Rethinking hospice chaplaincy: A spiritually motivated response to raw human need

Reverend Dr Steve Nolan is the chaplain at Princess Alice Hospice in Esher and the author of ‘Spiritual Care at the End of Life.

Here, he explores new ways of understanding the roles of hospice chaplains. 

I never met Dame Cicely Saunders. The nearest I came to her was when I visited the chaplain at St Christopher’s, the south London hospice she established. My tour of the hospice had reached the old chapel, and as I chatted with the chaplain, I caught a glimpse of her as she walked slowly passed the chapel door.

Whether Dame Cicely should be considered ‘the founder’ of modern hospice care could be debated. But her dynamism and drive had a significant hand in shaping the direction and values of the nascent movement. Yet she was not the only dynamic woman to have influenced the history of hospice care.

In 1843, Mme Jeanne Garnier opened a home for the dying in Lyon. In Dublin, Sister Mary Augustine inspired first Our Lady’s Hospice for the Dying, which opened in 1879, then further hospices in Australia and Great Britain. And in New York, Mother Alphonsa established St Rose’s Home in 1899. Working independently of each other, these women shared not only a common purpose but a motivation that was inspired by their spiritual beliefs.

Spirituality was clearly one of the key motivators that drove Dame Cicely. In the late 1940s, she converted from agnosticism to a deep evangelical Christian faith, which transformed the way she understood her work. Caring for the sick had always been a priority; following her conversion it became a religious calling.

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“Why Bother? Does it Even Matter?” Read an exclusive extract from Treating Body and Soul

In Peter Wells’ new book, Treating Body and Soul, various healthcare professionals reveal how they meet patients’ spiritual needs in medical settings.

Patients who are facing illness and uncertainty often find themselves reflecting on the bigger questions in life, and the core beliefs or principles they live by. These convictions, religious or otherwise, are integral to a patient’s identity, and consequently to their most fundamental emotional and spiritual needs. Perceptive clinicians have proved that, by recognising and working with their patients’ spiritual requirements, they have been able to significantly improve their patients’ experience in the medical setting.

In this extract, Peter Wells questions why we need to address the needs of the body and the soul in healthcare settings and why this shouldn’t just be the role of the hospital chaplain. He also explains how best to use this book.

Read the exclusive extract from Peter Wells here

For more information on this book, or to buy a copy, please follow this link.

Why healthcare practitioners must learn to self-care

Sarah Parry is a senior lecturer in Clinical and Counselling Psychology at Manchester Metropolitan University. Her new book, ‘Effective Self-Care in Clinical Practice,’ explores how compassion can enable clinical practitioners to foster hope and resilience for themselves and their clients. We talked to Sarah about her motivations behind the book and why it’s so important for healthcare practitioners to learn how to effectively self-care. 

Effective Self-Care and Resilience in Clinical Practice is a collection of essays from different practitioners, that explore the need for compassion in therapeutic work. Where did the idea for the book originate from?

Developing a personal compassionate framework for self-care has been an on-going endeavour of mine for some years. When I started working in healthcare settings that could, at times, present multiple challenges to my own well-being, I became increasingly curious as to how to overcome these emotional hurdles. I am also a great believer in the power of stories, both in terms of helping us see through the eyes of another, as well as giving us a mirror to hold up to our own experiences, helping us develop a deeper knowledge of ourselves. My motivation for this book came from my own experiences of struggling with competing demands and a realisation that working harder and harder isn’t always the answer. I wanted to understand more about how people developed effective self-care strategies based on compassionate teachings and practices, to enhance their own well-being, resilience and ability to maintain a hopeful outlook. Consequently, I started talking to colleagues who I knew managed their self-care well, as well as people I didn’t know at all at that stage but whose writings inspired me and encouraged me to think about how well I was looking after myself.

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Chaplains are worthwhile because….

Karen Murphy has worked in hospice chaplaincy for twenty years and has represented chaplaincy at national and international level. She is President of the Association of Hospice and Palliative Care Chaplains (AHPCC). Here, she argues the case for hospice chaplains. 

The Association of Hospice and Palliative Chaplains held our annual conference in May and considered the following statement: ‘chaplains are worth having because….’ As a group of skilled, trained and experienced chaplains, we had no problem in accounting for our role and purpose in a palliative care setting. There is a view, however, that in these secular days, the role of the chaplain is no longer valid or necessary. The daily conversations that chaplains share with patients and families soon render this argument redundant.

