NEW REALITY, RENEWED THEOLOGY Chaplains, Francis And the Healing Encounter

STEVEN J. SQUIRES, MEd, MA, PhD and PHILIP ANDERSON, MDiv, BCC

he theology of has tremendous influence on how the Catholic health care ministry should view pastoral care. Images and themes such as the culture of encoun- T ter, accompaniment and the field hospital are woven into the Catholic health care lexi- con. But what do encounter, accompaniment and field hospital mean, on a practical theologi- cal level, for those of us who provide pastoral care and for our encounters, especially with patients at the end of life?

Pope Francis’ rich images point to new oppor- condition or disease in a person does not mean tunities for theological renewal within all of the she has health (was healed). On the other hand, church’s ministries. First, the church’s mission healing can occur absent a physical or bodily cure. is not a cloistered one, enclosed in a cathedral with high walls differentiating, if not sequester- POPE FRANCIS AND THE HEALING ENCOUNTER ing, itself from its community. The mission is not The Gospels are replete with examples of healing. self-centered and more concerned with its own A paradigm passage is Luke 4:40, Jesus “laid his functioning than the plight of others. It is con- hands on each of them” and healed them.1 Heal- stantly assessing others’ needs and struggles. ing multitudes of people is a recurring theme, as It is enmeshed with community, possibly indis- in Matthew 14:14, 14:34, 15:29-31. It is reasonable to tinguishable from community. If mission were presume that healing includes social restoration, movement, outward-towards- others describes the movement, not inward-toward-self. Curing entails physical restoration, Second, appreciating the church and its mission as heal- which may not always be possible. ing encounter is a helpful eccle- Healing involves wellness while sial model. We are using the term ecclesial model here to speak of a acknowledging the interconnectedness view or perspective of the church. of mind, body and spirit. Healing was chosen intentionally over other terms such as curing. Curing entails physical restoration, which may meaning return to the community after illness iso- not always be possible. Healing involves wellness lated the people who were sick or disabled from while acknowledging the interconnectedness of others. In Everybody Leads, Chris Lowney states, mind, body and spirit. On the one hand, a cured “It’s been estimated that 700 of ’s 3,700

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verses somehow involve healing accounts.”2 In 2013, on the Feast of San Cayetano in Bue- The also refers to encounters nos Aires, Pope Francis reminds us that Jesus and that Jesus encourages his followers to undertake. the saints are with us in our encounters, and that He instructs the disciples to go to people to teach, meeting those in need “multiplies our capacity to heal and be present (Mark 6:7-13). Shortly before love.”9 his passion, Jesus speaks in parable about the Another dimension of encounter is reflec- judgment of nations, which involves seeing God tive/developmental. Sin, woundedness, unity, in encounters with others (Matthew 25:31-46). In diversity and peacemaking all are pivotal to the Paul’s First Letter to the Thessalo- nians, he guides his congregation’s encounters with others, “Admon- Biblical passages clearly support the ish the idle, cheer the fainthearted, centrality and the risk of going out to support the weak, be patient with all,” (1 Thessalonians 5:14-22) and so encounter others, rather than being on.3 These healing stories also are encounters. Biblical passages clearly or remaining sequestered. support the centrality and the risk of going out to encounter others, rather than being reflective/developmental encounter. Francis is or remaining sequestered (all talk and no action).4 more than aware of the sin and woundedness of Encountering God happens in two ways for humanity. The dangers of individuals being iso- Pope Francis. First, it is contemplative, within lated, even for the “sake of purity,” include self- prayer and discernment, often while doing centeredness and corruption.10 He compares St. ’s Spiritual Exercises and Exa- shutting out opportunities for learning and for- men.5 Second, encounter happens while meeting giveness to illness:11 “I prefer a Church which is others. Sr. Gill Goulding, CJ, STL, PhD, summa- bruised, hurting and dirty because it has been rizes Pope Francis, “[E]very Christian is invited out on the streets rather than a Church which is to share in the redemptive work of Christ; Chris- unhealthy from being confined and from clinging tians are called … to encounter others, to dialogue to its own security.”12 with them, without fear.”6 Clearly, the pope dem- Similarly, people should be conscious of undue onstrates this in his own actions, such as wash- self-centeredness and self-absorption, as well as ing the feet of Muslims, kissing the disfigured and excessive pride and self-importance, because inviting the differently abled to full participation these lead to blinders that obscure others’ plight: in liturgy. The use of encounter here is primarily in the sense of encountering others, not self. [N]o one in the renewal can think of him- Arguably, encounter has at least two dimen- self or herself as being more important or sions. One is spiritual/incarnational. Ignatian greater than the others, please! Because spirituality is at the heart of the spiritual/incar- when you think of yourselves as more national encounter for Pope Francis. The Spiritual important or greater, disaster is already on Exercises call us to “seek God in all things.” Fran- the horizon!13 cis advances this by explaining that God is every- where; we need to know how to find God to be Groups of people, including Christians, face able to proclaim God in the language of each and similar dangers. Francis warns about exclusivity every culture.7 In a 2014 address, Francis stated: within the church, explaining that “‘parallel jour- neys’ are a danger” because seeming safety in a Remember that the Church was born “on like-minded group is a façade for spiritual and the move,” that Pentecost morning. Draw developmental stagnation and complacency.14 close to the poor and touch in their flesh the wounded flesh of Jesus. Let yourselves be PASTORAL CARE APPROACHES guided by the Holy Spirit, in freedom; and Health care reform has had dramatic impact on please, don’t put the Holy Spirit in a cage!8 our health care ministries. New treatment modal-

