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Three Secrets of Spiritual Care: LISTEN! LISTEN! LISTEN!

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Chaplain blog: Reverend David Southall explains how listening can be more powerful than you think

If you follow me on Twitter @revdavesouthall then you  might have seen this Tweet: “Three Secret Steps to Giving Spiritual Care: Listen! Listen! Listen!”

It’s not meant to be trite, but I can understand how it feels like that to some. After all listening is so passive- especially when you have got a hundred and one other things to DO.

But if spiritual care is about “being there”, then you will have noticed, as you listen, that patients disclose things to those who they can trust and who they sense will understand.

And, make no mistake, the words patients use are important. So when the patient says: “It’s been a real rollercoaster ride” they are describing their present state by the use of a powerful metaphor. Or when they claim: “I’m like a boat at the mercy of the ocean,” we can get, in picture form, an expression of their spiritual and emotional state.

In fact, the more you look for these metaphors, the more you hear them. “I’m all washed up”; “like a rag doll”; “at the end of my tether”; “spiralling into a black hole” - all things patients have said to me in the space of one day.

So what?  How does this help with spiritual and emotional care?

Well, simply put, allowing people to give expression to the depth of their experience can actually change their situation and create new realities.

Don’t believe me? Well I even have a model for it (Oh how we love those models) – but before that: A STORY!

Fred, had just been given the news about the terminal nature of his illness, and was understandably struggling to come to terms with the fact that he had weeks rather than months or years to live. He was sixty-six years old and lived with his wife of 45 years and their disabled son of 35. He had been planning retirement and had already booked holidays abroad. I was asked to see him because of the level of spiritual distress that the Palliative Care Team saw him experiencing. and all I asked was if he’d like to tell me his story. And then I listened.

“I used to work in the steel industry in the Black Country. Hard graft. And we were so proud of the stuff we produced. You were in those days. I remember once that a German firm sent a steel tube to us as thin as a hair on your head. And our technicians looked at it, and did their bit. And then they sent it back to this German firm, this thin tube, as thin as a hair. Sent it back with an even thinner tube inside it that they had made. That showed ‘em. [Silence]… But steel’s all gone now … closed down … packed up … [Silence] … just…”

He didn’t need to finish the sentence: “just like me” is what he was about to say, linking demise of the Black Country Steel Industry in parallel with his own situation.

I went back to see Fred numerous times, and somehow this story came up again and again; but each time with a different spin. On the last time I saw him before discharge he seemed to have reached some resolution of his situation. He had thought of how, as the steel industry declined in his area, other things grew up in its place which were more conducive to well-being than the dirty “graft” of past industries. A situation which led to a better quality of life for others. And somehow, it seemed to me that he had linked this to his situation of terminal cancer; and had begun to see new meanings, new possibilities and new ways of seeing the world.

Far fetched? Well possibly, but a working model of this is given by H. L. Gaydos (Understanding personal narratives: an approach to practice. J Adv Nurs 2004: 49(3): 254-259).

I haven’t space to go into the details here but you can find them in the article. However, simply put, the idea is that by engaging with patients and sharing their space, words are spoken which can create new ways of seeing their situations.

I have written more about this here:; but really it can all be summed up in my simple Twitter mantra: “Three Secret Steps to Giving Spiritual Care: Listen! Listen! Listen!”

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