in regard to
    the quality of life they are living … .
    awakening the careless and indifferent to
    the deeper meaning of life … .
    in order that they may 
    turn before it is too late and
    be made whole.

    But, turn toward what? turn whither? It is easier to fulfill exact commandments – to obsessively tithe of mint, anise, and cumin – the minutiae – to act as if we know with certainty what to do. It is harder to fulfill inexact commandments – to faithfully perform mitzvah – gut-level efforts of justice and mercy – to act even while accepting we do not know for sure what to do. We must act – but in a world of “unknown unknowns,” with minimal reassurance that what we do is right.

    Perhaps it is but human nature to move on from addressing the most obvious national – and international – crises toward more circumscribed societal crises. Perhaps at times we seem to have fallen into the trap of becoming more focused on abstract populations rather than on individual persons of flesh and blood. Certainly Boisen and his colleague, Helen Flanders Dunbar, tried to avoid that trap. The CPSP held its first plenary meeting twenty-one years ago, having begun organizing – looking for that “something” not to be found elsewhere – two years earlier. Those “spiritual pilgrims” who banded together in the CPSP sought to help each other in a very personal way to work toward a difficult to define “recovery of soul,” so that they could better serve their people, better handle crises big and small. Theirs has been a messy journey – but a real one. While earlier generations of the faithful could feel they were standing on the “solid ground” of their religious traditions, the recent generations were coming face to face with a recognition that religious traditions themselves might be in crisis. Can we not at least try to work with each other and the world as it is within our uncertainty? I don’t have all the answers. Perhaps you need to consider the possibility that you don’t either.

    May the CPSP be blessed with a multitude of “productively disturbed believers” – open to exploring crises both within and without – struggling within an awareness of what they do not know!

    Endnotes:

    During the 2006 plenary of the CPSP, when an earlier version of these thoughts was presented – in the midst of a somewhat heated discussion about a then current event – “the war” – that was impacting most if not all of us – an experienced chaplain raised a hand and commented: 

    I think what you’re trying to say is that
    we need to figure out
    how to have strong feelings 

    without being self-righteous. 

    That chaplain knew better than I did at the time what I was trying to say. Some of these ideas – especially Boisen’s views – were explored in a much lengthier essay presented the year before: “Religion in Crisis and Custom: Formation and Transformation – Discovery and Recovery – of Spirit and Soul.” http://www.icpcc.net/ [click on “Materials”]; 

    http://www.icpcc.net/ [click on “Materials”]; 

    http://www.cpspoffice.org/the_archives/2006/01/formation_and_t.html#more

    http://www.cpspoffice.org/the_archives/Formation%20and%20Transformat.pdf

    (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”;

    http://www.metro.inter.edu/facultad/esthumanisticos/coleccion_anton_boisen/case_study/Religion%20en%20Crisis%20y%20en%20Costumbre.pdf .)

    The following are the bibliographic details of the cited items:

    The opening quotation is from Akavia ben Mehalalel, Pirkei Avot (“Ethics of the Fathers”) 3:1; the passage is included in most Jewish prayer books.

    In the 1st paragraph, the allusions are to The Bible, “Genesis” 3:19 and to William James, The Varieties of Religious Experience, “Lecture XVIII” (London: Longmans, Green & Co, 1902).

    In the 2nd paragraph, the reference is to The Bible, “Jonah” 4:5. 

    In the 4th paragraph, the patched together quotation is from Anton Theophilus Boisen, “Evangelism in the Light of Psychiatry,” J Relig. Jan 1927;7(1):76-80, p.76; Boisen’s language comes from a well-known 19th century paraphrasing of The Bible, “Romans” 13:11– for example, in the work of evangelist Charles G. Finney [Lectures on the Revivals of Religion, “Lecture X: To Win Souls Requires Wisdom” (NY: The New York Evangelist, 1835)].

