I am sharing with you links to two open access issues of the online chaplaincy journal Plainviews that focus on Hospice Chaplaincy.
I hope these articles will offer people some insight into the world of spiritual care within a hospice setting.
I am sharing with you links to two open access issues of the online chaplaincy journal Plainviews that focus on Hospice Chaplaincy.
I hope these articles will offer people some insight into the world of spiritual care within a hospice setting.
The following is very valuable advice to all who are impacted by death from a professional standpoint. While spiritual traditions discuss the need to contemplate one’s death, I think that those who are around death and dying on a constant basis could well heed some of the thoughts in the below piece. I know that those who train in chaplaincy specifically focus on awareness of one’s own death, but perhaps this is something that needs greater stress in all aspects of care for the dying.
Posted: 01/29/2013 3:57 pm
Rabbi, Temple Sinai, Sharon, Mass.; Author, ‘Facing Illness, Finding God: How Judaism Can Help You and Caregivers Cope When Body or Spirit Fails
“Have you ever been in a room with someone who has died?” I asked. “I mean, have you ever been with someone’s body?”
The minister, who was significantly older than I was at the time, shook his head.
“Then maybe before the family gets here, you ought to go in and be with her yourself, just so you can get through your own reaction. You might be more helpful to the family that way.”
I was working as a chaplain at a hospital in Cincinnati. It was Christmas. I was in rabbinical school, and each year I would volunteer to take that particular overnight shift so the Christian clergy could be home for their holiday.
This time, however, a woman died on Christmas Eve. Her pastor had come to the hospital to be with the family and say goodbye to his parishioner. But as I feared, he usually dealt with bodies that were cremated or embalmed and dressed up. He hadn’t been around the newly dead, especially someone he knew.
He went into the room. When he came back out, he was a bit shaken, but I could see he was OK. The family arrived, and he put his arms around them.
I realize talking about bodies may seem morbid and bizarre, but clergy often have a strange relationship with death. We are around it frequently. Like funeral home directors, doctors, and nurses, we see people for who they are in all their mortality. It inculcates a feeling of humility and awe. And yes, it is still unnerving.
As a rabbi, I have buried many people. I have buried old people, young people and — thankfully very rarely — children. I was once even part of a small Michigan town’s Jewish burial society called a Hevra Kadisha, where I washed a congregant and dressed him in shrouds. In Judaism, bodies are not traditionally cremated or embalmed. The body is left in its natural state and buried in an all-wood coffin so there will be no barrier to returning to the earth.
One day that will be me, I sometimes think.
Some of the most interesting people I have met are dead. I sit with families, listen to stories, usually with both laughter and tears, and am tasked with writing eulogies. The tales are fascinating. There is often sadness and anger, especially if the death was tragic, but there is usually also gratitude. Being close to death can also be strangely energizing. It makes you not want to waste time.
If I am fortunate enough to be with someone as he or she approaches death, I offer a prayer called the Sh’ma. In Judaism, people strive to say this central sentence of our faith: “Hear Israel, the Eternal is our God, the Eternal is One” (Deuteronomy 6:5). If they cannot say it, I often say it for them with the family. While Judaism has no one theology of what happens to us after we die, monotheism ultimately affirms the unity of all. We are born from infinity, live our unique journeys, and return to infinity. We rejoin the Oneness, which we never really left.
I remember very specifically the moment I made peace with death. I am embarrassed to say I don’t remember the man’s name. There have been just too many funerals since then.
Again, it happened during rabbinical school. I was called out of the fourth grade Hebrew class I was teaching by a professor of mine at Hebrew Union College and told to go visit a man in the hospital who was dying. This was a man whose end was long, painful and unjust. He was a war veteran and deserved better. My teacher asked me to go and say the Sh’ma with him and his family in a final act of faith before he died, despite all he had been through.
Near panic, I climbed into my car. Who was I to stand by this person’s bedside? Why was my teacher picking on me?
I drove to the hospital, and I was shocked that they let me in and led me right to the man’s room even though I did not feel I belonged there at all. His family was not there. I stood by this man’s bedside, I took his hand, I stroked his knuckles with my thumb, I recited the Sh’ma prayer, and I told him everything would be OK. I do not know what made me say that last part, but I did.
Ever since that night, I have had to believe that whatever room I find myself in, God is in that room with me, and we are all part of God’s Oneness. I cannot prove it. I cannot explain it. I just believe it to be true.
Death is disconcerting, upsetting, humbling and invigorating. It is as natural as it is inevitable. And it can be liberating to name our fears and say, “One day that will be me.”
That goes for you, too.
bereavement, chaplaincy, grief, grief and bereavement, grief and mourning, grief and recovery, grief and the holidays, haggadah, Jewish holidays, Passover, pastoral care, religion, spiritual care, spirituality, yizkor
The following is a very moving sermon I came across in researching online for a talk on grief during the holidays. The sermon was written for Yizkor on the Eighth Day of Passover and it relates the four sons found in the Haggadah to the process of grief.
PAS Home · The Four Children…of Grief and Recovery
April 06, 2010
Rabbi Elliot J. Cosgrove
Passover 5770, Eighth Day
In every generation, at every Passover seder, we return to the iconic passage of the four children. Four children: wise, wicked, simple, and the one who does not know how to ask. In every reading, we know that these children represent far more than first appears, and have been interpreted differently throughout the ages. Some interpretations draw on educational theory – that the four represent four Jewish approaches to learning: a posture of submission (the wise child), of criticism (the wicked), simplicity, and ignorance. Rabbi Yoseph Schneerson once explained that the four children represent four generations of the American experience: the wise child with roots in the European shtetl; the wicked child brought up in the American melting pot – cynical to his parents’ generation; the next generation, confused by his grandfather’s reverence and father’s irreverence, and then the fourth generation who, as a consequence of his mixed-up pedigree, has woken up not even able to formulate a question. Israeli Haggadot have similarly adopted the template of the four children with respect to attitudes towards the Zionist dream; women’s Haggadot have used the iconography of these children to portray the changing face of feminism. A simple passage, but not so simple – one that continues to resonate to different effect year in and year out.
