Professional Practice Advocacy Education & Research Spiritual Development EthicsWalk Conferences, Workshops, Education Opportunities Chaplaincy in the News Reviews TalkBack  
spacer
Archives
 

2/2/2005 Vol. 2, No. 1

Professional Practice
 

Tami Briggs on utilizing music in the dying process

Music: A Transformational Tool in the Health Care Setting

Music speaks to our hearts —often without words. It comforts during the heightened stress of pain, serious illness, and end-of-life care. It also contributes to creating an environment —an intimate, sacred space —for the terminally ill, the transitioning person, the family, and the attending medical staff. Music adds richness and depth and tenderness to the sacred experience of dying. As a therapeutic harpist, some of my most meaningful and deeply spiritual experiences have been playing the harp at the hospital bedside while working with a chaplain.

For example, the hospital chaplain I was working with asked me to come to the intensive care unit and play for a patient who was dying. His family was requesting my services. The patient, Thomas,* had been hospitalized for three months. When I arrived in Thomas’s room with my harp, there was a mixed feeling of relief and grief. He had been suffering for a long time. Although the family was very sad about his earthly departure, they were also relieved that his agony was almost over.

They were a quiet family and asked me to play some traditional Christian hymns. I chose Amazing Grace, Abide with Me, Beautiful Savior, Rock of Ages, and How Great Thou Art. As I played, Thomas visibly relaxed. After playing several hymns, I began to play non-familiar, “drifty”music, which helps the patient let go and transition. As each selection was slower and
s-l-o-w-e-r, his breathing became slower along with the music. The circle of connection was between his belabored breathing and the slow rhythm of the music, until the music was barely pulsing and peacefully, he took his last breath. This is the principle of entrainment where our bodies synchronize with the pulse or rhythm of the music —a very subtle but powerful principle.**

Hearing is the last bodily function to stop. As mentioned in Don Campbell’s The Mozart Effect, “Songs, prayers, and chants that surround the body after death create a powerful vehicle for the soul to travel beyond the physical senses.”[1] I continued to play while the chaplain gathered the family and hospital staff around Thomas’s bed and said a final farewell prayer. The room filled with beautiful light and a lovely, ethereal feeling —a very spiritual moment for all of us witnessing his transition.

Playing live music in tandem with a chaplain is a very special experience, but live musicians are not always available. CDs are the next best thing! In fact, two hospitals in the Twin Cities area (Woodwinds Health Campus and St. Francis Regional Medical Center) have put CD players and a supply of healing CDs by every bedside. There are many other facilities across the country currently securing funding for this project. Part of a larger vision, a “boombox by every bed”playing healing music in every patient’s room, as well as at every nurse’s station, changes the entire corporate culture of our hospitals/health care facilities in a dramatic, positive way. Music is an important and recognized contribution to transforming our healthcare system.

 

* Name changed for confidentiality.

** A CD suggestion that incorporates the entrainment principle is “Calm as the Night”(created and produced by Musical Reflections).

[1] Don Campbell: http://www.mozarteffect.com/Learn/read.html

Tami Briggs is the founding principal of Musical Reflections, whose mission is to provide therapeutic music to facilitate healing, transformational growth, and well being, as well as educate and encourage health care professionals to use music as a healing modality. She is a certified harp practitioner and has played the harp at the bedside of hundreds of hospital and hospice patients. As a composer and recording artist, she has released 11 CDs for relaxation, comfort, and stress reduction. Her CDs, as well as Grace Notes, her first book About Using therapeutic music at the bedside, are all available on her web site: www.musicalreflections.com

Do you have thoughts about professional practice you’d like to share with your colleagues? Send an e-mail info@PlainViews.org.

 

Advocacy
   

The Rev. Yoke-Lye Lim on being pastoral caregivers for our global neighbors

Tsunami –A Pastoral Response

A prayer of lament in Indonesian/Malay, then translated into English

Lepaskanlah kita dari dalam lumpur,
supaya jangan kita tenggelem.
Janganlah gelombang air menghanyutkan kita,
Atau tubir menelan kita,
Atau sumur menutup mulutnya di atasku.
Ya Allah, bersegaralah, melepaskan kita,
Menolong kita, ya Tuhan!
Manalah Tuhan?
Kita tenggelem ke dalam rawa yang dalam,
Tidak ada tempat bertumpu;
Kita telah terperosok ke air yang dalam,
Gelombang pasang menghanyutkan kita.
Manalah Tuhan?		 Deliver us out of the mire,
and let us not sink.
Let not the floodwater overflow us,
nor the deep swallow us up,
Nor the pit shut its mouth on us.

