“How do we sit with people who are living with extended uncertainty?  Many cross-cultural workers are suffering at the moment. I’m finding it really hard”, said Rose*, a member care worker.  Her face twisted as she said this to her member care support group.

Liz*, another member care worker, asked, “What do we say to cross-cultural workers living in the stress of extended uncertainty?  How do we respond when there are no answers?  Some people don’t know if and when they can return to Australia.  Others, are stuck in Australia and don’t know if and when they can get to location.” 

How would you respond?

Analysis

An analysis of the experience of the cross-cultural workers as they live with uncertainty and a lack of control, was the focus of the previous blog post, Betwixt and Between.  Here we turn our attention to the member carers’ experience and their discomfort.

What are Rose and Liz experiencing as they sit with cross-cultural workers experiencing uncertainty or suffering?

Helplessness is uncomfortable.  Many member care workers can relate to Webb (1990: 76), a pastoral carer, who writes about dreading pastoral situations when she didn’t know what to ‘do’ or when there was nothing she could ‘do’ to help.  Similarly, Rose and Liz can’t do anything about the uncertainty their cross-cultural workers are living with in this situation.  A lack of control is being experienced by both the member care workers and their cross-cultural workers. Member care encounters like these are similar to visits to the sick in hospital by chaplains, where patients are waiting to see how nature will take its course. 

What is our role?

Companionship during suffering is a significant gift.  Schaum writes about the power of companionship, or walking alongside, those who are suffering.    

Companionship is the greatest gift we can offer another who is in pain. In the presence of one who is experiencing difficulties of any severity, our primary gift is not facilitating a remedy for the problems at hand, but rather that of being a journey mate through their personal hardship as God’s purposes are explored…  What all of us long for when life is harsh is accompaniment…  There is no greater gift we can offer someone in the midst of lasting suffering than our simple, abiding, enduring presence.

Shaum, 2012: 132

Giving ‘attention’ to, or being fully present with, cross-cultural workers as they wait, is important in order to listen well and provide good member care. Kelly (2012: 25), an experienced chaplain, writes of the importance of listening with attention, providing ‘an attuned, non-judgemental presence in our waiting with others’ which conveys our concern and compassion. Webb (1990: 76) writes of her discovery of the power and significance of being fully present with people in times of trial. Waiting attentively is costly for member care workers.  

Waiting attentively is a draining experience but even more so when uncomfortable and anxiety provoking.  Kelly (2012: 32) writes that the ability to provide a non-anxious presence is vital for pastoral care.  We may end our attentiveness prematurely due to our discomfort with the cross-cultural worker’s suffering and so limit the pastoral encounter (Kelly, 2012: 33).  It is easy to respond to our anxiety by ‘doing’ things. 

It is common to want to take action when feeling helpless or uncomfortable.  Many member care workers gain comfort in unfamiliar situations by getting busy at some activity.  Rather than simply ‘being’ with the cross-cultural worker in their distress, we might offer a cup of tea, tissues, hugs, some other physical assistance or engage in anxious chatter (Kelly 2012: 34). Sometimes jumping too quickly to prayer can be another way we avoid our uneasiness and block a member care encounter.  Kelly (2012: 33-34) recounts the story of a chaplain who just didn’t know how to respond to a patient and so asked, “Can I pray for you?”; the patient replied, “If it helps you”.  While most cross-cultural workers will want to be prayed for and certainly, prayer is a vital component of member care encounters, it can invalidate their concerns if it is offered too soon. We need to wait until it is an appropriate time before we offer to pray.

Waiting attentively with another who is suffering or sad, seeking to hold them and the paradoxes and the unanswerable questions both verbalised or sensed in self or the other and allowing all that to be, is an immense challenge for any human being… As humans, we all innately want to make things better for others and ourselves, we want to get rid of pain and regain control; our first inclination is to stick a band aid on any open wound.

Kelly (2012: 32)

Waiting with cross-cultural workers in these uncertain situations is more challenging for some than others.  Anthropologists, Lingenfelter and Mayers (2003: 79), argue that some societies and personalities are more task-orientated than person-orientated. For those of us who are from more task-orientated cultures or have a more task-orientated personality, waiting is even more difficult. Our discomfort with waiting can also vary according to our status in some cultures.  

