Here is a thought of mine for the upcoming holiday of Shavuot. (Cross posted on my work’s blog – https://www.wilfcampus.org/shavout/)
belief, chaplain, chaplaincy, death, death and dying, death awareness, fear of death, grief, grief and loss, grief work, Immortality, intimations of immortality, pastoral care, psychology and religion, religion, spiritual care, Stephen Cave, TEDtalk
When did you first realize you were going to die? This is the opening question in a TedTalk from 2013 called 4 Stories we tell ourselves about Death. (As an aside, and maybe something I should have known, there is a transcript for this talk available, from which I am taking the block quotes). In this talk, Stephen Cave, author of the book Immortality, reflects on how people have created stories about our immortality. His premise is:
Just as there was a point in your development as a child when your sense of self and of time became sophisticated enough for you to realize you were mortal, so at some point in the evolution of our species, some early human’s sense of self and of time became sophisticated enough for them to become the first human to realize, “I’m going to die.” This is, if you like, our curse. It’s the price we pay for being so damn clever. We have to live in the knowledge that the worst thing that can possibly happen one day surely will, the end of all our projects, our hopes, our dreams, of our individual world. We each live in the shadow of a personal apocalypse.
We live with a conscious and often unconscious fear of death. The fear is something that can either hinder us or it can perhaps be a motivator for how we choose to live.
In analyzing this fear of death, Cave suggests that the stories we have developed for our lives are all bias driven. Regarding this bias, He suggests:
Now, the theory behind this bias in the over 400 studies is called terror management theory, and the idea is simple. It’s just this. We develop our worldviews, that is, the stories we tell ourselves about the world and our place in it, in order to help us manage the terror of death. And these immortality stories have thousands of different manifestations, but I believe that behind the apparent diversity there are actually just four basic forms that these immortality stories can take. And we can see them repeating themselves throughout history, just with slight variations to reflect the vocabulary of the day.
The four stories he describes and critiques are:
Instead, Cave presents a different model for understanding life and death. He pictures life the story within a book.
Now, I find it helps to see life as being like a book: Just as a book is bounded by its covers, by beginning and end, so our lives are bounded by birth and death, and even though a book is limited by beginning and end, it can encompass distant landscapes, exotic figures, fantastic adventures. And even though a book is limited by beginning and end, the characters within it know no horizons. They only know the moments that make up their story, even when the book is closed. And so the characters of a book are not afraid of reaching the last page. Long John Silver is not afraid of you finishing your copy of “Treasure Island.” And so it should be with us. Imagine the book of your life, its covers, its beginning and end, and your birth and your death. You can only know the moments in between, the moments that make up your life. It makes no sense for you to fear what is outside of those covers, whether before your birth or after your death. And you needn’t worry how long the book is, or whether it’s a comic strip or an epic. The only thing that matters is that you make it a good story.
In other words, life is the story we live, not the before or after the story.
I am particularly taken by this metaphor. None of us can know when the book will end. We can only keep building the story that is in the book of our lives. We cannot allow the fear of the book ending be the driving force of how we live. However, we can also not just let the book tell the story. We must work to write the story.
While I do not remember when I first recognized my mortality, I also know that there is a value in death awareness, not to detriment of living life, but to enhance how we live the life we have. Death awareness is a foundational element of chaplaincy/spiritual care training. It is the lesson that helps us be present to witness the death of others. It is a lesson about accepting and acknowledging one’s own fears.
As we continue to move closer to the time when communal prayer will be sanctioned in a limited manner, I want to further reflect on the value and challenges of communal prayer. First and foremost, many of our faith traditions put an emphasis on the special nature of public and communal prayer. In Jewish literature, there are a variety of statements that emphasize the greater value of being in a prayer quorum. For a quick summary of some of the sources, see the following piece from Chabad (click on the numbers for the sources):
A person should make an effort to pray in a synagogue with a minyan.1 G‑d never rejects the prayers of a congregation, even if sinners are amongst the crowd.2 Even if a person’s kavanah (concentration, intention) is imperfect, if he prays with a congregation, his prayers will be heard.3 Nowadays, as we all do not have perfect concentration when we pray,4 it is all the more important that we pray with a minyan.5 It is said that in the merit of praying with a minyan, one will make a living more easily and be blessed with the fruits of his labor.6 In fact, even if praying with a minyan causes one financial loss, G‑d will repay him by granting him extra success.7
Praying in a synagogue (with a minyan) is a segulah for long lifeAn elderly woman once came to Rabbi Yosi ben Chalafta and said, “I’m very old. My life has become unpleasant. I can’t taste food or drink, and I would like to pass away.” Rabbi Yossi said to her, “What mitzvah do you do every day?” She replied, “I go early every day to the synagogue even if it means leaving an enjoyable activity.” Rabbi Yosi instructed her to stop attending synagogue for three days. She did this and subsequently passed away.8 Thus, we see that praying in a synagogue (with a minyan) is a segulah (spiritually propitious act) for long life.