Make haste, Oh God, to free us!
Where were You Oh God?
We sank in deep mire,
Where there was no standing;
We had gone under the deep waters,
Where the flood overtook us,
Where were You oh God?

Just when the world was getting ready to welcome the New Year, Tsunami came. Fiercely it invaded us. It robbed us of everything. Shock, fear, loss, chaos and death.

For our neighbors in Southern Asia and South East Asia –from the islands, which dotted the Indian Ocean, and nations, which lined the coasts –the devastation of life is beyond comprehension. Humanity and life has taken a blow and suffered unimaginable losses.

Some of us in the West felt a faint, unspoken anxiety of what 2005 may bring us. “Will Tsunami come to us?”Among some religious circles the question arose, “What are the eschatological implications of Tsunami?”

Everything is gone –everything –the pain is as deep as the ocean chasm created by the earthquake. The anguish is too profound to be articulated in human words. The lament and travail will go on for a long time.

Although separated by water and land half the world away, immigrants in the United States whose country of origin is in that region of the Indian Ocean –from Somalia to Malaysia, India to the Maldive Islands, Sri Lanka to Indonesia –our shared stories, cultures and histories, our village and communal identity and resources now bind us together even closer. Seeing our brothers and sisters across the waters face the harsh realities of the disaster is heart-breaking for us.

While awaiting news of my family in Malaysia and Indonesia, my soul was pressed. I was at a loss for words to pray. Silence filled my inner world. In touch with my own sense of helplessness and vulnerability, I felt a special connection with my distant neighbors. I realized that it is our communal identity. So, it is with this kindred spirit and my feeble effort to intercede for my neighbors in Southern Asia and South East Asia, and as one who is in-between East and West, that I share a pastoral response to the devastation of humanity and our planet by Tsunami’s stealthy assaults.

Motivated by a genuine interest and concern for the well-being of others we offer pastoral care. Religious and non-religious communities and nations have responded with practical ways of caring through monetary gifts. Individuals have made trips to Southern Asia and South East Asia to offer aid and relief. While all of this is necessary, pastoral care demands we go beyond acts of charity. Pastoral care that eventually heals the human spirit and nurtures the human soul must be mindful of the human dignity of those whom we “help.”Born out of compassion, it must accord respect and honor with human sensitivity as one human being to another human being.

How shall we as pastoral caregivers care for our global neighbors directly or indirectly affected by Tsunami’s blow in these days of recovery? Some reflections and questions:           

1. Gain awareness of the cultural context of the region. South Asians and South East Asians share a communal identity of a “we”identity, not “I”. It is helpful to be mindful that our global neighbors affected across the seas have others from their community living in the United Sates. Their communal identity connects them. How shall we care for those in the United States? How shall we respond as compassionate pastoral care givers in such a way that supports these communal ties?

2. For many, often concrete life experiences are connected with spiritual meanings. For example: a life event, good or bad, may be interpreted with divine favor or judgment. Is it necessary to answer questions of “why Tsunami?”, “why South Asia?”, “why…?”,or, “Is the disaster a punishment from God?”It is helpful to be mindful that most are Muslims, Buddhists and Hindus. How shall we respond as compassionate pastoral care givers in such a way that honors and respects their religious backgrounds along with their spiritual world views?

3. When in prayer with them what images of God may be evoked? What theological implications and questions might be raised in how the divine is addressed in the context of the disaster? What’s appropriate and why? How shall we respond as compassionate pastoral care givers with respect to prayer, rituals and religious symbols?

4. How can we help and at the same time connect with the helplessness of our global neighbors in such a way that deepens our sense of solidarity with them? Is it possible that the overuse of “victim”may be stripping away their sense of dignity in circumstances that are already extremely vulnerable?

