The System has to be kept human

   Integrating spirituality into contemporary healthcare

by Rev. Dr. Russ Parker ( Director, Acorn Christian healing Foundation)

Defining Spirituality

However, before we can discuss ways of honouring and attending to the spirituality of patient need, we must understand what is meant by spirituality.   A definition offered in a recent document by the Mental Health Foundation states that spirituality is “...that aspect of human existence that gives it its ‘humanness.’   It concerns the structures of significance that give meaning and direction to a person’s life and helps them to deal with the vicissitudes of existence.   As such it includes such vital dimensions as the quest for meaning, purpose, self-transcending knowledge, meaningful relationships, love and commitment, as well as (for some) a sense of the holy amongst us.”(2)   All of these core values are set on a collision course when we become ill and find ourselves in hospital, a far country, where we are liable to be disorientated and in need not just of the best surgical care but of being helped to understand ourselves and what may be happening to us.  There is that sense of loss of connection with ourselves and consequently it is important that as patient, we are respected and be involved in the healing journey in which we have been placed.  Our need is both one of cure and care.  It is here that we observe a parallel journey in the world of Christian healing.

The parallel Journey of Christian healing

Christian healing, far from being just an issue of curing people of their sicknesses is also about empowering people to walk in newness of life.   Neither is it just an emphasis upon the ability of God to cure us by a supernatural act of grace but also about that same grace being found in the world and skills of professional healthcare.  Two brief examples from the New Testament Gospels will help to underline these principles.  The first is in the healing which Jesus bestows on a man who had attended a healing event for over 30 years(3).  The reasons for selecting him above all the other needy people there that day are not given but as we shall see, this seems to be a case of individual surgery rather than a universal diagnosis for those who are physically invalid.   Following his sudden healing there comes a private moment of dialogue in which the man is encouraged to radically alter his moral life style or his spiritual disease will carry bigger penalties than his former illness.   The concern is for the man to live a whole life rather than just be glad he is not physically ill any more.   The second account is the healing of ten lepers(4).   All ten are encouraged to return home to Jerusalem and to seek out the priest who functions rather like a general practitioner.   It is his responsibility to check that all contagion has been removed so that he can pronounce healing and the patient be allowed to re-enter normal as opposed to quarantined community.   Here there is no immediacy of cure but the journey of faith which involves the expertise of the general practitioner.  The interesting twist in this story is that one of the ten lepers would not be welcome at the door of the temple in Jerusalem because he was a Samaritan.  The physical healing they all received exposed the deeply embedded racial prejudices which had been temporarily suspended when they shared the same life-threatening predicament.  Yet when the Samaritan returns alone to Jesus, he is pronounced whole and not merely cured.  This underlines the importance of health and healing as not just being the removal of disease but the empowerment to walk in a greater maturity with an improved and greater connectedness with the world around me: the very core of how spirituality has been defined within the NHS.

Core dynamics of Christian Healing

In attending to this commitment to an improved quality of wholeness of life, Christian Healing agencies have offered a variety of resources.  Alongside of the opportunities to receive prayer with the laying on of hands in the context of church services there are such examples as Burrswood Christian Hospital in Kent which offers palliative care through a collaborative team consisting of  medical and nursing staff,  clerical support and professional counselling.   There are other initiatives such as the Christian Medical Fellowship, Nurses Christian Fellowship and Wholecare which have encouraged the implementation of Christian principles within professional healthcare.  My own society, Acorn Christian Healing Foundation, has encouraged the use of trained listeners within Primary Healthcare Trusts and Hospital Chaplaincies.   There are over 100 residential healing homes where visitors come to share their needs in a climate of spaciousness and confidentiality  and receive counselling and extended prayer.   In addition to this have emerged professional counselling centres staffed by Christians who see Spirituality as a core need of their clients but who nonetheless are careful not to impose their faith perspective upon them.

Despite the many differences of style and engagement in caring that these examples provide we can observe certain core dynamics that lie at the heart of their therapies.  
They are:

• The importance of patient narrative.
• The primacy of listening
•  The journey of reconciliation

We all have stories to tell and we are diminished when we are deprived the opportunity to share them when most needed.   Our stories are the windows we offer to others in order that they may see and understand where we think we are on our journey of life.   If you do not see me, what makes you think you can help me?   Christian healing is enabling people to share their wounded stories for two reasons; the first is that the sharer can feel understood and supported and the second is that we may attend accurately to their need.  This translates well to the context of professional healthcare such as the NHS.   A narrative approach to medicine has emphasised the importance of the patient’s experience and understanding of their health problems.   The story they tell reflects their beliefs about health and their understanding of how they became ill.  Whether they are accurate or not in their understanding it does nonetheless give the doctor and the nurse an insight as to where the patient is coming from and this should not be minimilised or ignored.  

