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It has taken me some time to digest this book and so commend it to others for both reflection and action.

Laurie Green has established a well-deserved reputation for his ministry amongst the poor and voiceless but also for his ability to think theologically. The book took me backwards into my story but also catapulted me forwards ainto imagining what kind of society we are building.   Within the tension between history and the future lies the key element in Greens persuasive, compelling and radical arguments in these nine chapters. I shall say more about that in a moment but one point at the outset is worth making. There is a quality to this narrative that is borne out of a life well lived and a text written in ‘retirement’ which leads me to feel that older people reflecting on their experience should have a much more honoured place and voice in our spiritual economy. There is some maturation and deep wisdom present in the way in which Green listens to the cry of the poor. Valuing Age might also mean moving older people voices into the forefront of social action.

Why should such a text take me backwards? Well, in the mid-1980s and after theological education in London and Cambridge I was ordained in the Diocese of Durham to serve my curacy in Consett. You may remember that it one stage in our economic history (1985)Winchester was regarded as the wealthiest place in the country and Consett the poorest – this was  the case because of the closure of the steelworks and the catastrophic consequences for thousands of workers across the area. By the time I had arrived many of the more entrepreneurial families had taken their redundancy money and relocated either in different parts of the country or across the north-east in new jobs. Some had resolutely stayed in the town that they were born in and felt inextricably connected with and thereby presenting a real picture of economic, social, cultural and spiritual poverty. It was a cold and bleak place and a living or dying reminder of the results of political policy that devastated huge sections of the industrial north. An example, quite simply, of the power and persuasiveness of economics over individuals and families. Money talks – people should listen!

Green reflects on this and takes us inside many stories of hardship and dismay. Green acts as an advocate for the forgotten residents of Britain’s housing estates and their devaluing marginalisation. At the centre of all of this are the experience and stories of poor people.

And what of the future trajectory? The advantage of having this book on my desk for so long before I dispatch it to the library for wider readership and use is that it has seen and experienced the decision of this country to remove itself as a member of the European Union. We live in uncertain times and it remains to be seen which parts of the community will bear the inevitable (perhaps?) consequences of our post Brexit world. I suspect that it will be the poor again who will pay some of the price of the economic and social uncertainty that faces this democratic position. We are faced again with Greens plea outlined in chapter 5 about how we challenge the present culture by seeking to lead a kingdom orientated life together. This book demands that we explore what are kingdom values might look like and how we challenge those things that contradict and undermine equality, justice, decency, faithfulness and goodness.

This book draws upon what Laurie Green has learnt – in a kind of long meditation on the beatitude ‘bless are you who are poor’. It stands in a noble tradition of Anglican antagonists who long to develop a new tradition that seeks to  learn from the poor and so offer a new theology that might enable the  merging our past and our future into a more sustainable present. It is nothing short of a tragedy that we continue to tolerate such significant levels of poverty in our country today. While  there are churches involved in social action and care of the marginalised and vulnerable we continue to live with an economic system that forces some people to live in the most appalling conditions. Not to keep on articulating the contradictions and paradoxes of this reality is, to return to an earlier analogy, to move Greens book from desk to library. Put another : way what is to be done now? Are we listening to the voices of the Poor? Are they to be our teachers? Perhaps it is the case that as long as we ignore these complex realities we ourselves become poorer as individuals and as communities.

Green is at his most creative in showing his reader how to be confident in theology and how, above all, to put it to work. It should become a core textbook for all those interested in enabling individuals and groups to become reflective practitioners.

James Woodward

Sarum College

 

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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

 

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Spiritual Care in Practice : Case studies in Healthcare Chaplaincy

Edited by George Fitchett and Steve Nolan

Paperback 2015, 320pp, ISBN: 978-1-84905-976-3

It seems as if English bank holiday weekends bring out the some of the more gloomy of stories in our newspapers. I imagine journalists finishing their holidays in France have left some of these pieces for their editors to fill in copy as and when needed. Whatever the case August 2016 has brought with it some profoundly disturbing reflections on the significant financial crises that face our National Health Service. Faced with the economic realities of overspend (where the causes seem less than clear) clinicians and managers are faced with some difficult choices to make in relation to priorities in health care spending.

