« Back to Issue 29

Carers, Not Counsellors

By J Alastair Ross.

J Alistair Ross

This article is the first chapter of a book in which the author offers help with counselling skills for faith-community workers (details at the end of the article).

Linda was the head teacher of a demanding inner city primary school in London. As a new minister in the area I had gone in to see her to ask if I could do an assembly and she explained to me the local education authority's policy about multi-faith recognition and how she didn't want to 'push' a particular religion. I did point out that in an effort to be politically correct she was discriminating against Christianity because it did not feature at all. Linda recognised this so we arranged to do a Harvest assembly together. As we met to prepare this, at only our second meeting, I simply asked how she was, as Linda seemed to me to be very tired, with what I felt was a grey-tinged weariness. At this point she burst into floods of tears and I sat with her as she sobbed. Eventually Linda said through her tears that she had been doing this demanding job for two years and I was the first person ever to ask her how she was as a person. For the first time in two years she felt cared for; and this led Linda, slowly but surely, on a journey of faith where she recovered a spiritual dimension to her life and found new ways to express it.

And it all began with an expression of genuine care. It does appear to be true that 'the human race can only survive because people care' (Virgo, First Aid in Pastoral Care, T and T Clark, Edinburgh, 1987, p.11). The rabbis of the Mishnah suggest that 'when people are created in the image of God they are all different. What they hold in common is simply their infinite value, from which the rabbis derived the rule that one who saves a single life is as if he had saved the entire universe' (Sacks, Faith in the Future, Darton, Longman and Todd, London, 1995, pp.108-9). That is one of three reasons for writing this book. I hope also that it will be of value to anyone who cares in any capacity in a church or faith community, for two other reasons:

The second is that we need to recognise and honour the vital role caring people play in the faith community. In offering care, they not only contribute to the health of that community, but to the worldwide community as well. They help provide a shelter, albeit temporary, from the hurricanes and storms that ravage and damage so many people's lives. They help provide the life-saving first aid that stems a bleeding artery until more experienced help arrives. As a young person new to motorbikes, I ran a Suzuki 125cc for a year before checking and then changing the oil. Nobody had told me this was an essential feature for the mechanical health of a motorbike, although I did learn when I saw various metal flakes in the treacle-like oil that was eventually coaxed out of the gearbox. It all made sense: the lack of performance; the overheating engine and the increased noise and vibration. All of this could have been avoided if I had paid attention to some simple but vital care of my machine. People, even more than machines, require that same level of simple, but vital, pastoral care in 'the great unchangeables of human existence: birth, death, love, companionship and faith' (Goodliff, Care in a Confused Climate, Darton, Longman and Todd, London, 1998, p.117).

Third, the pastoral care we give can always be improved and become more effective without a radical change in our identity as pastoral carers. There may be something seductive and attractive about the word 'counsellor' or 'psychotherapist', and indeed many people want to train as one or the other. To be a counsellor might imply wisdom, knowledge and an insight into the depths of human emotion, and that has a widespread appeal. But there are many more people who are able to exercise care, which is equally wise, knowing, and insightful. We could use the analogy of pastoral care being the fence at the top of a cliff that prevents people from falling, rather than being a specialist rescue centre for the fallen victims.

Defining pastoral care

The word 'pastoral' needs explanation in our supermarket, pre-packed culture, where what we eat is distanced from those who produce it. The term is figurative and metaphorical; describing God's care of his people in agricultural terms where God is the shepherd and we are the sheep. The term 'pastoral' then brings together the practical and the spiritual and was expressed historically as 'the cure of souls'. Caring for others - the meaning of 'cure of souls' - is the pastoral task of being 'accountable for shepherding the inner life of the people through the crises of emotional conflict and interpersonal pain towards growth in responsiveness towards God' (Oden, Pastoral Theology, Harper and Row, San Francisco, 1983, p.187) - God in this context is the ultimate being of religious faith.

