Dharma Care - Pastoral Care and Counseling from Buddhist Perspectives
Four Kinds of People  
            It is said that Sariputta, one of the Buddha’s most revered disciples, said that there are four kinds of people:
  1. People who have blemishes (“evil unwholesome wishes”) but who do not understand the true nature of their blemishes;
  2. People with blemishes who understand the true nature of their blemishes;
  3. People who do not have blemishes and do not understand the true nature of their not having blemishes and;
  4. People who do not have blemishes and understand the true nature of not having blemishes. (MN5)
 
Sariputta then ranks these four kinds of people in terms of superiority and inferiority.  The inferior person is the one with a blemish or not, who does not understand the nature of their blemish or the nature of their state of non-blemish.  The consequence of this ignorance, according to Sariputta, is an inability to make right effort to instigate then abandon the blemish.
Sariputta gives many examples of how one creates spheres of evil unwholesome wishes.  These examples can be boiled down to competitiveness – wanting to be favored, wanting to control reactions and perceptions in order to deceive and so on.  When the desire to be favored is not met, it causes anger and bitterness.
     As pastoral caregivers, we often meet patients and counselees who are angry, bitter or both.  This sutta brings to mind the dilemmas "nice" caregivers have about confronting people about their negativity, pain, suffering, anger, bitterness, etc.   For some people, confronting others is bad form.  But the sutta can be taken as guidance on the importance of confronting people about the obstacles to liberation.  Isn't one of the roles of a  Buddhist pastoral caregiver working with a Buddhist counselee to make them aware of the dangers of living and dying with a defiled mind?  I believe taking on this duty is less risky when working with a Buddhist practitioner because they probably have some amount of faith in the Buddha’s teachings.  But there is still a risk in observing and commenting on another's "negative" emotions.
     And what of the patient or counselee who is not a Buddhist?  Do we not have a duty to help them avoid living and dying with a defiled mind?    What if abandoning evil unwholesome wishes is not their goal but our goal for them?  What if we haven’t established the kind of rapport and alliance that would allow for this kind of discussion?  What if we don’t have time to explore this with the patient or counselee?  What if time is of the essence because the counselee is dying?  It is a dilemma. 
 
 
Right View and Truthful Speech
 
            Sariputta explained in MN 9 that right view is understanding, in part:
 
 
  • unwholesome and wholesome states, as well as the roots of unwholesome and wholesomeness
 
He divided unwholesome and wholesome into two categories:
 
 
Unwholesome                                     Wholesome
Killing living beings                            abstention from killing
 
Taking what is not given                    abstention from taking what isn’t 
                                                         given
 
Misconduct in sensual pleasures          abstention from misconduct in
                                                         sensual pleasures
 
False speech                                       abstention from false speech
Malicious speech                                 abstention from malicious speech
Harsh speech                                      abstention from harsh speech
Gossip                                                abstention from gossip
Covetousness                                      abstention from covetousness
Ill will                                                  non-ill will
Wrong view                                         right view
 
 
He identified the causes or roots of these unwholesome and wholesome states:
 
 
Unwholesome Root                            Wholesome Root
Greed                                               non-greed
Hate                                                 non-hate
Delusion                                            non-delusion
 
     On occasion a patient or hospice care receiver will ask you, the pastoral caregiver, for a medical opinion, medical information, a diagnosis or a prognosis.  Could it be that they ask the pastoral caregiver for medical information because they believe they can more readily get a religious leader to tell the truth because it is believed we possess a higher ethic around truth telling?   Or is it because they believe the way we tell the truth is more gentle and nurturing?  Or is there something about the the projections and fantasies involved in wanting the truth from a spiritual caregiver?  I think care receivers want something more than the truth from us.  They want the truth, but want their emotions, concerns, fears and joys held by some who understands life in many dimensions and therefore will not run in the other direction.
     Sariputta taught that one should abstain from false speech, therefore pastoral caregivers should not share medical information, prognoses, etc. without attributing the information to the source.  If the source is unknown, how can the caregiver know what is true?  The list of “wholesome action” does not include telling the truth.  There is a space between abstaining from false speech and engaging in truthful speech.  Maybe that space is curiosity.  Spiritual caregivers do well by those they care for when they are curious and inspire care receivers to be curious about their own process.  The space can also be empowerment.  How might we empower those we care for to hear, understand and hold the truth when we are not around?
     Compassionate confrontation means abstaining from false speech (right action) and may involve abstaining from truthful speech (wise action).  Beware of falling into the trap of being the go-to person for the truth.  It is a heavy burden indeed to be known as the truth teller, the information imparter.  Spiritual caregivers dwell in a variety of dimensions.  Let's help those we serve transcend suffering without spiritual bypass, and help them confront truth compassionately.
 
 
 
 
    
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