Books


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I have recently seen at close hand the work a busy acute hospital having to deal with an older person suffering multiple challenges to well-being caused in the main by intense confusion as a result of the Alzheimer’s disease. The result was shocking and frustrating. Although,of course, a one-off situation which was intensified by my own sense of powerlessness and pain at the way this person was treated – I suspect that this experience may well be replicated across the UK. We keep on being told that the NHS is in crisis principally for financial reasons but the central organising question this book suggests that there challenges are also moral : it asks is how we care for vulnerable people in such a way as to deepen compassion and alleviate suffering.

Fo me, this book came at the right time and Andrew Sloane deserves gratitude and praise for a powerful narrative that asked this question: can the focus of modern medicine change? The implication is that if it does not its very soul is in jeopardy. In the light of my own experience the reader will understand why this plea resonated so deeply and profoundly in my soul.

To return to the anecdotal –  I remember during my time teaching at the Birmingham University medical school exploring with groups of students how far their ethical teaching and curriculum help them make decisions. Since those teaching days a great deal of attention has been given to public and academic debate about medical and bioethical issues. Those groups of students and young doctors taught me that they relied as much on intuition (I need to respond quickly and so do what I feel is right) as much as the body of knowledge oclassified as medical ethics.  Sloane takes one step back from the issue of the relationship between theory and practice and asks his reader to explore the nature of medicine and its role in human community.

The  nine chapters seek to put theology to work by offering a framework of Christian philosophical and theological thinking which might enable us to understand the nature and purposes of medicine and its role in a Christian understanding of human society.

So what does the book do?

First it presents a description of the contexts in which medicine is practiced in the early 21st century, identifying key problems and challenges that medicine must address. It then turns to issues in contemporary bioethics, demonstrating how the debate is rooted in conflicting visions of the nature of medicine (and so human existence). This leads to a discussion of some of the philosophical and theological resources currently available for those who would reflect ‘Christianly’ on medicine.

The core of the text attempts to articulate a Christian view of medicine as a moral practice which might be shaped by a Christian social vision and a number of key theological commitments.

The book concludes with some powerful pedagogical reflections (pp 178 ff ). First Sloane asks that if it is the case that medicine is an expression of a community solidarity with those whose vulnerability is exposed and if its goal is to express appropriate forms of care for the frail then we should rethink how we train doctors. In terms of medical epistemology, the internal goods of medicine and their relationship to other goals always threaten to distort or corrupt the practice of medicine. And in this we all need to take responsibility in relation to our wildly unrealistic expectations about what medicine can deliver.

A final theme, and possibly to be developed in his future writing lies, in the embodied nature of medicine. If we are ‘knowing bodies’ then doctors in partnership with their patients need to understand what is going on in the body: to listen carefully to the story of our bodies as to discern both what matters and how we might embrace frailty and nurture wholeness. The undue focus on investigations, the obsession with tasks and performance  both detract from the human element of the clinical encounter and (in Sloane’s view) wrongly understand the nature and goals of medical knowledge. This reflects an ongoing interest in a number of public bodies in the UK concerning the medical humanities and how these might be built into a more holistic approach of nurturing both medicine and the medical profession. Medical paternalism and powerful self protecting  professionalism needs to be challenged if the world of medicine is to be re-engaged and transformed. However this will require from us that we reconfigure what medicine can and cannot do for us.

This is a stimulating and enriching book. It is inevitably stronger on theory rather than practice but its call and argument is clear and convincing.It deserves to be picked up and developed by those of us who seek wholeness and all those professional groups that are tasked to care for those in need.

I hope to use some of this work in our future learning at Sarum College (www.sarum.ac.uk ) and particularly in the Sarum Centre for Human Flourishing.

 

James Woodward

Principal Sarum College

9781849054973[1]

Jessica Kingsley Publishers 2015; 280 pages; £19.99 ISBN 9781849054973

I review this book (the second week of July 2016) when two particular conversations were at the forefront of my mind. The first was the smooth transition between Cameron and May into 10 Downing Street and the office of Prime Minister. What followed was much speculation about who would hold some of the key offices of state including the office of health secretary. This speculation triggered a great deal of social media interest in the health service and especially some of the frustrations on the part of healthcare professionals particularly about the culture of change, resource and the over politicisation   of care in the NHS.

The second was a conversation about church growth and how we face the reality of diminishing numbers (and perhaps even confidence) in religion today. Both of these areas of thought might take up many pages of a blog but they certainly shaped by appreciation and admiration of this book of 16 essays that explore issues of how we think about and deliver healthcare chaplaincy.

