Monday, June 29, 2015

The Issues of Religious Countertransference

Religious countertransference is something a Chaplain needs to be aware of particularly if he or she is coming into hospice Chaplaincy from a church pastor setting wherein the church pastor was the chief orator of church doctrine. The process of grasping the nature of chaplaincy is one some former church pastors struggle with. With that stated, let’s do the following… What follows is a brief description of what religious countertransference looks like and how it will affect the Chaplain. 1. Religious countertransference refers to the Chaplain’s emotional responses toward a patient’s religious language, beliefs, practices, rituals, or community that diminish the effectiveness of spiritual care. (Based on Griffith, 2006). 2. Religious countertransference arises when a Chaplain begins reacting to a patient’s religious expressions as though nothing more need be known about the patient as a person. Further, this reaction leads to an attempt to convince, convert, evangelize, or proselytize the patient to save him or her according to the Chaplain’s belief system. Religious countertransference obstructs the patient-Chaplain relationship in at least two ways: 1. Religious countertransference obstructs and obscures spiritual care options and demeans the calling of the Chaplain. 2. The most damaging effect religious countertransference has on the Chaplain is that the Chaplain becomes emotionally distant and disinterested in the spiritual needs of the patient. Patients need to feel that they are heard and need to feel that they may speak freely about their religious faith (whatever it may be). This fact is never more evident than when they are with their Chaplain. If a Chaplain has as an agenda item to get the person convinced to his way of religion, then the whole Chaplain-patient relationships is wounded. How do the above inform your chaplaincy?

Thursday, June 25, 2015

3 Crucial Steps to Take When Asked to Speak with a Non-hospice Facility Resident

The subject matter indicated by the title of this posting could not be more serious. There are many times when I have been asked to visit a depressed facility patient when making my assigned visits. Isn’t that what a Chaplain is supposed to do? Case in point, there was a time when a Chaplain asked me what his response should be when he was asked to visit with a facility resident that was depressed and talking about committing suicide. Here are 3 crucial steps to take: 1. Decline to see the resident as that person is not a hospice patient. This is a boundary issue and an ethical issue. 2. Urge the person making the request to contact her superior to have a psych-eval. 3. Urge the person making the request to evaluate if the resident is in imminent danger of harming themselves and follow the facility protocol for dealing with suicidal residents. This type of an issue is not a hospice Chaplain’s responsibility. To accept this offer is to endanger the Chaplain and the hospice in any litigation that may follow if the person did commit suicide. Chaplains, stay within your boundaries as an employee of the hospice. We can’t and needn’t think we can fix all people.

Wednesday, June 24, 2015

Welcome to my German readers!

It is a joy and pleasure to have all of you reading this blog. I welcome your input and feedback. Please feel free to leave a comment or two. If you would like a more personal communication, send me an email at Blessing to each of you!

Partnership…the wave of the now

The resources hospice has are many. In our hospice alone we have over 800 volunteers. These are folks who have experienced loss and “get it”. They give of themselves selflessly. I was at a ceremony yesterday and on the way one of our volunteers passed by and said he had to get home to change into his military uniform to go to a hospital to perform a “Salutes” pinning. The time was 4:30 PM. That means he would be out at night doing this event. Amazing dedication! This week I was in a meeting at a local hospital meeting with their chaplain manager along with another hospital’s chaplain manager. Our hospice volunteer coordinator was in the meeting as well. A partnership was formed as we developed a strategy to train their volunteers in how to do vigil volunteering and spiritual care volunteering. Apparently, there is not a high demand for vigil in the hospital due to a number of reasons. Our approach was to invite the chaplains to send their volunteers for training and we will use them in our work and when they are needed by the hospital then they are to go there. We assured the chaplain managers that these volunteers “belonged” to the hospital and we would train them and give them some on the job experience. Uniting energies is the wave of the now. Territorialism is passé. As you can see our corps of volunteers is so high that we don’t need to “steal” others’ volunteers, just get them trained and busy. If you don’t use volunteers you lose volunteers. That is a prime reason for partnering. The timing for this endeavor was perfect. I look forward to a great relationship with these chaplains and their volunteers. I’ll let you know how it works later in the Fall.

