A Phenomenology of Agency and Human Development
PREPARING THE WAY IN THE WILDERNESS Print

A Phenomenology of

Agency and Human Development for a

Pastoral Counseling Center in

Linn and Benton Counties, Oregon

COPYRIGHT 1997

By Rev. Jeffrey S. Lindner, D.Mn.

Executive Director
Pastoral Counseling Center of
The Mid-Willamette Valley

"Comfort, O comfort my people, says your God. Speak tenderly to Jerusalem, and cry to her that she has served her term, that her penalty is paid, that she has received from the LORD's hand double for all her sins. A voice cries out: "In the wilderness prepare the way of the LORD, make straight in the desert a highway for our God. Every valley shall be lifted up, and every mountain and hill be made low; the uneven ground shall become level, and the rough places a plain. Then the glory of the LORD shall be revealed, and all people shall see it together, for the mouth of the LORD has spoken."

-Isaiah 40:1-5

INDEX

INTRODUCTION

The Challenge
The Results

THE VISION: PUBLIC MINISTRY

The Agency
The Government
Third-Party Payers
Sponsor Communities

THE CARE

Science
Religion
Thinking Theologically: An Exercise
Critical Hermeneutics: Concept and Praxis

CONCLUSION

 

INTRODUCTION

The ease with which Christians understand and accept the powerful role the Church can play in the effort to meet the needs of our frontier Oregon community may be surprising to some. What that role will be and how to perform it well have more often been the challenging matters of consideration for those actually involved in the effort. In the case, for example, of the effort to address the unmet need for specialized mental health care in Linn and Benton Counties, we have not been spared from the intense and often conflicting pressures exerting themselves on the contemporary secular health-care system. Political, cultural, social, clinical, legal, economic, academic, and even religious forces have each had a vested interest in the practical formation of our effort. In our instance, however, availing ourselves of the opportunity to balance those forces on the unique fulcrum of the foundation and authority of the church has resulted in material, helpful, and even dramatic, results.

The Challenge

The levels of unmet need in Linn and Benton counties for specialized mental health care are unsettling. Formulae published by the National Institutes of Health yield unmet need ratios of 60% in Benton county and 90% in Linn county. The resources which do exist to provide such care are available for those who can purchase them in the private sector, personally or through third-party payers, or for those poor enough to be eligible for the limited services available through government agencies. The largest percentages of unmet need accrue to a population of so-called "working-poor", in counties where median family incomes range from $27k to $31k per annum.

The Results

In 1999, The Pastoral Counseling Center of the Mid-Willamette Valley will deliver 5300 hours of specialized clinical mental health services to 750 people. No one who asks for care will be denied services because of his or her inability to pay for it. 65% of those who come for care will pay $20 or less per session for that care. 30% will be unemployed. 52% will have no connection to any church or other faith community. The care will be provided by clinicians with current "standard of practice" credentials. In addition to their skill with state-of-the-art psychotherapies, these practitioners are trained to recognize and mobilize the religious and spiritual resources which may be available to their patients for the resolution of their conflicts. Actual client-contact hours for these practitioners will range from 50% to 300% higher, and the cost of delivering those services will be 30% lower, than those provided by practitioners through local government-funded agencies. Through the course of this year, the Pastoral Counseling Center will provide nearly a quarter of a million dollars worth of free specialized mental health care to the mid-valley community.

THE VISION: PUBLIC MINISTRY

The seat for this effective mission is the reflective devotion of its stewards -- volunteer and paid -- to its unique identity as a ministry of God. That priority has enabled us to distinguish a coherent paradigm for our caring activity which resists common but restrictive cultural assumptions about the skilled practice of care and which exploits practical alternatives revealed through the Christian religious tradition. Our thoughtful intention not simply to replicate 20th century capitalist or scientistic paradigms for transacting clinical relationships; to use the Jesus story and the historical role of the church as a sanctuary, with both its prophetic and pastoral connotations, manifests itself materially in our negotiation of the broad considerations involved both in sustaining an agency life as well as in nurturing the intimate, healing and transforming relationship between the one who suffers and his or her caregiver in the clinical pastoral moment.

The Agency

As an agency, our organization is subject to the same social, political, and economic pressures as any other agency in our culture and in our time. As a ministry, we intend to be responsive to those pressures without being defined by them. Three specific examples of the creative ways we have responded to those pressures without being defined by them are our relationship with the government, with third party payers, and with our sponsor constituencies.

The Government

In our relationship with the government, for instance, it has been our intention to give to Caesar that which is truly Caesar's, but to reserve rights and prerogatives which appropriately accrue to the church. We are incorporated in the state of Oregon as a not-for-profit corporation and file appropriate annual reports with the Charitable Trust Division of the Attorney General's office. We have obtained 501c-3 status with the Internal Revenue Service and abide by the rules and regulations which pertain to it. And we pay employers taxes.

We have made a conscious choice, however, not to seek licensure from the state of Oregon as a community mental health provider. The consensus of the stewards of our ministry has been that to seek state licensure for our agency would blur some essential lines of distinction. It would confuse the appearance of the primary authority by which we do our work and to whom we owe our primary accountability. By so doing, we might compromise some freedom and authority which have been provided for religious practitioners by the Constitution of the United States and by the Revised Statutes of the State of Oregon.