This morning, as we arrive at Yizkor, reflecting on the absence of our loved ones and the storehouse of memories that we are about to open, I want to draw on the image of the four children one last time during this festival. Not as a meditation on assimilation or feminism, but on the process of loss and recovery, how a person receives the blow of the death of a loved one, and then journeys forward. I want to share with you a modern midrash if you will, as to how the four children represent the manner by which we may reconstitute our own lives in the face of grief, as we walk through our own valleys in the shadow of death.
We work backwards from the fourth child, the one who cannot speak. When death occurs, this is the first step. The punch to the stomach, the gasp for air, the realization that our father, our child, our brother or sister or life partner has died. There is a numbness. As in Edvard Munch’s famous painting “The Scream,” we open up our mouths, but nothing comes out. At the moment when Aaron received the news of the death of his sons, he did not cry, yell, or scream, he was silent: Vayidom Aharon. The tradition notes the similarity between Vayidom and the Hebrew word for blood, dam, explaining that upon hearing of their death, it was as if the blood was drawn from him. He was cut loose from his moorings, hit by a tidal wave of despair. So many questions. Why? How could such a thing come to pass? Why not me? According to Jewish law, you do not become a mourner, an avel, until after burial, only then do you say kaddish. The period from the news of death until burial is called aninut. Catapulted into death, you cannot be consoled, grief is inexpressible – comfort or healing is altogether premature. This is the one who cannot speak. This is the bottom rung from which we must climb.
And climb we do, because however painful, whether death happens suddenly or after prolonged illness, all of us know, on some level, that we are mortal. Even as we rend our garments, feeling that which is dearest to us being torn away, we know that there is a simple truth, the third child, embedded somewhere in our collective consciousness. From dust we come and to dust we go. Everyone has a limited number of years on this earth. We realize that we are not the first to have lost a parent. There is another who has felt this pain – mourning after all is one of the very few experiences shared by all of humanity. So we allow for a hug, we allow for a kind word, we are brittle, but we are willing to let ourselves be touched by our family, by our community, for in that contact comes the restorative reminder that we are still alive. It is actually Jewish law that when you return from the cemetery you must eat a meal. Why? Because it reminds us that we are still alive. We are not yet ready to move on, we hurt, but we must recognize that it is not we who have died. Our questions are simple, fumbling inklings that we are aware of our world. Mah zot? What is this? What is this world that we have woken up to – as a widow, as an orphan? There are questions to which we know we will never receive full answers, but at least here and now, in this stage, we are able to find our voice, to shed tears, tears that may just plant the seeds for fruit to be reaped another day.
As anyone who has grieved will tell you, however, just as there are steps forward, there are steps backward. As Elizabeth Kübler Ross explained in her book On Death and Dying, there will be a time for anger, resentment, and depression. The second child comes in all forms, but it all reflects the same impulse – a refusal to accept this narrative as your own. This is not the story as it should have happened; it wasn’t supposed to be this way. We say: “The physicians didn’t do enough. Maybe I didn’t do enough. The rabbi wasn’t there when I needed him. My loved one didn’t hold on long enough. Where are my friends now? Where did everyone go after shiva ended? How dare people plan their future when I can’t see the next day? The resentment of the second child is not good or bad, wicked or otherwise, it is just resentment, pure and simple. We are frustrated, we are alone, we are in pain, we are alienated from everyone who doesn’t know our hurt and we are angry. As the poet wrote: “We read the world wrong and say that it deceives us.” (Tagore, Stray Birds, LXXV) We are the second child.
The stage of the second child may last for a long time or for a little. Our constitutions are inherently different, loss follows no set recipe. Each of us proceeds at his or her own pace. But we know, here on Yizkor, that we aspire to be the wise first child, with the possibility of acceptance, the child of hope. Haham, “wise” is a carefully chosen word. Nothing is whitewashed, our grief remains, but somewhere along the way we have chosen to leverage our loss towards understanding and growth, towards asking the questions that we couldn’t ask upon the news of death, that can’t be asked simply, that we rejected in our anger. Now we know that we must learn to reflect on legacy, to think back and consider how the values, qualities, and high ideals of our loved ones transcend death and how they inform our lives. We wonder how we are shaped by them, as an extension of and reaction to the generations that came before. It is not for any of us to change the past; our relationships with our loved ones had their strengths and weaknesses. But we the living have been entrusted and empowered to craft and draft our own narratives of memory, to tell the story to ourselves and to those around us – after all, it is Passover. The wise child knows that given the fragility of life, the acute awareness of our mortality wrought by the loss of those we love, we here in this room must live lives worthy of remembrance. The stage of wisdom is hopefully not so much any one stage or destination, but rather a philosophy of existence reflecting resignation and acceptance, anchors of memory and breezes of hope all mixed together.
Anyone who has studied the Haggadah knows that ultimately, the most important thing to say about the four children is not about one or the other, but about the four of them together. They are not necessarily discrete individuals; rather they are four aspects of all of our beings. Each one of us has elements of the four. The point, we know, is that no matter how wise, how wicked, how simple, or how introverted, each one has a place at the table, and they are all seated at the seder.
It would seem that what is true for the seder table, is true for this moment of Yizkor. We who are gathered here recognize the continuum of grief. On any given day we may find ourselves to be at one stage or another. But when we say Yizkor, every emotion is present and accounted for. We are at a loss being reminded of the death of our loved one; we grieve in the context of a community, finding comfort in the knowledge that we are not alone; we resent, as is our right, our losses; and we are not afraid to bring that emotion into this sanctuary. We also seek wisdom – to draw from the well of memory in hope that it provides sustenance for the years ahead.
