Monday, August 13, 2012

Clinical Pastoral Education... revealed!

So this is my final evaluation for CPE. We were told we could get creative, so instead of writing yet another boring monologue I wrote it in the form of a radio interview. I've edited out the bits about my peers - confidentiality, doncha know. But this may give some kind of idea what I spent more than 400 hours doing over the last 6 months.


Announcer: Good morning everybody, and welcome to “The CPE Final Evaluation Show!”. This morning we will attempt to enlighten you as to the significant journey Josie has been on as part of her CPE training. Let's start off with a bit of context. Josie, what prompted you to take this course?

Josie: Well, initially it was purely as a requirement for preparation for ordination. Basically, if I want to be ordained, I have to do it! But I had heard mysterious stories of personal growth and sleep deprivation from previous attendees so I was pretty keen to find out what this was all about.

Announcer: So you're an ordination candidate. Does that mean you're hoping to become an ordained priest?

Josie: Yes, if all goes well I'll be ordained in February 2013. I'll start off in a parish but hope to eventually move into a school.

Announcer: Sounds good! Let's move on to you learning goals. I hear you are quite a goal orientated person. How did you choose what goals you wished to work towards?

Josie: My first two goals I decided on very early in the course. My first came from a certain awkwardness I felt when praying in the company of others. Isn't awkward such an awkward word?

Announcer: Um, yes. So that first goal, can you remind us what it was again?

Josie: To be comfortable, confident and articulate in offering and sharing prayer in a pastoral context.

Announcer: I see. So where did this discomfort you felt come from?

Josie: Well, growing up in an unchurched family I was never exposed to prayer. And as I started to explore prayer for myself I found it difficult to find my own voice. I was always worried I was doing it 'wrong' if I didn't seem to pray like everyone else did. So although I was comfortable praying in a prepared manner, like at Church, I did not have any experience in offering prayer in a more intimate, pastoral situation.

Announcer: But later on you felt you had achieved this goal. What changed?

Josie: Partly practise. I mean, when you do something often enough you do start to get used to it. And I met some lovely patients who received my prayer with grace and thanks, for example Sally in verbatim #3. But the main thing that helped was finding my own voice in prayer.

Announcer: Was there someone in particular who helped you with this? (knowing look)

Josie: Why yes actually! Marjorie always seemed to comfortable and confident in her prayers. As first I thought I should try and pray like she does, because that seemed so effective. But Noela pointed out that Marjorie was so well loved because she was so authentic, and that finding my voice should prove the same. So I learned to offer prayer and if this offer was taken up to pray about what myself and the patient had been speaking about in my own words and those of the patient. And viola! It works! I do feel comfortable, confident and articulate in offering prayer because it is in my voice and with my understanding.

Announcer. That's great Josie.
Josie: But wait, there's more! About the same time I achieved this goal I also achieved the other one I set at the same time, to become secure in identifying myself as a pastoral carer.

Announcer: Oh?

Josie: Yeah, after a few (or maybe a few more) weeks of training it seemed silly to deny that I was fulfilling this role to others. When I was coming to people, in their beds or in their homes, it was as a pastoral carer and they accepted me as such (for example, Fred in verbatim 13). They were willing to share intimate parts of their lives with me. To deny my identity was also to deny their faith in me and in Christ. I came to realise that being a PC was not about me, it was about the patients. Kinda obvious really!

Announcer: Quite. So after you'd fulfilled these goals, did you set more?

Josie: Of course! I find setting and achieving goals to be very building of myself, and it is something I will continue with. My final two goals were to be accepting of my weaknesses, to see mistakes as opportunities for growth rather than misfortunes; and to use my newly found reflective listening skills in my intimate relationship as well as my professional ones.

Announcer: And how are they going?

Josie: Oh, I think these ones are going to take a little longer. As someone with a tendency towards perfectionism I can be quite hard on myself when I think I've stuffed up. Doing verbatims has been really helpful with this, because I've been able to listen, receive and give suggestions as to better practise in ministry without any anger or shame. It's occurring to me that a mistake can provide a learning you may not otherwise have found! As for my listening skills... well, that's something I will continue to work on. Practise makes perfect!

Announcer: Indeed it does. So, moving on to your Outcomes for basic part time CPE. Could you articulate for us some central themes of your religious heritage and the theological understanding that informs your ministry?

Josie: Probably.

Pause

Josie: Oh, you mean now? Sure. As an Anglican, a major part of my pastoral understanding is that we live through the via media, the middle way. We don't have a central ruling body that tells us what we have to think and believe, and this is very important to me. It means that even though we may have vastly different theological beliefs and understandings, mine is no more valid or real than yours. It means that though we may disagree, sometimes vehemently, in the end we are all brothers and sisters in Christ and connected in and through the Spirit in the power of God. I am comfortable and curious about differing views – and I find that my own can change as a result of new experiences and learnings.