In our society there is a direct correlation between status and waiting. The more important your status, the less you have to wait. Waiting reminds us that we are not in charge, that we cannot command instantly whatever it is we have to seek, so we have to wait. 

McBride, 2003: 22

Fortunately, all member care workers can keep growing their ability to wait and provide a non-anxious presence.  

Undoubtedly, the ability to provide others with a ‘non-anxious presence’ (Newell, 2008) in their time of uncertainty or transition is central to the provision of sensitive pastoral and spiritual care. What is key here is our understanding that it is perfectly normal at times to feel helpless or useless in the face of another situation or personal predicament, and not to feel overly anxious or guilty about having these feelings. In short, it is in normalising these feelings for ourselves, as well as others, and giving ourselves permission to feel this way that we free ourselves to some degree from being overly uptight and uncomfortable.  This can enable us to stay with another when we both sense, as carer and cared for, that, ultimately, the current situation is out of our control and has to be lived through rather than fixed or overcome. 

Kelly (2012: 32)

By normalising the discomfort we feel as member care workers, we can increase our capacity to provide a non-anxious presence to our cross-cultural workers.   It is normal, or natural, for Rose and Liz to feel helpless and anxious in these types of member care encounters.  They are living with uncertainty, just as their cross-cultural workers are.  When member care workers realise that it’s normal to feel helpless and useless, then they don’t need to feel overly anxious or guilty but having those feelings (Kelly, 2012: 32).

Our helplessness as member care workers is a ‘touching place’ with the liminal space our cross-cultural workers are inhabiting (Kelly, 2012: 32).  Both member care workers and cross-cultural workers are inhabiting the common ground of waiting and experiencing a sense of being out of control that occurs when living with uncertainty. 

Can Rose and Liz sit with their own helplessness, as well as their cross-cultural workers’ suffering?

Sometimes we are conscious of our failings as member carers after pastoral encounters.  Due to our anxiety and discomfort with waiting we might limit our provision of care by offering a tissue or chattering.  We wonder, “How much did I limit the care of this cross-cultural worker?”  This reminds me of the image of a misshapen piece of pottery, created by an apprentice potter.  Despite the imperfections, there is beauty in its form, as well as potential in the apprentice potter.

It is important that we continue to let the Bible interrogate our understanding. (Read more about our use of the Bible in the Theological Reflection Cycle blog post.)

A story to consider

Elkanah and his two wives, Hannah and Penninah, had come to Shiloh to offer worship and sacrifices to the LORD.  Eli was a priest there.  Hannah was very distressed because she was a barren woman.  Barrenness was accounted a great disgrace for a Hebrew woman; a source of shame.  Hannah’s distress was increased by Penninah, who did have children, and provoked her about her barrenness.  

Hannah went and started praying to the Lord at the Temple.  

“As she kept on praying to the Lord, Eli observed her mouth. Hannah was praying in her heart, and her lips were moving but her voice was not heard. Eli thought she was drunk and said to her, “How long are you going to stay drunk? Put away your wine.”Not so, my lord,” Hannah replied, “I am a woman who is deeply troubled.  I have not been drinking wine or beer; I was pouring out my soul to the Lord. Do not take your servant for a wicked woman; I have been praying here out of my great anguish and grief.”

Eli answered, “Go in peace, and may the God of Israel grant you what you have asked of him.”

She said, “May your servant find favour in your eyes.” Then she went her way and ate something, and her face was no longer downcast.

1 Samuel 1:12-18

Just as Hannah was distressed by her barrenness and Penninah’s provocation, many cross-cultural workers are distressed by these times of significant uncertainty.  

Eli’s false accusation of drunkenness was a very poor start to his pastoral encounter with Hannah!  As member care workers, we can also limit our encounters by responding inappropriately to cross-cultural workers.  Fortunately this wasn’t the end in the story of Hannah and Eli, since she corrected his mistake.

Although Eli did poorly in the first instance as a pastoral carer, he went on to offer Hannah words of comfort and blessing.  Later, after God had answered Hannah’s prayer and blessed her with a son, Samuel, and she had handed him over to Eli to fulfil her promise to the Lord, Eli also helped Samuel to discern God’s voice (1 Samuel 3).  This mirrors our experience as member care workers.  While we may block a pastoral encounter at one point, God works so that the cross-cultural workers may be in a much better place in the end.  In the long-term, God wasn’t limited by Eli’s mistake, and nor is God limited by our blockages during pastoral encounters.  We can also learn from our mistakes, just as an apprentice potter does.

