Applying Care: Three Models of Presence
Gregory Han, Rice University
The pastoral/spiritual care encounter is more than the chaplain being empathetic, a good listener, or a kind person. These, and other accepted actions, are important, but these actions need to be understood inside the context of a pastoral care practice, and this practice needs to be informed by pastoral care models. Care is encoded in actions, and I see the need to examine the overarching models that give shape and structure to these actions.
This paper will explore three models of pastoral presence. The purpose of this exploration is essential for two reasons. The first reason is to not only explore models of pastoral presence but also explore the dyad of the pastoral/medical presence. The kinds of pastoral care I am discussing occurs in the medical context. How does the pastoral contribution function within the larger medical care structures in which chaplains operate? The second reason is to further interrogate the role of presence. Hospital chaplaincy often uses the language of the “ministry of presence,” and in elaborating on models of presence, this paper will explore the status of presence as a role that the chaplain takes on.
The first model is presence as witness. Care providers practice not only a mode of observation; they are also witnesses to a patient’s pain, grief, loss, and hope. Thinking through various examples of “witness,” whether juridical or religious, we can understand that “witness” is a particular form of presence unique to the pastoral care identity, and one that merits close review. I would propose that care practices conflate “presence” with “witness,” and I think these are two different ways of being in the medical world that merit analysis.
The second model is storyteller. I will draw on various sources of narrative medicine and narrative theology to make more explicit the role that storytelling has in patient care. This is a practice that has potential to be practiced across care roles as many medical service providers capture patient data. What is the difference between taking a patient history and listening to a patient narrative? What lies in this difference is a capacity for patient story to be part of the care experience. Chaplain as “storyteller” is a more developed model (see Arthur Franks’ The Wounder Storyteller or the work of Rita Charon) and I want to engage another set of conversation partners, particularly Paul Riceour and Martin Heidegger, to elaborate more on the relationship of time and storytelling.
The third presence is pastoral care as spiritual guide. In religion and mythology, a psychopomp (Greek for “soul” and “conductor”) is a “soul guide” that aids the individual. This assistance is often through a transition into death; however, I propose that this role is not restricted to end of life transitions. Drawing upon mythological models, I will introduce models of spiritual care that can benefit from mystical traditions. While often drawn from religious systems, mystical traditions are often transgressive within their own religious contexts. They inform their source sectarian interests while pressing on the confines of those interests. In medical care settings, I would propose that patients can benefit from this dynamic, as they are often experiencing a liminality of drawing strength from established faith commitments while seeking guidance and encouragement that may not always be found within the limits of those commitments. This “soul guide” model is less developed in the pastoral care world, and I propose there is productive work in the religious and mythological literature to make for a rich dialogue.
I propose that examining these three models, both individually and in concert, can shed light on underdeveloped models of care that can inform pastoral practices, and can also serve as effective interlocutors in a deepening our understanding of what it means to care, and what it means to be caring.
The stakes are high for patients in medical care. Bodies are often stretched to the limits of what they can bear, and their internal worlds of mind, spirit, and soul, are stretched as well. I wish to pursue new ways of thinking through pastoral care models to identify new models of care for patients in need. I propose that thinking about pastoral care models can also inform models of care across multiple domains of patient care, such as the care that physicians and nurses offer.
This paper will explore three models of pastoral presence. The purpose of this exploration is essential for two reasons. The first reason is to not only explore models of pastoral presence but also explore the dyad of the pastoral/medical presence. The kinds of pastoral care I am discussing occurs in the medical context. How does the pastoral contribution function within the larger medical care structures in which chaplains operate? The second reason is to further interrogate the role of presence. Hospital chaplaincy often uses the language of the “ministry of presence,” and in elaborating on models of presence, this paper will explore the status of presence as a role that the chaplain takes on.
The first model is presence as witness. Care providers practice not only a mode of observation; they are also witnesses to a patient’s pain, grief, loss, and hope. Thinking through various examples of “witness,” whether juridical or religious, we can understand that “witness” is a particular form of presence unique to the pastoral care identity, and one that merits close review. I would propose that care practices conflate “presence” with “witness,” and I think these are two different ways of being in the medical world that merit analysis.
The second model is storyteller. I will draw on various sources of narrative medicine and narrative theology to make more explicit the role that storytelling has in patient care. This is a practice that has potential to be practiced across care roles as many medical service providers capture patient data. What is the difference between taking a patient history and listening to a patient narrative? What lies in this difference is a capacity for patient story to be part of the care experience. Chaplain as “storyteller” is a more developed model (see Arthur Franks’ The Wounder Storyteller or the work of Rita Charon) and I want to engage another set of conversation partners, particularly Paul Riceour and Martin Heidegger, to elaborate more on the relationship of time and storytelling.
The third presence is pastoral care as spiritual guide. In religion and mythology, a psychopomp (Greek for “soul” and “conductor”) is a “soul guide” that aids the individual. This assistance is often through a transition into death; however, I propose that this role is not restricted to end of life transitions. Drawing upon mythological models, I will introduce models of spiritual care that can benefit from mystical traditions. While often drawn from religious systems, mystical traditions are often transgressive within their own religious contexts. They inform their source sectarian interests while pressing on the confines of those interests. In medical care settings, I would propose that patients can benefit from this dynamic, as they are often experiencing a liminality of drawing strength from established faith commitments while seeking guidance and encouragement that may not always be found within the limits of those commitments. This “soul guide” model is less developed in the pastoral care world, and I propose there is productive work in the religious and mythological literature to make for a rich dialogue.
I propose that examining these three models, both individually and in concert, can shed light on underdeveloped models of care that can inform pastoral practices, and can also serve as effective interlocutors in a deepening our understanding of what it means to care, and what it means to be caring.
The stakes are high for patients in medical care. Bodies are often stretched to the limits of what they can bear, and their internal worlds of mind, spirit, and soul, are stretched as well. I wish to pursue new ways of thinking through pastoral care models to identify new models of care for patients in need. I propose that thinking about pastoral care models can also inform models of care across multiple domains of patient care, such as the care that physicians and nurses offer.