Announcer: For example?

Josie: Well, I had never considered myself to be an embodiment of Christ, although I had professed to believe and live it. After all, in the creed I do say that I believe in the resurrection of the body, and to me that occurs every day in our lives as people of the Book. But it wasn't until I started CPE and we started talking about who we are to our patients that I saw how this reality is played out in a tangible way. It is humbling and scary and such a profound act of worship to be in this position – there are really no words to describe it.

Announcer: You've moved on a bit past where we were going here Josie. Shall we go back to outcome 2 in a moment and stick with number three, what have you learned about yourself as a minister and person?

Josie: Okey doke! When I started CPE I considered myself to be quite self aware, but as it happens I was quite mistaken. In good ways as well as not so good, actually. A big one is my relationship with my own mortality. I had thought that after my cancer journey I was quite comfortable with the concept of my own death, but reading a wonderful book called 'May I walk you home?' showed me just how much I was avoiding that particular topic. I was also forced to confront the issue of rejection and what it means to me. What I was able to discover is that a patient can not reject me as a person because they don't know who I am – what they are rejecting is who they think I am, what role I am playing in their head. When I understood this it became easier to distance myself from feelings of resentment or grief following a rejected offering of myself. On a more positive note, I cam into CPE thinking that I would really struggle with handling criticism, but this has not been the issue that I thought it was going to be. I think it is because any criticism levelled my way really was made in love and with my own best interest at heart, given to build me up rather than bring me down. I found I welcomed it as it gave me an opportunity to look at things in a different way. And I learned that if I disagreed with it, after thought and prayer on the issue, then I didn't have to own it. That was liberating as well.

Announcer: You've touched on your cancer journey – can you share some other major life events, relationships and cultural contexts that influence personal identity as expressed in pastoral functioning?

Josie: Yeah, sure. I was brought up in a house that embraced difference and have worshipped in churches that do the same, from Sudanese refugees to parents of children with disabilities to our older citizens struggling with loneliness and loss. This means I am comfortable in many situations, not much phases or shocks me (yet). I have experienced mental illness in my life as well as those around me, and addiction as well. I understand that these issues run much deeper than can be seen or explained. Journeying with my father in law in his final months has given me an understanding and love for the dying. And of course having children gives me an automatic bond with anyone who has or loves children in their own life.

Announcer: So, do you feel more confident/competent in your ability to interact and communicate with patients/parishioners?

Josie: Absolutely. When presenting my verbatim about a woman with little sight or hearing, I discovered the importance of observing body language for permission for physical contact. It seems to be best not to ask too many questions, but to mirror the other's language and/or to put an emotion to what they are feeling, and people will often underrate their own emotions, for example they may say 'worried' instead of terrified (CPE 16/5/12). I am less worried about initiating a visit because the worst that can happen is that they will refuse. That's certainly not the end of the world! And we did some good work with Lynda about how to end a session to.

Announcer: You've mentioned initiating pastoral encounters. How hard/easy was this for you? What were the situations where this was difficult?

Josie: The longer I have been doing PC, the easier initiating a pastoral relationship gets. I can only offer myself, my presence and my time. I don't have to worry about not doing enough – I am not there to 'do' anything! I am certainly not there to 'help', as the guidelines for this evaluation seem to imply in this question.

Announcer: Ok, we'll keep that in mind. You've already touched on receiving feedback, saying that you found it easier than you expected. How about offering that feedback yourself?

Josie: That is something I struggled with at first, I must admit. I wanted to give feedback but I was worried I would come across too mean, so to speak. But when we reached a point where we trusted each other, it became natural to give feedback that I thought would help. It also became more about the other and less about me – if I failed to offer feedback because I was worried about how it would make me look I was doing no one any favours.

Announcer: So you found that when you focussed less on yourself it became easier to give and receive critique.

Josie: Exactly. I have never been in a small group situation like this one, and at first it felt very... confronting. I am a naturally open person so it wasn't that I didn't like sharing, but I did worry sometimes that I talk too much!

Announcer: You? Talk too much?

Josie: Silly, I know. But I had to become aware of the potential for me to dominate the conversation. Sometimes I really had to bite my tongue when I wanted to cut in or say something but realised that I needed to allow people time to think. I also was forced to become more comfortable with conflict. I know that it is a necessary and constructive part of life and relationships but it was something I needed to witness being used in a positive way to appreciate how it could be an effective communication tool.

Announcer: As we draw this segment to a close, is there anything you would like to say to the other participants in this course?

Josie: Why, yes!


Announcer: Well, that's enough talking from you, Josie. You are way over your word limit you know! Any final thoughts? Briefly?

Josie: I just want to thank everyone so much for joining me on this journey. It has been a privilege sharing it with you all, and I do strongly feel that God has a plan for all of our lives and that we are following it. Thanks be to God.