The well-founded critique of such a definition is that it puts the emphasis on a religious professional such as a minister or rabbi (Campbell, Rediscovering Pastoral Care, 2nd edition, Darton, Longman and Todd, London, 1986, p.23). A more inclusive definition sees pastoral care as 'the activities of an individual or a group acting (as an expression of their religious beliefs) in a way that helps others, from outside as well as within their own faith community. This help may be practical, spiritual or both. The end product of pastoral care is that the person has passed through a situation of crisis or change with their whole being - body, mind and spirit - having been attended to (Lyall, The Integrity of Pastoral Care, SPCK, London, 2001, pp.11f). Lyall helpfully explores the constellation of ideas, values, beliefs and traditions that construct the pastoral paradigm. By identifying these parameters, he shows how we can avoid a danger pointed out by Campbell (ibid., pp.189f):

'The high aim of pastoral care for human well-being must be qualified by an awareness of its limits. The pastoral ministry...is carried out in a complex world [and]... a confidence in the omni-competence of pastoral care must be avoided. Often the most caring pastoral act is referral to other persons or agencies better qualified to act.'

Giving someone a lift to see their GP, waiting for them and then letting them tell their story of the last hour is real pastoral care. Praying with someone facing redundancy or hospitalisation are other real examples of pastoral care. But praying with someone diagnosed with manic-depression and telling them to come off their medication as they are going to be healed, is not responsible pastoral care and falls into the trap mentioned by Campbell. On the other hand, suggesting that they talk through their issues with a pastoral counsellor is responsible pastoral care.

In the last thirty years the word 'pastoral' has become widely used in education to refer to the welfare of students with no particular religious reference. However, in this book the faith dimension of 'pastoral' is a vital, though not intrusive, component.

Defining church and faith communities

The word 'church' means literally the assembly of God's people - from the Bible concepts of the church as the people of God, a living, communal expression of the Body of Christ, marked by the presence of the Holy Spirit, have developed. The word 'church' is often associated with a building or a particular expression or denomination of the Christian faith, e.g. the Church of England. As different representations of the church have specific beliefs - the Roman Catholic Church has certain views about the origin of life and abortion - I refer to these by their specific name.

The word 'faith' according to Cantwell Smith can mean 'an orientation of the personality, to oneself, to one's neighbour, to the universe, a total response' (quoted in Jacobs (ed), The Care Guide, Cassell, London, 1995, p.166). This total response need not be religious and is found in many human activities. A football fan can have 'faith' in their team, despite evidence to the contrary week by week. A client can have 'faith' in their counsellor believing that through this unique relationship they will find the help they are looking for. I use the word 'faith' primarily to describe the 'human response to the presence and activity of the transcendent' (Webster, "Faith", in McGrath (ed) Modern Christian Thought, Blackwell, Oxford, 1993, p.208). What gives shape and meaning to this faith is the context in which it is held or experienced, so a faith community is a vital framework. A faith community is a specific, organised group of people in which a series of religious beliefs and values are adhered to as an expression of individual and corporate faith. So while a faith community may also be a church, I use the expression to describe all such faith groups, not restricting it to the Christian faith.

Carers with a context

Pastoral care and counsel has as its context the history, traditions, beliefs and values of a faith community. At the beating heart of every faith is a core of beliefs that define that particular religion, and as such give it a unique shape, colour and texture. The moment of drama when a priest declares with outstretched hands over bread and wine a prayer that transforms the material to the spiritual; the sheer historical wealth and present day intimacy of a Jewish family beginning Pesach or Passover celebrations with the words 'Mah nishtanah halaylah hazeh mikol haleylot?' (Why is this night different from all the other nights?)'; the silent moments when the words of a preacher become the very word of God and all space and time appear to stand still; the cry of the Imam calling the faithful Moslem to prayer. These snapshots of some aspects of religious life contain within them an image shaped by profound beliefs, which, like blood in a human body, pulse with life throughout any religious organism and organisation. To use another image, they are dynamic representations of belief more like a movie preview than a static photographic image. Often religious belief is presented in static terms, a slavish adherence to a legal code, which detracts from life and reduces belief to dogma. Belief is rather a process from the theoretical to the actual, from the 'out there' to 'in here', from the transcendent to the incarnate, from the written narrative account contained in the Bible, the Torah, the Talmud or Mishnah to the personal narrative of a person's life. Paradoxically in order for anything to be a belief, it needs to be trusted and acted upon as well as believed. You can believe Henry VIII had six wives or that Elvis Presley was abducted by aliens, without this information requiring any action: such beliefs do not necessarily impinge on our lives. When a potential belief (no matter how true it is) becomes an actual belief, it is an exciting moment, one that invokes awe and is often enshrined within religious traditions. Abstract truth becomes actual truth as it is recognised and acted upon. Much religious tradition concerns the maintenance and preservation of abstract truth, whereas my focus in this book is the point at which living truth happens, when theory becomes reality, when life events force us or expose us to discover what faith is really all about.