A patient shared with me recently that she had never had a religious faith, although she often thought it would be of value. Her long held view was ‘when you are gone, you are gone’. Now, facing her mortality having being diagnosed with terminal cancer, her thinking has shifted and for the first time, she is considering her life against an absence of faith. Our conversations are not concerned with my attempts to convert her to my way of thinking or persuade her to find a faith or belief, but to support her in this deeply challenging time. I can enable her to think through her questions and listen. At this point the value of chaplaincy becomes clearer as we offer spiritual listening, which is very different to counselling or social work listening. Chaplains have the capacity to instigate and support conversations that get to the root of someone’s spiritual distress and need. We are not afraid to ask the difficult questions about life’s meaning and purpose, and in my experience, patients seek out those with a belief in order to make sense of the spiritual disturbance and trauma experienced. A patient’s relative expressed this very clearly in a recent conversation, saying: ‘My mother, in her last weeks of life, wasn’t concerned with whether or not the chemotherapy had been successful, or what drugs she would need to be pain free. She trusted the doctors for this. What she valued was the time of the chaplain to help her think about life’s meaning and how to live and die well’.

There is a view that chaplaincy services are a waste of time and resources in a stretched and under –funded health service. The rationale for this view suggests that if patients identify spiritual need, they are likely to have religious faith, therefore will have the support of a local faith community. This view ignores the fact that patients faced with a terminal prognosis, while describing themselves as non-religious, will experience spiritual distress which is unfamiliar and frightening. Chaplains are an essential tool of our health care services which provide distinctive and relevant care for patients who are asking the big questions of life which have never been asked before. The positive impact of chaplaincy based on evidence and research is already emerging, with projects demonstrating the need for fewer GP appointments, reduced medication and a greater sense of well-being to live in the face of impending death. This body of research is growing and will offer to those cynical of chaplaincy, a quantitative and qualitative foundation for the chaplain’s continuing contribution to palliative care services.

For more information on Chaplaincy in Hospice and Palliative Care and to buy a copy of the book, follow this link

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The Way of the Hermit – an interview with Mario I. Aguilar

 

 

Mario I. Aguilar is Professor of Religion & Politics and Director of the Centre for the Study of Religion & Politics at the University of St Andrews. He is also a poet, an eremitic Camaldolese Benedictine Oblate, and has published widely in his interests in the theology of contemplation, the history of religion and issues of interfaith dialogue. We asked him some questions about his new book – The Way of the Hermit – and his life as a hermit. 

 

A hermit’s lifestyle is one of solitude and seclusion from society. When and why did you decide to become a hermit?

As I mentioned in the opening of my book I always wanted to be a hermit. However, this wish had to wait for years as I was a missionary in Africa and then started an academic career. To become a hermit or a monk requires a long process of discernment and this process was carried out over a period of twenty years with the informal support of different spiritual directors. I would say that the decision was taken when Cardinal O’Brien encouraged me to follow this different path within the archdiocese of St. Andrews and Edinburgh. The hermitage and the daily routines developed out of an ongoing prayer life rather than out of an institutional setting. This was seven years ago in Scotland and then I opened a hermitage in Chile.

Some people might find it surprising that you are a professor of religion and a political activist, as well as a hermit. How do you balance these two different sides of your life?

There is only one single life in every human being, thus a hermit relies on a discipline of life where the day is marked by several activities. The life of a hermit, in my case in the Benedictine tradition, starts very early (3.45am) with meditation and silence until it is time to start the university day. During the day, I extend that prayer to those whom I teach and my fellow researchers. Political activism happens naturally because it is an extension of God’s action in the world, a world that should live more deeply justice, peace and understanding. I return to the hermitage happy to be left with God but with reports to be written on behalf of asylum seekers, correspondence, and my own academic studies currently related to India and Tibet.

Your book, The Way of the Hermit, documents your conversations with hermits in Scotland, Chile and India. Did the lives of these fellow pilgrims seem similar or different to your own, and in what ways?

The lives and hopes of all human beings are very similar as the Dalai Lama would reiterate. Thus, I have found a deep communion and friendship with others who seek the Absolute in India and Chile. Particularly in India I have met over the years Buddhist monks, Hindu Sadhus and Sikh scholars with whom we have shared not intellectual thoughts but our very souls, eating together, chanting, and laughing about the joys of being together. I must confess that I have found that many people who live a religious commitment tend to be sad, I do not understand that. On returning to see others at the Golden Temple or in the bathing areas of Varanasi I have always found a warm hand and a ready smile. God has given us a journey and it is great to do it with others even when in silence.

