The Need for Adequate and Appropriate Treatment and Care

It was breaking news that flashed across the screen just as I was about to turn off the television and head out the door:  An active shooter was at the Navy Yard in Washington, DC.  I was saddened by the news, but not shocked.  The occurrence of gun violence had happened so frequently in the last few years that a low-grade numbness had begun to take root.  As analysts talked to reporters and television cameras, the issue of the easy access to high-powered weapons was raised once again, and as expected, the state of the perpetrator’s mental health was called into question.

It turned out that the shooter did have mental health issues, and although he had been arrested twice previously, had gun related altercations, and had even sought help at two Veterans Affairs hospitals, he did not receive the necessary treatment that might have kept him and his twelve victims alive.  Maybe there was a concern about confidentiality, and while confidentiality is essential in therapeutic relationships, so is a duty to warn.  Could it be that his symptoms were masked, or were his treatment providers at fault?

As I mulled over this thought, I understood why it might be difficult to take the next step when dealing with the mentally ill.  Indeed, our Loyola community was affected by gun violence and mental illness when Mary Marguerite-Kohn was killed by a mentally ill homeless man in May 2012.   As social services are reduced due to budget cuts, the options for referrals are few, and mental health professionals are hard-pressed to work in a system with varying state laws, and a lack of public funding.  The result is that response to serious mental illness in many cases has been retroactive at best.

Yet I live in hope that eventually, maybe when the debate about gun violence is spent, the focus would shift towards addressing adequate care for the mentally ill.  The solution offered by the National Rifle Association executive vice president Wayne LaPierre on his recent appearance on NBC’s Meet the Press that “they need to be committed” could not possibly be the answer.  As more citizens are exposed to gun violence, some are becoming traumatized, providing a new demographic of citizens with mental illness.  Law makers should realize that mental illness is not a crime, and even when it may not be curable, it is treatable in the proper environment.   It is time for them to respond to the mentally ill with adequate and appropriate treatment and care.  This will be beneficial to both the patients and those whose paths they will cross.

 

The Power of Release: Getting Rid of “Stuff”

Several years ago, I never missed an episode of Clean House starring comedienne Niecy Nash.  Ms. Nash helped homeowners recognize the benefit of parting with excess and useless possessions. She endowed them with a modern, efficient, and attractive living space which more closely reflected their personalities and lifestyles.

As counselors, we have similar roles in our clients’ lives. We facilitate their examination and assessment of thoughts, relationships, emotions, and actions which contribute negatively to their growth. Consequently, healing can begin when toxic issues are replaced by healthier lifestyles, nurturing support systems, and a more resourceful, positive sense of self.

But what happens when we are the ones who need to take stock of our lives? What if our workload is too demanding or our dance card is too full? Are we ready and willing to offload some of our activities to enjoy a more balanced lifestyle? That was my reality as I prepared to return to the classroom in just over two weeks. I realized that it was time to apply a Clean House intervention and rid myself of excess and useless activities that I had accumulated.

Letting go is not easy, especially when the relationship seems to be both harmless and enjoyable. The tendency is to hold on and try to make it work. This is akin to hoarding. The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduces hoarding as a distinct disorder. While hoarding usually refers to objects, if we were to focus on the “distress” factor, we may see similarities in a lifestyle that keeps us tired, under-performing, and unbalanced.

How do we determine which activities we wish to continue or suspend?  In my case, I asked the question, is it purposeful? Does this activity contribute in a meaningful way to my lifestyle or goals?  Can I allocate the time I spend on it to something more important or necessary?  I tried to respond objectively to determine what I would keep and what I would let go, and although in some cases it was heart-wrenching to release an activity, I realized that it was necessary.

When I finally decided what should be eliminated, it was liberating, and I experienced a discharge of tension that I had not previously felt. This reflected Eckhart Tolle’s statement that “sometimes letting things go is an act of far greater power than defending or hanging on.” I can now look forward to enjoying a sense of balance as I allocate my time to meaningful and purposeful projects, and focus on excellence in fewer goals, rather than mediocrity in many.

Social Media Revisits The Intensive Prayer Unit

Recently a friend posted news of her illness on Facebook. Within hours she had many “Likes” and it was heartening to note that many friends had offered to pray. This is not a unique situation. Those who utilize social media can attest to similar incidents where prayerful support is offered to those in need. Various forms of social media have made it easier to connect in prayer, and while technology has caused greater visibility, the practice of group intercessory prayer is not new.