One final thought – perhaps unexpected but also a bit inevitable. Maybe, just maybe, the point of the four children is not the children themselves, their qualities, and what they represent. Maybe the point is the one thing, or better yet, the one person, that all of them have in common – the parent who greets them all at the seder table. I have often thought that the real lesson of this passage is to reflect on the role of the parent, that divine personality, who created a seder table capable of seating everyone, responding to everyone, no matter who they are and what burdens they bear. So, too, for our service of Yizkor. We sit at this seder of Yizkor with our Father in Heaven, avinu sheh-ba-shamayim, at its head. None of us are the same, nor need be. Though joined by loss, each of us exists somewhere different on this path of grief and recovery. The promise of Yizkor is the promise of the seder; no matter who we are, there is a place for us waiting, a makom with our name on it – barukh ha-makom – a blessed God of nehama. Hamakom yenahem etkhem. The table is set, the moment of Yizkor has arrived.
The following story really touched me, both personally and professionally. When we enter the holidays, we can’t help but remember all those who have died in our lives and how much they are missing from our celebration.
Nobody expected my grandfather to show up at my apartment for Passover—two months after he diedBy Rebecca Klempner|March 18, 2013 12:00 AM
The first Passover after my grandfather died, my family knew that our grandmother would need us all to be together for the holiday, but we also knew she wouldn’t be able to host everyone. So Grandma, Mommy, and my 7-year-old brother squeezed into the two-bedroom apartment in Los Angeles where I lived with my husband, whom I’d married just one year earlier. My sister, who lived nearby, came over for the Seder and other meals throughout the holiday, and several other friends joined us as well. It was crowded but festive, like the crush at a happening party.
And then, on the sixth night of Passover, we got an unexpected visitor.
After kissing my mother and grandmother goodnight, I headed to the bedroom I shared with my husband, carefully stepping over my brother’s open suitcase and circumnavigating the sharp corner of the sleeper-sofa. My husband already lay in bed, curled on his side, breathing deeply. I lay down beside him with a book, drifting off after reading just a page or two.
As I slept, my grandfather, dressed entirely in white, entered my bedroom. He glowed with peace and holiness. Eyes twinkling, he beamed his usual vivacious smile. The vigor he’d possessed during my childhood had returned.
Grandpa’s presence was palpable, as if I could reach out and touch him, and—strangely—the sensation lingered even after I awoke with a start. Electricity charged the atmosphere in my room. Enthralled, I felt Grandpa’s benevolent but alarming manifestation emanating from a specific corner of the room.
Certainly, I would not be going back to sleep.
I crept from the room to go get a drink of water. When I entered the living room, I discovered Mommy sitting at the foot of the sleeper-sofa where Grandma was lying, speaking animatedly. She kept her voice was low to avoid waking my brother, still sleeping nearby. Grandma, who appeared agitated, listened intently.
“What are you doing awake?” I whispered.
“I had a dream,” my mother told me. “Of Grandpa. He came to comfort us.”
“And I had one, too,” Grandma added.
I flopped down into a chair. “Whoa.”
My mother turned to me, her eyebrow arched. “What’s wrong, honey?”
Before I had a chance to explain, my husband emerged from our bedroom. “I dreamed that Grandpa came to visit,” I said. “And it feels like he’s still in there.”
“In where?” my mother asked. I gestured over my husband’s shoulder into our bedroom.
“In that corner?” he asked, pointing to a specific area of our bedroom.
“How—how did you know?” I stuttered.
“I just felt something, something there,” he said.
The blood draining from my face, I nodded silently. Mommy and Grandma rushed over. But as everyone approached, the presence dissipated.
Grandpa had been more than a grandfather to me. He had acted as a substitute father after my parents divorced when I was 5 years old.
In my eyes, he’d been tougher than Muhammad Ali. He regularly lifted my sister and me high into the air when we were little, one in each arm. Every summer, Grandpa schlepped my sister and me from our home in Columbia, Md., to the beach in Ocean City and bought us frosty Popsicles on hot days. When Lee’s Ice Cream in Baltimore introduced cookies-and-cream ice cream, Grandpa mixed his own version for us at home with kosher Hydrox cookies instead of treyf Oreos. Grandpa fried crispy latkes at school with me at Hannukah and celebrated all my triumphs, large and small, with his booming voice and contagious grin.
When my sister and I grew up and left for college, Grandpa wrote us long letters in an almost indecipherable scrawl. He battled cancer during my first year at college, but triumphed. When we returned home, he pulled us close and said, “Are you still growing? So tall! So beautiful!”
Life was unpredictable, but Grandpa’s love never was.
On a Shabbat evening the February before he died, I had worried about Grandpa. The doctors had concluded that they could no longer fend off his cancer, which returned from remission shortly after my wedding. A hospital visit in January had left us with little hope—Grandpa, who’d once been so strong, had withered to a specter of his former self. My husband had held one of Grandpa’s hands while I had held the other. It had become unimaginably soft, his calluses faded from months lying in bed. Like the hand of newborn.
Now Grandpa had returned home, awaiting the inevitable.
In a dream that Friday night, I entered a wedding hall draped in white tulle and festooned with flowers. A groom approached the chuppah, the Jewish wedding canopy. Grandpa sat across the aisle from me. We stood as the bride entered, radiating joy and light. Just as my eye caught Grandpa’s, I awoke and sat up.
Grandpa had told me as a child, “My mother believed that if you dream of a birth or a wedding, it foretells death.” Shaken, I noticed the time—a few minutes past midnight. I knew with great certainty that my grandfather had passed to the next world.
In the morning, I quietly confided my dream to my husband. Not wanting to dampen the joy of the Sabbath, I said no more about my secret knowledge, but I walked around all day with a lead weight on my heart.
Our phone rang immediately after havdalah, the service that marks the end of Shabbat. Grandpa had died at home, surrounded by his wife and children, a few minutes past midnight.
