Ashland Theological Seminary

ASHLAND THEOLOGICAL SEMINARY

SELF-CARE AND THE PROFESSIONAL COUNSELOR: A DISCOVERY STUDY OF THE GRADUATES OF THE COUNSELING PROGRAM OF ASHLAND THEOLOGICAL SEMINARY – DETROIT

A DISSERTATION SUBMITTED TO

THE FACULTY OF ASHLAND THEOLOGICAL SEMINARY

IN CANDIDACY FOR THE DEGREE OF

DOCTOR OF MINISTRY

BY JOY P. CREEL

ASHLAND, OHIO

MARCH 20, 2020

To my daddy, not a day goes by…

To my mama, I am glad you are here…

To my God given mothers and fathers, words cannot express…

To my future: HEYYYYYY!!!

iii

Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.

Audre Lorde

iv APPROVAL PAGE

Accepted by the faculty and the final demonstration examining committee of Ashland Theological Seminary, Ashland, Ohio, in partial fulfillment of the requirements for the Doctor of Ministry Degree.

______Academic Advisor Date

______Director of the Doctor of Ministry Program Date

ABSTRACT

The purpose of this project was to discover the degree to which a select group of counseling graduates from Ashland Theological Seminary – Detroit have integrated the self-care practices taught in the mandatory Dimensions of

Healing course into their personal lives. The design of the project included a quantitative and qualitative survey, that measured the degree to which SELF-

CARE principles had been integrated.

Participants demonstrated an understanding of the SELF-CARE practices taught, but struggled with implementation mostly due to a lack of time and resources.

CONTENTS

LIST OF TABLES………………………………………………….. viii

AKNOWLEDGEMENTS…………………………………………... ix

Chapter 1. INTRODUCTION AND PROJECT OVERVIEW……. 1

2. BIBLICAL, THEOLOGICAL, AND HISTORICAL FOUNDATIONS……………………………………….. 20

3. REVIEW OF THE LITERATURE……………………. 47

4. DESIGN, PROCEDURE AND ASSESSMENT……. 72

5. RESULTS……………………………..……………….. 81

6. SUMMARY AND REFLECTION…………………….. 107

Appendix

1. PROPOSAL…………………………………………..... 126

2. ASSESSMENT TOOL………………………………………. 147

3. COVER PAGE……………………………………………….. 151

REFERENCES………………………………………………………….. 152

vii Tables

Table 1. Goals in Order of Prominence …………………………………….. 83

2. Goal #5: SELF-CARE Practices as a Necessity……………..…... 84

3. Goal #4: Understanding SELF-CARE Practices as a Biblical Practice…………………………………………..……………….….. 87

4. Goal #8: Overall Understanding SELF-CARE Practices ………. 89

5. Goal #3: Influence of SELF-CARE on the Participants Personal Lives……………………………………………………… 91

6. Goal #1: Integration of SELF-CARE Practices …………………… 94

7. Goal #2 Impact of the Integration of SELF-CARE Practices……. 97

8. Goal #6 SELF-CARE Practices Used ……………………………... 99

9. Goal #7 Time as a Factor in SELF-CARE………………………… 102

10. Understanding SELF-CARE ……………………………………… 104

11. Utilizing SELF-CARE Practices …………………………………… 105

12. Value Related to SELF-CARE Practices…………………………. 106

viii ACKNOWLEDGMENTS

To Abba God- I simply cannot imagine a life without You, the love You pour on me is like a fresh wind on a hot summer day. Thank You for the assurance that You are here through it all. Thank You that You love me and that my heart is safe with You.

To my mama and my family – Thank you for making me who I am. I would literally not be the person that I am without any of you.

To my God-given family – For choosing me and keeping me!

To Jerrolynn Hockenhull, Katherine James, Nyreia Harrington, Rochelle

Woods, Dawn Hinton, Ava Lewis, Sharon Marshall, Jacqueline Nelson and Mitzi

Smith –The black women with doctorates who all inspired me to become Dr Joy.

To the Shiloh Deliverance Church, my pastor Chioke Bracy, and apostles

Bobby and Carolyn Bracy and to the women of Faith, Love and Accountability – thank you for being my ‘Dissertation Doulas.’ The baby is here!

To Zies, my editor – For catching the typos and the tears…this is yours too! To Kathy –For your contribution to this work and my life I could never repay.

To Nyreia – For literally keeping me sane. Finally, to everyone who has prayed, texted, encouraged, chastened, called, loved, and believed in me.

To Jacquelyn Bailey – the best DMin adviser I have ever had.

To Sharon Marshall – For the forethought to create a curriculum that included SELF-CARE for the professional counselor.

To the faculty, staff, students and alumni of Ashland Theological Seminary –

Detroit – Thank You!

ix CHAPTER ONE

INTRODUCTION AND PROJECT OVERVIEW

When I stepped foot onto main campus for the Doctor of Ministry program for Ashland Theological Seminary, I already knew that my proposal would be on some aspect of self-care. I thought it highly ironic or coincidental that the first class I took would be entitled Self-care. I took this as a sign from God that I had picked a great topic for my project. What I did not know was that along this process, my project would be written in the midst of a life snatched from Earth, a situation that would tear my world to pieces.

In May of 2017, when I should have been in the height of my dissertation project and process, I was instead trying to figure out what had become of my life. I had received a phone call that would literally forever change my life. I now liken it to BC (before Christ) and AD (the year of our Lord), except my new era would be known to me as ADD (After my Daddy Died). It was after this terrible point in my life that my project manifested its soul.

I was worn out from driving 200 plus miles a day to make funeral arrangements and handle the affairs of my parents. My mother was significantly injured and fighting for her life in the ICU of a hospital near their home, as the result of a fatal car accident that had also claimed the life of my father on May 7,

2017. My mother was driving and my father was the front seat passenger. It was a regular Sunday morning where they had left their home for church, where my father was an associate minister and assistant to the pastor. After church they went to one of their favorite spots to have lunch before their granddaughter’s dance recital across town. On the way to the recital, my parents were struck by a driver, who was making a left turn on a red light.

Following this catastrophic event, I was thrown into the tasks of caregiving and estate planning. At 32, I had no experience with either. So, while maintaining a home in Sterling Heights, Michigan, a private practice in

Southfield, Michigan, and church membership in Saginaw, Michigan, I now added a daily trip to Flint, Michigan to care for my mother. For the first two months there was not one single day that I did not drive less than the aforementioned 200 miles.

The emotional energy was taxing enough, but adding my physical and mental fatigue, it was a recipe for disaster. Unfortunately, I was in a position where I did not have a choice. I had to do what was needed, even if it was to my own detriment. Or did I? In hindsight, during this time one thing I wish I had done differently was to prioritize finding time to care for myself. As a minister and clinician, who help people for a living, it seemed as if there were not enough hours in a day to help myself. One thing I had to learn through this process was the need to care for myself first. What I quickly realized was if I did not care for myself, who would care for those I serve?

Purpose Statement

Healing course into their personal lives. The research question was, to what

2 degree have a select group of counseling graduates from Ashland Theological

Seminary – Detroit integrated the self-care practices that were taught in the mandatory Dimensions of Healing course into their personal lives?

Overview

The focus of this project was to discover the degree to which a select group of counseling graduates from Ashland Theological Seminary – Detroit have integrated the self-care practices taught in the mandatory Dimensions of

Healing course into their personal lives. The participants were assessed to discover how they have utilized the self-care principles, and their survey results were evaluated.

Formational counseling focuses on ministering Jesus Christ to the broken. As a formational counselor, one of the things that could be difficult is ministering to oneself. But caring for oneself is a very needful task for the formational counselor, because in order for the formational counselor to take care of others, they must take care of themselves.

In order to address the concept of self-care, it was important to understand what self-care really was and why it was important to professional counselors, and important in the field of formational counseling. As a professional counselor, an individual could deal with many issues as they help others. For example, a professional counselor could deal with clients exhibiting emotional or mental health issues, substance abuse issues, career issues or even formational counseling issues. This is not an exhaustive list, but it shows the spectrum of issues a professional counselor could encounter. While

3 counselors help others deal with their problems, they also have their own issues and problems to contend with. As a counselor interacts with so many diverse problems and clients, the need for self-care increases. But what tends to happen is that the busier a caregiver gets, the more they neglect their own self- care.

Faced with this dilemma of having caregivers, who while caring for others, often do not care well for themselves, I then created the questions for my assessment tool. I researched possible populations of graduate students. I visited a supervision group for licensed counselors, where the majority of counselors present were Ashland Theological Seminary – Detroit Counseling graduates and leaders in the local church or personal faith traditions. I received permission to disseminate my assessment tool during this supervision group. I then administered the assessment tool to participants in person. Seeing that I needed more data, I then opened the assessment up online to obtain more responses.

Foundations

As a trained helper, how we care for ourselves must be analyzed and addressed. If not, burnout could occur because of the lack of care. My vision for this project occurred when I found myself in a situation where I had not cared for myself well. Many spiritual counselors have left their calling because they did not know how to care for themselves. I have learned from my own personal experience that not caring for myself was poor stewardship of my calling. My

4 own experience with the lack of self-care was what really motivated me to address this topic.

I became a licensed counselor in 2014, shortly before beginning the

Doctor of Ministry program at Ashland Theological Seminary. Before that, I had answered a call to preach and was an Associate Minister at my church. I also was the Visual Arts Coordinator, which meant that I was the director of graphic media at my church. In addition, I had just finished my second Master’s program and taught Sunday School and Wednesday night youth ministry. I was the ministry leader and committee chair for the Newsletter ministry at the church as well. I was also worn out!

Before entering the Master’s program at Ashland Theological Seminary, not only had I never heard the phrase self-care, I did not know how to engage in it. I honestly did not see the need for it until I was introduced to formational prayer. The “Dimensions of Healing” class, developed and instructed by Sharon

Marshall, was a life-saver for me. I had no idea I was drowning, and the information from this class was liberating for me. I was able to understand the paradigm of “being” juxtaposed to the paradigm of “doing”. I was able to apply this information to my secular employment, school, my ministry, and the work that I was doing for the church. I learned different spiritual disciplines that promoted self-care as well as other practical ways to put my well-being first. I realized that I had struggled for years to do so, possibly my entire life.

Because of this class, I knew before starting the doctoral program what I was going to do my project on. A formational prayer exercise highlighted that I

5 had agreed with the false belief that I had to perform to get approval from others. This was true even if the cost was my sanity, and even more frightening, my physical health. However, I had overcome all of this, or so I thought. It was not until I experienced a tremendous crisis (the death of my father) that I fell back into my old ways of “doing” instead of “being”.

This project focused on assessing how others like me integrated self-care practices as a result of the Dimensions of Healing class. Quite a few counseling graduates went on to become licensed counselors, formational counselors, or pastors. All of these positions and professions are in one way or another caregiving roles. The question that needed to be answered was whether or not they were caring for themselves.

Biblical Foundation

In the Biblical Foundation two main scriptures were discussed, Luke

10:38-42 and Mark 6:31-33. The NRSV was used throughout the document unless otherwise noted. Scripture points to the need to care for one’s self several times in both the Old Testament as well as the New Testament. In

Leviticus 19, Matthew 19, Mark 12, Luke 10 and Romans 13, the words noted as “The Greatest Commandment” in the book of Mark can be found echoing throughout scripture. Referring to the greatest commandment, Jesus said, “The most important one,” answered Jesus, “is this: ‘Hear, O Israel: The Lord our

God, the Lord is one. Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.’ The second is this:

6 ‘Love your neighbor as yourself.’ There is no commandment greater than these”

(Mk. 12:29-31).

Jesus points out that we must love our neighbors as we love ourselves.

The attention here should be directed to what Jesus infers. While this command to love your neighbors as yourself can be read throughout the scriptures, actually loving yourself has not been found as a command anywhere in the scriptures. Loving oneself may have been assumed or even considered natural, so much so that it was understood without being spoken.

How can you love or help others if you cannot love or help yourself?

Based on what Jesus is saying, one would assume that God has given us the innate ability to love self. Unfortunately, it is not unusual for Christians to get so caught up in taking care of others that they forget that there is more to life than the issues of others. One biblical example of this can be found in Luke chapter

10:

38 As Jesus and his disciples were on their way, he came to a village where a woman named Martha opened her home to him. 39She had a sister called Mary, who sat at the Lord’s feet listening to what he said. 40But Martha was distracted by all the preparations that had to be made. She came to him and asked, “Lord, don’t you care that my sister has left me to do the work by myself? Tell her to help me!” 41“Martha, Martha,” the Lord answered, “you are worried and upset about many things, 42but few things are needed—or indeed only one. Mary has chosen what is better, and it will not be taken away from her.” (Lk. 10:38- 42)

Miller asserts, “to desire only what Christ gives and not desire Christ himself is to be bought off by little trinkets, never to own the greater treasure of his

7 indwelling presence” (Miller 2000, 84). In this passage, Martha missed the presence of God because she was busy “doing”.

In Mark 6:31, Jesus invited His disciples to come away and rest because they had been working so hard that they had not even had an opportunity to eat.

This scripture shows Jesus’ humanity as well as His desire for his community to care for themselves. It also gives credence to the need to have others who will help you metaphorically “stop and eat.”

Theological Foundation

The theological foundation for self-care of the professional counselor was centered on the doctrine of the Trinity, and the power that operating in a safe community offers to those practicing self-care. Each person in the Trinity has an individual task that is assigned to them. Seamands notes that,

the doctrine of the Trinity has been described as the grammar of the Christian faith….As the Christian grammar, the Trinitarian doctrine enables us to speak rightly about the God who is revealed in Scripture as Father, Son and Holy Spirit. (Seamands 2005, 11)

Safe community can be a haven for self-care through the provision of encouragement and accountability. We can see a reflection of the Trinity operating in and modeling a safe and encouraging community at the baptism of

Jesus. When all the people were being baptized, Jesus was baptized, too, and the Trinity showed up to offer affirmation and support. Gorman would say that this is an example of how operating together is better than the sum of the individual parts (Gorman 2002, 48).

Since God is relational by nature, His nature is revealed within the Trinity.

Harrison discusses the notion that every human is unique. Even though we are

8 all different, God makes it possible to see Him in each individual because we are created in the image of God (Harrison 2010, 169).

God said that “it is not good for man to be alone” (Gen. 2:18). God gave

Adam Eve, but their relationship became severely distorted through the influence of sin. Kirwan articulates the need for counseling as he discussed the notion of the self being fractured into two parts: the needing self and the rejected self. Understanding these two fractured versions of the self is important in addressing self-care needs, and the self-identity questions that must be answered in order to progress in the formational counseling process. Directly related to the idea of acceptance, our “self-identity is basically each person’s answer to the question ‘Who am I?’” (Kirwan 1984, 75). Humans bear the

Trinity’s likeness when they live together in harmony as a community (Harrison

2010, 170). Along this line of thought, Wardle asserts:

There are several essential elements of such shared experience that serve as the blueprint for time spent together. The first of these characteristics is an uncompromising commitment to the centrality of Jesus Christ. It is His presence as Lord and Lover that marks a group as Christian and intimate. This means that time spent in worship and adoration is critical to spiritual community, as well as consistent contemplation and reflection upon His teachings and admonitions contained in scripture. (Wardle 2005, 76)

It would be beneficial for the formational counselor to be in a safe community to engage in care for themselves. Seamands outlines three areas that should be utilized by the formational counselor, who is practicing effective self-care. “First, a commitment to wholeness in our interpersonal relationships.

Second, a commitment to involvement in close-knit small group fellowship. And third, a commitment to healthy family relationships” (Seamands 2005, 40). God

9 highlights for us that we have to learn how to not only live, but also to love, in community.

Historical Foundation

This section began with a discussion on the history of the Sabbath in the early church, focused on the effects of the Schism of A.D. 1054 A.D. This was followed by a conversation regarding the dissention surrounding the legalities of the Sabbath, specifically from the Puritans. The Puritans were known for how they cared for the soul, so much so that they became known as the “physicians of the soul” (Keller 1988, 11). Throughout this section the need to celebrate the

Sabbath was demonstrated.

The church spent much of its history in contention about how and what to do to celebrate Sabbath. For centuries the church had been legalistic and ritualist about how Sabbath was observed. Tertullian was a church father who in his early writings discussed Sabbath in a ritualistic matter, but found himself on the other side of the fence; which was to celebrate Sabbath contemplatively as worship (Ferguson 2005, 152). As Tertullian’s view on Sabbath changed, he moved from the legalistic and ritualistic way of observing the Sabbath to a

“’perpetual sabbath,’ in which he professed to refrain from sin every day, and actually abstained from labor on none” (Andrews 1873, 300). Andrews discussed at length the fact that Tertullian switched his views on when the

Sabbath was to be observed (Andrews 1873, 322). The same questions surrounding Tertullian’s 155 A.D. to 240A.D. positions on Sabbath continued throughout church history. Another Sabbath conflict occurred in the 1700s.

10 John Wesley, one of the founders of Methodism, chastened those who did not keep the Sabbath day command, which involved remembering the Sabbath Day and keeping it holy (Wesley 1872, 163).

Contemporary Foundation

Understanding the benefits of self-care can help clinicians incorporate self-care practices in individual treatment plans to promote greater well-being in their clients. “Self-care” seems to be self-explanatory: what is done to care for oneself. Anderson defines it as, “care for the self as created by the image of

God and valued by God for its own intrinsic worth” (Anderson 1995, 8).

Anderson extends his definition by stating, “this care begins with the intentions and aspirations of our original caregivers, parents, and family members who undertake responsibility for the development of the self through personal and social interactions” (Anderson 1995, 8). Oswald says it this way,

Self-care is little more than being a steward of some rather special gifts – a physical body with it enormous resilience and beauty, the capacity to nurture others and be nurtured in return, the capacity to be aware of our lives as we are living them, the capacity to enjoy immense sensual pleasure through such simple things as a splash of orange juice in our throats in the morning or a child in our lap… I have come to call this “self- care for the sake of the kingdom.” I take care of myself, not only for my sake, or for the gratitude of the life given me by God, but also for the sake of others. If I don’t take care of myself, I not only hurt myself but I let others down as well. (Oswald 1991, 5-6)

Oswald notes the necessity of ministers and church leaders to not over fill their cups, or take on too much, as they attempt to live out their calling. He notes that when the body is affected by stress, it prepares to either fight or run

(Oswald 1991, 23). But neither of these are good responses for those who

11 serves as clergy or clinicians. Oswald notes that “enduring continual stress

[over a long period of time]” is “exceedingly unhealthy” (Oswald 1991, 26).

Lehr discusses burnout as a way to be codependent. He notes that this happens when pastors begin to rely on their congregation to fulfill needs that only God can fill. He notes that the term “burnout is too often a politically ‘safe’ term for a real disease – codependence” (Lehr 2006, 10). The way that Lehr discusses burnout can be likened to what Foster calls ‘superficiality. Foster says “superficiality is the curse of our age” (Foster 1978, 1). He sums up

“superficiality” as the connection of those based on the “muchness” and

“manyness” that is often enveloped in our daily lives, and how we spiritualize the need to be busy and distracted. His cure for this “superficiality” is the spiritual disciplines. One way to do this would be through the practice of Sabbath.

Self-care and God (Upward Journey)

Anderson says one must first take time to examine the concept of self before one can even begin to address the idea of self-care. He asserts that the self is difficult to define: “the concept of self has intruded into contemporary issues where legal and moral capacity is assessed with regard to an individual’s actions” (Anderson 2010, 16). Similar to Anderson, Shaw asserts that we engage our true self through our relationship with Christ, and it is the fulfilling of our core longings that can allow us to engage in self-care (Shaw 2013, 15).

One way in which we can enhance our relationship with God, fulfill our core longings, and practice self-care is through the spiritual disciplines.

“Disciplines are intentional ways we open space in lives for worship to God”

12 (Calhoun 2015, 22). How can an individual care for themselves if they have not made room for a relationship with God? Calhoun goes on to say, “they are not harsh but grace-filled ways of responding to the presence of Christ within our bodies” (Calhoun 2015, 22).

Community as Self-care (Outward Journey)

Anderson asserts that self-care cannot be attempted on one’s own. He notes that we are created in God’s image, which means we were created to be in community. He says “the divine image is not a religious quality of an individual person, but a spiritual quality expressed through the interchange of persons in relation” (Anderson 2010, 238).

Anderson says while Paul looked to the church for community, we do not live in the time of Paul. He states:

Unfortunately, the church in our culture is not often the place where we experience such open and trustful community; at least, not in the official programs and meetings. At the same time, the church is made up of the people who silently bear hurts, anxieties, and live with feelings of shame and loss of self-worth. (Anderson 2010, 239)

Wardle agrees that community is a necessity of self-care. He discusses how some of the church leaders come to his formational counseling classes when they are in need of care themselves. He asks them, “Where are they experiencing healing community?” He notes that the majority of the students he taught do not experience a safe place in community (Wardle 2001, 67). Wardle also says, “If you desire support, encouragement, counsel and accountability, become a part of a truly spiritual community” (Wardle 1998, 158).