Several years ago, Dr. Frank Richardson, a professor at Loyola University Maryland, founded The Intensive Prayer Unit at Johns Hopkins Hospital in Baltimore which offered prayerful support for patients upon request.  Praying for patients provides them comfort and hope by partnering spiritually with their treatment plans.

Such a partnership is similar to what pastoral counselors bring to clients. Like other mental health counselors, we provide psychological care, and we offer something more. Pastoral counselors who graduate from Loyola University’s program are equipped to provide mental health care through the integration of spirituality and psychology. Being a pastoral counselor goes beyond having a career; it is a vocation, a calling to respond to the needs of our clients holistically.

It is this holistic response which I bring to my practice with a goal of providing the best possible care. Although my way of intervention reflects my clients’ spiritual foundation, I look to the Bible for personal guidance and recognize that:

  • I am humbled by my clients’ willingness to trust me as they share their deep emotions. I find support in Psalm 37:3 “Trust in the Lord and do good.”

  • I value the gift of hope. When clients carry feelings of hopelessness, I hold hope for them until they can accept it themselves. I find support in St. Paul’s blessing in Romans 15:13:  “May the God of hope fill you with all joy and peace.”

  • I appreciate the power of prayer. While I do not pray with my clients during session, I pray for them often. I find support in Mark 11:24, when Jesus said “I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.”

Prayer is a powerful tool. The Intensive Prayer Unit reflected an insightful and influential element in establishing an organized medium for intercessory prayer that still exists, expanded through social media. It is possible for those in need to receive prayerful support universally and immediately. So the next time you find an online friend standing in need of prayer, join the Intensive Prayer Unit, and don’t just “Like,” – PRAY.

Creating Balance in Life

In a few days summer will be officially here. This is a much anticipated time for many of us. The weather forecasts are full of beautiful, sunny days, and opportunities abound to catch up with old friends, visit family, plan vacations, and tackle household projects. Summer can be a busy time, with a to-do list attached to each dawning day, and a zealous effort on the part of many to use the time wisely before cold weather returns. Yet, as I anticipate summer, I am mindful of the need to create balance in my life by including time to rest and rejuvenate.

In our current society, the words “rest” and “rejuvenate” may be considered old-school. Who has time to take a break? Even while asleep we remain connected with those who are awake through technology. Today, life’s pace is faster than it has ever been, and no one, including me, wants to be left in the wake of progress. I can recall dismal days that ended with no obvious outcome, feeling the rise of guilt, that I had allowed such emptiness into my schedule. Maybe they were not empty days after all; I just did not understand. Maybe their purpose was to allow my body and mind to enjoy a respite; a part of God’s plan. Rest and rejuvenation are indeed purposeful, and my goal this summer is to enjoy them.

When I consider the value of rest and rejuvenation, I am mindful of Ecclesiastes 3:1 which states “To everything there is a season, and a time to every purpose under the heaven.” \”Turn Turn Turn\” – The Byrds

This verse does not only speak to the notion of purpose, but also to balance. Balance provides an essential dimension to life. The dictionary defines it as a state of equilibrium or emotional stability, qualities that are important for Pastoral Counselors who are charged with the mission of the psychospiritual care of clients. To maintain that emotional stability, it is recommended that we include self-care in our schedule.

How easy is it for you to relax? Do you practice self-care? In the past, I maximized every weekend, and as many evenings as possible during the summer, with tasks.  In the process of doing, I forgot how to be. I forgot how to be calm; I forgot how to be mindful; I forgot how to be relaxed. I forgot how to appreciate uneventful days and simple pleasurable acts. I replaced “to be” with “to do.” Gratefully, this was brought to my attention, and I decided to change. I invite those among us who are caught up in doing, to pause, and try to practice being. Allow yourself to be still for a few minutes each day so your body and mind can recharge. Give them a chance to restore so you may create balance in your life.

Serenity, Courage, Wisdom

Hanging on a wall in my office, is a glass picture etched with the first four lines of Reinhold Niebuhr’s Serenity Prayer. At the end of each group session, my clients and I hold hands and recite the prayer together. As they leave, I pray that serenity, courage, and wisdom inform their decisions as they tend to their daily lives.

On Saturday, May 18, 2013, Loyola University Maryland held its 161st commencement ceremony. Among its graduates were members of the Pastoral Counseling and Spiritual Care Department. As they transition from the role of student to that of helping professional, I pray that serenity, courage, and wisdom inform their decisions as they tend to their clients.

