An Introduction To Pastoral Care

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An Introduction toPastoralCareA Workbook for TrainingEucharisticVisitors

ContentsLesson One: What Does it Meanto be a Eucharistic Visitor?.3Assignment: Lesson One.5Lesson Two: Attending to Process.6Assignment: Lesson Two.10Lesson Three: Pastoral Issues in Eucharistic Visiting. 11Assignment: Lesson Three.14Lesson Four: Death and Dying Issues. 15Assignment: Lesson Four.18Lesson Five: Ethical Issues in Pastoral Care. 19Assignment: Lesson Five. 24Lesson Six: Healing Ministry. 25Assignment: Lesson Six. 27Lesson Seven: Pastoral Care 28and Personal Spirituality. 28Assignment: Lesson Seven. 30Lesson Eight: Eucharistic Visiting. 31Distribution of Holy Communionby Eucharistic Visitors to Persons Unableto Attend the Eucharist. 33Procedure for Returning Communion Kits. 34Skill Practice Visit One. 35Feedback Form for Supervised EV Visit Two. 372An Introduction toPastoralCare

Lesson One:What Does itMean to be aEucharistic Visitor?In the early church it was, as it is today, notalways possible for all the members of thecommunity to gather together to celebrate theEucharist and to receive communion. In a culturethat was in direct opposition with the Christianlife, there were many reasons for not comingto church — most often outside reasons. Thesemight include, certainly, sickness or infirmity.It might also include the unwillingness of anemployer, a slave owner, or a father or husband to allow one to attend. It might include aheightened fear that one was being suspected ofengaging in a superstitio, the Roman name forparticipating in a religious cult that was understood to be in serious conflict with the aims andgoals of the state. In might be that in the midstof harvest or some other intense agriculturalactivity, it was not possible to leave the ruralarea surrounding the city and venture into townfor church.Nonetheless, in all of these circumstances communing was considered so important, so vitalto both the spiritual health of the person and theunity of the community that delegates (usuallycalled acolytes) were given responsibility fortaking the consecrated bread and sometimeswine to those members of the community whocould not be there. Sometimes this took placeeven when to do so endangered the life of theacolyte. History gives witness to acolytes who,An Introduction toPastoralCarehaving been apprehended by the authorities inthe midst of their acolyte duties were martyredfor the faith.Indeed, the bread of life was considered to beso spiritually nourishing that members of thecommunity, even those in attendance at theEucharistic gathering would take home a smallportion to be consumed for their continuinghealth and sustenance during the week. Thisshared sacred bread eaten with prayers arounda family table was the heart of the domesticchurch within the early church.It is helpful for us, who are being called to asimilar ministry in our own day, to understandas much as we are able from 2000 years awayof what the early church’s understanding wasabout this Holy Communion. Communion wasnot seen as magic at this period in time, farfrom it. What community members receivedwhen they received the Eucharistic elementswas a deep, full, healing, embodied experience of inclusion. By receiving blessed bread,members of the community were once againbonded to the community of love and prayerthat had together blessed that bread. They wereunited with Christ in the remembrance of his life,teachings, passion, and resurrection. They wereunited with Christ by being once again unitedwith Christ’s incarnated presence within theBody of Christ, the church. They were remindedof Christ’s promise of forgiveness and salvation through faith in him. They were remindedof their baptism, that extraordinary moment intheir lives when they became part of this holyfamily of God and partook of the bread andwine, the body and blood of their true Lord forthe very first time.3