Finally, L. David Brown writes:

“Perhaps the word ’charity’is a problem. It conjures up in our mind someone patronizingly offering a handout
to someone less fortunate. When we give, we need to ask: ’What is this doing to the one who receives?’At all
cost we will want to avoid demeaning another person. In other words, a gift cannot really be a gift to ourselves, when it gives us a superior worth.”[1]

Interestingly, when an Indonesian/Malay receives a gift, she/he says “terima kasih”(meaning “thank you”). The giver responds by saying “sama-same”(meaning “we are on equal ground and we are mutual in the give-and-take process.) Simply, both parties are edified.

In our “charity”let us preserve dignity. Here, perhaps, lies the essence of socio-cultural and economic justice.

[1] Brown, L. David. Take Care. Minneapolis, MN: Augsburg Publishing House, 1978, pp. 115-116.

Rev. Yoke-Lye Jerrymia Lim was born and raised in Malaysia, a country in South East Asia situated between Thailand and Singapore. Her family of origin all reside in Malaysia, and one of her sister-in-laws is an Indonesian. Yoke-Lye is married to Rev. Robert Lim, an ELCA pastor and chaplain. They have two teenage boys, AJ Yew (17) and R-J Wei (14). Yoke-Lye is a Board Certified Chaplain with APC. She was active with the APC certification committee (Southwest region) until a recent move to Indianapolis. She is an ACPE Supervisor and Chaplain at Clarian Health Partners, Inc., Indianapolis, Indiana. She is Pentecostal and was  ordained by The Vine Sanctuary Subang Jaya (Charismatic-Pentecostal) Church, Kuala Lumpur, Malaysia.

The Tsunami prompted friends who live in these regions to send e-mails to each other. They have formed an e-community for concern and support.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.

Education & Research
   

 

Chaplain Tom Kilts on Buddhism and identity in CPE

A Prophetic Opportunity for Buddhists

Buddhists involved in CPE training are asked to struggle with “identity”which traditionally has not been regarded as a matter of importance in Dharma teaching. I believe CPE has the potential to be a healthy training ground for processing the East/West tension of identity.

In the Western cultural milieu, the healthy development of a person comes through individuation and the establishment of a full-functioning identity. Generally in Eastern cultures where Buddhist traditions are coming from, the value of the individual is second to the whole as demonstrated in the popular Japanese saying, “The nail that sticks out the most gets pounded down the hardest.”When Buddhists, either cultural or converted, enter the CPE process they are forced to face and reconcile the issue of identity.

As is being found with Buddhist psychotherapists, there is the ever popular “Middle Way”that I feel makes CPE a prophetic opportunity for Buddhists currently in this struggle. In his book, Buddhist Practice On Western Ground (Shambhala, 2004), Harvey Aronson points out that a healthy claim of identity is in line with Gautama Buddha’s teaching. He points out that in each discourse Gautama clearly claims an identity while not holding the “I”to be permanent in any way. So there is a healthy balance of conventional identity function as well as the ontological position of selflessness. John Welwood in his book, Toward a Psychology of Awakening (Shambhala, 2000), asserts that similar to how Vajrayana Buddhism integrated shamanistic ideals and practices from pre-Buddhist Tibet, Buddhism here can benefit as well from an integration of healthy psychological principles with Dharma teachings. Through engaging the CPE process, Buddhists are called to participate in the integration of healthy western values of identity with the essence of Dharma teachings.

While embarking on the CPE journey together I offer these suggestions for Buddhist students and their Supervisors to address:

  • If the student is a convert she needs to reconcile the conversion experience by exploring how her original religion impacts and is a part of her identity.
  • If the student is a cultural Buddhist there needs to be constant clarification about the agenda of CPE and process around the tension of cultural values.
  • Harvey Aronsen’s book (cited above) should be required reading for both cultural and converted Buddhists in the CPE process.
  • The student and Supervisor should become aware of and participate in the ACPE Buddhist Network.

These are just a few suggestions. As Buddhists become increasingly involved with CPE, I am sure that more will need to be explored. Like all the great religious traditions, for every culture that Buddhism has entered, it has profoundly changed in expression as a tradition and has profoundly changed the culture it has entered. This is an important time for Buddhism in this culture and I believe that CPE will have a profound and positive effect on the shape that it takes here.