HEALTH PROGRESS www.chausa.org MAY - JUNE 2018 61 ities and more stringent admission criteria have the task force who raised strong voices for invi- led to lower inpatient volumes. At the same time, tational evangelization. The term may have allure readmission penalties and improved care in non- to some with long-term pastoral relationships. acute settings have led to higher inpatient acuity For instance, invitational evangelization is not a levels, as well as the need for more robust spir- hit-you-over-the-head method, often quoting the itual care in the ambulatory and home settings. Bible and preaching the Word, in the Christian Our system, Mercy Health, purposely has invited tradition. But neither is it the subtler evangelism our chaplains outside of hospital walls into outpa- that seeks to transform others through role mod- tient settings. We encourage their participation in eling and exemplary behavior of a life well-lived, chronic disease management groups and consul- including assisting others, through a particular tation with patients after difficult diagnoses in all faith. care modalities. Many evangelist approaches are difficult Of course, as with other disciplines, these new because they polarize, prompting responses demands have stretched our resources. The result that range from impassioned allegiance to defi- of an expanding scope is less time in acute care for chaplains and different expectations for our spiritual care Trained volunteers, such as pastoral departments. This has led to redefi- visitors, as well as church and nition of “work” for our chaplains, as previous responsibilities (such as parish pastors, attend to lower initial encounters) have shifted to volunteers. Trained volunteers, such acuity situations in hospitals. Board- as pastoral visitors, as well as church certified chaplains attend to higher and parish pastors, attend to lower acuity situations in hospitals. Board- acuity situations, such as grief, loss certified chaplains attend to higher acuity situations, such as grief, loss and distress, often at the end of life. and distress, often at the end of life. The stakes are high for these encounters. ant confrontation.16 Chaplains and caregivers Some recent feedback about pastoral accom- using an evangelist approach could catalyze paniment seems at odds with this changing land- misunderstandings and misperceptions, such as scape. In an overview of the 2015-2016 Pathways to patients believing they are being proselytized. For Convergence project examining end-of-life issues instance, “The term has been too narrowly con- in Catholic health care, the author notes: strued as preaching by a few rather than as wit- ness through practices of love of God and neigh- A few [participants on the task force] raised bor,” and proclaiming salvation through Jesus is a strong voice that accompaniment should “difficult for some to hear at first.”17 A Catholic reflect a pastoral theology of invitational dictionary defines evangelism as the “zealous evangelization, suggesting that those whom preaching of the Gospel, commonly applied to we offer palliative care to should be invited, persons or religious bodies that are dedicated to even explicitly, to an encounter with Christ converting people to Christ.”18 in order to find meaning in their life and to The spiritual care groups National Association see the reality of redemptive suffering that of Catholic Chaplains, Association of Professional is available only through him [emphasis in Chaplains, Neshama: Association of Jewish Chap- the original].15 lains and Association of Clinical Pastoral Educa- tion are skeptical of explicit evangelization. The choice to suggest a specific interpretation The National Association of Catholic Chap- of invitational evangelization seems out of place, lains cautions against pastoral visitors proselytiz- given the larger, and arguably, richer concepts of ing, evangelizing or recruiting.19 the healing encounter and accompaniment. The Association of Clinical Pastoral Education We cannot know the intent of those few on trains chaplains not to evangelize.20