Monday, June 22, 2015

"I am dying"... the documentary

“I am dying”… the documentary It was Saturday morning around 11:30 when I was channel surfing. My attention was directed to the National Geographic Channel. The program shown was riveting. “I am Dying” was the title. It was a close-up glimpse of patient Renee Heidtman — a spirited, active yoga instructor in her 20s — on her hospice journey after she was diagnosed with breast cancer. The film follows Renee and her family through her attempts to get treated, her final months of in-home care, and, finally, her death on April 11, 2013. The program was just 30 minutes long but was a powerful 30 minutes! If anyone doubts hospice nurses are angels, there could be no doubt left as two nurses were mentioned from the Sutter Care at Home Hospice. Their manner was delicate and compassionate. One of these Angels was providing instruction to Renee’s sister, Rita, and her Mother on how to instill the methadone between her cheek and tongue when Renee could no longer speak. The “Existential Slap” (see my 11/13/14 post) about crumbled Rita as she repeated what the nurse said and couldn’t grasp that her sister would no longer be able to speak. Life for Renee was coming to a too-early close. While spiritual care was not a part of the program, it was clear that it was needed. Renee, Rita, and their Mom would have benefitted from a clinically trained Chaplain who would provide comfort, counsel, and companioning along the way of this journey. There is much the hospice IDT does not see. In my 9/3/14 post, I wrote about what the Chaplain does not see because of the brief time he/she is engaged with the patient and family. However, in this documentary, a hospice team member did a great job suggesting a video diary. Two portions of that diary were portrayed. I will say to Rita, “How sad that Renee will not speak, but her legacy speaks on in her video diary.” Death may silence the day to day interaction, but a video diary can be a cherished place to go when the pain is too great. If you haven’t viewed this documentary, I urge you to check online or the National Geographic site. Hopefully, you will be able to view it and grow from it.

Thursday, June 18, 2015

Cynicism and Underlying Anger

Is it possible for a Chaplain to serve while being afflicted with cynicism and an undercurrent of anger? Whoa! Now, where did that come from? In my travels in the chaplaincy world I have come across more than one chaplain who was obviously exuding such negative energy. It seems to me that the only person those chaplains were fooling were themselves. The short answer to the question is, “No, a chaplain cannot serve hurting people with those types of feelings.” What kind of vexations would drive an otherwise healthy human being to seek solace among cynics? How about these, for starters: Overwork, Unemployment, "We’ll keep your resume on file", Politicians and other liars, Feeling like an alien in your own country, Feeling like an alien in your own family, Being ridiculed by your inferiors, Wondering if you’re inferior to your inferiors, Going bald, especially if you’re a woman, Getting stuck in a bad career, Realizing that a bad career makes a bad life, The decline of Western civilization, The triumph of cockroaches and investment bankers, Ugliness everywhere you look, Cheesy books that stay on the bestseller list for 187 weeks, Chronic disappointment, Realizing that everything you like to eat can kill you, Eating bean sprouts and dying young anyway, Eternal damnation as your final reward. ( When I read that list, I found a few things funny but some others not so. “Getting stuck in a bad career” and “Realizing that a bad career makes a bad life” shout for examination. Can a hospice Chaplain ever make either of statements and personalize them? Unfortunately, yes, they can and they have. If hospice spiritual care does not make your heart beat fast, then perhaps there is something nagging at you. Don’t you hear the voice of your CPE Supervisor calling for you to look inside and make a fearless inventory of what is there? Put it on the table and be honest with yourself. Cynicism can bite the best of us. Therefore, keeping a close eye on what is going on inside of our emotions is fundamental for a centered life. Cynicism is a defense mechanism that begins often in adolescence, and for many continues to thicken and harden as people age. “Coolness” is associated with cynicism. You’re cool, unemotional, a bit callous toward people’s feelings. You tend to attack things that are emotional and sincere. Cynicism is associated with a critical voice. The cynic is perpetually unimpressed. Nothing is ever good enough for the cynic. Life is an eye-roll, a yawn. This is a very limited, unhealthy state of mind. Cynicism is a form of armor. Children don’t start off cynical, but as they get hurt by life experiences, cynicism creeps in. Cynicism is like the slime that forms on a stagnant pond. Your energy is like water. When it is healthy, it moves and flows. When you are psychically injured, energy gets stuck. The water stagnates. Slime grows. Cynicism is the psychic slime that grows over an injury — a place of stuck, stagnant energy. Look at the ways in which you are cynical. Look at the things you are cynical about. These are clear indicators for you of where you have been injured, and have not healed. People who are cynical about loving relationships have been hurt in relationships. Or else they’ve never really had one; they’ve been rejected. People who are cynical about doing meaningful work often feel blocked and frustrated about a lack of meaning in their own careers. People who are cynical about spirituality were often damaged by negative experiences with religion; or else feel so victimized by life that it is impossible for them to believe in a loving universe. It is very easy to fall into cynicism. It is the common language of victimhood — and most people feel like victims. Cynicism feels like a defense against further victimization. But really, it is a block. It is the slime on the stagnant pond, cutting off light and air and flow. Cynicism is a block to healing, well-being, and expanded consciousness. In this world, it is very frightening not to be cynical. For every sincere, genuine person out there, there is a horde of cynics waiting to pick them apart, and tear them down. But if it weren’t for sincere, genuine people, nothing of real meaning and beauty would ever be created in this world. ( Please notice the ways in which you are cynical. These are signposts for you, leading you to places where you have stuck emotional/spiritual energy and unhealed injuries that bear examination. Wounds, spiritual wounds, that have never healed cause cynicism. Have any of those? You can name the situations that have wounded you deeply. Spiritual wounds at times defy healing. But, at least not examined, how will we ever know if the wound can heal? Cynicism and an undercurrent of anger will damage your work as a chaplain. Better to deal with it and get it healed than to risk hurting an innocent patient.

