The College of Pastoral Supervision & Psychotherapy is a theologically based covenant community, dedicated to "recovery of the soul" and promoting competency in the clinical pastoral field.
Valhalla, NY 10595
Rev. Dan Mena, M.Div., Ed.D, BCC
Director of Clinical Pastoral Education
July 16th, 2007
Roberta S. Loewy
Erich H. Loewy
Medscape General Medicine
This is in response to your article of March 14th, 2007 regarding Healthcare and the Hospital Chaplain. Download file
The Hospital Chaplain is today, in most cases, a clinically trained Chaplain. What does that mean? Clinically trained Chaplains are usually clergy who have earned a Master of Divinity degree and who have undergone rigorous training in acute and hospice accredited centers. At a minimum, they require to have completed 1600 hours of Clinical Pastoral Education at these centers under the supervision of certified supervisors. They learn not to engage in spiritual encounters or assessments nor to peruse medical records against the will or knowledge of patients. These Chaplains are keenly aware of the “Patients Bill of Rights” which clearly prohibits your claim. In addition, the Joint Commission standard RI.2.10, Element of Performance 4, under the Ethics, Rights and Responsibilities chapter states: “The hospital accommodates the right to pastoral and other spiritual services for patients.” The Joint Commission does not define how organizations must provide that service, which is determined by each hospital. Therefore, Chaplains move in accordance to hospital directives. In addition, Chaplains do not claim that JCAHO mandates spiritual assessments. On the contrary, spiritual assessments are conducted when appropriate for hospital administration in order to better understand and determine how best to provide Pastoral Care to patients. It is research, done and conducted with the patient’s permission, knowledge and concurrence for the patient’s benefit.
Clinically trained Chaplains do not minister to patients in a hospital setting on the same terms or principles as do clergy in the parish setting. Chaplains are trained clinically in Freudian depth psychology in order to determine where the patient is at and adhere to strict codes of confidentiality in the same manner as a doctor or a lawyer does with their clients. Parish clergy do not have this intensive training.
Being clinically trained, Chaplains are competent in the behavioral sciences. They do not perform their duties solely as clergy. On the contrary, trained in Freudian depth psychology, Chaplains deal with the patient’s psyche. The Rev. Anton T. Boisen, a Presbyterian minister and Dr. Richard Cabot of Harvard’s Medical School, played a significant role in founding the Religion and Health Movement in 1925. Dr. Cabot was instrumental in Rev. Boisen being appointed the first Chaplain at Worcester State Hospital.
Anton Boisen felt a calling to “break down the dividing wall between religion and medicine.” He believed that certain types of illness could be understood as attempts to solve problems of the soul. He invited four students to spend the summer of 1925 with him at Worcester State Hospital. One of the four, Helen Flanders Dunbar, a subsequent pioneer in the field of psychosomatic medicine, came as a research assistant. Boisen shaped the modern day clinical pastoral movement in his called for clergy to be clinically trained to listen and to understand in-depth the human condition of the “living human document” as opposed to passing out easy answers and solutions by way of sermon-nets and prayers.
Dr. Helen Flanders Dunbar later became the Medical Director of the organization of clinical programs called the Council for the Clinical Training of Theological Students in New York City. After her studies in Psychiatry in Vienna, she was appointed to the Psychiatric Department at Columbia Presbyterian Medical Center. She later became Director of the Joint Committee on Religion and Medicine. Her work is well known. Between 1931 and 1932 Dr. Dunbar supervised a combined study by physicians and clergy at Columbia Presbyterian Medical Center and Vanderbilt Clinic. Sixty-two patients, given the usual medical treatment, were contrasted with sixty-two patients treated “with the aid of a clinically trained Chaplain’s ministrations.” The results indicated that those patients that had received interventions by clinically trained Chaplains recovered sooner. From this point forward, the clinically trained Chaplain immediately became an integral part of the healthcare team. It was determined from the findings that the physician is not the only professional that has the ultimate responsibility for the patient’s care. The Chaplain today is an integral part of the interdisciplinary team. Hence, I would argue that the clinically trained Chaplain is indeed a healthcare professional.
You feel that your spiritual needs may be met by Mozart. The Chaplin’s or the patient’s spiritual needs may also be met by Mozart. After all, I would again argue that most Chaplains would agree that the artistry of Mozart is a gift from God. Freud, a self proclaimed atheist, declared that humankind, through its psyche, is a spiritual creature. God is not only in Mozart, but in Einstein, Erikson, Michelangelo, DaVinci, Reubens, Lautrec, Galileo, Goethe, Chopin, and even in the faces of our patients and our wives and our children.