    In the 5th paragraph, the references are to The Bible, “Matthew” 23:23 and “Micah” 6:8, plus to Donald H. Rumsfeld, US Department of Defense news briefing, 12 Feb 2002.

    In the 6th paragraph, the allusions are, of course, to “The Covenant” of the College of Pastoral Supervision and Psychotherapy.

    Robert Charles Powell, MD, PhD is the leading historian of the clinical pastoral movement. Many of his published writings are posted on the Pastoral Report. Readers can use the PR's search engine found on the left side-bar to locate his articles. As a practicing psychiatrist, his writings reflect his daily investment in his clinical practice of providing psychotherapy and care to his patients. Contact Dr. Powell by clicking here.

    _______________________________________________________________________________

    EDITOR'S NOTE: This is the fourth essay in a series -- and one might want to take a second look at the earlier three published during 2011:

    “Tolerance and Encouragement: Among the Roots of the Clinical Pastoral Tradition.” on the internet at http://www.cpspoffice.org/the_archives/2011/06/tolerance_and_e.html#more

    “Tolerance and Encouragement: At the Core of the Modern Clinical Pastoral Tradition.” on the internet at

    http://www.cpspoffice.org/the_archives/2011/09/tolerance_and_e_1.html

    “Tolerance and Encouragement: Within a Covenant of Mutual Accountability.” on the internet at http://www.cpspoffice.org/the_archives/2011/11/tolerance_and_e_2.html#more


  • 19 Jun 2013 12:13 AM | Perry Miller, Editor (Administrator)

    Know
    whence you have come,
    wither you go, and
    Whom before you must stand.

    Let us try, for a moment, to take the spirit of this admonition to heart – to keep realistic focus on 
    (a) whence we have come – what hard-won progress seems to have been made
    (b) wither we go – what potential progress seems to remain, and 
    (c) Whom before we must stand – that we are held accountable.

    Yes, the ultimate “whence” and “wither” is “dust” to “dust,” but we are called upon to make a “difference that makes a difference” along the way. That is the problem – and it is not as simple as it might sound.

    We will be judged. In advocating for a cause, in formulating a purpose, we, too, must make judgments. We must try, however, to avoid assuming that the ultimate standard by which the world will be judged is known. Some have sought to see “the judgment of G-d.” Talk about an elusive goal. The prophet Jonah, too, had sought to see the judgment of G-d – upon Nineveh – but, as a mere mortal, he was unable to anticipate – or appreciate – the breadth – and depth – of that divine judgment. Seeking theological insight is important. Fostering others’ seeking may be even more important. Knowing with certainty that you or I have found and understand the answers may be something else.

    We are called upon to act in the face of uncertainty, knowing that we are inadequate – but probably the best available – knowing that we do not know the end of the story – or even where it lies. All too often religious organizations have marched confidently forward, under-appreciating that mortals might not have all the answers – let alone even know all the questions. The world is complex – especially once we get down to working side-by-side with individual people – and we need gadflies from all sides to remind us, about what we do and do not know.

    That, to me, seems to be a recurring, underlying theme of the College of Pastoral Supervision and Psychotherapy plenaries: our need for gadflies – preferably humble ones. Anton Theophilus Boisen, who founded the movement for professional chaplaincy, considered it

    ever the task of the church to
    disturb the consciences of men [and women] in regard to
    the quality of life they are living … .

    awakening the careless and indifferent to
    the deeper meaning of life … .
    in order that they may 
    turn before it is too late and
    be made whole.

    But, turn toward what? turn whither? It is easier to fulfill exact commandments – to obsessively tithe of mint, anise, and cumin – the minutiae – to act as if we know with certainty what to do. It is harder to fulfill inexact commandments – to faithfully perform mitzvah – gut-level efforts of justice and mercy – to act even while accepting we do not know for sure what to do. We must act – but in a world of “unknown unknowns,” with minimal reassurance that what we do is right.