Friday, June 12, 2015

The Baby Boomer Generation

The Baby Boomer Generation This explosive generation comprised the years of 1946-1964. While the fundamental meaning of the moniker of the Baby Boomers had to do with the fact that after WWII, there were record numbers of babies born: In 1946 there were 3.4 million babies born, a full 20% more than in 1945; In 1947, another 3.8 million babies were born; Jumping to 1952, 3.9 million were born; and more than 4 million were born every year from 1954 until 1964, when the boom finally tapered off (these statistics were found on the website). This sustained boom of babies has yet to be surpassed in the history of America. What else went “Boom” with this generation? • Social booms o Rock and Roll music—i.e. Elvis Presley, The Beattles o The Sexual Revolution o Working mothers o The beginning of “cocooning” o Divorce was beginning to be accepted as a tolerable reality • Economic booms o Buy now, pay later=high indebtedness o 2 income families for the first time in American history • Technological booms o First TV generation o NASA and the moon landing o Technology and innovation influenced the school systems making America a leader in mathematics and science • Aging Booms o Retirement is seen a break from work and child-rearing and a time for exploration and activity o The Baby Boomer Generation will place a strain on the Social Security system when they retire simply because of the number of Baby Boomers in retirement. This is my generation. I recall so many revolutions in society, including the God is Dead movement. How will knowing more about this generation assist you to provide spiritual support to a Baby Boomer hospice patient? Do you see a connection between these characteristics and how that person is who he or she is? Might there be guilt or shame in the patient’s life? Why or why not? What type relationship to God or Higher Power might this person have?

Thursday, June 11, 2015

The "Silent Generation"