The implications of that obfuscation are more serious and tangible than might first seem to be the case. For instance, the legal counsel of the Christian Church (Disciples of Christ) in Oregon has advised us that state licensure for our agency or for its ordained practitioners could obscure the protection -- for some of our clients -- of clergy-penitent privelege, particularly as it pertains to court-ordered testimony, duty-to-warn and abuse-reporting statutes. In addition, the benefits of clergy-related provisions of the tax code become more questionable as a clergy-person moves further from the clearly identifiable employment-umbrella of the institutional church. Finally, the stewards of the ministry of the Pastoral Counseling Center have recognized the opportunity they have to provide a venue in which a clinical pastoral caregiver who understands his or her journey, call and ministry to have emerged from and been authorized by the church, to practice that ministry as an integrated function of the church.

The stewards of the ministry of the Pastoral Counseling Center are sensitive to the legitimate needs for public protection which state licensure is typically seen to provide. They have addressed those issues of quality of care, public accountability and recoverability of damages in a number of ways. Each practitioner at the Pastoral Counseling Center is licensed or certified and sustains an on-going practice review by the state or by an appropriate professional association such as the American Association of Pastoral Counselors or the American Association of Marriage and Family Therapists. The Pastoral Counseling Center announces publicly its commitment to abide by standards for agencies funded by The United Ways of America -- for example, the requirements for annual financial audits and for equal opportunity and affirmative action employment policies -- and submits itself to the United Ways' annual review of agency performance and policies and procedures. It publicizes its accountability to the standards of practice and code of ethics of the American Association of Pastoral Counselors. And it sustains professional malpractice and board of directors errors and ommissions insurance to provide for recoverability of damages for patients should an accident actually occur.

Third-Party Payers

The most common and practical motivation for practitioners to obtain state licensure is the access it is seen to provide to third- party payers. It is a common myth that a practitioner -- even a pastoral one -- cannot survive financially without the ability to recover payments from health insurance companies, health maintenance organizations or, in our state, the Oregon Health Plan. That myth has been costly in terms of paradigms of care which are seen to be viable in our culture and in terms of the defining influence it exerts on the actual caring activities which are available to the ones who suffer. It has engendered the unexamined assumptions among many that care which is not profitable for third-party payers is not important, useful or true, and that cures which cannot be effected in six or ten or twelve sessions cannot or should not be effected at all. The response of the caring community itself has been disappointing. Most caregivers have tended either to "manage" themselves with third-party payers their interpretations of the work they are actually providing or to pretend, however reluctantly, with their patients that pain reduction is a sufficient goal of care.

Fortunately, that myth has proven not to be true to our experience. Positioned by our belief that the Gospel has a particular alliance with disenfranchised people and by our belief that where there is a legitimate ministry to be performed by the church, the resources exist to perform the ministry, we have discovered that it is possible for clinical pastoral caregivers to survive, even thrive, in relationship with the forces of third-party payers without becoming defined by them. Coincidentally, we have discovered that it is possible to sustain a clinical and pastoral focus, viz a viz an economic one, for our care-giving activity in the midst of a conventional care-giving culture which seems driven to believe otherwise.

In practice, we have implemented this philosophy by distinguishing the mission and identity of our agency from the convenience or preference of third-party reimbursement for our patients. We have resisted the inclination to bring the entire agency under the aegis of the State of Oregon, while cooperating with the convenience or preference of certain of our clients to use the third-party resources which may be available to them. By virtue of particular credentials of some individual members of our staff -- Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, Licensed Professional Counselors and Psychologists -- patients who want or feel the need to use their third-party resources are enabled to do so. Those patients have the additional benefit of knowing that their care will not be terminated when the limits of their third-party resources are exceeded. Approximately fifteen percent of our patients utilize third-party reimbursement systems for their care.

Sponsor Communities

One important key to our ability to recognize and manifest such bold alternatives is our intimate covenantal relationship with the Body of Christ in our world today -- that is, God and the Holy Spirit as they are present in the community of believers -- the church. Simply, we believe authentic Christian ministries are essentially dependent on the community of Christian intercourse for discernment and invigoration. Our veritable existence was conceived from conversation and communion between local Congregationalists, Methodists and Catholics in the mid- 1970's. For nearly twenty-five years, we have grown and been strengthened by an expanding body of cellular relationships with our sponsor church communities. Presently, we are engaged in such relationships with nineteen sponsor churches.

Our rootedness in a broad constituency of individuals and communities who are self-conscious about our continued health and welfare yields great benefits for our sponsoring communities and for the vitality of our agency, as well as for the sufferers who receive our care. Through our covenantal relationship with one another, our sponsor communities enhance their pastoral ministries to themselves as well as their ministries of mission to the community-at-large. They benefit from the preaching and teaching resources offered by the Pastoral Counseling Center as well as from our more obvious clinical and consulting offerings. They also appreciate the publicly visible, credible and effective ecumenical ministry to the community-at-large.

Through our covenantal relationships with our sponsor constituencies, The Pastoral Counseling Center cultivates and sustains a trusting and trusted relationship with a natural community of referrals. It receives the benefit of the perspectives, interests, talents and skills from the varieties of personalities who are shared from within our sponsor constituencies to give leadership to our Board of Directors. And it receives a relatively nominal but consistent and greatly leveragable source of financial support.