For the early church, Eucharist was the part ofbaptism that one could repeat over and overagain. In the repetition of this shared meal,one’s faith was renewed, one’s sins forgivenanew, and one was empowered by the HolySpirit to live a holy life. While in our day andage, people are not always able to articulate thiskind of an experience of participation in the Eucharist; its potency in the often unspoken depthsof our souls is still real.The action involved in taking this Communionto the aged, the sick, the hospitalized, or othersunable to be present at our Eucharistic gatherings is no less holy an act than it was in thedays of the early church. All those things stillhappen for people when they receive the Eucharist from a Eucharistic Visitor in the 21st century. Those wonderful life blessings that unfoldfrom participation in the most sacred acts ofour life together still come to people when youtake them Communion. That is why Eucharisticvisiting is in largest part a pastoral ministry andwhy this course is called An Introduction toPastoral Care.As a Eucharistic visitor you will be part of thelarger team of pastoral care providers in yourcommunity. Through your ministry of listening,caring, and presence you will serve as a representative of the whole body of Christ. Throughyour presence, you bring the love, hope andprayers of the church to those in need. At itsheart, this is what it means to be a EucharisticVisitor.In part, how powerfully this is experienced inpeoples’ lives is up to you. The more conscious,humble, and aware you can be about what youare doing, the more you will be able to commu-4nicate the holiness of this activity to your brotheror sister in Christ. In part, how powerfully this isexperienced is up to the person you are visiting.Their openness, their conscious participation,their prayerfulness will also impact the experience. But also, in greatest part the power of thisexperience is up to the Holy Spirit, the Spirit ofGod that works miracles in peoples’ lives andin their hearts even when we are not really surewhat is happening and clearly are not in controlof the situation.When we who have the privilege of bearingthe holy sacraments enter a home, a hospitalroom, or any other setting, we are there becauseall Christians are representatives of the churchthrough the indwelling of the Holy Spirit withinus, and as representatives of the church we arerepresentatives of Christ. Christ makes himselfknown through his Body, the church, and wecome bearing holy bread and wine as representatives of the entire faith community.While we may be friends with the person we arevisiting, we do not enter as friends. We enter asambassadors of the church and incarnated expressions of Christ’s love for the world. What wesay, what we do, and how we interact with theperson we are ministering to must always beprimarily about that person’s relationship withthe larger community, not their personal relationship with us as individuals. If we individualize this experience and make it one-on-one, wehave done a disservice to God, to the church,and most especially to the person we are ministering to who needs to receive the love, prayers,support and help of the entire faith community.An Introduction toPastoralCare

Assignment:Lesson OneDescribe a time when the church ministeredto you — when you experienced the presenceof Christ in your own life through the loveand ministry of a brother or sister in Christ.An Introduction toPastoralCare5

Lesson Two:Attendingto Processknow from Holy Scripture that all acts of hospitality are by their nature, holy acts. Be consciousof the dynamics of Holy Hospitality in yourinteractions with those you visit.Task and Relationship FunctionsActive listening is a critical skill in pastoral care.Every pastoral encounter, no matter howtask oriented the purpose or how processoriented the focus, involves both task functions and relationship functions. The amount oftime spent on each of these functions will varyfrom situation to situation depending on thestage of the relationship and the activities mostimmediately in front of the people involved inthe encounter. To disregard task functions in arelationship-focused pastoral visit, or even moreurgently relationship functions in a task-orientedvisit is potentially harmful to the relationshipbetween the Eucharistic Visitor and the person(s)being visited.Within the context of a Eucharistic visit, it isimportant to remember that both these functionsapply. The task is to administer communion tothe person. But the relational element is criticalto performing the task. As one makes Eucharistic visits, one will find that some recipientswill be more focused on the task of gettingcommunion and others will be more focused onthe experience of receiving a Visitor. Anotherimportant task the communicant may identify isproviding hospitality to a guest. Remember thatin your visit you are both host at the table of theLord and guest in someone else’s environs. We6Active ListeningActive listening is a listening attitude thatinvolves — Care Acceptance Unconditional Positive Regard Genuineness Empathy Full Attention PatienceActive listening is an extremely effective toolin many interpersonal situations, includingpastoral care. When individuals feel listened to,they are more engaged, more productive, morepositive, and often happier individuals. Listening is one of the most important gifts Christianministers can offer in a Eucharistic visit.Non-Verbal SkillsActive listening involves the verbal skills of being able to reflect back both ideas and feelingsexpressed by the other person. It also involvesnonverbal skills. There are certain cues we cangive to another person that indicate we areAn Introduction toPastoralCare

