Reflections On Spiritual Care
Where did my impetus for spiritual caregiving come from?
Giving back to the world in return for gifts received is something handed down by my ancestors. In both my Italian and American families, there are a strong history and ethos of caring for people and the earth that resonate deeply with me. My paternal grandfather, Cleante Paci, protected Italian Jews in Umbria, Italy during WW2, helping escort them to safety during Mussolini’s and Hitler’s regimes. My maternal grandfather, Roger Revelle, contravened a city ordinance barring Jews from living in San Diego and actively sought and hired people of varying religions and ethnic backgrounds during his tenure as a professor at UCSD and Director of Scripps Institution of Oceanography. In my extended family are teachers, social workers, scientists, political activists, physicians and philanthropists whose mission is to try to better the world now and for the future.
My brothers and I were not raised with formal religion; my father was raised Catholic in Italy but didn’t want to pass it along to his children, and my mother was raised Episcopalian in La Jolla, California, but didn’t want to raise us Episcopalian. They went so far as to baptize my brothers and me in a Unitarian church in Cambridge, Massachusetts, but we didn’t attend any church on a regular basis. Despite not being raised with a religious practice, my brothers and I received a religious education by viewing Catholic art starting in our childhood. Every summer the five of us flew on a charter flight to Italy to visit my father’s family in Assisi. While there, my parents took us to innumerable churches and museums to view the medieval, renaissance and baroque art often embedded in the buildings themselves. That’s where I received my teachings in the life of Christ and of the saints. And what vivid, memorable teachings they were, as was the intention of the artists and religious patrons who put them there. When I’m in Assisi, I still go see the life of St. Francis by Giotto and scenes from the life of Christ by Lorenzetti on the walls of Saint Francis Cathedral; those images never lose their power.
During a gap year between high school and college, I accompanied my American grandparents to India where my grandfather was giving a series of lectures on climate change and its impact on agriculture. I stayed on in India for several months, working at a series of rural agricultural development and health care initiatives started by Indian colleagues of my grandfather. Through my grandfather’s friends, I had a meeting with the Dalai Lama in Dharamsala, resided at the Sri Aurobindo Ashram in Pondicherry, and began an exploration into and study of religion and spirituality that continues to this day. At that time, I intended to be a physician but when I began college that fall, I quickly learned that the pre-med course requirements were beyond my capabilities. Nevertheless, I continued to love the clinical and emotional aspects of health care. I volunteered at the Burn & Rehabilitation Center at Yale-New Haven Hospital and still remember the happy, tearful face of the severely burned Serbian immigrant to whom my Yale Slavic Chorus peers and I came to sing folk songs in his native tongue. At Yale, I majored in History, using primary sources including diaries, letters, and public and private records to investigate the lives of regular people. One of my main areas of study was Christian, Muslim, and Jewish history. Under the guidance of my professors, I studied the writings of philosophers and historians from each tradition and gained an understanding of where there was overlap and conflict between the three religions. The knowledge I acquired of times and places when the three Abrahamic religions co-existed peacefully and respectfully served me well as the U.S. has gone through convulsions of anti-Semitism and anti-Muslim xenophobia.
Shortly after I graduated from college, my father got sick with pancreatic cancer and died nine months later at age 58; this sparked the beginning of a deeper dive into spiritual life. In the moment of his death, I felt his spirit rushing out of his body and into another dimension. I wish that my mother, brothers, my father’s sister, and I, as we surrounded his body in our home, were able in that moment and in the days to come to help my father’s spirit along his path to the next life by praying for a peaceful passage. Instead, we keened in anguish and within an hour or so, stunned and bewildered, watched as the funeral home workers took his body away. After considerable spiritual reading and studying, I have learned that this period after death (for example, lasting 40 days in Judaism and 49 days in Buddhism) is crucial for supporting a loved one’s peaceful transition into the next phase of existence, or what some religions call the afterlife.
