success stories

Posted May 15, 2004

Book: Recognizing Spiritual Needs in People Who are Dying
Author: Rachel Stanworth
Oxford University Press, New York, pp. 255

An Excerpt from the Jacket:

Listening carefully is at the heart of good palliative care and this book provides a means of recognizing and talking about spiritual issues even when dying people do not use religious language. Looking closely at their individual stories, drawings, and behavior, the author demonstrates how often patients use a non-religious ‘language of spirit’ to express their ultimate concerns.

It is often easier to recognize than to explain spiritual issues, and Part One of the book considers psychological, spiritual, and theological interpretations of human experience. It also provides a detailed account of how the patients’ stories were collected. Drawing on a broad literature, but always grounded in patients’ words and deeds, Part Two explains how their ‘language of spirit’ works. Illuminated by patient art, Part Three shows what patients say with this language and how their experiences are mediated by metaphor. Part Four realistically suggests creative responses to the spiritual needs and the spiritual growth of terminally-ill people.

Aimed primarily at pallative care specialists and specialist nurses, this book will also appeal to health care chaplains, pastoral support workers, theologians, social researchers, and psychotherapists.

An Excerpt from the Book:

Various metaphors indicate the potential of silence to influence, ‘her silence helped him to make up his mind,’ or suggest that ‘silence is substance’, we attribute to it various characteristics. ‘Silence can be long, heavy, cold or hard’ (Jaworski 1993: 82-3). There is further ontological metaphor: ‘silence as container’. For instance, ‘the nurse washed him in silence’ or ‘they touched in silence.’ Considered in spatial terms, silence becomes a place where different events may occur — much as the different rooms in a house have different functions.

Silence has come to be seen as something at our disposal. It is often discussed in terms of techne, of a skill to be mastered, over those of poiesis, a mode for unpredictable and novel disclosures. When it is not oppressive, silence may be an excellent technique to encourage communication, but the notion that we use silence is being fostered at the expense of a wider picture. Manuals of communication rarely suggest that, somehow, silence may ‘use’ or change us or that silence can operate as a symbol or create a space for other powerful symbols to emerge and for something new to happen. Countless individuals from many cultures and traditions have entrusted themselves to silence in the hope of spiritual growth: “Be still and know that I am God’ (Psalm 46). In Zen, truth and silence are inextricably linked so that “those who know, do not speak. Those who speak do not know” (Watts 1985: 97). If silence can mediate a transforming encounter, make disclosures of an Ultimate bearing, it is surely part of a vocabulary of spirit and carers should be alert to this possibility (as well as the many others suggested earlier). It may not always be appropriate to regard the silent or withdrawn patient as problematic or depressed.

. . . .If silence repels it can also, sometimes simultaneously, attract. Many patients noted with appreciation the peace and quiet of St. Christopher’s (A hospital). More than once, deliberately constructed quiet times were mentioned: (Patient) Carla as she painted; Carol staring at her beacon; Fred and Hazel both meditated; Debbie regularly conducted a silent evening recollection of her day. For Eileen, the total containment she seemed to experience in the hospice chapel was comforting: ‘I’m calm there. Everything is good.’ If patients find themselves caught up in the ‘repellent attractiveness’ of silence, one can only wonder how they might be helped, if those who listen to them deny silence its symbolic potential — if they fail to recognize silence as part of a language of spirit.

Table of Contents:

Part One: Understanding Spirituality: How Far can Story Go?

1. How stories create and disclose meaning
2. Spirituality and psychology: stories with differing limits
3. Stories in the ‘listening’: collecting data
4. A story in the making: data analysis and interpretation

Part Two: Spiritual concerns expressed in non-religious ways

5. Features of a ‘language of spirit’

Part Three: Nine metaphors waiting to be recognized — how spirituality is mediated in the here and now

6. Patients’ sources of meaning and sense of self
7. Marginality and liminality: metaphors of the edge or the way?
8. Metaphors of control
9. Metaphors of letting go
10. Archetypal hero
11. Archetypal mother
12. Archetypal stranger
13. Recognizing life’s ‘surplus of meaning’

Part Four: Implications for spiritual care

14. Some inconclusive reflections