The role of faith community leaders

Within each faith community there is a central figure: the priest, pastor, clergy-person, rabbi, imam, guru and master. Some of these religious leaders are at the pinnacle of a faith structure and play a role in maintaining and supporting that structure. There may arise considerable tensions between the needs of an individual and those of the faith community. The fact that such a figure exists is important, especially in a culture and time when individualism dominates and everyone acts as a permanent consumer. The words 'faith community' are a reminder of our essential need to belong to a community, which transcends the crippling isolation of much contemporary existence. These observations raise three particular problems for such a leader, which I and others as ministers of one church or another have encountered. They are not insurmountable problems but they are real and may even indicate that those who do not have such a specific role within the faith community can often provide the most effective pastoral care and counselling. These problems resolve around: a) the representative role of the leader in relation to the wider community; b) time pressures and expectations; and c) the dynamics between people when one of them has a specifically religious role.

The Representative Role

There are times when a faith community leader or representative will hold a belief on behalf of that community that conflicts so profoundly with the individual's issues that it is difficult to reconcile the two. Mary was deeply distressed. Between her sobs she cried, 'I know what I believe. My beliefs are important to me and that's the problem. If they are true, then what I'm doing is wrong. But you probably don't understand how I feel. For the first time in my life I feel alive, I've discovered feelings I didn't know existed before, so what can I do? I want to carry on with my faith, but the two just don't fit together. What can I do? Do I, like an ostrich, stick my head in the sand and pretend that nothing has happened? Do I split myself in two and become a Jekyll and Hyde figure? Am I just going to become a hypocrite who says one thing and does another? Do I really have to make a choice?' Mary was expressing her confusion about having an affair with a man who loves her, rather than remaining faithful to her physically abusive alcoholic husband. Or to take other examples, should Paul 'come out' about his ambivalent, and possibly homosexual, sexuality? Can Susie use contraceptives to prevent pregnancy, when she already has three children under the age of three? These are some simple moral or ethical questions with which pastoral carers in a wide range of faith communities become engaged. These questions do not usually have simple answers, and are multiplied over and over when we begin to think about specific areas of belief. Can a daughter say Kaddish (a mourner's prayer) at her father's funeral? Is the ordination of women to ministry biblical? Can Protestant evangelical and Roman Catholic churches cooperate? Do Hindus and Muslims need to hear the Gospel in order to experience salvation? It is so much easier to ask the questions than to supply the answers. Yet a leader of a faith community is often expected to provide the answers; it is deemed to be part of her/his leadership of the community, of helping that community to be true to its faith position and stated beliefs. The key issue is often less what they say than how they say it. Jacobs illustrates this in his work on Fowler's contribution to the psychology of religious belief.

'Since they are trained to fulfil a faith-leadership role, one can assume they fall into one of two 'stages' of faith: there are those who see their tasks as guardians and interpreters, providing answers to those who question, and are likely to defend their faith against anything that might undermine traditional beliefs and values...There are other religious guides who have no particular axe to grind: they seek only to assist the individual find her or his own path. They do not impose standard beliefs and values, though they may point to some of the rich resources that can inform and enlighten...What is more difficult is to find the religious leader or the faith community that is open to debate and doubt at a profound level' ( ibid. 1995, pp.391-2).