As Passover approached just a couple months later, I wondered what the holiday would be like. Grandpa’s Seders had always opened a door to a magical reality, completely distinct from the quotidian world I inhabited the rest of the year.
We had always read the service all the way through from my grandparents’ art deco Union Haggadahs. With a booming voice, Grandpa had told the story of the slaves in Egypt as though it were his own personal drama. My young mind never once questioned the miracles of the Exodus—their reality had been handed down to me by my grandfather, who’d received it from his, and so on for more than 3,000 years.
Year after year, Grandpa had hidden the afikomen, undetected. His sleight of hand was worthy of Doug Henning. By the time the gefilte fish arrived on its china plate, Grandpa would have me on the edge of my seat, wondering where he’d hidden the matzoh.
In our youth, my sister and I balked when we were sent to the front door late in the Seder to invite in Elijah the Prophet. To us, Elijah the Prophet could be no one but the Boogey Man. After all, hadn’t Grandpa told us that the Boogey Man lingered by the front door at night?
As a child, I was greatly relieved when Elijah would fail to appear. Now, as an adult, I grieve.
Twelve years have passed since Grandpa died. My husband and I still live in the same tiny apartment, now (thank G-d) crammed with kids. When I begin to prepare for Passover, I inevitably think of my grandfather, who never met my children and would have taken such pleasure in them. Nevertheless, my husband and I try to make our Seders as magical as possible for them. I don’t think we have quite the same flair as Grandpa, but the kids look forward to Passover with as much anticipation as I did.
I don’t expect Grandpa to visit us again this year. When he appeared to us that first Passover, he knew we needed him. Today, we still miss him. We still wish he were here. But we no longer need reassurances of his unconditional love. His one final visit gave that to us.
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Rebecca Klempner is a wife, mother, and writer in Los Angeles.
Here is an article I wrote about Purim.
Giving to Others is Our Freedom
By Rabbi Bryan Kinzbrunner
Purim commemorates the Jewish survival from genocidal decree in the Persian Empire during the 6th Century BCE. The celebration of Purim today entails the fulfillment of three Mitzvot, which means religious obligation or commandments. On the night and day of Purim, Jews around the world read the book of Esther as a remembrance of the miracle of survival. Additionally, Jews observe Purim through giving gifts of food to each other, as well as to the poor. Both of these commandments are alluded to in chapter nine of The Book of Esther.
The act of gift giving in of itself is a symbol of freedom for the Jewish people. The giving of gifts can only be performed if one has a feeling of ownership for the item being given. A person enslaved or living under strict rule lacks the sense of ownership that comes from being a free individual. Freedom’s core is best expressed through the words of Emma Lazarus, engraved on the Statue of Liberty in New York Harbor which says:
“Give me your tired, your poor, your huddled masses yearning to breathe free.”
Some of the freedom we experience today comes from the ability to provide for the needs of others.
When people are in the midst of enduring tremendous suffering such as during and after Hurricane Sandy, human nature is such that often herculean efforts are made to continue to provide for and help those in this type of devastating situation. It has been shown many times over that many people manifest increased selfless behavior during times such as these which are perceived as excessively stressful and overwhelming. When the Purim story describes the celebration including the giving of gifts to friends and to the poor, it is describing the greater sense of altruism associated with these more difficult times. The commandment is a reminder not to rest in comfort, but to recognize that comfort comes with a responsibility. Therefore, the question that begs to be answered is this. If one who suffers and is traumatized can give when they don’t have much in emotional stock remaining to contribute, how much more should we, who are not in the midst of collective anguish, be able to provide to those who desperately need it?
As we celebrate Purim’s message of giving this year, my hope is for every person to take the time to recognize the tremendous responsibility all of us have to use the resources we possess individually in support of each other both in good and bad times. Chag Purim Sameach!
Rabbi Bryan Kinzbrunner is the Chaplain for The Oscar and Ella Wilf Campus for Senior Living in Somerset, NJ. You can contact Rabbi Bryan Kinzbrunner at 732-227-1212 or email@example.com. For more information on The Wilf Campus visit us at http://www.wilfcampus.org or call us at 732-568-1155.
Caregiver stress is one of the primary challenges faced in supporting someone ill. It can be difficult to always be even-keeled when taking care of someone else. The following interview discusses one approach to finding a balance with the stress that is inevitable.
Taking a Zen Approach to Caregiving
By JUDITH GRAHAM
Nathaniel Brooks for The New York Times
You try to help your elderly father. Irritated and defensive, he snaps at you instead of going along with your suggestion. And you think “this is so unfair” and feel a rising tide of anger.
How to handle situations like this, which arise often and create so much angst for caregivers?
Jennifer Block finds the answer in what she calls “contemplative caregiving” — the application of Buddhist principles to caregiving and the subject of a year-long course that starts at the San Francisco Zen Center in a few weeks.
This approach aims to cultivate compassion, both for older people and the people they depend on, said Ms. Block, 49, a Buddhist chaplain and the course’s lead instructor. She’s also the former director of education at the Zen Hospice project in San Francisco and founder of the Beyond Measure School for Contemplative Care, which is helping develop a new, Zen-inspired senior living community in the area.
I caught up with Ms. Block recently, and what follows is an edited transcript of our conversation.
Let’s start with your experience. Have you been a caregiver?
My experience in caregiving is as a professional providing spiritual care to individuals and families when they are facing and coping with aging and sickness and loss and dying, particularly in hospital and hospice settings.
What kinds of challenges have you witnessed?
People are for the most part unprepared for caregiving. They’re either untrained or unable to trust their own instincts. They lack confidence as well as knowledge. By confidence, I mean understanding and accepting that we don’t know all the answers – what to do, how to fix things.
This past weekend, I was on the phone with a woman who’d brought her mom to live near her in assisted living. The mom had been to the hospital the day before. My conversation with the daughter was about helping her see the truth that her mother needed more care and that was going to change the daughter’s responsibilities and her life. And also, her mother was frail, elderly, and coming nearer to death.