Blessed be God, the Father of our Lord Jesus Christ, the Father of mercies, and the God of all comfort, who comforts us in all our tribulation, that we may be able to comfort those who are in any trouble by the comfort with which we ourselves are comforted by God.

2 Corinthians 1: 3-4

What happened? How could these member care workers be cared for?

Rose and Liz could explore their feelings of discomfort with their support group and supervisors. Rose’s and Liz’s support group members and supervisors could provide them with validation, normalisation and reassurance about their feelings of discomfort and so reduce their anxiety. Validation is about assisting a person ‘feel that their emotions and struggles make sense and are understandable given the circumstances’ (This Way Up – Knowing, 2020: 8). Normalisation labels something as normal or ordinary, when a person is feeling it is weird or abnormal. Reassurance is about easing someone’s doubts or fears. More about validation, normalisation and reassurance is set out in the Betwixt and Between blog post.

Rose and Liz can be assisted to improve their member care provision.

In order to improve their capacity to wait attentively and provide a non-anxious presence, Rose and Liz could regularly explore this capacity with their supervisors or member care support group (Kelly, 2012: 34).   They could reflect about if and when they might be employing strategies to avoid discomfort, such as anxious chatter, making cups of tea or offering to do something. This will raise Rose and Liz’s awareness of their practices of avoidance.

Having built an awareness of the temptation to avoid their own discomfort and having received comfort from the validation, normalisation and reassurance Rose and Liz received, their anxiety may be reduced. This in turn may increase their capacity to wait attentively and provide a non-anxious presence, and so, to provide effective member care. With the comfort Rose and Liz have received, they can in turn may bless their cross-cultural workers.

After listening to and waiting attentively with their cross-cultural workers, Rose and Liz might offer validation, normalisation or reassurance to them, if appropriate. Examples of how validation can be achieved are sentences such as, “That sounds frustrating” or “I can understand why you’re exhausted”.  Examples of normalisation are sentences such as, “It is natural to feel discombobulated during these times of uncertainty” or “It is normal to feel quite tired during transition”. To provide reassurance, Rose or Liz might say, “I’m so sorry you had to cancel your holiday, especially when I know that you have been looking forward to seeing your grandchildren.  I hope you get to see them soon.”  Reassurance is also provided by companionship, offering to walk alongside them, if that is possible (This Way Up – Knowing, 2020: 9).

* All names of people and places in this blog have been changed to preserve anonymity.

Recommended Reading

Kelly, E. (2012) Personhood and Presence: Self as a resource for spiritual and pastoral care. London; New York: t&tclark.

References

Knapp, H. (ed.) (2015) ‘Emotional Communication’, in Therapeutic Communication: Developing Professional Skills. Thousand Oaks: SAGE Publications, Inc., pp. 89–108. Available at: https://us.sagepub.com/sites/default/files/upm-assets/61121_book_item_61121.pdf.

‘Knowing What to Say: During the COVID-19 Pandemic’ (2020). THIS WAY UP, St Vincent’s Hospital Sydney Limited. Available at: https://thiswayup.org.au/wp-content/uploads/2021/02/THIS-WAY-UP_Knowing-What-to-Say.pdf.

Lingenfelter, S.G. and Mayers, M.K. (2003) Ministering Cross-Culturally: An Incarnational Model for Personal Relationships. Second. Grand Rapids, MI: Baker Academic.

McBride, D. (2003) Waiting on God. Hampshire: Redemptionist Publications.

Schaum, S.E. (2017) Uninvited Companion. Colorado Springs: Cresta Riposo.

Webb, K.S. (1990) ‘Pastoral Identity and the Ministry of Presence’, Journal of Pastoral Care, 44(1), pp. 76–79. doi:10.1177/002234099004400112.

“How can I listen better?”, asks Mandy*.

Mandy, a Member Carer Worker, then goes on to recounts a few examples of pastoral encounters that had been less than ideal, to her supervisor, Heather*.