In 1990, a year after my father’s death, I spent time on a Franciscan retreat in Assisi. I remember the simple rigor of our days, praying at dawn, in the middle of the day, and then again in the evening, the spiritual dedication of the young people from around the world whom I met there, the small stone chapel where I’d go for its stillness and comfort. Most of all I remember the steep hike we took as a group in the early hours of the morning through the olive groves to the top of Mount Subasio. Once in the wide-open pastures where cows grazed, we were instructed to find a place to pray in solitude and greet the dawn. I remember succumbing to sleep in the grass while it was still dark and waking up under the hot sun. I still remember the peace of that place and I often travel there in my mind’s eye when I seek tranquility in my life.
In those years, also began to practice yoga and slowly started planting the seeds of a spiritual practice combining Yoga and Buddhism which would deepen over time. A friend in those early years introduced me to Tibetan Buddhism, Sogyal Rinpoche and his book, The Tibetan Book of Living and Dying. When I was diagnosed with cancer in 2000, that manual for how to approach death became real for me, not just an intellectual exercise. I would listen to audio recordings of it and other Buddhist teachings regarding death nearly every night for years; they helped me cope with the overwhelming anxiety that I would die, abandoning my children and everything I still wanted to do in my life.
My experience with breast cancer was a major turning point in my life. I was extremely fortunate to have access to excellent medical care--which I don’t take for granted since medical care in the United States is out of reach for many people. The doctors informed me my cancer was aggressive and followed my health carefully for several years. This coming face to face with my own mortality brought home even more strongly some of the lessons I had learned from my father’s illness and death. I explored my existential fears, grief and other feelings around loss and mortality in a cancer support group at Berkeley’s Women’s Cancer Resource Center and in my personal filmmaking and writing. I was helped profoundly by the work I did with a psychotherapist for years, the deep relationships within a monthly women’s group I have been a part of since 2005, and the love and joy I received from and gave to my family and friends. Finally, several guided therapeutic sessions I’ve undertaken have been life-changing; like the Holotropic Breathwork workshop I took with Stanislav Grof, MD during which I had a lengthy encounter with loved ones who had died, the Divine, and a love-suffused afterlife. These experiences have helped immensely to decrease and even dispel my fear of death and solidified my desire to help others hold less fear around dying.
My Christian roots, such as they were, grew an unexpected offshoot right around the pandemic. Though my husband Michael and I were married in a Catholic Church in Connemara, Ireland, and had both our daughters baptized Catholic, he and I and the children attended church as CEOs (Christmas and Easter Only). But around 2015, I began to attend a different church: St. Columba Catholic Church in Oakland. I fell in love with the community—which was very mixed racially, ethnically, and socio-economically—with the progressive, openly gay pastor, Aidan McAleenan, and with the warmth and jubilation of the services. I even became interested in converting to Catholicism. I did not act on this urge until, paradoxically, my husband Michael revealed he had been abused in Catholic school in Ireland starting when he was thirteen years old. Even though Catholic priests and seminarians had perpetrated Michael’s (and so many other children’s) abuse, I found support within the St. Columba community. Also, I wanted to “infiltrate” the Church, if you will: grow the number of progressive Catholics by becoming one myself. I believe, perhaps naively, that there is the potential for change in and by progressive Catholics, a potential for social and spiritual transformation that the huge, worldwide community of Catholics can help bring about if it is mobilized to do so. For these reasons, I chose to become a catechumen and was baptized on Easter, 2022. At the same time as I was studying and preparing to become a Catholic, I enrolled in the Interreligious Chaplaincy Program at the Graduate Theological Union in Berkeley, beginning those studies in January 2022. In my courses, I have learned about death and dying rituals in various religions, theological reflection, trauma-informed spiritual care, the do’s and don'ts of spiritual counseling, psychotropic substances and spiritual care, and many other topics.