The verse9 alludes to this: “Fortunate is the man who listens to Me to watch by My doors day by day, to watch the doorposts of My entrances. For he who has found Me has found life, and he has obtained favor from G‑d.” The phrase “doorposts of my entrance” refers to the entrance to a synagogue. When ten men pray together, constituting a minyan, the Divine Presence rests on them, as the Mishnah states,10 “When ten are sitting… the Divine Presence rests amongst them.” For this reason, the prayer of a minyan is considered more effective than private prayer, because no interceding angels are needed to raise the prayer to G‑d. Rather, the prayers are accepted immediately.11https://www.chabad.org/library/article_cdo/aid/1176648/jewish/Minyan-The-Prayer-Quorum.htm
In Jewish practice, there are certain prayers that are designated prayers to only be recited in a communal gathering, a minyan. As such, given the importance placed on these prayers, communal prayer is also ideal. However, there are circumstances that override the obligatory nature of communal prayer, including the communal responsibility of saving life. During the COVID-19 pandemic, the principle of a saving life was the driving force for most synagogues to “close” before the government mandated the closures.
In further reflecting on this topic, the following piece, When our shuls re-open, whom are they re-opening for? was written today by Rabbi Yaakov Jaffe. His opening question is a powerful thought that requires both communal and individual reflection:
As I ponder the question of the re-opening of our shuls, I wonder whether we are re-opening because this is something God has asked us to do, or something we are doing for ourselves. Is it a mitzva to re-open a shul? Or a voluntary act many Jews are now choosing to sign up for, without God having asked.
How do we know it’s the right time? Can we know what the right time is? Rabbi Jaffe proceeds to explain two principles driving the earlier decision to close synagogues, one, saving a life, which we already mentioned above and the prohibition of self-endangerment, placing oneself in harm’s way. For both of these principles, as we ponder reopening, there is a recognition of levels of risk in reopening:
Under Significant Risk – It would be prohibited to re-open; mitzva obligations are suspended until risk subsides.
Under No Risk – Mitzva obligations are in full force, and we must follow regular religious demands and shuls must re-open.
But today we face: Moderate or Small Risk – Small enough that we leave our homes, but large enough that we still feel its weight on our shoulders.
And therein lies the challenge. What is the level of risk a community is willing to accept and subsequently, what is my individual level of risk that I am willing to accept? Furthermore, what about if you are someone working in direct or even indirect contact within an environment of higher risk? What level of risk would be acceptable then? And whose responsibility is it to select who can and cannot go to synagogue, the community, the individual, both? Another question, which the article proposes is how do we normally measure risk in our lives. Do we always avoid risk? Do we consciously recognize the inherent risks in our daily functions?
Rabbi Jaffe offers the following perspective in answering the risk question:
Thus, returning to synagogue does not reflect a total absence of risk. It means that risk levels have reached the point where counter-pressures can be taken under consideration to permit the behavior on account of the valid gains which outweigh the risks. Anyone who feels more comfortable to err on the side of absolute zero risk may choose to do so, and Our Creator does not demand we take on risk for His Sake. But God permits us low risk, when the alternatives would be living lives missing something crucial and essential.
When we return to synagogue it will not be because God has asked us to, but because we have asked Him to. For many, communal prayer provides spiritual connection, more inspired prayer, and emotional relief. For the observant, it serves as a critical self-definitional component of the daily routine, establishing that our communities and social interactions are defined through shared faith and common goals. It is also a vital educational lodestar for teens and young adults in our communities, teaching them the critical value of religion when compared to other aspects of life, and is a critical therapeutic element for mourners of loved ones or those struggling with the anxieties of the pandemic. Though to be sure this is not our primary reason to return to shul, communal prayer also provides the human connection of being in the same room as friends, as community. Many feel empty, going months without communal prayer, as if there is something so important missing from their lives. A decision to return to shul is informed by all of these important values, and their ability to counterbalance risk, as much as it is informed by the obligation of communal prayer.