When Chaplains enter into the sacred space of a patient’s room they are very careful not to be anything but compassionate, not that all Chaplains are compassionate. However, they are trained to avoid interventions if the patient does not desire an intervention. They are trained to simply leave the room if no intervention or visit is wanted. Chaplains follow psychotherapist’s Carl Rogers’ theory of being “patient centered.” Rogers, trained by John Dewey, is an integral part of the understanding and training of 21st Century Chaplains who undergo modern Clinical Pastoral Education or CPE. In CPE, Chaplains are trained in family system dynamics, as the work of the Chaplain is not isolated to only the patient. Ministering to the patient’s family is also an integral and important part of the Chaplains scope of ministry.
Clinical Pastoral Education as the training ground of clinical Chaplains is international today, with clergy and graduate students in theology coming to this country to be trained from a number of countries throughout the world. In some countries, CPE has been established as indigenous and been successful in training locals in the axioms of CPE. CPE has grown in 82 years to include, in this country, the College of Pastoral Supervision and Psychotherapy; the Association for Clinical Pastoral Education, the National Association of Catholic Chaplains and the National Association of Jewish Chaplains. There are about 118 Theological Schools as members, and 21 Faith Groups and Agencies who are partners in the education of Chaplains. Today, the model of education that CPE represents is a vital part of theological and healthcare education.
Rev. Dan Mena, MDiv, Ed.D, BCC
Posted by Perry Miller, Editor at 7:28 PM
National Clinical Training Seminar
May 7-8, 2007
This year’s National Clinical Training Seminar (NCTS) packed more than a few highlights for participants who came from places as far away as Ohio to share in the CPSP seminar in Mahwah, New Jersey. NCTS, began in the early days of CPSP as an opportunity for supervisors-in-training to gather and reflect on themselves and their work as clinicians. The venue has expanded in popularity and now bi annually meets for all levels of CPSP members to share their work in small groups and gather information, insight and wisdom from each other and benefit from special guest presentations. This spring’s gathering also included two special opportunities for small groups to contribute their creative ideas and suggestions regarding CPSP development and planning for its future.
The Rev. Jill McNish, PhD., an Episcopal priest engaged in parish ministry, spiritual direction and adjunct teaching and author of Transforming Shame: A Pastoral Response (Haworth Pastoral Press: 2004) was our guest speaker for the seminar. She presented a two part seminar on the concept of shame and its implications for our selves as well as ourselves as pastoral caregivers. McNish argued that shame, as one of six inborn affects, (shame/humiliation, distress/anguish, and anger/distrust in Sylvan Tompkins’ Affect Theory) lies at the very center of human development and personality, and serves to both create conflict as well as be necessary for healthy development and growth. McNish’s presentation drew on societal codes of honor and shame found most particularly, but not restricted to dyadic cultures.
Using biblical examples from both testaments she presented a clear picture of how shame has been an integral factor in shaping how societies develop behavioral norms, boundaries and reinforces values. Shame, McNish argued, is the paradox of the human condition: to live in the reality of a finite body while understanding ourselves as made in the image of the Divine. This same tension is paralleled in the human yearning to merge with the larger collective all the while suffering the dread of losing the individual self that this merger implies. Without shame, there can be no real society or understanding of our own creaturliness in relationship to God.
McNish joked with participants that when she told her colleagues that the subject of her doctoral thesis was on shame; their response was a palpable silence or resistance to the topic. Mc Nish noted that the topic is “very close to the bone” in all of us and invariably elicits an unconscious return to our own feelings of shamefulness that leave us feeling less than ourselves. Even within the NCTS conference, McNish commented that the group seemed resistant to the topic. Shame is damaging to our sense of self and has as its subsidiaries guilt, embarrassment and shyness. Unlike guilt which is attached to an action, shame transcends remediation of an action we have either committed or failed to do; shame strips us of our concept of our very self in relationship to others. The gravity of shameful experience can be seen in its defenses including depression, addictions, envy, abuse of power, self-righteousness, withdrawal, perfectionism and often violent acting out. Every age suffers with its developmentally induced shame: the dependency of infancy; sexual awareness in adolescence; the failures and rejections of adulthood; and the body issues of old age.
