Finding the pluralistic in pastoral care

Spiritual caregiving is the holistic, 21st-century version of chaplaincy, the clergy-based, Protestant-founded attendance to the spiritual and emotional needs brought on by a serious illness, injury or death.

In Israel, where the spiritual care field is still in its infancy, and where anything remotely religious is often accompanied by political strife, practitioners have aimed to expand it well beyond religion, making it a more pluralistic practice.

“You want it to be theologically neutral,” said Dvora Corn, a family therapist turned spiritual caregiver.

Corn is chair of the Israel Spiritual Care Network, a group of about 22 Israeli agencies working together to change the language of spiritual care in public social service and social welfare. She and her husband, Dr. Ben Corn, an oncologist and head of the radiation department at Tel Aviv’s Ichilov Hospital, founded their own organization 11 years ago, Life’s Door-Tishkofet, which means perspective.

When they formed Tishkofet, the timing was right, said Corn. And as it turns out, they weren’t the only ones who saw the need for spiritual counseling in Israel.

“The traditional models in Israel had really lacked the level of spiritual dialogue that can offer a different way of modeling [caregiving],” said Corn. “We want to show practitioners and professionals who are non-spiritual practitioners, what spiritual care is across the lifespan. It’s a language of hope that gives people hope and resilience despite the fact that the person’s situation won’t change.”

The network is one of several organizations sponsoring this week’s annual conference on spiritual care, from January 27 to January 28 at Jerusalem’s Hotel Yehuda, working in conjunction with the Association of Jewish Chaplains, Tishkofet, JDC-Eshel and UJA-Federation.

Since 2006, UJA-Federation has allocated more than $6 million in funding to several organizations training spiritual caregivers in Israel, in its efforts to help advance the field in Israel’s medical establishment.

What’s unique about the conference, said Corn, is that it’s an annual gathering of Jewish and Israeli spiritual caregivers. The content of the two-day conference, which combines site visits with sessions, focuses on what’s happening in the spiritual caregiving world in Israel, Europe and the US.

In fact, say participants, the conference has become an example of Jewish pluralism within the field of spiritual caregiving and chaplaincy.

“You’re standing there with Haredim, Muslims, Christians, kibbutznikim, Masortim, and no one’s judging,” said Susan Lax, co-chair of the Spiritual Care Advisory Committee at UJA-Federation of New York. “I’ve had a rabbi standing there, dressed in black, and saying to me, ‘So what do you do?’” 

Lax first became a lay spiritual caregiver when a good friend was ill with cancer. Wanting to help, Lax began writing inspirational emails to her friend early each morning.

“I didn’t know if she was reading them or not,” said Lax. “Until one day I didn’t write one and she called to ask me if everything was okay.”

It was, unwittingly, the start of Lax’s career. 

Now Lax, an American-Israeli who splits her time between the two countries, is certified as a spiritual caregiver, and besides counseling women who are ill, at the end of their life, or on the other side of a traumatic illness, she also sends inspirational morning emails to women sick with cancer.

She estimates that hundreds of women receive her morning missives, although she doesn’t know exactly how many, or how they make their way to their readers. What she does know is that when people are in a spiritual crisis, they need spiritual care. 

“My belief is that we have no control over what happened yesterday and no control over tomorrow, but if we make moments today, we can bring joy into the day,” said Lax. “For women with cancer at different stages, control is a big deal.”

Lax was already working with the Federation when she discovered that practice of this field was very limited in Israel, largely because of fears of warring with the rabbinate, the country’s powerful organization of Orthodox rabbis who control many things having to do with religion, from kosher restaurant certification to marriages and end-of-life rituals. 

It’s true that spiritual caregiving, because of the use of the term “spiritual,” often crosses over into religion, said Lax. But many practitioners in Israel are trying to avoid that relationship. 

“Care of the spirit, the person, the soul, doesn’t have to be affiliated with religion,” added Lax, who also practices reiki, the Japanese technique for stress reduction and relaxation on some of her clients. “There’s something so wonderful about this being pluralistic.”

That’s certainly the approach of many of those involved in the Israeli network.

Corn, for example, comes from the field of social work and works with many medical professionals. Einat Ramon, head of the Marpeh program, part of the Masorti Movement’s Schechter Institute, is an ordained rabbi. But Ramon works to keep religious ethics at bay in her program, which offers a Clinical Pastoral Education (CPE) with an MA degree in Family and Community Studies. 

“We’re not for or against pluralism,” said Ramon, who wrote the standards for spiritual caregiving training in Israel. “But you don’t want the patient having to worry about all the labels.”

When Shechter entered the spiritual caregiving training field, the institute changed some of the standards for the Israeli cohort, said Ramon. While American chaplains study for 800 hours, the Israelis do about half of that.

“Religious people can be in it, and so can secular,” said Ramon. “We try very hard to neutralize all the difficult areas and work hard to find the joint areas. It’s hard to take the political out of it, but I think we’re doing it. It was a religious profession and now it’s being opened to nonreligious people.”

The overall theme is keeping the Israeli model more secular, with a lay chaplaincy model that doesn’t require a theological background.

It’s similar to the chaplaincy progress in the US, where faith-based hospitals have become more generic or secular, changing the model of spiritual caregiving, according to Reverend Eric Hall, President and CEO of HealthCare Chaplaincy Network Inc., the leading spiritual care organization in the United States

“Healthcare itself has matured or come to better understand the wholeness of healing,” said Hall, who will be speaking at this week’s conference. “Spiritual care, the implementation of it and impact and effectiveness of it, are not only beneficial to the whole healing process of the patient but equally impacts the bottom line.” In the US, every hospital is legally required to offer patients access to a chaplain or spiritual guide.

But some Israeli spiritual caregivers, who are also part of the network, don’t feel the same way about keeping religion out of spiritual care.

Miriam Berkowitz and Valerie Stessin, both Conservative rabbis and US board-certified chaplains, started their pastoral care organization, Kashouvot, as a placement service for chaplains. Now serving several departments in Israeli hospitals and long-term care facilities, including Hadassah Ein Kerem, they are modeling their version of pastoral care as close as possible to the original American chaplain model, looking for professionals who are clergy and “not embarrassed about that,” said Berkowitz.

“There’s a sensitive discourse in the field about it,” she said. “Until now, there’s been an attempt to try and separate from anything religious so that the rabbinate won’t take it over. So everyone’s bending over backwards that it’s just spiritual and not religious. But chaplaincy started with the clergy in America, with the Protestants, and while not every conversation is about faith, it’s good to have the grounding of prayer and tradition, to be able to do confessional prayers or tell a story from the Talmud.”

The Kashouvot chaplains don’t introduce themselves as rabbis, but if they’re asked, they identify themselves as such, said Berkowitz. 

“We feel strongly that we’re not just nice little ladies coming for a visit,” said Berkowitz.

“There’s a careful dance around certain topics, but with some people, if I don’t pray, I feel it’s a missed opportunity.”

The “Hope and Resilience” Conference will be held at Jerusalem’s Hotel Yehuda Hotel, January 27 and 28.