The Pastoral Counseling program offers skills that graduates bring to the workforce. When they enter the world of work, they may realize that even with excellent skills, difficulties arise. Sometimes the difficulties are due to agency culture, or clients may not be motivated to change. During those occasions, we ask God to grant them the serenity to accept the things they cannot change.

For what can be changed, extra effort may be necessary. Pastoral Counselors are called to be advocates for clients. We hold hope and provide reassurance that there is light at the end of the tunnel. As clients respond to treatment, their accomplishments may radiate into our lives. Buddhist philosopher Daisaku Ikeda stated that “when one takes action for others, one’s own suffering is transformed into the energy that can keep one moving forward; a light of hope illuminating a new tomorrow for oneself and others is kindled.”  Recognizing the value of advocacy, we pray that God grant them the courage to change the things that they can.

The third attribute recalls Solomon’s response to God’s magnanimous offer to give him anything that he wanted.  Solomon replied “give your servant an understanding mind to govern your people that I may discern between good and evil” (1 Kings 3:9).  In essence, Solomon requested wisdom, and God, delighting in his selfless request, made him the wisest man who ever lived.

Socrates stated that “wisdom begins in wonder.” As Pastoral Counselors enter the workforce filled with hope, wonder, and a burning desire for excellence, my prayer is for a spirit of discernment to accompany them so they recognize the times when change is not possible, and be at peace. For those times when they can facilitate change, they should have the courage to advocate for their clients. Yet most importantly, they should trust God for the wisdom to know the difference.

Our work as Pastoral Counselors requires us to facilitate change, advocate for our clients, and be discerning about their needs. The class of 2013 is equipped for these tasks, and I am convinced that the counseling profession has received a gift with the addition of these new graduates to their rolls.

Loving and Forgiving

PHOTO: L'Osservatore Romano

 

As I knelt in prayer after communion one Sunday morning, I became aware that my praying had been subliminally replaced by the words of the hymn being sung by the choir.  It was a sweet melody, and the lyrics had grabbed hold of my soul:

  

Loving and forgiving are you, O Lord,
slow to anger; rich in kindness,
loving and forgiving are you.

(You Tube: Psalm 103: Loving and Forgiving)

I stayed on my knees savoring the significance of the words, realizing how blessed I was to be the recipient of God’s love and forgiveness.  The hymn ended, but the lyrics continued to demand my attention. I imagined myself to be loving and forgiving, slow to anger, and rich in kindness. I thought “how awesome that would be.”

The themes of love and forgiveness are not new to Christians.  They echo through religious writings, and occur often in the Bible.  In Colossians, Chapter 3, we learn that “if one has a grievance against another; as the Lord has forgiven you, so must you also do.”  In that same chapter, St. Paul reminds us to put on “heartfelt compassion, kindness, humility, gentleness, and patience” (v. 12), and “over all these things, put on love, that is, the bond of perfection” (v. 14).

Practicing love and forgiveness is usually associated with spirituality, but it does not reside there alone.  If not in our personal lives, as pastoral counselors, we encounter clients whose health and/or relationships are compromised by an inability to forgive and love.  Oftentimes they believe that expressions of love or forgiveness might be misinterpreted for weakness.  Therefore, our initial task might sometimes be to help our clients release themselves from bondage by practicing forgiveness.  We help them recognize how challenging it is to love when filled with rage and resentment. Forgiveness offers them freedom to love.

What happens when one refuses to forgive?

If you’re unforgiving, you might pay the price repeatedly by bringing anger and bitterness into every relationship and new experience.  Your life might become so wrapped up in the wrong that you can’t enjoy the present.  You might become depressed or anxious.  You might feel that your life lacks meaning or purpose, or that you’re at odds with your spiritual beliefs.  You might lose valuable and enriching connectedness with others. (Mayo Clinic)

We can reverse those symptoms.  When we love and forgive we imitate Jesus, who with his dying breath asked his heavenly father “forgive them, for they know not what they do” (Luke 23:34).  We must strive to love and forgive as our heavenly father loves and forgives us.  “God never gets tired of forgiving us; it is we who get tired of asking for forgiveness” (Pope Francis I).

My Lenten Journey: A Personal Catholic Perspective

On February 28, 2013, our Holy Father Pope Benedict XVI became the first pope in 600 years to retire as head of the Catholic Church.  As I reflected on what this meant for me as a Catholic, I realized what a great act of submission this might have been for our Pope Emeritus, and the significance of it occurring during the holy season of Lent.

