My Experience Of Providing Pastoral Care

Published Date: 02 Nov 2017

Patient: Nancy

Length of Visit: 60 minutes

Number of Visits with This Person: 1

Date of Writing: 12/09/2010

Luke and Nancy was the first inter-racial couple that sought membership at Spencer Memorial immediately following the 2003 "White flight". For seven years of being their pastor, I have watched them grow diligently in their spiritual walk with the Lord, but something always seems to be lacking within their relationship especially around the Thanksgiving holiday, something that they couldn’t get around to talk about but was bothering them. On one Wednesday after Bible Study Nancy asked if she could schedule an appointment so that she and Luke could meet with me. I told her that it was okay. And so we set an appointment to meet an hour earlier on the next Wednesday before Bible Study. When we met following prayers on that Wednesday, Nancy begins by saying that they came to see me to discuss about the death of her father which loss she cannot seem to get rid of.

The presenting problem is one in which Nancy’s father passed away almost immediately when she became a member of Spencer. This occurred rather suddenly after her father was diagnosed of cancer. When word reached her that her father was terminal and the doctors have given him up, she immediately went to be with her mother to assist her while they prepared for the inevitable. Two weeks later after her arrival on Thanksgiving Day, her father passed away leaving her with a sudden stricken grief that after seven years she is finding it very difficult to dealing with her feeling of loss.

Recently Nancy went back home to visit her mother and while helping her mother to clean up the house and to perhaps rearranged her bedroom, because her visit back home had been infrequent since her father passed away. During her visit she was beset with her feelings of loss and now she tells me that she feels as if she should have moved beyond experiencing such strong feelings given that so much time has passed since the death of her father.

She and her father became close after a long period of estrangement between them and she describes their relationship developing over the years into more unique friendship than that of father and daughter. She tells me (with Luke holding her hand while sobbing) that some days are worse than others. On those days when she is so stressed up, she feels the sharp pain of her loss more strongly because she cannot just pick up the phone and call her father (something she had grown accustomed to); for her father had grown to become her best friend in spite of their past history and he had been their for her over the last few years of his life. During this whole session, Nancy pattern of speech appears normal yet she wept throughout it. But what was helpful is that we kept good eye contact during our discussion until she became emotional which minimize it. Below are statements showing that during one point of the session empathy was for the most part effective:

Nancy: I guess this may sound crazy, but this past Thanksgiving, I went home and my Mom was able to convinced me so that we can get rid of his clothes. Something that I said out loud to Mom that we were never ever going to get rid of his clothes because it was the only physical memory that I had of him. On Thanksgiving Day while going through his closet I could smell his distinct cologne (Kouros) on his clothes. It was too difficult; I broke down in the closet crying.

Pastor: I know that it must have been hard for you, because I also lost my father to sudden stroke.

Nancy: Pastor Morris, it was the hardest thing for me to do.

Pastor: It takes a lot of strength to carry that through.

Nancy: You can say that, it does. I break down whenever I begin to talk about him.

Pastor: You miss him

Nancy: Yes Pastor, I miss him so much (she begins to openly sob with Luke arms around her in an effort to console her).

Nancy was referring to the feelings of her loss that never seems to go away after seven years. My intent during this session was to reflect on those feelings. In addition, she was critical of herself in the early part of our session for not having moved beyond her feelings of loss. The reason this example was chosen to illustrate particularly well reflected empathy is due to the fact that it was at this point that she began to cry. When her feelings of missing her father were then return to, Nancy crying increased even more.

At this point in the session, I had managed to convey warmth, positive regard and respect for both Nancy and her feelings. I could sense how much she was hurting and my responses were genuine and sincere. Furthermore, in order to make sure I understood her and to communicate that she was being heard, I repeated often to her the things that she was saying to me.

Concerning issues of diversity, the reality is that I am an African Pastor and the person I am counseling is a Caucasian female. Despite this, any cultural issues that might have been present were not glaringly obvious. I felt comfortable in communicating with her.