Culturally, the identification of our ministry with a community of churches also presents a conceptually accessible and publicly acceptable platform for our care. People in our culture tend to understand, accept and even appreciate the church's historical role as a care-giver whose motivating interests are simply the healing, reconciliation and redemption of a hurting and broken world.

THE CARE

Our intention not simply to replicate 20th century capitalist or scientistic paradigms for transacting clinical relationships, but to use the Jesus story as our primary metaphor for care is manifest as well in our vision for the intimate, healing and transforming relationship which occurs between the one who suffers and his or her caregiver in the clinical pastoral moment.

Science

Clinically, we brook no rival in the competence of our work. We cultivate an atmosphere of expectation for responsibility and excellence in care. Each staff therapist at the Pastoral Counseling Center has achieved standard-of-practice credentials in psychology, social work, marriage and family therapy or pastoral counseling and sustains a relationship of continuing accountability with at least one organization of professional peers. The staff calendar schedules weekly individual clinical pastoral supervision, staff case conference, and a clinical theory study group. Our agency provides occasional three-hour sessions with visiting clinical consultants, as well as financial reimbursement for the continuing education and professional conference activities of senior clinical staff. In addition, eighty percent of our senior staff receive supplemental individual clinical consultation outside our agency, and all staff members are familiar with the medical, psychiatric and social service resources which exist in our community and make referrals outside our agency when and where appropriate.

Seward Hiltner has said that a theory without a practice is irrelevant, but a practice without a theory is non-correctable. At the Pastoral Counseling Center, we have identified a coherent body of clinical theory for our work and are involved in a systematic effort to learn that theory well and to employ it in a consistent manner as a practicing community. While our staff members maintain conversance with the brief, solution-focused and strategic/systemic techniques which are the talk of the day, we believe those techniques tend to be derived or derivable from more substantial, more adequate, more enduring and finally more flexible theories of human development. Specifically, we employ a sophisticated genetic field theory of human development for our clinical assessment and care. The broad theory includes psychodynamic and depth-psychological theories of psycho-sexuality, ego-psychology, object-relations theory, self-psychology, faith development, moral development and critical hermeneutics. We believe the breadth and depth of our field theory appreciates and accommodates most adequately the vicissitudes of the human mind and the opportunities which exist for its authentic transformation. We believe our clinical work reflects state of the art competence for mental health care.

Religion

The truly distinguishing characteristic of our caring activity, however, is its religious literacy. We recognize that there can be more substance to pastoral clinical care than a fish sign in one's yellow page advertisement and the ability to be warm and nice to one's patients. At the Pastoral Counseling Center, we understand religious literacy to mean 1) a considered familiarity with the religious dimension of human life; 2) a studied acquaintance with the variety of languages for describing the religious dimension in human life; 3) the ability to recognize and name the religious dimension of a client's experience; 4) the ability to use religious understanding to formulate and implement liberating and redemptive experiences in a clinical setting.

Thinking Theologically: An Exercise

Over the past decade we have developed an exercise designed to de-mystify (then, ultimately, to re-mystify) religious practice for our lay-caregivers, to acquaint them with the basic language, method and themes involved in thinking theologically, and to empower their personal investigation of religious practice in their work. We recognize that a three or four hour exercise in thinking theologically is not a reasonable substitute for a seminary education. We also recognize that a seminary education is not a reasonable substitute for a vital personal spirituality and the immanent role it can play in the manifestation of healing and redemptive encounters. This exercise is designed to open the door for lay-caregivers to a life-long process of enlightened and methodical consideration of the religious dimension of their work. Other structures in the day-to-day life of our agency provide for the longer-term seasoning of the experience.

We begin the exercise by reflecting on Alfred North Whitehead's definition of religion. "Religion is the longing of the spirit that the facts of existence should find their justification in the nature of existence," he said, and therefore "the final principle of religion is that there is wisdom in the nature of things." We discuss the accuracy of Whitehead's definition to our experience of religion. Does the definition fit the manifestations we commonly describe as religions? Is a "God" concept necessary for such a definition of religion? Are there other manifestations which fit the description but which we do not commonly call religions? Is our understanding of those other manifestations affected or enhanced by considering them to be religious?

Our intention with this first discussion is to broaden and to clarify the meaning of the term religion and to lay the foundation for our later distinction between religion and theology. We want the hearer to begin to understand the vital function of religious manifestation for organizing human experience, to begin to recognize the common and not so common manifestations of that function, and to begin to notice the relative adequacy with which different manifestations of that function achieve their ultimate goal.

Next we discuss the etiology and meaning of the word theology. We observe its roots in the Greek words qeos: God, and logos: word, and understand that the word "theology" itself refers to words about, talk about, or the study and interpretation of God and concepts of God. We discuss the relationship between theology and religion, and understand that while common usage is frequently more liberal, technically, theology refers to interpretations of theistic religions. Theology, for instance, is more properly used to describe interpretations of religions such as Christianity, Judaism, Hinduism or Islam. Technically, it is less proper to speak of Buddhist or Wiccan religious interpretations as theological simply because they lack a qeos.

Conceptually, it is extremely important to emphasize the distinctions between religion, theology and spirituality. The three are frequently confused in common cultural discourse and each has a precise and important meaning which is important to understand and to maintain as we explore them respectively. For our purposes, religion is the broad manifestation of the narratives people construct to ground their particular experiences of reality in their understanding of its essential nature. Theology is the methodical interpretation of theistic religious narratives. And spirituality is the cultivated and disciplined personal practice of a religion or theology.

