Elements of an Effective Pastoral Care Encounter

By Chaplain Joy Le Page Smith, MA, BCC 

Author of  The Chaplain is In: Journal to Health and Happiness 

1. Do more listening than talking.
2. Listen in a new way: listen with the heart. (I pray inwardly as I listen.)
3. Sense where the person is emotionally. There are five major categories of feelings. Listen to what feelings might be behind their words, like sadness, regret, anger, guilt. There may be places where you hear joy and gratitude. If so, get the person to share more with you about what is bringing them comfort and hope. This will help them find their focus in their faith.
4. Watch for what is not being said as well as to what is being said. There may be something they cannot put into words, but you are hearing it through the feelings the person is subtly revealing. You can ask, “What is the hardest part for you?” When a person is expressing emotional pain, you may feel, too. What is helpful is to simply say, “I am sorry for your pain.” Continue listening, being with them as they give words to whatever shortcoming, sorrow or failure that is weighing on her or his mind.
5. Let silence be. It is powerful to allow minutes wherein nothing is said. Lots comes up from the depths of a person’s heart when a caring person is so very present, waiting, wanting to extend these moments during which a person can feel and think.
6. Let the person’s gruffness or anger be. It is O.K. for them to voice anger–even anger at God. Affirm their ability to express the emotions they are feeling.
7. Be willing to risk: “Would you like to talk about what you are thinking and feeling right now?” Expect the person to deny being angry, even when you hear it in his or her voice. But trust it. They will have heard you. They will think about your question.
8. While with people, if our demeanor and tone of voice indicate care, we have done our job well. Often, people will continue pondering our presence with them after we leave, or later on in their lives. What we say is not what carries the most weight. It is our being there, our listening which says to them, “You are valued.” “You are important.” “You matter.” “I’m here for you.”  
9. When you leave the visit, take time to examine the encounter. How did it strike your own heart? Did you have discomfort, fear, or anger while listening to the person? Did you have a tendency to judge the person at any point? Ask God to help you identify where your own life pain has not been healed.  Do not expect yourself to do this work perfectly. God will use even our mistakes. Just try not to make them. ;-)
10. Remember that the primary focus of our work as a caring minister of God’s love is not to change a person’s mind, give answers or to tell that person how to think–or feel!
11. Our best gift to a person is to extend unconditional acceptance, unconditional positive regard. This appropriately honors God, who has sent us to serve. God honors all of us where we are at any given time–allowing us the experience of growth in this life. Where a person is now, does not mean they will be in that same place spiritually in a month, a year, or at the end of life.
12. A wonderful aid to good visitation comes in regarding the person as a “living document.“ This means that we have much to learn from them and we do learn much when we listen for the message that is under all.
13. Regarding losses, life circumstances, persistent disease, and pain, ask, “Can you forgive this happening to you?” (Tell them what medical science has discovered about forgiveness and how important it is to even one’s physical health.
14. Watch for your own discomforts. Deal with these after the visit while alone, e.g. fear of death, disability, disfigurement, loss of speech, body functions, etc. We are human; we feel all of these, at times, during the work.
15. Stay out of the picture. (Telling patients our story is rarely helpful. What is helpful is when we extend a loving, listening presence.)
16. You can ask, “When you became ill, were you under a lot of stress?” (Often the answer is, “Yes.”) Follow with, “Talking about our stresses greatly relieves them. Would you like to talk about the stress you have been experiencing through this circumstance?” This can be a time for explaining how we help our immune systems when we talk or have tears, releasing what we are holding tightly inside ourselves.
17. You may feel called to minister to a person during a time of trauma (i.e., after a fire) stay calm and comfortable within chaos. Know the extreme expression of emotion will end. Meanwhile, remind yourself of the benefit when a person has cathartic emotion and that such outward expression of inward grief and pain is an important aspect of mourning losses.
18. Hearing the patient first, before stepping into the role of pastoral counseling is not only essential to good pastoral care, but it is polite. It is caring.
19. Take care of yourself. Live a balanced life to avoid burn out. We must know when it is time to get alone with God. Praying, journaling, doing our own screaming and crying can be important to some of us.

Sometimes it is not an easy task to maintain unconditional warm regard for a person. Yet, only if we come to a person with acceptance of them, their life, their person–and what they believe—can we bring to them the love that heals. Without saying it, we are God’s love to people as He has called us to this work. We are bringing God’s help to those who hurt.

May God give you the courage to go where He leads you

And to be the person He calls you to be.

 May you thirst to be in His Word each day—seeking always

To follow the Holy Spirit’s lead as you work with patients.

“First do no harm” (the Hippocratic Oath)

Dr. Gordon Mate, author of When the Body Says No, states that children who hold their emotions in rigidly are taxing their nervous systems. When the adults in their lives discourage their expressing difficult emotions, children have no other recourse than to hold in their anger and sadness, ever so tightly. Dr. Mate connects serious illness, in some instances, with the fact that the nervous system only has so much energy to expend for “pushing down powerful emotions that cry out for expression.”

Below is a technique to use with children, which will help them validate their emotions. This will
result in their having less stress and better health. When a child is upset, ask, “What are you
feeling?” 

Mostly, both big people and little people have to learn how to validate emotions through
identifying what is felt and how the feeling relates to what is happening in life. The key to success
within this work is to watch when you feel uncomfortable or unhappy about something said or
done. Then do the work of identifying what emotion is arising.

The following five simple steps will give children a method for identifying what it is they are
feeling. 

