Being with the wounded: Pastoral care within the life of the church

Stanley Hauerwas

Article first appeared in ABC Religion & Ethics.

While pastoral care is primarily associated with those ordained, I do not believe that what makes pastoral care “pastoral” is that it is done primarily by the ordained. Pastoral care is the work of the whole church, even if in reality our care of one another seems primarily to fall on the clergy.

Of course, most of what the clergy do is the work of the whole church, but that is why some are given particular responsibility to see that such work be done. We ― that is, the laity ― expect the clergy to visit the sick, counsel those seeking to end their marriage, pray with a family whose child has just died, help a gay couple overcome their anger at the church, force an addict to recognise they are an addict, confront a member of the vestry about a racist remark they made, or suggest to a member of the church who insists on wearing a “Make America Great Again” baseball hat to Rite One that such a hat is inappropriate in worship. The list could go on seemingly forever.

The challenge facing my attempt here to say how I think the clergy ought to care pastorally for those so wounded stems not only from the fact that I am a lay person, but also that I am not burdened for having a reputation for being pastorally sensitive. I did go to seminary and I was assigned to a church in which I bore the responsibility for keeping the Methodist Youth Fellowship (MYF) entertained by organising an interminable series of group experiences ― the primary form of which turned out to be, at least in New England, taking the kids to bowl duck pins. Already heavily under the influence of Karl Barth, I finally told this group of young people if they were only coming to church under threat from their parents they should just stay home. About half of them took me up on the suggestion by ceasing to come to Sunday night MYF altogether. As we say in Texas, some of their parents were “none too pleased.”

All of which is a way to underscore that I am not a guy that is known for insightful work in pastoral theology. For example, I had my decision not to seek ordination confirmed just as I was graduating from seminary. I ran into Gaylord Noyce in the hall at Yale Divinity School. Gay was a great souled person who taught Pastoral Care courses, in addition to running field work at Yale. Gay asked me what I was planning to do upon graduation. I told him I had been accepted into the PhD program, so I was staying on to do a graduate degree. Gay responded by observing he often tried to convince those intent on pursuing a PhD to think again and consider going into the ministry. But then he quickly added, “As far as you are concerned, Stanley, I think you are making the right decision.”

Given the direction my work has taken over the years, I suspect many would think Professor Noyce’s judgment abundantly confirmed. Shorthand summaries of what I have been about, such as “the first task of the church is not to make the world more just but to make the world the world,” do not sound very pastoral. Even worse is my claim that the challenge before us is “in the shadows of a dying Christendom the challenge is how to recover a strong theological voice without that voice betraying the appropriate fragility of all speech but particularly speech about God” ― this does not sound like a stance that has much time for taking seriously the wounds of a people in advanced industrial societies who along the way discover their lives are without meaning.

My general view is: what did such people expect? My advice for those so identified is for them to quit taking themselves so seriously. What they need is to have their narcissism countered by being drawn into the eschatological mission of the church to witness to Christ’s cross and resurrection. Doing that I take to be what pastoral care should be about, for no other reason than it gives us as followers of Jesus good work to do ― and what could be more important than that?

Given these judgments, it will be hardly surprising that I have little sympathy for clergy who think their ministry of pastoral care to be the expression of a more general stance identified as a helping profession. Admittedly those who so understand their ministry may often manifest pious pretentions necessary to justify their self-proclaimed identity as someone who responds to a crisis “pastorally,” but I do not think such piety is sufficient to justify describing what they do as a church practice.

There is the problem, moreover, when the ministry becomes just another helping profession, and those who occupy that office discover they have no protection from those they are supposed to help. People think they can ask those who identify as “helpers” to do anything because those committed to be a “helper” do not work for a living. As a result, it does not take long before those in the ministry who identify as “helpers” soon discover they feel like they have been nibbled to death by ducks. A little bite here and a little bite there, and before they know it they have lost an arm. Hence, those that started out wanting to be “of help” often end up violently disliking those they are allegedly helping.