It is in the above that I feel the focus of my wanting to reflect more on communal prayer is driven. In our current situation, we have been forced to reflect on how we engage in the communal religious practices of our faiths. What has it meant to us? In addition to the theological values we espouse about being together, why do we find a need to be together? Sure, we could avoid the question and say that it is a selfish question to spend time figuring out what we get out of it instead of just asking what we bring to it. Yet, in today’s more autonomous, democratic, free choice environment, both sides of the coin have a place in this discussion.
I personally struggle with the answer to these questions. I miss the camaraderie of being with others, the routine that it was creating for me. Over the years, I have on again, off again made effort to attend at least once a day, including a concerted effort over the past 7 months before the pandemic. I miss those elements. Yet, I also find myself saying that the risks of being together are complicated and am not sure if the risks are worth taking at this time.
In answering his question, Rabbi Jaffe offers one final reflection:
God has not asked us yet to return to synagogue. But we have asked Him to do so. And if we return for the right reasons – for spiritually grounded reasons, and in the right ways – with safe practices and with health security, we must hope that we will find God waiting for us there in synagogue when we have returned.
Regardless of what we all choose to do individually and communally, it is my hope that the choices are not just haphazard. Let us hope that we have seen the worst of what this virus has to offer and that with continued vigilance we can mitigate the rampage we have had to endure.
clergy, COVID-19, crisis, pastoral care, Pastoral crash, pastoral crisis, pitfalls of leadership, religion, self care, self reflection, spiritual care, spiritual crisis, spirituality, the coming pastoral crash
The Coming Pastoral Crash presents a very challenging, and quite frankly scary, perspective on how clergy will find real struggle resulting from the ongoing stressors during the COVID-19 pandemic quarantine. Before looking at some of the author’s points, I have heard and seen many of the same from colleagues and in many ways in my own work/life imbalance during this time. I think regardless of how one serves others, whether as a congregational clergyperson or as a chaplain, many of these points really stick out.
In grief support and counseling, we always remind people never to make rash decisions in the midst of crisis. I believe the same to exist during these times. Yet, I am sure many questions are arising in the minds of colleagues. Is this what we signed up for? Do we have the will and desire to continue helping others? Would there be something else we would be happy to do? These questions and others I feel are summed up well in the following:
Charles Haddon Spurgeon, the great Baptist “Prince of Preachers,” once told his students that if they could be happy doing something besides ministry, they should do it. I’m sure there were several reasons why Spurgeon gave this advice. But the reason his advice makes sense to me is because…
Being a pastor is hard.On the Rise and Fall of Pastors
Similarly, there is a comment in Ethics of Our Fathers (1:10)
Shemaiah and Abtalion received [the oral tradition] from them. Shemaiah used to say: love work, hate acting the superior (literally rabbinate), and do not attempt to draw near to the ruling authority.https://www.sefaria.org/Pirkei_Avot.1.10?lang=bi&with=all&lang2=en
Of course, these points exist even in normal times, to recognize the difficulties of serving others. How much more so during a crisis, especially one that has global ramifications. The author notes a multiplicity of areas that can potentially lead to the Crash. A few of these I have already alluded to and noted in previous posts this week. These areas are:
They are serving in ways for which they have no training or experience.
They are doing their best, but unable to keep it up.
They are worried about ministries that are unable to operate, and if they will be able to operate later.
They are exhausted. Less gathering does not equal less work.
They are not feeding their souls.
The future is cloudy.
The collapse of the job and financial markets impacts churches.
They are physically not healthy.
They have conformed to a 7 day schedule.
They are unwilling to take time off.
They do not seek out mental health.
They are in dangerous spiritual territory.
This list of items, described in the article, all point to a coming crashing point. As we reflect on these past few months, I think all of the uncertainty has had such a tremendous impact on how we function. It leads to mistakes, errors and frustrations over decisions we normally wouldn’t find ourselves making. While exhaustive, this list misses one more major point, namely the overwhelming loss from death and illness. When clergy have multiple members die in a short period of time, it is draining. During this pandemic, especially in the hot zones, this has become of primary concern. The constant pain of death will also take a major toll. Who will the helpers turn to if we are all in need of help?
The author offers a potential prescription for how to overcome or work through many of the above challenges so as to potentially avoid the crash. His two messages are:
Ministers must commit to ministering to their own hearts first.
Ministers must commit to look out for one another.