That’s hard, isn’t it?
Yes, because we live in a death-denying society. Also, we live in a fast-paced, demanding world that says don’t sit still — do something. But people receiving care often need most of all for us to spend time with them. When we do that, their mortality and our grief and our helplessness becomes closer to us and more apparent.
How can contemplative caregiving help?
We teach people to cultivate a relationship with aging, sickness and dying. To turn toward it rather than turning away, and to pay close attention. Most people don’t want to do this.
A person needs training to face what is difficult in oneself and in others. There are spiritual muscles we need to develop, just like we develop physical muscles in a gym. Also, the mind needs to be trained to be responsive instead of reactive.
What does that mean?
Here’s an example. Let’s say you’re trying to help your mother, and she says something off-putting to you like “you’ve always been terrible at keeping house. It’s no wonder you lost my pajamas.”
The first thing is to notice your experience. To become aware of that feeling, almost like being slapped emotionally. To notice your chest tightening.
Then I tell people to take a deep breath. And say something to themselves like “soften” to address that tightness. That’s how you can stay facing something uncomfortable rather than turning away.
If I were in this position, I might say something to myself like “hello unhappiness” or “hello suffering” or “hello aging” to tether myself.
The second step would be curiosity about that experience. Like, wow, where do I feel that anger that rose up in me, or that fear? Oh, it’s in my chest. I’m going to feel that, stay with it, investigate it.
Why is that important?
Because as we investigate something we come to understand it. And, paradoxically, when we pay attention to pain it changes. It softens. It moves. It lessens. It deepens. And we get to know it and learn not to be afraid of it or change it or fix it but just come alongside of it.
Over hours, days, months, years, the mind and heart come to know pain. And the response to pain is compassion — the wish for the alleviation of pain.
Let’s go back to what mother said about your housekeeping and the pajamas. Maybe you leave the room for five minutes so you can pay attention to your reaction and remember your training. Then, you can go back in and have a response rather than a reaction. Maybe something like “Mom, I think you’re right. I may not be the world’s best housekeeper. I’m sorry I lost your pajamas. It seems like you’re having a pretty strong response to that, and I’d like to know why it matters so much to you. What’s happening with you today?”
Are other skills important?
Another skill is to become aware of how much we receive as well as give in caregiving. Caregiving can be really gratifying. It’s an expression of our values and identity: the way we want the world to be. So, I try to teach people how this role benefits them. Such as learning what it’s like to be old. Or having a close, intimate relationship with an older parent for the first time in decades. It isn’t necessarily pleasant or easy. But the alternative is missing someone’s final chapter, and that can be a real loss.
What will you do in your course?
We’ll teach the principles of contemplative care and discuss them. We’ll have homework, such as ‘Bring me three examples of someone you were caring for who was caring toward you in return.’ That’s one way of practicing attention. And people will train in meditation.
We’ll also explore our own relationship to aging, sickness, dying and loss. We’ll tell our stories: this is the situation I was in, this is where I felt myself shut down, this was the edge of my comfort or knowledge. And we’ll teach principles from Buddhism. Equanimity. Compassion. Deep inner connectedness.
What can people do on their own?
Mindfulness training is offered in almost every city. That’s one of the core components of this approach.
I think every caregiver needs to have their own caregiver — a therapist or a colleague or a friend, someone who is there for them and with whom they can unburden themselves. I think of caregiving as drawing water from a well. We need to make sure that we have whatever nurtures us, whatever supplies that well. And often, that’s connecting with others.
Are other groups doing this kind of work?
In New York City, the New York Zen Center for Contemplative Care educates the public and professionals about contemplative care. And in New Mexico, the Upaya Zen Center does similar work, much of it centered around death and dying.
People who want to read about this might want to look at a new book of essays, “The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work” (Wisdom Publications, 2012).
In an interesting set of studies, we see how religious tension could be eased through finding commonality. I would suggest that commonality’s value can be overemphasized at times, and lead to a loss of the uniqueness of facing crisis.
Main Category: Psychology / Psychiatry
Article Date: 09 Jan 2013 – 0:00 PST
Understanding how thoughts of mortality influence individuals’ beliefs sheds light on the commonalities among different groups’ motivations and could help ease tensions between opposing viewpoints, according to University of Missouri experiments that tested the relationship between awareness of death and belief in a higher power. The study found that thoughts of death increased atheists, Christians, Muslims and agnostics conviction in their own world views. For example, contrary to the wartime aphorism that there are no atheists in foxholes, thoughts of death did not cause atheists to express belief in a deity.
“Our study suggests that atheists’ and religious believers’ world views have the same practical goal,” said Kenneth Vail, lead author and doctoral student in psychological science in MU’s College of Arts and Science. “Both groups seek a coherent world view to manage the fear of death and link themselves to a greater and immortal entity, such as a supreme being, scientific progress or a nation. If people were more aware of this psychological similarity, perhaps there might be more understanding and less conflict among groups with different beliefs.”
His research suggests that morbid imagery, such as news headlines or caricatures of enemies in war propaganda, can reinforce nationalistic and/or religious ideals by keeping death on the mind and subconsciously encouraging denial of opposing ideologies. This research suggests that religious symbols and stories involving death, such as the crucifix, function psychologically to remind the faithful of mortality and subconsciously reinforce one particular world view to the exclusion of others.
For the study, Vail and his colleagues conducted a series of three experiments by first encouraging thoughts of death in study participants and analyzing their responses to a questionnaire. The first experiment examined Christians and atheists in the United States. The results suggested awareness of death in Christians increased their belief in God and denial of other traditions. Atheists also continued to adhere to their world views, although no increase in denial of other philosophies was observable because atheists by definition started with no belief in any religious traditions.