actively engaged in what they are saying. Theseinclude facing the person who is speaking, looking at them when they are speaking, makingeye contact, nodding in affirmation of what’sbeing said.While cultural differences make it impossibleto always know if someone is listening or not,bodily actions can offer important cues. If youare working in a multi-cultural setting, it will beimportant for you to learn the cues for listeningused by the people you are ministering to.Roadblocks to Active ListeningThere are also roadblocks to active listening.These include — Distraction Impatience Rehearsing (mentally rehearsingwhat you will say next whilethe person is still talking) Controlling Advice givingopportunity to share. Hearing the feelings beingexpressed by those we are visiting can be verymeaningful to the Visitor as well as the personbeing visited. By simply reflecting back a feelingyou hear being expressed in a visit, you mayhelp the person you are ministering to, copewith their isolation and separation. To strengthen your ministry as a Eucharistic Visitor, developyour own affective vocabulary and your comfortin hearing the emotion of others.Open-Ended QuestionsThere are times in listening situations whenthe communication process requires more thansilent listening with appropriate non-verbal cuesand more than reflecting feelings that one hasidentified in the conversation. At these times,and after one has gone as far as possible inconversation using the first two skills, it may behelpful to use open-ended questioning to allowthe conversation to progress. An open-endedquestion is a question that invites full conversation and does not control the direction thespeaker must take. Open-ended questions cannot be answered with a yes or no or a specificpiece of data. Over-identificationExamples of open-ended questions are: Boredom Can you tell me more about that?Verbal Helps in Active Listening How did you feel when that happened?Reflecting FeelingsIn many situations the most valuable gift wecan give someone is validation of their feelings. Particularly those who live alone, or havebecome isolated as a result of their health, mayexperience intense feelings that they have no Do you want to say anything elseabout this situation?An Introduction toPastoralCare Can you clarify that? Can you give an example?7

What brought you to that place? What was your goal in that situation?While “why?” questions can be open-ended,they are not always helpful. “Why?” questionsare rarely asked in active listening, because theycan seem accusatory and often force individualsto come up with answers to questions for whichthey do not necessarily have answers. Activelistening is first and foremost about allowingthe speaker to speak his or her own words andfeel heard. If questioning strategies are used inactive listening, they are inviting, not controllingin nature and purpose.Open-ended questions are non-judgmental andnon-blaming. Open-ended questions are notaccusatory or evaluative — Didn’t you think aboutwhat you were doing? Why did you think youcould get away with that? How did you get talked into that? How did you get yourself into that mess? Are you serious?ParaphrasingParaphrasing is the skill of condensing andreflecting content. While feeling reflection is asimilar skill, paraphrasing emphasizes the content being conveyed rather than the feeling being conveyed. Paraphrasing allows the speakerto hear their own message with a different set ofwords. It also allows the listener to clarify if he8or she has correctly heard the speaker. Paraphrasing is especially useful in situations wherethe speaker is still trying to make sense of asituation, because it can allow the speaker tohear a situation from a slightly different perspective.SummarizingSummarizing is an active listening skill thatutilizes all of the skills you have previouslylearned. Summarizing involves actively listeningto an individual and then at the end of an entirestory, activity, or even an entire Eucharistic experience being able to encapsulate the essence ofwhat you have heard in relation to both contentand affect and communicate that essence backto the speaker. Summarizing uses both feelingreflection and paraphrase but does this in combination on a larger body of material.Issues in Pastoral CareCrisis ManagementAll ministries, because people share them in,have the potential for being opportunities forhope and healing in the lives of individuals.Those suffering from personal difficulties, mental illness, depression, or loneliness often seekhelp and support within the church. Becauseof this, it is important for those facilitating anyEucharistic visits to have some very basic skillsin crisis management.An acronym often used by crisis counselors toassess the risk level of a situation that mightpotentially be life threatening is built aroundthe name SAL. Related to this, the questionsone must be able to answer with regard to theperson in crisis and who is talking of suicide areAn Introduction toPastoralCare