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The Code of Ethics (130.13) for the Association appropriate for encounters with those who are of Professional Chaplains specifies, “Members suffering. Invitational evangelization, specifically, shall affirm the religious and spiritual freedom could be rife with misunderstandings that alien- of all persons and refrain from imposing doctri- ate those we serve. nal positions or spiritual practices on persons Some chaplains and caregivers may still seek whom they encounter in their professional role further, specific guidance for healing encounters. as chaplain.”21 Keeping the ever-listening God at the center is a The National Association of Catholic Chap- start.24 The next step is to take time to be reflec- lains’ Code of Ethics for Spiritual Care Profession- tive about spiritual/incarnational and reflective/ als has a similar statement.22 developmental features of encounter. It is not self- We acknowledge that invitational evangeliza- absorbed nor self-centered to provide your own tion may be an effective pastoral approach when healing encounter, as long as doing so does not used by parish in the context of a sustained, adversely impact encounters with others. The fol- ongoing relationship. lowing rubric with questions and reflections may If equating evangelism with proselytization is advance this next step: an understandably common issue, then encourag- How does the expanding scope of disciplines ing those who are suffering to encounter Christ like pastoral care reflect in my understanding of is not the solution. Servant/lifestyle evange- healing encounter? For instance, how does my lism, as exemplified by Pope Francis, is a much understanding of the healing encounter change better approach for several reasons. First, it is or stay the same? (For example, do I think of it as central to and inseparable from Catholic health more like a field hospital now?) care. Embodying mission and values is servant How can we use the concept of the healing evangelism. encounter to transform ourselves? How are we Second, many recognize the quote often attrib- inward-focused, isolated or blinded to seeing God uted to St. about preaching the in others? Gospel always, when necessary using words. Before or after encounters, recall an instance Catholic health care participates in the legacy of where you were part of or witnessed proselyti- service to continue the healing ministry of Jesus.23 zation, direct evangelism or other inappropri- It was what foundresses such as Catherine McAu- ate accompaniment. What did this reveal about ley did by starting ministries of healing and teach- accompaniment? For instance, how was it directed ing for the poor and underserved. towards others or towards self? Third, it is paradigmatic of Pope Francis’ heal- Ask yourself, what are the subtle ways that I ing encounter and other associated approaches might impose my views on others? How might this such as the culture of encounter, accompaniment reflect my own needs? and the field hospital. The focus of servant/life- What are examples of accompaniment or style evangelization is outward-towards-others, healing encounters within the church, for exam- not inward-towards-self, embodying “the last will ple, the work of Fr. James Martin, SJ, with the be first, and the first will be last.” (Matthew 20:16) LGBT-QI community? How do such examples Fourth, it is our concern that aggressive give a new interpretation to what church ministry attempts at evangelization will brand Catholic means? health care negatively, thus pushing away people Reflect on the ways that churches and min- who are most vulnerable and ascribing an agenda istries can better work together to strengthen of proselytizing to our ministries. Servant/life- the quality or increase the number of healing style evangelization is a form of accompaniment encounters. and encounter, so there is not a need to refer to evangelization at all. A frequent discussion within Catholic health care involves the distinguishing factors of Catho- REFLECTING ON APPROACHES AND ENCOUNTERS lic health care when compared with other-than- There are boundaries for chaplains and others Catholic providers. Common responses seem to who facilitate health care encounters. Preaching, be excellent mind-body-spirit and end-of-life care recruiting, proselytizing and evangelizing are not as an alternative to the Right to Die movement.

