Pastoral care can enhance social work, but what the heck is pastoral care?
These are my first reading responses for a class on Pastoral Theology and Care, in which I write too much, and also have to use MLA citation after years of using APA.
As an Asian American woman who has just finished a year studying social work, I found Kujawa-Holbrook’s “Love and Power: Antiracist Pastoral Care” particularly compelling. I noticed similarities between social work, which seeks to meet the needs of marginalized populations, and antiracist pastoral care, which seeks to correct deep power imbalances experienced by all marginalized people (Kujawa-Holbrook 13). However, while social work aims to enhance well-being and meet basic needs (“Code of Ethics of the National Association of Social Workers”), antiracist pastoral care aims to bring about authentic healing and reconciliation (Kujawa-Holbrook 13). This focus on healing and reconciliation represents two functions of pastoral care highlighted by Lartey in “In Living Color: An Intercultural Approach to Pastoral Care and Counseling.”
I find that the emphasis on healing and reconciliation are unique to pastoral care, and reveal ways in which pastoral care can enhance social work. Although social work aims to bring about healing among individuals and communities, such healing does not necessarily involve the recognition of mystery and transcendence. Pastoral care uniquely calls for people to be open and attentive to the ways in which “power, grace and goodness are often not found in the obvious places” and that there is a “mysteriousness about life, which is not reducible to sociological, psychological or physiological analyses and explanations” (Larty 26). While social work may utilize reconciliation to bring about forgiveness or to rehabilitate those who have committed offenses, pastoral care does not use reconciliation as a means to an end, but considers reconciliation itself a worthwhile pursuit. This sentiment is reflected by Kujawa-Holbrook’s assertion that “if life is improved for one person, all benefit” (14).
When serving as a chaplain intern at the Texas Medical Center, I recall instances in which there were stark contrasts between patients who embraced mystery and transcendence, and patients who refused to see power, grace and goodness beyond obvious places. The most joyful man I met was a patient who had undergone yet another cardiac surgery, who spoke fondly of his grandchildren, yet lived far from them and was in the hospital without any visits from his children. His eyes lit up every time he saw me; he made jokes and gripped my hand as we prayed together. His conversations were full of praise for God, and he taught me more about perseverance and delighting in life than I could teach him. His smiling presence stood in stark contrast with a woman who had just undergone gastric bypass surgery, who was always surrounded by family, but was grumpy and frowned for most of the time I visited her. I remember nothing about her except the way she lay, a storm on her bed, encircled by her family.
However, as poetic as it sounds to practice the Jewish tradition of tikkum olam by seeking to heal and repair the world, and as ideal as it is to believe the Christian tradition that “we are all called to live in community with each other, to be transformed for the sake of one another and the world,” (Kujawa-Holbrook 14), I am troubled by the practical considerations involved with practicing these traditions. In the field of public health, social workers and public health professionals wrestle with the concept of QALYs and DALYs: Quality-Adjusted Life Years and Disability-Adjusted Life Years. QALYs and DALYs are ways to quantify disease burden by considering the number of years that would be added to a life by an intervention and the number of years lost due to illness, disability or early death. QALYs and DALYs are used to make decisions about the cost-effectiveness of producing a life-saving drug, or the risk involved in testing a new therapy, or the age at which a person should be considered too old for a liver transplant. These practical questions, resolved by ostensibly reductionist cost-benefit ratios and cold value judgments based on age and genetic predisposition shake antiracist pastoral care’s assertions that “justice does not admit of partitioning” (Kujawa-Holbrook 14). On the ground, every day, people win and lose– one person’s bone marrow transplant means another person’s failure to receive life.
Yet Lebacqz and Driskill (62) remind me that pastoral caregivers care “in the context of ultimate meaning,” thus “acknowledg[ing] the religious nature of life’s value and significance.” Pastoral care, as defined by the Latin term cura animarum is concerned about the “care of souls” (Lebacqz & Driskill 62). In this way, though people must divide individuals, groups and communities into those who are deserving and undeserving of limited time and resources, those providing pastoral care understand that ultimately, we are called to agape, unconditional love, which “[impels] us into relationship with others, [and] enables us to recognize injustice and to desire to do something about it” (Lartey 29). We cannot love unconditionally perfectly all of the time, nor can we perfectly bring about justice, but Christians conceptualize agape as the “unconditional love of God” (Lartey 29). In this way, Christians and others recognize the mystery of how power, grace and goodness are present in unexpected places, and the transcendence in and by which justice can be ultimately brought about.
Kujawa-Holbrook, Sheryl A. Injustice and the Care of Souls: Taking Oppression Seriously in Pastoral Care. Minneapolis, MN: Fortress Press, 2009. Print.
Lartey, Emmanuel Y. In Living Color: An Intercultural Approach to Pastoral Care and Counseling. Philadelphia, PA: Thomson Shore, 2003. Print.
Lebacqz, Karen, and Joseph D. Driskill. Ethics and Spiritual Care. Nashville, TN: Abungdon, 2000. Print.
National Association of Social Workers. Code of Ethics of the National Association of Social Workers. Washington, DC: National Association of Social Workers, 2008. Web.