REPORT TO PLENARY
MARCH 31, 2014
Raymond J. Lawrence, General Secretary
Myron Madden has been our wisest pastoral resource. He died last June 4. Brian Childs and I attended his funeral, along with three other CPSP persons. There were also five pastoral clinicians present who were not part of CPSP. The church should have been packed with pastoral clinicians at his funeral. Myron was a giant in our field. We will not see the likes of him again soon. Fortunately we in CPSP had the best of him in his last two decades of life. He functioned as chaplain to every Plenary until his health failed him at age eighty-eight. What he meant to us cannot be measured. And I have letters describing how much we meant to him as well.
It would be a mistake to claim blithely that Myron was widely recognized and honored. He wasn't recognized and honored as widely as he deserved to be. He was recognized and honored by too few. He was too much Freud and too much Shakespeare for typical Christians. And he was too brilliant and insightful for most pastoral clinicians. Tulane University Medical School hired him to teach their young psychiatrists, but the Christian seminaries kept him at arm's length.
In 1999, Myron wrote about his experience attending Wayne Oates' funeral in Louisville, Kentucky. Wayne had been his sometime-mentor, older brother, and finally his dear friend. As you may know, Wayne Oates was rejected much of his life by the clinical training movement as well as the seminaries and the religious community at large. Again, too much Freud. Myron noted that Wayne's mother seminary sent no representative to honor and claim him as one of their own as they laid him in his grave. Myron added that it could be said of Oates, as it was said of another, that "he came unto his own, and his own received him not." So, too, could the same be said of Myron.
In my early years as a clinical supervisor, in the 1970s, I used to contrive ways to be placed on an ACPE Certification Committee assignment. Those certification reviews were never casual. They were intense and dangerous. Most people were not certified on the first committee review. Myron was at his best in those reviews. Invariably Shakespeare, Freud, or the Bible—or all three— typically were woven into the review process as Myron engaged the soul or psyche of a candidate.
Through the years of my friendship with Myron, he constantly hounded me to read the novels of Pat Conroy. I resisted Myron's overtures. I thought Myron was referring me to fun reading that would not have the weight of Freud or Shakespeare or the Bible, Myron's three warhorses. Barely a couple of years ago I finally did read the just-published East of Broad, and it stunned me. I finally understood Myron's fascination with Conroy. Conroy probes with exquisite skill and courage the dark recesses in human relationships. That's what was attractive to Myron, and also made Myron such a good therapist. Then last year, alas too late for Myron, Conroy published his memoirs, The Death of Santini: The Story of a Father and His Son. Conroy had what may have been one of the most narcissistic and abusive fathers ever to have been documented. Though Conroy describes his family life like it was in all its perversity, he never gave up the paternal relationship. He continued to honor his father even while describing in delicious detail his extraordinary perversity and abusiveness. So now I'm going to read pages 117 and 118 from The Death of Santini for Myron. Maybe you will be able to hear him laughing. (Reading not included in this posting.)
According to Myron, our focus as human beings and professionals is always about selfhood and relationship. Ideology and theology exist only in service to selfhood and relationship.
The loss of Myron is huge. We will all have to work harder in the time ahead to carry forward the light and wisdom that he embodied.
There is a lot of unrest in CPSP at present. I don't like guns, and certainly don't like violence, verbal or physical. But as Ralph Waldo Emerson said in 1861, "I do love the smell of gunpowder." When people feel strongly enough to fight for something, it means they care, even if it's just themselves they care about. That's at least a start. Too many people don't care about much of anything. That's much worse. We have a lot of people in CPSP who care about something. Some of them may be misguided. I myself may be misguided. But if you care about something, that's a good start. We're going to have some heated exchanges at this meeting, and there is nothing wrong with that. Nobody’s going to get hurt, if I have any say so in the matter. We will keep our hearts and minds on the Covenant. The Covenant trumps every rule and every standard. We will, of course, struggle over matters that we disagree on, but I believe we will, in the end, love and care for each other, and we will do just fine.
What other group do you belong to in which you can put in writing in the most scathing terms your view that the leadership is misguided, perverse, and ought to resign, and live to tell about it? You can't do that at the office; or at church; or in the garden club. We are a tolerant, accepting, and non-reactive community. Let's keep it that way.
While some of us claim to be concerned about the future of our community, I am not. But I do want to share with you this morning my perception of the big picture in the clinical pastoral movement. It is a picture that I see with growing alarm. You yourselves will need to decide whether my perceptions are accurate, or perhaps simply the views of an aging male for whom the dreams of earlier years have materialized in only the most fragmentary ways.