    Perhaps it is but human nature to move on from addressing the most obvious national – and international – crises toward more circumscribed societal crises. Perhaps at times we seem to have fallen into the trap of becoming more focused on abstract populations rather than on individual persons of flesh and blood. Certainly Boisen and his colleague, Helen Flanders Dunbar, tried to avoid that trap. The CPSP held its first plenary meeting twenty-one years ago, having begun organizing – looking for that “something” not to be found elsewhere – two years earlier. Those “spiritual pilgrims” who banded together in the CPSP sought to help each other in a very personal way to work toward a difficult to define “recovery of soul,” so that they could better serve their people, better handle crises big and small. Theirs has been a messy journey – but a real one. While earlier generations of the faithful could feel they were standing on the “solid ground” of their religious traditions, the recent generations were coming face to face with a recognition that religious traditions themselves might be in crisis. Can we not at least try to work with each other and the world as it is within our uncertainty? I don’t have all the answers. Perhaps you need to consider the possibility that you don’t either.

    May the CPSP be blessed with a multitude of “productively disturbed believers” – open to exploring crises both within and without – struggling within an awareness of what they do not know!

    Endnotes:

    During the 2006 plenary of the CPSP, when an earlier version of these thoughts was presented – in the midst of a somewhat heated discussion about a then current event – “the war” – that was impacting most if not all of us – an experienced chaplain raised a hand and commented: 

    I think what you’re trying to say is that
    we need to figure out
    how to have strong feelings 
    without being self-righteous. 

    That chaplain knew better than I did at the time what I was trying to say. Some of these ideas – especially Boisen’s views – were explored in a much lengthier essay presented the year before: “Religion in Crisis and Custom: Formation and Transformation – Discovery and Recovery – of Spirit and Soul.” http://www.icpcc.net/ [click on “Materials”]; 

    http://www.icpcc.net/ [click on “Materials”]; 

    (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”;

    http://www.metro.inter.edu/facultad/esthumanisticos/coleccion_anton_boisen/case_study/Religion%20en%20Crisis%20y%20en%20Costumbre.pdf .)

    The following are the bibliographic details of the cited items:

    The opening quotation is from Akavia ben Mehalalel, Pirkei Avot (“Ethics of the Fathers”) 3:1; the passage is included in most Jewish prayer books.

    In the 1st paragraph, the allusions are to The Bible, “Genesis” 3:19 and to William James, The Varieties of Religious Experience, “Lecture XVIII” (London: Longmans, Green & Co, 1902).

    In the 2nd paragraph, the reference is to The Bible, “Jonah” 4:5. 

    In the 4th paragraph, the patched together quotation is from Anton Theophilus Boisen, “Evangelism in the Light of Psychiatry,” J Relig. Jan 1927;7(1):76-80, p.76; Boisen’s language comes from a well-known 19th century paraphrasing of The Bible, “Romans” 13:11– for example, in the work of evangelist Charles G. Finney [Lectures on the Revivals of Religion, “Lecture X: To Win Souls Requires Wisdom” (NY: The New York Evangelist, 1835)].

    In the 5th paragraph, the references are to The Bible, “Matthew” 23:23 and “Micah” 6:8, plus to Donald H. Rumsfeld, US Department of Defense news briefing, 12 Feb 2002.

    In the 6th paragraph, the allusions are, of course, to “The Covenant” of the College of Pastoral Supervision and Psychotherapy.

    Robert Charles Powell, MD, PhD is the leading historian of the clinical pastoral movement. Many of his published writings are posted on the Pastoral Report. Readers can use the PR's search engine found on the left side-bar to locate his articles. As a practicing psychiatrist, his writings reflect his daily investment in his clinical practice of providing psychotherapy and care to his patients. Contact Dr. Powell by clicking here.

    _______________________________________________________________________________

    EDITOR'S NOTE: This is the fourth essay in a series -- and one might want to take a second look at the earlier three published during 2011:

    “Tolerance and Encouragement: Among the Roots of the Clinical Pastoral Tradition.” 
    “Tolerance and Encouragement: At the Core of the Modern Clinical Pastoral Tradition.” 