McNish challenged the group to imagine faith communities wherein shame could be safely explored and confronted. Do we, as CPSP, confront our own sources of shame? One could say that CPSP itself strives to do this very thing by claiming as part of its mission “recovery of soul” and through the creation of chapter life in which members are invited to share not just the work they do but the fullness of themselves, shameful and otherwise.
On a corporate level, it might be said that CPSP has had to deal with the organizational shame of being a child of its parent, ACPE, which has worked to shame CPSP in the larger society rather than celebrate its birth and development. What is it to be the child of a parent that seeks to disown it, to deny its legitimacy? How does CPSP’s own healthy narcissism and understanding of self suffer from never having been afforded the gleam in our parent’s eye? To our credit, we have been like the hyacinth bulb forced in winter—a fragrant reminder that spring is deep within us ready to be born, even when the traditional soil has been stripped from us. We have brought pastoral care and supervision to new places. We have served in leadership positions in centers and organizations locally and globally and in dialogue with members of our sister pastoral care organizations. We have granted equivalency to those certified by other sister organizations seeking certification with us. We have carried out the very work which has birthed us.
CPSP has already proven itself as a vital, life giving organization that wants to serve a hurting world in whatever ways it can. That has, however, proven shameful to our parent because our identity has become a source of competition not pride. Our failure to receive the blessing of our parent has inspired us to claim our own path in pastoral care in new and innovative ways and structure which have differentiated us from ACPE. ACPE’S recent motion 43 to ask centers to drop dual accreditation is to metaphorically have the shame carried out into the desert like a scapegoat and be rid of it. But CPSP will not go away, even as some of its supervisors are cut out from traditional settings because of ACPE desire for monopoly. Sadly, it is the centers themselves that will be deprived of good people to serve them; the shame is passed along to those who choose alphabets over people.
The fact is both ACPE and CPSP are here to stay—here to stay to serve a world broken apart by addiction, violence, war, emptiness and spiritual hunger. Our prayer should be
“ the harvest is plentiful, but the laborers are few”; therefore beseech the Lord of the harvest to send out laborers into His harvest.” (Luke 10:2) not whose harvest it is or whose laborers should go.
Posted by Perry Miller, Editor at 8:32 PM
PAUL POTTS SINGS OPERA
I was taking another look at YouTube to see what possibilities might exist for CPSP's use when I stumbled upon Paul Potts and the TV show "Britain Has Talent". I clicked on the video. Out walks onto the stage a rather odd and awkward looking man. He had a broken front toot and a slight stutter in his speech. You could see the fear in his eyes as he was about to perform. He looked so out of place. One could not help but wonder why he bothered to show up.
Later I was to learn that this shy and humble man had been bullied as a kid because he was different and because his family was extremely poor. In his adult life he had also fallen on hard-times as well. He and his wife were almost broke due to medical problems. Every workday morning he would get on his bike at 6:00 AM and peddle 30 miles to his work as a mobile phone salesman trying but not succeeding at earning living.
Life had always been hard for Paul Potts. Very early in his life he found refuge and solace from his loneliness in his voice and the music he could make. Music became not only his friend but his passion. Although, riddled with self-doubt, he discovered the one place he could feel good about himself. That place was the protective but creative world of his own music. Recently, however, life had become so overwhelming that he had all but stopped singing. As clinicians we could almost predict what would begin to unfold for Paul Potts. He was a broken man.
Back to the YouTube clip. One member of the judge's panel asked, "What are you here for today, Paul?" He says, "I'm going to sing opera". You could see the rolling eyes of the judges. The music starts. He waits. Awful moments of awkwardness seem to be developing as the music started to play. He was silent. Was he going to be able to sing? I fully expected to see this frightened and awkward looking man so consumed by anxiety turn and walk off the stage in utter humiliation. Before I could finish this dreaded thought, I heard this clarion sound that must have emerged from the depths of this man's soul. I not only knew the depth of my own emotions at that unexpected moment but I could see from the camera shots the tears in the eyes of the audience and hear the spontaneous eruption of applause and shouts that began to thunder as he sang.
He was an unlikely candidate to be a winner. Somehow, however, he found the courage to trust and to honor his passion---his music and love of opera. His is a very poignant and heart warming story of human courage, humility and the transformative power of human passion.
I don't want to force the analogy too far but in many ways CPSP is an unlikely winner. First, I will share with you a bit of history. About twenty years ago some of us had come to believe that the Association for Clinical Pastoral Education (ACPE) had lost its soul in a bureaucratic quagmire and a misuse of its power, even against its own members.