13 Pettit adds that we must not just learn to love, but learn to love well.

Pettit discusses at length Five Key Principles to Learning to Love: 1) Love does not default to the status quo. 2) Love is not primarily concerned with sinning less. 3) Love is a dynamic process. 4) Love must be a commitment in every season of life. 5) Love is sustained when we experience His love (Pettit 2008,

56). The practice of these Five Key Principles better prepares us to practice self-care in community.

Self-care Practices (Inward Journey)

No one self-care practice is considered right for everyone or every situation. Wardle states that “a caregiver must take active steps to care for

[their] own personal well-being. . .unless the caregiver faithfully attends to [their] own life, involvement” (Wardle 2001, 51). Wardle also shares that being so diligent to “do” and “serve” can compromise the life of the skilled helper. The foundation for adequate self-care is both a right and a responsibility (Wardle

2001, 52).

The caregiver has the right to care for themselves regularly. Wardle admits, “some in the Christian community would take exception to that statement, believing that it is somehow noble to compromise personal health in service to others” (Wardle, 2001, 52). Oswald agrees, stating that he feels “the tension in the room rise when the subject of self-care comes up. It just doesn’t set right with some [Christians]” (Oswald 1991, 4).

Oswald contends that it is difficult for us to be proponents of God if we do not care for ourselves. He also asserts that self-care is not narcissism (Oswald

14 1991, 5). Cloud and Townsend note that our needs are our own responsibility.

It is not wise for us to wait for someone else to care for us. We must understand that caring for ourselves is neither bad, selfish nor a luxury (Cloud and

Townsend 1992, 107).

Context

The survey participants were graduates of the counseling program at the

Ashland Theological Seminary – Detroit Campus. This study assessed to what degree the graduates were or were not using the self-care practices that were taught in the Dimensions of Healing course. I interacted with many of the participants at a local supervision group of licensed counselors. I was fortunate that the facilitator of this group allowed me to use her group as the primary source of my participants. The setting was a group supervision session, led by a licensed professional counselor with supervisory status, who was also an

Ashland graduate from the Detroit Counseling program. The eleven participants were all limited licensed counselors in the state of Michigan, and were predominantly female and African American (22 out of 23). The other twelve participants were gleaned from their anonymous participation in a Survey

Monkey assessment sent via Facebook and Email.

I focused on graduates of the Detroit counseling program, who were required to take the Dimensions of Healing course, were currently working in the counseling field, or identified themselves as caregivers and ministry leaders. I had hoped to have at least twenty-five graduates participate in the assessment, but only 23 completed it.

15 Project Goals

Healing course into their personal lives. The research question was, to what degree did a select group of counseling graduates from Ashland Theological

Seminary – Detroit integrate the self-care practices that are taught in the mandatory Dimensions of Healing course into their personal lives?

My project goals were as follows:

1. To discover the degree to which participants have integrated the self-care

practices taught in the mandatory Dimensions of Healing course into their

personal lives.

2. To discover the degree to which participants’ personal lives have been

affected by the integration of self-care practices.

3. To discover the degree to which the self-care practices have influenced

the personal lives of the participants.

4. To discover the degree to which the participants understand self-care

practices as a biblical practice.

5. To discover the degree to which the participants perceive self-care

practices as a necessity.

6. To discover the self-care practices used in the personal lives of the

participants.

7. To discover the degree to which time is a factor in self-care practices.

16 8. To discover the degree to which the participants have an overall

understanding of self-care practices.

Design, Procedure, and Assessment

A survey was created that was distributed both in person and online to the target participants. This ensured that I reached as many graduates as possible. The hope was to gather the data from the assessment of 25-50 people in the targeted population. The final count for the number of participants was

23.

The assessment included both quantitative and qualitative questions which was developed based on the project goals. A seven-point Likert scale was used to measure the degree of incorporation of self-care practices, ranging from completely agree (7) to completely disagree (1) with a neutral mid-point (4).

The final section contained three open-ended qualitative questions.

Personal Goals

Initially, this project was less than personal for me. In my mind, I thought that I was handling self-care pretty well. Prior to attending seminary for my

Master’s degree, I had never heard of the phrase self-care. So when I heard it for the first time, and I began to learn the concepts of self-care and how to live out this notion of self-care, I began to do just that. I was very good at it, until it was tested in a way that I did not know was even possible.

My journey has been one filled with quite a few ups and downs. Since graduating from the counseling program, there have been times when I needed to engage self-care practices but felt like I could not for various reasons. In light

17 of the following goals, I was able to use this process to gauge how effective my own self-care practices have been following graduation.

My personal goals were as follows:

1. To be more open to the Holy Spirit through the implementation of self-

care practices.

2. To be more aware of the presence of God through the spiritual disciplines

of prayer.

3. To be more fully engaged with Jesus through the implementation of

formational prayer practices in my personal life.

Definition of Terms

Self-care – “care for the self as created by the image of God and valued by God for its own intrinsic worth” (Anderson 1995, 8).

Dimensions of Healing – “this course is designed to provide an understanding of some of the holistic approaches to healing, with a major focus on the role of the Holy Spirit in Healing. Provides the student with an overview of the pastoral counseling process. Emphasis will be placed upon the students personal and spiritual growth” (ATS Course Catalog 2017). This course focuses on the healing aspects of self-care.

Formational Counseling: A ministry of the Holy Spirit where the caregiver provides spiritual care to individuals in need (Wardle 2001,15).

Plan of the Paper

As previously stated, it was the purpose of this project to discover the degree to which a select group of counseling graduates from Ashland

18 Theological Seminary – Detroit have integrated the self-care practices taught in the mandatory Dimensions of Healing course into their personal lives. The following chapters include biblical, theological, and historical foundations

(Chapter Two); a review of the contemporary literature (Chapter Three); a detailed description of the method, procedures, and design of the project

(Chapter Four); and results (Chapter Five). Chapter Six includes a summary and reflection of all of the findings as well as implications of self-care as it relates to clinicians’ work.

19 CHAPTER TWO

BIBLICAL, THEOLOGICAL, AND HISTORICAL FOUNDATIONS

On May 7, 2017 my life changed forever. My mother sustained numerous broken bones, and my father was killed as the result of a car accident. At 32, I became a caregiver, planned my first funeral, and my heart was irrevocably broken. At the time, I was in the beginning stages of this doctorate of ministry project and dissertation process. After reflection on that time in my life, not once did I stop to put a plan in place for my self-care. The only thing I knew for sure was that my mother had to be cared for and my father had to be buried.

Who do you love? Take a moment and get that answer in your mind.

Who is that person, or those people? Maybe your initial thought was of a parent who nurtured you from birth. Perhaps you thought of your significant other, who after you first laid eyes on them swept you off your feet, or of the children you bore, or saw birthed. However, I would be highly surprised if the first response that came to your mind was yourself.

Having done this exercise with many people and groups and in many different settings, I have not yet had anyone’s initial response refer to themselves. It can be so easy to love those who have loved us, and even those who cannot love themselves. Sometimes that love has caused us to neglect our own self-care in the name of loving others. But is this what God and the church over time have really asked us to do?

20 In this chapter I provide biblical, theological, and historical foundations supporting my project and I hope answering this question. The first section focuses on the Biblical Foundation, introducing self-care themes throughout scripture that validate the need for caregivers to engage in self-care. These themes are rest/contemplation and community, focusing on two primary scriptures: Luke 10:38-41 and Mark 6:31-33. The second section focuses on the Theological foundation. Upon its completion, the reader should have an understanding of the Trinity as community, and Sabbath as a theological construct. The final section focuses on the Historical foundation. In this section the reader should understand the history of the Sabbath, as well as the importance of engaging the Sabbath.

Biblical Foundation

The goal of the biblical foundation section is to lay a strong biblical foundation for the need of professional caregivers to engage in self-care. In this section, the reader engages the themes of rest, contemplation, and self-care through community. The primary scriptures used are Luke 10:38-42 and Mark

6:31-33. As mentioned in Chapter One, The NRSV translation of the Bible was used throughout the document unless otherwise noted.

Luke 10:38-42

Luke 10:38-42 tells of the account of two sisters, Mary and Martha. The two had the opportunity to host Jesus and His disciples in their home. The text introduces the concern that Martha had with her sister in Luke 10:40. Martha was distracted by her many tasks, so she came to Jesus and asked, “Lord, do

21 you not care that my sister has left me to do all the work by myself? Tell her then to help me” (Luke 10:40 NRSV). The role of these two women has been interpreted as a representation of the juxtaposition of a life that is active versus the contemplative life (Metzger 1993, 602). Martha can be viewed as a representative of Christians that focus more on activity, and serving others.

Mary is a representative of Christians who take time to sit and glean for Jesus for themselves.

A different insight on this passage can be gleaned from Hearon, who discusses the idea of servitude as it relates to women. Her premise is that people, especially women, should not have to choose between what Metzger describes as the active life versus the contemplative life (Hearon 2004, 393).

From her perspective, both are needful and important in the Christian life. Like the Old Testament account of this idea of rest, there is no question whether or not the restful life or the contemplative life is necessary. What is demonstrated throughout scripture is how making space for contemplation and rest (self-care) makes space for divine instruction.

The theme of rest can be found throughout scripture. Some scholars have even used the pericope in Exodus 20 as the command to rest:

Remember the Sabbath day, and keep it holy. For six days you shall labour and do all your work. But the seventh day is a Sabbath to the LORD your God; you shall not do any work-you, your son or your daughter, your male or female slave, your livestock, or the alien resident in your towns. For in six days the LORD made heaven and earth, the sea, and all that is in them, but rested the seventh day; therefore the LORD blessed the Sabbath day and consecrated it. (Ex 20:8-11)

22 This theme can be inferred from the Mary and Martha text, as Jesus allows for and encourages Mary’s contemplative state. This is key in understanding that time spent with God is Holy and sacred. It appears that Mary was able to enjoy that understanding, but Martha was not. However von Rad cautions against the notion that Mary’s time with Jesus was an “institution of Sabbath;” for him it seems that what some view as a declaration of the sabbath, instead of a rule, is simply an announcement of rest (von Rad 1972, 62).

A similar theme can be observed with Elijah. Brueggeman highlights that the need to be still, like Mary, and rest and even sleep as a necessity should not be negated; according to Brueggeman, “sleep is a time when the inscrutable powers of God work their will with us” (Brueggeman 2000, 244). This was illustrated when Elijah rested and slept, subsequent to the traumatic encounter he had with Ahab and Jezebel in 1 Kings 19. It was while Elijah was sleeping that God sent His angel to nourish Elijah for the journey that was ahead.

Patterson and Austel assert that God’s activity in self-care for Elijah occurs when time is spent in Sabbath, and God “tenderly nourishes and leads his prophet to a place where he would get some much-needed instruction”

(Patterson and Austel 1999, 149). Similar to Mary in this moment, Elijah had to pause before he could receive instruction.

In this reading, Martha can be seen working and tending to the duties of the house. Martha was in the presence of God but was more concerned with her hosting duties. Martha was busy preparing for Jesus, but was not attentive

23 to what He had to say while she was in His presence. Mary, on the other hand, could be seen at the feet of Jesus, taking in all that instruction He had to offer.

As Jesus and his disciples were on their way, he came to a village where a woman named Martha opened her home to him. She had a sister called Mary, who sat at the Lord’s feet listening to what he said. But Martha was distracted by all the preparations that had to be made. She came to him and asked, “Lord, don’t you care that my sister has left me to do the work by myself? Tell her to help me!” “Martha, Martha,” the Lord answered, “You are worried and upset about many things, but few things are needed-or indeed only one. Mary has chosen what is better, and it will not be taken away from her.” (Lk. 10:38-42)

In this pericope, Mary appeared determined to get what she needed.

Johnson says, “she was attentive to what he was saying and therefore received him as he was” (Johnson 1991, 173). Once Mary found herself positioned to receive what she needed, Jesus would not allow that to be taken from her; not even the tattling of her sister would make Jesus stop Mary from receiving in this contemplative state the hearing of the word and taking it in (Kilgallen 2003, 555).

According to Metzger, the Greek translation of this scripture is: “Martha was distracted by much service.” The term service here can imply that what

Martha was doing was probably both good and needful. Often times when there are things that have to be done, an individual may feel like they cannot stop for that sacred Sabbath moment to lean into whatever God may have for them in the present moment (Metzger 1993, 602). Johnson agrees with Metzger as he notes Martha’s request of Jesus was an accusation against her sister (Johnson

1991, 174). Bartlett however deduces that Martha’s service should not be overlooked as she is operating in a gift from God; disagreeing with Metzger,

24 Bartlett says this of serving: “[serving] is a gift in the first place, [it] is not possible through the strength of the server, but only through the strength that God provides. So, then, God gives gifts; God gives words; God gives strength”

(Bartlett 1998, 304).

To negate Martha’s service is to negate the service of the caregiver. Thus it is imperative that operating in gifts is not negated, as observed as Peter speaks to the need for serving others. He says:

The end of all things is near; therefore be serious and discipline yourselves for the sake of your prayers. Above all, maintain constant love for one another, for love covers a multitude of sins. Be hospitable to one another without complaining. Like good stewards of the manifold grace of God, serve one another with whatever gift each of you has received. Whoever speaks must do so as one speaking the very words of God; whoever serves must do so with the strength that God supplies, so that God may be glorified in all things through Jesus Christ. To him belong the glory and the power forever and ever. Amen. (I Pet 4:7-11).

Kelly’s states that when a caregiver is serving to the glory of God, their service does not go unnoticed. However it is vital that the caregiver recognize the self- care balance between the busy life and the restful contemplative life (Kelly

1981). Kelly states, “[the caregiver] gives glory to God when they heartily acknowledge that whatever service they offer the community, in charitable good works, edification or anything else, is in fact the overflowing of his abounding goodness” (Kelly 1981, 181).

Perhaps Martha was so upset at having to serve without her sister’s help that she had to get Jesus involved to play referee, trying to get Him to get her sister to act the way she was, instead of being aware of and accepting the invitation to sit at His feet and be with and for Him, in that moment. “Martha’s

25 worries are of less concern than is listening to the word of the Lord” (Kilgallen

2003, 555). In considering sacred moments and rest as self-care, it is needful to understand that while things have to be done and these things may be very necessary, the time may or may not be efficacious. The aforementioned Peter text gives individuals the ability to see that there will always be things that could be done, but finding the right balance or harmony is so necessary. As Hiebert asserts, “Christian service should be rendered in a spirit of humility and divine enablement” (Hiebert 1984, 260). A further question can be raised, If she felt she needed her sister’s assistance, was Martha serving out of her own strength or out of the strength provided to her by God?

An individual can see that Mary’s willingness to pause and be contemplative in the form of listening is important because it also speaks to relationship. Kilgallen refers to Mary as a disciple in this moment; he says that the disciple is blessed by pausing, listening and hearing (Kilgallen 2003, 556).

Scripture demonstrates that rest and the contemplative life, a life of self-care, can lead to the care, instruction and blessing from God. This is also thematic in the life of Jesus.

The next text highlights Jesus, who had told Martha that her sister was doing the right thing essentially by not working but worshipping in the moment, making sure his friends the disciples were caring for themselves. The sixth chapter of Mark provides another example of the value that Jesus placed on self-care in the form of rest and community.

26 Mark 6:31-33

Mark 6 references where Jesus invited His disciples to come away and rest, because they had been working so hard that they had not even had an opportunity to eat. The setting of this text is the wilderness; biblically, the wilderness holds much symbolism as it is often either a place of provision or punishment (Kim 2018, 62). According to Kim, in this text, Jesus’ wilderness provision is self-care in community, in the form of rest and nourishment. It is clear that Jesus and His disciples would be exhausted if they did not soon care for themselves. “He said to them, ‘Come away to a deserted place all by yourselves and rest a while.’ For many were coming and going, and they had no leisure even to eat. And they went away in the boat to a deserted place by themselves” (Mk 6:31-33).

In this text Jesus’ humanity is obvious, as is His desire for his community to be well along with Him, to rest and eat. According to Beavis, this is atypical for a Markan account of scripture, as Mark is typically known for highlighting

Jesus’ divinity (Beavis 2011,88). She notes that Hedrick makes this point in reference to the Markan Christ, “Jesus is a highly successful worker of deeds, wondrous and beyond normal human ability” (Hedrick 1993, 221). This humanity that is seen in this text gives credence to the need to have others in our lives who will help us metaphorically stop, eat and rest (Hubbard et al. 1989, 339). A level of accountability comes with being in community, and there should be those in the lives of caregivers who share their space who can gently speak to the need to care for themselves.

27 According to Marshall, Mark and Luke both highlight Jesus’ display of self-care, and he agrees more with the way in which Mark suggests that Jesus would retreat with others in order to engage in self-care in community; in this scenario is was his disciples (Marshall 1979, 210). Hobbs makes a valid point in his commentary, noting that “the pressure of [Jesus’] ministry was so great that

Jesus was repeatedly withdrawing, often alone” (Hobbs 1966, 101). However,

Marshall makes the point that Jesus’ withdrawal with the disciples, to engage in the act of self-care through rest, prayer or eating, displayed His humanity and demonstrated this need to be in community and care for yourself within that community (Marshall 1979, 210). It was during times of performing miracles and ministering to masses that Jesus needed to find a way to do self-care. To this point Godet notes:

While seeking to calm the excitement produced by His miracles, Jesus endeavored also to preserve his energies from any spiritual deterioration by devoting part of His time to meditation and prayer. As Son of man, He had, in common with us all, to draw from God the strength He needed for His hours of activity. (Godet 1981,169-170)

The Bible has many passages that speak to the need for individuals to have good interpersonal relationships within community. According to Kirwan, there is a human need for individuals to be in close relationships. Love and trust are implied with Jesus and His disciples, and Kirwan notes that the notion of love is assumed throughout scripture (Kirwan 1984, 38). Earlier in this sixth chapter of Mark, Jesus commissioned the 12 to go out in pairs to do the work of ministry, which is an example of closeness: “perhaps for protection, mutual support… or because a valid testimony requires two agreeing witnesses

28 (Geddert 2001, 137). The relationship of the disciples to one another and with

Jesus further demonstrates self-care within community. Jesus’ ministry did not consist of him trying to minister to multitudes alone and Jesus did not send the disciples out alone. According to Beavis, this can be paralleled to early missionaries ministering in community “such as Peter and John, Paul and

Barnabas, Paul and Silas, Priscilla and Aquila, Andronicus and Julias, and Titus and ‘our brother’” (Beavis 2011, 101).

In his commentary, Geddert highlights Mark’s discussion of the “glory side (glowing reports of missionary success), and the cross side (courageous and costly self-sacrifice)” (Geddert 2001, 147). As Mark links missionary success and self-sacrifice (which is essentially the work of the modern-day caregiver noted in this project), he adds this notion of rest, pause, and nourishment (Geddert 2001, 147).

According to Beavis, the apostles in the text represent the caregivers.

They “return to their master and report to him everything they had done and taught. The busy scene of people coming and going, so that the missionaries don’t even have time to eat…Jesus’s instruction to rest with him in a solitary place” is no different than the other places in the Markan text, except that the disciples were invited to come along with Jesus (Beavis 2011, 105). Kirwan makes the following observations throughout the old and new testaments. The first is that humans are created with social needs and spiritual needs, and God did this by design. The second is it is necessary to have good interpersonal relationships. These relationships should be intact with both God and other

29 people. It is these interpersonal relationships that will fulfill both the spiritual and social needs. Finally, if those needs that God designed are not met though good interpersonal relationships, this can negatively affect the individual (Kirwan

1984, 41). Perhaps these points expressed by Kirwan can be observed even earlier in Mark 6 when Jesus commissions the disciples. They go off together to be witnesses for each other in their missionary work and then are invited to go away with Jesus for rest and sustenance.

The spiritual needs of the people were being met because Jesus and his disciples had been performing miracles and teaching. It was Jesus who took a moment to look at his friends to let them know it was time to stop. Donahue and

Harrington have the conversation about the ‘desolate place’ mentioned in scripture. They note that often when Jesus went to pray, he would find a

‘desolate place.’ They go on to discuss the notion of rest. According to

Donahue and Harrington, the Greek word ‘anapausathe’ alludes to the similar version of the word found in Psalm 23. This version of the word ‘anapauseos’ literally means water of rest (Donahue and Harrington 2002, 204). Bergant makes the point that the rest found in Psalm 23 is indicative of the care that is provided from God as the Shepherd. As the Shepherd, God “attends to both the physical needs of the sheep and to the soul” (Bergant 2013).

It is interesting that many commentaries skip over the Psalm 23 reference, which could be deemed a scripture to support self-care. Mann glosses over this fact that Jesus recognizes the need of His community, and instead uses this opportunity to focus on the designation of the disciples as

30 missionaries and apostles (Mann 1986, 298). Donahue and Harrington use a parallel description to show that these Greek words are related to that in Psalm

23, as it pertains to a shepherd caring for the psalmist. In this psalm, the shepherd provides rest and peace (Donahue and Harrington 2002, 203).

Donahue and Harrington go on further to discuss rest which parallels with the scripture, “Come to me, all you that are weary and are carrying heavy burdens, and I will give you rest. Take my yoke upon you, and learn from me; for

I am gentle and humble in heart, and you will find rest for your souls” (Mt 11:28-

29). In this text, Jesus promises rest to all those who are weary (Donahue and

Harrington 2002, 204). An inference can be made here that just as Jesus promises rest, it is necessary for individuals to engage in rest (to come unto him) as a form of self-care.