The second experiment, conducted in Iran, found that Muslims reacted similarly to Christians when they were thinking about their own mortality. A third trial observed agnostics and found that thoughts of death tended to increase their belief in a higher power. However, unlike Christians and Muslims, they did not increase their denial of Buddha, God, Jesus or Allah. Instead agnostics increased acceptance of all of those world views.
“In our study, individuals’ minds appeared to rally around certain personal guiding concepts when faced with fear of death,” said Vail. “Agnostics seemed to hedge their spiritual bets. They believed more firmly in a higher power. Yet at the same time, they expressed continued belief that the specific nature of that power was beyond human knowledge.”
british journal of psychiatry, chaplaincy, mental health issues, mental-health, neurotic disorder, pastoral care, religion, religion and spirituality, SBNR, spiritual, spiritual but not religious, spiritual care, spirituality, university college london
The following piece is very interesting food for thought. Is it possible that being spiritual but not religious could increase the likelihood of mental disorder? We often hear people define themselves this way, but I wonder of some who claim to be spiritual but not religious assume that ritual and emotion are diametrically opposed and since they aren’t observing ritual, they are automatically not religious.
By Dan Merica, CNN
Washington (CNN) – Can being spiritual but not religious lead to mental health issues? The answer is yes, according to a recent study.
The study, published in the January edition of the British Journal of Psychiatry, says spiritual but not religious people, as opposed to people who are religious, agnostic or atheist, were more likely to develop a “mental disorder,” “be dependent on drugs” and “have abnormal eating attitudes,” like bulimia and anorexia.
“People who have spiritual beliefs outside of the context of any organized religion are more likely to suffer from these maladies,” said Michael King, a professor at University College London and the head researcher on the project.
Thirty percent of respondents who identified as spiritual said they had used drugs, a number that was nearly twice as much as the 16% of religious respondents who said they had used drugs, according to the study. Among the spiritual respondents, 5% said they were dependent on drugs, while 2% of religious respondents identified as dependent.
On mental health issues, the study said spiritual but not religious people were more likely to suffer from “any neurotic disorder,” “mixed anxiety/depressive disorders” or “depression” than their religious counterparts. Overall, 19% of spiritual respondents said they suffered from a neurotic disorder, while 15% of religious respondents responded the same way.
The practice of being spiritual but not religious is difficult to define and has a number of gray areas. The phrase is generally used to describe people who do not attend church, atheists who believe in some sort of higher power, free thinkers and the unaffiliated. It is also used for people who blend different faiths.
In short, King writes, “People who have a spiritual understanding of life in the absence of a religious framework are vulnerable to mental disorder.”
King, who said he has received a substantial amount of hate mail over the study, defended his findings, “If you take drug dependency, they are about 77% more likely than religious respondents, 24% more likely to having a generalized anxiety disorder. These are quite obvious differences.”
The study was conducted with the government of the United Kingdom, which asked the questions as part of a larger psychiatric study.
With a sample of 7,403 British people, the study found that nearly 19% of England’s population is spiritual but not religious. That number is higher in the United States, where, according to a 2002 Gallup Poll, in a sample of 729 adults, 33% of Americans identified themselves as “spiritual but not religious.”
Past academic studies in the United States have come to similar conclusions, said Tanya Luhrmann, a psychological anthropologist and the Watkins University professor at Stanford University. Most academic research about religion and well-being, said Luhrmann, has found that religion is good for you.
According to Luhrmann, organized religion provides three outlets that benefit churchgoers’ well being: social support, attachment to a loving God and the organized practice of prayer.
“When you become spiritual but not religious, you are losing the first two points and most spiritual but not religious people aren’t participating in the third,” Luhrmann said. “It is not just a generic belief in God that works; it is specific practices that work.”
People who identify themselves as spiritual but not religious push back against the notion that they have no community to fall back on or impetus to help the poor. In an interview with CNN in June 2010, BJ Gallagher, a Huffington Post blogger who writes about spirituality, compared spiritual but not religious people to people who complete 12-step programs to beat addiction.
“Twelve-step people have a brilliant spiritual community that avoids all the pitfalls of organized religion,” said Gallagher, author of “The Best Way Out is Always Through.” “Each recovering addict has a ‘God of our own understanding,’ and there are no priests or intermediaries between you and your God. It’s a spiritual community that works.”
Heather Cariou, a New York-based author, identifies as spiritual instead of religious. She told CNN last year that she adopted a spirituality that blends Buddhism, Judaism and other beliefs.
“I don’t need to define myself to any community by putting myself in a box labeled Baptist or Catholic or Muslim,” she said. “When I die, I believe all my accounting will be done to God, and that when I enter the eternal realm, I will not walk though a door with a label on it.”
Younger people identify as spiritual but not religious more frequently than their older counterparts. In a 2009 survey by the research firm LifeWay Christian Resources, 72% of millennials (18- to 29-year-olds) said they are “more spiritual than religious.”
The phrase is now so commonplace that it has spawned its own acronym (“I’m SBNR”) and website: SBNR.org.
Traditionally the words “religious” and “spiritual” were closely linked, but over time the latter word began to describe an experience disconnected from the traditional confines of religion, particularly organized religion.
A widely discussed survey of adult Americans by The Pew Forum on Religion and Public Life released in October found that the religiously unaffiliated both believe in God and define themselves as spiritual but not religious.
Sixty-eight percent of the religiously unaffiliated believe in God and 58% say they often feel a deep connection with nature and the Earth, in a spiritual way. Additionally, the study found 37% classify themselves as “spiritual” but not “religious” and 21% say they pray every day.
As expected, the practice of being spiritual but not religious has been roundly criticized by those who participate in organized religion. Jesuit priest James Martin told CNN in June that the phrase, “I’m spiritual but not religious,” can boil down to egotism.
“Being spiritual but not religious can lead to complacency and self-centeredness,” said Martin, an editor at America, a national Catholic magazine based in New York. “If it’s just you and God in your room, and a religious community makes no demands on you, why help the poor?”