To combat crashing, one must take care of the self and make sure to be able to support others. We have to find new meaning in the work we do and more importantly, meaning in ourselves that transcends the work. We need to remember to insist on giving ourselves the permission to maintain our own health and wellbeing in small ways. We also need to look out for each other. He makes the point that in many ways only other clergy understand the particular challenges we face. I think this is a very true statement. Yet, I would also caution that seeking help from another in the same situation might result in a shift of who is giving and receiving the help at any one time.
In conclusion, without the mindfulness and recognition of our boundaries and limitations, we may very well be traveling into an abyss of pain and depression, crashing and being unable to continue to provide for others. As the marathon that is the COVID-19 pandemic continues, it is incumbent to remember that slow and steady can and should be the mode of practice.
communal practice, community, empowered judaism, havurah, prayer, religion, religion and spirituality, religion vs spirituality, religious practice, solitude, spirituality, synagogue, Tablet Magazine, william james
As we begin to grapple with the ramifications of reopening of faith based/religious institutions, it is incumbent upon each of us to evaluate the pluses and minuses of the experiences of being alone or connecting through virtual means. Basing myself on an article I recently read, The Trouble with ‘Solitude’ I would like to offer some thoughts both from the piece and from a self evaluation of being disconnected from others as it relates to communal practice.
In recent weeks, unable to be with my synagogue community, I have been thinking about James’ view of religion as inherently solitary. And I have decided that it’s total bunk. Religion, even highly personalized, idiosyncratic musings to oneself about the nature of the universe, is a highly social affair. It’s almost impossible to do alone.
I find myself in agreement with this comment if one presumes that the foil here is the word religion. Yet, in much of recent research literature, William James’ definition of religion, “the feelings, acts, and experiences of individual men in their solitude … in relation to whatever they may consider the divine,” is more connected to how we define spirituality today. As a way to frame this, I will site one image that defines the similarities and differences between religion and spirituality.
Regardless, the author’s sentiment remains critical, as solitude is often not as conducive to spiritual growth and finding a deeper sense of meaning about the universe. We need others to push us, move us, prod us. We need others to laugh with, celebrate with and cry with. And yes, we can Zoom, but we hear again and again about how zoom isn’t the same. Don’t get me wrong, the efforts to keep communities connected through videoconferencing have been well received and for many have revived shrinking religious communities. Yet, as the author indicates:
In the past weeks, we have seen how bereft people are at having to bury loved ones with no funeral. Friends have postponed weddings, because that kind of covenant, commitment, or oath seems to require an audience. In Judaism, newborn boys are going without the traditional circumcision ceremony, which is not just a snip but a public snip, to which the entire community is supposed to be welcome (you don’t invite people to a bris; rather, you announce it, so anyone might come).
So much of how we connect is in physical presence. So much of how we find spirituality is from the connections with others in performing religious practice. Sure, we all desire times of solitude, but we want the solitude when we need it, not when it is forced. I would presume that the enforced nature of not being physically connected is part of the challenge.
Early on, I had posted on Facebook a question, what were my friends calling their at home prayer spaces. How did they define their synagogue away from synagogue? I must confess I never personally answered the question because I couldn’t find the right name that fit my mood. Even now, I am not sure there is one way to define the space. Yet, I think this practice was valuable as both a way to laugh a little at the forced change and also to find a way to acknowledge the reality placed before us.
Not to downplay the value of solitude, the author also describes:
Of course, “the more the merrier” is not always the best principle. Some spiritual work is best done away from the crowds. The great religions have recognized that certain people, on certain journeys, require solitude. Roman Catholics have an old tradition of hermits and the cloistered religious. In Judaism, the Hasidic master Nachman of Breslov (1772-1810) taught his disciples hitbodedut, meditation as a private conversation with God, done in a quiet room or, best of all, in the woods or a field. Buddhist meditation, in its many forms, requires silence, a retreat from the cacophony of other people.
There is much to be said for the solitude. There is much to be said if one takes advantage of the quiet and is intentional. Yet, I think for most of us, neither extreme of only the communal or only the individual, is ideal. As the author concludes:
James was right to dethrone the church or the congregation as the sole approved guide to everyone’s spiritual journey. But he was wrong to say that solitude was the one true alternative. As for me, I want neither megachurch nor to be alone with my thoughts. All this enforced time with just my wife and children has reminded me that, sometimes, the family is the best unit of religious observance and reflection. To the Friday night Shabbat dinner, we have, under quarantine, added the Saturday night candle-lighting for Havdalah, or separation, the return to ordinary time after the Sabbath. The search for the divine in one’s own family, I am finding, beats the madness of crowds—and the maddening triviality of my own mind.