Let me give you an outline of book. Its editors are leading academics in the area of health, practical theology and chaplaincy studies. In particular Andrew Todd’s work in the Cardiff Centre the Chaplaincy Studies deserves particular respect and admiration for its quality and professionalism.

The book is divided into four parts. The first part (constructing spiritual care) explores models of spiritual care; discourses of spiritual health care; models of healthcare chaplaincy and how chaplains use the Bible as interpreters in their work. The second part (negotiating spiritual care in public) explores the value of spiritual care and the need for negotiation and persuasion for its value in the public domain; some legal and policy frameworks for spiritual care; the work of chaplaincy in a multi-faith and secular environment and the particular relationship between chaplaincy and nursing.

The third part (researching spiritual care) offers an overview of methodologies for research in spiritual care; deals with the particularities of research health context; looks at the significance of volunteers in the culture of the NHS and offers a particular process of observing, recording and analysing spiritual care in an acute setting. Finally part four discusses the practice of the spiritual care in the context of suffering; opens up the much vexed question of assisted suicide; digs deep into the care of those living with mild cognitive impairment and offers experience of spiritual care in a children’s hospice.

The editors provide a comprehensive subject and author index and throughout the work there is a careful structure and system of referencing. While it is almost impossible to provide consistency across a wide range of essays and chapters the editors have succeeded in providing a very useful and significant addition to the literature in this field.

So this leads to my to opening areas of discussion. The first is developed a little in this book that needs further work. How do we deal with our expectations around care and our experience of care in the NHS? With it’s ever developing technology and increased skill and professionalism is the health service nurturing a culture within which people feel valued, understood and responded to? Put more simply – is the health service looking after people as well as it might ? Are there  some indications that despite our increased investment in resources people feel dissatisfied with the quality of engagement, support and compassion. Perhaps it is inconceivable and impossible to deliver but should we always try to start with the patient and the patient voice when developing a narrative for care? This is of course where chaplaincy is at its absolute strongest – it engagement, understanding and transformative presence in and through the attentive and caring relationship. Chaplaincy needs to beware  of its tendency to detach itself from the patient experience in the ever understandable necessity for organisational security and affirmation. The power is  with the patient! Professionalism is always grounded in the narrative of the experience of illness.

The second and I admit a less obvious area of church growth is yet another area where chaplaincy may be critical in turning around the way in which individuals and groups access the spiritual (hence my organising title).Chaplains meet people where they are and on their terms within their life experience. This is an opportunity to illuminate, enlarge and connect with the spiritual – especially in times of crisis and difficulty. It may be that chaplains are altogether best placed to keep the rumour of Angels alive through their presence and engagement. Investment in agency and chaplaincy should be a key element to the churches strategy for recovering the pastoral as part of deepening spiritual connectivity and faith.

This is a very good book and I commend it as a stimulating, resourceful and informed collection of essays on care.

James Woodward

Principal Sarum College

 

 

 

 

I am gathering together a small collection of books all published by Jessica Kingsley who is certainly one of the most innovative and ground-breaking publishers working in this       field.

Their list covering a range of books on dementia is well worth examining.  ( http://www.jkp.com )

These first two books handle at first hand the experience of living with dementia

People with Dementia Speak out

Lucy Whitman  2015 JKP 304 pages £14.99

and

Whatever the hell happened to my brain? Living beyond dementia.

Kate Swaffer 2016 JKP 391 pages £13.99

Whitman has gathered together 23 people from diverse backgrounds and in a well-organised book there is a deeply moving range of accounts of experiences of living with dementia. There is honesty and a searing articulation of frustration and fear. The cumulative effect of the devastating impact of memory loss on people’s lives is both moving and disturbing. The individual accounts of how identity is broken down and reframed service as a reminder of the life changing effects of dementia on people and their families.

My only regret about this text is that it probably will not receive as wide a readership as it might. We need surely to embrace this devastating condition as belonging to the whole community as we attempt to work out what makes the human flourishing as we hold all those who are vulnerable. It demands that we refashion what it might mean to be human and limited and bounded by our bodies and brains. In other words all of us can learn about how to live well as we attend to those who struggle to maintain well-being. There is a quality, integrity and life to these accounts which we can all learn from.

I should also add that there is a comprehensive and helpful range of resources and further reading at the back of the book along with a clear glossary. Let Prof Graham Stokes have the final word (global director of dementia care at BUPA)

“for some who read this book the experience will be an epiphany. Therefore might it be possible that what we do to help a person with dementia, in some way to be kind to them, is diminished only by the limits we place on our ambition, imagination and humanity’ ( page 259).

Kate Swaffer  was 49 years old when she was diagnosed with dementia. In this book, she
describes  her experiences of living with dementia, exploring the effects of memory difficulties, loss of independence, leaving long-term employment, the impact on her teenage sons, and the enormous impact of the dementia diagnosis on her sense of self.