    “Tolerance and Encouragement: Within a Covenant of Mutual Accountability.” 


  • 17 Jun 2013 9:31 AM | Perry Miller, Editor (Administrator)

    Out of our great love and respect for Myron C. Madden, the genuine patriarch of CPSP, and our love for his wife Ann, four members of the CPSP community attended his Memorial Service, held in historic St. Charles Street Baptist Church in New Orleans. They were Brian Childs, George Hankins-Hull, Pat Davis and I.

    Myron was pastor of St. Charles Street Church before he became director of Chaplaincy at New Orleans Baptist Hospital, and began his clinical career. He was a member of that church when he died.

    Former colleagues from Baptist Hospital and the St. Charles Street Baptist pastor conducted the service. A full choir sang, and a reception followed. Robert Pearce, who succeeded Myron as Director of Pastoral Care at Baptist Hospital, was the master of ceremonies. He pointed out that three giants in our field had died within one week, Myron and Will Campbell, who was Plenary speaker in 2006, each died on June 4, and the radical Catholic priest Andrew Greeley on May 30.

    Ann greeted us warmly at the reception, and told us again how much his participation in the CPSP community meant to him. Myron was our perennial Plenary Chaplain until very recently when he became unable to travel.

    The CPSP delegation warmly reconnected with former ACPE colleagues and friends in attendance: Robert Pearce, Gene Huffstutler, Bill Carpenter and Jenny Thomas.

    The Memorial Service bulletin included the following words written by Myron in To Love and Let Go:

    “Love carries the pain of separation; the sweetness of the present is shadowed by a divided path ahead... Love yearns to own and possess and control and hold, but love knows it must yield, and loose, and unbind, and let go.”

    Myron now belongs to history, but the memory of him will remain in our hearts.


    Raymond J. Lawrence, CPSP General Secretary
    raymondlawrence@gmail.com

  • 12 Jun 2013 9:42 AM | Perry Miller, Editor (Administrator)

    I would like to second the call of Ron Fuhrman to re-examine the CPSP statement on marriage equality. To begin, I confess that whilst fairly new to the CPSP family (Centennial Chapter member 2010) and that I do not entirely understand or have knowledge about how such statements or proclamations are made there are several questions that come to my mind.

    First, was the statement written by merely the two executives listed, or in some executive session, or crafted in larger, broader context of the CPSP community? Comments already made seem clear that the statement itself is not representative of the belief and value system of the entire membership of CPSP and there has been a modest decorum of response from differing sides. I also (personally) think some of the language of the statement is not well thought out and I wonder how “helpful” it truly is to those the statement is intended for. But, greater than this, the integrity of the CPSP organization is at stake when the voices (executive or not) of a few with power begin making statements aimed at being representative of a large whole without due diligence or due process. CPSP and its executive leadership down to its chapter membership is beholden to a greater sense of accountability - to one another and to the constituencies we serve.

    Second, why was the statement made at this time? The answer to this question, of course, may be easily understood with a response from the executives writing and publicizing it. 

    But why March 14, 2013? What is the significance? What is the meaning of making a proclamation on this date? Is it in response to an offense? A reaction to another date or statement of historical import? And why are we responding now (2013) to a congressional action made in 1996? It all seems like the CPSP statement is a “Johnny-come-lately” type of action. The declaration coming before the annual Plenary raises its own questions for me as to its validity. Is it reflective of a shift in leadership? Values? Direction? Or, is it about something else?