The idea of a smaller collective approach to spirituality, assuming the family is the collective, is appealing. Of course, if one is living alone, then there can only be solitude, which is beset with a myriad of other challenges. For me, I think I have not done well with seeing the family time in such a spiritual way, as I personally prefer being “alone” in my thoughts and in my spirituality. Yet, I continually wonder if many have found the family religious and spiritual oasis we have as a place of growth. And when we begin gathering as small groups, will the small groups be more meaningful and powerful than the large religious spaces we occupied before the pandemic.
In writing these words, I am most struck by how much this debate reminds me of the debates I have read about the founding of the Havurah movement in the late 1960s, early 1970s and the arguments presented in the 2010 book Empowered Judaism (and countless other sources). While not someone who offers predictions, I do wonder if there will be a period during the reopening of religious institutions where the ideas of creating smaller groups will be encouraged and if those groups will find ways to maintain connections even in a time when institutional life can return to “normal.”
What is the value of prayer? For a person of faith, this can seem like a non-starter question as the answer would often be that prayer is engaging in conversing with Gd. Yet, I think most of us continue to ask this question, even if the actions we take appear to express the implicit value of prayer. In our current world, this question has also found itself being engaged in by scientific research. While research in prayer is challenging as it relates to setting up controlled experiments and defining what prayer means, it is still an area of exploration.
Much has been spilled about the “power” of prayer as it seems like an elusive answer. There was a recent piece in the Wall Street Journal, “The Science of Prayer” that engages some of the current scientific observations about the value prayer can offer in our lives. The timeliness of this piece is on display in the following reflection:
“There may still be some atheists in foxholes,” says Kenneth Pargament, a professor emeritus in the department of psychology at Bowling Green State University in Ohio, who studies how people use religion to cope with major life stressors and trauma. “But the general trend is for the religious impulse to quicken in a time of crisis.”
A fundamental value of prayer is in how it can be a method we use to cope with trauma and crisis. One way Jewish communities express this practice is via the inclusion of the recitation of extra chapters of Psalms or other prayers outside of the formal prayer structure. While there is a hope and wish that the prayers result in a positive outcome, there is clearly an element of prayer that is most focused on the recognition about our not being in control. As an example:
“This is what prayer can do,” says Amy Wachholtz, associate professor and clinical health psychology director at the University of Colorado Denver, and lead researcher on the meditation study. “It lets you put down your burden mentally for a bit and rest.”
Prayer allows for a pause. It can also be seen as a means of connection to others, as in the following comment:
Prayer can also foster a sense of connection—with a higher power, your environment and other people, including “the generations of people who have prayed before you,” says Kevin Ladd, a psychologist and director of the Social Psychology of Religion Lab at Indiana University South Bend.
I think the idea of prayer as connection to others is something to emphasize in this moment of physical distancing and semi-isolation. Through prayer, we can find an approach of continued engagement with community even when we are not within the physical space of the others in our community. Regardless, as this piece expresses, prayer has multiple functionalities that are of value throughout life, during moments of crisis and moments of calm. Prayer is a method of self-care and communal connectivity.
The teenage years are one’s for exploration of self and one’s place in the world. It is the formidable period when children start to ascend the ladder to adulthood. It is a complicated time of change and increased autonomy while still remaining in need of parental support. It is also a time of “rebellion” from the values of one’s parents. In a piece in the Wall Street Journal, The Teenage Spiritual Crisis, there is discussion of why teenagers show increased struggle with the religion of their youth, while also beginning to see their faith in a more sophisticated way, One point which I find in need of more discussion is how teenage rejection is less about denial of Gd and more about religion not always being in the forefront of their lives. The rejection is more in ritual and outward showing of faith than in underlying belief.
By Clare Ansberry
Thomas Ramey quit praying a few years ago when he was 16 years old because it didn’t seem to matter.
The 18-year-old, who was baptized and confirmed as a Methodist, doesn’t believe in an afterlife, but still believes in a God. He goes to church regularly because he likes playing in the youth band, volunteering and listening to people who have different opinions. “I doubt everything,” says Thomas, who plans to study engineering.
That is true of many teens, who grew up praying, going to houses of worship, and studying religious texts. As 6-year-olds, they were convinced there was a God and heaven and that everything in the Bible was true, for example. Now they aren’t so sure.