Chaplain Tom Kilts, Director of Pastoral Care and Education at Griffin Hospital, a HealthCare Chaplaincy partner institution, in Derby, CT, is a minister of the Nyingmapa lineage of Tibetan Buddhism. He is an Associate Supervisor with ACPE, and has been working in the field of spiritual care for ten years. Tom has worked in two different Planetree facilities, his current position at Griffin and at California Pacific Medical Center in San Francisco, CA. He currently lives in Connecticut with his wife and daughter.

Do you have thoughts about education & research you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.

Spiritual Development
   

Dr. Diane Bridges on a valiant woman

"It's Okay, Mom"

I was called to the Intensive Care Unit to be with a family experiencing profound grief and distress after their mother attempted suicide. The woman had taken a large overdose of drugs and then went to her car where she locked the doors and turned on the ignition. Now her life was hanging by a thread and there was extensive and profound brain damage.

As I spent time with the family in the waiting area, they began to tell me their mother's story. She had once been a church going woman but tragic events had happened in her life and she had stopped going to any place of worship.

Three of her children had long ago burned to death in a house fire and shortly thereafter her husband left her. She struggled on her own to raise what was left of her family and later on contracted cancer of the throat which left her without speech. This inability to speak was gut wrenching for her, her family and her friends and had led to a certain amount of isolation and depression.

As her remaining children sat at her bedside keeping the vigil and hoping she could be aroused, their prayer was: "It's okay, mom. We understand and we love you. We always will." They wept and held hands and hugged, and all of us prayed for Marie who died within 24 hours.

In that short period of time I felt bonded to this heartbroken and fragile family. They asked if I would conduct a memorial service in her honor and explained that, while their mom no longer went to church, she still believed in God. I agreed to do this and the day before the service one of the daughters phoned to tell me that they had discovered that Marie had written her own eulogy. Could this be read aloud by one of us? Of course!

The difficult part of all of this was that Marie told it like it was, speaking of both her feelings of being let down and her deep appreciation of those gathered. Truly, we heard Marie "speak" of gratitude and grief and pain. She was a valiant woman and she wished others peace. There was not a dry eye in the chapel. The silence was profound and intense. In the presence of such eloquence and in the presence of Marie's casket before us, I invited the "congregation" to rise and give Marie a standing ovation. Thunderous and sustained applause trumpeted Marie to her eternal rest.

Dr. Diane Bridges received her doctor of ministry degree from the University of Toronto, St. Michael's College. She is the director of spiritual & religious care at the Trillium Health Centre in Mississauga, Ontario, Canada, one of Canada's top 100 employers, and is a member of CAPPE/ACPEP and the APC. She has authored a number of articles on bereavement and grief recovery. Her passion is the healing ministries.

Do you have thoughts about spiritual development you’d like to share with your colleagues? Send an e-mail of any length to info@PlainViews.org.



EthicsWalk

EthicsWalk addresses spiritual care as an ethical enterprise. It explores why relationships between spiritual care providers and those they serve need protection, and examines what that protection entails. PlainViews invites our readers to share their responses to each EthicsWalk column, which will be published in the following issue.

If you’d like to respond to EthicsWalk, please send a comment of no more than 100 words. You can use the e-form below (click on "hearing from you," link) or submit your commentary to the editors in the body of an e-mail (or as a Microsoft Word attachment) sent to Info@PlainViews.org. Please put the phrase “EthicsWalk” in your subject line.

We look forward to hearing from you.

Tending the Spiritual Care Provider’s Space

Monitoring internal signals that caution a spiritual care provider when one’s own needs and wants challenge healthy boundaries was the focus of last month’s discussion. This month’s acknowledges that boundaries can be pushed subtly and inappropriately by those being served. It’s fine to negotiate a boundary with self-aware and non self-serving intentionality if it benefits the spiritual care relationship and does no harm to the person served or the provider. The danger is superficial awareness of self and other or grandiose assumptions about the special-ness of either. Hence, the wisdom of practical, professional boundaries.

Pirkei Avot 1:6 advises —“get yourself a teacher, find someone to study with.”[1]   For spiritual care providers, this applies to work as much as study. Spiritual care providers need a mentor, supervisor, spiritual director, or therapist; preferably, a licensed professional with whom one can enter into a “privileged and confidential”relationship. This will be a person from whom no secrets are hid; who is present as the spiritual care provider’s own “trusted professional.”Additionally (not instead of), one should engage regularly in peer supervision.