There is a brief discussion on verse 31 by Hubbard et al. In summation, they discuss the term ‘to rest for a while,’ noting that its implication is the necessity for the disciples to stop what they were currently doing. It is their opinion that this phrase stands out in the Markan text because it is not common throughout Mark’s gospel to reference Jesus’ compassion to the disciples; often

Mark only refers to the multitude. Further, these authors make this connection with the phrase in Mark 6:34, noting that this may foreshadow the “same attitude… and express his concern for his disciples who had been so preoccupied with the comings and goings of the people that they could not even find time to eat” (Hubbard 1989, 339).

31 This passage highlights Jesus’ care and concern for His disciples’ well- being: while He knows that the work they are doing is incredibly important, He demonstrates that they are incredibly important to Him as well. Lane explains that the presence of Jesus will allow for rest, which is the provision of God (Lane

1974, 225). Dowd would be in opposition to this being specifically about self- care, as she posits these verses as mere symbolism. She introduces that the author of Mark uses the symbolism of rest that points back to the Psalm 23 shepherd as a provider, which leads to the feeding, beginning in Mark 6:34

(Dowd 2000, 68).

One may assert that Jesus would not allow his friends, those who left all and followed Him at His word, to perish because of the need to care for others.

Mann discusses at length Jesus’ compassion toward the multitude as Jesus was willing to make sure that everyone was fed (Mann 1986, 301). With Mann’s emphasis on the miracles and the mission, Mann misses Jesus’ equal concern for those that he walked with daily (Mann 1986, 301). One cannot deny the importance of understanding the mission of the disciples and the work that they had set before them in performing miracles. Yes, helping others along the way is important and needful, but similar to the Mary and Martha passage, this cannot be done to the detriment of ones’ self.

It is needful for these biblically supported truths to continuously be unpacked, as Kirwan notes that the more biblical truths we uncover, the more knowledge we have about God’s original intent (Kirwan 1984, 41). It is true that caring for others is important, but if an individual is not a good steward of

32 themselves and their self-care, there will be little they can do to care for others. van Iersel (1998) points out that Jesus was well aware of the need for the disciples to rest. They had gone out and casted out demons and done all manner of missionary work, so much so that Jesus offered them an invitation to rest (van Iersel 1998, 225). Ultimately, an individual can note from this Markan pericope that operating in and taking care of self in community is vitally important to Jesus. So much so, that Jesus took time to note the physical fatigue of his apostles and offer a solution that they would come together and rest and eat.

The objective of this section was to provide a Biblical foundation for self- care. It was my intent to establish Jesus’ support and practice of self-care and to explicate the themes of rest, contemplation and nourishment. Additionally, these biblical examples led to a discussion of self-care within community.

Theologically, this connects with the theological foundations of the Trinity as the role model for sacred community, and the practice of Sabbath.

Theological Foundation

This section discusses the theological concepts of Trinity and Sabbath.

The first section involves the theological foundation for the need for self-care of the professional counselor centered on the Trinity as sacred community. The second foundation focuses on how observing Sabbath as a spiritual discipline offers individuals the ability to commune with God and care for self.

33 Trinity

Seamands describes the Trinity as grammar as it relates to Christian faith. Essentially, he defines grammar as guidelines that ensure that we use the language in a correct manner and helps individuals adequately apply appropriate meaning so that one can adequately articulate their thoughts about

God. Seamands goes on to say that “the doctrine of the Trinity has been described as the grammar of the Christian faith…., the Trinitarian doctrine enables us to speak rightly about the God who is revealed in Scripture as

Father, Son and Holy Spirit” (Seamands 2005, 11). According to Seamands, for the Trinity to be like grammar is not to say it is simple communication, but it describes communion, the Godhead with itself and us with the Godhead. When one considers the notion of self-care in community as it relates to the doctrine of the Trinity, it can be described as not only our life with God, but also our life with each other (LaCugna 1991, 228). This speaks about a deeper knowing, a knowing that leads to experiencing God’s harmony within the lives of the individual caregiver and with each other.

In this project, caregivers identified longing for peace, harmony, and rest as goals of self-care. Harmony is also a key aspect of the doctrine of the Trinity, understanding that the three individuals of the Trinity are not three gods, but are

One God, existing in unity and unison: “The Father is the eternal Father, the

Son the eternal Son, and the Spirit eternally distinct from both Father and Son.

This diversity speaks of the richness of God, while never allowing the richness of differentiation to lead to discord” (Ware 2005, 20). Just as the Father offers

34 himself in the Trinity, He offers himself to individuals as well. The same goes for the Son and the Holy Spirit as they lend themselves to individuals. “God relates to us in a threefold manner, and this threefold, free, and gratuitous relation to us is not merely a copy or an analogy of the inner Trinity, but the Trinity itself”

(Rahner 1974, 35).

Since God is relational by nature, we can get a glimpse of His nature which is revealed within the Trinity. Tanner states, “God is different from the world in virtue of the fullness of God’s trinitarian life, but it is this very fullness that enables God to overflow in goodness to us” (Tanner 2001, 13). Harrison notes that every human is unique, and even though we are all different, God makes it possible to see Himself in each individual because we are all created in the image of God. Humans bear the Trinity’s likeness when they live together in harmony as a community (Harrison 2010, 170). An individual becoming more aware of their likeness to the Trinity is a necessary step in living out a life inclusive of self-care, especially within a safe community.

Theologically speaking, a safe community can promote self-care through its members sharing encouragement and practicing accountability. An example of this was at Jesus’ baptism, found in Luke 3. This act shows the power and necessity of community so much so that even the Trinity is physically together at one time in support and approval of this act of Jesus’ baptism. Miller supports this thought that coming together as community is a direct reflection of the image of God (Miller 1979, 27). Tanner says this “[reinforces] the unity of being between Father and Son by a unity of love and joyful affirmation; the Holy Spirit

35 is the exuberant, ecstatic carrier of the love of Father and Son to us” (Tanner

2001, 14). Gorman shares how operating together is better than the sum of the individual parts (Gorman 2002, 48). The pursuit and experience of harmony is needed to exist in a safe community. The Doctrine of the Trinity promotes harmony by operating within and modeling a safe and encouraging community.

To properly care for themselves, the formational counselor should consider being engaged in community. The same can be said for all counselors and those who spend their lives caring for others. According to Tanner, this is especially true because “god’s manifestation in the world is completed in Christ through the work of the Spirit who enables us to return the love of God shown in

Christ through a life lived in gratitude and service [to others] to God’s cause”

(Tanner 2001, 14). Similarly, Seamands outlines three areas that should be utilized by the formational counselor who is practicing effective self-care: “First, a commitment to wholeness in our interpersonal relationships. Second, a commitment to involvement in close-knit small group fellowship. And third, a commitment to healthy family relationships” (Seamands 2005, 40). God stresses that we have to learn how to not just live and love, but also live and love in community.

Crabb agrees that human beings are created in the image of the Trinity and also must find a way to operate in community. His perception was that the thing that characterizes the inner life of the Father, Son and Holy Spirit is relational personhood. It is this same relational personhood that is paramount to human personhood as well (Crabb 1997, xvii). Peter explains, “the issue

36 regarding personhood prescinds from the issue of substantialist metaphysics. If we follow the classical logic and think of a person as a substance, then every community including the Trinity is a mere aggregate of individuals (Peters 1993,

36). Understanding this relational personhood is important in understanding the essence of Trinity. Tanner notes, “God is not changing God’s relation to us in

Christ but changing our relation to God” (Tanner 2001, 15). Tanner’s idea is that we are being brought to the triune God for relationship with Him. There is a constant invitation from the relational trinity to individuals to be brought into deeper relationship with the Trinity (Tanner 2001).

It is important to remember that we are defined by God. It is better to start with the Triune God as our example, who exists “as one in the communion of three persons, Father, Son and Holy Spirit” (Seamands 2005, 35). By starting with the Triune God, we reach a different perception of personhood. The names of the three persons offer an implication of that relationship (Seamands 2005,

36). Peters notes that according to Joseph Bracken, “community and personhood are correlative. Neither is prior. Each requires the other. Hence, in one and the same moment, all of the three divine persons are constituted as individual existents, and God as Trinity is constituted as a divine community”

(Peters 1993, 37). According to LaCugna, “person indicates relationship…

Trinitarian doctrine is therefore inescapably a theology of person, regardless of how this is formulated” (LaCugna 1991,180).

The example given by Seamands is that the Son is only the Son by virtue of His relationship to the Father (Seamands 2005, 35). Gunton says it this way:

37 “God is no more than what Father, Son and Spirit give to and receive from each other in the inseparable communion that is the outcome of their love” (Gunton

1991, 10). In agreement, Downey notes that we are not beings who are self- contained, that can pick and choose if and when to be in relationship. He says,

“From our origin we are related to others. We are from others, by others, towards others, for others just as it is in God to exist in the relations of interpersonal love” (Downey 2000, 63).

As an individual considers the example of the relational nature of the

Trinity, they begin to get an understanding about how it may be beneficial for them to operate in intimate groups with one another. The accountability and harmony that can take place in community can be vital elements that speak to an individual’s ability to care for themselves. Peters states that an individual’s relationship with God “requires community with others and a sharing of the deepest kind” (Peters 1993, 26). There are many ways that this can be done, but one other theological construct can help us to operate more intimately in community. That is the theological construct of Sabbath.

Sabbath

Sabbath is a time and a place of rest, but also worship. Sabbath is a moment in time and a time set apart. However it is so much more than one specific day of the week. Allender discusses Sabbath from three different perspectives: the Sabbath as a commandment, the Sabbath as a day of delight, and the Sabbath as a feast. He notes that “Sabbath rest is not an option; it is a commandment” (Allender 2009, 6). Calvin sees Sabbath as God establishing

38 the necessary time for humankind to rest, not as a declaration that God needed to rest (Calvin 1948, 106).

It is interesting to think of Sabbath as a commandment. Allender notes that if we think of it as a commandment, then we are supposed to set aside the day. He states, “If we violate this normative structure, there will be consequences that spiral through all dimensions of life” (Allender 2009, 7). One such consequence could be the lack of self-care, leading to burnout and disharmony in our lives.

Bonhoeffer would agree with Allender, and add that in honoring the

Sabbath, we honor the creator of the Sabbath. According to Bonhoeffer, you cannot separate the Creator of rest from His creation, which is the act of rest.

He says:

God remains the Creator, but now as the one who has accomplished his work. We now understand rest to be at the same time the rest of his creation. His rest is our rest (as his freedom is our freedom, his goodness our goodness). Therefore God sanctifies the day of his rest for Adam and for us whose heart is restless until it finds rest in God’s rest. As far as we are concerned this rest is the promise which has been given to the people of God (Bonhoeffer 1962, 40).

The second concept Allender covers is that the Sabbath is a day of delight for humankind. This contemplative or restful time is a time that God blesses. Calvin says it this way, "first, therefore, God rested; then he blessed this rest, that in all ages it might be held sacred among men; or he dedicated every seventh day to rest, that his own example might be a perpetual rule"

(Calvin 1948, 106) In the Genesis creation story when the Trinity rested on the seventh day, it set the model in place for the Sabbath day observance.

39 Moltmann notes that the Trinity wasn’t tired from “creational enterprise.” He contends that the Trinity was setting a precedent for humankind to follow of resting together after having been engaged in work together (Moltmann 2000,

28). This concept promotes self-care in community and the benefits of self-care following times of working together.

Bonhoeffer introduces the Sabbath as the day of the Lord’s resurrection.

He says “it is the day of rest, the day of victory, of dominion, of perfection, of transfiguration; for us, it is the day of worship” (Bonhoeffer 1962, 45).

Bonhoeffer goes further to note that the holy day should be treated as a holiday, such that “rest happens after work is accomplished” (Bonhoeffer 1962,46). Often the point that the Sabbath is a Holy time to be spent with God in a space of contemplation is overlooked by this thought that Sabbath means rest only. The

Sabbath is not only about resting but spending time in that contemplative state with God, which is an act of worship (Calvin 1948, 107). While there are some points of agreement between Bonhoeffer and Calvin, Calvin makes it a point to note that Sabbath is much more than a holiday. He says

God did not command men simply to keep holiday every seventh day, as if he delighted in their indolence; but rather that they, being released from all other business, might the more readily apply their minds to the Creator of the work. Lastly, that is a sacred rest which withdraws men from the impediments of the world, that it may dedicate them entirely to God. (Calvin 1948, 106).

For Calvin, Sabbath remains about relationship with the creator, which speaks to Allender’s metaphor of Sabbath being a feast to enjoy communion with God. Additionally, Ellis also discussed the idea that we establish solid relationship with God when we engage in Sabbath. His thought is that we do

40 not have to operate in pretense. In fact, for Ellis we allow God to “move toward a reformation of the image of God’s self within us. In such rest, a sense of self- worth can be reclaimed, and we can rediscover enjoyment in the goodness of creation” (Ellis 2006, 318).

Allender also asserts that the Sabbath is a communal feast which is a

“sensual delight to be enjoyed in communion with God, others, and creation”

(Allender 2009, 65). This time does not have to be a literal feast, but it may be.

Barth highlights that this time is about communing with one another in the beauty as it relates to the Trinity. He says:

God’s triune being ‘is radiant, and what is radiates is joy. It attracts and therefore it conquers. It is therefore beautiful.’ In other words, the triunity of God, its difference in unity, its relationality and harmony, its being and economy, its loving interweaving of persons as if in a cosmic dance, radiate beauty. (Barth 2001, 114)

Barth states that the Sabbath should be an enjoyable and continuous dance.

Allender agrees with this thought by writing, “The Sabbath is a day when we enter a dance with God and others and experience a beauty that takes our breath away” (Allender 2009, 67). McNeill would agree that the rested body can more fully engage God which is why he states, “we are to meditate throughout life upon an everlasting Sabbath rest from all our works, that the Lord may work in us through his Spirit” (McNeill 1977, 400).

Experiencing Sabbath as a lifestyle instead of only an event is beneficial to self-care, especially for those who are in the helping professions. It is needful to the spiritual health as well as the physical health of caregivers to take time away from the cares and the woes of others, and dare to dance with the Triune

41 God, to replenish our energy, our perspective, and our harmony. Placing our emphasis in self-care on the Trinity as our role model and on experiencing the

Sabbath regularly are essential to this project

Historical Foundation

This section discusses the history of the Sabbath in the early church, focusing on the effects of the Schism of A.D. 1054 A.D., followed by a discussion of the Sabbath’s importance to the church. That discussion highlights how the church, specifically the Puritans, thought legalistically about the Sabbath. There will also be a brief conversation around Tertullian and his change of mind from the legalistic view of the Sabbath to a more holistic view.

In the early Christian period, a phenomenal gulf developed between the

Roman church leaders and church leaders in Constantinople. It centered on what should or should not occur or be done on the Sabbath. This divide continued to widen until 1054 A.D., when the fellowship between them was finally broken. Odom notes, “one of the main issues involved in the controversy was the matter of fasting on the Sabbath” (Odom 1963, 74).

In 1053 A.D. an aggressive protest arose against making the Sabbath a day of fasting, which was a Roman practice. The Roman fast included using only unleavened bread for communion, mandating celibacy for clergy, and using the blood of animals and the flesh of strangled or suffocated animals (Odom

1963, 74). The Metropolitan Archbishop Leo of Achrida and Patriarch Michael

Cerularius of Constantinople wrote an open letter to Bishop John and the church in Trani in Ampulia. This letter not only addressed the bishop but also the

42 monks, and the pope amongst others (Odom 1963, 74). When the bishop of

Candida came into possession of the letter, he had it translated into Latin and gave it to Leo IX the bishop of Rome. The monks, priests and others began to review and debate the letter until June 24, 1054. On June 24, 1054 Humbert and his associates went to the monastery and debated publicly with Nicetas

Stethatos. This was done before the emperor and other high-ranking officials of the church (Odom 1963, 76). This contention continued, and it was not until the eleventh century was drawing to a close that the persistence of the Roman

Empire and its hierarchy mandate on fasting during the Sabbath declined

(Odom 1963, 79).

Arguments about what the Sabbath is and when it should be celebrated have occurred throughout church history. Earle notes that one such group that had much to say about the legalistic ways in which and times when the Sabbath should be observed were the Puritans (Earle 1893, 252). According to

Andrews, “Novatian, who wrote about A.D. 250, is considered the founder of the sect called Cathari or Puritans” (Andrews 1873, 311). According to Andrews,

Novatian’s treatise established the Sabbath to be observed on the 7th day

(Andrews 1873, 314). Elizabethan puritans had a massive amount of rules surrounding how and when the Sabbath day should be observed. “The puritans found in Scripture support for this observance of Saturday night, from the words in Genesis, ‘The evening and the morning were the first day” (Earle 1893, 256).

Arguments about the when and how of the Sabbath have been directed against the observance on Saturday night. These arguments have been made by both

43 American and English authors (Earle 1893, 257). Earle noted the poetic satire.

She says:

In the “American Museum” for February, 1787 appeared a poem entitled, “The Connecticut Sabbath.” After saying at some length that God had thought one day in seven sufficient for rest, but New England Christians had improved his law by setting apart a day and a half.” (Earle 1893, 258)

When to celebrate the Sabbath had been one of the major contentions throughout history. Tertullian, an early church father, saw the Sabbath as

“consisting of prayer, holy conversation, and chanting praise, along with the common meal of fellowship” (Ferguson 2005, 152). Tertullian earlier in his works spoke about the ritualistic or legalistic portion of the Sabbath. This includes when, specifically what days and time, and also in what positions

Sabbath should be celebrated. Later in his life, he had further discussion about what it meant to practice Sabbath. Tertullian is said to have changed sides concerning Sabbath, because his views on Sabbath moved from more legalistic to practical as he developed the ideas of the Sabbath Temporal and the

Sabbath Eternal (Strand 1971, 144). Andrews discusses at length the fact that

Tertullian switched his views on when the Sabbath was to be observed

(Andrews 1873, 322). It could be that Tertullian was not an enigma as described by scholars like Strand and others. Perhaps Tertullian was enlightened about what makes Sabbath truly important after spending time implementing a form a self-care, which in a monastic lifestyle involves practicing spiritual disciplines like solitude and silence.

The same questions surrounding Tertullian’s 155 A.D. to 240A.D. views on Sabbath continued throughout church history. Another Sabbath conflict

44 occurred in the 1700s. John Wesley, one of the founders of Methodism, wrote a work entitled A Word to a Sabbath-Breaker. In it, he chastens those who do not keep the Sabbath day command holy. From this work, Wesley specifies blessings that come to those who keep the Sabbath: peace, joy and rest. He also admonishes the reader to not throw away their blessings, but to fully engage in the Sabbath. Wesley continues this conversation with an implication that honoring the Sabbath is self-care. He shares that honoring the Sabbath affords the individual “a peace which the world cannot give; joy, that no man taketh from you; rest from doubt and fear and sorrow of heart; and love the beginning of heaven” (Wesley 1872, 164), all of which are a result of self-care and things most people hunger and thirst for. As he chastens the readers of this work, he also warns that the lack of Sabbath can lead to unrest essentially due to stress and excess work (Wesley 1872, 165).

Sabbath throughout history, whether seen as an event or a lifestyle practice, has been and still is a powerful activity. The celebration of Sabbath leads to greater balance and harmony in one’s life.

Conclusion

This chapter sets forth the biblical, theological and historical foundations for this project. The initial section focused on two scripture passages. The first discusses the idea of the contemplative life versus the busy life and ultimately making an efficacious decision to choose when to do what needs to be done so that an individual will not miss the opportunity to care for themselves when an opportunity arises. The second scripture stressed the importance of community.

45 It discussed the need to walk in accountability with those who will care about those that are being served, but also caring about those who are serving. Jesus cared about his disciples and took time to make sure that they cared for themselves, by experiencing nourishment, solitude, rest and community.

In the Theological section, the Trinity was explored as a relational community. A safe community was also shown to be an essential ingredient for a person to be able to care for themselves well. Finally, caring for themselves well is also a part of Sabbath. Also provided was an historic overview of the idea of Sabbath and the rifts that the Sabbath has caused over the centuries.

Ultimately the reader should have an understanding that as much as the early church fought regarding this concept of Sabbath throughout the centuries, the agreement is that Sabbath should in fact be celebrated.

Throughout this chapter it has been my goal to lay the necessary biblical, theological, and historical foundations for my project as it relates to the need for self-care for professionals who are in helping fields, specifically licensed counselors who graduated from Ashland Theological Seminary – Detroit. In the following chapter I will engage pertinent contemporary literature as it relates to this project.

CHAPTER THREE

REVIEW OF THE LITERATURE

Burnout can happen as a result of the lack of self-care. After helping so many others, burnout can come as the unwelcomed realization of self-neglect.

It is important to realize that helping others cannot be to the detriment of one’s own wellbeing.

This chapter dialogues with contemporary writers who discuss self-care as a prevention or response to burnout. Self-care is examined from three vantage points: the upward journey (self-care in relationship to God), the outward journey (self-care in relationship with others -- community), and the inward journey (self-care in relationship to self). Included is also a discussion on how the spiritual disciplines can be used as a form of self-care to fight against burnout.