The teen brain grows rapidly, and with it the ability to think more abstractly and critically. In early adolescence, teens begin to establish their own ideals and recognize hypocrisy in people and institutions around them. They deal with heartbreak and social cliques, see suffering in the world and wonder if there is a God who cares. They are trying to figure out their place and how and if something like religion belongs.
Exploring such questions is the most important work a teen can do, says Lisa Miller, a clinical psychologist and author of “The Spiritual Child.” Research shows that adolescents with a strong personal spirituality are found to be 60% less likely to be severely depressed as teenagers, she says.
Andrew Zirschky, academic director of the Center for Youth Ministry Training in Brentwood, Tenn., says some children start doubting faith in middle school, when many of them begin preparing for confirmation and bar mitzvahs and bat mitzvahs.
“Right when kids are having the most doubts, we ask them to affirm their faith,” says Dr. Zirschky. Many plow ahead despite misgivings because they feel pressured to do so, he says, and because churches do a poor job of allowing faith and doubt to coexist. He asks sixth-graders to draw the image of God they had in first grade. It is often a white bearded figure sitting in the cloud. When he asks them to draw the image now, they draw hearts, and use words like “loving” or “All-knowing.”
“At some point, you have to doubt your previous understanding of who God is and replace it with a better one,” he tells them.
While teens doubt, they aren’t ready to give up on the idea of God and the importance of religion. A significant majority—84% of 13- to 17-year-olds believe in God, according to a National Study of Youth and Religion, a longitudinal survey of more than 3,000 teens conducted in 2002 and led by researchers at the University of North Carolina at Chapel Hill and University of Notre Dame. Three years later, belief among the same teens, then 16- to 21-years-old, slipped to 78%.
Teens often see God as a cosmic therapist, solving problems and generally making people happier, but distant, says sociologist Patricia Snell Herzog, who worked on the study. A large majority believe religion is important, but many become less actively involved as they age through adolescence. “Religion is just there in the background,” says Dr. Herzog. “We describe it as the furniture of their life.”
Thomas Ramey was born and raised in Decatur Ala., part of the U.S. known as the Bible Belt. He went to Wesley Memorial United Methodist Church three times a week, twice on Sunday and every Wednesday. His mother, Lisa, taught Sunday school.
When he was 8 years old, and able to read, he received his first Bible, which he and his mother read together. “He always asked lots of questions,” says Mrs. Ramey. At 11, after weeks of studying, he was confirmed, and was a Chaplain aid for his Boy Scout troop, leading prayers before meals and at campouts. At that time, he says he believed in God and what the Bible said.
His views started changing in his midteens. His youth group had cliques. He was in the social outcasts group, he says, and he encountered some hostility from certain church leadership against some of his friends who were gay.
“When you see people behave in wrongful, hurtful, hypocritical ways, it’s kind of hard to believe that God cares,” he says.
Philip Galyon, the current youth minister, says teens in high school identify fallacies and hypocrisies. “They push back,” he says, and ask, “Why do people who say they are Christian treat other people poorly?” He remembers struggling when he was age 17 and his parents divorced. His father was a minister. “I thought why should I still believe this?” He wondered what good their faith did.
Thomas hit another hard stretch when he was about age 16 and three people close to him died, including a friend of the family who had dementia. Thomas and his mother visited often, helping the man’s wife care for him. “For weeks I prayed for God to kill this man so his wife wouldn’t have to see him in pain anymore,” he says. “He suffered and died in a terrible way.”
“Thomas is very compassionate,” says Mrs. Ramey. He stops in twice a week to help an elderly neighbor empty her trash and works in a soup kitchen.
Sometime after that, he quit praying. “If something bad is going to happen, it’s going to happen,” he says. “Deal with it head on. I am not going to sit there and say to God ‘Don’t let this happen and don’t let that happen.’”
Thomas still believes in God. The earth and solar system are too complex and fragile not to have something influencing and connecting everything, he says. “Whether whatever created us, loves us, is a different matter,” he says. He doubts there is an afterlife and isn’t troubled by that.