Specific: Is this plan a specific well thoughtout plan for suicide or a generalized wish?The more specific the plan, the more immediate the threat. Available: How available is the means ofsuicide? The more immediately and readilyavailable the means of suicide, the moreimmediate and dangerous the threat. Lethal: How lethal is the means being contemplated? The more lethal the means, themore immediate the need for intervention.In all circumstances a person who articulates a wish to die or to kill themselves isa person in serious need of help who mustbe taken seriously.What SAL allows one to do is to determinewhether immediate, official crisis interventionsuch as a 9-1-1 call is called for or if this personneeds to be taken to a mental health resource,referred to a counselor or therapist, or referredto a clergy resource. Responsible EucharisticVisitors do not try to handle situations that gobeyond their level of knowledge and expertise.Effective Eucharistic Visitors make referrals andfollow up with those to whom they are accountable when a crisis arises. Clergy and professional lay staff can help EVs determine the mostappropriate next step in a difficult crisis situation. It is vital that these resources be utilizedquickly and responsibly. If you are ever in asituation where you need to make a referral to amental health resource or call 9-1-1, please letyour priest know immediately as well.ClosureIt is important to the life of every group, nomatter how short the group or task-oriented theprocess, that people have the opportunity to saygood-by and complete “unfinished business”when the group ends. Take time to say goodbye to those you are visiting before you end avisit.Also, when you have been in a relationship witha parishioner over some period of time, makeevery effort to say good-bye to them at the closeof your EV-communicant relationship.Saying good-bye to those you have ministeredto who are returning to health and can return toregular attendance at church is a great joy. Saying good-bye to those who are dying is an act offaith, of love and of Christian hope. In both thesesituations these moments of closure can be veryimportant to the people you have visited as theyface their futures and re-imagine their relationship with both Christ and the church.BibliographyCorey, Gerald and Marianne Schneider Corey.Groups: Process and Practice, Monterey, CA:Brooks/Cole Publishing, 1977.Yalom, Irvin D. The Theory and Practice of GroupPsychotherapy, 2ndedition, New York: Basic Books,Inc., 1975.Many thanks to Steve McCormack of Oakland,California, for his help in the Art of Listening pilotproject.An Introduction toPastoralCare9

Assignment:Lesson TwoWhat is the most valuable groupexperience in your life?How important was trust to that experience?Describe what made that groupexperience so valuable to you.10An Introduction toPastoralCare

Lesson Three:Pastoral Issues inEucharistic VisitingThere are few situations in life that leaveone feeling more alone and vulnerablethan a physical condition that leaves onetemporarily or permanently incapacitated. To alarge extent, we control our life circumstancesthrough our bodies. When we are free to movearound as we like, we can determine the actions and relationships we choose to be a partof. We can act to make ourselves more or lesscomfortable, more or less challenged by life. Wecan move physically into closer proximity withothers or we can physically and emotionallydistance ourselves from others.When physical circumstances limit our abilityto move and act, they also limit our autonomyand our sense of self-definition. Sometimes asa result, we come to see ourselves as powerlessrather than powerful, reactor rather than actor,receiver rather than giver. Effective Eucharisticvisiting reminds individuals of the spiritualauthority given to them at baptism, an authoritythat speaks of their continuing spiritual powerto effect their own lives even at times whenphysical limitation have become extremelypronounced. Effective Eucharistic Visitors respectthe autonomy and the giftedness of those theyare visiting. They never forget that they, as EVs,are the recipients of grace and blessing, evenmore than the givers. They remember that itis only through the gracious hospitality of theperson they are visiting that they are able toexercise this ministry at all.An Introduction toPastoralCareJust as active listening demands a relationshipof mutuality and respect, all Eucharistic visitsmust be built upon this attitudinal foundation aswell. While empathy for the person being visitedcan be an important force for building relationship, pity can be equally destructive. Even sympathy may communicate a devaluation of thedignity of the communicant if one communicatesintentionally or unintentionally that the personbeing visited is either helpless or hopeless.Eucharistic visits are the church’s opportunity toaffirm the integrity, the dignity, and the continuing value of one who cannot be present at thecommunity’s assembly. Such visits can affirmthe gifts, strengths, wisdom, and goodness ofindividuals. In many instances this will onlybe seen as the appropriate respect that is due.In other circumstances, you will be bringing apiece of the Gospel message that has almostbeen lost in the life of this person. By servingas a Eucharistic Visitor, one has the opportunityto concretely live out one’s baptismal call to“respect the dignity of every human being.”Empathy means feeling with. No two people areidentical and their internal responses to any given situation are also not identical. We can neverknow what another person is feeling or experiencing. The best we can do is to try and putourselves in their shoes so that we can imaginewhat we might feel in similar circumstances. Yet,we must never be fooled into thinking we knowhow someone else feels.Effective pastoral care centers around effectivelistening, allowing the other person to sharetheir story, to name their pain or joy, to expressthe reality of their own life journey in their ownwords, in their own time, and in their own way.11