While the critical hermeneutical model for the ministry of the Pastoral Counseling Center can accommodate a variety of religious orientations, the accidents of history, geography and culture find us born into institutional existence and sustained in that existence by communities which are essentially Christian. Additionally, the personal religious and spiritual journeys of the current members of the clinical staff are also Christian. Given those accidental facts of our existence, this exercise, as well as our day-to-day reflection on the religious and spiritual dimension of our work, is conducted from a Christian theological perspective. It is worthwhile to note the relativity of that hermeneutical perspective and to be prepared to be conditioned by other perspectives which may one day come to bear more forcefully on our lives.

Historically, there have been many objects of Christian theological inquiry. Much of the language for describing those investigations sounds at least vaguely familiar to most people. Most of us have heard words and phrases such as biblical theology, practical theology, historical theology, liberation theology, sacramental theology, systematic theology, and so on. These particular words and phrases tend to bring to mind dark, dusty, monastic libraries filled with thick and unfathomable tomes, attended by bald-headed friars wearing God knows what underneath their heavy, wool dresses. The simple fact of the matter is that however dense and impenetrable or light and uplifting a particular Christian theology may be, it has at least one thing in common with every other Christian theology. It contains within itself an interpretation of the relationship between God, Jesus and humanity. Or, in more scholarly language, every Christian theology contains within itself, implicitly or explicitly, doctrines (or ways of visioning) of God, Jesus and Humanity.

Because every theology contains within itself some construal of the nature and relationship of God, Jesus and Humanity, those three concepts can be used as benchmarks for determining the "lay of the land" for any particular theology. The question, "How does this person/church/theology view God, Jesus and Humanity?" becomes the key to recognizing and understanding its manifest or latent theology. As we learn to answer that question pertaining to a patient's clinical presentation, we are enabled to name for ourselves that patient's own theological vision, to recognize its distinctness in relationship with other theological visions, to observe a dialectic between those visions and to use that dialectic to inform, explicitly or implicitly, a conversation with the patient about liberating and redemptive alternatives. In a clinical setting, of course, that conversation has much more to do with a way of being with one another -- the transforming experience of feeling heard and understood -- than it does with an intellectual discussion about the merits of alternative theologies.

In the next phase of the exercise, we simply do theology. We begin by free associating with one another about the variety of words we can think of to describe God, Jesus and Humanity. The results of our most recent use of this exercise follow:

God:

lover presence forgiver shepherd darkness light warrior
spirit ultimate mystery creator compassion loving covenant
holy holy one mother lord sustainer son holy spirit
trinity presence ground judge powerful graceful holy ghost
suffering father king master redeemer parent transcendent
abba fire wind rock change forgiving relationship
immutible process infinite heaven hell law here & now
law love word wisdom promise omnipotent

Jesus:

savior prophet vine bread lamb light shepherd
water chosen beloved son abba jew teacher
rabbi messiah christ baby prince redeemer sustenance
sage spirit rebel brother creator sacrifice forgiveness
suffering Adam servant brash angry violent compassion
man priest apostate king navigator risen revelation

Humanity:

frail beauty flesh Adam dark urgent light
dark sin blind joyous lost confused sinner
disciples children hardness of heart softness of heart lost
good worthy redeemed saints body of christ teachable
laborers sheep foolish virgin sand greedy apostles
subjects siblings sustained beloved object of God's love foundation

We observe and savor the colorful variety of language humanity has formed through its attempt to describe its experience and understanding of God, Jesus and itself. We notice the similarities and contradictions of description of the very same object. God is forgiveness. God is judge. God is omnipotent. God suffers. Jesus is king. Jesus is servant. Jesus is truth. Jesus is apostate. Jesus is a shepherd. Jesus is a lamb. We notice that some of the descriptions apply to all three, such as good, beautiful or suffering. We also observe the difficulty of maintaining some descriptions of one, while maintaining particular descriptions of others. How does an omnipotent God sustain a suffering creation, while it sacrifices His only beloved son?

It is important to understand that each of the words reflects some true attribute of God, Jesus or Humanity, and deserves abiding respect for its own authenticity. It is also important to recognize that to limit God, Jesus or Humanity to any single one of these descriptors distorts our perception. None of the words captures entirely the essence of the object of its description. Only in stark and candid relationship with each other do these words begin to fulfill their capacity for conveyance of the complex qualities of the objects they attempt to describe.

As we reflect further on these words, we notice that some of them seem to gravitate toward each other. Some seem to fit more comfortably with each other than with others. Judge seems to fit better with sin and sacrifice than with mother, brother and co-creator, for instance. As we look for and note those easy alliances, themes, even mini-narratives, begin to emerge. God as lover, Jesus as love and Humanity as beloved, for example. God as King, Jesus as Prince and Humanity as subjects is another. God as mystery, Jesus as revelation and Humanity as lost then found, or God as Father and Mother, Jesus as Son and Humanity as his brothers and sisters, or God as angry judge, Humanity as sin, and Jesus as sacrifice and propitiation are others.