Nonetheless, I do believe that some gender issues were obvious, yet I attempted to feel and replicate her loss, there were times when her feelings were so strong that it was rather painful. Moreover, I strongly believe that I did not feel her pain at anywhere near as compare to what she felt. More or less at a certain point, I had to quickly construct a wall in my mind to stop her pain from invading my emotion. Described below at one point, I even try to repair or fix it by changing the focus from her pain to envisioning good memories. Since in general, males are perceived to handle emotion in a different way, I target this as a gender issue. We are not expected to often give full expression to our feelings, and there may even be the tendency to down play those feelings that we experience. As male we tend to be problem solvers. Women often complain that they just want their husbands to listen to them, and not offer solutions.

Therefore, even though I am a Pastor trained to listen, the fact that I am a man may sometimes interfere with my ability to be fully open to intense emotions.

Given the restrictions imposed as a consequence of being unable to ask unrestricted inquiries, I was unable to gather as much information that could perhaps be helpful in relating her concerns from a theoretical perspective. However, using the information that I have, one possible way of considering Nancy’s emotions pertaining to the death of her father is from a pastoral perspective. It is very important that pastoral wisdom include some general knowledge of grief and mourning process that is informed by those who have done researched and written about it. One of the most influential interpretations of the grief process has been Erich Lindemann’s study called "Symptomatology and Management of Acute Grief,"1 in it he affirmed grief in that article as "work," something necessary for life rather than something pathological that should be avoided. He also described five things that he had observed in acute grief: (1) guilt, (2) anger, (3) bodily distress, (4) preoccupation with the image of the deceased and, (5) loss of customary of patterns of conduct. 2

Lindermann theorized that there are discernible stages in the grief process that the grieving person and those who care for that person should be aware of. When Nancy recently visited her parent home she was overwhelmed with fresh feelings of loss, almost as fresh as they were seven years ago when her father passed away. Furthermore, she expressed her displeasure

1An article Published in the American Journal of Psychiatry in September 1944

2Patton, John Pastoral Care (Abingdon Press Nashville, TN 2005) pp. 51-52

in still undergoing such strong feelings after so much time has passed. This displeasure could be viewed as her inclination to move in an affirmative direction toward health. In other words, it is her self-actualizing tendency that was seeking to express it.

Again keeping the lack of information in perspective, a possible hypothesis concerning why she has not moved further along through the stages of grief might be that there does not exist in her societal system the essential conditions that would allow her to discover the know-how and order to process her grief. She may also have family members that handle pain differently and tried to discourage open expression of such emotions. If such is the case, then providing positive regard, warmth and empathy might allow her to move beyond much of the pain that she reports experiencing.

The below example shows a point in the session, where the focus was shifted as a result of my response.

Nancy: I was in denial when the new first hit me that my father was terminal. Mom called me from the hospital and broke the news to me of which I requested to speak to my father, which I did trying to assure him that there was some kind of mistake and everything will be fine. That was when I got on the next available flight for Dallas. I went down immediately to be with him. Two weeks after my arrival he passed away.

Pastor: That was fast. And it seems that you have a lot of good memories of your father

Nancy: Yes I do have a lot of good memories, but I the hardest thing is the emptiness brought about by the loss. In this example, she described her experience of losing her father. In response, I attempted to direct her focus on the good memories that she had of her father, rather than the loss. However, it was clear that she wanted to focus on the loss and her current feelings of emptiness, demonstrating this by going away from it and then immediately coming back to it. It was when I regain control of the situation and said….

Pastor: Nancy, as a pastoral counselor, I certainly am open to the grieving process for those who had lost a loved one but not for such a long period. However, I must honestly say that there is more to the grief that you are undergoing. Even though you have not explain what brought about your estrangement with your parents I am quite sure that it has something to do with your prolonged grief.