In my youth, Lent was synonymous with personal deprivation. We were expected to give up something meaningful and to abstain from meat and poultry on Ash Wednesday and on Fridays. Any digression warranted a trip to confession. Although I still abstain from meat on the required days, my Lenten practices have transitioned from deprivation to thanksgiving.

Lent culminates with Easter, which celebrates the resurrection of Jesus Christ. It is significant because it brings meaning to our faith. St. Paul reminds us that if Christ had not been raised, our faith would be useless and we would still be in our sins. Therefore, I strive to make my Lenten journey less about what I give up and more about what I can do. It is about preparation, thanksgiving, and being engaged prayerfully and reflectively to celebrate Jesus Christ’s victory over sin and death.

Options for Lenten practices include community prayer, such as Stations of the Cross, daily Rosary recitations, and daily Mass, or personal prayer and daily devotions.  Another means of service is to contribute to the Catholic Relief Services Rice Bowl project, a simple yet meaningful way to fulfill St. James’ directive in his New Testament letter:

If a brother or sister has nothing to wear and has no food for the day, and one of you says to them, “Go in peace, keep warm, and eat well,” but you do not give them the necessities of the body, what good is it?  So also faith of itself, if it does not have works, is dead. (James 2:15-17).

This is my personal perspective, and one that I feel honored to share. It is not intended to represent the views of the Pastoral Counseling program at Loyola University, Maryland, which is home to many faiths and Christian denominations.

As the journey towards Easter continues, I encourage everyone to be mindful of each other, and the blessings that we have individually and collectively received. I pray for our Pope Emeritus, that his decision was one of acceptance of God’s will. I especially pray that we acknowledge God’s favor in our lives with generous and prayerful acts of thanksgiving.

Appreciating Death’s Role in Life

The universal reality of life is death.  Everyone must die; it is a natural phenomenon and a necessary part of the normal life cycle. Yet, even with this understanding, rarely is the western world prepared to accept death, especially the death of a loved one.  The focus of this writing is not on sudden or tragic deaths, but on those which allow time for preparedness, and occur as a consequence of illness and/or aging.

As universal as death is, the way it is viewed differs among cultures and religions.  Death is treated with dignity by some, or it may be feared by others.  Certain cultures respond to death with elaborate rituals, while others see it as simply transitioning from one life to the next.  However, what is usually present, regardless of specific traditions, is grief.  Grief, like death, is a universal experience,and it is also personal.  It is what Stephen Levine describes in his book, Healing into Life and Death, as “the rope burns left behind when what we have held to most dearly is pulled out of reach, beyond our grasp.”

The analogy of “holding on” is most present when caring for someone with a terminal illness.  It is difficult caring for a loved one who is not expected to survive.  It is sometimes hard for the dying to let go, which increases our grief, and invites guilt.  However, when faced with such circumstances, we can look to scripture for comfort.  What did Jesus do as he awaited his own death? At first he prayed, “Father, if you are willing, take this cup away from me.” (Luke 22:42).  So often we pray for a miracle.  We try to reason with God, making promises, seeking answers, none of which provides peace.  But Jesus continued, “still, not my will but yours be done.”  He handed over his anguish to his father in heaven and found peace and strength to continue his life’s journey to the cross.  We can, too.  In the presence of death, we can turn to our God in prayer, for peace and strength.

Finding peace does not negate grieving.  The rope burns eventually go away, but until then, we grieve.  Where do grieving people go?  Some turn to their religious institutions for solace.  Others are comforted by family.  Some find consolation in silence, and some seek support from professionals to help them normalize their lives.  Pastoral counselors are among members of the helping professions who are prepared to meet clients in their grief, and help them to gain respite from the pain and guilt that they feel.  Graduates of Loyola’s pastoral counseling program are trained to apply traditional therapies with a spiritual approach.  It is our spiritual approach that better prepares us to assist clients who have met death on life’s journey.

Death provides a deadline for what we can accomplish in life.  It is an important deadline since it propels us to live a more vibrant and richer life while we have the opportunity.  Irvin D. Yalom, M.D., stated that if we tune in to our clients’ narratives, we will recognize that they are subtly sharing death concerns.  As therapists, we must be prepared to hear them. As pastoral counselors we are uniquely prepared to address them.  Although we grieve when our loved ones die, we can be mindful of Dr. Yalom’s acknowledgement of death as “the condition that makes it possible to live life in an authentic fashion.”