The book explores how living a life of silence and contemplation can contribute to interfaith dialogue. Could you explain how this is so?

The Western world uses too many words, too many texts and too many twitters. We try to understand something to accept its relevance. In silence the quarrels disappear because in silence and contemplation we cannot run away from who we are: human beings on a journey. The many dialogues between faith practitioners in conferences and formal meetings are very fruitful indeed. However, I have found a deeper dialogue sitting in silence with Hindus, Buddhists, Muslims and Sikhs because it is that very silence that binds us. I cannot speak Punjabi or Hindi but I can understand our common language of silence, reverence and devotion.

What have been the toughest challenges you’ve faced while living an eremitic lifestyle?

It has always been the challenges from outsiders who want a writer and a monk to become a small celebrity. I have had to clarify many times that hermits do not need other hermits to carry on their lives and that I do not have meditation classes in my hermitage. The keeping of a daily structure and discipline gets interrupted sometimes but I return to read the lives of hermits I admire and that set a very clear example for me: Abishiktananda, Bede Griffiths, Raimon Panikkar, and those sadhus without name who have inspired me in India over many years.

Do you have any advice for readers who would like to apply eremitic practises to their own lives?

Set a small routine of prayer and meditation for your daily life, start and keep to it. Do not read about it, or talk too much about it, just do it! And the Absolute will be waiting for you.

The Way of the Hermit is out now. Why not join our mailing list for new books on religion and spirituality? Sign up here.

8 Ways to be Spiritual AND Radical

1963_march_on_washingtonI’ve spent most of my adult life in bridging the gap between radical activists and anarchists on the one hand and the more socially conservative world of religion on the other. I’ve met inspiring people in both worlds and learned not assume which will contain the real world-changers. Many radicals are deeply spiritual and many religious people can do radical things. Is it possible to be both spiritual and radical? I think so.

From activist and Anglican priest, Keith Hebden.

  1. Discover who you are

Spend time exploring your own story with others and in private. Think about what the key moments have been in your life that have helped shape your values and your sense of identity. Hold each one up to scrutiny too. Marshall Ganz, who worked as an organiser among agricultural workers in the USA talks about having a story of ‘Self’, ‘Us’, and ‘Now’. If we can communicate with others, from the heart, the experiences that make us care about social justice, then we can better connect with theirs. Once we’ve found that connection we can act together. Marshall was deeply shaped by his experience as a Jewish emigre and second generation holocaust survivor. He learned the value of challenging racism and applied this in his work on labour movements amongst migrant farm workers.

  1. Discover who you are not

Just as we tell stories about ourselves, so do other people.  Everything you think you know about yourself is provisional at best. When I was only 18, I remember hearing a visiting speaker to my college say these profound words, “you are not who you think you are; you are not who other people think you are; you are who you think other people think you are.” Understanding our sense of self as spiritual, atomic, biological and social and that all these things are fluid helps us to allow ourselves to change and be changed by others, and not to expect other people to fit into the pigeon holes we like to put them in.

  1. Find Joy in your actions

Saul Alinsky, a pioneer of Community Organising in post-depression Chicago wrote that “An action that drags on becomes a drag.” We need to be agile in our social movement and always willing to find new and creative ways to respond to the bleak or circus-like messages of our oppressors. People come together for festivals and celebrations; if you want to bring people together find something worth celebrating: a win, a shared resource that can bring about change, something that brings you joy.

  1. Use the experiences of your own people

As an Anglican priest I am part of a community that has a rich tradition of ritual. We use ash for repentance and lamentation, we sing songs, we process and much more besides. When I wanted to mobilise church-goers on debt justice I tried getting them to hand out petitions and join a workshop but these things were way outside the experience of many. When I suggested a Prayer Walk for Debt Justice we mobilised seven churches in just three days. We used ash to mark ourselves as a sign of our complicity with an unjust world and ashed the doors of the payday lenders in our town centre: many people signed a petition and got directly in touch with the executive mayor as a result. Most importantly, we shared a meaningful public action that brought prayer and politics back together.

