The Oates Journal (ISSN: 1098-1446) is a publication of the Wayne E. Oates Institute addressing issues related to spirituality, ethics, and healing from the perspective of pastoral care and counseling.

An autoethnographical account of a psychiatric patient’s experience and its relevance to chaplains.

When researchers do autoethnography, they retrospectively and selectively write about epiphanies that stem from, or are made possible by, being part of a culture and/or by possessing a particular cultural identity. (Ellis et al, 2011)

It was a particularly stressful time that summer of 1998. My mother had just died and my only sister had been told her breast cancer was back and she didn’t have long to live.

A large screen image of the planet earth rising over the moon's horizon greeted me as I walked into a Southern Illinois University classroom to begin the winter term of 1970. At the time it was still a new image for us; a fresh look at the evidence of a new cosmology. It was the beginning of a new decade, which we greeted with a sense of world changing optimism in the face of a world divided by war, racial and ethnic hatred, and economic inequities. We were part of a design class focused on envisioning new solutions to world problems.

A Brief Case Study

Joe, 26, is a Staff Sergeant in the United States Army having joined the military at the age of 19. Three months ago he returned home from his second deployment overseas within a four year period of time. Most recently he served in Afghanistan as an infantry soldier with his first tour being in Iraq. During his seven year career, Joe has been transferred to three bases. Joe has been married for the last six years to his high school sweetheart and together they have two children ages four and two. Joe has been an excellent father and an attentive husband until recently when he started experiencing nightmares and a change in his personality became noticeable. A once fun-loving and easy-going person, Joe has been viewed most recently as tense, edgy, and arguing with his family. He has not been an active father or husband for the past three weeks. Though going to work, he has been speaking negatively of his fellow soldiers, something that has never happened before. Joe’s commander has noticed these differences and has asked him to attend counseling. Fearful that his career is in jeopardy, Joe confides to his wife the recent problems he has been experiencing. Together they seek out a counselor and come to you.

I often leave this large inner city hospital with stale air trapped like a puddle in a pothole in the bottom of my lungs. I try to take deep breaths as I walk to my car in an attempt to dislodge that laden air and replace it with light fresh air. I say what I was taught to say to the cancer survivors who seek a new way to handle stress, “Breathe in the breath of life, breathe out all anxiety.” 

When I met with my surgical oncologist in October one of the things he said to me was, “Whatever you are doing, keep doing it. It is working.” He went on to add that a number of people that share my particular type of cancer, live well and much longer than expected without other medical interventions. So what are they doing that is different? Inquiring minds want to know. I want to know.

In a conversation with a colleague last week, I heard myself voice my usual critique of the Presbyterian church’s reliance on the corporate, hierarchical structures of “scientific management.” I trace the trajectory of the current administration of the denomination to the move from offices in New York and Atlanta at the time of the reunion between the two branches that had split at the time of the Civil War. When the new office was established in Louisville in 1987, a consultant from the secular, corporate world was named executive director. That person’s strong Presbyterian identity aside, his appointment was a shift from a long-time practice of hiring people with track records in ministerial leadership. Not for the first time, I should add, was secular organizational culture applied to church organizational design.

Picking up from last week’s post in which I listed lots of changes in the world and in the church, and celebrated chaos as the path to hopeful change, this week I want to offer a two-part approach to encourage leaders to address the challenges of change.

The numbers 6, 12, 18, 23, and 32 might seem like the winning lottery numbers, but they represent the number of years that recent patients to whom I have ministered have been separated—but NOT divorced. The state of Texas does not have a provision for legal separation. Therefore, the rights and responsibilities of marriage may remain intact, even if the couple has been living independently for years. Living separately while still married may have its short term benefits for allowing marital stress an opportunity to subside and for the couple to evaluate whether the marital relationship is sustainable. However, when separations to stretch into years and even decades, the prolonged separation can affect health care decision making.