We recognize easily the patterns which have emerged as similar to the religious orientations we encounter in our lives every day, but don't often take the time to name. Each of us has experienced a patient who wants to use Jesus to force a spouse to act right, who wants to be religious but not use those words, who believes pain is punishment from God, or who can't accept that a truly inclusive God could have normative expectations. We also notice that the patterns fit our connotations of various religious communities, denominations or churches in our midst. Each of us has felt the almost instinctual shift in our field of expectation when one referral speaks, for instance, of his affiliation with Pastor Shelton's Assembly of God Church, versus another's reference to his or her pastor, Liz or Lois, from the Congregational Church.

We take the time also to notice that some of those patterns feel more comfortable to us, personally, than other patterns. As a group, we feel more comfortable seeing God as loving and forgiving than as judging and punishing. We would rather see Jesus as a brother, a messenger, or a man with a prophetic vision than as a metaphysical transaction between God and Satan for the purchase of immortal souls to a life which truly begins only when our earthly forms perish. And we prefer to see ourselves as nice, inclusive people without a particular theological agenda. Finally, with some discomfiture, we recognize that this religious inkling itself is a pattern of expectation and that, contrary to what may have been our self-perception, we do indeed have a theological orientation, if not an orthodoxy, at our own agency.

Our prior observation of the respectable but limited truth revealed through individual words is also true of the patterns, narratives or, more specifically, the theologies they form when deployed together. It is important to understand of these patterns or narratives, as well, that each reflects some true attribute of God, Jesus or Humanity, and deserves abiding respect for its own authenticity. It is also important to recognize that to limit God, Jesus or Humanity to any single one of these narratives is idolatrous -- it distorts our perception and finds us worshipping something less than God as God. None of the narratives captures entirely the essence of the object of its description. Only in stark and honest relationship with each other do these narratives begin to fulfill their capacity for conveyance of the complex qualities of the truth they attempt to describe.

More personally, it is useful to remind ourselves as caregivers and as human beings, too, that our personal comfort is not the sole definition of God's true manifestation. Acknowledging real other-ness in religious manifestation is not simply an identification of opportunities to transform those manifestations into less personally threatening ones. There is a powerful opportunity for self-discovery, self-transcendence and divine revelation in our attendance to the limits of our comfort and the manifestations which exceed it.

At this point we take some time to notice that the narratives we have observed tend to accrue to broader "fields of orientation" or attitudes to the task of interpreting God, Jesus, Humanity and their relationship with one another. Our cultural idiom characterizes its intuitions about those attitudes with descriptions such as conservative, liberal or progressive. We have little trouble identifying with one another local religious communities which, in our experience, seem generally to fit those shoals. We talk a bit about those particular communities and what it is about them that leads us to group them the way we do. Our conversation tends to revolve around considerations of literal or metaphorical interpretations of scripture and tradition, rigidity or flexibility about those beliefs, and the emphasis of a particular religious community on one or another tenet of our broader religious tradition.

This simple exercise of paying attention to the variety of words we use to talk about God, Jesus and Humanity, noticing how those words themselves ally with one another in ways that form coherent narratives, and recognizing the parallels between those narratives and the stories our patients tell, or the parallels between those narratives and the distinct religious personalities they manifest in various faith communities, is de-mystifying and empowering for lay-caregivers seeking to understand the ways religious experience manifests itself in our day-to-day lives.

Now it becomes accessible and useful for us to consider the basic forms in which that day-to-day experience has been considered by the community of people who study those things. The point here is less to know what Aquinas, Luther, the Niebuhrs, Tillich or Reuther said, than it is to become familiar enough with the common language of theological conversation to be able join it in a meaningful manner. As truly intentional pastoral caregivers, it is helpful to expose ourselves to the language which the pastoral community has cultivated to name the uniqueness of its experience. The vital tools which that tradition has to offer our immediate efforts to construct creative caregiving alternatives are implicit in its language. For the task of introducing some of that language, I turn to the typology of David Tracy.

In Blessed Rage for Order, Tracy identifies five basic models for contemporary theology. He names them orthodox, liberal, neo-orthodox, radical and revisionary. While each of those words has natural connotations in its vernacular, Tracy identifies specific and technical definitions for them. For Tracy, the essential distinction between each of the models is to be made through what Tracy calls its self-referent and its object-referent.

In the orthodox model, the believer (self-referent) is interpreting the tradition (the object-referent) to the traditional community. Both the strength and weakness of the model lay in that it perpetuates the tradition. Through the orthodox model, a tradition finds self perpetuation, which is certainly desirable to those who are ensconced in that tradition. The essentially "epistemologically solipsistic" perspective of the model, it's tendency not to be too distracted by the facts of its surroundings, tends to limit its accessibility and persuasiveness to those who already believe. A typical statement from an orthodox perspective might be simply to repeat in various iterations, "God loved the world so much that He sacrificed His only Son for it, and whoever believes that will live forever."

In the liberal model, a modern consciousness (the self-referent) -- replete with its unequivocal "...commitment to critical investigation of all claims to meaning and truth, religious or otherwise..." -- interprets its religious tradition (object-referent) according to its a priori assumptions of reasonability. A typical statement made from liberal perspective might be prefaced with the phrase "As reasonable moderns, we all know what God/Jesus must really have meant here was..."