“I listened for over an hour to Jessica* while she talked about changes that had to be made to her plans: the transitions to a new role and living situation, as well as frustrations with some relationships.  I had been attentive throughout the conversation, utilising continuers such as ‘Yeah’ and ‘Mmm…’.  When Jessica finished speaking, I said, ‘That sounds challenging’.  Then there was a long silence. Mandy wondered what to say next.”

“During a pastoral encounter, Janet* talked a little about how she and her husband had tried to adopt a child some years earlier.  Janet continued her story, speaking about missing out on the experience of parenting.  Then she went quiet and there was a long, long silence.  Mandy wondered what she could say to provide Janet with an opportunity to share further.”

“David* shared that he had been notified that his visa had finally come through.  There was much excitement and relief expressed.  However, sometime later, the documentation had still not arrived in the post.  His family declared, ‘It’s a sign that you’re not meant to go’.  Then, sometime later, the missing visa turned up out of the blue.”  

What would you say?

Analysis

Member Carers (MCs) provide times of ‘listening’ and ‘being with’ Cross-Cultural Workers (CCWs), in order to give them an opportunity to talk and reflect about their concerns.   As MCs, we want to offer a listening ear, genuine interest and an attentive presence. We use conversation to establish a relationship, build rapport and elicit our CCWs’ problems.  MCs want to facilitate the disclosure of the CCW’s concerns about their physical, mental, emotional and spiritual well-being.  Some of these concerns may involve painful self-disclosures requiring skilful listening techniques (Harvey et al., 2008).  MCs provide attentive listening which is a rare experience for most recipients. Very few people can listen well. Here are some common pitfalls to avoid and some techniques to experiment with.

It’s not about us

It is important that pastoral encounters are led by the CCW, so as to facilitate the disclosure of their unique story.  A question worth asking yourself is, “Am I directing the conversation according to my agenda or according to the CCW’s?”  If you listen to them, you will hear what is important to him or her.  Certainly, if we, the MCs, are talking more than the CCW during an encounter, there is a problem! 

Switches 

It is also important for MCs to avoid employing a change of the topic of conversation, or switch, if we are to allow the CCW to lead the conversation.  Switches can be tempting when pursuing our own agenda or we are uncomfortable with the topic raised.  It is easy to create a switch by reflecting back inappropriately or through the use of questions.  

Questions are often problematic

Questions often block encounters.  By avoiding the use of questions, MCs can remove the power inherent in being a questioner, and in contrast, allow the CCW to lead the conversation.  Asking for information can be interpreted as a threat, an imposition and the CCW may feel compelled to respond (Harvey et al., 2008).  As mentioned already, questions can be used as switches and so direct the conversation towards our own agenda. It is easy for MCs to use questions to satisfy our curiosity or to avoid something we find uncomfortable such as silence. 

Open questions are often necessary and appropriate at the beginning of a pastoral encounter. Open questions allow the CCW great scope for response.   For example you might ask: 

• “What’s happening?”
• “How are you?” 

So, what techniques can we use to improve our interactions with CCWs?

Establishing mutuality

Sometimes it is beneficial for the MC to undertake a little personal disclosure to establish mutuality between them and the CCW, and so encourage them to open up.  However, this should be used with caution. It is easy to talk too much about ourselves.

A little spontaneity can also be used profitably in this regard if undertaken wisely. It is often useful for building rapport in the initial stages of an encounter.

Listening techniques

Various techniques are worth experimenting with during pastoral encounters in order to improve our listening skills.  

Harvey et al (2008), undertook some discourse analysis regarding chaplaincy to identify the means by which patients were invited to disclose their concerns.  This research found that these pastoral encounters were similar to ordinary informal conversations.  However, they also identified commonplace conversational devices, elicitation hooks, which were deployed skilfully to achieve the key spiritual activities of ‘listening’ and ‘being with’ the client.  This research found that skilful chaplains use various conversational strategies, or elicitation hooks, to construct opportunities or ‘slots’ for emotional expression and self-reflection (Harvey et al., 2008).

Elicitation hooks are simple invitations to describe a state of affairs.  They include both continuers, such as ‘Uh uh’ and various reflective listening practices: verbal repetition, as well as reflection of themes that have emerged, the use of metaphors, observations and politeness.  These techniques, or elicitation hooks, are also beneficial for pastoral encounters with cross-cultural workers.

Elicitation hooks

Verbal repetition

Mandy (MCW): What’s happening?