This discussion begins by defining burnout, then moves into a conversation regarding self-care deficit theory. A dialogue follows which outlines the upward, outward and inward journeys. This chapter ends with a brief discussion about spiritual disciplines as a form of self-care to prevent or remedy burnout in each of the three journeys.

Burnout

“Burnout is a fluid and interchangeable term that boasts many definitions.

The actual definition of burning out is best described as a progressive state occurring cumulatively over time with contributing factors related to the individual” (Gonzalez 2019, 11). Freudenberger’s definition is “to fail, wear out

47 or become exhausted by making excessive demands on energy, strength or resources” (Freudenberger 1974, 159).

For a clinician, this can be manifested as the lack of time with family, or symptoms that are similar to depression and stress. The idea of burnout for those in the helping field is known as compassion fatigue. Compassion fatigue was “first introduced by Joinson (1992), and describes the gradual lessening of compassion among care-giving professionals who work with traumatized individuals” (Decker et al. 2015, 30). Those who work with traumatized individuals and individuals in crisis in turn can experience vicarious trauma and crisis. Vicarious trauma can also cause individuals to have the same types of symptoms that come from crisis or traumatic events (Decker et al. 2015, 43).

Wright asserts that not all trauma is created equal, and everyone is not affected the same by experiencing the same trauma or crisis. Wright offers a definition of crisis as a “crucial time and a turning point in the course of anything”. He contends that trauma is a response to crisis (Wright 2003, 194).

For caregivers who deal with trauma and crisis, it is imperative that they become aware of their own responses to such events.

According to Figley, burnout is “the cost of caring” (Figley 1995, 103).

For the clinician it is important to be aware of the likelihood and signs of burnout.

Joinson points out that caring professions “set [a care giver] up for compassion fatigue” (Joinson 1992, 119). She discusses the importance of being aware that because of the helping profession, burnout out/ compassion fatigue is nearly inevitable because of the way a caregiver must care. For Joinson, she notes

48 that the key to avoidance of burnout is self-awareness, so that the caregivers know the signs so they can avert it with self-care (Joinson 1992, 119).

May asserts that “addictions are not limited to substances” (May 1988, 9).

Lehr discusses burnout as a type of codependence, or the addiction of helping others. He created his own definition of codependence as burnout:

A set of maladaptive behaviors that a person learns to survive in an experience of great emotional pain and stress that are passed on from generation to generation. These behaviors and their accompanying attitudes are self-defeating and result in diminished capacity. Codependents do not take adequate care of themselves and are far too controlled by (or controlling of) other persons’ behaviors and attitudes. (Lehr 2006, 11)

Lehr’s premise is that caregivers become addicted to helping others, to the point of depending on helping others to make them feel good about their life’s work. According to Lehr, this leads to burnout because then the helper is not caring for themselves properly and not allowing themselves to be cared for

(Lehr 2006, 12). May helps us to see that addiction is inappropriate attachment, and an individual can be attached inappropriately to things that are good (e.g. helping others). This type of addiction appears benevolent, but is not. Often individuals are blinded by these good addictions simply because they make the individual feel good and look pious. May calls these “Attraction Addictions” (May

1988, 38).

Bowlby has developed a theory of attachment that supports May’s argument. Attachment is “a psychological connectedness between human beings” (Bowlby 1969, 194). When Bowlby developed this theory, he used an infant-adult developmental model. However, this theory can be translated to

49 relationships across the life span and within any context. Ultimately if an individual is not aware of their toxic attachment, helping others can become more important than helping themselves. When a caregiver is self-aware, they can implement appropriate self-care techniques to help them navigate these toxic attachments. If they do not, they can be affected by what Orem calls self- care deficiency (Orem 2001,137).

Self-Care Deficit Theory

Dorthea Orem, a nurse theorist, developed the Self-Care Deficit Theory.

Orem defines self-care as the “performance or practice of activities that individuals initiate and perform on their own behalf to maintain life, health and well-being” (Orem 2001, 141). Orem divides self-care into two orientations: internal and external (Orem 2001,141).

Internal self-care are practices that are internally positioned and they regulate internal aspects such as thoughts and feelings. In contrast, the external positioning of self-care are practices that are intentionally done to include others, in order to be held accountable to the practices of self-care

(Orem 2001,141).

Orem made the observation that the caregivers (in her case nurses) were subject to burnout based on their perceived need of patient care. She also alludes to the need for the caregiver to spend time with family and their spiritual beliefs to make sure that they are providing the best care for their care-receiver

(Orem 2001, 142).

50 Self-care as a Cure to Burnout

“The topic of self-care has emerged in the last 30 years as a particular focus of health concerns” (Becker et al. 2004, 2066). They assert that focusing on self-care essentially allows individuals to experience healthier lives (Becker et al. 2004, 2066). Other related clinical professions, such as nurses, often use terms that are considered synonymous with self-care, such as self- management, self-monitoring, and self-efficacy (Richard and Shea 2011, 255).

There is much discussion around these terms and they are given their own separate definitions. These authors note that self-care is “situation specific and culturally influenced; involves the ability to make decisions and perform actions, thus is directed toward activities under the control of the individual” (Richard and

Shea 2011, 256).

Lipson and Steiger note a definition of self-care as “activities performed by individuals or communities to achieve, maintain, or promote maximum health”. Lipson and Steiger express the need for clinicians to maintain good self- care practices in order to maintain good health for both the caregiver and the care receiver (Lipson and Steiger 1996, 16).

Theologically, self-care is defined by Anderson as “care for the self as created by the image of God and valued by God for its own intrinsic worth”

(Anderson 1995, 8). Anderson extends his definition of self-care by stating,

“This care begins with the intentions and aspirations of our original caregivers, parents, and family members who undertake responsibility for the development of the self through personal and social interactions” (Anderson 1995, 8).

51 Calhoun’s definition of self-care is “[honoring] God by nurturing and protecting the limits and desires of the body, mind and spirit” (Calhoun 2015, 90).

Calhoun’s thought is that each individual should be taking care of themselves as a way to honor God and should also present self-care as worship. Oswald says it this way,

Self-care is little more than being a steward of some rather special gifts – a physical body with its enormous resilience and beauty, the capacity to nurture others and be nurtured in return, the capacity to be aware of our lives as we are living them, the capacity to enjoy immense sensual pleasure through such simple things as a splash of orange juice in our throats in the morning or a child in our lap…I take care of myself, not only for my sake, or for the gratitude of the life given me by God, but also for the sake of others. If I don’t take care of myself, I not only hurt myself but I let others down as well. (Oswald 1991, 5-6)

Swenson asserts that in order to care for self, it is imperative to discontinue what has been adopted by society as a nonchalant way of passivity

(Swenson 2004, 205). Swenson notes that one must be able to add margins to their lives as a form of self-care. It is his opinion that we must have two plans as it relates to self-care – short-term and long-term. For the short-term, the only concern is the present moment (today). Our responsibility is to live out today only. Swenson does not discredit the future, but he describes choosing to “value the things God values and cease valuing those things of no value to Him”

(Swenson 2004, 207). James also asserts in agreement that in order for self- care to be achieved well, one must start where they are, and they must deal with all of their current issues in order to implement self-care (James 2016, 7). Her defining thought is that self-care is the balance between selfishness and selflessness (James 2016, 76).

52 When Swenson discusses long-term self-care, he shares that “God would have us set about rebuilding using the instructions previously given. He has already told us what to do – now we just have to do it” (Swenson 2004, 207).

Swenson expounds on this long-term notion of self-care where a person only has to walk out God’s principles in the long term in order for self-care to happen in an organic way.

McNeal notes that “struggles with boundary issues frequently reveal a lack of self-care” (McNeal 2006, 154). He explains that “focusing exclusively on taking care of everyone else leads to not taking care of your own physical and emotional health (McNeal 2006, 154). He goes further to note that there is little room for things like physical exercise, rest, and there especially is not enough time for a spiritual discipline like solitude” (McNeal 2006, 155). In essence, this means that when we accept the call to be who God has called us to be, we accept the call to care for ourselves and care for ourselves well. God does not call us to show grace to others and leave ourselves without the same grace. It would be best for all individuals to care well for themselves, to show God that they are grateful for the being that He created; not doing this can lead to burnout

(McNeal 2006).

Self-care and God (Upward Journey)

Wardle introduces the idea of the upward journey as the journey between mankind and God. In this journey, the individual has to seek to build, strengthen and maintain their relationship with God. In essence, the upward journey is the

“commitment to pursue intimacy with the Lord above all else” (Wardle 2001, 13).

53 Similarly, Miller states, “to desire only what Christ gives and not desire Christ himself is to be bought off by little trinkets, never to own the greater treasure of his indwelling presence” (Miller 2000, 84). It is detrimental to a person’s pursuit of self-care to just want what one could ask God for, and not desire the fullness of who God is. Miller contends that we have to be sure about our relationship with God because there are some places in our lives that can only be filled by

God alone (Miller 2001, 28).

Anderson says you must first take time to examine the idea of self before you can even begin to address the idea of self-care. Anderson asserts that the term self is one that is difficult to define without a deepening relationship with

God. He says that “the concept of self has intruded into contemporary issues where legal and moral capacity is assessed with regard to an individual’s actions” (Anderson 2010, 16). He believes that these actions are healthiest when they come from a fulfillment of our internal needs derived from our relationship with God. Anderson shares that the only way to be in touch with

God is to be in touch with self, which means self-care is a priority (Anderson

2010).

To understand this concept of self as it relates to self-care, Shaw notes that “God sees us differently than we see ourselves.” Often an individual will see only their flaws and only the things that they do wrong. God sees individuals wholly fulfilled and cared for (Shaw 2013, XV). When this is understood, we can engage in self-care through the concept of self-fulfillment, which Anderson says is “an intrinsic need and positive good for every person. It is when self-fulfillment

54 leads to a craving for self-indulgence that the craziness and chaos begins”

(Anderson 2010,39). It is this “craziness and chaos” that Shaw says develops into harmful behaviors that are the polar opposite of self-care (Shaw 2013, 15).

Shaw also provides an explanation of core longings. He says “there are essentially six core longings: love, safety, understanding, belonging, purpose, and significance. Regardless of culture, ethnicity, age, or gender, these core longings exist in every human spirit” (Shaw 2013, 19). Ultimately Shaw states that no matter the individual’s context, they will have these core longings. Shaw explains further that “one or more of these core longings may be especially strong depending on a person’s background, temperament and personality.

There also can be some overlap between these core longings, as they are intertwined within every human being” (Shaw 2013, 19).

Wardle says the world attempts to answer its self-care deficits through dysfunctional behaviors, which result from our core longs not being fulfilled.

Some of the most notable dysfunctional behaviors are idolatry, money and power, personal performance, approval, position, sexual activity, Godless pleasure and career advancement (Wardle 2005, 65). All of these can hinder both self-care and our relationship with God, thus our core longings will not be met.

Shaw says that because we are “created in the image of God, we were made to reflect God relationally…God’s desire is for the whole person, and He desires to fulfill these human core longings” (Shaw 2013, 19). As it relates to our relationship with God, our self-care is necessary so that we can honor God for

55 His desire for relationship with us. According to Shaw, in order to reach rest and contentment, these “core longings are meant to draw us into God’s embrace”

(Shaw 2013, 19) which allows us to rest in Him.

Rest is a spiritual discipline, “a truly human act of submission to and dependence on God” (Calhoun 2015, 74). This spiritual discipline enhances the upward journey and makes individuals more effective in the outward journey.

Community as Self-care (Outward Journey)

Gonzalez describes “externally oriented self-care distinguished as a deliberate action performed by an individual that involves interactions with others in the environment [community]” (Gonzalez 2019, 8). Anderson makes us aware that self-care cannot be attempted on one’s own. Since we are created in God’s image, we were created to be in community. He says “the divine image is not a religious quality of an individual person, but a spiritual quality expressed through the interchange of persons in relation” (Anderson 2010, 238). It is important for individuals to have a relationship with God and to be self-aware. It is impossible for an individual to live a healthy life without having healthy exchanges with others. We are made in God’s image and living well in community is necessary (Anderson, 2010).

Since we are created in God’s image, we have similar desires as God.

Gorman says “because God is a person, he is capable of having relationships.

He is not an inanimate object, a force, a principle, or an impersonal dynamic.

God is a person enjoying and pursuing relationships” (Gorman 2002, 24). Just as it is important to pursue a relationship with God to ensure that we stay on

56 track with self-care, it is important that we pursue relationships with others for this same cause. Gorman’s premise is that in order for an individual to remain healthy, they must pursue relationship with others (Gorman 2002).

Self-care in community is supported by Calhoun, who says that we are better together than apart. Calhoun adds that individuals are not meant to live in isolation. People are meant to walk with each other and help each other maintain accountability (Calhoun 2015, 150). If an individual does not have anyone to be accountable to, it becomes difficult for them to accomplish a goal that may be set before them. This is especially true as it relates to self-care.

Anderson says that while Paul looked to the church for community, he notes that we do not live in the time of Paul. He makes the following statement.

Gorman says “true community is more than being together. It requires trust” (Gorman 2002, 81). Developing true community also requires love. This notion is further addressed by Pettit when he asserts that we must not just learn to love, but we need to learn to love well. Pettit discusses Five Key Principles to

Learning to Love: 1) Love does not default to the status quo. 2) Love is not primarily concerned with sinning less. 3) Love is a dynamic process. 4) Love must be a commitment in every season of life. 5) Love is sustained when we experience His love (Pettit 2008, 56). If an individual does not have trust and love for those who are in their community, they will not be open and vulnerable.

57 This will make it difficult to hold themselves accountable for self-care with those individuals.

One thing that can keep individuals from being accountable to those in their community is personal shame. A Christian can feel shame for not caring for themselves well. Petit notes that shame can be passed around a community and can cause an individual to hide and not seek out relationships (Petit 2008,

183). “Shame is a wound felt from the inside, dividing us both from ourselves and from one another” (Kaufman 1989, 16). It is important that the caregiver deals with their shame so that they are able to engage with community for accountability as it relates to self-care.

Silf agrees with the idea that being able to remain in community contributes to personal growth, which includes growth in caring for ourselves.

She says these accountability relationships may be the very places where we are being drawn beyond ourselves. They may be the very places that stretch us towards new understanding, deeper love – the places that contain the seeds of our growth (Silf 2005, 4). This aspect of growth is paramount where self-care is concerned.

Self-care is not a one-time event. It is a lifetime process that an individual grows into, with the help of those around them in community. James says it this way: “don’t get it twisted: it’s about you, but it’s not only about you”

(James 2016, 73). She explains how ‘self’ can make us believe that it is all about us and our needs. James states “whereas [this] journey is uniquely your own, you do not travel it alone (James 2016, 74). She goes further to say,

58 “Along with embracing all of you, it is imperative to avoid allowing this journey to lead one to function from a narcissistic, self-centered way of being” (James

2016, 74). James’ idea is for the individual to be certain to think of themselves, but not to the extent where it becomes narcissistic and they are only thinking of themselves. Other people matter greatly and are needful for the individual to grow.

It is important to fully understand that while self-care is solely about how an individual cares for themselves, self-care enables individuals to better care for others and also operate better in community. “Being a part of a safe, rewarding community promotes relationally healthy living” (James 2016,74). In order to be a part of a safe and rewarding community according to James, there are three elements that a healthy community must have. A healthy community must be safe, accepting, and reciprocal (James 2016, 74).

If a community is safe, “individuals are free to be themselves without constant fear of rejection, judgment or betrayal…Individuals who engage within these types of environments are safe from physical, psychological, emotional and spiritual abuse” (James 2016, 75). Gorman agrees with James. She says that “developing a climate of security and belonging is essential” (Gorman

2002,97). In the event that individuals do not feel safe, it makes operating in community much more difficult, which can sabotage self-care efforts.

Wardle wholeheartedly agrees that safety is vital to healthy community.

Wardle discusses how some of the church leaders come to his formational counseling classes and they themselves are in need of care. He asked them

59 the question, “Where are you experiencing healing community?” He notes that the majority of the students he teaches do not experience a safe place in community (Wardle 2001, 67). Wardle says that “if you desire support, encouragement, counsel and accountability, become a part of a truly spiritual community” (Wardle 1998, 158).

This “truly spiritual community” that Wardle discusses would likely be in line with the second element of a healthy community that James discusses— being accepting. The accepting community “understands that [individuals] are uniquely different and accepts individuals for who they are” (James 2016, 75).

Even when the self-care desires are not the same for each individual in the community and there is a need for change, “the desire for change doesn’t equate rejection or mistreatment of the person; the desire for change speaks of preference” (James 2016, 75). Bilezikian shares richly about a truly spiritual community as God as community:

Community as God ordained it was not an incidental concern of his nor did it happen haphazardly as the serendipitously creative result of a transcendental cosmic brainstorm. Community is deeply grounded in the nature of God. It flows from who God is. Because he is community, he creates community. It is his gift of himself to humans. (Bilezikian 1997, 27)

There are many relevant spiritual disciplines that individuals can engage in as a community to increase their self-care. Calhoun shares the list of “small groups, covenant groups, hospitality, spiritual friendship and prayer partners”

(Calhoun 2015, 150) as ways in which individuals can stay accountable to their self-care.

60 Self-care Practices (Inward Journey)

If an individual commits to a life of self-care and helping others, that individual will hopefully perpetuate this decision from the stance of being a wounded healer. This phrase was coined by Nouwen, who said that an individual must know and acknowledge their own wounds and heal from their own place of woundedness. This is vital to self-care. If an individual is not in touch with themselves and their self-care needs, they cannot possibly help others well on their journey with self-care. They may also wind up suffering from burnout. Henry Nouwen writes:

How can wounds become the source of healing? This is a question which requires careful consideration. For when we want to put our wounded selves in the service of others, we must consider the relationship between our professional and personal lives…no minister can keep his own experience of life hidden from those he wants to help. Nor should he want to keep it hidden. (Nouwen 1972, 88)

Wardle says “when a person honestly desires to lead another on the journey toward emotional well-being, he must be mindful of his own pilgrimage towards wholeness” (Wardle 2001, 39). This pilgrimage towards wholeness keeps self-care at the forefront. If an individual cannot or has not cared for themselves, how can they possibly care for others well? Wardle asserts, “Can a caregiver effectively help others in pain if he is not facing his own deep wounds” (Wardle 2001, 39)? Wardle strongly urges the caregiver to do their own work. His assertion is that a caregiver cannot be effective in this mission to help others if he or she is not doing their own work. This is the heart of self- care.

61 Curtis and Eldredge talk about the origin of this type of journey beginning and ending in the heart of man. They note that this true journey [of self-care] is not the story that can be seen by the world. They say the “true story of every person in this world is not the story you see, the external story. The true story of each person is the journey of his or her heart” (Curtis and Eldredge 1997, 7).

One could deduce from Wardle, Curtis and Eldredge that the work of self-care begins in the heart, with ones’ self.

Wardle is clear when he states that “self-care is the caregiver’s responsibility. This means that investing in personal health and well-being is the most responsible thing that the caregiver can do” (Wardle 2001, 52). The individual is responsible for the body and the mind that was loaned to them by

God. Wardles writes:

To be an effective servant of the Lord, the caregiver must care for himself. The people who need him, need him to be well. It’s that simple. But the other dimension of responsibility is that no one can do it for the caregiver. While he should be accountable to others about personal well- being, he alone is responsible. It is his job to make time for the Lord, get good counsel, open his spirit to inner healing and take care to exercise and rest. (Wardle 2001, 52)

Wardle also shares that being so diligent to always do and serve can compromise the life of the skilled helper.

Having adequate self-care is a right and a responsibility (Wardle 2001,

52). The caregiver has the right to care for themselves regularly. Not only do they have the right, but it is their responsibility to themselves and God to take care of themselves properly. It is the opinion of Wardle that “some in the

Christian community would take exception to that statement, believing that it is

62 somehow noble to compromise personal health in service to others” (Wardle,

2001, 52). Many Christians have been taught that thinking of themselves first is an act of selfishness. Oswald agrees with Wardle, stating that he feels “the tension in the room rise when the subject of self-care comes up. It just doesn’t set right with some [Christians]” (Oswald 1991, 4). Individuals who are caregivers must think of themselves first, because if they are not well, who will care for their care receivers?

Oswald’s position is that it is difficult for us to be proponents of the God that we are imaged after if we do not care for ourselves. He also asserts that self-care is not narcissism; it is the ability for an individual to appreciate themselves as not only a gift, but a resource (Oswald 1991, 5). Cloud and

Townsend note that our needs are our own responsibility. It is not wise for an individual to wait for someone to care for them. He or she must understand that caring for themselves is neither bad, selfish, nor a luxury (Cloud and Townsend

1992, 107). Caring for oneself is a prerequisite of the healing process of others.

Likewise, Swenson warns against emotional overload. He states that it “saps our strength, paralyzes our resolve, and maximizes our vulnerability, leaving the door open for further margin erosion” (Swenson 2004, 79). If caregivers will not take the opportunity to look at their own emotional overload, then they run the risk of their margins completely dissipating. Swenson’s assertion is that with no margins, there cannot be self-care, so it is necessary to look closely at one’s own emotional overload. Seigel would say that a person who engages in

63 healthy self-care can achieve a level of attunement that is necessary to help those in their care (Seigel 2011, 129).