Fundamentally, the neo-orthodox model is a continuation of the modern, liberal project. With its emergence from the aftermath of two world wars and the atrocities of fascism, it is greatly humbled about "evolutionary optimism" (ie, things just get better and better), and the power of liberated humanity to fulfill its own potential -- both major tenets of the liberal model. Neither does it yield to the regressive temptation to orthodoxy. "Orthodox theologies give rise to more orthodoxies; liberal theologies give rise to neo-orthodoxies." In the neo-orthodox model, a subject with basic, though critically informed, existential attitudes of Christian faith, (self-referent), interprets his or her religious tradition as a dialectic involved with an often wholly-other God of Jesus Christ (object-referent). A typical statement made from a neo-orthodox model would sound something like, "As reasonable moderns, we may think we know what God or Jesus really meant here, but there is obviously more to the story -- probably more than we can ever really know."

The radical model assumes that God must die in order for the authentically liberated human being to live. In radical theology, a subject committed to contemporary, post-modern secular intellectual and moral values (self-referent) interprets a reformulated Christian tradition which has negated its central commitment to God and redefined Jesus as the primal example of authentic liberation for humanity (object-referent). A typical statement from a radical orientation might sound like, "What you see is exactly what you get. God must die in order for humanity to live."

The revisionist, revisionary, or critical hermeneutical model continues the critical intellectual trajectory of the liberal model. It loves and respects the orthodox, liberal, neo-orthodox and radical moments and sees its own path as through them rather than around them. It sees itself bringing the force of more recently forged tools in philosophy, linguistics and the social sciences to bear on the theological task. The practical result is a dramatic revisioning of both our modern secular and religious traditional heritage in which the religious dimension of common human experience is identified and acknowledged and the reasonable limits of religious language and experience are accepted.

The vision which emerges from those capitulations is of a "subject-in-process-on-trial"; of a humanity involved in an urgent but never-ending process of public conversation and discovery in which the relative adequacy of proximate perceptions of ultimately inaccessible truth is determined, only to be considered again in the light of the new perception. In the revisionary model, a subject committed to revisionist notions of secularity and of traditional Christianity (self-referent) interprets philosophically derived meanings present in common human experience and in the Christian tradition (object-referent). A typical statement from a revisionary perspective might be, "There is more to what you get than what you see, although what you see is a pretty good clue to what you get."

It is worthwhile to observe at this point that revisionary theology attends to each of these theological forms -- orthodox, liberal, neo-orthodox and radical -- in the same manner in which we have attended first to the words, then the narratives in the earlier phases of this exercise. It respects the authenticity and authority with which each reveals important aspects of the objects of its attention -- God, Jesus and Humanity. It assumes a truth which is too big for any single theology to describe, and avails itself of their relationships with one another - their identities, similarities and their non-identities - to discover a more refined perception of the objects of their attention than would be possible with any single theology.

Revisionary theology takes the further and rather dramatic step of tackling the matter of the public truth status of religion. By demonstrating the presence of a religious dimension to all human experience, and by accepting linguistic analysis of religious language as "logically odd", with world-changing meaning "in front of the text", (that is, "this worldly"), it establishes the common ground for publicly accessible and verifiable conversation between traditionally secular (read scientific) attitudes and traditionally religious attitudes about a reality which is reasonable, if neither other-worldly nor scientistic.

By this final move, we have taken the step into a conceptualization of meaning and truth as so large that neither words, narratives, theologies or sciences are independently sufficient to describe it. We have come to comprehend that only through dynamic, critical hermeneutical conversation between authentic traditions involved in the search for meaning and truth, do we begin adequately to tap the reservoir of insights, perceptions and understanding which are presently available to us. That "critical hermeneutical" foundation has important implications for caregivers, particularly those whose raison d'être is the sound practice of religiously and scientifically informed care in a public setting; caregivers like us.

The deep and marvelous critical hermeneutical foundation described by Tracy is made useful for us through Don Browning's model for "practical reason". For Browning, every act of care, ostensibly secular or pastoral, involves considerations in five dimensions of significance. He names the dimensions the visional, obligational, tendency-need, environmental-contextual and rule-role. For ease in remembering, he playfully suggests the acronym v-o-t-e-r.

According to Browning, every caring act is informed by some fundamental, world orienting metaphor, narrative or vision. Quoting Mircea Eliade, "Human beings have an irresistible need to turn the raw material of their experience into orienting myths." Those myths or narratives carry within themselves the normative connotations for our existence. Consciously or not, we envision ourselves within the context of a story. Through the narrative of that story we experience our "feel" for the normativity for our lives -- what fits, what doesn't; what's right what's not; the "should-" or "shouldn't-ness" of our activity. Any single act can be viewed as desirable or undesirable, depending on the subject's "vision"; his orienting myth or narrative.

As pastoral caregivers, it is interesting to note that the "scientific" theories we use often have very unscientific visional connotations. The easiest to observe are some which have been sophisticated enough to name their narratives. Freud used the Oedipus myth. Kohut uses Odysseus and Telemachus. The humanistic psychologies have much less well articulated visional dimensions, but have wielded crippling visional authority for our own culture.

For Browning, it is within the visional dimension of his model for practical reason that we identify and discuss the relative adequacy of the visional underpinnings of, and their implications for, the praxis we are considering.

