Dharma Care - Pastoral Care and Counseling from Buddhist Perspectives
    
Right Livelihood
      When embarking on the Buddhist path, one comes to one of the eight "road post" called Right Livelihood.  Is chaplaincy right livelihood?  It is said that The Buddha said some spiritual leaders make money through "base" activities like predicting weather, the health of future harvests and bad fortunes,.  He was concerned about composing poetry, philosophy, medicine and traditional  (though he was referring to ascetics and Brahmins) chaplain ritual duties such as consecrating building sites and giving ritual rinsings and bathings (DN 1).  What do we do as chaplains that may be considered wrong livelihood?
     From a Buddhist point of view, professional spiritual caregiving is wrong if it inspires greed, hatred and delusion.  Does consecrating space and using water in rituals (like baptism) create delusion?  As it relates to ritual rinsings, The Buddha said the defilements of mind including:
:
  • Ill will
  • Anger
  • Revenge
  • Contempt
  • A domineering attitude
  • Envy
  • Avarice
  • Deceit
  • Fraud
  • Obstinacy
  • Presumption
  • Conceit
  • Arrogance
  • Vanity
  • Negligence
will not be be abandoned by bathing (MN 7).  But what ritual baths that create the illusion of purity?  These are questions Buddhist pastoral caregivers and counselors do well to ask ourselves as we contemplate and perform rituals. 
     Spiritual philosopher Jean Gebser believed that throughout time people have been in different levels of consciousness starting from aperspectival to magical, mythical, mental, and ending, hopefully, in the integral.  Insight Buddhists tend to be in the mental, but the religious society we live in tends to be a combination of magical, mythical and mental.  In your ritual making, are you attempting to perform magic to comfort the patient?  This is a common dilemma worthy of being examined.  Are you tapping into the mythical to inspire the patient to something greater?  Sometimes we are too mental or reality seeking to see the power of myth.  Do we fall into a trap of being too mental when simple presence is required?  What are we actually getting paid for?
     A great practice for keeping us engaged in right livelihood is to ask ourselves, "What did I do to deserve this?"  Some pastoral professionals count the number of people who join their faith as a way of knowing they deserve their earnings.  Can a Buddhists count the number of people who were liberated as the result of our pastoral caregiving and counseling?  Let's learn to dwell in the mystery of our work without the need to conjurers.  Let's be equanimous about the results of our work and refrain from using the earnings as an ego booster.  We may be involved in deeply satisfying work, using wisdom and presence to aid others, but whether it is right or wrong livelihood is a complicated matter.
 
Letting Go of Results
      It is said that The Buddha said there three types of patients; one who will not recover even if she obtains proper nourishment, medicine, and  nursing, one who will recover with these things, and one who will recover only if she receives these things. Whether the patient has what is needed to heal, whether they will or will not heal, all types of patients should be cared for.  
     The Buddha compares the three types of patients to the three types of people:  one who will see the Tathagata and hear the dharma and will not attain spiritual qualities; one who will attain spiritual qualities even never having seen the Tathagata or heard the dharma; and one who will only reach spiritual qualities if they see the Tathagata and hear the dharma.
     There are all kinds of people and therefore all kinds of patients and chaplains.  There are all kinds of illnesses and diseases, and all kinds of treatments.  There are all kinds of outcomes and often no positive outcome.  Chaplains can bring their "A game" and the patient can give them an "F". 
     Working in a hospital means being surrounded by professionals who are results oriented.  From a scientific point of view, nurses, doctors, dietitians, technicians, social workers and other professionals are there to diagnose, treat, cure, nourish and coordinate resources for people whose abilities are impaired or impacted.  But what about the chaplain?  Can we guarantee an outcome?  Can we even come close to assuring any spiritual attainment?  The inability to guarantee spiritual attainment is no reason to refrain from providing pastoral care because we possess no assessment tool that will predict the type of patient we are dealing with.  Can you become comfortable with uncertainty about your abilities?
     I have seen many chaplains struggle with becoming comfortable with uncertainty.  How do we become comfortable?  There are many paths to becoming comfortable with uncertainty.  One path is the path of humility.  Remember, if patients do not become well with everything they need, your presence will not be the cure.  If people do not attain spiritual gifts even in the presence of The Buddha or the truth or ultimate reality, they will not attain it in your presence.  Let this be a relief!  Another path is selflessness.  Your presence with a patient has very little to do with your decision to be there.  Many factors, seen and unseen, are at play and were at play before meeting with the patient.  What happens is not just about you.  What you represent to the patient and what they represent to you is a mystery on an unconscious level.  So even if you believe you know what the two of your are about, until you've had time to reflect deeply, you really do not know and fortunately do not have to know.
     There are many types of patients, many types of contexts where we meet patients, many types of people with a variety of capacities for spiritual attainment, many types of chaplains and many circumstances that bring patients and chaplains together.  For your ease of mind, let go of being result oriented and dwell in mysterious presence with a curious mind open to wonder and surprise.  Your experience as a spiritual caregiver can be enriched (and you can manage your energy levels better) when you let go of results.
 
Befriending the Fearful
 
            In MN 2 it is said that the Buddha said, among many things, that the taints can be worked through by the cultivation of:
 
·        Mindful enlightenment
·         Investigation-of-states enlightenment
·         Energy enlightenment
·         Concentration enlightenment and
·         Equanimity enlightenment
 
Buddhist pastoral caregivers would do well to ask themselves, “How would The Buddha instruct this particular "tainted" patient to cultivate higher states of mindfulness, investigation, energy, concentration and equanimity?”  In MN 4, the Buddha says to a brahmin who is fearful of meditating in the forest, that fear arises in scary places when the mind is not pure.  Purity is knowing that the teachings are beneficial and that The Buddha will be a leader, helper and guide while practicing in those scary places.
     Fear is commonplace among people who are institutionalized for one reason or another.  Isolation from the familiar often gives rise to fear. The Buddha said that he subdued his fear whenever it arose, by being still. “What if I subdue that fear and dread while keeping the same posture that I am in when it comes upon me?”  In other words, what if we attempted to face fear with courage and equanimity?  What if we encouraged counselees to do the same?  If we do so, let's promise to accompany them on the journey, if welcome, and travel as far as we can go.  It is said in the suttas that many benefits arise from sitting with fear like intimately knowing our karmas.  Knowing, understanding and working through karmas is a precious path to purity supported by the absence of the activities of our regular daily lives.  Being incarcerated or bedridden can be opportunities for working through taints, understanding karmas, and working toward enlightenment.  This is a spiritual journey traveled well with a patient, compassionate and skilled spiritual companion -- the chaplain or pastoral counselor.
     If a Buddhist chaplain or counselor is to do as the Buddha would have done, then it seems consistent with this sutta that a chaplain would assess whether she should be a leader (when a leader is needed), a helper (when a helper is needed) and or a guide (when a guide is needed).   In other words, a Buddhist chaplain can lead a patient to learn how to be mindful, can help a patient cultivate energy, or can guide a patient in becoming more equanimous.  Knowing which role to play and when to play it requires a meditation practice, experience and wisdom.  Moreover, it is recommended that we have practiced sitting with our own fears.  Ask yourself, "What am I really afraid of?"  Make note of your answers.  Sit with one fear at a time.  Notice what arises and where in the body it arises.  Notice the presence of constriction.  Is there any narrowing of views?  Confusion?  Tendency to distance and isolate?  Blame?  Though fear may not feel good, the material that arises is good for spiritual caregiving.  Use it for the liberation of those you serve.
     
    
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