Chaplaincy is under fire from different directions. Some church leaders suggest chaplaincy is something other than ministry — something you do if you “fail in ministry” or (strangely) want a “back door into ministry.” Meanwhile, some in chaplaincy (or, “spiritual care,” as they prefer to call it) want to separate chaplaincy from ministry and turn it into something anyone can do, as long as they can pass a multiple-choice test–it doesn’t matter if they have a theological degree, pastoral experience, or ecclesiastical endorsement.
The latter perspective is represented by the Spiritual Care Association, formed in 2016 by the Health Care Chaplaincy Network.
Here are my observations.
- This is part of a trend to secularize, laicize, and quantify spiritual care.
- We need to uphold to both sets of critics the understanding of chaplaincy as a specialization in ministry. This assumes the chaplain has a broad professional theological education and broad pastoral experience and endorsement by a recognized faith group. I think the military has preserved the heart of chaplaincy by defining what we do as “religious support,” and not “spiritual care.”
- It seems to me that the SCA wants to reduce chaplaincy to quantifiable interventions that can be done by anyone regardless of their education or professional experience. And I think they want to go this route so that “chaplaincy” can be objectified and “chaplains” can be state licensed, and thus they can bill for their services. Or so that healthcare institutions can save money by training other staff (nurses, social workers, etc.) in “spiritual assessment” so that they don’t have to pay professional chaplains.
- What a diminishment this is of the chaplain’s role! And yet we’ve all been on this slippery slope. Seminaries have cut the M.Div. to 72 hours, they want to rush people through it in two years (and offer it through distance learning), find a minimalistic substitute for real pastoral experience, and focus on a “process” of CPE that has no content.
- But I wonder, how’s a chaplain supposed to do a real religious needs assessment or “spiritual” assessment without an understanding of people, of theological traditions, of religious needs of different faith groups? How’s a chaplain supposed to probe meaning and purpose and questions of existence without a grounding in philosophy and theology?
- And what an impoverishment this is of a theology of ministry! Ministry is reduced to tasks, and these tasks have readily observable outcomes. I reject that completely. Ministry is not a set of tasks, but an identity. It is to be a pastor, a shepherd. And the role of the chaplain is to be a sign of God’s grace. It is to be a bearer of the Word. And I agree with what the Augsburg Confession says about ministry in Article V: “That we may obtain this faith [that justifies], the Ministry of Teaching the Gospel and administering the Sacraments was instituted. For through the Word and Sacraments, as through instruments,the Holy Ghost is given, who works faith; where and when it pleases God, in them that hear the Gospel…”
I recently read Raymond Lawrence’s reflection on the history of CPE, and I think he makes some points related to these that are very valuable.
Raymond J. Lawrence, Recovery of Soul: A History and Memoir of the Clinical Pastoral Movement (New York: CPSP Press, 2017).
“Institutional chaplaincy is currently a clinical wasteland. The numbers of hospital chaplains have greatly multiplied many times over since the beginning of the clinical pastoral movement in 1925. However the quality of the work is at best uneven and in general very weak.
“A major contributing factor in this deterioration in quality and competency has been the radical shift in the underlying philosophy of chaplaincy. In 1999, the ACPE and the APC decided it was time to erase ‘pastoral’ from its lexicon and replace it with ‘spiritual.’ In their campaign to accomplish this, they petitioned the Joint Commission requesting that it delete ‘pastoral care and counseling’ from its directory of auxiliary hospital services and replace the category with ‘spiritual care.’ Figuring that all these pastoral authorities in the ACPE and the APC knew what they were doing, the Joint Commission complied. Many, if not most of the hospitals in the country followed suit and renamed their chaplains departments. Interestingly, one of the leaders in this initiative was Joan Hemenway, who at that time was director of pastoral care at the Bridgeport, Connecticut, hospital. Her own hospital board refused to go along with her recommendation to change the name of her department. ‘Too California,’ the hospital board countered….” (p. 165)
“If the pastoral clinicians in 1999 had read any substantive theology, they might not have gone so easily astray. The preeminent theologian of the 20th century, Paul Tillich, had explicitly warned against relying on the category ‘spirituality’ in modern discourse, saying that it was a confusing word, having drifted too far from the meaning it carried in ancient history. But no one was reading Tillich anymore. …(pp. 165-166)
“Pastoral care and pastoral counseling carried with them a body of literature, Seward Hiltner being arguably the leading theoretician of pastoral work in the mid-20th century. Spiritual care had no significant literature and still has none, simply because the category has yet to be defined. The result is that spiritual is defined by any speaker according to the speaker’s own desires and predilections, a perfect definition of babble, and a platform for raw narcissism. (166)
“The most effective antidote to spiritual is clinical. Deriving form the Greek word klini, meaning ‘bed,’ clinical refers to the body in bed as the focal point of attention. Those who elect to attend to the spiritual do not focus on the body in bed, but on some vaporous something out there, up there. (166)…
“The APC chaplains may be professionals, but they do not have a tradition of functioning as clinicians. More often than otherwise, these chaplains are professional prayer warriors. Generally they function like broad-spectrum evangelists, regardless of their specific religious tradition. Their main objective is to engage in religious conversation with patients. Typically that means enticing patients to pray or to listen to prayers on their behalf. That kind of work doesn’t take much training, and certainly not much clinical acumen. It requires the skills of a Fuller Brush salesman.”