Insofar as the ministry is understood as a helping profession, it is difficult to avoid an alienation between those who help and those that need help. One of the great gifts of being in the ministry is the permission it gives to be present to people in crisis when they are often at their most vulnerable point in their life. They are often appreciative that you are present during the crisis, but after the crisis is over they prefer that you be kept at a distance. They excommunicate those who have been present during the crisis because they fear those that have seen them when they were so vulnerable. That they do so makes the up building of the community difficult, to say the least.

Understanding the pastoral task

Admittedly, more needs to be said about the pathologies surrounding pastoral care, but I think it important to step back a bit to provide what I hope is a perspective on the work of pastoral care that makes such care so important for the up-building of the church. So we have to begin with the basics.

To be a human being is to be subject to being wounded in countless ways. In his insightful book Incarnational Ministry: Being With the Church, Sam Wells distinguishes being troubled, from being hurt, afflicted and challenged. He does so to suggest how being with those that are afflicted is a particular challenge given that affliction seems to have no end. And yet Wells argues that the Christian understandings of ministry means we have an obligation to be present to one another, particularly when we are those who are wounded, in a manner that those wounds do not isolate us. We are not called to be perpetually strong. We need to know how to ask for help. Such help, moreover, we believe to be an indication of how God would have the church be a witness to a world that seems to think it does not have the time to care for the wounded.

I assume, therefore, that pastoral care is an essential practice that makes the church the church, but I do not understand why that means that pastoral care and pastoral theology should be understood as a distinct practice and/or discipline. In his book Leading God’s People: Wisdom from the Early Church for Today, Christopher Beeley rightly argues that one of the fundamental pastoral tasks the Fathers thought incumbent on the pastor was:

Strengthen the flocks under you. Encourage them with the apostolic writings; lead them with the Gospels; counsel them with the Psalms.

So was the pastoral task understood to be part of the general project of what it means to build up the church in holiness. Some worry, however, that if the pastoral task is understood as the building up of the church in holiness, then the church cannot be “prophetic.” The church cannot be both because, it is assumed, there is a fundamental difference between the pastoral and the prophetic tasks of the church.

The most charitable interpretation of the dualism between the pastoral and the prophetic is to think that distinction reflects the traditional division between the priestly and prophetic offices that characterise the ministry of the church. I assume those offices can have quite different expressions and perhaps even be in tension, but that does mean they are exclusive alternatives. At least, they are not exclusive alternatives if you remember they are both necessary for the church to be the church.

For example, for a people to exist who have been given the time to care for the dying in a world that increasingly thinks such care is a waste of time is at once prophetic and pastoral. We dare not forget that care for the dying is one of the essential pastoral tasks Christians enact. Thus my judgment that, if in a hundred years Christians are identified as people who do not kill their children or the elderly, we will have done well. But what an extraordinary pastoral challenge it is to form and sustain a people who have not let their desire to be compassionate in the face of their neighbours’ suffering turn them into killers.

I think all I have just said about the importance of pastoral care is true, but I still do not understand how or why there needed to be something called “pastoral care” as well as “pastoral theology” that is distinguished from just plain old “theology.” Sarah Coakley explores how this division may have occurred by reminding us of David Kelsey’s analysis, in his Between Athens and Berlin, of Schleiermacher’s attempt to make theology a professional discipline in the University of Berlin. Coakley observes this had the effect ― admittedly, unintended ― of making theology affectively-orientated and anti-rational. This has resulted, I fear, in much of the work done in the name of “pastoral care” and “pastoral theology” being conceived and justified in a manner that God became an afterthought. Coakley calls attention to the extraordinary influence of Anton Boisen, who founded the Clinical Pastoral Education (CPE) movement, whose method of “living documents” she describes as potentially providing a profound learning experience. Yet she also describes the theology that informs that method as “derisory anti-intellectual shavings from the table of university theological discourse.”

Of course, pastoral care has always been characteristic of how Christians have understood their responsibility for one another. But that care has taken diverse forms throughout Christian history. Though I am not happy “pastoral care” is distinguished from what the church does when she baptises and communes, I do not mean to deny that Christians have rightly cared, supported and sustained one another when they have been beset with illness, betrayals, poverty and the general slings and arrows that are inevitable given the fact we are fleshly beings. That Christians have so cared for one another, moreover, has a history worth a brief reminder.

