Trifocal Lenses of Spiritual Care

Peter L. VanKatwyk

Spiritual care has been envisioned through the trifocal lenses that represent premodern, modern and postmodern perspectives:

  • The premodern lens shows how people in an immediate and convincing way experience God’s presence or the Sacred through prayer, religious texts and traditions, personal devotions and communal worship.
  • The modern lens utilizes the critical studies of sacred texts and theological perspectives, as well as the knowledge of the medical and social sciences in appropriating spiritual insights and directing spiritual care.
  • The postmodern lens shows the limits of external, authoritative, “objective” sources of knowledge, and the potential distortions of social conventions and cultural images that shape our world and life views. In this postmodern context, spiritual care seeks out new possibilities through collaborative learning that is strength based and case specific for each situation.

The task of the chaplain therefore is both to honor the distinctiveness of each of these lenses as well as to have the flexibility of using these three lenses interchangeably and simultaneously.

In the premodern context religious or spiritual experiences come in ways that appear immediate, intuitive and unquestionable as apparent in the following case illustration: William James in his classic “The Varieties of Religious Experience” recounts the moment of dread

“When suddenly there fell upon me without any warning, just as if it came out of the darkness, a horrible fear of my own existence. Simultaneously there arose in my mind the image of an epileptic patient whom I had seen in the asylum, a black-haired youth with greenish skin, entirely idiotic…moving nothing but his black eyes and looking absolutely non-human. This image and my fear entered into a species of combination with each other. The fear was so invasive and powerful that if I had not clung to scripture-texts like ‘The eternal God is my refuge,’ etc., ‘Come unto me, all ye that labor and are heavy-laden,’ etc., ‘I am the resurrection and the life,’ etc., I think I should have grown really insane.”

In these words James describes the panic of existential dread and the intervention of spiritual resources in scripture. In institutional care the spiritual care provider often encounters moments of anxiety that press for instant comfort and assurance.

The premodern perspective connects with a person-centered approach in spiritual care; offering a compassionate and confirming presence through sacred texts, religious rituals and prayer.

In the practice of spiritual care the chaplain in a similar fashion experiences an immediacy of spiritual inspiration and guidance. Bergin, a one-time research associate of Carl Rogers, has coined the term meta-empathy – denoting the presence of a transcendent spiritual guidance and enlightenment for the pastoral care provider. He defines it as openness to inspirational impressions that convey spiritual insights or convictions about the individual that differ from ordinary diagnostic categories or treatment hunches. In meta-empathy not only the patient/client but also the spiritual chaplain finds a spiritual grounding, a therapy-friendly moment that fosters a sacred alliance between therapist and Spirit in co-therapy. Prayer and silent reflection are often relied on as the traditional tools in this premodern perception of the process of attunement to a spiritual presence.

In the modern mode the chaplain functions as a professional in accordance with set standards of knowledge and skill competencies while emphasizing an evidence-based approach that links valid knowledge to effective clinical practice outcomes. From this perspective, authentic spiritual care is steeped in the traditions of religious care and informed by current clinical research and the social sciences.

A postmodern perspective focuses on the internal, subjective process through which people make sense of the world and find their place and purpose in life. This is the concept of constructivism where people are not passive recipients of general knowledge that corresponds to external, objective realities. People rather are seen and treated as active agents generating their own particular maps of idiosyncratic meanings and values by which to understand the world and live their lives.

Spiritual care in the postmodern mode attends to a person’s process of meaning-making – a process that is embedded in larger cultural, religious and family contexts. Care-providers invite themselves as participants in these personal quests for meaning while identifying and, hopefully, deconstructing and reconstructing destructive themes. The role of narrative therapy in spiritual care is to listen to the stories that bind and limit with a view to collaborate in the creative writing of more generous stories that spring free from old plots into new possibilities

Hospice Chaplaincy is a nonprofit organization committed to promoting excellence in spiritual care at the end of life. We are committed to the belief that people from all backgrounds, cultures and faith traditions should experience the end of life in a way that matches their own spiritual/religious values and goals. The task of dying is complicated and often confronts us with lots of spiritual, emotional and physical suffering. Hospice Chaplaincy is dedicated to providing support and professional development resources for hospice chaplains, patient advocacy, and education services to the public, to create a cultural shift to inform and transform our thinking around the psychosocial and psychospiritual issues at the end of life .

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