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)

Throughout the day I turned to God in prayer, pleading for our country’s well-being and safety. I prayed for peace and to forsake my arising fears. It was an emotional rollercoaster. Trying to think about anything else was difficult as disquieting thoughts surfaced persistently.

“We have to own up to our feelings,” is a lesson learned through life and my work as a mental health counselor. Prayer became my best match for all the emotion felt. I was reminded to pray for myself first, then for all involved. Amazing the change that comes through caring and praying for others, while setting aside the tendency to be judgmental.

Anger is a challenging emotion. I like many others, grew up believing anger was bad, something to avoid, or at least hide. Feelings were denied, pushed down deep inside. The reasons for this were in part due to messages perceived incorrectly, like “If you are a good Christian you won’t get angry.”  Beyond that, to a child it can seem like “dangerous business” to show ire.

Unfortunately, in many homes there is little teaching on how to effectively deal with difficult emotions. The results?  The gulping down of feelings, which is hazardous behavior to both emotional and physical health. Ideally, somewhere in time we come upon the truth of Ephesians 6: 26, “Be angry and sin not . . .” We are expected to feel these feelings and to honor them by admitting the feelings to ourselves and to God. The verse continues with, “Do not let the sun go down on your wrath, nor give place to the devil.” Here, we see God’s desire for us to let Him help us move beyond our anger, our hurt feelings, the shock and awe of dangerous and difficult happenings—and to do so before we close our eyes to sleep. This makes sense from a psychological stance, as in this way we do not let it settle securely into our subconscious mind—where it is hard to heal.

But what about all those early years during which some of us denied anger, slept on it, and let it creep down into the cerebral grooves giving root to bitterness? Is there hope for its safe release so we can be free of its affecting our future?

According to one psychologist, Eugene Wiesner of Billings, Montana who for decades taught workshops on “God’s Psychology,” the answer is “yes.” He explains that old, tamped-down anger must be allowed to surface and come to healing. How does that happen? By forgiving our enemies. And, forgiving everything that has hurt us in life.  What good can come of hanging on to all that old stuff? It serves only to burn the soul like an acid.

So, rather than to avoid situations that trigger the anger or fall into old patterns of sullenness or resentment, he advises looking at that old pain each time it arises, then setting the will afresh to let it go. That is forgiveness. And, that is healing. Life is a learning experience—and God expects us to mature spiritually as we increase in years.

Then when the battle gets hot, and much is surfacing, calling for help through prayer carries tremendous power, and can put finishing touches on the task. One many multitudes of people have used throughout history is “The Jesus Prayer.” [1]

Wiesner taught that each time difficult feelings are triggered it is healing to simply ask Jesus to succor us as we lift these up to Him. In this way, given time, our souls become free from all the buried wrath and sorrows.

He told of dealing with frequently explosive feelings toward one of his sons. Yet, after working for three years with his emotions and using the “Jesus prayer,” Wiesner found the patience and endurance he had longed so much to gain. He said, “I eventually came to love my son unconditionally.”

Through the years, I, too, learned that persevering in the hard work of inner healing, choosing to persistently forgive the painful happenings of life. This sees me no longer at the mercy of my emotions. Jesus’ taught us to forgive, even to pray for our enemies. Doing so may seem like a hard pill to swallow, but it is good medicine, as it brings peace to one’s heart.

[1] If you want The Jesus Prayer” go to my website at www.healing-with-Joy.com and click on “Quick Aids.”