Varieties of pastoral care

Although the care Christians give one another is not limited to those that are designated as priests and ministers, it is nonetheless the case that those charged with priestly functions often find they have the responsibility to provide care for those who suffer. This has been true throughout Christian history, as the book by William Clebsch and Charles Jackle, Pastoral Care in Historical Perspective, as well as G.R. Evans’s A History of Pastoral Care, make clear.

But those histories also help us see that what has been meant by pastoral care has differed across time. For example, Clebsch and Jackle identify at least eight different epochs of Christian pastoral care, each with its own emphases. In the first era of Christian existence, pastoral care was understood to be the sustaining of souls through the vicissitudes of life. The church under persecution meant the pastoral task became the reconciling of troubled persons to God and the church. The political and social establishment of the church meant the goal of pastoral care was then understood as the guidance necessary to have the laity behave according to the norms of what was now assumed to be constitutive of a Christian culture. This pastoral project was supplemented later around a sacramental system designed to heal all maladies. The Reformation and Enlightenment focused on that newly discovered character ― namely, the individual, who needed help if they were to pass through the pitfalls of a threatening world ― as the subject of pastoral care.

Clebsch and Jackle are more than ready to acknowledge that these generalisations about how pastoral care was understood across time are just that ― generalisations, that oversimplify these different epochs. Yet I think their attempt to remind us that pastoral care, itself a relatively recent description, reflects different understandings of what it means to be wounded is important. Any attempt to understand the work done in the name of pastoral care will often draw on what it means to be wounded in this particular time and place. Accordingly, any attempt to develop a theological account of pastoral care will require some presuppositions drawn from the cultures in which the church finds itself. Such an account entails the difficult task of determining what narratives we are living out ― narratives that are often unknown to us.

Clebsch and Jackle identify four basic functions that they believe constitute the pastoral ministry of the church. They are healing, sustaining, guiding and reconciling. Of course, what each of these practices entailed would differ from one time and place to another, but Clebsch and Jackle maintain that some form of each of them has always been present in the church. For example, they observe that in the early Middle Ages catechetical training for the moral life was dependent on the classification of sins with appropriate penalties enumerated in the penitential manuals. That the manuals are now thought of as “ethics” is but an indication that the distinction between pastoral care and moral formation could not be imagined.

I call attention to this historical account of pastoral care by Clebsch and Jackle to help us understand why the recent developments in pastoral care and pastoral theology are so significant. They observe that at the heart of pastoral care is an understanding of what it means to be a being that can be hurt, as well as how we should respond to being hurt. What it means to be hurt, to be a vulnerable human being, is a correlate of an understanding of human personhood they argue has assumed a particular character in this time called “modern.” According to Clebsch and Jackle, the conviction that any limit on our desires is problematic is in deep tension with traditional assumptions. Pastoral care now means helping people become self-fulfilled when it is not clear what that might mean.

That transformation of what is meant by pastoral care, Clebsch and Jackle suggest, is obvious given the different reasons people now go to seek help from the pastor. They observe not that long ago people went to their pastor because they felt bad, but today people seek therapy not because they feel bad but because they do not feel good. This has had the effect of putting extraordinary pressure on marriage and the family, because often people focus on the family ― and, in particular, their marriage ― as the source of their unhappiness.

Clebsch and Jackle point out that there simply is no place in the structure of the modern congregation where a serious discussion of the state of one’s soul can be examined. That absence reflects the presumption that what we do with our lives is our own business. Some form of counselling now becomes the paradigm of pastoral care. The character of such counselling is not easily identified because there are numerous psychological theories that inform those doing the counselling. As H. Richard Niebuhr observed in his The Purpose of the Church and Its Ministry, a book well worth revisiting, the modern conception of human nature that has shaped the church’s pastoral care has underwritten a naturalistic anthropology and, as a result, the religious character of our lives has been lost.

Modernity and the wound of living

I think we get some idea of the character of contemporary understandings of pastoral care by attending to the account that Alasdair MacIntyre provides in After Virtue of the main characters that have authority in modernity ― that is, the rich aesthete, the manager and the therapist. Each, in their own way, is an expression of a culture of emotivism which is based on the presumption that, insofar as our lives makes sense, they do so only by the imposition of our arbitrary wilfulness. Such wilfulness is required because it is assumed that our lives have no end other than what we can create and impose by the sheer force of our arbitrary desires. As a consequence, it becomes impossible to avoid the reality that all our interactions are manipulative.