  1. Breathe

We can easily become overwhelmed with the world as it is and misunderstand or exaggerate our own roles in it. None of us are superheroes but, as Gandhi put it, we can “Be the change that we want to see in the world”. Learning how to be is the heart of what Dorothee Sölle calls a “mysticism of resistance”. Spend time each day in quiet contemplation, stillness, or mindful prayer. Take as a gift those fleeting moments when you will experience your unity with all things visible and invisible. These moments of mystical encounter will be your most important resource when you come under pressure.

  1. Kick off your shoes

It’s nobody’s fault. Somehow we lost our connection with rest of reality. We separated ourselves from nature and spirit. We put on our shoes and laid out the concrete and bunkered down. I’ve met people who have tried to go completely feral and it’s nearly killed them; we are domestic creatures now, for good and ill. But kick off your shoes every now and then. Some people make a permanent practice of it and go their whole lives barefoot; some people do so from necessity. Whatever way you do it, find ways to genuinely experience both the beauty and the horror of nature who is neither your friend nor your enemy but is as animated as you or I and with whom we belong. Throw caution to the wind and go a little wild.

  1. Make friends with death

Death is our constant companion. This truth is better experienced in some cultures than in others. In the western world human death is often professionalised, sanitised, and deftly dispatched of. Bits of our own bodies die in any given moment; whether vegan or omnivore, every human has a diet that relies on the deaths of others. Our body is a whole community of cells, bacteria, and viruses whose lives and deaths keep us in motion. Your own death is both a statistical certain and an illusion. By learning to live with our own death, and meditate on death, we learn to live lightly to our own place in the world and take the risks that are needed for social change.

  1. Become re-enchanted with religion

‘Religion’ can be seen as a dirty word. Leading a retreat with environmentalists in 2016 I was gently challenged by a woman who had had her fill of religion and said she wanted nothing to do with it. She was a Quaker and a member of a local Quaker Meeting! At the heart of the word ‘Religion’ is ‘Ligio’ which is where we get ‘ligament’ from too. Without ligaments to bind our bones together we wouldn’t be able to move as a body. In its broadest sense, religion is the binding together of people, in a voluntary association, to use spiritual tools for social change. To be spiritual but not religious is to play into the individualism that capitalism relies on. To commit ourselves to particularity and community – with all the compromise that this entails – is true radicalism.

Dare to be radical: dare to be religious.

To buy a copy of Re-Enchanting the Activist, click here.

Follow Keith on Twitter here.

Talking to Keith Hebden about Spiritual Activism and Social Change

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Re-Enchanting the Activist

Author, Anglican cleric and prominent activist Keith Hebden talks to us about his new book, Re-Enchanting the Activist, and his motivations for getting involved in faith-based, community activism.

What motivated you to write Re-Enchanting the Activist?

My own experience of being a burned out and disillusioned activist was a real motivator for me in writing this book. Many years ago I lost sight of the ‘Why’ of activism because I was so excited by ‘how’.  At the same time a load of stuff happened in my personal life, some of which I describe in the book, that put my well being under pressure. It was at this point that I discovered some great spiritual writers who integrated politics and mysticism beautifully. People like Dorothee Soelle and Simone Weil. It was the beginning of a whole new adventure.

When did you first realise that you wanted to be a part of community activism?

I’ve been a church-goer pretty much all my life and that’s been a huge source of social action for me, even as a child. I’ve always been political and I’ve always been both religious and spiritual but how those things integrate changes over time. But you could say it was the Indian church that first taught me that politics and religion were one and the same. I owe much to the Dalit Christians – those that others have called ‘untouchable’.

While compiling the first-hand accounts that make up the book, did you come across any viewpoints that particularly surprised you? Or any that you disagreed with?

I have found the emerging gender politics a real challenge to my understanding. I’ve always found it frustrating the way people insist that ‘boys’ are like this and ‘girls’ are like that. But the idea that gender is a fluid concept and that people can relate to it in more ways that just ‘male and female’ still blows my mind. The implications are huge.

The book explores the relationship between spirituality and political activism. Why do you think modern activists will benefit from being open to spirituality?

I think most activists are open to spirituality but are sceptical about religion. I argue that religion is simply a commitment to a particular spiritual journey alongside particular people. Spirituality only really has meaning in community and so the type of spirituality I call for might be new to many activists for whom religion is normally beyond the pale.