So what is a verbatim anyway?

This. Only not nornally with yourself. Ahem.

Name: Josie
Age: 30
Gender: Female
Marital Status: Married
Religion: Anglican
Date of visit: 6th August
Place: Patient's home
Date when Written: 6th August
Length of Visit: 10 minutes

Background:I know and trust this particular patient extremely well. We have no secrets although she does have hidden depths.

Plan: To be a pastoral presence to the patient, to see if there was anything she wanted to talk about and pray with her as indicated.

Impressions: Josie seemed to have something bothering her. She looked a little disturbed. There was a small child playing on the floor beside her.

Pastoral Call:
C1: Good morning Josie. I can see that something is bothering you. You look quite disturbed.
P2: I am disturbed. I am finding myself at odds with some of the core tenets of my faith and I just don't know what to do!
C3: You're finding yourself in disagreement with some of the core points of Christianity?
P4: I don't know, that's the problem.
Pause.
Basically, my faith and my identity are tied together intimately. My body, my mind, my soul – all these are part of my self as part of God's creation. And obviously being female, a woman, is a huge part of that. But so much of what we say in Church is tied to a masculine understanding of God. In the creed, we talk about the Father, the Son and the Holy Spirit, who we call the Lord. Three male entities. How I can I be part of something that is male? How can a God that is understood as male be a part of me, a female?
C5: You sound very distressed. It's hard when you feel like you are being denied a place in God.
P6: Yes! That is how it feels, like I am being denied, like my essential femaleness is somehow less than important. I know that people say that it shouldn't matter, that God is essentially genderless, but a central part of Anglicanism is 'what we pray is what we believe'. So when we pray to a male God we are internalising this message that God, and Godliness, is male.
C7: You are conflicted.
P8: Yes. When I am on my own I can understand God as genderless or Father or Mother or Spirit or anything really, depending on who I need God to be at that time. God is fluid and ever changing. But when in a group I feel like I need to pray to God the father. And that's when I feel like I am betraying a part of myself. I wouldn't mind if this was one of a number of ways we image God, but it seems to be the predominant one.
C9: So when you are praying in Church or with a group of people, you feel like praying to a male God is separating you from God. That sounds terribly upsetting.
P10: It is. And then I start to wonder how I can belong to a Church, be ordained into a Church, when I disagree so strongly with so much of our tradition.
C11:You worry that if you don't agree with the party line you shouldn't be part of the group?
P12: I guess so. And how can I, who know so little, be right and the whole historical Church be wrong?
C13: You feel like you aren't equipped to make this decision.
P14: But that's silly thinking. No one except me can tell me how I should or shouldn't be feeling. And nothing would ever change if no one ever questioned the status flow. We are celebrating 20 years of women priests this year and that would never have happened if someone, somewhere, hadn't challenged however many years of tradition.
C15: Every change starts small, I guess.
P16: Yes. And I'm not forcing anyone to change the way they talk or think about God, I'm just using my God given gifts and spirit to choose the way I talk and think about God.
C17: You sound a little more positive about that. That you can only be faithful to yourself and God.
P18: I think I am. We don't have to agree with everything our denomination does to be a member of it, especially Anglicanism! I can dislike the gendered language for God and change it within my own sphere and talk to others about it and still be a faithful Anglican, and more importantly a faithful child of God. I really don't feel like God wants me to change who I am in that regard – I am a woman and I am concious of those who find gender a barrier to God. Maybe one of God's paths for me is to challenge this understanding! It's very biblical, after all.
C19: Maybe you are someone who will change the way we understand God, even on a small scale. That sounds exciting.
P20: It is. Exciting and a little daunting. But I know God will lead me, one way or another. I can only do what I feel drawn to do, and hope God will correct me if I go too far astray.
C21: Faith and hope. An excellent combination.
P22: I think so.

At this point the baby needed attention so we wrapped it up.

Analysis:
What happened or was happening in me during the visit? How was I responding?
This is an issue which is close to my own heart, so I felt I really understood where the patient was coming from. It was hard not to give advice or validate what she was saying, but that's not why I was there. It's not about whether or not I approve of what she is doing, but how she feels about it that matters.

Theological Evaluation:
This was one of the rare encounters (for me) which is explicitly theological. I am reminded that Jesus challenged many centuries of tradition in understanding God – and gave us a relational term for speaking to God , 'Abba'. I think it was the relational rather than male aspect of this that is important. And Moses also had trouble defining his role when God summoned him. Maybe it's ok to be confused!

Pastoral Opportunity:
I found this very helpful, to have a discussion with myself and dig deeper into how I was feeling. I think this is something I can continue to do.

Supervisory Request: Is speaking to yourself the first sign of insanity? Or is it just using the skills I have been given to grow in God?