HEALTH PROGRESS www.chausa.org MAY - JUNE 2018 63 Pope Francis’ healing encounter and associated 9. Francis, Transcript of the Video Message to the Faith- behaviors mentioned here further excellent care. ful of on the Occasion of the Feast of Saint We believe the healing encounter model, with its Cajetan (San Cayetano), Aug. 7, 2013. http://w2.vatican. accompanying approaches, behaviors and reflec- va/content/francesco/en/messages/pont-mes- tions, are practical steps to embody a culture of sages/2013/documents/papa-francesco_20130807_ encounter, accompaniment and the field hospital. videomessaggio-san-cayetano.html. If done correctly, they will distinguish Catholic 10. , para. 97. health care from its counterparts. 11. Evangelii Gaudium, paras. 91, 93, 97. 12. Evangelii Gaudium, para 49. STEVEN J. SQUIRES is vice president of mission 13. Francis, Address to Members of the Catholic Frater- and ethics at Mercy Health, based in Cincinnati. nity of Charismatic Covenant Communities and Fellow- He is a 2016 CHA Tomorrow’s Leader and has 11 ships, Oct. 31, 2014. http://w2.vatican.va/content/ years of experience in Catholic health care. francesco/en/speeches/2014/october/documents/ papa-francesco_20141031_catholic-fraternity.html. PHILIP ANDERSON is regional director of ethics 14. Massimo Faggioli, The Rising : Ecclesial Move- and spiritual care at Mercy Health–Cincinnati. He ments since Vatican II (Mahwah, NJ: Paulist Press, 2016), is a 2014 CHA Tomorrow’s Leader and has 10 years 135. of experience in Catholic health care. 15. MC Sullivan et al., “Pathways to Convergence: Exam- ining Diverse Perspectives of Catholics on Advance Care Planning, Palliative Care, and End-of-Life Care in the ,” Health Progress 98, no. 6 (November- NOTES December 2017), 79. 1. One could substitute healing for curing in the Gospels, 16. Laceye Warner, “Evangelism,” in the Dictionary of as many examples exist of mind, body, spirit, and social Scripture and Ethics, ed. Joel Green (Grand Rapids, restoration. Healing appears in some passages, such as Michigan: Baker Academic, 2011), 287. the healings at Gennesaret (Mark 6:53-56). 17. Warner, “Evangelism,” 287. 2. Chris Lowney, Everyone Leads: How To Revitalize the 18. John Hardon, Modern Catholic Dictionary (Bard- (Lanham, Maryland: Rowman & Little- stown, Kentucky: Eternal Life, 1999), 197. field, 2017), 50. 19. The National Association of Catholic Chaplains, 3. The Church of England adapted this passage as a Summary of Responses from Members Regarding Prepa- commissioning for confirmands, also known as The ration and Use of Volunteers in Pastoral Care Settings. Great Commission or the Pauline Commissioning. Some www.nacc.org. Protestant denominations still regularly use The Great 20. Carole DiZeo, “A Listening Ear,” NACC Now 197 Commission. (May 11, 2015). www.nacc.org/nacc-now/nn-issue-197/. 4. Francis, Evangelii Gaudium, para. 88. 21. Association of Professional Chaplains Code of Ethics 5. Francis, The Name of God Is Mercy: A Conversation www.professionalchaplains.org/Files/professional_ with Andrea Tornielli (New York: Random House, 2016). standards/professional_ethics/apc_code_of_ethics. 6. Gill K. Goulding, A Church of Passion and Hope, (Lon- pdf. don: Bloomsbury T&T Clark, 2016), 282. 22. National Association of Catholic Chaplains, Code of 7. Francis, with , My Door Is Always Ethics for Spiritual Care Professionals para. 103.3, www. Open: A Conversation on Faith, Hope and the Church in a nacc.org/wp-content/uploads/2017/01/Code-of-Ethics- Time of Change (London: Bloomsbury, 2013), 102. for-Spiritual-Care-Professionals-2015-2012.pdf. 8. Francis, Address to Participants in the 37th National 23. Juliana Casey, Food for the Journey: Theological Convocation of the Renewal in the Holy Spirit, June 1, Foundations of the Catholic Healthcare Ministry 2014. http://w2.vatican.va/content/francesco/en/ (St. Louis: The Catholic Health Association of the speeches/2014/june/documents/papa-francesco_ United States, 1999), 47. 20140601_rinnovamento-spirito-santo.html. 24. Lowney, Everyone Leads.

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