Given this tension faced by faith leaders, pastoral care may well be better provided by others within the faith community who do not have the added burden of being a leader.

Time Pressures and Expectations

Imagine this scene commonly experienced by ministers or rabbis. After conducting a service on a Sunday morning or on the Sabbath, a queue forms of people wanting to see you. An elderly lady wants to tell you the story of her week, which you know from previous experience, will be time consuming. You want to talk to some new people to welcome them personally, whilst escaping the clutches of the first lady. As you edge across to intercept the new couple on their way out, another person darts in front, blocking your progress and then proceeds to utter what sounds like a rehearsed speech about something that is troubling them about the church or synagogue. Before you can recover from this onslaught, a child tugs at your trouser leg wanting to show a new toy; you bend down to say 'hello', and as you stand up, there looms the one person you didn't want to speak to who wants to continue the argument begun at a fraught meeting earlier in the week. The musicians want their music and songs for the evening service; the steward needs to give you a rota of readers; someone wants to be prayed for, and so the demands stretch on and on.

In this hectic process there are three casualties. The first is the faith leader. He or she is bombarded, because everyone wants something from her/him. As a consequence, he or she may retreat emotionally and spiritually, giving as little as he or she hopes may satisfy each of the people who ask for some attention to their needs. It is not surprising that faith community leaders experience burnout or compassion fatigue, especially if they fail to recognise the full range of the demands placed on them. The second casualty is the faith leader's family, who bear a hidden cost (Coate, Clergy Stress, SPCK, London, 1989, pp.187-191). The third casualty is pastoral care. Mary Anne Coate in her book on clergy stress and the hidden conflicts of ministry has several chapters entitled 'the strain of ...'. She talks about the strain of caring, proclaiming, relating to God and of 'being'. Pastoral care is only one aspect of a faith leader's role; and it may be the one that can most helpfully be delegated to others, who do not have the multi-faceted cluster of demands from the whole faith community. Because they are free within that community to concentrate on the specific area of pastoral care, they are able to give greater focus and commitment to it.

Role Confusion

A serious issue for a faith leader who is also a counsellor is role confusion (Jacobs, ibid., p.38). The client may be wondering, 'is the person who is preaching or explaining the Torah speaking as a faith leader or my personal counsellor? Are they saying those words because they know more about me and are trying to tell me something they cannot say elsewhere? How can I take communion when the minister knows what I have thought and done in the last few weeks?' An even more complicated dynamic is the psychological process called transference. Transference happens when a person, usually unconsciously, transposes on to the faith leader emotions, which they had experienced earlier in life in relation to a significant person such as a parent or a partner. Transference feelings often polarize into good 'positive' transference and bad 'negative' transference. For example, an adult who was abused as a child may transfer negative feelings about the abuser on to the faith leader. So if a faith leader experiences an exaggerated reaction that seems inappropriate, confusing or alarming, one important reason may be that a transference reaction is occurring.

Kevin moved to a new parish as its vicar and after a warm welcome got on with his responsibilities. Everything seemed to be going well apart from a problem with the church cleaner. He gave her time, listened to her complaints, supported her role at a parochial church council meeting and thought that they had developed a good working relationship. Soon, however, other problems surfaced and she became very critical of him. He could not work out what was happening. Later he met his predecessor at a conference and discovered that he had experienced similar problems with her. Kevin explored this process with a colleague who provided pastoral supervision and they came to a conclusion: it turned out that the cleaner had once been married to a wealthy, dynamic businessman, and had lived in a big house in the village. They had been through an acrimonious divorce after which she had moved to the less fashionable outskirts of the village. Kevin and his family lived in a substantial vicarage not far from the cleaner's former house. He came to the church with the reputation of being a dynamic leader. As he pieced this together using his supervisor's suggested concept of transference, Kevin saw that in many ways he was similar to the cleaner's former husband, and the acrimony and hurt experienced by her were coming out in her present relationship with him. Despite knowing this, there was little Kevin could do and eventually the cleaner was replaced, repeating at another level what had happened to her before.

