Feelings Aren’t Dangerous: A Response to The Gospel Coalition and Gloria Furnam

A while ago an email drifted through my inbox from The Gospel Coalition. Ususally I delete them, mostly because I find most of them to be uninteresting or not that helpful. Thankfully they list the subjects of the email right off, so you can delete them fairly quickly. But this one caught my attention, because one of the articles in the email was called “Moms, Don’t Trust Your Fickle Feelings“.

“OK”, I thought, “don’t rush to judgment – see what they say.”

And I got mad. Continue reading

Advertisements

Chaplain Tom Becraft on Caregiver Burnout

I recently read a fantastic article by Tom Becraft on managing the seemingly unmanageable barrage of stress and grief that can come in heathcare chaplaincy. He begins with the summary of the first hour of one day:

  • 6:30 a.m.   The morning shift is just starting. I have just entered the office and am taking off my coat. The desk phone rings. It is from the nighttime hospital supervisor regarding an unfolding situation in Room 1040. A 34 year-old mother of four small children has had a massive stroke apparently caused by a sudden dissecting carotid artery. Brain death is likely. Considerations: how to emotionally and spiritually support this large non-English speaking family; how to facilitate the organ donor requester process; how staff, some of whom are young mothers, might experience this death; how to prioritize. I clip my cell phone and pager to my belt and head out.

Continue reading

So Many Straws: Reflections on Self Care, and the Lack Thereof

“You’d better be careful, Sam. You’re going to burn out like this.”

These were words from my CPE supervisor several years ago. At the time I was a bit taken aback. After all my schedule certainly seemed manageable, and I felt I was doing OK at work and at home. Sure I had my struggles, but found a way to pick up and keep going every time. This March I realized he was right. Continue reading

The Caregiver’s Dilemma

A week or so ago I sat down to plan some things out. I find that I don’t tend to be a planner unless I feel the need to have something concretely in front of me to refer back to. This was less of a planning than a brainstorming session, really. Brainstorming to develop the plan. The plan was how to fix myself. The brainstorming was to figure out how.

Caregivers rarely take the time to consider their own needs. They are constantly putting others’ needs before their own, in some cases to their own detriment. Sometimes it’s saintly, and sometimes it’s sick. After talking with a few people I found that I was teetering toward the sick end of the spectrum myself. Continue reading

Why I’m a Chaplain – III: “The Church” and the wandering path

At one point in my life I had wandered away from my faith. Not wandered, more like stormed out to be honest. That’s a whole other issue. I came back though, and a big reason I came back was I attended a Christmas service at a large megachurch here in Pittsburgh that changed my perspective on myself and my relationship with God. I started attending and joined about a year later. Continue reading

Standing in the hallway

once again I haven’t written in a while. once again due to feeling incredibly busy.

We had a speaker at our hospice a few days ago who talked about how social workers and chaplains tend to be seen as mildly irrelevant in hospice care. Many chaplains, for example, routinely carry caseloads of over 100 as well as on call duties. I know one chaplain who has over 100 patients and a church. That to me is insane.

Given the fact that I have about 80 patients, and only about 60 of those I see regularly, I should feel like I’m on a luxury cruise. However that’s hardly the case. Admissions happen on an almost daily basis, and these require quick attention even though the impulse is to put them off until absolutely necessary. A quick phone call to the family or patient can usually tell you how much of a problem there may be, so that can help to prioritize things.

Continue reading

Joshua 4: Message for a facility memorial service

I thought I’d pass this recent message from a memorial service our hospice hosted at a personal care facility. They had started a rock garden and we donated a tree to serve as a memorial marker.

…Joshua said to them: “Cross over before the ark of the Lord your God into the midst of the Jordan, and each one of you take up a stone on his shoulder, according to the number of the tribes of the children of Israel, that this may be a sign among you when your children ask in time to come, saying, ‘What do these stones mean to you?’ Then you shall answer them that the waters of the Jordan were cut off before the ark of the covenant of the Lord; when it crossed over the Jordan, the waters of the Jordan were cut off. And these stones shall be for a memorial to the children of Israel forever.” Joshua 4:4b-7

This scene marks a pivotal point in the history of Israel. This nation of former slaves has survived forty years in the wilderness, scraping by only at times by means of miraculous intervention, to arrive at the land promised to them several generations before. Nobody who heard that promise is alive to see it fulfilled. Even Moses, who lead the bedraggled group for those 40 years and who was for all that time their closest connection to God, died before this scene. This nation of nomads has finally arrived at the end of their journey from slavery to freedom.

Continue reading

How Not to Say or Do the Wrong Thing

I chaplain friend of mine passed this article along from the LA Times:

How not to say the wrong thing

It works in all kinds of crises – medical, legal, even existential. It’s the ‘Ring Theory’ of kvetching. The first rule is comfort in, dump out.

Susan Silk and Barry Goldman

April 7, 2013

When Susan had breast cancer, we heard a lot of lame remarks, but our favorite came from one of Susan’s colleagues. She wanted, she needed, to visit Susan after the surgery, but Susan didn’t feel like having visitors, and she said so. Her colleague’s response? “This isn’t just about you.”

“It’s not?” Susan wondered. “My breast cancer is not about me? It’s about you?”

