***update 9/15/17: I received a link to an excellent, comprehensive article by Rachelle Slotman on identifying and coping with burnout. The link is here and I have also posted the full article here. Thanks to John Hawthorne for the link!***
I wrote previously about what I call the Therapeutic Triad, describing how any counseling or caregiving relationship includes three elements: myself, the other and God.
What I’ve experienced in my years of counseling and chaplaincy is that often the relationships between these three can be problematic and can malfunction. Where ideally the relationships between the three elements should flow freely in both directions, it seems that problems arise when these relationships only flow in one direction or when one of the three elements is neglected. This neglect can impact the counselor’s effectiveness and also create stress, tension and helplessness in both the counselor and the counselee.
One thing I learned in CPE was that while clerical authority certainly was not to be abused, it was not to be neglected either. This can happen when a Chaplain or minister minimizes, diminishes or rejects their own authority or responsibility in a caring relationship. This can happen when a counselor takes on a passive role or else fails to utilize or recognize the skills and resources that they may have to help the other.
In formal ministry such as Chaplaincy it is especially important for the helper to have a clear and concrete sense of their role and purpose. When that role is not really flushed out or clearly understood, it’s easy to default to just wanting to make others feel better. I had this once described to me as being the “happy Chappie”, who sees their primary role as to make others happy and therefore avoids difficult topics in a relationship.
This person may identify themselves as “only a Chaplain” or “just the congregational care director”, or “just” anything! He or she may feel that they have little to offer, or feel that it is not their place to provide advice or opinions. By minimizing their role in the triad, the caregiver’s role becomes diminished. Meanwhile it may be precisely because of this role that the other person came to the Chaplain or pastoral caregiver in the first place.
There are many reasons why clergy especially may set aside their own authority. They may have come from an environment where clerical authority was abused and therefore want to distance themselves as far away from it as possible. Clergy may also feel that others will be automatically put off by their role and the authority that comes along with it and therefore leave it out of the picture completely. While it is certainly true that some are put off by clerical collars or a bible in hand during a visit, it isn’t helpful to assume this from the get-go. A skilled Chaplain can recognize when and how to lay down the emblems and images that may be associated with their role while not rejecting the role completely.
Another way in which neglect happens in this area of the triad is when the caregiver or Chaplain neglects their own needs: the need for self care, the need for rest, and the need for God in their own lives. Dennis Portnoy wrote that those who are involved in the daily care of someone who is suffering on a daily basis are at risk for developing what he called “compassion fatigue” as well as caregiver burnout. Both involve physical, emotional and spiritual symptoms that become not only detrimental to the person’s role as a caregiver but to their own health and well-being. While education on burnout detection and prevention is becoming more prevalent, moving from understanding and recognizing burnout and fatigue is often more difficult than it seems.
While the solutions to personal neglect and poor self care are relatively simple – adequate rest, hobbies, exercise – movement in these areas can be difficult in that the caregiver may not feel free to actually do them. Personal care may be seen as selfish or neglectful. There may not be recognized resources available to the caregiver or Chaplain to help them cope with their caregiving tasks. Perhaps most importantly, when the identity of one’s self as a caregiver is so ingrained into how they perceive themselves as a person he or she may have difficulty even visualizing themselves not being a caregiver at any point in time. To not be a caregiver, even for a brief time, may provoke anxiety and distress as they no longer feel “themselves” when not doing their job.
It is extremely important for a Chaplain or a caregiver to be able to both accept their role and cherish it, but still be able to put it away on a daily basis. When this doesn’t happen end results can be devastating for the Chaplain or caregiver, as well as for those who are cared for by them. I’ve seen family members collapse under the weight of their role, leaving hospital or hospice workers to scramble to find resources to help not only take care of the patient but now also for the caregiver.
Finally, neglect can occur when the caregiver neglects or rejects their own relationship with God. This third part of the triad can be neglected even by clergy, even though it may not be recognized. The caregiver or Chaplain can neglect their relationship with God by seeing themselves as without the need for God as a caregiver or source of strength. The notion that “I can do this myself” or “it’s my responsibility – no one else’s” can not only wall off the support of others for the caregiver but cause a sense of distance from God.
To neglect one’s own self in the caregiving relationship is like trying to help someone else with their oxygen mask on a depressurized airplane before you put on your own. Pretty soon you’re both in need of help.
***Update: Anna Kucirkova forwarded the following helpful post for your further reading: Fireproof Your Life: How to Recognize Burnout and Escape Your Own Personal Inferno
Next: Neglect of the Other
4 thoughts on “Problems in Caregiving Relationships: Neglect of the Caregiver or Chaplain”
Great post. Thanks so much. I will read, mark, and inwardly digest the content! Might I add that I have also found that spiritual caregivers are operating very much in a medically driven hard science environment. That makes for the need to constantly be teaching what we are all about. For example, if a chaplain provides “presence” the usual question is, “so what did you do?”
I think some of the relationship problem is simply the product of people operating from different disciplines, and hence, different worldviews. I am often asked what the word “existential” means, and even after giving countless explanations find that my work-mates still don’t grasp it. Sigh….it might have to do with the neglect of a common liberal arts vocabulary such as was widely taught thirty years ago, but has since gone by the by wayside in most education.
Anyway, keep posting. it is really good stuff, and refreshes me to read what you have to say.
Thanks so much for your kind words. Ours is a difficult job to qualify unless you experience it in your own life.
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