Interacting with patients of a different faith: the personal reflection of a Buddhist chaplain.

How can a spiritual care provider interact on a meaningful level with patients whose faith beliefs are so radically different from his or her own? How can we provide spiritual comfort to families who are using religious resources that are so far outside the chaplain's theological area of expertise? These are questions that touch not only on the foundations of my own personal faith, but also on the very principle of providing spiritual care to another.

My spiritual practice has awakened in me a profound sense of gratitude for all that I have been able to witness and receive. I became a chaplain to begin to 'repay' some of the abundance with which I had been blessed.

I formalized and focused my commitment by receiving the refuge vows from my teacher, Norhla Rinpoche. Instead of seeking solace in wealth, security, or safety, I chose to seek my refuge in the deeper meaning found in Buddha's example as shown by the deepest truths, or Dharma; that is to say that I find refuge in every example of authentic truth, awakening, and community that I find--be they Buddhist, Christian, Pagan or what have you. In other words, enlightenment is to be found in every mindful moment, Dharma rings true no matter the language, and compassionate community transcends denomination.

Part of the initial attraction of Buddhism for me was that such loose interpretations are far from heretical--indeed, self-definition is even encouraged.* With such a fluid grounding, I eventually discovered professionally that I was able to participate in the spiritual truths that my patients and families found in an amazing variety of religious forms, or even in the absence of formal religiosity, without compromising my own theological background. This goes beyond merely observing and validating another's viewpoint. I have found that in the intimacy of the pastoral care relationship, simply understanding and embracing diversity is not enough. True pluralism requires that both parties in a relationship allow themselves to be nurtured and transformed in the interaction. This is my understanding of the expectations of the profession as well as my own spiritual beliefs.

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My path and my training have consistently led me to work with patients and families in the midst of transition and loss. I am a palliative care chaplain with hospice training, working mostly with life-limiting or terminal illness. As many palliative care professionals of all disciplines will tell you, working with people at the end of life not only stimulates the growth of one's own faith, it requires it. When faced with the inevitability of death, patients, families, staff, and even the community are forced to seek a definition of health that transcends empirical understanding. In my experience, every transition we weather carries with it this same opportunity, but only death requires it.

In the face of existential responsibilities of this magnitude, very few patients or families arrive in my care with their spirituality fixed and firm. The larger questions of life cannot be answered with static skills or understanding but, rather, require a dynamic participation. Religious forms or concepts that no longer apply to the present situations have to be set aside or abandoned, and unanswered questions become increasingly more urgent. Patients wrestling with their mortality display an incredible array of spiritual resources and strengths, but few have experience applying them directly to their mortality. Knowing the patient's denomination or general faith background will lend little or no insight into the patient's progress in adapting and applying their deepest beliefs to their situation.

Concepts such as compassion, gratitude, peace, surrender, belonging, and especially love transcend any religious boundaries. Finding these blessings in the midst of sorrow, loss, isolation, despair, and death is in and of itself an extremely spiritual experience. Yet the words and the concepts they imply cannot begin to capture the awesome power of living these things. The responsibility of a spiritual care provider is not to shape or influence this journey, but simply to recognize its profound power. By naming the authentic spiritual presence found in any moment of relationship, the patient's previously held spiritual beliefs are validated by the chaplain's symbolic spiritual authority, regardless of denomination. The only things that change are the words and concepts that the patient uses to communicate this awareness.

I recall one patient who reacted to hearing his terminal diagnosis by "curling up in a spiritual ball trying to wait through all the blows that were landing." He described being in that place like being in a dark womb wherein he found a singular luminous presence. Following "the light of that presence" led him back into the world again with a remarkable amount of humor, grace, and acceptance. As I shared with him my admiration and gratitude for being able to witness his journey, he in turn shared his admiration and gratitude for my ability to appreciate it. What happened next is difficult to describe, but our mutual respect for the profound power we saw reflected in one another led to a sort of feedback loop that ended with both of us deeply moved, weeping, and almost literally glowing.

The words we used that evening were neither religious, nor even all that profound, but the experience was transformative for both of us. Religion is indeed an important part of our culture, history, and beliefs, but in the moment of relationship, in the very present reality of dealing with difficult issues, religious concepts are simply the tools we use to experience life or reality to its fullest potential. It is all too easy to mistake the tools for the experience itself. A Zen Buddhist friend of mine calls this "trying to eat the menu," or as Joseph Goldstein recently wrote, "religious or philosophical concepts are only descriptions of experience not the experience itself." (1)

As a chaplain, I journey with my patients to the very depths of meaning in their lives and then invite them to apply that meaning to the present moment. Ultimately, the healing comes in companioning them on this journey, not championing any one form of dogma over another. What authority and gifts I offer are not as a Buddhist but rather as a human being with deeply held beliefs. I believe that enlightenment, waking up to increasing depths of spiritual truth, is possible in the midst of trauma and grief. I believe that finding enlightenment in dark times is not only healing but transformative. When faced with the power of what this kind of spiritual growth can do, I frankly do not care what words you choose to describe it; I am comfortable lifting prayers in whatever language is best understood by my audience.

In my tradition, there are levels of generosity beginning with material gifts, then the gift of fearless presence, and culminating in the gift of Dharma, or Truth. What I aspire to give to the world in repayment for all it continues to give me is simply that ... Truth. What I am beginning to understand is that the truth is not a statement of religious fact but rather a level of participation in what is before us all the time. To stand with another and simply compassionately speak to the depths of what is present, even if it that is death, is to embody the truth of every religion.

The chaplain's job as a religious person is to develop his or her own faith to the point where they can relax or surrender their beliefs enough to join another person in theirs. The patient's role is to apply their historical beliefs to a new and often difficult situation or to create new beliefs. Ultimately, it is the depth of relationship or synchronicity between these two roles that determines the depth of healing that will occur, not the homogeneity of their beliefs.

Reference

1. Goldstein J. One Dharma. San Francisco, Harper Collins, 2002, p 5.

Tim Ford, MA, MS, CT

From the Department of Pastoral Care, Virginia Commonwealth University, Richmond, VA.

Reprint requests to Tim Ford, VCU Medical Center, Main Hospital, 2nd Floor, RM 2-210, 401 North 12th Street, PO Box 980664, Richmond, VA 23298. Email: [e-mail]

*Western Buddhists often quote the Kalama Sutra in which Buddha tells an audience to "Rely not on the teacher/person, but on the teaching. Rely not on the words of the teaching, but on the spirit of the words. Rely not on theory, but on experience ... after observation and analysis, when you find that anything agrees with reason and is conducive to the good and the benefit of one and all, then accept it and live up to it."