Towards a Narrative of Hope and Resilience: A Contemporary Paradigm for Christian Pastoral Ministry in the Face of Mortality Thesis submitted in accordance with the requirements of the University of Chester for the degree of Doctor in Philosophy Alexis J. Smith 5-Feb-16 1 2 Table of Contents Abstract …………………………………………………………………………………………………….4 Chapter One: Living with the Reality of Our Mortality……………………………………….…5-44 Chapter Two: A Historical Perspective on a Christian Narrative of Hope…………….…45-106 Chapter Three: The Importance of Story: Possibilities of Healing Metaphors………..107-149 Chapter Four: Theory for a Hermeneutic and Theology of Hope and Resilience…….150-219 Chapter Five: A Critical Understanding of How to Foster Hope in Others…………….220-269 Bibliography…….…………………………………………………………………………………270-312 3 Abstract Towards a Narrative of Hope and Resilience: A Contemporary Paradigm for Christian Pastoral Ministry in the Face of Mortality Alexis J. Smith Analysis of current pastoral care practice, particularly of Christian pastoral care providers and chaplains, reveals a contemporary lacuna in Christian theological frameworks which contributes to North American Christians’ inability to connect a theological understanding of death with the experience of their human finitude despite the presence of considerable literature on death and dying. This gap deprives many Christians of the possibility of finding a unique and specific source of hope and strength within their own faith tradition for facing crisis. This thesis provides a methodology and theological foundation for a uniquely Christian contribution for facilitating hope, resilience--even transformation--throughout the various stages of life until the time of death. Extensive analysis of Christian views of death, as contrasted with non- Christian views, examined through early Christian writings, late Medieval and early Reformation texts, and the late twentieth century work of Moltmann contributed insights into theological frameworks to remedy the gap and also uncovered themes, metaphors, and language that could be important as Christians interpret life experience and dying. The thesis then utilized three contemporary fields of study to apply the insights into a practical ministry model: (1) research in resilience; (2) Narrative Therapy as developed by White and Epston and utilized by Christian therapists; and (3) hermeneutic theory from Capps, Browning, and Gerkin. Insights from these sources were critically evaluated for application in pastoral counselling, support, and education to help people, both in crisis and when facing death, find a substantial hope that transcends the reality of what they are experiencing. This thesis proposes a distinctively Christian response to death that enables people to retain a sense of their own worth and dignity in order to live meaningful lives until they die. Many people find 21st Century healthcare impersonal and non-empathetic; the work of this theses is intended to be important for helping people regain their sense of self and identity, thereby supporting healing and resilience. In addition, the thesis proposes pedagogic and theological reflection methods that would enhance the practice of chaplains in a rapidly changing healthcare environment that will increasingly require them to demonstrate how their practice enhances the wellbeing of those they serve and provides a contribution that is unique and has value to the healthcare system. 4 Chapter One Living with the Reality of Our Mortality “No man has power over the wind to contain it; so no one has power over the day of his death. .Anyone who is among the living has hope. .(Eccles. 8:8, 9:4) Introduction This chapter introduces the themes that will be explored throughout this thesis, beginning with a discussion of how the fear of death and avoidance of death preparations in contemporary society influence not only people’s ability to cope with mortality and loss, but also how they live. From there, the discussion moves to examining how changes in society--particularly the medicalization of the dying process, the institutionalization of the dying, and even the individualization of society--have contributed to this anxiety and denial of death. The chapter continues by critically examining current theory that informs pastoral and chaplain practice in the United States (US), particularly the work of Elisabeth Kübler-Ross whose work is problematic for Christians because of incompatibilities in theory, language, and theology. Analysis of current practice reveals a contemporary lacuna in Christian theological frameworks which contributes to North American Christians’ inability to connect a theological understanding of death with the experience of their human finitude despite the presence of considerable literature on death and dying. This gap deprives many Christians of the possibility of finding a unique and specific source of hope and strength within their own faith tradition for facing crisis. In addition, the lack of a strategy for linking theological understanding of death to a theory of pastoral 