Gerald May: The Chaplain as Physician

Samuel Blair.

I’ve been reading the excellent book Simply Sane by Dr. Gerald May, primarily for my personal benefit but secondarily for professional benefit. It wasn’t recommended to me by anyone, and I honestly can’t remember how I stumbled upon it, but I’m glad I did.

It’s an excellent book for those doing pastoral care as well as teachers and educators. I recently read a passage that struck me as to how well it spoke to the position that many Chaplains find themselves in: wondering what to do.

I had an older woman come on service a few days ago who appeared to be greatly depressed. When I introduced myself and gave the usual opening “how are you today?”, her response was “I want to die. Can you give me a shot?” She asked me several times to give her a shot to kill her. She also asked our nurse several times to give her a shot. When we told her that we couldn’t, she was upset. She didn’t have any complaints of pain, and was still able to care for herself a good deal (more than others at the facility). She told us she felt useless and wanted to die. Now.  I talked with her a bit about her own value apart from her being able to do things, but she was having none of it. My first thought was “what do I do?”

While it would certainly be interesting to go into depth about the ethical and moral implications of her request, the various responses I could have used, the theology and meaning of suffering and so on, I want to focus on that response “what do I do” as it’s pivotal in May’s understanding of the therapist-patient relationship.

To May, we are all far too concerned with “doing” when it comes to the self. The self as an objectified thing to be fixed doesn’t exist in May’s thought. Rather he labels the constant need many feel to improve ourselves through money, power, learning, security and so on as a kind of insanity. Sanity, on the other hand, is not doing but being. People run to counseling when they feel that they need to be fixed (“Anything to kill the nagging sanity”), and the therapist often joins in the insanity by offering fixes.

Fixing though is different from healing. Fixing can actually perpetuate the deep disconnection to the self as self rather than self as object, while healing allows the growth to happen on its own.

Too often one thinks of the physician or psychotherapist as ‘one who heals,’ but nobody ever heals anybody else. No one person ever heals another. Nor does any one person heal himself or herself. Like growth, healing is a natural process…It happens. You don’t do it; at least not with any will.

May uses the physician’s relationship to the body as an example of our role in healing. Too often we think of the physician doing something that causes healing – “the doctor fixed my back,” or “the doctor cured her pneumonia.”

However May reminds us that the body is doing the healing; the doctor is merely providing the best conditions for healing to happen. For any physical healing to happen, May says:

…the role of the physician is relegated to three primary activities: 1. To bring the diseased or injured part back to a more natural state. 2. To cleanse and purify. 3. To provide rest.

In the same way the therapist can best promote healing not by adding things for the client to do, fix or work on. The therapist best promotes healing by providing the same three conditions that the physician provides. The therapist may ask the client to do things that promote them, but this may involve taking things away rather than adding new things to do.

This works in chaplaincy in very much the same way. The Chaplain promotes healing not by piling on more burdens, but by promoting a state of grace, calm and acceptance so that healing can happen from within.

Yesterday I met with a man with terminal lung cancer who is deeply spiritual, but struggling with guilt over not being able to pray as he thought he should and for having doubts at times concerning his faith. Using May’s three components of healing, I:

  • brought him back to a normal state by discussing his doubts as a normal part of faith and growth.
  • provided cleansing and purifying by discussing forgiveness, grace and providing communion as a sign of these.
  • provided rest by being a nonjudgmental presence, not requiring or demanding anything from him in spite of his many “shoulds.”

He found all of these very helpful and he said he felt peaceful, even joyful, at the end of our visit.

Unfortunately, as with the first woman I mentioned, we too often value ourselves based only on what we are capable of doing. Nearly all of the patients who have told me that they wanted to die did so because they were worthless because the could no longer do and simply being was not acceptable. I find these cases very difficult in that there is often a lifetime’s worth of resistance to being, including being in a normal state of having needs and being old. It’s very difficult to change a world view that has been in place and has in some way or another “worked” for the past seventy or eighty years.

It’s these cases where I so often feel the need to “do” myself. “What can I do to fix them? How can I make them better?” The answer, of course, it that I can’t, and that we can’t. That realization can be freeing as well as frightening.

Samuel Blair in one of our contributors here and also writes regularly on his blog “The Chaplains Report.” 

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