The same theme came up again when our friend Katie had a brain aneurysm. She was in intensive care for a long time and finally got out and into a step-down unit. She was no longer covered with tubes and lines and monitors, but she was still in rough shape. A friend came and saw her and then stepped into the hall with Katie’s husband, Pat. “I wasn’t prepared for this,” she told him. “I don’t know if I can handle it.”

This woman loves Katie, and she said what she did because the sight of Katie in this condition moved her so deeply. But it was the wrong thing to say. And it was wrong in the same way Susan’s colleague’s remark was wrong.

Susan has since developed a simple technique to help people avoid this mistake. It works for all kinds of crises: medical, legal, financial, romantic, even existential. She calls it the Ring Theory.

Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. For Katie’s aneurysm, that’s Katie. Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma. In the case of Katie’s aneurysm, that was Katie’s husband, Pat. Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a Kvetching Order. One of Susan’s patients found it useful to tape it to her refrigerator. Continue reading

Dealing with Anger

One of the challenges some chaplains face, myself included, is the need to be liked and avoid conflict.  We want people to feel good and comforted, and this is what often leads us into the profession.  We’re the Rogerians in the room: providing that unconditional positive regard to all comers. Trouble is that when conflict takes place, it can feel like failure. So when conflict is on the horizon we dodge it. I can talk myself into twists trying to avoid or minimize whatever the problem is. Which tends to make the problem worse. Then when that conflict does erupt I tend to look at myself as the cause of it, as if conflict and anger are wrong and my fault. In doing so I take responsibility for their feelings and reactions, which isn’t healthy or logical.

One of the harder parts of my own development as a chaplain is raising that emotional boundary between myself and others. It’s easy in the caring professions to open one’s self up too much and to care too much for the other person, which neglects ourselves. This isn’t just chaplains but nurses, social workers, and on down the line. Sometimes this self-neglect takes the form of taking on what the other person needs to do – the “fix-it” or “savior” mentality, an outward focus that neglects the self’s boundaries. However I also see that this self-neglect can be inward focused as well, where I don’t try to fix the other person as much as make their problem my own – their problem is a bad reflection on me, so I take it personally. This can happen a lot with handling anger. This still avoids the problem though, and all I end up doing is taking their anger and internalizing it because it’s directed at me.

What I fail to do though is see that even though it’s directed at me it is still their anger, their emotion. How they choose to express it is their issue, not mine.

Overcoming Nature

I watched the film Temple Grandin with my wife over the weekend.  My wife works with autistic children and their families, and had been looking forward to seeing this movie for some time.  Grandin is a PhD and expert in animal husbandry, as well as autisitc.

Part of the story revolves around how she seeks to revolutionize the cattle industry by reorganizing slaughterhouses to make them more amenable to cows actually behave, making the whole process more humane as well as efficient.  For example, rather than forcing cows into insecticidal dips with prods and slick  chutes, which occasionally result in drowning, Grandin’s model uses curves to lead the animals to a stepped platform, where the animals simply walk into the dip, swim through, and back out.  It’s all pretty amazing in how simple the design and process appears, yet how complex the behavior is that the process is built upon.

What else is interesting is her reason for doing so.  Most of us would think that her affinity for cattle and the desire to limit their suffering would have led her to denounce the whole industry, but that wasn’t the case.  She understands and respects the life that is present in each animal (in the film, after a cow is killed before her she asks “where did it go?”), but doesn’t have the deep emotional connection that we would expect due to her autism.  The reason she sees for treating the animals humanely is simple but deep: “Nature is cruel, but we don’t have to be.”

I thought about this in light of hospice care.  This same thinking guides a lot of our care and judgment regarding care for those we care for.  We see nature at it’s most cruel sometimes.  I recently had a patient whom I was close to pass away.  He had struggled with pulmonary fibrosis for several years, struggling to breathe continually and leashed to an oxygen tank.  He gradually grew weaker and more dependent, to the point where he could only walk short distances.  Then he had a serious stroke, taking most of whatever he had left.  He could talk, though slurred, and could understand, but was otherwise unable to move.  Even his head had to be propped up with a neck pillow.  It was tremendously sad to see the cruelty of nature at work here, and our job was to make sure that cruelty was dealt with as best we could.

The physical pain was manageable, but the psychological and spiritual pain was tremendous. I spent time with him the day he died in his home, holding his hand and praying for him along with our staff and his wife and daughter.  Some of his grief was directed at God, and I can’t say that I blame him.  You can’t go through an illness like that, or accompany someone along that road, without wondering why.

There are plenty of answers out there for sure: the fallen world, suffering as part of life, the stripping of everything to increase our dependence on God, the work of the devil, the work of God, and so on.  Yet I found Grandin’s insight to be one of the simplest and maybe truest at the moment.  Nature is cruel in many ways, and we can’t overlook or overcome that cruelty.  Sin and death are, at least for now, permanent fixtures in the world.  However part of realizing the kingdom of God in the here-and-now is to see that while these can’t be overcome, we don’t have to fatalistically succomb to it.  Jesus reminds us, over and over again, that he has “overcome the world”, and even though that cruelty is still there in the world, we can overcome it as well.  Nature is cruel, but we don’t have to be.