5 practice means that North American Christian pastoral care providers, including chaplains, struggle with understanding specifically how theological belief helps others cope and be resilient in the face of suffering and death. A Note on the Context of Thesis This thesis is about meaning-making and the use of narrative to facilitate people’s finding hope and resilience even in the midst of suffering, dying, and death. Because I propose using narrative applications as found in Narrative Therapy, it is appropriate to also provide the context from which I write since my context shapes my research findings and interpretations in some unique ways. I am a white, American female who has been a staff chaplain since 2002, first as a staff chaplain for Hospice and now as a Board Certified lead chaplain in a large hospital system. Before seminary and chaplaincy, I taught university-level classes in Management, Human Resources, and Economics. I was raised in the Episcopal Church, but am now Anabaptist and am ordained as a Mennonite. I have experienced suffering at the hands of others and through grief and loss. (My mother died two years ago, my mother-in-law died in December 2013, and I am currently caregiving for my 92-year old father.) All of these experiences, the odd juxtapositions and contradictions of my life, and the sufferings I have experienced, are gifts that give me a unique perspective, shape me, and shape my interpretations. They also give me an ability to see and analyse situations in unique ways. My life stories are important to me because of how they have contributed to my view of self and how working with has brought personal transformation. Even the research for thesis has become part of my story and 6 part of the ongoing transformational work. The writing is rooted in a passion—the desire to see others overcome hardship, suffering, and even the despair so often linked to death in order to find freedom from the bondages of interpretations that do not work for them, to find life abundant, and transformation even in the face of death. In addition, I work within a non-profit, US healthcare system rather than the UK system of statutory healthcare. Our hospitals are, by law, inclusive and respectful of all faiths; however, 77% of the US population still identifies themselves as Christian. (The number of “nones” is growing.)1 According to the 2011 ONS survey, 59% of the population of the UK still identify themselves as Christian.2 The US has a growing number of “cultural” Christians, people who identify themselves as Christian because of family, heritage, or culture rather than religious practice. “This group makes up around one-third of the 75 percent who self-identify as Christians—or about a quarter of all Americans.”3 Despite differences, the US and UK share a growing awareness that healthcare as it has been provided in the past may not be sustainable in the future. Like the UK, US healthcare is going through a time of cost/benefit analysis and in many cases, financial austerity. Chaplains are under pressure to prove their “quality, safety, effectiveness and value for money of their practice.” Ewan Kelly speaks to the 1 Frank Newport, “In U.S., 77% Identify as Christian,” Gallup Politics (Princeton, NJ, 24 December 2012), Summary of Gallup Poll Survey from 2011, http://www.gallup.com/poll/159548/identify-christian.aspx leading U.S. pollster. 2 “Religion in England and Wales 2011,” Office of National Statistics (11 December 2012) Summary of 2011 results, http://www.ons.gov.uk/ons/rel/census/2011-census/key-statistics-for- local-authorities-in-england-and-wales/rpt-religion.html 3 Ed Stetzer, “The State of the Church in America: Hint: It’s Not Dying,” Christianity Today (1 October 2013), http://www.christianitytoday.com/edstetzer/2013/october/state-of-american- church.html. Author used 75% from another poll, Pew Charitable Trust for 2012. 7 unique and important role that today’s chaplains have within healthcare saying, “One of the greatest challenges chaplains face in a healthcare context is to explain succinctly what they actually do and how their services can be best utilized.”4 In collaboration with other chaplains, the NHS Scotland developed a list of chaplain’s primary responsibilities, which holds true for US chaplains also. These are: Engaging in a therapeutic listening, talking and being present with people in difficult times. In doing so chaplains: o affirm that fear, anxiety, loss and sadness are part of the normal range of human experience in healthcare; o establish trusting relationships in which others can explore hard questions relating to mortality, meaning and identity; o help them to (re) discover hope, resilience and inner strength in times of illness, injury, loss and death. Helping individuals, families and communities in healthcare to make significant moments in life and death using ritual and in other meaningful ways. Resourcing, enabling and affirming healthcare colleagues in their delivery of spiritual care – supporting them in reflecting on their own spirituality and that of patients and their carers.