“One of the tactics that these emerging religious experts untrained in pastoral care and counseling resort to now is to change the language. They avoid discussing religion, theology, chaplaincy, pastoral care and counseling, and have adopted the new lingo of spirituality. In the realm of spirituality there are no experts because no one quite knows what is meant by spirituality.” (166-67)
“Unlike any attempt to be spiritual, we do know more or less what it means to be pastoral. To be pastoral is to function like a shepherd or farmer caring for the life and welfare of the flock and the land. This is a specific and concrete task. A shepherd concerns herself with the lief and welfare of all her animal and plant life, and the earth itself. As the military likes to say, shepherding is ‘boots on the ground.’ When the flock is in danger or the crop is at risk, the shepherd knows what to do. We can understand what shepherding or pastoring means. In addition to the concept of pastoral, we also know clearly what counseling and psychotherapy mean: listening to a troubled person. And that means sometimes endlessly listening, until a pattern emerges or connections reveal themselves that might lead to clarity and a deeper understanding of the exigencies of life. …. (170)
“The late Donald Capps, in a private conversation with me, made an observation that is pertinent in this context. He said: ‘Any encounter between a religious authority and a patient or parishioner is ipso facto religious, just as any consultation between patient and physician is ipso facto medical.’ The implied authority of the office ensures that. Nothing specific need occur in either instance. The encounter does not require prayer or any discussion of spirituality however defined. The agreement between the religious authority and the subject to converse is itself the outcome, or the first of perhaps many outcomes. Nothing need be added, neither prayer, nor sacrament, nor discussion of spirituality. Regardless of what is done or said, or left undone or unsaid, the encounter is by definition pastoral and religious. Sometimes the pastor, and sometimes the physician, essentially does nothing. Or perhaps they simply listen …. Following Capps’ observation, the current urgency of institutional chaplains to pray with patients, an impulse quite widespread, suggests that chaplains are anxious, lacking in confidence about their inherent role as religious authorities and the aura that is carried with that role.” (171)
“As the new century unfolded in 2001, … the role of the pastoral clinician had become blurred, bereft of definition. Into this vacuum marched a number of physicians and psychologists who posed as amateur theologians and redefined the pastoral task as one of summoning the powers of the gods for the benefit of suffering persons. The relative success of this incursion wrote fini on any notion that pastoral clinicians were actually clinicians any longer. They became pastoral fantasists under the suasion of these new amateur religious leaders with their grab bags of spirituality.
“In such dire straits the only conceivable hope now is for pastoral clinicians to stage a resurrection, or insurrection, and reassert the Freud-Boisen-Dunbar thesis. That thesis asserts that healing comes when an intelligent and informed pastoral person listens carefully and mostly silently to the accounts of a suffering person. And in that listening always keeping the unconscious and its perverse and unpredictable ways clearly in view—at least in the corner of the eye—and observing whatever connections can be made that might promote healing. Which is to say, the only hope for the future for pastoral clinicians lies in a reassertion of the authentic talking cure that was promoted by Anton Boisen and Helen Flanders Dunbar, a cure they learned from Sigmund Freud. And we must add, supplemented by attention to community building, a calling in which religious communities have historically demonstrated some expertise.” (181-182)