There is no one self-care practice that is considered right for everyone.

Calhoun reminds us that “God inhabits our bodies, delighting in every inch of us…God knows us through and through and still wants to make his home inside of us” (Calhoun 2015, 81). Calhoun quotes Palmer, saying “self-care is never a selfish act – it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others” (Calhoun 2015, 81). According to Calhoun, people are gifts, and in order for the gift to last and have its usefulness, individuals must care for themselves. She discusses the responsibility one has to themselves, but even more so the responsibility they have to God.

Calhoun alludes to the idea that the more individuals care for themselves, the more they honor God and the better stewards they are. She notes

“respecting our bodies (including their limitations) is a way God communicates his counsel and will to us” (Calhoun 2015, 81). She would fully agree with Cloud and Townsend with the need for boundaries as she shares that “we need boundaries. We need rest. We need to say no as well as yes.”

Those who care for others have to spend time caring for themselves. As

Wardle says, self-care “is foundational to the caregiver’s calling and the only path to an empowered and grace-filled ministry” (Wardle 2001, 63). There are many ways to engage in self-care to diminish burnout for the care giver. One such way is through the spiritual disciplines.

64 Spiritual Disciplines

Calhoun says that spiritual disciplines are “the desire for more of God to intentional practices, relationships and experiences that [give] people space in their lives to ‘keep company’ with Jesus” (Calhoun 2015, 19). These activities keep individuals grounded and closer to Jesus. Foster adds that “we must not be led to believe that the Disciplines are for spiritual giants and hence beyond our reach, or for the contemplatives who devote all their time to prayer and meditation” (Foster 1978, 1). Foster asserts that spiritual disciplines are for everyone. No matter the age or vocation, it is important for individuals to learn and apply which disciplines work for them in their individual contexts (Foster

1978, 1).

Spiritual disciplines open individuals to God. Foster’s premise is that we are given disciplines to allow us to be the recipients of God’s grace; they “allow us to place ourselves before God so that He can transform us (Foster 1978, 6).

He contends that the disciplines ground individuals so that God can do His work to transform individuals. He notes that “by themselves, the Spiritual Disciplines can do nothing; they can only get us to the place where something can be done”

(Foster 1978, 6).

Calhoun presents an expansive list of spiritual disciplines which can be used as a means of self-care. There is no perfect self-care practice. An individual must choose what is right for them.

The biblical concept of Sabbath is a block of time where work halts, time stops, and an individual centers themselves in an effort to contemplate God.

65 “The traditional Jewish Sabbath begins at sundown on Friday and ends at sundown Saturday. In most Christian traditions, Sabbath has been observed on

Sunday” (Scazzero 2015, 144). Scazzero believes that Sabbath has a rhythm simply because of the fact that it happens once a week. He notes that because

Sabbath is meant to happen at least once a week, that it is a clear distinction to what the rhythm of the world has to offer. He says, “God’s Sabbath rhythm is a reflection of the rhythm that undergirds all of creation” (Scazzero 2015, 145).

Mueller agrees, “To remember the Sabbath is not a burdensome requirement…but rather a remembrance of a law that is firmly embedded in the fabric of nature. It is a reminder of how things really are, the rhythmic dance to which we unavoidably belong” (Mueller 1999, 69). Using Sabbath as a boundary is a good self-care practice. Scazzero says that the problem with caregivers and leaders is that they do not have good boundaries and they “allow

[their] work to trespass on every other area of life, disrupting the balanced rhythm of work and rest that God created for our good” (Scazzero 2015, 146).

Further, Mueller states that the Sabbath is a necessity. But it is not the stopping that is the discipline, it is the surrender that Sabbath requires that is the discipline. He says, “Sabbath is not dependent upon our readiness to stop. We do not stop when we are finished. We do not stop when we complete our phone calls, finish our project, get through these stack of messages, or get out this report that is due tomorrow. We stop because it is time to stop” (Mueller 1999.

82). Mueller states that an individual must surrender in order to experience

66 Sabbath, because there is always something to do, somewhere to go, and for caregivers, someone to care for.

Skovholt and Trotter-Mathison say it this way, “In the theater of life, the other becomes the illuminated part of the stage; our I is often outside the illumination” (Skovholt and Trotter-Mathison 2011, 5). Just by the sheer nature of caregiving, it is not unlikely for caregivers to find themselves out of the spotlight. This is evident when Skovholt and Trotter assert that “sometimes… those in caring professions lose touch with their own viewpoint, their own needs”

(Skovholt and Trotter-Mathison 2016, 5).

In essence, individuals must turn their self-care into worship, and practicing Sabbath allows that to happen (Anderson 2013, 22). Anderson adds that practicing the spiritual discipline of Sabbath leads to the spiritual discipline of rest (Anderson 2013, 22). Calhoun discusses the spiritual discipline of rest as a spiritual act. She notes that “[individuals] are not made to work 24/7… There is a finiteness to [their] time and energy. And to live as though there isn’t is destructive as well as delusional” (Calhoun 2015, 75).

For Calhoun, the act of resting is different than Sabbath, because

Sabbath can be considered and observed as a community activity, while only the individual can rest for themselves (Calhoun 2015). Vanier speaks specifically to the notion of rest as a cure to burnout. His thought is that the people who get burned out are too generous with themselves. This generosity leads them to be emotionally destroyed (Vanier 2001, 177).

67 Like Calhoun, Vanier separates Sabbath and rest. He states that many people have not made the distinction of the community for myself and myself for the community. He even takes this separation further saying that people will not rest until they truly surrender the idea that they have to be with others. He finished his thought saying that individuals must be still and reflect on their own deep needs. In doing this, they will be able to comfort their inner child within who is crying because they feel alone (Vanier 2001, 178).

Vanier says that rest is the cure for burnout that happens within community. Therefore, self-care in the form of rest is a necessity. If an individual is not well and has been burned out as a result of caregiving or some other community activity, the only thing that individual will be able to communicate is emptiness and sadness (Vanier 2001, 180). For Vanier, caregiving is not the problem. He ends by saying that to be constantly present and nourishing to others, one must take the opportunity to stop (which is what he equates to Sabbath) and rest (Vanier 2001, 180).

Another form of self-care that is a form of spiritual discipline is meditation.

Foster explains that Christian meditation is an attempt to “empty the mind in order to fill it”. His concept is that it leads individuals to inner wholeness which is imperative where self-care is concerned (Foster 1978, 15). Calhoun attempts to clarify Foster’s thought as she notes that Christian meditation is not to empty the mind to nothingness. However, it is to empty the mind to the negativity of the world and open it to the positivity of God. Where self-care is concerned, it is to help the caregiver understand that God is near (Calhoun 2015, 192).

68 The final spiritual discipline to discuss is prayer. Prayer is the cornerstone of the Christian faith. Where self-care is concerned, prayer is the very way that a caregiver can communicate with God. As Calhoun reveals, prayer denotes relationship and there are many different types of prayer that will provide a pattern for communicating with God (Calhoun 2015, 230). Another form of self-care that a caregiver can partake in is a form of inner healing prayer called formational prayer. Inner healing prayer is a type of guided prayer that is used to help those who are wounded and broken emotionally seek God for the healing that only he can give (Calhoun 2015, 254). For caregivers who are suffering from compassion fatigue/ burnout, this type of prayer can be extremely beneficial in promoting self-care. In it, they can find themselves with Jesus in a safe place, where He can offer healing for their traumatic event.

Wardle developed a step by step formational prayer model that allows individuals to be healed through an encounter with Jesus through the ministry of the Holy Spirit (Wardle 2005, 24). For a caregiver using this method as a spiritual discipline, it can be extremely helpful in the healing of their emotional wounds (Calhoun 2015, 255). Caregivers who are whole emotionally are less likely to harm others. This is why it is equally important for caregivers to practice emotional self-care.

Breath Prayer is another type of prayer for caregivers to practice who are short on time. According to Calhoun, breath prayers are short heartfelt prayers that can help center an individual in the presence of God This type of prayer reminds individuals that they only need to breathe to communicate with God.

69 The entire prayer is completed in a single breath. To practice this prayer, one must consider their nearness to God and breathe in His presence and breathe out their prayer. (Calhoun 2015, 232).

Conclusion

The literature substantiates the belief that those who care for others must do a better job of caring for themselves. The reality is that the lack of self-care ultimately leads to the lack of care for others. The new information discovered that was most eye-opening was the difference between rest and Sabbath, as I had been taught that the terms were interchangeable. This literature shows that

Sabbath is the discipline of stopping all work and obligations, and rest is the discipline of releasing and surrendering. Both Sabbath and rest are integral spiritual disciplines needed to combat burnout. The scope of this project specifically explores the clinicians who matriculated from Ashland Theological

Seminary–Detroit’s counseling program, to determine to what degree they are using the self-care methods that they have been taught.

There is no one size fits all method of self-care, and there are a variety of techniques and disciplines to utilize to practice it. The research shows that self- care is necessary. This chapter has explored theories surrounding burnout and self-care deficit. Ultimately the authors that were explored discussed self-care as a response to burnout for caregivers.

Self-care was then examined from the vantage points of the upward, inward and outward journeys. This chapter concluded with a conversation about how some spiritual disciplines can be used to promote self-care to fight burnout.

70 Chapter four will discuss the design, procedure and assessment used to evaluate the self-care practices of some graduates of Ashland Theological

Seminary – Detroit’s counseling program.

71 CHAPTER FOUR

DESIGN, PROCEDURE, AND ASSESSMENT

This chapter will discuss the context, design, procedure and assessment of my project. The purpose of this project was to discover the degree to which a select group of counseling graduates from Ashland Theological Seminary –

Detroit have integrated the self-care practices taught in the mandatory

Dimensions of Healing course into their personal lives. The research question is to what degree do a select group of counseling graduates from Ashland

Theological Seminary – Detroit integrate the self-care practices that were taught in the mandatory Dimensions of Healing course into their personal lives?

The course was designed to teach different methods of self-care, including aspects of formational prayer. The need for self-care in clergy and clinicians is imperative. I wanted to discover to what extent the graduates understood the need for self-care. I chose this course because of the content specific to self-care that this course provides. I also wanted to determine whether the participants were using the principles taught in the Dimensions of

Healing course in their personal and professional lives and to what degree they were implementing the principles. The goals for my project are:

1. To discover the degree to which participants have integrated the self-care

practices taught in the mandatory Dimensions of Healing course into their

personal lives.

2. To discover the degree to which participants personal lives have been

affected by the integration of self-care practices.

72 3. To discover the degree to which the self-care practices have influenced

the personal lives of the participants.

4. To discover the degree to which the participants understand self-care

practices as a biblical practice.

5. To discover the degree to which the participants perceive self-care

practices as a necessity.

6. To discover the self-care practices used in the personal lives of the

participants.

7. To discover the degree to which time is a factor in self-care practices.

8. To discover the degree to which the participants have an overall

understanding of self-care practices.

Context

Ashland Theological Seminary – Detroit has been a part of the metropolitan Detroit community for nearly 40 years, since 1983. The counseling program in Detroit has been an integral part of the Detroit center since 1993.

Sharon Marshall, a two-time graduate of Ashland Theological Seminary (both the Master’s in Pastoral Counseling and the Doctor of Ministry in Formational

Counseling), designed the Dimensions of Healing course as a part of her dissertation project. This class was first taught in 2004 by Marshall at the

Detroit Center. She taught it until 2016.

In this course, one of the assignments was to create a self-care plan.

The self-care plan had to consist of a detailed account about how you plan to finish the Master of Arts in Counseling program. Very similar to the self-care

73 plan that we had to write as a part of the Doctorate of Ministry program, the plan had to include a calendar with a two-year time span for the duration of the

Master’s program. The course also included reading Margin by Richard

Swenson, which spoke directly to the need to create margins or boundaries in one’s life, especially during stressful times such as completing a master’s degree.

Additionally, students were taught different methods of self-care and were briefly introduced to some aspects of formational prayer. Some of the principles of self-care that were taught include the need for self-care and the notion that self-care is indeed a biblical practice. Other methods of self-care that were discussed were some of the different types of prayer (eg. breath prayer, centering prayer, formational prayer, guided prayer). Additionally, students were taught about different spiritual disciplines that can be used for the purposes of self-care.

As a graduate of the Ashland Theological Seminary – Detroit Counseling program, I had the pleasure of completing this course, and found the self-care practices to be life-giving for me personally and professionally. As a practicing clergy and clinician, I wanted to poll fellow Ashland Theological Seminary -

Detroit Counseling graduates to ascertain whether or not they were using the principles that we learned in Dimensions of Healing and to what degree.

The context of this study involves participants who have graduated from the Ashland Theological Seminary – Detroit Counseling program. By the nature of the counseling program offering a license and seminary degree, many of the

74 graduates of the counseling program are bi-vocational. This means they are practicing counselors and are leaders in their ministry context. Being bi- vocational was not a requirement for participation in the study, and the survey was anonymous. The participants who were present to take the survey thanked me for doing this project because they are leaders in their ministry context and they also believed in the importance of self-care.

Participants

The target population for this project was Ashland Theological Seminary-

Detroit Counseling graduates who had taken the Dimension of Healing course taught by Sharon Marshall. The target pool was Detroit counseling graduates from 2004 until 2016. The Ashland Theological Seminary -Detroit Counseling program does not have an official alumni association, so I understood that I would not be able to solicit all of the graduates of the counseling program for their participation. The program does have a Facebook page, where many graduates do participate.

The desired number of participants was between 25-50 graduates. I was able to gather project data from a total of 23 Ashland Theological Seminary -

Detroit Counseling graduates. All of the graduates who participated were all currently licensed and practicing Limited Licensed Professional Counselors

(LLPC) or Licensed Professional Counselors (LPC) in the State of Michigan. It bears well to note that at least 12 of the participants were also active leaders in their respective ministry contexts. While this was not by design and was not a requirement for the study, it could make for interesting inferences during the

75 analysis of the assessment. The majority of participants (22 of the 23) were

African American. In the area of gender, women dominated the participant pool, with 22 of the 23 being female.

Procedure and Assessment

I developed a 27-question survey which included a seven-point Likert scale and three open ended questions. The Likert scale measured the level of agreement each participant had with each question, focusing on the degree to which the participants were utilizing self-care principles. The scale ranges from

“strongly disagree” (7) to “strongly agree” (1). Specifically, the scale was

“strongly agree” (1), “moderately agree” (2), “slightly agree” (3), “neutral” (4),

“slightly disagree” (5), “moderately disagree” (6), and “strongly disagree” (7).

The survey ends with open-ended questions. These questions gave the participants an opportunity to share their experiences in their own words. It was also important to me to gather pertinent demographic information while allowing the assessment to remain anonymous. For the assessment, the demographic portion included age, gender, race and graduation year. The survey was available in both paper form and online through Survey Monkey.

Next I contacted a colleague who facilitates a counseling supervision group that is for practicing clinicians, many of whom are Ashland Theological

Seminary -Detroit Counseling graduates. I gained permission from the group facilitator to share about my project with the group, and I attended the group on a Thursday evening. The group was held at Shiloh Deliverance Church in

Detroit, MI.

76 I gave a very brief overview to the group about my dissertation and what I needed from them. I shared that the survey was to be anonymous and asked them to complete it and place the completed survey in a manila envelope. The survey included a cover letter which included an invitation to participate and instructions for participation in the survey. I left the group and returned when the group was over to collect the envelope. Eleven of the twelve people present were qualified to take the assessment; they took the survey and turned it in before they left. A few of the participants remarked that they were glad that they were able to take a look at their current self-care practices.

This sample size was too small, but it was a good start. In order to get a larger sample size, I sent out an initial invitation to Ashland Theological

Seminary -Detroit graduates via our ATS-Detroit Counseling Facebook page. I also sent out emails to the graduates who have public emails for their private practices. A week later, I sent out the Survey Monkey link along with the cover page to the graduates, and asked them to complete the survey. From the ATS-

Detroit Counseling Facebook page, I was able to obtain 12 more completed surveys. The participants from the ATS-Detroit Counseling Facebook page submitted their surveys anonymously (via Survey Monkey). I manually entered the data from paper responses from the supervision group into the Survey

Monkey site so that all of that data would be consistently analyzed.

Assessment

From the point of approval of my assessment, I created the digital version of the assessment tool on the Survey Monkey website.

77 Originally, I hesitated on doing a digital version of the assessment tool, because I wanted to have everything in paper form. However, ultimately, I chose to have a digital version of the survey for those that I may not be able to reach in person. I chose the Survey Monkey website because it was user- friendly and for the purposes of my project the free option was the best option. I was able to create the survey, and through the site, I was able to create a link to the survey. I posted my link in the Ashland Theological Seminary – Detroit

Counseling Facebook group along with the instructions on completing the survey. I also sent the link to a few of my personal contacts from my own cohort as well.

The Survey Monkey website was beneficial because it also allowed me to have the paper surveys entered in as well. I entered all the manual data in myself. The Survey Monkey site also gives options for interpreting the data.

For the purposes of this project that information was not helpful. However, having all of the information in one place was very helpful.

From the site I was able to run a report that presented me with the percentages for each of the areas on the Likert scale. I found the Likert scale to be extremely beneficial because it helped to standardize the scoring of each of the questions. This scale simplified the process in understanding whether or not the goal was reached.

The assessment tool consisted of 27 total questions. There were three questions for each goal. Additionally, there were open ended questions at the end of the survey. The three open ended questions were to determine how well

78 the participants understand self-care, whether or not they used the principles taught in the Dimensions of Healing course and whether or not students experienced value in the class as it relates to self-care principles. A copy of the cover letter and instructions as well as the assessment are included in Appendix

Once I received the surveys, I wrote out all of the information for each goal and each question on a large white board. I did this because I wanted to see all of the responses in one place to begin organizing them. I started by writing out each of the eight goals. Then I found each of the questions that related to each goal, which there were three per goal. I wrote each of the three questions under their respective goal. I wrote each heading and question in a different color to help with the organizational process.

Once I completed writing each of the goals and the questions, I went through the results and wrote the percentages of agreement. I analyzed all answers for the Likert scale to determine whether or not each goal had been accomplished. As I was entering data, I noticed that a few of the open-ended questions were left blank. My initial thought was that this may skew the responses. Unfortunately, I do not have the feedback as to why the participants who left those questions blank decided to leave them blank. I took the open- ended questions and categorized the similar responses. Once those were cataloged and categorized, I began the process of further analyzing the responses.

79 I assessed the extent to which the goals were achieved based on the information that was provided by each graduate. In the next chapter, the analysis of the assessment data is presented: the collated data, the average responses for each question as they relate to each goal, and a discussion of the open ended questions in the survey.

80 CHAPTER FIVE

RESULTS

This chapter provides the results of the data that analyzed in this research project. The purpose of this project was to discover the degree to which a select group of counseling graduates from Ashland Theological

Seminary – Detroit have integrated the self-care practices taught in the mandatory Dimensions of Healing course into their personal lives. The research question is to what degree do a select group of counseling graduates from

Ashland Theological Seminary – Detroit integrate the self-care practices that were taught in the mandatory Dimensions of Healing course into their personal lives?

The previous chapter noted that this course was designed to teach different methods of self-care, including formational prayer. This project sought to discover to the extent to which graduates understood the need for self-care and could articulate it in their life context. It also sought to determine whether the participants were using the principles taught in the Dimensions of Healing course in their personal and professional lives and the degree to which they were implementing the principles. The goals for my project were:

1. To discover the degree to which participants have integrated the self-care

practices taught in the mandatory Dimensions of Healing course into their

personal lives.

2. To discover the degree to which participants personal lives have been

affected by the integration of self-care practices.

81 3. To discover the degree to which the self-care practices have influenced

the personal lives of the participants.

4. To discover the degree to which the participants understand self-care

practices as a biblical practice.

5. To discover the degree to which the participants perceive self-care

practices as a necessity.

6. To discover the self-care practices used in the personal lives of the

participants.

7. To discover the degree to which time is a factor in self-care practices.

8. To discover the degree to which the participants have an overall

understanding of self-care practices.

The instrument was designed with as a 27-question survey to be answered based on a seven-point Likert scale, and three qualitative questions. The Likert scale measured the level of agreement each participant had with each question, focusing on the degree to which the participants were utilizing self-care principles. The scale ranges from “strongly disagree” (1) to “strongly agree” (7).

The open-ended questions follow the 27 quantitative questions. These three qualitative questions gave the participants an opportunity to share their experiences in their own words.

It was also vital to gather pertinent demographic information while allowing the assessment to remain anonymous. For the assessment, the demographic portion included, age, gender, race and graduation year. The survey was

82 available in both paper form and online through a popular assessment site called Survey Monkey.

This chapter presents the results of the survey as it relates to the goals that were measured. Each goal will be presented in the order of prominence as they were identified by my findings. The results for the qualitative findings will be presented following the discussion of my eight goals.

Table 1: Goals in Order of Prominence

Goals Average

5 – To discover the degree to which the participants perceive self- 5.64 care practices as a necessity.

4 – To discover the degree to which the participants understand 5.48 self-care practices as a biblical practice.

8 – To discover the degree to which the participants have an 5.42 overall understanding of self-care practices.