His strongest belief these days is in “the equality of all humans from birth to death, and that the only meaning we have in this world is that which we inject into it.”
clergy, death, death and dying, death awareness, end of life, end of life choices, end of life planning, health care, healthcare, pastoral care, patient decision making, religion, spiritual, spiritual care, spiritual support
Some years ago, I was asked to address a group of community clergy regarding death, dying and end of life care. In the course of my lecture, I indicated that this topic is mostly taboo from a pulpit because the clergy themselves struggle with a sense of self death-awareness. Most in the audience agreed. As I continued, focusing one how our public prayers contain many references to death and life after death. We can say the words in prayer, but to have intention and meaning in those words tends not to be emphasized.
A short piece, Religion, patients, providers, was published describing the value of religious leaders having end-of-life discussions. While it is unfortunate that the article doesn’t discuss the importance of how chaplain/spiritual care providers can be a resource for this discussion, it is encouraging to see the increase in confronting the realities of life in religious communities.
Religion, patients, providers
By Eliza Blanchard
Published 8:13 pm, Friday, December 2, 2016
Talking about death is a daunting topic, and we applaud the growing number of congregations that are giving their members tools and resources to have conversations with their families and loved ones around end-of-life preferences.
But as important as these discussions are, it is also crucial that health care providers are prepared to have end-of-life conversations with patients, especially when religion plays a role in the patient’s decision-making.
In the United States, where 78 percent say religion is important to their lives, it will inevitably emerge in health care. A study found 41 percent of patients thought of a time when religion influenced one of their health care decisions. Its impact might be patients needing a kosher, halal or vegetarian hospital meal or requests to coordinate medical procedures around prayer times.
The most profound intersection may be in end-of-life care. Religion can influence the procedures patients want to receive, or reject, such as starting artificial respiration or removing this support once it is in place. Religious beliefs may affect patients’ beliefs about the afterlife and help frame their illness in a context that medical professionals need to understand.
Yet health care providers are often ill-equipped to discuss religion when it does come up, with one study finding that one in five medical residents reported being unprepared to care for patients whose religious beliefs affected their treatment. This discomfort means that important conversations about how religion affects patients’ end-of-life decisions simply never happen.
Medical students, residents, nurses and nurses’ aides need training that goes beyond a one-off course in cultural competence. They need expertise in taking a spiritual history as a routine part of taking a patient’s history.
Even when patients don’t know right away what their care might entail or how religion may be relevant for them, asking these initial questions can open the door to further conversations and make the patient more comfortable voicing their beliefs if and when they become relevant. The result can lead to better care every day, and certainly as life draws to a close.
Clinicians need to learn to recognize signs of spiritual distress so they can refer patients to pastoral care for spiritual support and guidance. These should be skill sets that we expect from our providers and that they are trained to execute.
Today, more and more organizations and communities, including religious communities are promoting open, honest and proactive conversations around end-of-life preferences.
As that trend continues, it is important to ensure that health care providers need know to ask about a dimension of many people’s lives that influences their choices, and then incorporate their patients’ religious beliefs and practices into a plan for care.
As we were sitting in our hospice team meeting yesterday, someone shared a story about how a Santa Claus brought comfort to a dying boy and how the boy died in his arms. See our hospice blog for the video and article.
Being a caregiver is often one of the most taxing and emotionally draining tasks someone can take upon him/herself. I have been witness time and again to the burnout that occurs to the best of people, to people who’s hearts are in the right place but eventually wear down because of the details needing attending to. I came across a list of 5 ways to practice mindfulness as a caregiver which can combat feelings of being overwhelmed.
Here are five ways you can bring mindfulness into your caregiving.Photograph by Corey Kohn
By Nell Lake
Many of us find ourselves caring for loved ones braving old age, decline, and dying. Caregiving is demanding—at times overwhelming. Yet it can also cultivate intimacy, wisdom, and insight. For my book, The Caregivers: A Support Group’s Stories of Slow Loss, Courage, and Love, I chronicled the experiences of the members of a caregivers support group for more than a year. Here are some things I learned about mindful caregiving:
1. Be where you are
It’s a central principle of mindfulness: trying to do one thing at a time, and knowing that you’re doing it, and doing it with kindness toward yourself.
Caregiving often requires responding to seemingly countless needs, appointments, tasks. Studies show caregivers face higher rates of stress and illness than non-caregivers. If you’re feeling overwhelmed, lonely, frequently angry and irritable or guilty, and/or crying a lot, you’re likely at risk of burnout. Some suggestions for easing your stress:
• speak with your doctor. He or she should be able to help you find resources that help.
• call your local senior center to ask about sources of support such as senior day care and/or respite programs and support groups.