Raymond Lawrence, the author of The Underground Report, gave voice to what became for some an ultimate concern about the ACPE and its direction. Three of us met to plan a meeting to be held in the Episcopal Church’s Phoebe Needles Conference Center near Roanoke, Virginia to discuss the ACPE situation as well as explore the possible necessity of forming an alternative to the ACPE. Although the invitation went out to all members of the ACPE, only sixteen of us showed up and one was the President of ACPE who would serve to both listen to our concerns and also to provide ACPE's point of view.
The limited display of interest and response was a disappointing beginning. During the overnight intensive meeting, however, CPSP was born. The birth of CPSP stirred within its founders both hope and vision but also fear and trembling.
In a matter of only months following the formation of this new pastoral organization, several of the fifteen founding members dropped out likes flies sprayed with DDT. The future of CPSP was not looking good.
We soon found a way to make matters even worse for ourselves. This new organization, who only a few months prior introduced itself to the world as the College of Pastoral Educators and Psychotherapists (CPEP) proclaiming that we would be a serious player in the clinical pastoral movement decided during a knock-down-drag-out meeting in Little Rock, Arkansas to change our name to the College of Pastoral Supervision and Psychotherapy (CPSP). So far we've stuck with this name.
To the outside world CPSP looked awkward, out of place and a sure loser. Many thought they would see CPSP soon walk off the stage of the clinical pastoral movement humiliated by our failed attempt. Our critics judged us harshly. Their eyes rolled at the foolishness of CPSP's mission to establish a grassroots pastoral certifying and accrediting organization that had no paid leadership, avoided hierarchy and centralization of governance like a plague and who gave small groups we called Chapters enormous power to shape their life together as a community of clinically trained clergy.
During these eighteen years CPSP has made it own mistakes. We've looked and I'm sure acted foolish. We've faltered, stumbled and failed many times along our path. Even more regrettable, we've even failed and disappointed one another at times when we should have been bigger and wiser. We've faced down bullies who thought we had no right to exist. We've had our times of self-doubt and discouragement. I'm sure this path as described will be found within our future path as well. Life is hard and complex. CPSP knows this far too well. We are human. Somehow CPSP as a community has continued and to re-discover the truth as our Covenant states, "... life is best lived by grace..." we keep finding a way to be a very human, gracious and often a humble community.
What has kept and continues to keep CPSP on the stage of the clinical pastoral movement? I think it is because of the passion, imagination and creative force found in the individual lives of those who make up our community. In essence, CPSP and its way of being a community calls forth those unique people, many of us who have fallen on hard times in life, but who yet know that we can make music within the clinical pastoral movement that comes from our souls and the passion of our hearts as human beings and pastoral clinicians.
CPSP, like Paul Potts, is an unlikely winner.
Posted by Perry Miller, Editor at 9:41 PM
It is not to early to mark your calendar and even reserve your room for the 2008 CPSP Plenary to be held in Little Rock, Arkansas on March 30-April 2 2008 (Yes, we will be there on April Fools Day).
Although registration cost, speakers, Plenary Brochure and other detail information will soon be made available to the community, posted below is a flyer designed to wet your appetite.
-Perry Miller, Editor
Posted by Perry Miller, Editor at 8:30 AM
SNAPSHOTS OF THE 2007 CPSP PLENARY HELD IN RALEIGH, NC
The CPSP has many faces, not all who are depicted here, that contribute to CPSP being a vibrant and creative community dedicated to the "...Recovery of Soul..." in the clinical pastoral movement.
Perry Miller, Editor
Posted by Perry Miller, Editor at 8:30 PM
Group Photo from CHCC Study Course 2006
The College of Health Care Chaplains located in the United Kingdom will have its Annual Course of Study starting Monday, July 2. The event will be held in Edinburgh, Scotland. The Conference theme is "Spiritual Care in Paediatrics: Child's Play?"
Last year I had the good fortune to represent CPSP at the 2006 CHCC Course of Study that was held in Durham, England. As previously reported, the 2006 conference was packed with impressive and informative presentations The same, I'm sure, will be the case for this year's Course of Study.
Chris Swift, CHCC President who was Guest of Honor at the 2007 CPSP Plenary this spring, encourages members of the CPSP community to take advantage of a special blog the CHCC will provide during the event. At the end of each day you can go to The College of Health Care Chaplains website to hear and read the presentations of the day. These PDF and audio files can be downloaded and used for CPSP Chapter presentations and discussions.
Perry Miller, Editor
Posted by Perry Miller, Editor at 7:41 AM