You never expected to be lying in a hospital bed with such a serious, possibly life-threatening illness. Most people don’t. You’re feeling sick, weak, frightened and disoriented. And despite being surrounded by loving and supportive family and friends, you’re feeling strangely alone.
Your hospital roommate is very ill too. She’s quite a religious Catholic, so you weren’t surprised when her family asked her nurse to arrange for a visit by the hospital chaplain. You yourself are a non-believer, so the thought of speaking to a chaplain would never have occurred to you. When the chaplain visited your roommate, you overheard bits and pieces of what sounded like a profound and lengthy conversation about her life story, and her feelings about it. The conversation didn’t seem to be focusing predominantly on religion, God or the afterlife. Actually, as far as you could tell, it sounded more like a psychotherapy session.
In a modern hospital like Sunnybrook, spiritual care practitioners are trained to understand diversity in beliefs.
That’s because it was. Hospital chaplains, or spiritual care practitioners, as they are more often called today in Canadian hospitals, receive considerable psychotherapy training. They learn the art and skill of active listening, empathy, comforting, mirroring, reframing, and constructive feedback. By the very nature of who gets drawn to this profession, they tend to be compassionate, reflective, deep-thinking, philosophically minded people. They provide spiritual guidance and conduct specific religious rituals upon request, but they are also good at providing meaning-oriented counseling.
In a modern hospital like Sunnybrook, spiritual care practitioners are trained to understand diversity in beliefs. In secular societies, at least half the urban population is atheistic, agnostic or spiritually uncertain, and this proportion of the population is rapidly rising. As well, the religious proportion of the population is itself culturally highly diverse. Increasingly, spiritual care practitioners are being trained to understand and respect non-believing worldviews, as part of our society’s diversity[i].
Spiritual care practitioners’ training emphasizes regarding the individual human life as a narrative that is constantly in the process of being re-written; a “living human document” lending a person’s life story coherence and meaning. As people strive to make meaning in their lives, most find comfort by reflecting on how their life has mattered to others. Most of us need to affirm that we have had some significant positive impact, leaving some sort of legacy.
Even, or especially, in the course of a serious or terminal illness, the empathy and interest of others mitigates suffering by affirming to the patient that they matter. Very ill people are often helped by having someone to talk with as they reflect on the meaning in their lives. Relationships are often the most powerful source of meaning in our lives, and relationships with caregivers in hospital during a serious or terminal illness can sometimes be especially profound.
Hospital chaplains, or spiritual care practitioners, as they are more often called today in Canadian hospitals, receive considerable psychotherapy training.
As a psychiatrist, I try to emphasize the personal impact that the patient is having on me in the therapeutic relationship we form. I try to express gratitude to my patients for sharing their life experience with me, for teaching me profound lessons about the human condition, teaching me how to live, and how to approach the end of life. It may be comforting for them to know that their impact on me, and the lessons I am learning from them, will be transmitted through me to other patients as well as to students, having a ripple effect on more lives than they could possibly know[ii].
Spiritual care practitioners do all this too, and many of them do it very well. Our hospital’s spiritual care practitioners describe their work this way:
Chaplains/Spiritual Care Therapists provide emotional and spiritual support to patients and family members in exploring their beliefs and values and helping to discover or make meaning/purpose in living with cancer and life events; listening deeply to the person by exploring one’s lifetime contributions, choices and legacy, reconciling losses in life, examining significant relationships, as well as facilitating religious needs and rituals where desired.
So, give some thought to asking your nurse to arrange for a spiritual care practitioner to drop by, if you need this kind of help, but don’t really need to see a psychiatrist. Hopefully you’ll be able to lay to rest the outdated stereotype of a chaplain as only interested in speaking about God and religion. And as a family member or friend, knowing how hard these kinds of conversations can be, and appreciating the value of an objective therapist, consider suggesting this service to your loved one.[iii]
[i] The spiritual care practitioners at Sunnybrook are a particularly progressive group. At their invitation I have been actively involved in the process of helping them to more deeply understand the secular humanist worldview. I too have learned from them.
[ii] This kind of therapeutic relationship with a hospital caregiver may be all the more valuable for those individuals who are truly isolated, or who feel that their lives have been less satisfying, more frustrated or alienated.
[iii] For more on the topic of secular chaplaincy, as well as the subject of how personality type and worldview intersect to shape how people cope with cancer as an existential crisis, see: https://www.youtube.com/watch?v=wJgStR_znAo