Over the last two decades, my yoga and meditation practices have continued and deepened. Because of the confidence I gained from my prenatal yoga practice while giving birth, I trained as a post-partum yoga teacher after my first daughter was born. In the summer of 2022, I completed year-long Anusara yoga teacher training and since then I teach Chair Yoga to folks at a low-income senior residence in Oakland, Gentle Yoga to seniors with limited mobility at a medical clinic in Berkeley, and Restorative Yoga to all ages at a yoga studio in Berkeley. I have undertaken further trainings in Yoga for Cancer and Chronic Illness and Yoga for Dementia and have worked with those populations in various settings. My interest, passion, and spiritual calling lie in helping folks–especially the elderly, those dealing with illness or disability, and those facing death–find peace and joy through the combination of movement, breathing and awareness that is yoga.
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How do I define spirituality?
For me, spirituality is the element of our lives that is:
transcendent, mysterious, ineffable, full of love and light but also solemn, majestic, deep, profound, beyond all measure.
that which through individual or communal ritual, meditation, and practice we pay attention to, spend time to connect with, honor, and celebrate. This can be done sporadically, daily, hourly, or even continuously, depending on one’s preferences, capacities, and goals.
that which connects all of us to each other, to the Divine, and to all creation including Mother Earth, Father Sky, and all of nature including animals, plants, water, air, insects, etc.
that which is timeless, exists before and after we are on this earth.
that which holds us and all creation in a loving embrace even when we cannot see or feel it.
that practice, belief, and faith that helps us find and create meaning in our lives when (individually and as communities) we face loss, illness, death, natural calamities but also occasions of joy, celebration or union like marriages, births, and milestones of various kinds.
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What is spiritual care and how do I conceive of providing it?
For me, spiritual care covers a range of different religions and spiritual practices—whether or not they are affiliated with a particular institution or body—as well as a range of ways of providing service, including through somatic means like yoga.
From my Buddhist training, I hope to bring the capacity to sit quietly with a careseeker, and listen, reflect, and accompany them without the need to necessarily do or change anything. And accompany them as an equal without feeling I am there as someone with more capability to “help” or “resolve” or “solve” what’s happening in their lives. But rather that together we can co-create a way to be more at ease with what they’re going through.
From the teachings of Vietnamese Zen monk Thich Nhat Hanh, I’ve gained the awareness that there is no beginning and no ending, no coming and no going, no birth and no death, that we humans are not just interrelated with one another but with plants, animals, the air, the waters, and that what harms one of us harms all of us and what benefits one of us benefits all of us.
From my studies of Tibetan Buddhism and Sogyal Rinpoche’s The Tibetan Book of Living and Dying in particular, I bring the practice of tonglen where one meditates on breathing in the suffering of another or others and breathing out healing and solace for that suffering. Here, American Buddhist nun Pema Chodron describes the tonglen practice:
"On the in-breath, you breathe in whatever particular area, group of people, country, or even one particular person...maybe it’s breathing in the physical discomfort and mental anguish of chemotherapy; of all the people who are undergoing chemotherapy…Or maybe it’s the pain of those who have lost loved ones… you breathe in with the wish that those human beings or those mistreated animals or whoever it is, that they could be free of that suffering, and you breathe in with the longing to remove their suffering.
And then you send out – that peoples’ hearts and minds feel big enough to live with their discomfort, their fear, their anger or their despair, or their physical or mental anguish. But you can also breathe out for those who have no food and drink, you can breathe out food and drink. For those who are homeless, you can breathe out/send them shelter. For those who are suffering in any way, you can send out safety, comfort.
So you breathe in with the wish to take away the suffering, and breathe out with the wish to send comfort and happiness to the same people, animals, nations, or whatever it is you decide. Do this for an individual, or do this for large areas, and if you do this with more than one subject in mind, that’s fine… breathing in as fully as you can, radiating out as widely as you can."