There is a profoundly challenging honesty about the experience and especially the stigma associated with dementia and the many inadequacies in care and support. Kate wants to change the way we both think about and respond to dementia and offers some radical suggestions about how a community might hold all those who because of dementia are taken into the difficult area of needing to develop a new and meaningful personal identity.
Let Kate have the final word here: and as I share it I hope to that this book will be very widely read.

 

 

These two books remind us that as well as listening to the experiences of people living with dementia there are significant political, economic and social challenges to improving and developing care.

I picked up the first book (Qigong for well-being in dementia and ageing by Stephen Rath JKP 2015 168 pages £15.99 ) with some ambivalence and curiosity but soon moved beyond misunderstanding and prejudice to see how traditional Chinese medicine can support emotional and physical well-being in people with dementia. This book presents a set of exercises and breathing techniques which I tried and found them to be very restorative! The book is carefully illustrated and deserves some careful attention amidst our reductionist and medicalized  approach to care.

Person Centred Dementia Care (by Dawn Brooker and Isabel Latham JKP 2015 224pages £17.99) has very quickly established itself as a leading textbook in guiding healthcare professionals to improve care from diagnosis to the end of life for people with dementia. It embraces a range of contexts and offers guidelines for practice. It is well written, carefully organised and accessible for a busy healthcare professional. The text is clearly earthed in reflective practice and draws upon up-to-date research and development in this area.

Although at first glance a technical book with a limited market the authors open up a refreshingly broad grasp of an individual living with dementia and each of the chapters lead us into a richer understanding of what person centred care should look like. There are many places in my own experience where I should like to take this book and ask that it be used to change care.

 

James Woodward

Principal Sarum College

 

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Spiritual Accompaniment and Counselling: Journeying with psyche and soul

Edited by Peter Masden Gubi 

Jessica Kingsley Publishers 2015  paperback 192 pages  £16.99

Here at Sarum College ( www.sarum.ac.uk )  our two year certificate in spiritual direction is very popular to a wide variety of individuals who wish to build upon, reflect and improve their practice. In a world dominated by individualism, consumerism and materialism all of us need places and people we can draw upon for support, friendship and direction. This is particularly the case when we face crossroads, choices or crises.

As I write (10th July 2016) the General Synod of the Church of England has gone into private session to continue its deliberations about how far and to what extent it can embrace the agenda of inclusivity around gender and sexuality. While there are strong feelings on all sides there are far too many individuals and groups who regard Christianity with suspicion and even would want to place a significant health warning to its ability to embrace the ever wider and sometimes more complex horizons of people’s identity and experience. One might argue that there is a great deal that is lost in this political marginalisation. Put another way – who do we turn to when life becomes difficult and perplexing? The danger for the church is that its spiritual wisdom is overlooked in favour of therapy and therapeutic practice.

This volume of essays, nine in all, attempts very successfully to explore what it might be like to attune to the spiritual processes  of other people especially in the area of crisis, abuse, grief and pain. The essays intelligently explore the lifespan and how forgiveness and wholeness might be embedded into practice. The Christian tradition has a great deal to learn from the way in which psychotherapy and counselling seek to embrace a spiritual dimension. One might argue that if one wants to look for creativity and life in matters of the soul and spirit then it is to the liminal edges that one might look. These essays represent the very best of that creative liminal margin.

These are carefully written and skilfully edited essays. They deal with relationship, forgiveness, spiritual crisis, pain, suffering, lifespan development, grief and spiritual abuse. There is an excellent essay by Lynette Harborne on the importance of supervision and as ever with Jessica Kingsley books the book is attractively printed with a clear index and bibliography. Clarity and skilfulness in presenting complex material is one of this book’s key strengths.

Gubi writes in his introduction that this book is written to heighten practitioners awareness of the spiritual dimension in listening (page 22) – what follows in the subsequent  170 pages will stimulate, illuminate and expand horizons in such a way that we might all be challenged to work for human flourishing and societal well-being.

James Woodward

Principal Sarum College

 

 

9781785920363

Making the case for the relevance of pastoral care today, this book explores the role of pastoral care through the prism of music. Using musical analogies, the author provides a new way of understanding and practising pastoral care, grounded in practical theology. Challenging overemphasis on mission, he shows that pastoral care remains essential to the life of the church, especially when engaging with extreme situations such as dying, suffering or war, and considers the role of pastoral carers in the specific pastoral encounter and in the life of the church in general.