    As such, the timing of the statement is curious to me because it seemingly dwells in relative obscurity with no real meaning or purpose apparent. This leads to a third question that remains for me, and perhaps one that for the entire membership of CPSP, ought to be the most troubling. By making such a statement (without collegial collaboration and dialogue and without any seeming intentionality as to the timing or date of declaration) is CPSP cowing to the same political antics that have been characteristic of its predecessor, ACPE? Of course, this implication has huge ramifications, especially in light of the recent request for a special assessment of CPSP members for replenishing the legal fund. And, for me, it begs the question of what type of an organization am I part of? I understand that CPSP, in a sense, is undergoing an organizational-type of puberty as it grows and matures and in such times there can be misguided moments and desired outbreaks (rebellions) and undesired outbreaks (acne) that occur as part of the process. But, we do well in those types of moments to minimize exposure and strengthen and affirm the unique characteristics which set our organization apart from others. CPSP beleaguered relationship with ACPE and with the organizations and institutions from which our younger organization is attempting to prove credibility and solidarity do not need such frivolous statements made without good thinking - no matter how well-intentioned they may be.

    _________________________________

    Brad Kenney
    Centennial Chapter, Colorado
    BKenney@chcc.org


  • 12 Jun 2013 9:35 AM | Perry Miller, Editor (Administrator)


    Thank you for the bold and prophetic declaration CPSP has released regarding marriage equality. Your public dismay over the injustices of DOMA, and the compelling ethical principles included in your statement will serve as a witness to truth and justice. You have taken a timely and courageous action which will embolden other pastoral care providers to join hands and hearts in the pursuit of marriage equality and family values.

    Sincerely,

    Paul W. Dodd, Chaplain (Colonel), U.S. Army (Ret)

    Tom Carpenter, Esq. (CAPT USMC 1970-1982)
    Co-Chairs, The Forum on the Military Chaplaincy

    http://www.doddpcp.com/
    http://forumonthemilitarychaplaincy.org/

    -------------

    Tom Carpenter is a former Marine, an A-4M and airline pilot, attorney, consultant and blogger. He served on the SLDN board for 16 years and was co-chair for 6 years. Tom is an Honorary Lifetime Member of OutServe and is presently co-chair of the Forum on the Military Chaplaincy. Tom lives in Los Angeles with his husband of 20 years, Art.
    tomcarpenter@roadrunner.com

    Chaplain (Colonel) Paul W. Doddd, U.S. Army (Ret) served 31 years as a military Chaplain. He has served with the 101st Airborne Division (Air Assault), Area II Support Activity-Korea, Military District of Washington, 130th Station Hospital in Heidelberg, Walter Reed Army Medical Center, and Brooke Army Medical Center. He retired as Command Chaplain of the U.S. Army Medical Command.

    Military decorations include six awards of the Meritorious Service Medal and the Legion of Merit. He is a Licensed Professional Counselor, a Fellow in the American Association of Pastoral Counselors, and a Clinical Member of the American Counseling Association. He has served on the Military Advisory Council for Servicemembers Legal Defense Network, the Religion and Faith Council of the Human Rights Campaign, and is Co-Chair and Founder of the Forum on the Military Chaplaincy. Paul is the father of two daughters, Christi and Jeanna, and the grandfather of three grandchildren.
    doddpw@aol.com

  • 11 Jun 2013 9:45 AM | Perry Miller, Editor (Administrator)

    A Certified Public Accountant I'll call Deb recently showed me how she balanced the life score after a huge loss.

    Deb lost a leg and her job as supervisor of 35 others in a large accounting firm. When I first met her she expected to finish inpatient rehabilitation in about a week, and I saw her again for the last time the day of her discharge. Having long since left her church and, she said, been "scratched," she scratching church and maybe God from her balance sheet.

    Her nurse told me that Deb might benefit by talking with a chaplain, but did not say why. As directed, I donned gown and gloves to avoid infection but was told that a mask was not necessary as long as I kept my distance. I expected my first visit with her to be routine.

    After I knocked, she invited me in, peeked over a laptop, and laid down half-glasses. I was surprised to see the stump of her leg, covered by elastic, propped up on the bed on a pillow in front of her.

    "Please sit. Are you a pastor? she asked.

    "No, I am a chaplain. So how are you doing today?" 

    "Except for missing a leg and losing my job, I'm doing fairly well."