– CNN’s John Blake and Richard Greene contributed to this report
While this is somewhat outside the purview of my usual blog posts, I can’t resist publishing the following list. Chief Rabbi Lord Jonathan Sacks was asked to list the 10 books he believes are essential for Jews to read. While I am not sure I agree with some of the specifics of the list, I am quite fascinated in his thinking. From my reading, it is clear he is trying to present Judaism as a lifestyle and not merely a religion built off of ritual. There is a history, theology, philosophy and spirit behind the laws and customs. In a sense, without those elements, there is no baseline for the Jewish people.
Dec 05 2012
To be a Jew is to read. To learn, to study, to exercise the mind in pursuit of God and truth, is the holiest act. The Talmud, in a passage that dazzlingly illustrates the world of the sages, tells of a certain Rav Hamnuna who was taking a long time over his prayers and was thus late for his class in Jewish law. His teacher Rava said, “Here is a man who sets aside eternal life and engages in mere mortal pursuits.” (Shabbat 10a). Compared to study, prayer was a mere this-worldly activity. Is there any other religion in which that could be said?
So the idea of a Jewish bookshelf is something of a contradiction in terms. There are bookshelves, “houses full of books” (a rabbinic phrase), libraries, “houses of study.” “Of the making of many books, there is no end,” said Kohelet. Jorge Luis Borges, director of Argentina’s National Library, once wrote a short story, The Library of Babylon, in which he imagined a library containing every possible book. That is a Jewish idea of paradise. In Judaism, not only does the world contain the Book: the Book contains the world. “God looked into the Torah and created the universe.”
But we have to start somewhere. If someone were to ask me which ten books to read to understand what Jews are and what we believe, this would be my recommendation:
(1) The book of Devarim, Deuteronomy
Whilst the whole of the Torah is to be treasured no other single book so summarises the whole of Jewish faith: law, narrative, theology, the first two paragraphs of the Shema, the Ten Commandments, a summation of Jewish history and a visionary glimpse of the Jewish future. The name Devarim (literally “words”) is deliberately ironic. At his first encounter with God, Moses had said, “I am not a man of words” (ish devarim). Here at the end of his life he becomes not just a, but the, man of words in a series of eloquent speeches unparalleled in their prescience. The entire book of Devarim is, in fact, a covenant in vastly extended form, in which the relationship between the people Israel and God is articulated and affirmed. God will be their sovereign; they are summoned to create an exemplary society built on compassion, justice and the dignity of all, especially the powerless and marginal. If you want to understand what Judaism is, this is where you begin.
(2) Sefer Tehillim, the book of Psalms
Tenakh, the Hebrew Bible, consists of three kinds of text, Torah, Neviim (Prophets) and Keutvim (“the Writings”). The simplest way of differentiating them is that the Torah is God’s word to man, Neviim is God’s word through man, and Ketuvim is man’s word to God. Of the last, the book of Psalms is supreme. It is the music of the Jewish soul in its conversation with God. It runs the entire musical range, from choral symphonies to chamber music, from praise to penitence, from public celebration to private, sometimes heart-rending, plea (“My God, my God, why have You forsaken me?”). There is no greater religious poetry than this.
(3) Pirkei Avot
All the great works of the sages – Mishnah, Gemarra, and Midrash – are essential reading. But Avot, AKA “The Ethics of the Fathers,” is unique as a sustained account of what it is to live the life of Torah. Avot is to the Oral Law what Proverbs is to Tenakh, a book of wisdom. But this is the distinctive wisdom of a group of people who traced their ancestry to the prophets and were real, if quiet, revolutionaries, turning Judaism from a religion of state, politics, Temple and priests into one of synagogue, school and house of study. Avot is the classic statement of the life of study and teaching.
(4) Rashi’s commentary to the Torah
Non-Jews almost never understand how Jews read the Torah: always in stereo, listening to the written text with one ear, the classic commentaries and super-commentaries with the other. Of these, none has been more loved than that of Rashi. He is always there when you need him, explaining why this word not that, what the connection is between one section and another, anticipating all the questions you are likely to ask. His answers are not always straightforward – his grandson Rashbam claimed to have gone further into the “plain sense” of the verse – but they faithfully reflect rabbinic tradition. Rashi may not be the last word in Torah commentary but he is the first. Indispensable.
(5) Judah Halevi, The Kuzari
Halevi (c. 1075-1141), the greatest Jewish poet of the Middle Ages, was also one of its finest thinkers. His philosophical masterpiece, The Kuzari, would read almost precisely like a riposte to Maimonides’ Guide for the Perplexed, were it not for the fact that it was written several decades earlier. Halevi stands at the opposite end of the spectrum to Maimonides, critical of the claims of reason to give an account of the human spirit, preferring “the God of Abraham” to “the God of Aristotle,” anticipating Buber’s distinction between I-Thou and I-It. Written as an imagined dialogue between the King of the Khazars (who converted to Judaism in the eighth century) and a rabbi, it is an engagingly readable statement of Jewish faith and a defence of Jewish particularity. It is available in several translations.
(6) Maimonides, Laws of Repentance
Maimonides was Judaism’s greatest philosopher, but his philosophical masterpiece, The Guide for the Perplexed, is deeply perplexing and deliberately obscure. His greatest single achievement was the Mishneh Torah, the most comprehensive, lucid and logically structured code of Jewish law ever written. Some parts of this are utterly unprecedented, and The Laws of Repentance is a fine example. Not only does it take you through the laws of repentance; it also guides you through its history, psychology and philosophy. You will encounter magnificent accounts of freewill, life after death, the messianic age, and what it is to serve God with love, all in ten short chapters of crystalline prose. No one else ever wrote halakhah like this.