Having such professional relationships helps one discern and direct one’s responses to one’s own desires as well as recognize potential miscues coming from others. There are sexually aggressive and emotionally abusive colleagues, patients, students and congregants. There are sexual and psychological predators among people who seek the counsel and services of spiritual care providers. One must exercise self care while caring for others.

Healthy boundaries provide safe space for appropriately intimate spiritual care relationships. Before allowing a boundary to be negotiated differently, ascertain why someone wants your additional time or “irregular”attention. Until motives are clear, be careful about divulging more than “directory”information about yourself or your work habits. Be circumspect about meeting times and locations —stick to the norms and practices of the institution and profession.

In the daily routine, spiritual care providers, as do all professionals, need to pay attention to the World of Reality for the “other”person. The impact of the care provider’s attentions and normal, appropriate affection-born-of-concern may be very different for the other than the provider’s intent. Perception is reality for the preceptor; and it is the impact of the transaction, not the intent, by which any misunderstandings will be judged when emotional, physical or sexual exploitation are experienced or alleged.

Especially, when the other’s intent (or the provider’s) is questionable, meet only in locations where other people are accessible. McDonald’s booths are private, yet safely - public if the hospital cafeteria is closed. Use the spiritual care office only when others are obviously nearby. Close the door but open wide the curtains! (Office doors should all have a window.) Avoid off-site or night visits with people to whom there is a budding special “attraction”—from the provider, from the other, or mutually.

It is always the spiritual care provider’s responsibility to monitor the emotional, spiritual, psychological and physical safety of a relationship —for themselves, the other person(s), and community.

Comments welcome!

[1] In rabbinic times, works like Pirkei Avot (“The Chapters of the Fathers,”but often translated as “The Ethics of the Fathers”) and its companion work and commentary, Avot d’Rabbi Natan (“'The Fathers' According to Rabbi Nathan”) present an ethical vision that is something like classical stoic ethics.

Anne Underwood has an undergraduate degree in religious studies, a master’s degree in rural sociology and a mid-life law degree obtained after working over a decade as a college administrator. She has mediated for the Maine family courts since 1983. Currently she serves as an advisor to the ethics commissions of ACPE, APC, the CCAR (Central Conference of American Rabbis), and NAJC, and consults with a variety of Protestant faith communities on issues of power, fair process, and congregational conflict management. Her articles on mediation and restorative justice have appeared in the ACPE News, The APC News and on the ACPE web site. Articles on clergy accountability and judicatory processes are published by the Alban Institute and The Journal on Religion and Abuse. A chapter, “Clergy Sexual Misconduct: A Justice Issue,” appears in Body and Soul: Rethinking Sexuality as Justice-Love, Marvin Ellison and Sylvia Thorson-Smith, editors, The Pilgrim Press, 2003.

 

Reviews

Macky Alston reviews the film John Paul II: The Millennial Pope

John Paul II: The Millennial Pope

John Paul II: The Millennial Pope offers a wonderful introduction to chaplains working with Catholics. The film is an excellent resource both for better understanding of Catholic issues and for educating about Catholicism within a multifaith context.

The world reacted to the election of Karol Wojtyla to the papacy in 1978 with surprise and hope. Pope John Paul II was the first non-Italian elected pope since the fifteenth century. He was a young poet, skier, actor and playwright, a media savvy intellectual, and a man who had lived through World War II and the invasion of his homeland, Poland.

In the more than 25 years since, as this film clearly shows, this pope has emerged as a man at war with the twentieth century. Pope John Paul II speaks vehemently in this film against communism, feminism, capitalism and consumerism. He opposes many secular ideologies and believes that the 20th century is the most evil and tragic of all centuries, that the devil is active and within each of us. He decries the exalting of the individual, and believes that humanity has lost its sense of the sanctity of life. This documentary offers fascinating insights into the pope’s view of the role of pastoral care in modern society.

Pope John Paul II: The Millennial Pope reveals a very intimate portrait of a man of seeming contradictions. One example: Poland welcomed him home in celebration one year after his election to the papacy and he told crowds there that Poland