3 – To discover the degree to which the self-care practices have 5.41 influenced the personal lives of the participants.

1 – To discover the degree to which participants have integrated 5.27 the self-care practices taught in the mandatory Dimensions of Healing course into their personal lives.

2 – To discover the degree to which participants personal lives 5.19 have been affected by the integration of self-care practices.

6 – To discover the self-care practices used in the personal lives 5.17 of the participants.

7 – To discover the degree to which time is a factor in self-care 4.71 practices.

83 Quantitative Analysis

Goal #5: Self-care Practices as a Necessity

The most prominent score was goal #5: “To discover the degree to which the participants perceive self-care practices as a necessity.” The composite for this goal was 5.64. The three quantitative questions that formed this goal were:

“I believe practicing self-care is a necessity” (#5); “I believe practicing self-care in my personal life is important to my life balance” (#13); and “I believe that when I practice self-care, my life feels more harmonious” (#21). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree,

(2) moderately disagree, (1) strongly disagree.

Table 2. Goal #5: Self-care Practices as a Necessity

Statements Average Responses

5 – I believe practicing self-care is a necessity 5.74 23

13 – I believe practicing self-care in my personal life 5.61 23 is important to my life balance

21 – I believe that when I practice self-care, my life 5.57 23 feels more harmonious

Composite 5.64 N=23

The average score for question 5 was 5.74. Eighteen of 23 participants strongly agreed that practicing self-care is a necessity. One respondent moderately disagreed, and there were four that strongly disagreed. The result

84 for question five was that the majority of participants believed that practicing self-care is a necessity.

For question 13, “I believe practicing self-care in my personal life is important to my life balance,” 16 of the 23 respondents strongly agreed with this statement. Two moderately agreed with the statement, and five strongly disagreed with this statement. The results revealed that the majority of the participants strongly agreed that self-care is important to their life balance.

The average score for question 21 was 5.57. The question was “I believe that when I practice self-care my life feels more harmonious.” Fifteen out of 23 reported that they strongly agreed that their life feels more harmonious. Two moderately agreed. One person reported that they slightly agreed, and one person reported that they moderately disagreed. Four reported that they strongly disagreed that their life feels more harmonious. Here the majority strongly agreed that practicing self-care is important to the feeling of harmony in their lives.

The majority of the respondents believe self-care is a necessity. There were 18 out of 23 participants who agreed to some degree that self-care is a necessity. The score 5.64 represents the overall level of agreement of the participants who believed that practicing self-care in their personal life was a necessity. Question 5: “I believe practicing self-care is a necessity” dealt with the belief that practicing self-care was a necessity. Question 13: “I believe practicing self-care in my personal life is important to my life balance” measured whether or not the respondent believed that practicing self-care was important to

85 their life balance. Question 21: “I believe that when I practice self-care, my life feels more harmonious” deals with the notion of the participants’ lives feeling more harmonious as a result of practicing self-care.

Goal #4: Understanding Self-care Practices as a Biblical Practice

Goal four had the second most prominent score: “To discover the degree to which the participants understand self-care practices as a biblical practice.”

The composite for this goal was 5.48. The three quantitative questions that formed the goal were:” I understand that self-care is a biblical practice.” (#4); “ I understand that there are specific scriptural passages that assist me to articulate self-care as a biblical practice.” (#12); and “I understand that practicing self-care principles assists me in living a more Bible-focused lifestyle” (#20). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree.

The average score for question four was 5.61. Sixteen of 23 strongly agreed that they understand self-care as a biblical practice. Two respondents slightly agreed. Two moderately disagreed and three strongly disagreed. The result for question four was that the majority of participants believe that practicing self-care is a biblical practice.

Question 12 had an average score of 5.5, “I understand that there are specific scriptural passages that assist me to articulate self-care as a biblical practice”. Eleven of the 23 respondents strongly agreed with this statement.

86 Table 3. Goal #4: Understanding Self-care Practices as a Biblical Practice

Statements Average Responses

4 – I understand that self-care is a biblical 5.61 23 practice

12 – I understand that there are specific 5.35 23 scriptural passages that assist me to articulate self-care as a biblical practice

20 – I understand that practicing self-care 5.48 23 principles assists me in living a more Bible- focused lifestyle.

Composite 5.48 N=23

Four of the respondents moderately agreed with the statement. One respondent slightly agreed. Two reported to be neutral. One slightly disagreed, two moderately disagreed, and two strongly disagreed. The results revealed that the majority of the participants strongly agreed that self-care is a biblical practice and the majority can articulate this with scripture.

The average score for statement 20 was 5.48. The question was “I understand that practicing self-care principles assists me in living a more Bible- focused lifestyle.” Fourteen out of 23 reported that they strongly agreed that they understand that practicing self-care assists in living a more Bible-focused lifestyle. Three reported that they slightly agreed. One person reported being neutral. One person reported that they slightly disagreed. Two reported that they moderately disagreed. Two reported that they strongly disagreed. The result

87 displayed that the majority strongly agreed that they understand practicing self- care can assist in living a more Bible-focused lifestyle.

The majority of the respondents understand self-care as a biblical practice. There were 16 out of 23 participants who agreed to some degree that self-care is a necessity. The score 5.48 represents the level of agreement of the participants who believed that practicing self-care is a biblical practice. Question

4: “I understand that self-care is a biblical practice” dealt with the belief that practicing self-care was a biblical practice. Question 12: “I understand that there are specific scriptural passages that assist me to articulate self-care as a biblical practice” measured whether or not the respondent understood that there are specific scriptural passages that articulate the notion of self-care as biblical practice. Question 20: “I understand that practicing self-care principles assists me in living a more Bible-focused lifestyle” deals with the notion of the participants’ understanding that practicing self-care principles assist in living a more Bible-focused lifestyle.

Goal #8: Overall Understanding of Self-care Practices

The third most prominent score was goal #8: “To discover the degree to which the participants have an overall understanding of self-care practices.” The composite for this goal was 5.42. The three quantitative questions that formed this goal were: “I understand that what constitutes a self-care practice.” (#8); “I understand how to articulate self-care practices to others.” (#16); and “I understand how to model self-care practices with others” (#24). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly

88 agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree,

(2) moderately disagree, (1) strongly disagree.

Table 4. Goal #8: Overall Understanding Self-care Practices

Statements Average Responses

8 – I understand that what constitutes a self- 5.35 23 care practice.

16 – I understand how to articulate self-care 5.65 23 practices to others

24 – I understand how to model self-care 5.26 23 practices with others

Composite 5.42 N=23

The average score for question 8 was 5.35. Eleven of 23 strongly agreed that they understand have an overall understanding of self-care practices. Five participants moderately agreed. One participant slightly agreed. There were two that moderately disagreed and three that strongly disagreed. The result for question eight was that the majority of participants have an overall understanding of self-care practices.

Question 16 had an average score of 5.65. The statement was “I understand how to articulate self-care practices to others.” Eleven of the 23 respondents reported that they strongly agreed with this statement. Seven of the respondents moderately agreed with the statement. One respondent slightly agreed. One reported that they moderately disagreed. Four reported that they

89 strongly disagreed. The results revealed that 19 respondents agree to some degree that they have an understanding on how to articulate self-care practices to others.

The average score for question 24 was 5.26. The statement was “I understand how to model self-care practices with others.” Ten out of 23 reported that they strongly agreed that they understand how to model self-care practices with others. Four reported that they moderately agreed. Two reported that they slightly agreed. Two reported being neutral. One person reported that they slightly disagreed. Four reported that they moderately disagreed. One person reported that they strongly disagreed. The result displays that the majority, 16 individuals, agree to some degree that they understand how to model self-care practices with others.

The majority of the respondents have an overall understanding of self- care practice. Sixteen out of 23 participants agreed to some degree that they had an overall understanding of what constitutes a self-care practice. The score

5.42 represents the level of agreement of the participants surveyed who believed that practicing self-care is a biblical practice. Question 8: “I understand that what constitutes a self-care practice” dealt with the understanding of what constitutes a self-care practice. Question 16: “I understand how to articulate self-care practices to others” measured whether or not the respondent understood how to articulate self-care practices to others. Question 24: “I understand how to model self-care practices with others” deals with the idea that the participants understood how to model self-care practice to others.

90 Goal #3: Influence of Self-care on the Participants Personal Lives

The fourth most prominent score was goal #3: “To discover the degree to which the self-care practices have influenced the personal lives of the participants.” The composite for this goal was 5.41. The three quantitative questions that formed this goal were: “My personal life has been positively influenced by the self-care practices.” (#3); “I am inclined to share the self-care practices that have influenced me.” (#11); and “My professional life has been positively influenced by personally integrating self-care practices” (#19). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree.

Table 5. Goal #3: Influence of Self-care on the Participants Personal Lives

Statements Average Responses

3 – My personal life has been positively 5.52 23 influenced by the self-care practices.

11 – I am inclined to share the self-care 5.57 23 practices that have influenced me. 5.13 23 19 – My professional life has been positively influenced by personally integrating self-care practices.

Composite 5.41 N=23

The average score for question 3 was 5.52. Nine of 23 strongly agreed that their personal lives had been positively influenced by the self-care

91 practices. Eight participants moderately agreed. Two participants were neutral.

Two moderately disagreed and two strongly disagreed. The result for question 3 was that the majority of participants (17) agreed that their lives have been positively influenced by self-care practices.

Question 11 had a total score of 5.57. The statement was “I am inclined to share the self-care practices that have influenced me”. Thirteen of the 23 respondents reported that they strongly agreed with this statement. Three moderately agreed with the statement. One slightly agreed. Two were neutral.

One slightly disagreed. Three strongly disagreed. The results revealed that 17 respondents agreed to some degree that they are inclined to share the self-care practices that influenced them.

The average score for question 19 was 5.13. The question was “My professional life has been positively influenced by personally integrating self- care practices.” Nine out of 23 reported that they strongly agreed that their professional life had been positively influenced by personally integrating self- care practices. Six moderately agreed. Three were neutral. One slightly disagreed. Two moderately disagreed. Three people reported that they strongly disagreed. The result displays that the majority, 15 individuals, agreed to some degree that self-care has influenced their personal lives.

The majority of the respondents have reported that self-care practices have influenced their personal lives. Fifteen out of 23 participants agreed to some degree that their personal lives have been positively influenced by self- care practices. The score 5.41 represents the level of agreement of the degree

92 to which all 23 respondents believe that self-care practices have influenced their personal lives. Question 3: “My personal life has been positively influenced by the self-care practices” dealt with the positive influence self-care practices have had on the participant’s personal lives. Question 11: “I am inclined to share the self-care practices that have influenced me” measured whether or not the participants would be inclined to share the self-care practices that have influenced them. Question 19: “My professional life has been positively influenced by personally integrating self-care practices” shows that the participants’ professional lives have been influenced by integrating self-care practices.

Goal #1: Integration of Self-care Practices

The fifth most prominent score was goal #1 “To discover the degree to which participants have integrated the self-care practices taught in the mandatory Dimensions of Healing course into their personal lives.” The composite for this goal was 5.27. The three quantitative questions that formed this goal were: “I have integrated the self-care practices that were taught in the

Dimensions of Healing course into my personal life: (#1); “Ashland Theological

Seminary – Detroit offering the self-care principles in the Healing Dimensions course has added value to my personal life” (#9); and “I utilize the self-care practices that were taught in the Dimensions of Healing course in my personal relationships” (#18}. As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree,

(4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree.

93 Table 6. Goal #1: Integration of Self-care Practices

Statements Average Responses

1 – I have integrated the self-care practices 5.17 23 that were taught in the Dimensions of Healing course into my personal life.

9 – Ashland Theological Seminary – Detroit 5.61 23 offering the self-care principles in the Healing Dimensions course has added value to my personal life 5.04 23 18 – I utilize the self-care practices that were taught in the Dimensions of Healing course in my personal relationships

Composite 5.27 N=23

The average score for question 1 was 5.17. Five of 23 strongly agreed that they had integrated the self-care practices that were taught in the

Dimensions of Healing course into their personal lives. Eight participants moderately agreed. Five participants slightly agreed. One participant was neutral. Three moderately disagreed, and one strongly disagreed. The result for statement 1 was the majority of participants (18) agreed to some degree that they have integrated the self-care practice into their personal lives.

Question 9 had a total score of 5.61. Fourteen of the 23 respondents reported that they strongly agreed with this statement. Three of the respondents moderately agreed with the statement. One respondent slightly agreed. One slightly disagreed. One participant moderately disagreed. Three participants

94 strongly disagreed. The results revealed that 18 respondents agree to some degree that value was added to their personal lives.

The average score for question 18 was 5.04. Seven out of 23 reported that they strongly agreed that they utilize self-care practices in their personal relationships. Six people reported that they moderately agreed. One person reported that they slightly agreed. Four people reported being neutral. Two reported that they moderately disagreed. Three people reported that they strongly disagreed. The result displays that the majority, 15 individuals, agreed to some degree that they have integrated self-care practices into their personal lives.

The majority of the respondents have reported that that they have integrated self-care practices. Eighteen out of 23 participants agreed to some degree that they have integrated the self-care practices that were taught in the

Dimensions of Healing course into their personal lives. The score 5.27 represents the level of agreement of the degree to which all 23 respondents believe that self-care practices have influenced their personal lives. Question 1:

“I have integrated the self-care practices that were taught in the Dimensions of

Healing course into my personal life” dealt with whether or not the participants have integrated the self-care practices that were taught in the Dimensions of

Healing Course. Question 9: “Ashland Theological Seminary – Detroit offering the self-care principles in the Healing Dimensions course has added value to my personal life” measured whether or not the participants believed that the self- care principles from the Healing Dimensions course added value to their

95 personal lives. Question 21: “I utilize the self-care practices that were taught in the Dimensions of Healing course in my personal relationships” shows that the participants utilize the self-care practices that were taught in their personal relationships.

Goal #2: Impact of the Integration of Self-care Practices

The sixth most prominent score was goal #2 “To discover the degree to which participants personal lives have been affected by the integration of self- care practices.” The composite for this goal was 5.19. The three quantitative questions that formed this goal were: “My personal life has been impacted in a positive manner by integrating self-care practices” (#2); “Others recognize the impact that integrating the self-care practices have had in my life” (#10); and “I have more joy in my life as a result of the integration of self-care practices”

(#17). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree.

The average score for question 2 was 5.61. Twelve of 23 strongly agreed that their lives had been impacted in a positive manner by integrating self-care practices. Five participants moderately agreed. Two participants were neutral.

96 Table 7. Goal #2 Impact of the Integration of Self-care Practices

Statements Average Responses

2 – My personal life has been impacted in a 5.61 23 positive manner by integrating self-care practices.

10 – Others recognize the impact that 4.70 23 integrating the self-care practices have had in my life. 5.26 23 17 – I have more joy in my life as a result of the integration of self-care practices.

Composite 5.19 N=23

Two moderately disagreed, and two strongly disagreed. The result for statement

2 was the majority of participants (18) agreed to some degree that they have been positively impacted by integrated self-care practices into their personal lives.

Question 10 had a total score of 4.70. Four of the 23 respondents reported that they strongly agreed with this statement. Four of the respondents moderately agreed with the statement. Four slightly agreed. Six were neutral.

Three slightly disagreed. One moderately disagreed. One strongly disagreed.

The results revealed that 12 respondents agreed to some degree that value was added to their personal lives. While this is a majority, it is important to note that it is only a slight majority.

97 The average score for statement 17 was 5.26. Twelve out of 23 reported that they strongly agreed that they have more joy in their life as a result of integrating self-care practices. Three people reported that they moderately agreed. One person slightly agreed. Two were neutral. One moderately disagreed. Four people strongly disagreed. The result displays that the majority,

16 individuals, agreed to some degree that they have been impacted by the self- care practices that they have integrated in their personal lives.

The majority of the respondents have reported that that they have been impacted by integrating self-care practices. Seventeen out of 23 participants agreed to some degree that they have been impacted by integrating the self- care practices that were taught in the Dimensions of Healing course into their personal lives. The score 5.19 represents the level of agreement of the degree to which all 23 respondents have been impacted by integrating self-care practices into their personal lives. Question 2: “My personal life has been impacted in a positive manner by integrating self-care practices.” dealt with whether or not the participants personal lives have been impacted by integrating the self-care practices that were taught in the Dimensions of Healing Course.

Question 10: “Others recognize the impact that integrating the self-care practices have had in my life.” measured whether or not the participants recognized the impact that integrating the self-care principles from the Healing

Dimensions course had in their lives. Question 17: “Others recognize the impact that integrating the self-care practices have had in my life.” shows that others

98 recognize the impact that on the participants that integrating the self-care principles has had.

Goal #6: Self-care Practices Used

The seventh most prominent score was goal #6, “To discover the self- care practices used in the personal lives of the participants.” The composite for this goal was 5.17. The three quantitative questions that formed this goal were:

“I use formational prayer as a means of self-care in my personal life” (#6); “I use spiritual disciplines as a form of self-care in my personal life” (#14); and “I create healthy boundaries as a mode of self- care in my personal life” (#22). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree.

Table 8. Goal #6 Self-care Practices Used

Statements Average Responses

6 – I use formational prayer as a means of 4.61 23 self-care in my personal life.

14 – I use spiritual disciplines as a form of 5.43 23 self-care in my personal life. 5.48 23 22 – I create healthy boundaries as a mode of self- care in my personal life.

Composite 5.17 N=23

99 The average score for question 6 was 4.61. Six of 23 strongly agreed that they use formational prayer as a form of self-care in their personal life. Three participants moderately agreed. Three slightly agreed. Six participants were neutral. One slightly disagreed. One moderately disagreed, and two strongly disagreed. The result for question 6 was the majority of participants (12) agreed to some degree that they use formational prayer as a means of self-care in their personal lives. It is worth noting this question received the most neutral responses (6) in the total survey.

Question 14 had a total score of 5.43. Fourteen of the 23 respondents reported that they strongly agreed with this statement. Two respondents moderately agreed with the statement. One respondent slightly agreed. Four moderately disagreed. Two strongly disagreed. The results revealed that 17 respondents agreed to some extent that they use spiritual disciplines as self- care.

The average score for statement 22 was 5.48. Ten out of 23 reported that they strongly agreed that they create healthy boundaries as self-care. Five moderately agreed. Two slightly agreed. Two were neutral. One moderately disagreed. Three people strongly disagreed. The result displays that the majority, 17 individuals, agreed to some degree that they create healthy boundaries as self-care.

The majority of the respondents reported that they use spiritual disciplines and create healthy boundaries most frequently as it relates to the type of self-care used in their personal lives. The score 5.17 represents the level

100 of agreement with the different types of self-care used in their personal lives.

Question 6: “I use formational prayer as a means of self-care in my personal life” dealt with whether or not the participants use formational prayer in their personal lives. Question 14: “I use spiritual disciplines as a form of self-care in my personal life” measured whether or not the used formational prayer in their personal lives. Question 22: “I create healthy boundaries as a mode of self- care in my personal life” shows to what degree the participants create healthy boundaries as a mode of self-care in her personal life.

Goal #7: Time as a Factor in Self-care

The least prominent score was goal #7 “To discover the degree to which time is a factor in self-care practices.” The composite for this goal was 4.71.

The three quantitative questions that formed this goal were: “Time is a factor that dictates which self-care practices I use” (#7); “I have found time during the day in which I can implement self-care practices in my personal life” (#15); and

“My schedule makes it easy for me to schedule self-care practices at least on a weekly basis” (#23). As previously indicated, a Likert scale from 7-1 was used for these questions: (7) strongly agree, (6) moderately agree, (5) slightly agree,

(4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree.

The average score for statement 7 was 5.35. Eleven of 23 strongly agreed that time is a factor that dictates which self-care practices they use. Four participants moderately agreed. One participant slightly agreed. One participant

101 Table 9. Goal #7 Time as a Factor in Self-care

Statements Average Responses

7 – Time is a factor that dictates which self- 5.35 23 care practices I use

15 –I have found time during the day in 4.52 23 which I can implement self-care practices in my personal life 4.26 23 23 –My schedule makes it easy for me to schedule self-care practices at least on a weekly basis

Composite 4.71 N=23

Note: The scores are mean scores. There were 23 participants (n=23). Each question was rated on a scale of 7-1 with (7) strongly agree, (6) moderately agree, (5) slightly agree, (4) neutral, (3) slightly disagree, (2) moderately disagree, (1) strongly disagree. was neutral. Two slightly agreed. Three moderately disagreed, and one strongly disagreed. The majority (16) agreed to some degree that time was a factor in choosing a self-care practice.

Question 15 had a total score of 4.52 Five of the 23 respondents reported that they strongly agreed with this statement. Four respondents moderately agreed with the statement. Three respondents slightly agreed. Five were neutral. Two slightly disagreed. Four strongly disagreed. The results revealed that 12 respondents agreed to some degree that they have found specific times during the day in which they can implement self-care practices. While this is a majority, it is important to note that it is only a slight majority.

