Carrie Doehring presents a model for spiritual or pastoral care in her book, The Practice of Pastoral Care: A Postmodern Approach. As subtitled, her approach is “postmodern” in the sense that she uses a reflexive process of identifying the understood context -- and especially how social privilege shapes that understanding of reality. [Location 4568]. While she offers a comprehensive and integrated method, with case studies, filmic narratives, verbatims, and metaphoric tools, I was particularly impressed with her use of the “story-telling” aspect. By active and embodied listening, the caregiver can, if appropriate, co-create with the care receiver, a lived theology. The benefit for the care seeker, is not only co-creation of a healing narrative, for example, but also to develop post-recovery realizations.
The integrated method for both active and embodied listening to the stories of others, enables a pastor to provide appropriate care outside our own tradition to a diverse and multicultural population. Doehring also exposes the importance of paralinguistics and body languages. Seekers reveal information in body language, tone of voice and certain phrases reflect codes and privileges. The pastor must listen and look for clues to the care seeker’s emotional state beyond what is conveyed in wording.
Doehring frames the conduct of care. The nature of the relationship is limned, including its contractual, fiduciary, confidential, and even “intimate” boundaries. It may seem obvious that “because of the power differential” between a spiritual caregiver and seeker, “any form of consent is inauthentic”. She cautions that not only does sexual contact occur (!), but “The most common type of boundary crossings occur when caregivers wander across boundaries without even being aware of it…”. Desires create self-deception which is easily elaborated by secrecy. Most denominations have policies in codes of ethics, and it may be necessary to preempt potential risks, and consult others to gain insight, to avoid compromising the “helping” or pastoral role. The pastoral role, and the needs of the seeker, take precedence in any dual relationship – whether in a friendship, business or a social moment. Self-reflexivity with trusted peers will help with discernment. And all professional codes of ethics include provisions for referral when the limits of expertise are reached.
Doehring is particularly strong on practical guides for “self-care” for caregivers. Often the caregivers neglect their own health while being called upon in unrelenting emergencies. “Given the intrinsic satisfaction clergy gain from helping, clergy put the needs of others before their own.” Her own research is cited showing caregivers not only feel stress, and neglect themselves, but feel guilty, and lack self-compassion. Clergy are more obese, unhealthy, and twice as likely to be depressed, than the general population. Fortunately, “Spiritual practices can enhance self-compassion…”. One strategy for enhancing self-care is to identify a keystone habit that can start a cascade effect which deepens spiritual integration and transformation. This becomes part of the contract of care integrated with ethics, law, support, boundaries, disclosure, and avenues of reflexivity.
Doehring introduces and applies practical “tools”. These include a “trifocal lens”, embedded theology, Pergament’s criteria for meaning-making, and three orders of language. As for caring for the mix of “cultures” today, where Pastoral theologian Emmanuel Lartey proposed "intercultural" as a term for this "enigmatic composite” (2003, p. 13), Doehring uses the same term in her narrative approach. She sees pastoral care as “a cocreative process of intermingling stories". This cocreation takes into account "the interacting multilayered stories of people embedded in overlapping familial, communal, and social systems". ( )