In many settings where we take the Eucharisticelements we will develop an understanding ofthe life situation of our brother or sister in Christ.In others, we may never be able to understandwhat they are living with or through. In bothcircumstances Christ can be present. Healing cantake place. Ministry is possible if the EucharisticVisitor remembers that they are simply a conduitfor Christ’s Gospel message, not the source ofhealing, hope, and comfort.When ministering in a home, hospital or hospice it is important to remember that one is theguest. At times, it may be important to recognizethat one has come at an inopportune time, evenif one has a scheduled appointment. At othertimes it may be important to include otherswho are present in the visit that is taking place.Eucharistic visits can provide much needed support to family members and caregivers as wellas the principle person for whom the visit wasmeant. Inviting others to be a part of the visitand receive communion is an act of Christianhospitality. So is allowing them the room todecline participation.Maintaining appropriate personal space isanother element to sharing the hospitality ofa Eucharistic visit. Sitting on the beds of thebedridden can be a significant violation of thatperson’s hospitality and an expression of overfamiliarity. Visits should take place ideally bybringing a chair in close enough proximity tothe person who is being visited so that one canbe easily seen and heard but still respectful ofthe personal space of the person receiving thevisit. Entering someone’s bedroom withoutknocking and asking permission is at best,rude. Performing tasks like tidying a space or12straightening bedclothes without first beingasked is also an act of over familiarity. If it appears that helpful assistance can be offered in asituation, one must always ask permission first.Remember you are the guest, not the host, thecaregiver, or the family member. When a Eucharistic Visitor has made many visits and developed a true comfortableness in hospital, carecenter, or sick bed settings, one still does nothave the prerogative to assume responsibilities,no matter how uncomfortable and ill equippedothers around you might appear to you to be inthis setting.By the same token, there is a kind of authorityand responsibility one receives from one’s host.When a visit is scheduled, expected, and wantedit is inappropriate to allow oneself to be shooedaway by an unaware family member or medical staff member. When medical procedures aretaking place one can simply step outside for amoment, reschedule if necessary, or often askif the care provider can wait and return in theamount of time needed to finish the Eucharisticvisit. In any of these circumstances it is most important to take your cue from the person beingvisited. It is up to them to decide whether youshould continue your visit or curtail it. In mostsituations, you will find that medical personneland family members are deeply grateful for theunique ministry you offer and will go out of theirway to be helpful and cooperative regardingyour visit.An absolutely critical issue in all hospital visitation is hand washing. If you are making aEucharistic visit in the hospital, wash yourhands upon entering the room and wash yourhands upon leaving. This is vitally importantAn Introduction toPastoralCare