Nancy: (Sobbing again…) you are right pastor. 17 years ago after falling in love with Luke in College I took him to ask for my parents blessing because we had decided to get married since we were three months pregnant. Not telling them that he is an African American, we drove to my home time in Dallas Texas during our Christmas break. When we arrived, my parents did not receive Luke and forbid me to get marry to him. Because we love each other and were caring a child I went against their decision and got married to Luke thus being banished or ostracized by my parents. For many years I struggle with that feeling of guilt, not until our third child was born my Father decided to forgive me and bring home his grandchildren. This time Luke and I along with our children were received like the "Prodigal Son" in the Bible. I have never seen my father so happy in his life. From that day we developed a stronger relationship. When we left Dallas, my father and I talk to each other every day via telephone. Then all of a sudden this short relationship came to an end when I received the call that he was terminal. (she begins to weep…)

In view of this new revelation, I decided to reference the family- systems theory which offers better ways to understand and resolve such problem. For instance: From a Bowenian family-systems perspective, there have been some key emotional cutoffs in Nancy family system when she was banished. It's not entirely clear how these things work, but family-therapy research indicates that Nancy present dilemma is somehow connected to this cutoff; moreover, it is only by repairing it and reconnecting with the long-lost, left-behind, and thrown-out members of her family that her "presenting problem" will resolve itself. Therefore, one aspect of a "treatment plan" recommended would involve my "counseling" her toward a "self-differentiated" balance between these two extremes (guilt and grief).

Two aspects of importance in this shift of focus are the accuracy of the Nancy’s statement, and the motive prompting me to shift focus. As she had been talking about her father I began to get the impression of how close they had been and how much she still missed him assuming that these were good memories. However the reality could have been that there existed more bad memories in Nancy’s relationship with her father than good. What may be more important is the possible unconscious motive behind the shift.

This was the first time she had actually described her immediate experience surrounding her father’s death. Her description of the shock in losing him was vivid. By my response, it was as if I was trying to reduce the intensity of the feelings that were being expressed. As it turned out, this attempt at changing the focus of the session possibly affected it less than it otherwise could have. This was due to the fact that Nancy shifted it right back to where she wanted it, and we went on from there.3

I think my greatest strength in this session was my ability to provide empathy4 through reflection. This allowed me to both check my understanding, as well as communicate to Nancy that she was being heard. What was of particular importance was my ability once or twice to

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3 Taylor, Charles The Skilled Pastor Fortress Press (Minneapolis, MN 1991) p.66 ABC Theory

4Mitchell, Kenneth All our Loses All our Griefs Westminister, John Knox Press (Louisville, KY 1983) pp.107-110

offer advanced empathy, moving away from her stated words to the indirect emotions beyond her words.

As pertain to my weaknesses and partiality to change the focus at one point in the session from intense emotions to that of good memories is obviously my most glaring weakness. To some degree, I have felt in the past a sense of inadequacy in counseling those with loss, as well as the need for more specific training in doing so. Perhaps what is needed most is a challenge for me to improve my ability to feeling more at ease in the midst of such grief, especially sitting wordlessly. What were the possible outcomes in the situation? One is what did occur – Nancy realized that her prolonged grief was because of her guilt.

What healing did you bring to the person seeking counseling, how did you sustain such healing, what guidance did you gave, was there any suggestion for reconciliation?

I listened to her story. I acknowledged her pain and the difficulty of the situation (grief, helplessness, frustration). I recognized that the loss was not the only issue, but merely the catalyst for other issues she is dealing with. I asked her a leading question that caused her to reveal her hidden guilt which led us to the process of healing.

What was the respond of the person to your attempts to render pastoral care? Nancy responded in a positive manner later on during the session, probably because she wanted to put her guilt behind her.

What could you have done differently and why? Sharpen my listening skill perhap so that I can be able to relate to her needs, her grief, and her guilt in a personal and professional manner.

What might you do next to promote continuity in the growth and support of the individual?

I will meet with her occasional to see how she is coping, as well as inquire about her healing