(7) Sefer ha-Hinnukh
The classic work on the 613 commandments, written in the thirteenth century, author unknown, possibly R. Aharon ha-Levi of Barcelona. Judaism is the life of the commands which together constitute the choreography of life aligned with the will of God. The commands turn the prose of the everyday into religious poetry, and life into a work of religious art. This work, proceeding through the commands, their scope and logic, in the order in which they appear in the Torah, is one of the best introductions to biblical law.
(8) Elie Wiesel, Souls on Fire
No account of Judaism would be complete without some taste of the Hassidic movement that swept across Eastern Europe in the eighteenth century. Hassidism, a revivalist movement that emphasized simple piety, devotion in prayer, and serving God in joy, was one of the most creative phenomena in Diaspora Jewish history, and the figure of the Tzaddik or Rebbe, the charismatic leader of a sect was a genuinely new type. There are several collections of stories about these colourful figures, and Wiesel’s is probably the most accessible. Touching, humane and profound, they are an essential dimension of a fully rounded Judaism.
(9) R. Joseph Soloveitchik, The Lonely Man of Faith
R. Joseph Soloveitchik (1903-1993) was perhaps the greatest Jewish thinker of the twentieth century, a unique blend of two worlds, the yeshivah (his grandfather, R, Hayyim of Brisk, was one of its greatest minds) and the university (he wrote a doctorate on neo-Kantian epistemology). This short work is a fine example of his method, a philosophically inflected form of midrash, in which he does several things at once: resolves a series of difficulties in the two creation accounts of Genesis, suggests an orthodox response to Biblical Criticism, develops a phenomenology of the religious personality, and offers a critique of Western modernity. A complex gem of contemporary Jewish thought at its best.
(10) Paul Johnson, A History of the Jews
“All Jews who are at all conscious of their identity as Jews,” wrote Isaiah Berlin, “are steeped in history.” So a Jewish bookshelf must have at least one volume covering the history of our people, a story with more sweep and drama than any fiction. It is hard to single one out – there are many, most of them excellent. For me, however, Johnson’s is one of the best written and the most insightful. Who could improve on this stunning summation of the Jewish task: “No people has ever insisted more firmly than the Jews that history has a purpose and humanity a destiny … The Jews, therefore, stand right at the centre of the perennial attempt to give human life the dignity of a purpose”? A lovely, uplifting book.
Chaplaincy is challenged with proving its worth scientifically. Over time, without quantifiable research, chaplaincy becomes seen as expendable. While most people would not agree with the expendability of chaplaincy, without evidence backing it up, something will get lost in the shuffle. Here is an article that argues for the need for more evidence based research into spiritual care/chaplaincy.
Let’s add science to health-care chaplaincy without losing its art
By Linda Emanuel, Published: DECEMBER 06, 3:43 PM ET
You may not know that there is such a thing as a professional health-care chaplain.
I know, because as a physician, I’ve worked with many, and have seen how the chaplain’s art helps patients, loved ones, and stressed-out staff find meaning and comfort.
I recall the notation that a chaplain wrote in the medical chart after visiting a patient recently diagnosed with cancer: “Engaged the patient in expressing his fears of treatment. Identifying courage he can draw upon from his religious practice of prayer.”
How did this chaplain know what to do? Some of the best chaplains I’ve known cannot describe what it is that they do with words everyone will understand in more or less the same way. Ask them, and they say it’s an art based on training and years of experience.
Even more distressing is the all too often absence of connection between these acts of chaplaincy care and what the doctors and nurses are doing for the patient. How much rich opportunity are we missing to provide better care?
The teams of health-care professionals in hospitals – physicians, nurses, social workers and others – often include professional chaplains—but not always. Professional chaplains are trained and board certified (like the rest of us in health care) to meet the needs of people from any faith or no faith. They help to identify and call on sources of strength to cope with a life changing health situation. Professional chaplains are active listeners. They clarify and address concerns, and facilitate communication between the patient, family, and the health care team. They aim to help the care plan integrate the beliefs, values and practices that are important to the patient and family.
Picture this: You’re hospitalized with a life-threatening disease and being visited by busy doctors, nurses, and the people who take you to the testing lab. None is intentionally unkind. But it’s fairly likely that aside from, “How are you feeling today?” or “Are you in any pain?” nobody is asking you how you feel deep in yourself, whether you are in spiritual pain. But body and spirit are one. They cannot successfully treat one while ignoring the other.
During the era of enthusiasm for all things scientific, the role of spirituality in illness was dismissed as subjective and lacking hard data. Yet we can define spirituality in words. We can feel it. So why does something so powerful have such poor evidence? Have we been measuring the wrong things or the right things in the wrong way? We need to ask what should we be measuring and how.
Why does it matter? If we knew how to assess what a chaplain does for a patient, we could guide chaplains just as we do for physicians. Research has told us that diagnosis A calls for actions B.
We can learn much about the spirit from post-traumatic stress disorder or PTSD. A person’s response to trauma can matter almost as much as the trauma itself, whether it comes from combat, being a victim of a violent crime, or the shock of a natural disaster. Faces of too many patients pass through my mind but one face in particular I have never forgotten. A young man returning from Vietnam to an unwelcoming broken life, described himself as feeling “like a dog.” I asked him for how long and he answered: “Since I was a puppy.” He was trying to make light of his suffering, but our eyes met, I saw his face contort, and we both seemed to know he was in spiritual pain. Was there something that could have helped him more than the medical care for his septic foot I was providing?
We need to know how often people feel spiritually abandoned while in the arms of medical care. We need to know how to measure what matters, when chaplains should be asked to consult, what chaplains should be trained to look for, and how to respond based on the data. Health care chaplaincy researchers have begun to mobilize to capture the science of chaplaincy care.
It’s a sacred task whose time has come.
Dr. Linda Emanuel is senior vice president for research and education at HealthCare Chaplaincy in New York and Buehler Professor of Geriatric Medicine and director of the Buehler Center on Aging, Health and Society at Northwestern University, Feinberg School of Medicine.