You made the headlines in 2014 for your 40 day hunger strike in solidarity with people that rely on Britain’s foodbanks. What did you learn from that experience?

We were careful to describe it as a fast rather than a hunger strike, partly because it was explicitly a religious act but also because we had a particular cut-off point of 40 days rather than an open-ended action. I learned a lot about my own limitations and need for other people; there’s no way I could have fasted for 40 days without the care of others: I don’t have the temperament for this kind of endurance! Most importantly I learned to reflect on the huge difference between fasting and real hunger. Hungry people are often in debt, unable to pay utility bills, humiliated and made lonely by the experience. They often don’t know when or if the experience will end. My experience was affirming, powerful, and time-limited. They couldn’t be more different and yet through one I was able to stand alongside those who were suffering with the other.

You’ve been cautioned on a number of occasions for your involvement in direct activism. Have you ever done anything that you later regretted?

There aren’t many actions that I have done that I would not do differently. You only learn by experimenting. For example, when I was arrested in Gloucester Cathedral for protesting an anti-Palestinian group I went to the press before telling my Church leaders. This meant the bishop got calls from the press without being prepared. I learnt quickly that if you want support of sympathetic powerful people then, when possible, you need to keep them in the loop. Of course, activists also need to be agile and often covert so all lessons learnt are held lightly too!

Your religion is Christianity – would the book speak to activists of other faiths?

I am confident that my book will speak to activists of any faith, despite most of the resources being either Christian or Buddhist. My last book was aimed at Christians and yet many atheist friends said they found it helpful and exciting and wanted to share it with their peers. This book is deliberately expansive enough to mean that it can be a resource for anyone who is an activist and considers spirituality to be important. But that doesn’t mean it won’t be challenging.

What would you say to people who claim that religion has no place in politics?

You won’t be surprised to hear that I’ve had this thrown at me many times. I used to argue with people who said that religion has no place in politics, but now I don’t bother. In Europe we have a long history of the privatisation and domestication of religion that correlates with the rise of the state’s monopoly on territory and violence. But religion is supposed to be public and dangerous – in the best sense of both words. Usually when people tell religious figures to butt out of politics it’s more that they don’t like how they intervene rather than the fact of it.

You mention in the book that many people would describe themselves as ‘spiritual rather than religious.’ Why do you think that is?

Religion has got a bad press and in many ways that is well deserved. People want to be free individuals with their own spiritual agency. That’s all well and good but individualism is hardly counter-cultural and it is not going to change the world. We need a common life and that means reinventing religion – not as rugged individuals but as interdependent spiritual seekers.

What would you like readers to take away from the book?

A desire to find other people, in the places they live and work, with whom to conspire for a better world. We need to change the world as it is into the world as it should be and we can only do that together. We need to be more than just steam valves for an unjust system, we must also be whistle-blowers on the steam valves and a spanner in the works.

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For more information on his new book, click here.

Author Q&A with Dr Monika Renz

Dr Monika Renz shares her perspective on optimal palliative care and talks to us about her most recently published title, Hope and Grace.

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Could you tell us a bit about your background? Where you grew up and whether there were any early influences in your decision to enter the palliative care field?

I grew up in Zurich. My father was a business leader; my mother was a psychologist. Since childhood, I have been interested in the human condition, particularly health and spirituality. I was first influenced by my father’s focus on efficiency, and as a psychotherapist, I began looking for efficient therapy methods.

A second early influence was music: My mother told me that I had begun singing before speaking! Since I was 5 years old, my hobby has been piano improvisation. Without reading notes, I played whatever I heard and as a child discovered the healing effect of music. When I was a teenager, research on intrauterine hearing had just come to the fore. I was fascinated and became interested
in music therapy.

At the University of Zurich, I studied educational psychology, psychopathology, and ethnomusicology. The deepest influences on my therapeutic work with dying patients came from several accidents and longer periods of personal illness. As a patient, I experienced what I later called a transformation of perception. I discovered two different states of being: In one, I suffered great pain, and in the other state, I had none. In the one state, I was present and in control, and in the other painless state, I was somehow far away from time and space but very clear. I looked deeper into this phenomenon when writing my doctoral dissertation on primordial trust and primordial fear under Professor Heinz Stefan Herzka. Years later, I studied theology to better understand patients’ spiritual distress. My theologic dissertation dealt with redemption from early behavioural imprinting. Continue reading