From Wellness to Wonder: The Active Life, the Contemplative Life, and the Great Coherence
Warren Kinghorn, MD, ThD, Duke University, Durham, NC
Interventions for burnout and moral injury among health care practitioners often pursue coherence through some sort of rebalancing of time and energy away from patient-oriented work and toward the educational and “personal.” Medical trainees enjoy “wellness days” and press their training programs for “service/learning balance.” Early-career clinicians seek disciplines and practice sites that will foster “work-life balance.” The idea is that if work is balanced with the rest of life, then clinicians will be happy, healthy, and sustainably productive.
In the Summa theologiae, following Aristotle, St. Thomas Aquinas describes efforts to rightly order our everyday, mundane activities—including the productive activity of work—as the active life (vita activa). The active life is the life devoted to various forms of productive activity, such as building, serving, cultivating, teaching, and nursing. The active life “provides for the necessities of the present life by means of well-ordered activity” (STh IIaIIae q. 179 a. 2 ad3). For Aquinas, the active life is a good because God’s creation is good and needs care and love, and because it is within the active life that the moral virtues are formed and cultivated. Aquinas’ vision of the active life is a powerful resource for health care in the way that it points away from mechanistic and procedural responses to “burnout” and points toward a dynamic, relational vision of interconnected social wholes in which persons pursue the common good together, as purposive agents, through mutual relationships of giving, receiving, tending, and caring.
Aquinas, however, does not consider the active life sufficient for human fulfillment or flourishing. The active life, rather, both points to and is sustained by a higher and deeper form of life, the contemplative life (vita contemplativa). Because human flourishing (beatitudo) is sustained only through the pursuit of God as the highest end of human life and action, so also healthy manifestations of the active life are sustained only through the contemplative life—which for Aquinas, as interpreted by Josef Pieper, enables the wayfarer (viator) to see God in and through all things, and to find ourselves drawn more deeply toward love of God and toward love of God’s good creatures—including ourselves and all those who are around us. The active life and the moral virtues cultivated within it prepare the way for the contemplative life, but the contemplative life additionally requires the cultivation of intellectual virtues and the training of the mind—through practices of prayer, careful listening (auditus), reading (lectio), and meditation (meditatio)—as well as the infusion of the theological virtue of charity. Exceeding the imaginative and practical possibilities of the active life, the contemplative life makes possible genuine play and creativity, genuine Sabbath rest, and genuine celebration and festivity.
In this presentation, I will detail Aquinas’ account of the active and contemplative life and will then explore—and invite those in the audience to consider—how Aquinas’ vision challenges contemporary “burnout interventions” in health care systems, which often remain locked in mechanical, industrial paradigms even when they employ activities that carry names like “mindfulness” and “meditation.” Health care practitioners, teachers, and leaders who inhabit faith traditions have a unique opportunity to pursue the great coherence by encouraging practitioners to root themselves in sources of light and truth that modern, secular health care cannot recognize or name, and therefore to discover a much deeper well that moves beyond wellness and points to wonder.
Sample sources:
Thomas Aquinas. Summa theologiae IIaIIae qq. 179-182.
Josef Pieper, Happiness and Contemplation. South Bend, Ind.: St. Augustine’s Press, 1998.
Josef Pieper, In Tune With the World: A Theory of Festivity. South Bend, Ind.: St. Augustine’s Press, 1999.
In the Summa theologiae, following Aristotle, St. Thomas Aquinas describes efforts to rightly order our everyday, mundane activities—including the productive activity of work—as the active life (vita activa). The active life is the life devoted to various forms of productive activity, such as building, serving, cultivating, teaching, and nursing. The active life “provides for the necessities of the present life by means of well-ordered activity” (STh IIaIIae q. 179 a. 2 ad3). For Aquinas, the active life is a good because God’s creation is good and needs care and love, and because it is within the active life that the moral virtues are formed and cultivated. Aquinas’ vision of the active life is a powerful resource for health care in the way that it points away from mechanistic and procedural responses to “burnout” and points toward a dynamic, relational vision of interconnected social wholes in which persons pursue the common good together, as purposive agents, through mutual relationships of giving, receiving, tending, and caring.
Aquinas, however, does not consider the active life sufficient for human fulfillment or flourishing. The active life, rather, both points to and is sustained by a higher and deeper form of life, the contemplative life (vita contemplativa). Because human flourishing (beatitudo) is sustained only through the pursuit of God as the highest end of human life and action, so also healthy manifestations of the active life are sustained only through the contemplative life—which for Aquinas, as interpreted by Josef Pieper, enables the wayfarer (viator) to see God in and through all things, and to find ourselves drawn more deeply toward love of God and toward love of God’s good creatures—including ourselves and all those who are around us. The active life and the moral virtues cultivated within it prepare the way for the contemplative life, but the contemplative life additionally requires the cultivation of intellectual virtues and the training of the mind—through practices of prayer, careful listening (auditus), reading (lectio), and meditation (meditatio)—as well as the infusion of the theological virtue of charity. Exceeding the imaginative and practical possibilities of the active life, the contemplative life makes possible genuine play and creativity, genuine Sabbath rest, and genuine celebration and festivity.
In this presentation, I will detail Aquinas’ account of the active and contemplative life and will then explore—and invite those in the audience to consider—how Aquinas’ vision challenges contemporary “burnout interventions” in health care systems, which often remain locked in mechanical, industrial paradigms even when they employ activities that carry names like “mindfulness” and “meditation.” Health care practitioners, teachers, and leaders who inhabit faith traditions have a unique opportunity to pursue the great coherence by encouraging practitioners to root themselves in sources of light and truth that modern, secular health care cannot recognize or name, and therefore to discover a much deeper well that moves beyond wellness and points to wonder.
Sample sources:
Thomas Aquinas. Summa theologiae IIaIIae qq. 179-182.
Josef Pieper, Happiness and Contemplation. South Bend, Ind.: St. Augustine’s Press, 1998.
Josef Pieper, In Tune With the World: A Theory of Festivity. South Bend, Ind.: St. Augustine’s Press, 1999.