The obligational dimension of Browning's model is the location for discussion of the manifest moral philosophical implications for the praxis we consider. It is the arena within which we bring the normative indications from our visional propensities to bear with other more philosophical derived normative principles, such as the normative principles of reversibility or universalizability of the actions we are contemplating. In this dimension, we discuss the relative adequacy of the various moral obligations which may be seen to weigh in the present circumstance.

The tendency-need dimension is the realm with which most counselor-types are most familiar. It is the dimension of consideration for praxis which attends to the things which science has taught us about the biology, psychology and sociology of the human organism. For us at the Pastoral Counseling Center, for instance, this is the dimension in which we employ our broad genetic field theory of human development. It is where we scan, assess and discuss the relative adequacy of our clinical observations of our patients' presentation in terms of narcissistic, pre-structural, ego psychological, object-relations, cognitive, systemic, and even moral and faith models of human development.

As we were working through this exercise recently, one staff person hypothesized that the environmental-contextual dimension must be the dimension in which we consider the place or setting in which we do what we do. "My pastoral care is going to be different if I'm responding to someone who's been hit by a car and is laying bloodied in the street, than it will be for someone who's sitting in my office." Indeed, the environmental-contextual dimension considers setting and more.

Within the environmental-contextual dimension, we also discuss the relative adequacy of the cultural and temporal connotations and the political and economic implications for our care. Such an environmental-contextual conversation might address questions such as: How will we respond to a patient whose employer and third-party payer wants us simply to stop that person's pain quickly so he can return to being an economic asset rather than an economic liability? How will we respond in that situation when it appears that considering himself in such a manner seems to have been a major component of his distress in the first place? Can we envision an environment for our care which doesn't perpetuate dehumanizing patterns of economic or political valuation? Is it desirable to do so?

The fifth dimension, the rule-role dimension, of consideration for Browning's model for practical reason provides for conversation about the most relatively-adequate manifestation in behavior -- the most relatively adequate act -- of correlations among the conversations from the other four levels. This dimension essentially describes the praxis of Tracy's "subject-in-process-on-trial". For us, it describes the urgent, decisive and consequential moment of praxis which occurs within the context of a never-ending process of enlightening conversation about care.

Together, the critical hermeneutical perspective and Browning's practical model for implementing it are important to us as pastoral caregivers for a number of reasons. They name and make coherent and useful a theological attitude toward which most of us already lean, but haven't fully realized. They distinguish and authenticate that theological attitude in the history and range of theology. Furthermore, they articulate a specific and highly nuanced answer to the ubiquitous question, "What makes pastoral counseling unique?"

For our purposes, pastoral counselors conceive of meaning and truth as so big that no single language can entirely contain it. They recognize the importance of naming, knowing and living their own (religious) linguistic tradition, while simultaneously recognizing the value of other language traditions and of engagement with them in authentic conversation as an effective means for tapping more adequately the reservoir of understanding which is presently available to us. And they strive to bring the force of that understanding to bear on wholesome caring activities in a consistent, methodical and disciplined manner.

The critical hermeneutical perspective and Browning's model for practical reason also provide tangible tools for our practice of care. Browning's model particularly offers an organized framework for methodically considering the material of our patients' presentations. The model suggests particular and pertinent questions to consider in our efforts to appreciate and understand the complexity of the being before us. How has this person experienced her world? Is it malevolent or benign? What sustains or motivates this person? Has this person had redemptive experiences in her life? If so, what have they been? If not, what meaning has she made of her inconsolability? How does she view herself in relation to her world? Powerful? Impotent? Alone? Accompanied? How have these experiences composed for her a story and how does that story compel her to behave?

The model invites critical reflection on the similarities and differences between a patient's responses to the questions and the caregivers responses to those same questions, and finally, for pastoral caregivers, it call for some display of a critically correlated caring activity which manifests the tangible form of a benevolent God employing the limited resources of the moment in the service of a healing and reconciling intention.

As we observed earlier, the goal of this exercise is not to make lay-clinicians at the Pastoral Counseling Center into scholars of theology. The exercise is intended to be a tool for developing the religious literacy of our staff. It exposes non-theologically trained clinicians to reasonable concepts of religion. It clarifies important distinctions between the often confusing language of religion, theology, spirituality and pastoral care. It heightens their sensitivity to the religious language and themes that are already a part of their experience and lexicon and makes a connection with the basic language of the formal tradition of theological investigation.

The exercise also places us in a specific location in the history and range of theological tradition, along with an exposure to the matters which make that particular place such an important place to be. It introduces a specific model for interpreting the uniqueness of clinical pastoral care, as well as a practical tool for the conduct of that work. As it accomplishes these things, the experience of the exercise also de-mystifies religious practice for our lay-clinicians and empowers their continued personal investigation of it in their work.

Critical Hermeneutics: Concept and Praxis

In a recent issue of Modern Drummer, drummer T. Bruce Wittet said of drumming, "There's technique and there's vocabulary." It is possible, he was saying, to have disciplined, articulate and fast hands, but still not be able to play music. Similarly, critical hermeneutics and practical reason offer powerful ways to understand and to talk about the practice of wholesome care. However, understanding and talking about wholesome care are not the same things as wholesome care. David Tracy has said, "Praxis is theory's own originating and self-correcting foundation... Praxis sublates theory, not vice versa." Theologies and psychologies become truly meaningful for clinical pastoral caregivers only to the extent that they increase our ability to mobilize ourselves in healing and transforming ways for the ones who come to us for care.

