I get an e-journal on medical chaplaincy that usually gets a brief look-over when it ends up in my inbox.  While the articles are usually either clinically-minded or introspective, there has been an ongoing back-and-forth discussion on what exactly the practice of chaplaincy should look like.

Chaplains have a bit of a blind task at times in the medical world.  We are asked to provide spiritual care for someone who may not be able to understand us well or at all due to dementia.  We may have folks who are even unresponsive.  The question obviously arises as to how that happens.

The answer has been called by some “the art of presence” or the “practice of presence”.  The idea is that some cases do not require direct intervention or active participation, only the conscious presence of a caring individual.  This has numerous benefits in the hectic world of medicine, where nobody has time to simply sit and be with someone for even 30 minutes. 

The question arose in discussion though about whether or not the chaplain’s primary stance is one of passivity and witness.  Chaplains are often trained in models of therapy that involve active listening, reflection, and unconditional positive regard.  But are there situations and circumstances that require more direct intervention?  Should we correct erroneous attitudes?  Should we give advice when asked?  What if I’m wrong?  Then again, what if I’m right?

I have given advice and offered correction, but only after I feel that the other person has been fully heard and when they feel that I have fully heard them.  I’ve been in situations where I’m at the end of the rope and asked for advice and not gotten it.  It is frustrating to be answered with silence but also a time to recognize that answers aren’t easy.