Our story focussed approach recognises the complex, multi-factorial nature of the causes of ill health.  Therefore a headache, whilst having a common final physical pathway, may be caused by a physical disease(tumour), or a psychological condition of depression, or a social condition of stress due to over-work or finally , a spiritual condition of a broken relationship due to hurt and unforgiveness.  It is here that an integrated team comes into its own.   The doctor is no longer the single handed healing professional although he or she may be at the centre of this team consisting also of nurses, the Chaplaincy team and other carers who may be needed.   Naturally this calls for good communication and commitment within the team.  

Judith Shelly and Arlene Miller in their book Called to Care see a special significance in narrative sharing in the role of the nurse.   They relate how it is so easy for the patient to be caught up in medical procedures such as medication that needs to be given, the lab tests that need to be taken, the assessments that need to be documented and the charting that needs to be completed.  The patient is in danger of becoming merely that shadow behind these tasks.  The nurse has a primary task of accompanying the patient on the journey through statistics and keeping their humanity and story in view.  This sometimes means being the silent presence on the road of suffering and other times of engaging in conversations about meaning and reconstructing identity and values as the patient struggles to come to terms with what is happening to them(5).   Under girding this approach is the belief that recovery of health is a step on the redemptive journey towards ‘shalom’ or wholeness which is precisely the objective of all Christian healing ministries.   Yet the telling of stories is an interrupted journey if it is not done in the presence of an authentic listener.

The Primacy of Listening

It was the late Dame Cicely Saunders, the founder of the first modern hospice in the UK, who said that people will say more in a climate of listening.   Listening lies at the hear of Christian Healing and as such is modelled in the ministry of Jesus in the Gospels.  The physician Luke tells the familiar story of the two leaving Jerusalem on the Emmaus road(6).  They encounter the risen Christ but fail to recognise him because they are preoccupied with all that had gone wrong in the city.  What follows is fascinating.  They spill out the story of Jesus, they tell of his love and untimely and brutal death on the cross.  A story he knew only too well and yet he lets them speak and does not interrupt them.  Nothing they told him was a surprise to him but their ability to comprehend what had actually happened, namely the resurrection, is only engaged once they have told their tale.   It is only after they have spoken that Jesus tells them the rest of the story.   The process is interesting to observe; first comes the story and then comes the diagnosis which both connects with where they are and then helps to move them on.  This is translatable to all spheres of healthcare.  

An example of this is Acorn’s partnership with Hospital Chaplaincies and their volunteer teams.  The Rev. Phil Sutton, Head Chaplain at the John Radcliffe in Oxford, pioneered a listening resource within the A and E departments of the Royal Bath and Wells hospitals.   His volunteer team were trained in listening skills and delivered this resource to patients and their relatives.  They were encountering people at greatest need, dealing with the shock and trauma that relatives often feel when faced with bad news concerning their loved ones.  He reported that the levels of hostility, often focussed on the ward staff, decreased as patients and relatives were given the opportunity to talk about their feelings of shock and sense of disorientation.   He also noted that the ability to talk in a climate of listening was of real benefit to those patients and relatives who felt that their world was under immediate threat.  They felt respected and understood and this enabled them to better connect with the medical needs and conditions at hand.   One can immediately see the benefit of such skills being part of the induction training for all nursing staff.

Yet listening alone is only part of the journey to recovery and healing.  It often brings us to the place of needing to make choices as to how we face up to what is going on in our lives and bodies.  This is the challenge of reconciliation.

The Journey of Reconciliation

Conclusion

We have seen that Spirituality matters within healthcare and that this is a parallel journey with Christian Healing Ministries.   Perhaps this is the time to explore ways where a closer collaboration may be encouraged that includes the whole of the medical and nursing staff along with the Chaplains, to become that multi-disciplinary team that demonstrates our care of the whole person and so restore a fuller humanity to those who pass through our hospitals.

References