Hold up one of your hands with your palm open toward your face. Look at your fingers. Let
your first four fingers represent a feeling: glad, sad, mad, and “afrad.” (The word “afraid” is
tweaked here to allow a rhyme.) In this exercise your thumb can represent guilt. My suggestion is
to present these steps to your children, helping them to memorize the process. The idea, here, is to
get the children to identify their feelings and feel O.K. about expressing them, rather than to act
out their feelings.

Step 1: Beginning with your little finger, say, “glad,” while deciding whether or not this is the
emotion you are feeling. Probably, you aren’t feeling glad in the midst of a difficult moment. Yet,
this little finger (our glad finger) can remind us that within every difficult circumstance we can find
something for which to be glad or grateful.

Step 2: Move to your ring finger and say, “sad,” while asking yourself, “Am I feeling sad? Have I
been hurt by this thought of mine or by what has happened just now?” Our negative thoughts can
hurt as much as words from others. Watch for them and weed them out as quickly as they come.
Negative thoughts pull you down and are self-destructive.

Step 3: Next hold up your middle finger and say, “mad,” as this is one of our frequent feelings. 
Keep in mind that irritation and frustration are derivatives of anger. Ask, “Am I frustrated? Am I
irritated?”

Step 4: Now, hold up your index finger and say “afrad” (afraid). Consider the emotion of fear
by asking yourself, “Am I feeling fear or anxiety in this situation?”

Step 5: End with your thumb, saying, “My thumb stands for guilt.” Ask yourself, “Is guilt what I
am feeling within this situation?” If we have done something hurtful to oneself or to another, wecan ask to be forgiven. Then, release that feeling of guilt, as it no onger belongs to you.  Thumbs up for overcoming that guilt.

Taking time with children in this way allows for intimacy through opening the door for them to talk about what in life has become hard for them.

wwww.healinglifespain.com

It took this pandemic for us to get a grasp of what it means to see a full face. Clearly, we know half-a-face is not enough. We feel cheated in only seeing the eyes of the person coming toward us. When a person’s eyes search for our eyes we naturally look to the person’s mouth for the rest of the message he or she may be trying to send.

We are getting more used to living with the truth that a life-threatening disease is alive among us. Time has passed and a good share of us have stepped up to trusting the vaccines. We have more of a sense of safety, now, while being around others. Yet, for some of us there is a definite discomfort when a stranger moves in “to close for comfort.”

One day, when the COVID virus is faced down by the vaccine and herd immunity truly exists, we will gain an increased appreciation for life, and for one another—especially the enjoyment of seeing the full face of others.

Ideally, we will also value the fact that life is tenuous. Not one of us knows how long we will be alive. What we can know is that “there is a God ” and there is life after this experience on earth.

Meanwhile, the most healthy way to live is extended in Scripture, “ Rejoice always,  pray without ceasing, in everything give thanks; for this is the will of God in Christ Jesus for you,” (1^st Thessalonians 5:16-18). We can only do this through embracing the mystery that lies within life: we have no control over the fact our lives will end. And—we have no way of knowing the “when.” Some may get a medical diagnosis that says “time is short,” and old age also hands us the opportunity to “get ready to leave.” So, when Scripture tells us to “rejoice always” there is a secret in that: A built in reward of better health. A field of medicine, psychoneuroimmunology (PNI), holds research bearing this out. Studies in SPECT MRI have proven our brain makes significant changes when we pray. This indicates we were made to transcend. People who pray consistently know prayer greatly relieves the most difficult types of angst that life can bring.

God has taken care of our need for emotional help and healing. After talking with God in prayer, take some moments thinking (or journaling) about all there is for which to be thankful. Notice how you feel when you finish. Mostly, this lifts a person’s mind and emotions bringing reassurance, transcendence and empowerment to get past the hard stuff.  

Working our way through a heavy heart comes with the package of being a human who loves. Tears and talking about the despair of missing someone we formerly looked forward to seeing, hearing, touching is one of the hardest burdens we bear. Often remorse, anger and hurt bring questions that plague: “Why did this have to be!? What help is there for my loss?”

We can get depressed, particularly if we fail to feel our anguish and communicate it to loved ones who can listen. Counseling is sometimes a must. This was true for me when my close friend, many years ago, was murdered by her 14-year-old son . . . shock knocked my life apart for he was a good student, involved in sports and seemed oh-so-normal. And, then—my friend was gone! A deadly influence resulted in the tragedy of taking his mother’s life.

Time has lessened the pain, but I still hurt when this terrible memory returns, but, thankfully, I was given an opportunity to make a difference in his young life—once I could forgive him. I had to work through such a hideous thing, so unnatural and impossible to comprehend. What touches me today is knowing I will see my friend again in the eternal realms as she was a believer in our Lord Jesus. And, I will see her son again, as he chose to let Christ become master of his life after serving time in a closed treatment center.

The shortest verse in the Bible is “Jesus wept” as He came to terms with the death of His close friend, Lazarus. He, being God, raised his friend up out of death. Knowing our limits, we cannot do that very often. So we look to the Great Healer in the hour of our exceedingly painful losses. He said, “Come to Me, all you who labor and are heavy laden, and I will give you rest. Take My yoke upon you and learn from Me. For I am gentle and lowly of heart, and you will find rest for your souls. For, My yoke is easy and My burden is light,” (Matthew 11:28-30). It is the Light of Christ that will help us through our darkest moments.