It is against this background that George Fitchett (working out of Chicago) and my colleague Steve Nolan offer this collection of case studies and critical reflections that speak very lucidly about what healthcare chaplains do from day to day in and through their presence and engagement in this ministry.

Take a look at the cover above and it will give you some insight into two or three of the key characteristics of chaplaincy as embodied by Steve Nolan who is pictured there. There is a quality of listening and engagement. It is done together and across professional boundaries. Look at Nolan’s hand – it appears to indicate some assertion, perhaps responding to a disagreement within that small group but with a gentle but determined sense of direction. I am guessing that the conversation focuses upon the patient and their care.

Whatever the picture conveys to you – inside the book is a treasure chest of experience. None of the authors are unafraid to open themselves up to critical self reflection. There is careful attention to experience. All of this is evaluated with responses from professionals within chaplaincy, psychology, psychiatry and nursing as together the team explores the central focus of the importance of spiritual care for healthcare. This element within the work of human flourishing is an absolute necessity and certainly not a luxury!

The book is carefully edited and I should be wanting to use some of it in facilitating learning around the nature of the pastoral and Pastoral engagement here at Sarum College. Again and again the chapters remind the reader of the vital role of story and the necessity for imagination if there is to be some measure of transformation and flourishing in both the practice and experience  of care. This is certainly Pastoral and practical theology at its very best.

 

Here is some further information from the book:
“From a 16-year-old with a belief that God would enable a miraculous recovery from paralysis, to an African man with a history of psychosis and depression whose cultural belief in witches complicated his treatment, to a dying Jewish man, aggressive and isolated due to his traumatic life experiences, each case includes insight into the patient’s needs and chaplain’s perspectives, discussion of spiritual assessments and spiritual care interventions, and accounts of significant encounters and dialogues.

The nine paediatric, psychiatric and palliative case studies and reflections in this ground-breaking book will enable chaplains to critically reflect on the spiritual care they provide and communicate their work more effectively, help healthcare professionals develop a clearer understanding of the care chaplains deliver, and provide an informed perspective for those who develop policy around spiritual care and need to make the case for chaplaincy services. ”

James Woodward

Sarum College

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Here at Sarum College our aspirational strapline is Learning to nourish the human spirit ( see something of our work  at http://www.sarum.ac.uk) and as I complete the first year of my presence, engagement and leadership of the College I have been much intrigued about what it is that enables such nourishment and learning to take place. Over the course of August we have attracted many varied individuals and groups into the College. At the moment we are busy recruiting to our MA programmes having just published the new academic course brochure. This is the context within which I offer this short review.

It is impossible for any of us to sit still and this book Transformative Imagery ( Ed by Leslie Davenport JKP £19.99 ISBN 9781849057424) happily landed on my desk at the right time for reflection and review. We have just embarked upon a re-organisation of  the colleges learning into a number of centres and  have established the Centre for Human Flourishing. In conversation with my skilled and creative colleagues on Friday we began to explore how best to communicate and convey of vision for connection and gathering with those who come here. We want to do this in such a way that can dig deeper into our human condition and what it might mean to work together for wholeness through personal and social change.

In the context of this conversation  I was glad to be challenged to look again at the images and pictures we use when we attempt to try to capture some of that work together.

The expertise and professional skill of Leslie Davenport is demonstrated through this book and its careful organisation and intelligent accessibility. It covers an extraordinary amount of ground. Part one opens up the foundations of guided imagery through four chapters that look at the history and overview of the use of guided imagery. Part two offers four further chapters which examine imagery for health and healing. Part three explores the subject area in relation to depth psychology and Part four offers five chapters that discuss the nature of spiritual images in wisdom traditions. The final part gathers together seven chapters challenging the reader and practitioner to apply some of this good practice and thinking in and through their work. The book is clearly printed and offers comprehensive resources. It is not surprising therefore that Davenport has succeeded in pioneering the adoption of guided imagery into the mainstream practice of medicine and psychotherapy.