• make a list of activities that nourish you, and try to build one or more of these into your days: journaling, say, or taking walks outside, calling a supportive friend, taking some time to do yoga, meditating—whatever helps you come back to yourself and the moment you’re in.
It’s so easy to adopt the habit of mind that another person’s needs matter more than yours, but one of the most important things you can do to prevent burnout over the long haul is to value your own well-being.
2. Be gently aware of loss and change
Much caregiving is for people with dementia or other long-term chronic illness. Your family member is changing, going through decline—very slowly. Your mother might be losing her ability to communicate; your father’s personality might be changing. It can feel as if your family member is “gone but not gone.” Caregivers often experience long-term uncertainty—and this can be very stressful.
It helps to be aware of slow loss and its particular challenges—and to give yourself permission to feel grief and the other feelings that arise along the way. Letting the feelings simply exist, seeing that they change, can help you gain more clarity, control, and a sense of space.
Mindful awareness doesn’t mean ruminating on loss in a negative way. Thoughts such as “this shouldn’t be this way; this isn’t my mother!” will mostly feed stress. Yet taking time to see the stressful thoughts and storylines that form in your mind can help you not get completely caught up or identify with them. You may even find more acceptance of what’s happening—to see it as natural, a part of life, rather than an aberration.
3. Meet your family member where he or she is
Try to accept the effects of your family member’s aging and illness, the way their mind and body work at this point in their lives. With people with dementia in particular, it’s really helpful to try to create good feelings in as many moments as possible. Studies show that, even for someone who doesn’t remember something you said five minutes before, good feelings last for quite a while. A person with dementia might have a good laugh or hear a song they love or watch a wonderful scene from a movie—and hours later they’ll still be feeling the effects of these. Arguing with their perceptions—saying, “it’s Tuesday, not Thursday” or “you already said that six times today”—is not just futile; it creates stress for both of you.
“Meeting them where they are” is a good principle no matter your family member’s particular illness or impairment. Maybe he or she can’t walk up the stairs anymore and feels cranky about losing mobility. If you can let go of the story “this shouldn’t be this way,” you’ll likely save yourself a lot of suffering. Instead of all this happening to you, it just is. It happens to everybody.
4. Seek out support. Ask for help. Share your story.
Caregiving is isolating; it usually happens in private homes, behind closed doors. Yet connection is vital to us as human beings. The support-group meetings I followed gave the caregivers a chance to connect with others who understood. The members felt trust with one another and usually said whatever they needed to—even shared thoughts and feelings that they didn’t share with others outside the group. Mutual support helped them to be resilient in the midst of their challenges.
Meanwhile they gave one another very little advice. Probably no one likes unsolicited advice, but to caregivers, being told how to handle unique, personal, and challenging situations can be particularly frustrating. The group understood this, and mostly just told stories and listened. They did, however, learn practical things through their listening: They heard about ways others had solved problems, and about available resources. A person caring for someone in the early stages of a disease often learned by listening to another person caring for someone in later stages.
I saw enormous value in the group that I followed, and think a good group can be a profound source of support. But support groups are not for everyone, of course, nor do I think all groups are equal. You may join one, decide it’s not helpful at all, and go looking for a different one. You may find other ways to receive connection and support. This is the central point: to recognize when you need support and seek it out.
5. Be kind but don’t try to be a saint
One of the caregivers I followed, Penny, was upset one evening. She’d brought home two cannoli to share with her mother—a rare treat in their household. Before Penny had had a chance to offer them, her mother had found them and scarfed them both down. Penny discovered this and felt like yelling. Instead she went into another room and wrote “wrathful emails” to her sister. She vented, in other words, which helped. A few days later, she laughed about the incident in her support group.
Being kind doesn’t always mean feeling kind. It does mean doing the right thing in a particular moment. Of course, trying to feel compassion, having that as an intention, is good—but of course one isn’t going to feel compassion in every moment.
Again, it’s important to direct kindness inward. There’s a teaching: when you’re being generous, know that you’re being generous. When you have good qualities of mind, being aware of them can help to further cultivate them. In your caregiving, acknowledge that you’re being caring. You’re helping someone. Even when caregiving feels hard, it can be sustaining to recognize your generosity. You’re helping someone to have a good end to her or his life.
Nell Lake is the author of The Caregivers: A Support Group’s Stories of Slow Loss, Courage, and Love, published by Scribner and released in paperback this Spring. Names in both the book and in this blog are pseudonyms.
This article also appeared in the February 2015 issue of Mindful magazine.