The Silent Generation: 1925-1947 In hospice care, we serve many from this generation; therefore, it is imperative that we gain insight into their experiences socially, religiously, and internally. Some of my most fascinating moments of hospice ministry have come as a result of my interactions with folks from this generation. Unfortunately, in many cases, dementia has blunted their ability to communicate. This fact is one of the motivations I had to create the Communication Care Kit, a tool I developed to assist a patient with dementia to have an ‘awakening’, albeit, a brief awakening. So, who are these people? What was happening in their world as they grew up? What values did they hold dear? Who are they? They grew up during the Great Depression and World War II. Their behavior is based upon both of these cataclysmic events. By far, they are the wealthiest generation. The family structure-model was men go to work, wife stayed home to rear the children. Today, the Silent Generation comprise the largest lobbying organization…AARP. What was happening in their world as they were growing up? These events shaped the lives of the Silent Generation: • World War II • The Great Depression • The Cold War • The birth of the Civil Rights Movement • McCarthyism • Their overall outlook about children: “Children should be seen, not heard” and, thus, the moniker of the “Silent Generation.” They are hardly silent in the 21st century. What values characterize the Silent Generation? • “Waste not, want not” • Need to be needed • Conservative • Financial stability • Traditional family values • Patriotism • Quality service • Desire comfort • Sacrifice is always noted and remembered • Solid work ethic With the above serving as a snapshot of this generation, how do you provide spiritual care? What issues or crises are these people experiencing religiously? Would you provide care any differently for this generation compared to a more laid back generation? What do you think you could learn from patients and spouses of this generation?

Wednesday, June 10, 2015

The 6 American Generations...Part 1

What are the characteristics of the people we visit? It is possible to paint with huge brush and stereotype people. That’s not my purpose. Instead, I think it helps to know what might be important to persons of various American generations. There are 6 distinct American generations that we serve in hospice. Let’s look at them and discover a bit more of who it is that we are serving and what characteristics make them who they are. The Great Generation These folks were born between the years of 1901-1926. The term ‘Great’ typifies the following: • Their Depression was the Great One • Their War was the Great One • Their Work Ethic remains Great • Their Civic Pride, Patriotism, and Duty remain Great • Their Personal Morality and Standards of Right and Wrong are Great • Their Loyalty to jobs, family, community, schools is Great • Their Grit in having to grow up without refrigeration, A/C, and electricity is Great. • Their motto: “Use it up, fix it up, make it do, or do without” is Great • The view of money and debt is Great • Can you think of other characteristics of this generation that could be listed here as Great? • What do you think would be a good way to connect with a patient from this generation? • Are there topics you think would be wise to steer clear of? • What role do you think faith played in their lives? What about in their faith community? In tomorrow’s post, we will examine the Baby Boomer Generation.

Tuesday, June 9, 2015

Hoping for a miracle…

Hoping for a miracle… It’s been my experience that when the life of a loved one is coming to a close, family members often ask the Chaplain if he/she has a miracle for them. I don’t mean that in a harsh way. It’s just what loving family members want. Are they in denial of the finality of death? Can they not see that their loved one’s breathing has longer periods of apnea? They might be in denial. Perhaps denial is what moves them to desire a miracle. At this point, they cannot fathom life without their spouse, their Mother or Father or sibling. I think we are looking at human nature square in the face at this point. Yes, they can see the signs of decline… labored breathing, apnea, and so forth. So, Chaplain, do you have a miracle? What is your response to the family member? The reason I ask is simple… this happened to me recently. I stood at the bedside of a dying woman whose daughter responded to my statement that if there was anything she needed to be sure to ask with: “Yes. If you have a miracle, I would like that.” What is there to say to that? What would you have said? I would like to hear.

Tuesday, June 2, 2015

"The Spiritual Side"

I had the privilege recently to be the focus of an interview conducted by a local television station. You can find it at this site: Just put the link in your URL and look for the video titled, "The Spiritual Side". Your feedback is welcome.

Monday, June 1, 2015

Monday Musings

Monday Musings Mondays seem to be a good day for reflection. Yesterday provided great fodder for reflection. The graduates were recognized yesterday in worship. Along with all of their long list of awards and academic success were photos of each graduate from when they were in pre-school. It was at that point that my mind took a trip back to when each of my children were so young. It’s amazing what a mind can do. In what seemed like a split second I reviewed their lives to where they are now. It was somewhat an emotional moment as I saw their successes and their painful moments. Interesting what triggers such thoughts. If you recall, my last post had to do with the Conundrum of Ephesians 4:11-12. During the greeting time in worship yesterday, my Pastor asked if I would teach “Ministry Beyond the Walls of the Church” during July. The purpose of the training is to help the church to know how to care for people in crisis. Cool. I’m looking forward to that. A trained church can do much. How was your weekend? Any reflections you care to share?