Much of our learning is diminished through a dualistic approach that emphasises the cognitive, the physical and the tasks and functions of relating and living at the expense of meaning, mystery and transformation. I have an intuition that many individuals and groups who seek places of learning beyond school or university are longing for something more beyond these materialistic and capitalist models of controlling truth. The chapters of this book demonstrate the extraordinary capacity of human beings for imagination – for moving beyond the immediate and obvious into a deeper place of connectivity and fulfilment.

In the formation of lifelong learners who will engage in living with an emotional intelligence so sadly lacking in many areas of our society this book is really important. However written as it is out of the American context and experience some of it will not be easy to translate into northern European structures and cultures. This reviewer, nonetheless, is determined to use this framework of learning and expertise to shape the work of the Sarum centre for human flourishing. For that inspiration and encouragement this review expresses admiration and gratitude for this volume of essays.

 

James Woodward

Principal Sarum College

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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

 

 

 

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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

 

 

A Learning Guide by Elizabeth MacKinlay and Corrine Trevitt

Jessica Kingsley Publishers 2015

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I have recently experienced the hospitalisation of a close relative and, once again, have been surprised by the culture of care in our Hospitals. There is a kind of functionalism that serves to depersonalise an individual, their family and their well-being. This was highlighted with an inadequate discharge note which is full of inaccuracies. Even in this task focused culture someone took little care over getting the facts of this individuals life right.

Human beings are storytellers. Our lives are full of them – our lives are a story to be explored, reflected upon and communicated. Of course one of the fears that many of us have is that if our memory fades somehow we will become so forgetful that we hardly know who we are. This is particularly complex when we look beyond the physical or indeed the factual to the deeper and profounder shape of our personhood as spiritual beings. In other words the spiritual is so very often a undeveloped dimension of our living and loving.

MacKinlay and Trevitt have produced a map with  insightful, clear, comprehensible instructions that will help facilitate spiritual reminiscence. This volume emerges out of a research project that took place in care communities in Sydney and Canberra. Wherever possible the authors seek to avoid technical language which gets in the way of listening and speaking to older people who have dementia. Although a relatively short volume the breadth and depth of experience of dementia is self obvious through these carefully organised chapters.

This learning guide falls into two parts. The first opens up the reader to some learning about what it might mean to work with people who have dementia. Spiritual care, dementia and communication are explained in chapters 1,2 and 3. Reminiscence work, spiritual reminiscence and how this take shape in the process of small groups is explored in chapters 4, 5 and 6.

Part two offers a six week guide to a weekly session which explores particular topics in spiritual  reminiscence. These are life meaning; relationships, isolation and connecting; hopes,fears and worries; growing old and transcendence; spiritual and religious beliefs and practices.

Two appendices with references for further reading and an index complete this mapping out of the journey of reminiscence therapy.

This reviewer has not yet had the opportunity to use some of this material but certainly intends to do so as a way into exploring the spirituality of ageing with ministerial students, clergy and others engaged in pastoral care. There is a strong sense from using some of the material for myself that the process works creatively and practically. This is very important because so often there is a widespread acknowledgement of the importance of the spiritual but very little help in applying what that might mean in practice when applied to people’s experience and lives.

I would wish, of course, to take these exercises into that busy acute ward where amidst the activity there was so little attention to the individual. My fear is that so much will need to change in how we think and deliver healthcare so that it becomes more whole person and person focused. Our storytelling may need to get political as we agitate for change!

In this respect this learning guide not only offers us practical help but it also suggests that we need to re-vision the way we practice care with older people.

I hope is widely read and used.

James Woodward

Sarum College Salisbury

 

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