In such a context, the task of the therapist, as MacIntyre puts it, is to “transform neurotic symptoms into directed energy, maladjusted individuals into well-adjusted ones.” The therapist must do so, moreover, assuming that there is no normative framework other than respect for their clients’ autonomy that can shape their interactions.

To be a moral agent in such a culture entails that we can never be fully present in our actions because if we are to be free we must always be able to stand back from our actions, as if someone other than ourselves did what was done. Such a perspective is the only way to avoid being determined by particularistic narratives that would constrain our choices. The therapist cannot avoid reflecting these conditions because the therapist cannot assume a narrative that can help us make sense of the moral incoherence of our lives. Thus MacIntyre’s claim, in Ethics in the Conflicts of Modernity, that any challenge to these modern habits of thought faces the difficulty of only being able to think about our lives in terms that exclude those concepts needed for any radical critique.

What MacIntyre helps us see is how the eclectic character of the various psychological theories that so often inform pastoral care reflects liberal political theory and practice. That many people in advanced industrial societies suffer from a sense that they are alone because no one — including themselves — understand who they are is expected result of living in a time when freedom is assumed to be found in having a unimpeded choice.

Adrian Pabst observes that such a view of life is the outworking of the basic logic of capitalist economy which destroys human attachment to, and affections for, relationships and institutions by embedding them in impersonal exchanges. As a result, people are abstracted from concrete human relations because the economy treats everyone as a commodity with a market price. The result is seldom noted because the ideologies that are commensurate with capitalism are grounded in abstractions from any embodiments that constitute our humanity.

Thus my oft-made claim that modernity names the time when people came to believe they should have no story determining their lives except the story they chose when they had no story. In America, that story we assume is the story called freedom. That story produces people who think they have been wounded by being born. To so understand the human condition reflects the double-bind insight that what we thought we did in freedom turns out to be but another name for being fated by what can only appear retrospectively as our arbitrary choices.

That story grounds our presumption we have been mistreated, that we have been victimised, because we discover we cannot acknowledge we have been determined by the story we thought was our choice. Accordingly, we resent the lives we have forged because somewhere along the line, if we are lucky ― and luck is a Stoic category ― we are forced to acknowledge we have been wounded by what we thought to be our free decisions. I take it to be one of the fundamental convictions of Christians that we have been given a way to live that frees us from this kind of endemic narcissism that would otherwise possess our lives.

Pastoral care in the conditions of modernity

That counselling is now central for how pastoral care is understood I think is a response to this general unease about our lives. Pastoral care became a necessary course to train clergy to help people ― including themselves ― to come to terms with the incoherence of our lives. In the process, those seeking therapy might also be able to acknowledge who they hurt along the way, as well as who has hurt them. The language of reconciliation can cover a multitude of sins. I am aware that the training in the psychological disciplines that shape pastoral care may be more substantive than this characterisation, but the general worry to avoid being judgmental makes it difficult to articulate a normative commitment other than avoiding being judgmental.

It is not surprising that the theology that shaped the development of pastoral theology was primarily various forms of Protestant liberalism. Liberal theology comes in many shapes and sizes but, in general, to use Barth’s characterisation, liberal theology was the attempt to talk about God by talking about humanity in a very loud voice. Paul Tillich was the theologian who provided a theological method ― that is, the method of correlation that was designed to show how interpretations of central theological concepts could illuminate aspects of human experience. Tillich’s “method” had the advantage of employing psychotherapeutic insights as well as other social sciences to illumine the human condition.

But that “advantage” is also the problem if you think, as I do, that such a method risks isolating those who are in need of pastoral care from the church. That some people trained in pastoral care now become free standing therapists ― free standing in the sense they have no authorisation from any ecclesial body ― is the inevitable outcome of the development of pastoral care as a separate discipline without theological warrant. Simply because such therapist are ordained does not mean their work is “pastoral.”