    "I am sorry to hear of those losses. What do you plan to do now? "

    "My father and stepmother invited me to stay with them in Texas."

    "Is that what you want to do?"

    "It is the most practical thing to do. My stepmother has family there, and it will be good to have caring people around."

    During this first visit and before the next, I began to imagine the hurt she was experiencing from both the loss of her job and loss of her leg. On the last visit she told me more about her job, explaining that she could not get disability income without resigning but that she would also not have been able to perform to her expectations. In both visits she talked more about her job than she did about the loss of her leg, rehab, and imminent move.

    "That will help. I hope that you will receive the care you need."

    "Yes, thank you! (brightening up a bit). Not to worry; I'll do what's necessary. I always have." (determined).

    She told me generally about her marriage, which had ended several years ago, and how she had became successful through hard work. 

    "Before you move, will you talk with someone about adjusting to leaving your job?

    "If you mean a pastor, no. I left my church at 23 years old. They have scratched my name from their book. I do have friends and coworkers here, though, and I have talked with them."

    "Do you believe that God has also 'scratched your name from his book'?"

    "I'm not sure, but it doesn't matter."

    During our second visit, when she was dressed and ready to leave the hospital, we went over the same ground as my mind traveled along my friendship with a couple from Deb's church denomination. The wife, who was my secretary, had taken care of her husband, who was being treated for Wilson's Disease soon after their marriage. I mentioned something about them.

    "Sure. (bitterly, I felt.) That's what the church teaches. In sickness and health."

    I did not respond, but continued thinking. After the husband's recovery his wife developed MS and he cared for her and their two adopted children during her illness, until she died many years later. He lived only a year after her death.

    "What happened to them?" I told her.

    "Sorry to hear that you lost your friends."

    "Thank you. I think of them often, of their love and the sacrifices they made."

    Because her expression of sorrow sounded more sincere than I felt mine had been about the loss of her leg and job, her balance sheet seemed more balanced than mine. I replayed her replies against my own. Her losses, and how she handled them, did not seem to require support as much as did her determination to overcome them. She also expected to receive physical and emotional support from parents and friends. Leaving church had left her on her own and off the "book," and she felt that help from God did not matter to her recovery. Not being a CPA, with her losses, I would hope for the grace of God as well as help from people, some from church.

    ________________________________________

    Dominic Fuccillo 
    Domenic is a CPSP Clinical Chaplain in Littleton, Colorado

  • 05 Jun 2013 9:50 AM | Perry Miller, Editor (Administrator)

    Myron Madden died peacefully in his sleep early Tuesday morning. Myron was 95 years old. He had been alert and conversant the evening before, discussing with his wife Anne the need for them to plant two new fig trees. Ever reaching out to inquire about the feelings of others, he asked Anne how she was doing with all this sickness.

    Withe the death of Myron CPSP has lost its patriarch. Myron served many years, until he was unable to travel, as chaplain to our annual Plenary Meetings. He blessed us in so many ways. He urged us onward with a faith in the value of the kind of work we do that inspired us all.

    The following funeral arrangements for Myron have been announced:
    Visitation at Honaker Funeral Home in Slidell, Friday, June 7, 4:00-8:00 pm

    Visitation at Rocket Funeral Home, Ringgold, LA, Sunday, June 9,12:30-1:30 pm

    Burial at the Madden Cemetery near Fryeburg, LA, Sunday, 2:00 p.m.

    Memorial Service, St. Charles Avenue Baptist Church, New Orleans, June 15, 10:00 a.m.


    On the same day Will Campbell also died. Will was not an official part of the CPSP, of course, but he was really one of us. Will was a memorable speaker at the CPSP Plenary Meeting in Virginia Beach in 2006. His obituary can be read in the June 5 edition of the New York Times.

    _______________________________________

    If you wish to send condolences to his wife Ann, the address is 805 Jefferson Court, Slidell, LA 70458 or you can Email: Madden823@aol.com