Spiritual counsel

Christian Century, Oct 17, 2001 by Rodney J. Hunter

IN 1993 JOHN PATRON coined the phrase "paradigm shift" to describe a dramatic turn in the practice of pastoral care. Patton pointed out that pastoral care was focusing more and more on social and cultural concerns, moving from a "clinical pastoral paradigm" to one that Patton named "communal-contextual."

Both models evolved during the second half of the 20th century. Before that, another paradigm had prevailed throughout most of the church's history. Pastoral care concentrated primarily and often exclusively on the gospel message. It disregarded the concrete particularities and individuality of persons and contexts and tended, as Patton said, to "universalize its understanding of human problems and express them in exclusively religious terms."

In the 1950s, churches and clergy left the classical paradigm behind and became caught up in the excitement over pastoral care as a healing art, a kind of therapy shaped by a new psychological consciousness. By the '60s, the pastoral care movement had morphed into an ecclesial and academic establishment. Mainline seminaries employed clinically trained professors of the therapy, and theological students flocked to their courses. A new ministerial profession--professional counseling--appeared, and psychotherapeutic modes of thought pervaded theological reflection and congregational life.

Derived largely from psychotherapy, the clinical paradigm was concerned with the individual's personality and psychopathology. In the late '70s, the therapy appropriated family systems theory and a more social approach that focused on the dynamics of relationships. By the '90s, some version of this approach was included in most seminary instruction, usually in combination with elements of the older, individualistic model.

Narrative theory and theology also made an impact when Charles Gerkin and Donald Capps urged pastoral counselors to have their "clients" (an unfortunate term) create and articulate a narrative of their experiences--to "tell their stories." Pastors were taught the skill of eliciting these stories, as well as the skill of listening to them.

While it did not abandon psychology or systems theory, the narrative approach emphasized meaning-making as fundamental to human life and to the pastoral role. In this context, pastoral caretakers could reintroduce theological concerns, and identify social and cultural differences.

The most comprehensive change, however, has come in the past decade with the communal-contextual paradigm. In today's liberal seminaries, the pastoral themes are social and cultural: gender, race, ethnicity, aging, together with their associated forms of oppression, abuse and violence. Closely related is a strong emphasis on fostering community that is inclusive, just and caring. Today we aim to "hear all voices." The influx of women into seminary teaching has been key to this shift.

As valuable as the latest developments have been, it would be a mistake to sweep away what was gained in the past, and what was generally good in the earlier paradigms, including the classic one--in which theology was central. Telling and hearing stories, for example, can lapse into uncritical exhibitionism or romanticism if one does not apply the clinical paradigm, with its critical edge of analytic psychologies and empirical assessments. The "communal-contextual" approach requires reflection too. This term has acquired strong interpersonal connotations that tend to idealize and romanticize the often unglamorous task of living together in family, church or civil society.

Missing in much contemporary discussion of pastoral care is the structural element that makes community dependable and trustworthy over time. Terms like institution and organization suggest what's missing, for these are vitally important for providing the secure boundaries and resources necessary for trustworthy, deep, enduring relationships and for a stable community that encourages healthy and meaningful personal living. By this logic, pastoral care ought to be concerned about fostering personal commitment to religious institutions and organizations, and about shaping personal lifestyle in relation to traditions of moral and spiritual practice. But it is not clear whether the teachers of pastoral care acknowledge this fact or its implications for pastoral care and counseling, even though the "communal-contextual paradigm" is a priority, and creating community is often invoked as a fundamental aim of ministry.

Clinical pastoral education (CPE) remains a central component of training in pastoral care. It complements classroom instruction with pastoral experience in situations of intense need and suffering.

CPE courses continue to increase, apparently driven by an influx of laity--a trend which may suggest a softening, broadening and secularizing of the "pastoral" part of CPE. Minority participation, mainly from African-American and Pacific Rim students, has also increased.

CPE is based, however, on the secular-medical model of professionalism. It does not fit easily with the diverse cultural and spiritual traditions that people bring to hospitals and to CPE programs. CPE must incorporate the reality of cultural pluralism and the presence of non-Christian faith traditions into its process.