Here is my commendation

‘We live in interesting and complex times. Modernity has given us choice and freedom to shape our destiny in many, often competing, directions. The Church is only one place where the shape of human experience is opened up and attended to in our struggle to flourish. This context provides us an opportunity to reimagine how theology and its practice might contribute to well-being. Performing Pastoral Care is a serious and substantial contribution to our understanding of this practice as it calls us all to rediscover our pastoral heart with imagination and creativity. Interdisciplinary in its focus – music and theology both blend and dialogue to provide a stimulating, intelligent and well-organised narrative. The reader is asked to look outwards through a number of lenses and using a variety of methods to engage with the paradoxes and ambiguities of human experience. It succeeds in providing a significant contribution to the literature around music and pastoral theology and its carefully organised chapters offer practical tools for the resourcing of the shapes of pastoral activity and performance. I hope that it will be widely used as part of the ongoing conversation about what might need to be transformed in and through us as we seek to reach out and serve our world and its peoples. I shall be adding it to core reading lists for my students.’
– Dr James Woodward, Principal of Sarum College

 

 

REMEMBERING JIM BIRREN

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One of the towering figures in gerontology has died : James E. Birren, founding

Director of the Andrus Gerontology Center, at the University of Southern California,

died at the age of 97.  His achievements were extraordinary   Foremost among these,

is creation of the Andrus Gerontology Center at USC, as well as the Leonard Davis

School of Gerontology.  His books and other publications are extensive, and many

distinguished gerontologists have been  nurtured by Jim Birren.  To get just a glimpse of

these, visit:

http://gero.usc.edu/2016/01/15/remembering-james-e-birren/

 

Jim Birren, then in his late sixties, was only getting started. His 30-year

retirement would witness pioneering work in areas far removed from the behavioral

psychology in which he began his own academic work in the 1940s.  Like a small

number of distinguished psychologists (e.g., Jerome Bruner and Leon Festinger),

Birren would “go boldly where no one has gone before” toward the in-depth

exploration of wisdom, autobiography, and the search for meaning.  His generativity

didn’t stop with his retirement nor will it stop now that he has left our world.  Instead,

we are all inheritors of the vision of “positive aging” that he has left behind.

This is the book that has been hugely influential in my own thinking about old age

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For more on guided autobiography, visit:

http://www.guidedautobiography.com/

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Chaplaincy Ministry and the Mission of the Church

Victoria Slater, SCM Press 2015, 160 pages, pbk, no price marked, ISBN 978 0 334 05315 6

 

There are three distinctive and attractive characteristics of this book. The first is the authors’ skilful ability to open up her research in an accessible and stimulating way. The second is the quality of theological reflection based, thirdly, in the reflective practice of her experience as a healthcare chaplain.

 

Six chapters work together towards a conclusion in responding two questions: ‘What is chaplaincy?’ and ‘What is the significance of chaplaincy within the ministry and mission of the church?’ These questions are discussed within the context of the extensive social reach of chaplaincy and in its ability to connect with a range of people beyond the traditional reach of the church. We are reminded of the growth and development of chaplaincy in recent years but also of the need for ongoing theological reflection on practice. Slater shows how critical theological reflection is for the illuminating of our wisdom about mission, the nature of God’s involvement in the world and how discipleship and vocation might be nurtured. This narrative takes seriously the significant and seemingly irreversible decline in numbers across church congregations but also challenges some of the marginalisation of chaplaincy present within church structures and discourse.

Chapter 1 offers some historical perspective in the context of our pluralistic and ever-changing culture. Chapter 2 models a practical theological approach with a careful use of experience through three case studies. It deals with role, relationship, self understanding and practice within a theological framework. Chapter 3 looks at the relationship between chaplaincy and mission opening up some of the tensions that are present in the ways in which we value some ministry above others. Chapter 4 deals with the identity of chaplaincy, necessary Slater makes clear for an understanding of good practice. Throughout there is an articulation of the distinctiveness of chaplaincy. With this in mind chapter 5 offers some challenges to the institutional church and the range of ecclesiologies always present when we explore the nature of mission. Chapter 6 keeps an eye on the future as it offers some guidance and frameworks within which to develop practice. It aspires to wanting to support further chaplaincy research and indeed encourage innovation through the setting up of new chaplaincy roles. Dialogue, presence, openness, reflection, faithfulness and transformation are key words fleshed out in and through the shape of the six chapters.

This reviewer shares the authors conviction that part of the future of church will lie in its moving beyond traditional models and boundaries into an engagement that meets and connects with people where they are and through what they are experiencing. This book, therefore, deserves to be used by all those who might want to explore ways in which we might be faithful to the gospel and share its grace. Our structures need this voice to inform this urgent task of reflection on the future shape of being church.

JWW Sarum College

http://www.sarum.ac.uk

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