The total score for statement 23 was 4.26. Three out of 23 reported that they strongly agreed. Four moderately agreed. Five slightly agreed. One person

102 was neutral. Six slightly disagreed. Two moderately disagreed. Two people strongly disagreed. The result displays that the majority, 12 individuals, agree to some degree that their schedule makes it easy for them to schedule self-care on a weekly basis. The majority of the respondents reported that time is a factor in implementing self-care practices. The score 4.71 represents the level of agreement of the degree to which all 23 respondents have been impacted by the lack of time. Question 7: “Time is a factor that dictates which self-care practices I use” dealt with whether or not time is a factor in choosing which self- care practices they would implement. Question 15: “I have found time during the day in which I can implement self-care practices in my personal life” measured whether or not the could fine time during the day to implement self-care practices. Question 23: “My schedule makes it easy for me to schedule self-care practices at least on a weekly basis” show that the individuals schedules are busy and because of their busy schedules they lack self-care on a weekly basis.

Qualitative Analysis

Following the quantitative questions, each participant was asked to answer three open-ended questions. These questions were designed to discover the degree to which each participant understands and integrates the self-care principles that were taught in the Dimensions of Healing course at

Ashland Theological Seminary – Detroit. The first question was: “How did the

Dimensions of Healing course help you better understand self-care?” The second question was: “How have you been able to utilize self-care practices in

103 your personal life?” The third question was: “What have you found to be valuable about your self-care practices in your personal life?”

All 23 participants answered the first open ended question (survey question #25) and third open ended question (survey question #27), and 22 participants answered the second open ended question (survey question #26).

The answers have been coded and charted by themes in table format. The themes are listed in the order of prominence based on the number of times each theme was selected as an answer to the question.

Table 10. Understanding Self-care

Question # 25 How did the Dimensions of Healing course help you better understand self-care? Most Used Theme Responses

N=23

1 – Helped me understand the definition of 14 self-care (code as DEFINITION)

2 – Helped me have a better quality of life 11 (code as OUTCOME) 9 3 – Helped me develop self-care practices that I use (code as METHODOLOGY) 7 4 – Helped me decide to prioritize self-care practices (code as PRIORITY)

The participants were instructed to give two examples if possible. The majority (14) of the responses noted that the course helped them to better understand self-care by providing a definition of self-care. Eleven noted that because of the outcome (experiencing a better quality of life) they better

104 understand and experience self-care as result of the course. Nine responses reflect that the methodology learned to practice self-care helps the participants better understand and utilize self-care as a result of the course. Seven responses suggest that prioritizing self-care as a result of the course helps them to better understand and experience self-care.

Table 11. Utilizing Self-care Practices

Question #26 How have you been able to utilize self-care practices in your personal life? Most Used Theme Responses

N=23

1 – Inward Journey (personal growth) 22

2 – Upward Journey (growth in my 17 relationship with God) 8 3 – Outward Journey (growth in my relationships with others and my clients)

The participants were instructed to give two examples if possible. The majority (22) of the responses noted that the participants have been able to utilize self-care practices in their personal life as it relates to their personal growth. This was coded as the inward journey. Seventeen noted that they utilize self-care practices as it relates to their relationship with God (coded as the upward journey). Eight responses show that the participants are able to utilize self-care practices as it relates to others (coded as the outward journey).

Table 12. Value Related to Self-care Practices

Question #27 What have you found to be valuable about your self-care practices in your personal life?

105 Most Used Theme Responses

N=23

1 – Value Related to Self 17

2 – Value Related to God 6

3 – Value Related to Others 4

There were 17 participants who responded that they were able to experience an increased value and priority in their relationship with themselves

(coded as value related to self). Six responses noted an increased value in and appreciation for their relationship with God (coded as value related to God).

Four respondents note an increased value as it relates to their valuing their relationship with others (coded as value related to others).

Conclusion

This chapter shows the results to twenty-four quantitative statements and three qualitative questions designed to discover the degree to which each participant understands and integrates the self-care principles that were taught in the Dimensions of Healing course at Ashland Theological Seminary – Detroit.

Chapter six reflects on the responses to the questions and includes a summary based on the findings of this chapter.

106 CHAPTER SIX

SUMMARY AND REFLECTIONS

On May 7, 2017, I received a phone call that would shake my core. This phone call started a season of traveling a minimum of 200 miles per day, often more! I would go from my home in Sterling Heights, Michigan to the hospital in

Flint, Michigan then to my second home in Saginaw, Michigan. Then to my office in Southfield, Michigan. Finally I would arrive back home in Sterling

Heights or back at Hurley Hospital in Flint, Michigan. The phone call that I received notified me about a terrible accident that my parents had been in. My dad was killed and my mother was in for the fight of her life. One day as I made it back to my office, I realized that my body literally could not go any further.

I’m not sure what happened next because I passed out near the couch in a colleague’s office. Another colleague came in and found me, probably wondering why I was not in my own office. I am still wondering the same thing.

As a clinician, it was this time in my life that I learned what it meant to live a marginless life. While I had a reason for this lack, it was a lack nonetheless. I simply did not have enough time to employ what I knew was necessary to be successful as a Christian clinician.

For that time when I could not care for myself well, my community ushered me through. We have a massive need for community to help us, especially when we cannot help ourselves. Jean Vanier says: “in community people care for each other and not just for the community in the abstract, as a whole, as an institution or as an ideal way of life. It is the people that matter; to

107 love and care for the people that are there, just as they are (Vanier 1989, 20).

The professor who had been teaching in the other room and found me passed out in another colleague’s office required me to go home to recuperate. It was community that helped me remember to care for myself.

This project began to form while I was in the Doctorate of Ministry program, but it manifested its substance when my dad died. The real life of this project came when I had to remember to care for myself. The results of this project demonstrate the need for Christian clinicians to self-care, specifically taking the necessary time to care for themselves. This chapter will reflect on the results of this project, beginning with each project goal. I will discuss insights I have personally gleaned from this project, and possible future applications derived from this work. Finally, I will reflect upon my personal goals.

Project Goals

Healing course into their personal lives. The research question is to what degree do a select group of counseling graduates from Ashland Theological

Seminary – Detroit integrate the self-care practices that were taught in the mandatory Dimensions of Healing course into their personal lives? The overall goal of this project was to see how clinicians who were graduates of the counseling program at Ashland Theological Seminary – Detroit understood and

108 utilized the self-care practices that they had been taught in the Healing

Dimensions course in their personal lives.

This course was created by Sharon Marshall as a result of her work in the

Doctorate of Ministry program in Formational Counseling. This course specifically covered the notion of self-care as a clinician. I wanted to discover if the course was serving its purpose in helping Christian clinicians care for themselves. The project goals were

1. To discover the degree to which participants have integrated the self-care

practices taught in the mandatory Dimensions of Healing course into their

personal lives.

2. To discover the degree to which participants personal lives have been

affected by the integration of self-care practices.

3. To discover the degree to which the self-care practices have influenced

the personal lives of the participants.

4. To discover the degree to which the participants understand self-care

practices as a biblical practice.

5. To discover the degree to which the participants perceive self-care

practices as a necessity.

6. To discover the self-care practices used in the personal lives of the

participants.

7. To discover the degree to which time is a factor in self-care practices.

8. To discover the degree to which the participants have an overall

understanding of self-care practices.

109 Chapter Four explained that each participant was given a survey. The survey was comprised of 27 questions: three quantitative questions per goal and three additional qualitative questions at the end of the survey. For the quantitative questions, the participants were given a seven-point Likert scale of agreement. I review each goal in order of prominence.

Goal Five: Self-care Practices as a Necessity

The goal that had the most prominent score was goal #5: “to discover the degree to which the participants perceive self-care practices as a necessity.”

Responses suggest that the participants understood and agreed that practicing self-care is a necessity. The average score for this goal was 5.64. The three quantitative questions that tapped into this goal were: “I believe practicing self- care is a necessity” (#5); “I believe practicing self-care in my personal life is important to my life balance” (#13); and “I believe that when I practice self-care, my life feels more harmonious” (#21). This goal had the highest degree of agreement for the entire survey.

One reason that this was the highest goal is that the graduates of

Ashland Theological Seminary – Detroit understood what they were taught in the Healing Dimensions course about self-care being a necessity. Another reason this may have been so high is that these clinicians understand the need to teach self-care to their clients.

One of the major outcomes of seeing the necessity of self-care is the ability to explain the need for self-care to others. In reality though, just because they know what to do does not mean that they will actually do it. It is possible

110 that prior to the class, participants may have known about self-care, but this study shows that after the class they knew that self-care was a need.

For the majority of these clinicians, self-care was done in order to have harmony and balance in their lives. James sees self-care as the fulcrum that balances selfishness and selflessness. She states that while there may never be a “perfect balance,” there is a need for balance (James 2016, 77). As clinicians understand the need for self-care, the hope is that they will begin to see the need to practice it.

Goal Four: Understanding Self-care Practices as Biblical Practices

The goal with the second most prominent score was goal #4: “To discover the degree to which the participants understand self-care practices as a biblical practice.” The composite score for this goal was 5.48. The three quantitative questions that assessed the goal were: “I understand that self-care is a biblical practice.” (#4); “I understand that there are specific scriptural passages that assist me to articulate self-care as a biblical practice.” (#12); and

“I understand that practicing self-care principles assists me in living a more

Bible-focused lifestyle.” (#20).

One reason that this goal would rank with the second highest level of agreement may be that Marshall taught this course with a scriptural focus.

Many of the topics covered were justified or nullified by scripture. Also, all of the clinicians who took the survey profess to be Christians, so it would stand to reason that they believe that the idea of self-care as a biblical concept can help them live a Bible-focused lifestyle.

111 There is a major implication that it may be difficult for clinicians who were taught self-care at Ashland to share this topic of self-care with a non-Christian individual, if the clinicians believe it is useful to help live a Bible-focused lifestyle.

It would be important in a future study to address self-care from a non-biblical point of view as well. If the belief is that self-care is for everyone, it will be extremely important to be able to reach others who are not concerned about the

Biblical implications of self-care. Dr. Richard Swenson shares that the lack of margins or self-care is a problem that we all deal with, and it is not exclusive to one sect of people (Swenson 2004, 28). For this reason, I feel that it is necessary to look at this idea from both a spiritual and secular perspective.

Goal Eight: Overall Understanding of Self-care Practices

(#16); and “I understand how to model self-care practices with others” (#24).

This goal shows that the clinicians who responded had an overall understanding of self-care practices. Seventeen out of 23 understood what constitutes self-care principles and 19 of the 23 knew how to articulate self-care principles to others.

Sixteen understood how to model self-care practices. A possible reason for these numbers could be that the clinicians who took the survey had a sufficient understanding to teach these practices to others.

112 The implications of this are that understanding self-care practices and being able to articulate self-care practices, and understanding how to model these practices will be helpful for their clients, their ministry and their personal lives. These areas are what Swenson refers to as relational environment,

“these are the same areas Christ spent His time developing and where His teaching is focused” (Swenson 2004, 32).

Goal Three: Influence of Self-care on the Participants Personal Lives

The fourth most prominent score was goal #3: “To discover the degree to which the self-care practices have influenced the personal lives of the participants.” The composite for this goal was 5.41. The three quantitative questions that assessed this goal were: “My personal life has been positively influenced by the self-care practices” (#3);” I am inclined to share the self-care practices that have influenced me” (#11); and “My professional life has been positively influenced by personally integrating self-care practices” (#19).

This goal shows that the majority of the participants agree to some degree their personal lives has been impacted by self-care. The question with the highest level of agreement was question #11, “I am inclined to share the self-care practices that influenced me.” This directly correlates to the question in the previous goal about being able to articulate what self-care principles are.

One possible reason for this higher level of agreement may be that the participants are clinicians and it is beneficial for clinicians to be able to articulate self-care principles to their clients so that they do not experience burnout as a client.

113 One implication of this goal is that the participant may possibly experience a higher quality of life if their life has been impacted by self-care. It would have been interesting to know how the participants’ lives had been influenced by self-care. Another aspect that could have been more informative would have been to evaluate their understanding before they took the course versus after they took the course.

Goal One: Integration of Self-care Practices

The fifth most prominent score was goal #1 “To discover the degree to which participants have integrated the self-care practices taught in the mandatory Dimensions of Healing course into their personal lives.” The composite for this goal was 5.27. The three quantitative questions that assessed this goal were: “I have integrated the self-care practices that were taught in the Dimensions of Healing course into my personal life” (#1); “Ashland

Theological Seminary – Detroit offering the self-care principles in the Healing

Dimensions course has added value to my personal life” (#9); and “I utilize the self-care practices that were taught in the Dimensions of Healing course in my personal relationships” (#18).

Though the majority of the participants agreed to some degree that they had integrated the self-care practices that were taught in the Dimensions of

Healing Course, only five strongly agreed. This could be the case for many reasons. One possible reason could be the amount of time that people have in their schedules. Or, it could be the same phenomenon that we see with nurses who are in bad health. One study notes that “despite significant education

114 targeted at this group surrounding health promotion and health behaviors of patients, it seems that this knowledge is not always transferred to their own behavior” (Blake 2011, 238).

The implications of falling into a “do as I say, not as I do” phenomenon is that the clinicians can experience burnout at a higher rate. Unfortunately, according to research, this is not abnormal for clinicians across the medical field. One study shows that nurses and doctors are among those that are in the worse health (Blake 2011, 231). This study “indicates that the health profile of pre-registration nurses is relatively poor” (Blake 2011, 231). This correlates with the counselors who do not actually integrate self-care. The counselors have the information and they know how to articulate self-care to their clients and others.

However, in this study only five of 23 agreed to the highest degree which is

“strongly agree.”

Goal Two: Impact of the Integration of Self-care Practices

(#17).

115 With this goal, I found that any evidence of the integration of self-care was impactful. The flaw in this is the same as the previous goal. Clinicians were not integrating to a high enough frequency. While there was evidence of an impact as a result of integration, many of the clinicians were not regularly integrating the practices.

Essentially the implications of the findings are that integrating self-care is impactful, and more integration is needed. One future study that follows from these findings involves discovering avenues for clinicians to actually practice what they teach. One limitation that I will speak to in goal #7 is the lack of time in the schedules of busy clinicians.

Goal Six: Self-care Practices Used

The purpose of this goal was to discover which self-care practices the participants used. While formational prayer was used to some degree, considerably more participants used spiritual disciplines as self-care more than formational prayer. Another significant discovery is that more people engaged in spiritual disciplines above both formational prayer and boundary-setting as self-care.

116 The implications of the use of spiritual disciplines over boundary-setting could be significant. Cloud and Townsend say that boundaries are necessary to a balanced life and self-care. For them, balancing self-care is impossible without boundaries. (Cloud and Townsend 1992, 31). James says that life rarely remains in a balanced state. She says “consequently, a healthy depiction is truly reflected in our understanding of the need to adjust based upon the current life situation” (James 2016, 78). She asserts that self-care is the fulcrum that balances selfishness and selflessness. One of the long-term implications of choosing spiritual disciplines over boundary-setting could be the spiritualization of being over-worked, because boundary-setting is not practiced to create healthy margin in one’s life. A good balance between having boundaries and practicing the disciplines would be best.

Seven: Time as a factor in Self-care

The least prominent score was goal #7 “To discover the degree to which time is a factor in self-care practices.” The composite for this goal was 4.71.

“My schedule makes it easy for me to schedule self-care practices at least on a weekly basis” (#23).

This goal sums up the practice of self-care for these clinicians. Evaluation of these questions suggest that they have not found time to be intentional about

117 self-care practices during the day. Additionally, their schedule is too busy to schedule weekly self-care practices.

These participants are too busy. Individuals can miss out on so much of life because they make themselves too busy. Foster discusses the notion of

“muchness” and “manyness”: “if we expect to succeed…we must purse ‘holy leisure’ with a determination that is ruthless to our datebooks” (Foster 1978, 21).

Simply put, in order to have the benefits and balance of self-care, it has to be scheduled and regarded as highly as any other important appointment in our datebooks.

Application

Christian clinicians have a need to engage and integrate self-care into their lives on a regular basis. Unfortunately, clinicians’ calendars get full and it becomes difficult to practice what they know. As a result of this study, I have found that these clinicians largely understand self-care and the implications of utilizing self-care principles. However, time limitations hamper practice.

This study relates specifically to graduates of the Ashland Theological

Seminary-Detroit Counseling program; however, the lack of clinicians’ self-care may be a much more widespread problem. One way to address lack of clinician self-care would be to design a post graduate workshop and offer it on either a monthly or quarterly schedule. This workshop would offer different self-care practices during the time of the workshop so that the clinician can engage and be regenerated to some degree during the workshop. Some of the topics could include the need for boundary setting, spiritual disciplines, preventing burnout,

118 and time management. As a bonus, it could include an actual self-care activity specifically designed for the clinician. I would like to offer this workshop to all graduates at a minimal cost.

I would also like to include in the Dimension of Healing Course a section specifically on the need to schedule self-care. In this portion of the class it would be beneficial to offer solutions to time management issues, also focusing on when the students graduate as well. Additionally, in the self-care plan that students have to develop during the course, I would add a calendar assignment where the student can map out their year of self-care. Foster notes “if we are constantly being swept off our feet with frantic activity, we will be unable to be attentive” to our own needs of balance and self-care (Foster 1978, 20).

Teaching students before graduation how to manage their time well may result in clinicians who will better schedule self-care practices.

Further Study

There are many ways to further this research. There are two ways I will address for further study. First the self-care study could be expanded to include other ministerial leaders (e.g. pastors, and church executives). Secondly, the population could be expanded to include non-Ashland Theological Seminary-

Detroit Counseling graduate clinicians.

Many of the participants who took this assessment were ministry leaders in their local congregations and personal faith traditions. Expanding this study to Ashland Theological Seminary-Detroit graduates who are ministry leaders

119 may be helpful in determining what leads to burnout for ministry leaders who are clinicians.

This became a study about self-care. In the curriculum of Ashland

Theological Seminary-Detroit Counseling program, this topic is covered heavily in the Dimensions of Healing Course. It would be interesting to discover what other mental health programs are teaching as it relates to self-care and how their students are applying this information. One question for further study might be to what degree are non-religious counseling programs teaching self-care.

There are many resources that could be developed that would help clinicians and ministry leaders to not experience burnout. I would like to investigate further exactly what self-care practices clinicians are engaging. I would also like to study what specific time restraints they are encountering as it relates to scheduling self-care on a regular basis.

Personal Goals

The term “roller coaster” does not adequately defined the ups and downs of my life. I began this chapter with a discussion about my father who was killed in a car accident and my mother who was seriously injured. Since graduating from the counseling program there have been times when I needed to engage self-care practices but felt like I could not for various reasons. It was my community who helped keep me on track with my self-care practices and ultimately my personal goals for this project.

120 My personal goals were as follows:

1. To be more open to the Holy Spirit through the implementation of self-

care practices.

2. To be more aware of the presence of God through the spiritual disciplines

of prayer.

3. To be more fully engaged with Jesus through the implementation of

formational prayer practices in my personal life.

Personal Goal One: Be More Open to the Holy Spirit

Before my father’s passing, I was in a really good place as far as work, ministry and self-care were concerned. As a matter of fact, the day he was killed. I was heading home from mini vacation in Tennessee with some friends and ministry colleagues. We had just had an amazing time being present for our mutual friends’ album release party and ultimately just hanging out with each other. My phone rang, and little did I know that call would define the rest of my life.

From that point in 2017, it became very difficult to implement self-care practices. There were many reasons why this difficulty occurred. One was that I was the one who had to bear the brunt of the responsibilities where my parents were concerned. In an instant, I was living my life for someone else. The thought of implementing any kind of self-care practices at this time was so far beyond me. I just had to get things done.

121 The years 2017 and 2018 are a fog as it relates to my own self-care.

Things began to change for me the day I found myself passed out in my colleague’s office on her couch, let me pause here and say I did not find myself

– another colleague found me. She informed me that I was going to her house because she knew I was in no shape to care for myself, let alone wait on the

Holy Spirit to do whatever He was going to do.

So how did I do with goal number one? Initially, I was say I was failing but that changed once I began to lean on my community. That day in 2017, when I was passed out, I allowed community to care for me when I could not care for myself. From there I began to meet with a spiritual director who shared that I would have to forgive God because I was not going to be able to move forward effectively without the help of Holy Spirit.

I began to work on the places where I had not forgiven God in my heart.

Once I did that, I was able to re-invite the Holy Spirit to a deeper part of my life, including to be a part of my process of implementing self-care principles. The main thing that I found with this goal is that it was so much easier to do it with the Holy Spirit than without Him.

Personal Goal Number Two: To Be More Aware of God

When you are going through trials and processes it can be very difficult to be aware of God. For me, it was easier to go into survival mode where I felt like

I had to do everything on my own. I found myself really leaning into the work of

Richard Foster to help with my awareness of God through the method of spiritual disciplines.

122 During the time when I was allowing my community to care for me, a colleague introduced me to Foster’s work Celebration of Discipline. It was here that I fully learned and internalized that “God intends the Disciplines of the spiritual life to be for ordinary human beings: people who have jobs, who care for children [or sick parents], who must wash dishes and mow lawns. In fact, the

Disciplines are best exercised in the midst of our normal daily activities” (Foster

1978, 1).

Through this I was absolutely able to achieve this goal of being more aware of the presence of God through the spiritual discipline of prayer.