Perhaps even more troubling is Stephen Pattison’s suggestion that the psychological perspective threatens to subordinate the “historical concern of the church for morality and the goals and purpose of human life.” As a result, Pattison argues that secular caring methods are unconsciously allowed to seep into Christian attempts at pastoral care. In the name of love the Christian care of one another is determined by a utilitarian logic that underwrites a morality that cannot help but result in judgments that make the Christian commitments ― commitments such as our unwillingness to keep the promises we make ― problematic.

I think it no accident that the rise of pastoral care and pastoral theology was matched in ethics with the development of situations ethics. Joseph Fletcher’s “love is the only norm” seemed to express the fundamental judgment associated with pastoral responses to difficult human relations, particularly having to do with marriage. Fletcher’s justification of cases ― such as Mrs Bergmeier’s “sacrificial adultery” ― fit the commitment of those doing pastoral counselling to avoid being “moralistic.” Those influenced by Fletcher’s identification of agape with utilitarianism often failed to recognise that the justification of adultery in the name of love construed in utilitarian logic is the same logic that justified dropping the bombs on Japan.

The account of the development of pastoral care I have just given does not do justice to the complexity of much of the work done under the headings of “pastoral care” and “pastoral theology.” I am not apologising because I think, as Stephen Pattison has argued, that the pastoral care movement, particularly in America, has ignored the theological tradition that makes the care given through the church Christian. It is not at all clear that Christians are called to be mature or well-adjusted, but it is surely the case that the care Christians give one another ― and particularly the care that is thought to be the province of those that occupy the pastoral office ― will and should depend on being an expression of the fundamental convictions that make Christians Christian. We are not without resources for such an endeavour. And one of those resources has the name Karl Barth.

Karl Barth and pastoral care

Deborah Hunsinger begins her book Theology and Pastoral Counseling: A New Interdisciplinary Approach by observing that pastoral counsellors have not been interested in the theology of Karl Barth. She notes, however, that Barth returned the compliment by paying little attention to the discipline of pastoral counselling and care. It is important, however, not to forget that Barth was a pastor in Geneva and Safenweil. Those engagements clearly left a life-long mark on him. In one of his last interviews, which was primarily about his love of Mozart, Barth responded to a question about why he did not continue to be a pastor by observing:

my whole theology, you see, is fundamentally a theology for pastors. It grew out of my own situation when I had to teach and preach and counsel a little. And I found that what I had learned in the university was of little help in this. So I had to make a fresh start and I tried to do this.

Barth began his reflections on the care that the church is to provide by observing that the church had recently seemed to reawaken to her political and social responsibilities. She thus has the task to face ever anew the questions and challenges raised by the modern developments in psychology and education. According to Barth, the church will be asked, “What is pastoral care?” and “What is Christian education?” ― which means the church should not and cannot attempt to escape the necessity of remembering the challenges raised by her presence in “a world engulfed in a sea of misery.” Such a world is waiting for the church to become itself. It is waiting to hear because God has spoken.

Hunsinger calls attention to Barth’s exploration of the place of pastoral care in terms of the relationship between the forgiveness of sin and healing. Barth observes that in Mark’s account of Jesus’s healing of the paralytic, Jesus does not first say, “You are healed,” but rather “your sins are forgiven.” The scribes who were present challenged Jesus for acting as if he has the authority to forgive sins. Jesus seems to side with them by acknowledging that only the Son of Man has such authority. It is by such authority, moreover, that Jesus says to the young man to stand up, take up his mat and go home. Drawing on Barth’s reflections of this healing miracle, Hunsinger observes that for Barth the forgiveness of sins is clearly differentiated from healing, yet they both occur in a single event. For Barth, therefore, healing is placed in the larger context of a theological claim about Jesus’s identity.

In 1934 Barth delivered lectures in France that became a small book entitled God in Action, which can be read as a mini-Dogmatics. It is therefore not surprising that, in the first lecture, Barth develops his account of revelation and why it is the necessary starting point for all theology. He argues, in typical Barthian fashion, that any knowledge of God we may have is and has been brought about by the initiative of a sovereign God. For Barth, God’s reconciliation with us is not a truth that revelation makes known, but reconciliation is the truth of God Himself. Because revelation is God Himself, the church must contend against all forms of knowledge that would subordinate theological claims to other discourses. When the church thinks it must translate the Gospel into idioms that are not Christologically disciplined, the result is the transformation of theology into ideology. In the process the church is secularised.

