By Rachel Payne, Boston University
Carrie Doehring’s book A Practice of Pastoral Care: A Postmodern Approach is becoming a core text in chaplaincy programs across the country. We talked with Dr. Doehring about the impact of her book and what makes for good chaplaincy work today.
Q: Your book is used widely in seminary classrooms, but it is a core text in chaplaincy-focused programs. Why do you think it is particularly valuable for the theological education of future chaplains?
A: There are some excellent books on spiritual care that I would describe as being primarily grounded in a Christian tradition. I think the reason my book is popular is because it lends itself to more of an intercultural context of care, which of course is what healthcare and military chaplaincy are.
Q: You identify your approach to spiritual care as “intercultural.” What does that mean?
A: It’s the term that has been used in pastoral theology literature to identify different paradigms of care. There’s been a historical paradigm, which came out of traditional Christian approaches to pastoral care, that saw the goal as salvation, often based on the belief in the exclusive truth of one’s own tradition. In the 1950s, a clinical paradigm was articulated more clearly, with a focus on one-on-one healing relationships and self-actualization. A communal-contextual paradigm emerged out of African-American, feminist, and Womanist pastoral cares. Emmanuel Lartey began articulating the intercultural paradigm, which talks about people as embedded in multiple cultural paradigms. The intercultural approach really values the particularity of one person, one religious tradition, and how people practice their beliefs. This approach is open to various sources of authority. Some would say the clinical paradigm has been eclipsed by the communal-contextual and intercultural paradigms, but I really appreciate how I and other pastoral care theologians have been formed in that approach to have a deeply self-reflexive stance. I’m also a huge advocate for evidence-based intercultural spiritual care because working in healthcare contexts, chaplains need to become much more research-literate and fluent in describing how they are using research-based findings in the care they provide.
Q: You are mindful that readers may come from various religious traditions, although you situate yourself in the Christian tradition. What contribution do you think the book makes to prepare students to provide spiritual care to those who come from other faiths? Will it connect to those who do not ascribe to any religious tradition?
A: I have relied for many years on this wonderful article by Susan Nelson, a feminist process theologian, called “Facing evil: Evil’s many faces: Five paradigms for understanding evil.” The five orientations to suffering that she offers I have found so useful for students. But they are all theistic. And the reason I continue to use them is because in chaplaincy so often you encounter patients who are living out these embedded, theistic beliefs. The research on negative religious coping and religious struggle always feature a judging god. But the theologies of lament and ambiguous suffering that Nelson highlights — the process theologies in Christian tradition, the Jewish tradition of a highly relational God, and Buddhist worldviews involving ambiguous suffering — are so transposable that they have a lot of relevance and meaning across traditions.
Q: One of the things that you are trying to do is to get caregivers to be more intentional about the theologies they carry. You make several distinctions, but an important one is attention to embedded and embodied theologies. Say a bit more.
A: I teach students to pay attention to how they experience stress in their bodies and the orienting system that gets triggered by stress. That orienting system, we would say in theistic terms, is a theology that we are putting into practice. When students can recognize anxiety and hold it with compassion, that allows them to look at the shame-based or anxiety-based theology they are putting into practice. Tools such as compassion practices help them react in more complex ways and thereby reveal goodness or God as they appear in the midst of suffering.