CPE reflections (6)

6. Questions in pastoral care

Although asking questions comes naturally to many of us and strikes us as a polite and normal, it can can actually be experienced as prying or interrogatory in pastoral situations. As B. Preston Borgia (‘Responding to Questions in Pastoral Care’) puts it,

Generally speaking, questions possess two characteristics: they demand answers, and they put one on the defensive.

Of course, this is partly a function of relationship. In a clinical pastoral context, an unequal power dynamic is often hard-wired into the situation. A chaplain possesses power that a patient doesn’t — e.g., a (semi-official) role in the hospital, freedom to move around and enter or exit the hospital, and sometimes even privileged information about the patient.

This is why the chaplain’s ‘way in’ to a conversation is so important. From experience I can tell you that it’s tempting to simply launching into questions — perhaps hoping to form a rapid spiritual assessment so you can help the patient (this can be symptomatic of a personal or professional agenda eclipsing the needs of the patient). Establishing (as explicitly as possible) some form of ‘contract’ or understanding with the patient can be an effective means of mitigating against the unequal power dynamic. This can be achieved by spending a little time explaining who you are and what you’re doing — without waffling. In addition, it’s usually wise to find ways to allow the patient the opportunity to give (or withhold) permission to proceed with the interaction.

The need to be careful with questions is more than just a matter of context and relationship, however. I found Borgia’s stress on the way questions often convey subtle — or not so subtle — messages and value-judgements to be really helpful in sharpening my self-awareness. If I ask a patient ‘Why do you persist in smoking if it keeps landing you in hospital?’ or someone I’ve been building a bit of a pastoral relationship with ‘Why are you considering divorce?’ there is an obvious (disapproving) value judgement there.

I’ve found that the more I cultivate an awareness of this fact, and learn to check myself whenever I want to ask a Why question, the more able I am to move the conversation forward in a productive way. To create what the author’s of The Harvard Negotiation Project’s book, Difficult Conversations, call a ‘learning conversation’.

(It’s similar in a lot of ways to the vexed issue in youth and university ministry (which has formed much of the background of my own previous ministry experience) of travelling overseas. When a Christian young person tells you they’re thinking about doing some travel, I can tell you (from bitter personal experience) that the one of the worst things you can say straight up is ‘Why are you thinking of doing that?’ It may be perfectly appropriate and helpful to probe their motives at some point in the conversation. But opening with that sort of question doesn’t only demand justification but communicates your disapproval load and clear. Ultimately, it’s a sure-fire way to create — or fuel — antagonism between you and the person you’re speaking with. And possibly even to consolidate them in a decision that they may well have arrived at for very bad reasons.)

Something similar applies to responding to questions you’re asked — and not just the difficult Why question. As Borgia goes on to explain:

[T]he intent of questions in a counseling situation is almost always to express some concern or feelings, or to introduce a subject.

Learning to pick up the concerns, feelings and messages is a delicate art, and something I struggle with — not least because I want to make sure that rather than always trying to dig into the ‘question behind the question’, I take people’s questions seriously — treating them as genuine and not always assuming there’s a hidden agenda.

Nevertheless, I can see how Borgia’s five suggestions for responding to direct questions may help me defuse my own defensiveness and sharpen up my sense of whether the question is genuine or if there’s a message (or story) behind what’s being said:

  1. Seek clarification (NB: this doesn’t always have to be a question)
  2. Make a statement testing the intent of the question
  3. Verbalise your sense of the emotional state of the questioner (e.g., ‘You seem to be agitated…’)
  4. Make a generic/inclusive statement (e.g., ‘Most of us feel that way sometimes…’, ‘That’s a pretty normal thing to worry about’, etc…)
  5. Comment on the process. As Borgia puts it, ‘Often this means ignoring the question altogether in favour of noting what is happening at the moment between [the] counselor’s own feeling about what is happening (e.g., “I’m finding myself becoming angry about this barrage of questions, and I wonder if you’re angry, too?”)’.

All this can help me respond rather than react.

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