Accordingly, what must be called into question, Barth argues, is the modern presumption ― a presumption given philosophical status by Descartes ― that people no longer worry if God exists. Now we worry what meaning our existence may have. We worry if we exist because we have no sense that we are dependent creatures. We no longer recognise that our very existence is a gift that requires the ongoing training that comes by being made a disciple of Christ. The name of that community which makes discipleship possible is called “church.”

Pastoral care is not, therefore, some specialised arena that is distinguished from the everyday work of the church. But if the church is to provide the care for one another that is an expression of our being a people whose sins are forgiven, Barth identifies two mistakes that the church must avoid.

The first mistake is when the church thinks she is divine revelation institutionalised and, as a result, cannot acknowledge her essential humanity. Thus Barth’s oft-made contention that the church reflects the glory of God, but a reflection is not a possession. But it is equally and perhaps even more destructive when, as is often the case in Protestantism, the church is considered just another voluntary association. Both these mistakes place too much trust in our insights and trust God too little. For the church faithfully to exist means it must be sustained by the courage that comes from the work of the Holy Spirit. A church so constituted calls into question all false courage that is based on large numbers, moral qualities, programs of action, or being admired by those without.

That Barth is such a fruitful resource for helping us know how to provide pastoral care for one another is not because what he has to say about pastoral care is so thoughtful. Barth is helpful, not for what he says, but for what he does not say. He does not say that as a community the church is primarily about a compassionate response to our mainly self-inflicted wounds. For Barth, pastoral care is an expression of the Christological centre of the church’s faith that makes possible the care of Christian and non-Christian alike who have been wounded. Those wounds help Barth locate our lives in an ongoing narrative that reflects God’s glory in the world. At the very least that glory is manifest in the existence of a people who have been storied by a gracious God.

Some may worry that the church is too far gone to be such a presence, but in fact the church already has the resources to reclaim the pastoral office as an expression of the work of the Holy Spirit. If you doubt that, simply turn to the section of the Book of Common Prayer identified as the “Pastoral Offices.” There we have prayers such as “For the Sanctification of Illness” in which we pray:

Sanctify, O Lord, the sickness of your servant N., that the sense of her weakness may add strength to her faith and seriousness to her repentance; and grant that she may live with you in everlasting life; through Jesus Christ our Lord. Amen.

I should like to think that the humanity of such a prayer Barth would think matched his extraordinary love of all things human. For Barth, nothing human is foreign to what it means to be Christian. What could be more human, to be at home in the world, than the worship of a God whose Son is to be found in Mary’s belly. A church determined by such a narrative has the capacity to identify and refuse to serve the idols of this world. That Christians refuse such idols will sometimes result in persecution because the idols of the world cannot stand to be ignored. Because Christians do not try to be more than human, they are more humanistic than the humanist just to the extent that we have learned to confess that we are not our own creator.

Being consumed

Pastoral care is an office to be filled not only by the ordained, but there is no question that those set aside to preside at the Eucharist have a particular responsibility for the wounded. We worship a wounded saviour. We follow as a people also wounded. Such a people cannot help but care for one another in a manner that imitates God’s care for our wounds. They must, therefore, be persons who have learned to be in the presence of suffering without resorting to simplistic explanations. When all is said and done, pastoral care requires those who are to be agents of care to be people of deep humanity.

The challenge is: how do you train someone to be a human being? Often people of judgement seem to come from nowhere and we are mystified in their presence. Yet such people have to exist if we are to be the church that offers one another the care that binds the wounds of death. Whether there is a discipline of pastoral care or pastoral theology, I suspect, matters little. What matters is that we are wounded people caring for one another in the name of that wound called “the Christ.”

Why then, given the rather dour character of these reflections, would anyone want to go into the priesthood? What I have hoped to provoke here is a clear sense the difference that Jesus makes for our care of one another, and how that difference makes a life of joy possible. If at least some of what I have said is right, then I cannot imagine a more satisfying vocation than that of being a priest. At the very least, to be a priest is to be given good work to do. What more could one want than to have your life so consumed?

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