Mitigating Existential & Spiritual Distress: Part IV The Narrative

Spiritual Direction in the Journey of Illness

Person As Patient: Though I stand at heaven’s gate, holding onto a remembrance yet feeling far from it waiting for a miracle, within the chalice of pain I encounter God as my brokenness longs in longing to be redeemed from this immanent of experience.

Person As Spiritual Director Caregiver: Traveling into the inner world of unknown darkness of another, I hold onto the light of life, keeping a vigil listening for the far off rumbles and catching the echoes of their past hopes for Thy to be resurrected again in our hearts.

THE NARRATIVE

IMPORTANCE OF THE NARRATIVE

In John J. Cicero’s essay Positive Psychology: A New Paradigm, he addresses the need to allow others to communicate their narrative by refraining from interrupting, or by giving advice. This is crucial in creating an environment where the sacred can become palpable.

In looking at the theology of illness and our faith experience it has an implicit and explicit relationship with our Creator.

Cicero points to the work of Irish theologian Dermont Lane’s work on the meaning hope within illness: "hope takes energy to act, hope rises from within the person but only as an encounter with the external world of human beings for the human to exist always means to coexist and that is to be always in relationships".

It is in an illness when we are stripped down to work out becoming receptive to many moments of grace.

THE PHENOMENA OF THE META STORY

Storytelling is the unconscious talking, they do not know what. Let the story break into the consciousness. If low trust in the listener or the storyteller, the story is more abstract.

Listening for these types

Data Back Then Story

What I was a kid, I                       . I remember long ago                      .

Response: What were the feelings back then, feelings now, offer some self disclosure.

Reinvestment or Rehearsal Story

Goes back into the past to rehearse because it has the same thematic words

Response: look for keywords

I know Someone Story

Tells you a story about themselves as someone else

Anniversary Story

A rehearsal story told at a given time of the year

Counter Story Saying the opposite.

1 pgs. 3-19 Spiritual and psychological aspects of illness: Dealing with sickness, loss, dying and death Edited by Musgrave and McGettigan

Metaphor – a things, place, object, person, represents deep into the mind a symbolic form – the way the unconscious creates the metaphor… “Tree rattling inside”

Do a story check…I was wonderful if                                        

YOU CAN NOT ‘NOT’ TELL OUR STORY

TYPES OF ILLNESS NARRATIVES

“Illness stories are therapeutic for tellers who have a real opportunity to be heard and to hear themselves. As they tell and retell their story they can unravel the truth of their own experience of illness and begin to adjust to the person they have become. From this position they can begin to uncover the person they could become. Telling their story has given them the opportunity to step outside of themselves and witness who they are. This dis-identification allows new possibilities to emerge” (Sharon Kitly).

The Restitution Story

This is a story in the medical community expects this is not the story of someone with a chronic permanent illness. The person will feel isolation and may have an increase in their suffering if they are expected to give such a narrative.

The caretaker needs to be there for them.

The Chaos Story

Paraphrased: When someone lives with unrelenting pain suffering from a chronic permanent disability or life limiting disease they may face multiple problems related to work, family, social, financial or where there is a little solution to be found.

The caretaker needs to honor the person suffering.

When they are overwhelmed by the intensity of their illness they are unable to speak coherently, for a lived chaos cannot be told. Only when they’re able to stand outside the chaos killer story begin to emerge. The challenge of listening is to refrain from staring the teller away from the difficulty of telling. The listener is to hear. The narrative is often disjointed and without sequence. This particular story it’s difficult to listen to by family or friends because they hope things to return to normal and they tell her to return to their formal self. Usually platitudes or silences tend to follow (Sharon Kitly).”

When they cannot share their true story there’s an increase of fear. And further upset.

The Quest Story

Shea: This is when the person understands this as a learning journey where the individual believes their illness had led them to new insights and transformation. There is a sense of giving up the old, a renewal of finding, a new gratefulness to the condition. Accepting life “unconditionally” finding a new fuller sense of self, what can be reclaimed… finding a grateful life in conditions that the previously self would consider unacceptable.

There's an acceptance and a deeper meaning within the narrative for the listener to listen for.

NURTURING

For all three it is the story of the patient’s journey, and it is theirs to tell.

Change can only be nurtured by the spiritual director/ caretaker:

1.          By holding the sincere belief that the story you are hearing needs no change

2.          By helping the person ‘hear exactly what story she or he is telling

3.          By helping the person know that they are living a story that is theirs to tell

STORY LISTENING

TAKEN FROM: What do I say? Talking with Patients about Spirituality.

Some patients find the only way they can express their feelings is by a story. Some may have languages for their feelings, they are thinkers. We are to encourage and to respond to their stories to help them make sense of their story.

Help connect story to the present if they are unable

statement or questions:

• I think I can see why you told me why you told me that story. Or

• Is what happened to you then, what is happening to you now?

To gain perspective from their story– privately analyze their story

• what values and beliefs are revealed in the story

• what life themes emerge

• how does past influence the present

• what unresolved conflicts are coming to the surface

• what might this story be as a metaphor

• how does patient portray themselves?

• why did they tell the story now?

Do a Story Check

• Ask: The stories you are telling me seem to have a theme about  . Can you tell me more about them? or

• I learned from your story you value         how does that help you now?

• Help patients see the story in a redeeming or meaningful context

• This is your life now, how would you like your story to end

• What will it take you to achieve the happy ending

2 What do I say? Talking with Patients about Spirituality.

 REFLECTION QUESTIONS WILL BE ADDED HERE SHORTLY

*This 6-Part Series is for spiritual directors who accompany individuals facing life-altering illnesses, as well as those who serve as caregivers. It draws from presentations I have given to spiritual direction interns, nursing students, nurses, and parishioners involved in ministry to the sick and homebound. The content is shaped by my background in family practice as a chiropractic physician, my years of service as an on-call chaplain at Yale New Haven Health, and my work as a patient advocate and spiritual director accompanying individuals through illness and suffering, and years of collecting notes from various sources. I take no personal credit for the work as original.

Part I: Introduction & Definitions

Part II Signs & Symptoms

Part III Listening & Assessment

Part IV The Narrative

Part V Human Development

Part VI Offering Scriptures