At the Pastoral Counseling Center, we try to be intentional about that move from thinking clearly and well about what we do, to doing clearly and well what we think. Tracy also said, "Any proper understanding of praxis demands some form of authentic personal involvement or commitment." In the final analysis, that move becomes the transformation of our critical hermeneutical model for practical reason into an articulate spirituality - the cultivated and disciplined personal praxis of our theology.

The cultivated and disciplined personal praxis of our theology does not mean the dumb reiteration of a text. Again, per Tracy, "...any merely technical understanding of praxis as mere practice (mechanically and routinely applied theory) must be negated." It is possible to become so focused on the text, or the proximate manifestation of a scientific or religious truth, that one becomes distracted from the underlying Presence to which that manifestation alludes. The true brilliance of the text we are using is its constant aim toward that Presence, focused and guided by the best of what we already know; its constant reminder to read between the lines for the disclosure and transformation we seek.

In our real life together, that spiritual praxis means, then, learning to know what we do know, while at the same time providing for ourselves regular opportunities to be encountered and transformed by that which we do not. It manifests itself in a variety of ways through the day to day life of our ministry, both individually and collectively.

Each member of our staff self-consciously views him- or herself as religious and actively pursuing a religious life. Each is a member of a specific community of faith and participates in the rhythm and rituals of that community. And each of us periodically uses the setting and discipline of self-reflection and deliberate self-transcendence available through personal psychotherapy or spiritual direction.

Our clinical pastoral case conference is a vivid expression of our beliefs about "poly-centric manifestations of meaning and truth" and the value of authentic conversation for accessing their power. We approach those conferences with the assumption that none of us has a monopoly on truth, but that each of us exists as a reliable, though partially obstructed, vantage point for its horizon. We try to trust the game of conversation around our clinical material as a means for the disclosure of deeper understanding of our common work, for supporting each other in our work, for challenging each other toward improving our caregiving skills, and for building a more cohesive community of care.

Our weekly meetings of individual clinical pastoral supervision serve a similar purpose: to rehearse what we know with an eye toward self-transcendence, with the intention to improve our ability to care. These meetings should not be confused with conventional and simplistic stereotypes of a supervisory relationship as one in which the one who knows the truth imparts that truth to one who knows not the truth, who is then graded by the accuracy with he or she is able to replicate the truth which has been imparted.

Critically informed clinical pastoral supervision as a spiritual discipline is framed by one generation's fundamental commitment to generativity through succeeding generations. It is framed also by successive generations' desires to reap the benefits of the discernment of its forbears. It respects the value and continuity of truth's prior disclosures, and endeavors to make those disclosures available to succeeding generations in meaningful ways. At the same time it respects the limits of those prior disclosures and is constantly on the lookout for the new and pertinent ways truth will make itself known. Critically informed clinical pastoral supervision is a spiritual discipline as much for the supervisor as for the supervisee. Both assume that their authentic conversation with one another about the material of the supervisee's work, within the framework of the things that are commonly be known about care, will enhance and expand the ability of both to care well.

In The Symbolism of Evil, Paul Ricoeur says, "The symbol gives rise to thought, but thought always returns to and is informed by the symbol." The fundamentally defining symbol for our own clinical pastoral ministry is the story of a benevolent God Who loved His creation so much that He gave His Son to it, so that if it wanted to, that creation could know everlasting life. That symbol gives rise to much thought by us about the role we play in the story of that loving God and His relationship with His creation. Much of that thought is reflected in this paper. That thought persistently refines and articulates the story for us, and enables deeper, richer, more compassionate, and more helpful acts of healing and reconciliation. But it always returns to the story for its warrant.

Once per month, the clinical pastoral caregivers at the Pastoral Counseling Center ritually return to the symbol which has given rise to the articulation of their ministry. On the fourth Monday of each month, our staff comes together in a worship service. We invoke the Spirit of the One who has given us life. We sing songs. We read from His ancient story. We acknowledge our role in the story He continues to tell. We accept our own limits, but invite Him to work through us to accomplish His intentions in time. We break bread and drink wine together as His Son taught us to do. And we ask Him to continue to be present among us and within us as we endeavor to re-present his love to our hurting and broken world.

Through our ritual of worship we literally come into being with one another. The ritual releases us from the distractions of our day to day lives, softens our defenses with one another and with God, and releases us in the moment for the moment. It clarifies and focuses with us our place in the order of things and reminds us of the feeling of being present; simply and clearly present -- with God, with each other -- so that we may learn to do it better with the ones who come to us for care.

CONCLUSION

For nearly twenty-five years, the leadership of the Pastoral Counseling Center of the Mid-Willamett Valley has striven to prepare the way in the wilderness, to make straight in our desert a highway for our God. They have walked the valleys of a secular culture for which religious visions carry little valence. They have climbed the hills of a conventional health-care delivery system which defines itself in contradistinction with the church. And they have smoothed the rough places of human resources; caregivers who believed, but needed help with their unbelief. Through the course of those trials, the leadership and stewards of the ministry of the Pastoral Counseling Center have been guided by a vision of a sanctuary in the wilderness where an emotionally and spiritually lost and wandering people may be spoken tenderly to and find refuge, comfort, healing and hope. I believe they enjoy considerable success in that endeavor.