The presence of transference leads some to conclude that a counselling role is not appropriate for a minister (Krebs quoted in Lyall, Counselling in the Pastoral and Spiritual Context, Open University Press, Buckingham, 1995, p.57), whilst others continue to see it as an important function.

The minister is a living moving target for transference by many people when that minister is functioning as preacher, priest, teacher and even in short-term pastoral counselling ... Since we ministers, as a result of our own particular and unique relationships with persons, do receive emotions and fantasies and expectations which were originally learned earlier in relationship to others, a part of our competence is the ability to recognize this when it takes place and to respond to others with genuineness in the reality of the present (Switzer quoted in Lyall, ibid., p.58).

In my own experience, it is much more difficult to recognise what is taking place in relationship to transference than Switzer suggests; and for the sake of clarity of boundaries I would no longer see people for counselling in a church where I belong either as a leader or a member. These different difficulties can leave the faith leader feeling less than integrated, and in contradiction to the faith so clearly professed. Is there another way of managing these issues? The concept of 'holding' is important in the therapeutic world (see Winnicott, The Maturational Process and the Facilitating Environment, Karnac, London, 1990, and Jacobs, D W Winnicott, Sage, London, 1995) and it can have vital pastoral application.

'Holding relationship' as pastoral care

One of the vital tasks performed by a mother for a child described by Winnicott is that of 'holding'. Gomez amplifies this,

Holding is both physical and emotional. The good-enough mother contains and manages the baby's feelings and impulses by empathising with him and protecting him from too many jarring experiences ... the mother's holding enables the baby's 'true self', the spontaneous experience of being, to develop coherence and continuity.

At times then there will be tension, disagreement or conflict between individual needs, beliefs and values, and group or community needs, beliefs and values. In effect the pastoral caring role can provide a 'holding environment or relationship', which gives security for a person in their vulnerability, crisis or doubt. It encourages the emotional and spiritual dimensions of a person's true self to emerge. Some pastoral care begins with the person, discovering their hopes, hurts, fears and joys and then moves, often slowly, towards enabling that person to become integrated with their faith context and within their faith community. Or it can begin with a particular faith tradition or understanding and work towards applying this in the complex and often chaotic life experience of each person. Both directions are possible and both are demanding, often accompanied by the perpetual feeling of being stretched between two seemingly opposing forces and the nagging fear of becoming detached from both. It is important to help pastoral carers to span this gap, to create sufficient space for fresh perspectives, and to develop a 'holding environment or relationship'.

It is also important for denominational leaders and trained counsellors to provide additional resources for those who practise pastoral care - resources drawn from the counselling and therapeutic world - to equip them further and help them in their ongoing task of care. It should not be their intention to turn carers into amateur counsellors, something that requires different and equally specialised training. My first attempt at repairing my first motorbike (other than changing the oil) highlights one of the issues about learning to practise pastoral care properly. It was very easy to dismantle the engine taking less than an hour, but enormously difficult to re-assemble it in the days that followed. And I was trying to do this with a hammer and a screwdriver and the three spanners that came in the toolkit with the motorbike. What I really needed was an instruction manual, a proper set of spanners and a socket set. The objective then is to offer a set of skills to help in the vital pastoral task of care and counsel in church and faith communities, so that pastoral carers can become even more effective. It is vital, too, for the carer to know when it is time to refer someone to a person with more specialised expertise and training. One of the skills of pastoral care is to enable people to seek the right kind of help at the right time.

The Revd J Alistair Ross is Head of the Department of Counselling at Birmingham University and also Honorary Research Fellow at the Queen's Foundation for Ecumenical Theological Education. He is a Baptist minister.

The book from which the above article is adapted is entitled Counselling Skills for Church and Faith-Community Workers, published in August 2003 by the Open University Press at £14.99 (ISBN 0 335 20055 9).