“I don’t do religion”

In healthcare settings, chaplains notice now more than ever an increasing number of religiously non-identifying patients. These individuals are likely to benefit from new strategies to discuss their concerns. One new approach is using a “third voice,” where chaplains utilize landscape pictures to engross patients in a conversation surrounding their spiritual and existential worries. This technique introduces a “third thing” into the discussion between chaplain and patient, allowing the patient to lose themselves in the photo. Analysis of the discussion can advise decisions about treatment, quality of life, and individualized care. Though these feelings are not religious in nature, they reflect an existential path that individuals are taking while connecting viewers to something larger than themselves. This intervention is reported in a recent article in Journal of Pain and Symptom Management by chaplain Stephen Obold Eshleman and Lab colleague chaplain Shelley Varner Perez.

This intervention helped a quiet and frail veteran and dialysis patient who appeared captive to his dialysis machine. He insisted that he didn’t “do religion” and was thus reluctant to converse with Chaplain Obold Eshleman. Eventually, this man on life-supporting blood treatment was able to open up and express deep feelings of sadness to the chaplain. Photographs helped facilitate conversation between the patient and the chaplain. When the man identified a picture of a dilapidated homestead as best describing his life, the chaplain was able to help name feelings of abandonment and isolation. Further, the chaplain was able to trace the patient’s feelings to an experience of once being a foster child who felt abandoned. Through the discussion of this photo, the man’s spiritual struggle was recognized, discussed, and attended to.

Oftentimes chaplaincy touches on sacred or existential language but does not use religious words. Photography can lead to a spiritual journey as people are often able to see themselves in an image. Despite the veteran being tethered to his dialysis machine, when he viewed the photograph he was able to cross into sacred territory and realize spiritual truths, understand their significance, and allow for self-exploration. Spiritual care invites self-exploration and honors spiritual patterns and customs regardless of culture or religion. Truly “seeing” a photograph means patients can open up and bring new meaning to aspects of their lives while meaningfully conversing with chaplains. Photos also help chaplains recognize the profound feelings of patients, as seen with Chaplain Obold Eshleman identifying the veteran’s need for belonging and self-worth. Within a healthcare system aiming to cure physical illnesses, photographs can allow spiritual care to invite patients to become authentic and truly free. Regardless of the veteran’s physical recovery, his chaplain was able to validate his suffering and make him feel valued and understood. Images and symbols allow for the “nearly known” to become recognized.