Eighty-nine years ago this coming summer Boisen ran his first clinical pastoral training unit. (He did not call it CPE, but rather Clinical Pastoral Training.) He enlisted four trainees, three men and one woman, Helen Flanders Dunbar. These summer interns did not sign on as chaplains, but rather as orderlies, making beds, delivering towels, and sometimes emptying bedpans. As orderlies, they conversed with patients during the day and in the evening participated in clinical seminars on what they had learned from patients. Their assignment was to understand the dynamics of the troubled mind and how they might be of therapeutic help as pastors.
Boisen organized this program because he had been a psychiatric patient a couple of years previously, and no one in the psych hospital would sit down and listen to him. The staff, including the psychiatrists, wanted to give him quick advice and send him on his way. No one had time to listen to him tell his story. He knew in part what was wrong with him. His troubles had begun stemming largely from what his parents had done to him, and he wanted to tell someone of his continuing torment. He wanted to—as we like to say—process his story.
Much of what I observe today in the clinical pastoral movement at large, including CPSP, is a betrayal of Boisen's training approach. Instead of ministers in mufti, disguised as orderlies, we have become purveyors of religion and religious ideology…chaplains as spiritual head-trippers. We in the clinical pastoral movement today have become advocates of spirituality, peddlers of religion, low-paid liberal evangelists, hoping to entice people to become more spiritual, whatever in God's name that might mean. This is Boisen turned upside down or inside out. He sought to understand the human journey in all its interiority and mental suffering, not to patch it over with religious salve.
A part of the eclipsing of Boisen was the shift of clinical training programs from psychiatric hospitals to general hospitals. Today there are very few psychiatric hospital training programs. For Boisen, that was the only place to be. It's easier in a general hospital to be friendly, say a prayer, and move on. Psychiatric patients don't usually put up with that sort of thing. They'll tell you what they really think, and leave you like a puddle on the floor. The general hospital permits a more superficial sort of pastoral care and counseling than the typical psychiatric hospital.
Another force that diminished Boisen to some extent was the assault on Boisen by Richard Cabot who had earlier been his principal supporter. Cabot had no interest in psychiatric issues, considered psychiatry bogus, and sought to train ministers to be helpmates of physicians, whom he considered the authentic healers. The Cabot philosophy eventually gained preeminence in the ACPE, a state of affairs that still prevails. I recently reviewed a case in which the chaplain asked a patient if she had an active spiritual life, and the patient replied, "Do you mean do I talk with spirits?" That's just what the chaplain deserved. Two things are wrong with the question the chaplain asked. One is that people do not know what we are talking about by spiritual. We don't even know what we are talking about with such language. The currency of our language is debased. The second thing wrong with the question addressed to the patient is that it communicates that the chaplain has in mind something that he wants to patient to be doing. It is not our business to be promoting a program of behavior. Perhaps, but only after we have been significantly apprised of the patient's situation, we may—may is determinative here—have some recommendations in the behavioral arena. If we have as our objective in relation to patients to lead them to be more spiritual, we will be lost before we begin. Lost in words without clear meaning, and lost because we are prescribing before we diagnose. This is professionally fatal in a clinical setting.
We are being misled by the pundits in our field. The book, Paging God: Religion in the Halls of Medicine, was published two years ago to some fanfare. The metaphor, paging god, is obscure. Does it mean that the medical staff pages god and they get us? Or, does it mean that they page us and we then page god? Either way, it is a catastrophic metaphor for anyone who aspires to be a serious pastoral clinician. The author does not grasp the significance of the clinical pastoral training movement and certainly doesn't understand Boisen.
Now, if you work in a medical setting and you own this book, Paging God, or are thinking of purchasing it, I have some unasked-for advice. Wrap this book in brown paper or keep it hidden in your desk, out of sight. If a medical clinician sees the title and gets the notion that you are in the business of paging god, or worse, that paging you is tantamount to paging god, you will never be taken seriously in that institution. Whatever, whoever god is, and that is a matter of many differing views, he or she is certainly no cosmic bell-hop. God assuredly doesn't answer pages.
The late and great and wonderful Lutheran pastor Paul Scherer, whom I had the joy of knowing, once said that God answered every prayer, and virtually every answer was a great big 'No.' I always think of that when someone tells me that they will be praying for me.
We know of course that people in desperation often cry out to god. If I were falling from an airplane at twenty-five-thousand feet I would likely be the first and loudest one praying, but I doubt it would avail me anything. People in extremis sometimes cry out to god, and we should sit with them patiently until the hysteria passes. There is no good reason why we should pile on, adding to their panic.
The author of Paging God is quite affirming of American middle-class religion and of chaplaincy, but it's not the chaplaincy we inherited from Boisen. The book notes approvingly a Unitarian chaplain who carried with him a pocket full of rosaries in case he met a Catholic patient. No mention was made of any extra pockets for comparable Hindu, Muslim, Buddhist, Eastern Orthodox, or Protestant religious artifacts. And what about agnostics? They are our largest clientele. The chaplain who carries gifts for persons of only one religious tradition is going to get a very bad reputation very quickly. And if she carries gifts for every tradition in her many pockets, she's going to get a worse reputation.