Betty(CCW): I’m exhausted!  There’s been so much going on.

Mandy: Yeah, uh uh (short silence)

Betty: Yes, I’ve been feeling like a dog’s dinner for weeks.

Mandy: Mmm

Mandy: A dog’s dinner?

Betty: Yes (She elaborates further)

In this dialogue, the query was extended or ‘hooked’ by means of ‘Yeah’ and ‘uh uh’, followed by a short silence.  This elicited further comment by Betty on her state of being. ‘Continuers’, or ‘pastoral noises’, are extraordinarily effective during pastoral encounters for creating opportunities for the cross-cultural worker to continue to disclose their concerns.  ‘Continuers’ such as ‘Mmm…’ or ‘Uh uh’ or ‘Yeah’, have the effect of inviting more commentary from the cross-cultural worker (Harvey et al., 2008). They communicate that you are listening.

Verbal repetition is another technique which is effective for eliciting further comments by CCWs.  As illustrated above, the practice of listening for a keyword or phrase whilst a client is speaking and then repeating it, can be effective at encouraging further disclosure.  In this instance, Mandy responded with ‘Mmm’ and a repetition of Betty’s words, ‘feeling like a dog’s dinner’ (with appropriate intonation).  Harvey et al (2008) argue that repetition reveals that the listener is closely attending to the client, as well as intentionally converging the interaction, which brings a sense of unity.   

Let’s have another look at Mandy’s pastoral encounters and the techniques she chose to use in each context:

Reflecting back themes

Mandy had listened for over an hour to Jessica while she talked about changes that had to be made to her plans, including transitions to a new role and living situation, as well as frustrations with some relationships.  Mandy had been attentive throughout the conversation, utilising continuers such as ‘Yeah’ and ‘Mmm…’.  When Jessica finished speaking, Mandy said, ‘That sounds challenging’.  Then there was a long silence. Mandy wondered what to say next.

During the pastoral encounter, Mandy noticed that there was a theme of loss in Jessica’s story.

Mandy: Wow!  You are experiencing a lot of loss at the moment.

Jessica: Yes, Yes!  (This was said loudly and emphatically. There was another long silence.) 

Jessica: I’m feeling better now (Her face relaxed and her speech slowed).

Mandy reflected back the theme of loss she had noticed in Jessica’s story. Jessica’s response indicated that Mandy had ‘hit the nail on the head’ and that Jessica had felt heard. Mandy’s observation of Jessica’s face relaxing and the slowing of her speech confirmed that the encounter had been helpful for Jessica.

During another pastoral encounter, Janet talked a little about how she and her husband had tried to adopt a child some years earlier.  Janet continued her story, speaking about missing out on the experience of parenting.  Then she went quiet and there was a long, long silence.  Mandy wondered what she could say to provide Janet with an opportunity to share further.

Mandy: The adoption process is really challenging.

Janet: Yes! (Spoken with emphasis)

Then Janet spoke at some length about associated griefs of that time and beyond.

Mandy’s reflection about the challenges of the experience Janet had shared, enabled further sharing by Janet.

If a CCW has been expressing frustration, the MC might say, “It sounds like you’re frustrated”. The CCW’s response can confirm, qualify or deny the MC’s reflection.

Metaphors can also be used as reflective devices.   

David shared that he had been notified that his visa had finally come through.  There was much excitement and relief expressed.  However, sometime later, the documentation had still not arrived in the post.  His family declared, ‘It’s a sign that you’re not meant to go’.  Then, sometime later, the missing visa turned up out of the blue.

Mandy: It sounds like a rollercoaster ride!

David: Yes! (Nodding vigorously)

In this example Mandy uses a metaphor to reflect back.

If the MC’s reflection has hit the nail on the head, the CCW will usually respond with agreement such as an enthusiastic ‘Yes’, or nod emphatically, as David did in the example above.  Alternatively, the CCW can qualify the MC’s reflection.

Observations

Reflecting back an observation you have noticed about the CCW is a useful option.  For example, you might say, ‘You look a little sad’.  If a CCW has been crying for some time and then changes the topic, the MC might very gently say ‘and all these tears’, to offer them an opportunity to explore their grief.

Politeness

Sometimes CCWs share a concern but don’t elaborate despite the use of continuers and reflective listening techniques.  At this point, politeness techniques can be employed. You could ask:

“Would you be able to tell me a little bit about how this is affecting you?”