As a teacher of yoga, I bring breathing practices developed over thousands of years to reduce anxiety, stress, fear, agitation, anger, desire, etc. There are many different practices–including breathing but also involving movement or absence of movement, and directing our awareness– that we do in yoga to calm the mind and spirit, or to enliven ourselves from torpor, or to prepare ourselves for death. One of these is yoga nidra or yogic sleep, which is a way of practicing for the time of death. In yoga nidra, by activating and then releasing different parts of the body, we allow our physical form to rest deeply. We then direct our awareness/life force/prana/breathing inwards towards the central channel of the body (where Yogic philosophy believes that our abiding self resides) and then upwards out the crown of the head toward the Divine. It’s a powerful practice and I believe can be helpful to those facing death imminently. I know that, more simply, working with the breath during times of anxiety–including existential anxiety–can help to quiet the mind and the spirit and bring us in touch with our essential nature that is timeless and abides before and after our body’s existence. That essential nature is part of the Divine, within and all around us.
From my Christian background, I incorporate sacred art, music, text and prayer that bring beauty and connection to something larger and more abiding than our suffering in the present moment. I believe engaging in the arts can be a spiritual practice; they are a way for us to connect to a dimension of our lives that is beyond time and space, through which we can reflect on our life and its meaning, and in which we are connected to all that’s gone before and will come after us. I think that offering fine art, the literary arts and music to careseekers can provide solace. The arts let us see our connection to people–e.g. Bach, Giotto, Rumi– who have existed far before us and yet with whom we are still in dialogue. The arts connect us with the age-old human need to find and create beauty and meaning. We can feel less alone when we view, listen to, read or create art; we can feel ourselves part of a huge fabric of humanity that has existed for millennia. For me, it’s the same as when we engage in spiritual practice; we become part of a fabric in which every being holds a unique and essential part.
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To conclude, I share from Emmanuel Y. Lartey’s excellent article, “Interfaith Spiritual Care: Postcolonial African Christian Perspectives,” which reflects many of my own beliefs.
“Implications for Spiritual Care across Religious Traditions
1. Plurality is normal
The work of care for persons has to recognize the plurality that is enshrined and embodied in humanity. We are created in diversity. Every endeavor we engage therefore has to engage this reality. Religious plurality is divine. It is an inevitable implication of creation and expressed in many ways in the religious traditions of the world. Interfaith spiritual care can be a means by which we normalize humanity’s God-given diversity, especially religious diversity.
2. Cultivate respect and nurture humility
Out of respect for God, humanity and truth it is imperative that we recognize the many-sidedness of our world. We are set in a world replete with fascinating complexity and enriching variety. Approaching this requires an acknowledgment that we do not have nor know it all. We can learn much more about life, God and truth by respectful listening and humble engagement. The arrogance of the past manifest in colonial conquest and subjugation of peoples has impoverished the greater portion of the human family thus rendering all of humankind less than we could be. Now is not the time for suppression but rather for the irruption of subjugated knowledge in all its resplendent beauty and richness.
3. Clearing the mind of violent thoughts engenders calmness
A crucial task of spiritual caregivers needs to be helping people to be free of violence both internal and external. The unrest in the world today stems largely from internal unrest borne of inner violence or thoughts of violence. When the other’s selfhood, community, ethnicity, religion or property becomes the target of my inner despising it is a short step to acts of violence against them. When religion’s motivating force is harnessed towards the subjugation (whether through conquest or conversion) of the other, destruction of the other follows rapidly. What is sorely needed is the means of calming our turbulent inner unrest. Spiritual caregiving needs to make this a priority.
4. Uncertainty and ambiguity are a part of mature and healthy faith living
Pastoral Caregiving and especially counseling theory has often lifted up the truism that uncertainty and ambiguity are the very stuff of life itself. As such health and maturity are premised upon a person’s ability to cope with existential anxiety. Insecurity is most often expressed by clinging to certainty in the face of the disappointments and ambiguities of life. Counselors often work hard to help clients live authentically and with integrity in the face of the trials and traumas of life. The call of this paper is to all people, including peoples of various faiths, to recognize and assist each other to own uncertainty and ambiguity as existential realities and faithful responses to life. Faith itself requires uncertainty and ambiguity, for faith is the obverse of certainty.