You don't need clinical training to learn to say prayers, or to learn how to distribute religious artifacts. By handing out religious artifacts one shows one's hand as one who espouses conventional religious beliefs and practices, already tilting the pastoral relationship toward "don't tell me your doubts, disbeliefs, or agnosticism," which everyone has. The patient is not going to disclose religious doubt to a peddler of religious artifacts…or to purveyors of spirituality. The axiom is: We approach patients without memory or desire. If we bring our own agenda to the pastoral counseling relationship, it is contaminated from the start.
On any journey it is often difficult to decipher exactly where one is at a specific time, and whether one is on course, or drifting. But my reading is that the clinical pastoral movement, that is almost a century old, is off course, and drifting. Boisen's monumental discovery—simple though it was—was that troubled persons need to be heard as they try to make sense of complex life experiences and self-defeating life choices. Though Boisen seems never to have found a competent counselor or therapist for himself, he nevertheless went on to train others to be just that. So when he was released from psychiatric lock-up, he signed on as chaplain at a psychiatric hospital and offered patients what he never got for himself, an intelligent, sensitive, and psychiatrically informed listening ear. Then he started training other ministers, and thus began clinical pastoral training.
Boison said that Freud was exactly correct: that Freud's talking cure was the treatment of choice for most human inner conflict; and that the proper role of religious authorities is to listen and to make connections. The talking cure is the nature of our work, if we're competent clinicians. Today the talking cure has mostly been turned on its head. Now, in most of our field, the chaplains talk (either to god or the patient) and the patients listen.
A major blow to Boisen's heritage occurred fifteen years ago when the principal leaders of the clinical pastoral movement beseeched the JCAHO, requesting them to delete "pastoral counseling" as the description of the chaplain's role and asked that they replace it with "spiritual care." Two things are wrong with that.
1. Our profession gave away the powerful concept of 'pastoral,' shepherding the sheep, a metaphor rooted in every culture, connoting nurture, vigilance, and protection. We replaced it with 'spiritual,' which fuzzily connotes something up there or out there, certainly out of this world.
2. Second, it gave away 'counseling' and replaced it with 'care,' a much less weighty mandate.
The wholesale abandonment of our roles as pastoral counselors has been a catastrophic blow to our work, and I sometimes wonder if we can recover.
The deceptive argument made in support of erasing 'pastoral' and replacing it with 'spiritual' was that spiritual was more compatible with a variety of faith traditions. It was a phony argument. First of all, the label chaplain was not critiqued at all, and it is the most specifically Christian label of all the common terms, referring to a medieval Christian chapel. Secondly, we fool ourselves when we accredit all forms of religion with the benign label 'spiritual' as if they are all equally truthful. It's a shallow accommodation. All religions are not equally truthful or beneficial. Some are worse than others. I won't get into that. Furthermore, spiritual as a label leaves agnostics and atheists at the station. I happen to know the secret lives of many of you, and I am not afraid to say that we have a significant number of agnostic clinicians among us, and some of our best clinicians are in that group.
The wider clinical pastoral community of which we are a part is no longer serious about the issues that Boisen gave his life for. It has traded in Boisen for the popular saccharine comfort food of spirituality. I fantasize that a suitable inscription to chisel into the tombstone of the clinical pastoral movement might be: "Here lay those who first sat at the feet of Anton Boisen but who later resorted to paging god."
We in CPSP must keep the Boisen flame burning. And we can.
As good pastoral clinicians we can do this. We can listen rather than talk, and we can make connections where we see connections. We can descend into the messiness of human relationships, and leave the gods and their spirituality to take care of themselves, something of which they are quite capable.
Our arena as pastoral clinicians is -to examine how we blindly reenact the abuse we received from our parents and authorities and how hard it is to remember the love they offered us, even in its fragmentariness and brokenness. -to parse how we hurt each other, and hurt ourselves. -to parse how we sometimes love each other, and sometimes hate each other and often don't know the difference -to explore as we listen to ourselves and others the depths of our envy and resentment -to observe how we screw each other in both senses of the word, and what malign or benign motives drive us to do such things -to explore how it is and how it came to be that often the most difficult person to love is ourselves ! -to expand this brief list until we understand in depth the meaning of all our behavior.
This is a large and profound mandate. But this is our arena. This is where Boisen lived and worked. This is what Myron Madden taught us to do.This is our arena. Let us go and do what these great souls who preceded us taught us to do.
Raymond J. Lawrence, CPSP General Secretary
Raymond J. Lawrence,
CPSP General Secretary