The request has been softened in a couple of ways.  This phrase uses ‘hedges’; words, phrases  and clauses which help to lessen the force of an utterance.  For example, ‘Would you be able to tell me…,’ ‘a little bit’ make the speaker sound less authoritative and imposing (Harvey et al., 2008).

Outcomes

It is worthwhile spending some time reflecting on the outcome of each pastoral encounter. Did you notice any physical signs of a change in the CCW’s mood as a result of your pastoral encounter? A relaxation of their face or their posture, the slowing of their speech, the lowering of the volume of their voice and the cessation of tears, are all possible indicators of relief given. In the examples above, Jessica’s face relaxed and her speech slowed, confirming her declaration that she felt better.

Benefits of writing verbatims

Verbatims are a useful tool to assist us to keep improving as listeners. Verbatims are produced by writing down as accurately as possible what was said by both parties immediately after a pastoral encounter.  Then, you can read through the dialogue and note how many questions you asked, as well as to reflect on possible alternatives to your responses.  It can also be fruitful to take your verbatim to your supervisor to reflect together on how you might improve.

Offering hope

While it is best that the conversation is led by the CCW, it is often helpful to seek to offer some hope when you are about to leave a pastoral encounter. 

After Mandy has listened to Paul talking about his anxiety about an impending medical procedure, she sought to encourage him as the encounter wound up.

Mandy: I hope your procedure goes well and that you can go on that holiday you are looking forward to.

Prayer is also an encouragement and can offer significant hope when it is sensitively undertaken. It is easy as MCs to use prayer to assert our own agenda. It is even possible to abuse the power we have in the relationship through prayer, particularly if cross-cultural workers are vulnerable. Asking for prayer points and then sticking to those items requested, as well as the terminology that was used by the cross-cultural worker, reduces the risk of discouragement or worse.

Let’s now reflect on an example of a pastoral encounter in the Bible.

A story to consider

Now when Job’s three friends heard of all this evil that had come upon him, they came each from his own place, Eliphaz the Temanite, Bildad the Shuhite, and Zophar the Naamathite. They made an appointment together to come to show him sympathy and comfort him. And when they saw him from a distance, they did not recognize him. And they raised their voices and wept, and they tore their robes and sprinkled dust on their heads toward heaven. And they sat with him on the ground seven days and seven nights, and no one spoke a word to him, for they saw that his suffering was very great.” 

Job 2:11-13

Job’s friends did a great job of ‘being with’ him for the first week.  They had left their jobs and their lives to go to visit him.  When they arrived, they visibly expressed solidarity and identified with him by tearing their robes and throwing dust on their heads in mourning for him.  Even better, they sat in silence for seven days with him (as was customary for mourners at that time)!  

However, after this wonderful beginning, they pursued their own agenda (Job 4ff), finding it too hard to sit with the mystery of his suffering.  It is really hard to remain present with people who are experiencing suffering.  It is tempting to look for solutions.  Job’s friends gave into this temptation, trying to solve his problems through theological discussions. They discussed the theology of divine retribution, arguing that God punishes those who sin and blesses those who are faithful to him.  They jumped to conclusions about the source of Job’s suffering and  ended up ‘blocking’ the pastoral encounter.  Further, they discouraged Job.  While their earlier time of listening was beneficial, they didn’t end well.

Final Thoughts

It is often better to simply offer our ears, instead of offering our insights, our reasonings and our theology (Barnhart, 2016).  It is best to avoid pursuing our own agenda during pastoral encounters, lest we are like Job’s friends and cause harm.   

* All names of people and places in this blog have been changed to provide anonymity.

Recommended Reading

Harvey, K. et al. (2008) ‘“Elicitation Hooks”: A Discourse Analysis of Chaplain-Patient Ineraction in Pastoral and Spiritual Care’, The Journal of Pastoral Care & Counselling, 62.

References

Barnhart, Z. (2016) ‘What Job’s Friends Did Right’, Gospel-Centred Resources from Midwestern Seminary, 26 October. Available at: https://ftc.co/resource-library/blog-entries/what-jobs-friends-did-right/.

Kelly, E. (2012) Personhood and Presence: Self as a resource for spiritual and pastoral care. London; New York: t&tclark.