Additionally, I have been able to add additional spiritual disciplines such as meditation, lectio divina and journaling. God’s presence is all around us, and I am grateful for the ways that I have been able to experience it throughout this process.

Personal Goal Number Three: To Be More Fully Engaged with Jesus

During the process of both this dissertation and my father’s death, it was necessary for me to add both a therapist and a Spiritual Director to my life. Both my therapist and my spiritual director were well versed in Formational

Counseling.

It was through these processes that I was able to integrate spiritual direction and formational prayer practices into my personal life on a regular schedule. My spiritual director encouraged me to employ safe place on a weekly schedule as a form of self-care. Safe place is a method of spiritual formation

123 taught by Terry Wardle to help an individual invite the Holy Spirit into their safe place and rest in His love and care in that place.

When I met with my therapist and my spiritual director, I would be positioned for formational prayer. It was in these very hard sessions that Jesus showed up the most. He allowed me to rest fully in Him and recognize His presence in my difficult places. As a result of this, formational prayer is a regularly scheduled occurrence in my personal life. On Monday mornings at 10 am, you can find me stilled away somewhere engaging with Jesus. From this, I would say that this goal was achieved.

Concluding Thoughts

Healing course into their personal lives. My expectation was to find out what the self-care need of clinicians were.

Through this project I have found that with clinicians in ministry, we may be embarking upon a “do as I say, not as I do” phenomenon as it pertains to self-care, which I found in helping professions is not uncommon. A portion of my research revealed that most nurses found themselves in poor health. The problem here is not that these professionals are unaware of what to do. These professionals choose to do otherwise by not considering their own well-being.

This was significant for me in many ways. This really has to be a primary focus of mine now and moving forward. I know that as a clinician who happens

124 to be a ministry leader, it is so important for me to care for myself. It is safe to say that I am the most important person when it comes to my care. I now know that I have to schedule my self-care and stick to it just as I would any other obligation on my calendar. For me, meeting Jesus in formational prayer and through the spiritual disciplines have been life changing and have added so much value to my life. They have also helped me get the balance back in my life that I lacked and desperately needed. Additionally, it is of the utmost importance for me to share this reality with clients and other clinicians and ministry leaders, so that we can ultimately live a healthier life that does not end in burnout.

125 APPENDIX ONE

Proposal

ASHLAND THEOLOGICAL SEMINARY

A DISCOVERY PROJECT ON SELF-CARE AS A PROFESSIONAL COUNSELOR

A PROJECT PROPOSAL SUBMITTED TO THE FACULTY OF ASHLAND THEOLOGICAL SEMINARY IN CANDIDACY FOR THE DEGREE OF DOCTOR OF MINISTRY

BY JOY P. CREEL

ASHLAND, OHIO FEBRUARY 2, 2018

126 Purpose Statement

It is the purpose of this project to discover the degree to which a select group of counseling graduates from Ashland Theological Seminary – Detroit have integrated the self-care practices taught in the mandatory Dimensions of

Healing course into their personal lives. The research question is, to what degree do a select group of counseling graduates from Ashland Theological

Seminary – Detroit integrate the self-care practices that are taught in the mandatory Dimensions of Healing course into their personal lives?

Overview

The focus of this project is to discover the degree to which a select group of counseling graduates from Ashland Theological Seminary – Detroit have integrated the self-care practices taught in the mandatory Dimensions of Healing course into their personal lives. The participants will be assessed with an assessment tool to discover how the graduated counselors have utilized the self- care principles. I will evaluate the survey results from the results of the assessment tool.

Formational counseling focuses on ministering Jesus Christ to the broken. As a formational counselor, one of the things that can be difficult is ministering to oneself. The ministry of the formational counselor (caregiver) is never done… or is it? In order for the caregiver to take care of others, they must take care of themselves. The purpose of this project is to address the notion of whether or not graduated students of Ashland Theological Seminary – Detroit actually use the self-care principles that they have been taught.

127 In order to be able to address the concept of self-care, one must be comfortable with understanding what self-care really is and why it is important to professional counselors and in the field of formational counseling. As a professional counselor, an individual can deal with many topics as they help others. For example a professional counselor can deal with clients with emotional health issues, mental health issues, substance abuse issues, career issues or even formational counseling issues. This is not an all inclusive list, but an effort to show the span and spectrum to which a professional counselor is involved.

While dealing with the issues of their clients and care-receivers, a counselor has to be sure that they remain healthy by caring for themselves. The counseling students of the Master of Arts in Counseling program offered at

Ashland Theological Seminary – Detroit are uniquely positioned to be skilled helpers with an eclectic approach to the helping relationship. This includes being introduced to the notion of formational counseling. Formational counseling is a helping relationship that takes place between a highly trained caregiver and an individual who seeks the ministry of Jesus Christ as the answer to their pain. The pain that an individual experiences can come from a plethora of avenues such as: substance abuse, addiction, living lies, dysfunctional family behaviors, mental health issues, etc. (Wardle 2001, 42).

One thing that formational counseling does is share the love of God as a healer with the individual. When an individual enters into the helping relationship, it is considered a healing journey. As a formational counselor, one of the most

128 important parts of that journey is making sure that the counselor stays healthy by caring for himself or herself. The format of the counseling program includes a class designed to teach the principles of self-care. The class is entitled

Dimensions of Healing. This project will help determine whether or not the graduates utilize these principles in their daily lives.

Ray S. Anderson asserts, “self-care is not an individual project of self- help. Rather, it is care for the self as created in the image of God and valued by

God for its own intrinsic worth” (Anderson 2009, 8). How we interpret and appropriate this care comes initially from our primary care givers, family members and others “who undertake responsibility for the development of the self through personal and social interactions” (Anderson 2009, 8). Eventually as individuals we have to be able to assume the responsibility of our own self-care.

This requires the ability to make wise choices as it relates to those we encounter in our daily lives but also those we serve in ministry (Anderson 2009, 8).

Foundations

As a trained helper, this notion of how we care for ourselves must be addressed. If not, we will experience burnout because of the lack of care. My vision for this project occurred because of this truth. I have seen many spiritual counselors back away from their calling because they did not know how to care for themselves. What I have learned from my own personal experience is that not caring for myself is poor stewardship of my calling.

In the sections to follow I will discuss personal, biblical, theological, historical and contemporary foundations. As I begin with the personal

129 foundations it is important to me that I mention that it is my own experience with the lack of self-care especially that motivates me to address this topic.

Personal Foundation

I became a licensed counselor in 2014 shortly before beginning the

Doctor of Ministry program at Ashland Theological Seminary. Before that, I had answered a call to preach and was an associate minister at my church. I also was the Visual Arts Coordinator, which meant that I was the director of all things graphic media at my church. From the computer to the screens ... I did it. In addition, I had just finished my second masters program, and I taught Sunday

School and Wednesday night youth ministry. I was also the ministry leader and committee chair for the Newsletter ministry at the church. I was also worn out!

Before entering the masters program at Ashland Theological Seminary, not only had I never heard the phrase self-care, I did not know how to engage in such a task. I honestly did not see the need for this thing called self-care.

When I was introduced to self-care as a necessity, I did not realize the need was so great until I was introduced to formational prayer on top of all of the other things that I have mentioned.

The Dimensions of Healing class, developed and instructed by Sharon

Marshall, was a life saver for me. I believe it was so impactful because I had no idea I was drowning. The information from this class was beyond liberating for me. I was able to understand the paradigm of being juxtaposed to the paradigm of doing.

130 I was able to apply this information to my secular employment, school, my ministry, and the work that I was doing for the church. I learned different spiritual disciplines that promoted self-care as well as other practical ways to put my well being first. I realized that I had struggled for years to do so, possibly my entire life.

One of my own personal healing experiences through a formational prayer exercise highlighted that I had agreed with the false belief that I had to perform to get approval. This was true even if the cost was my sanity and me; even more frightening to some extent my physical health.

This project will focus on assessing how others like me integrated self- care practices as a result of the Dimensions of healing class. There is a great number of counseling graduates who went on to become licensed counselors, formational counselors, or pastors. All of these positions and professions are in one way or another a caregiver to others. The test will be if they care for themselves.

Biblical Foundation

In the Biblical Foundation we will discuss two scriptures Luke 10.

Scripture points to the need to care for one’s self several times in both the Old

Testament as well as the New Testament. In Leviticus 19, Matthew 19, Mark 12,

Luke 10 and Romans 13 the words noted as “The Greatest Commandment” in the book of Mark can be found echoing throughout scripture. Referring to the greatest commandment Jesus said “The most important one,” answered Jesus,

“is this: ‘Hear, O Israel: The Lord our God, the Lord is one. Love the Lord your

131 God with all your heart and with all your soul and with all your mind and with all your strength.’ The second is this: ‘Love your neighbor as yourself.’ There is no commandment greater than these” (Mk. 12:29-31).

One may find it less than interesting that Jesus points out that we must love our neighbors as we love ourselves. The attention here should be pointed to what is inferred by Jesus. While this command to love your neighbors as yourself can be read throughout the scriptures, actually loving yourself has not been found as a command anywhere in the scriptures. One can assert that loving yourself can be considered to be assumed or even natural, so much so that it goes without saying.

How can you love or help others if you cannot love or help yourself?

Based on what is being asked of humankind by Jesus one would assume that

God has given the innate ability to love self. Unfortunately, it is not unusual for

Christians to get so caught up taking care of others that they forget that there is more to life than the issues of others. One biblical example of this can be found in the book of Luke chapter 10

As Jesus and his disciples were on their way, he came to a village where a woman named Martha opened her home to him. She had a sister called Mary, who sat at the Lord’s feet listening to what he said. But Martha was distracted by all the preparations that had to be made. She came to him and asked, “Lord, don’t you care that my sister has left me to do the work by myself? Tell her to help me!” “Martha, Martha,” the Lord answered, “you are worried and upset about many things, but few things are needed—or indeed only one. Mary has chosen what is better, and it will not be taken away from her” (Lk. 10:38-42).

In his book, Into the depths of God, Miller asserts this thought, “to desire only what Christ gives and not desire Christ himself is to be bought off by little

132 trinkets, never to own the greater treasure of his indwelling presence” (Miller

2000, 84). In this passage Martha missed the presence of God. Here she is completely enthralled with doing for others, so much so that she is in the literal presence of the messiah and misses the encounter. As Christians it is often that one can get caught up like Martha “with the preparations that have to be made” that we can miss the invitation to bask in what Jesus has to share.

Theological Foundation

The theological foundations for self-care of the formational counselor is centered on the doctrine of the Trinity and the power that operating in community offers loving neighbor as we love God and self. Each person in the

Trinity has an individual task that is assigned to them. Stephen Seamands notes in the text Ministry In The Image of God that “the doctrine of the Trinity has been described as the grammar of the Christian faith….As the Christian grammar, the Trinitarian doctrine enables us to speak rightly about the God who is revealed in Scripture as Father, Son and Holy Spirit” (Seamands 2005, 11).

Safe community can be a haven for self-care through encouragement and accountability. We can see a reflection of the Trinity operating in and modeling a safe and encouraging community at the baptism of Jesus. When all the people were being baptized, Jesus was baptized too. Julie Gorman would say that this is an example of how operating together is better that the sum of the individual parts. (Gorman 2002, 48).As he was praying, heaven was opened and the Holy Spirit descended on him in bodily form like a dove. And a voice came from heaven: “You are my Son, whom I love; with you I am well

133 pleased” (Luke 3: 21-22). This act shows the power and necessity of community so much so that even the Trinity is physically together at one time in support and approval of this act of baptism. Miller would support this thought with his notion that coming together as community is a direct reflection of the image of God (Miller 1979, 27).

Since God is relational by nature His nature is revealed within the Trinity.

In her book God’s Many-Splendored Image Nonna Harrison discusses the notion that every human is unique. Even though we are all different God makes it possible to see Him in each individual because we are created in the image of

God. In Genesis God said that “it is not good for man to be alone” (Gen. 2:18).

God gave Adam Eve, but their relationship became severely distorted which

William Kirwan addresses in his text Biblical Concepts for Christian Counseling.

Kirwan articulates the need for counseling as he discusses the notion of the self being fractured into two parts: the needing self and the rejected self is related to this need for self-care as it relates to answering the self-identity questions that must be answered in order to progress in the formational counseling process. Directly related to the idea of acceptance our “self-identity is basically each person’s answer to the question ‘Who am I?’” (Kirwan 1984,

75). Humans bear the Trinity’s likeness when they live together in harmony as a community (Harrison 2010, 170). Wardle asserts:

134 contemplation and reflection upon His teachings and admonitions contained in scripture. (Wardle 2005, 76)

In order for the formational counselor to properly care for themselves they must be engaged in community. Seamands outlines three areas that should be utilized by the formational counselor who is practicing effective self-care. “First, a commitment to wholeness in our interpersonal relationships. Second, a commitment to involvement in close-knit small group fellowship. And third, a commitment to healthy family relationships” (Seamands 2005, 40). God blares the point at us that we have to learn how to not just live, but also love in community.

Contemporary Foundation

The word phrase self-care seems to be one that is self-explanatory. One who takes care of themselves. Self-care as defined by Ray Anderson is “care for the self as created by the image of God and valued by God for its own intrinsic worth” (Anderson 1995, 8). Anderson extends his definition of self-care by stating “this care begins with the intentions and aspirations of our original caregivers, parents, and family members who undertake responsibility for the development of the self through personal and social interactions” (Anderson

1995, 8). Roy Oswald says it this way,

Self-care is little more than being a steward of some rather special gifts – a physical body with it enormous resilience and beauty, the capacity to nurture others and be nurtured in return, the capacity to be aware of our lives as we are living them, the capacity to enjoy immense sensual pleasure through such simple things as a splash of orange juice in our throats in the morning or a child in our lap. I like to think of self-care as a commitment we make to God when we accept the role of resident religious authority. When we accept the call to be an agent of Grace, we simultaneously promise to forgo the easy life of self-indulgence, which

135 can be a stumbling block to God’s agents. I have come to call this “self- care for the sake of the kingdom.” I take care of myself, not only for my sake, or for the gratitude of the life given me by God, but also for the sake of others. If I don’t take care of myself, I not only hurt myself but I let others down as well. (Oswald 1993, 5-6)

In essence, this means that when we accept the call to be who God has called us to be, we accept the call to care for ourselves and care for ourselves well. God does not call us to show grace to others and leave ourselves without the same grace. We take care of ourselves to show God that we are grateful for the being that He created, which is us.

Self-care and God (Upward Journey)

Anderson would say that you must first take time to examine the notion of self before you can even begin to address the notion of self-care. Anderson asserts that the term self is one that is difficult to define. He says that “the concept of self has intruded into contemporary issues where legal and moral capacity is assessed with regard to an individual’s actions” (Anderson 2010, 16).

Community as Self-care (Outward Journey)

Anderson makes us aware that the notion of self-care is not one that can be attempted on one’s own. His text notes that we are created in God’s image, which means that we were created to be in community. He says “the divine image is not a religious quality of an individual person, but a spiritual quality expressed through the interchange of persons in relation” (Anderson 2010, 238).

Anderson says while Paul looked to the church (in the book of

Thessalonians) for community he notes that we do not live in the time of Paul.

He makes the following statement.

136 unfortunately, the church in our culture is not often the place where we experience such open and trustful community; at least, not in the official programs and meetings. At the same time, the church is made up of the people who silently bear hurts, anxieties, and live with feelings of shame and loss of self-worth. (Anderson 2010, 239)

This notion of community being a necessity of self-care is one that Terry

Wardle would tend to agree. In his text, Healing Care, Healing Prayer, Wardle discusses how he teaches the Doctor of Ministry program in formational counseling. He talks about how some of the church leaders come to the classes and they are in need of care. He asked them the question where are they experiencing healing community? He notes that the majority of the students in which he teaches do not experience a safe place in community (Wardle 2001,

67). In his book, Draw Close to the Fire, Wardle says “if you desire support, encouragement, counsel and accountability, become a part of a truly spiritual community” (Wardle 1998, 158).

This notion is further addressed by Pettit when he asserts, we must not just learn to love, but learning to love well. Pettit discusses at length Five Key

Principles to Learning to Love: 1. Love does not default to the status quo 2.

Love is not primarily concerned with sinning less. 3. Love is a dynamic process

4. Love must be a commitment in every season of life. 5. Love is sustained when we experience His love (Pettit 2008, 56).

Self-care Practices (Inward Journey)

There is no one self-care practice that is considered right for everyone.

Wardle states that “a caregiver must take active steps to care for [their] own personal well-being. . .unless the caregiver faithfully attends to [their] own life,

137 involvement” (Wardle 2001, 51). Wardle also speaks of being so diligent to do and serve can compromise the life of the skilled helper. The foundation for adequate self-care is right and responsibility (Wardle 2001, 52).

The caregiver has the right to care for themselves regularly. It is the opinion of Wardle that “some in the Christian community would take exception to that statement, believing that it is somehow noble to compromise personal health in service to others” (Wardle, 2001, 52). Roy Oswald would agree with

Wardle stating that he feels “the tension in the room rise when the subject of self-care comes up. It just doesn’t set right with some [Christians]” (Oswald

1993, 4).

Oswalds position is that it is difficult for us to be proponents of the God if we do not care for ourselves. He also asserts that self-care is not narcissism

(Oswald 1993, 5). In their text, Boundaries, Henry Cloud and John Townsend note that our needs are our own responsibility. It is not wise for us to wait for someone else to care for us, we must understand that caring for ourselves is neither bad, selfish nor a luxury (Cloud and Townsend 1992, 107).

Context

The desired survey participants will be graduates of the counseling program at the Ashland Theological Seminary – Detroit Campus. This study will assess to what degree the graduates are or are not using the self-care practices that were taught in the Dimensions of Healing course. Graduates of the counseling program will be the targeted audience, they will be asked to complete a survey. I will request permission from AU for a list of graduates

138 I will focus on graduates who are currently working in the field or identify themselves as caregivers. As a graduate of the Detroit counseling program I have found it necessary to engage in healthy community to be held accountable for my self-care practices. I know both the importance of caring for yourself along with your clients and the effects of not caring for yourself and the toll it can take on you in the long run. Hopefully, through this discovery project I will be able to bring some awareness for the need of continuous self – care practices.

Definition of Terms

Self-care – “care for the self as created by the image of God and valued by God for its own intrinsic worth” (Anderson 1995, 8).

Project Goals

Healing course into their personal lives. The research question is, to what degree do a select group of counseling graduates from Ashland Theological

139 Seminary – Detroit integrate the self-care practices that are taught in the mandatory Dimensions of Healing course into their personal lives?

4. To discover the degree to which participants have integrated the self-care

practices taught in the mandatory Dimensions of Healing course into their

personal lives.

5. To discover the degree to which participants personal lives have been

affected by the integration of self-care practices.

6. To discover the degree to which the self-care practices have influenced

the personal lives of the participants.

7. To discover the degree to which the participants understand self-care

practices as a biblical practice.

8. To discover the degree to which the participants perceive self-care

practices as a necessity.

9. To discover the self-care practices used in the personal lives of the

participants.

10. To discover the degree to which time is a factor in self-care practices.

11. To discover the degree to which the participants have an overall

understanding of self-care practices.

Design, Procedure, and Assessment

The design is a survey that will be distributed both online and by mail.

This will ensure that I reach as many graduates as possible. The procedure will be to gather the data from the assessment of 25-50 people in the targeted population.

140 The assessment will include both quantitative and qualitative questions which will be developed based on the project goals. A 7-point Likert scale will be used to measure the degree of incorporation of self-care practices; ranging from completely agree to completely disagree with a neutral mid-point. The final section will be qualitative with three open-ended questions.

Personal Goals

My journey has been one filled with ups and downs. Since graduating from the counseling program there have been times when I needed to engage self-care practices but felt like I could not for various reasons. Prayerfully, along with following goals I will be able to use this process to gage how effective my own self-care practices have been following graduation.

My personal goals is as follows:

12. To be more open to the Holy Spirit through the implementation of self-

care practices.

13. To be more aware of the presence of God through the spiritual disciplines

of prayer.

14. To be more fully engaged with Jesus through the implementation of

formational prayer practices in my personal life.

Field Consultant

My field consultant will be Dr. Katherine E. James, PhD, Associate Pastor of Shiloh Deliverance Church. She is also a professional fellow for Ashland

Theological Seminary. As a licensed professional counselor her expertise in the helping field will greatly benefit my project.

141 REFERENCES

Anderson, Ray S. 1995. Self-Care: A Theology of Personal Empowerment & Spiritual Healing. Eugene, OR: Wipf and Stock.

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143

APPENDIX TWO

Assessment Tool

144

145

146

147 APPENDIX THREE

Cover Page

Dear Colleagues,

I hope you are having a wonderful start to the New Year! My name is Joy Creel, a Doctor of Ministry candidate. This letter serves as an invitation for you to participate in my Doctor of Ministry final project, which focuses on the Dimensions of Healing Course created and taught by Dr. Sharon Marshall at Ashland Theological Seminary-Detroit Center.

For those of you who are able, please complete the following questionnaire. I truly want to thank you so much for your willingness to participate in this survey. It is my hope to use the information gleaned from the questionnaire to examine the self-care needs and practices for us as counseling professionals.

In His Service,

~Joy

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