TO THINE OWN SELF BE KIND: Taking Time to Practice Self-Care

I came awake suddenly on New Year’s morning, instantly noticing the time. It was 12:20 a.m., and, for the first time in many years, I had missed the ball dropping at midnight in Times Square. I was disappointed in myself – especially since recently I had been sleeping more than usual. My friends had been reminding me about my hectic schedule over the last semester, and the fact that my body might be telling me that I needed to slow down. I knew they were right, but there was so much to do, and I was determined to get it done. But, as I lay there that morning, I realized how tired I truly was, and how little time I had allocated to self-care.

Practicing self-care is vital. For counselors who are regularly inundated with their clients’ sufferings and painful experiences, it is even more important. An effective self-care regimen lets counselors replenish their sense of well-being, allowing them to be more effective with clients. Counselor self-care provides a win-win situation for both clinicians and the clients they serve. There are many suggestions for self-care techniques, but the best one is that which gives you pleasure, and a sense of rejuvenation. In “The Resilient Clinician,” Dr. Robert J. Wicks writes about solitude, silence, and mindfulness, as means of replenishing the self. These are effective self-care techniques. Can you think of others you can incorporate in your lives?

For some clinicians, the practice of self-care is scheduled into their day. It might be a bubble bath before bed or a bike ride before dinner. Whatever you choose, make it a priority and not just something you do if time permits. You can even add to your regimen on occasion by doing something spontaneous in between client sessions, e.g. deep breathing, stretching, or simple Qigong exercises or breathing techniques. Self-care also includes the basic health activities of regular medical and dental visits, healthy eating, and daily exercise. Some counselors find it helpful to belong to a social support group, or may retain a therapist who they see on a regular basis. There is no limit to activities, as long as they are geared to caring for your mind, body and soul.

Those of us who do not practice self-care can become overwhelmed. We might find ourselves becoming reactive or overly emotional. This is disadvantageous to our clients, as well as to ourselves. As we begin a new year, let us resolve to take care of ourselves. It might be getting more productive sleep, or losing weight, or finding time for solitude, all of which I plan to do. What about you? What will you do? Whatever you decide, make it something enjoyable, sustainable, and beneficial, and begin it right away. Your body will thank you, your mind and soul will thank you, and you will be more focused and motivated in your work with clients.



Shining a light in the darkness of despair: Holding hope for the client until (s)he is ready to receive it

The holiday season is live and the malls are crowded with shoppers. Beautifully decorated stores lure customers through their doors with a promise of exclusive sales. Names placed on lists are checked off as patrons load gifts into their shopping carts. Churches welcome their flock and extend an invitation to those who have strayed, to “come home for Christmas.” Brightly lit homes greet holiday guests, and scrumptious dinners are planned for families who travel by plane, train, bus, and car to spend Christmas with their loved ones. Everywhere the atmosphere is electrified with joy and excitement, as Christians and non-Christians alike prepare to celebrate the birth of Jesus Christ.

Christmas is considered by many to be the most wonderful time of the year. It commemorates the birth of our Savior. But for those who are submerged in the darkness of despair, it is a difficult time. Consider the wife who is celebrating Christmas without her husband for the first time; the daughter whose mother died before they could reconcile after an argument; the mother with no money to buy gifts for her children; the children whose mother can’t find her way home after a night of drugs and alcohol; the old man who is all alone simply because he has no one left. For them, Christmas is a time of want; a depressing reminder of what they have lost, or never had. As pastoral counselors we are tasked to make a difference for those who are in despair and to offer them a sense of hope.

Hope is what Jesus’ incarnation is about, and why He is the light of the world. In John 12:46, Jesus said “I have come as Light into the world, so that everyone who believes in me will not remain in darkness.” During the Christmas season there are many people in darkness. Pastoral counselors are uniquely qualified to help shine a light into their world.  As psychospiritual healers, integrating psychology with spirituality, we are often called upon to compassionately hold hope for our clients until they are ready to receive it themselves. What a beautiful gift that one can receive at Christmas – the gift of hope.

As I serve my clients during this blessed Christmas season, I know that I cannot undo their past, but I can try to soften the impact as I prepare them to face life as it unfolds.  Christmas is much more than the commercial trappings that are propagated by businesses. Jesus came on earth to shine a light so that no one will remain in darkness as long as they believe in him.  He came to give us hope. Pastoral counselors have an opportunity to help our clients claim that hope and escape from the darkness of despair.  This is such a significant and honorable role for us, and one that I accept with gratitude and humility.