medical protocol which is made even more critical because of your contact with the Eucharisticelements which your brother or sister in Christwill be consuming after you have touched them.Hand washing is critical!Another extremely important concern in a Eucharistic visit is the length of the visit. This willvary somewhat from person to person basedupon their time restraints and stamina. Forthose who are seriously infirmed an extremelybrief visit of five to ten minutes can be far morebeneficial than a longer stay. Even the shortestof visits should include some brief word of theGospel message and some brief prayer alongwith the administration of the bread and wine.For those for whom the primary issue is isolation rather than physical incapacity, a longervisit will likely be in order. This may includeparticipation in more portions of the liturgyof the word that was presented at the SundayEucharistic celebration at church, including thereading of the lessons and the psalm, sharingsome portion of the homily and the sharing ofthe prayers of the people. Many people whoregularly receive the Eucharist from a EucharisticVisitor have a deep yearning to continue theirown Christian ministries, to minister as wellas be ministered to. Often these people havethemselves been called to rich, vital intercessoryprayer ministries. Sharing prayer needs andpraying together in a Eucharistic visit can bedeeply meaningful for all involved.An Introduction toPastoralCare13

Assignment:Lesson ThreeDescribe a time in your life whenyou felt deeply understood.What, if anything, did the other person do that made this possible?Describe a time when you feltdeeply misunderstood.What dynamics seemed to leadto this misunderstanding?14An Introduction toPastoralCare

Lesson Four:Death andDying IssuesOne of the most difficult aspects of Eucharistic Visitor ministry is the frequencywith which one confronts death. Manyof the people you will be visiting are peoplewho have lost the mobility to be able to attendchurch on even an irregular basis. Many of themwill never again regain this mobility. As theirEucharistic Visitor you may become one of thelast real links this person has to the gatheredcommunity.For individuals who have been active, vitalmembers of their faith community engaged inministry and service, this growing passivity intheir lives may be experienced as deep loss. Itmay also be a sign to them that they are dying.It is not unusual for Eucharistic Visitors to haveconversations with those they visit about theirfeelings of loss and grief.While you are not there as the pastoral counselor to those dealing with issues of grief andloss, death and dying, you are a pastoral careprovider — by virtue of your caring ministry tothis person. It is important that as you begin thisministry you spend time in thought, prayer, andconversation about how you cope with grief anddeath. Those experiencing great loss in their life,whether it is temporary loss or permanent loss,need to feel safe in voicing these feelings. Theyalso need to be in the presence of others whohave themselves wrestled with the full Gospelmessage of life, death, and resurrection.An Introduction toPastoralCareThe Gospel neither denies the reality of death,nor gives death the final word. The Gospel is amessage of hope and promise, even in the faceof life’s most grief filled moments. Effective pastoral support neither tries to deny the losses oflife nor minimizes those losses. Effective pastoralsupport also offers a word of hope, promise,and solidarity to the individual who is grieving.The promise of the Gospel is that we are neverleft alone to face what life may bring. God isalways there with us, loving us and caring forus through the whole experience.In almost no situation is the voicing of platitudeshelpful to effective pastoral care. Such one-linerstake very complex, ambiguous, often confusinglife experiences and over simplify them in a waythat denies the truth of the moment. They oftenpresent a theology deeply antithetical to whatthe grieving Christian knows about faith andlife in Christ. They control the situation at a timewhen the clearest reality of the moment is thatthe situation is out of our human control.Avoid these phrases at all costs — “Well it’s allfor the best.” “God helps those who help themselves.” “It was God’s will.” “It was their time.”“All we can do is leave it in God’s hands.” “Godhas a better plan that we cannot see.” “God tookthem.” Even if this is your personal theology, it isoften not the theology of those you are ministering to; and at this moment in someone’s lifethey do not need to hear your theology, theyneed to articulate their own.By the same token, if someone you are ministering to uses one of these platitudes, it is not upto you to dissuade them from their theologicalviewpoint. If they are questioning what to believe and want to talk it through more fully, they15

will as

visiting is in largest part a pastoral ministry and why this course is called An Introduction to Pastoral Care. As a Eucharistic visitor you will be part of the larger team of pastoral care providers in your community. Through your ministry of listening, caring, and presence you will serve

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