Brian Walsh, a Spiritual Care Provider at CAMH, recalls a woman who had been referred to him to deal with grief over the death of her mom. She had been receiving inpatient and outpatient treatment for depression and cognitive health issues at CAMH.
“She felt that she had one good night each week and that was when she was volunteering in a community garden,” says Brian. “So we started there, and explored the meaning of gardening for her.”
There was the metaphor of the ground itself, and the cycle of life that rises from and falls back to it. “It gave her some context for her life and a new way to see relationships and think about her mom.”
Truth, nature, knowledge – CAMH Spiritual Care Provider
Brian Walsh takes a client-centred approach to spiritual care. He
studied comparative religion and has used some Celtic poems and triads
as a starting point for group discussions. The tag line on his email
reads: “Trí caindle forosnat cach ndorcha: fír, aicned, ecna… Three
candles that illumine every darkness: truth, nature, knowledge.”
There was the act of weeding – to strengthen and nourish the plants she cared for. “She realized there were things to keep in her life, and things she could not keep,” Brian says.
And there was a sense of investing in the future, knowing that a small perennial she planted today might create beautiful blooms next year.
Utimately, providing spiritual care to CAMH clients is about “a quest for purpose,” he says.
Sparking hope and purpose
“Every single person needs a sense of hope and purpose in their lives,” says Shawn Lucas, Manager of CAMH’s Spiritual Care Services. “None of us can get out of bed, let alone survive, without that. Our clients face challenges that may seem insurmountable. But they have the resources inside themselves to discover that spark of hope and purpose – sometimes they need some support to get there.”
CAMH Spiritual Care Services Manager Shawn Lucas
Clients may be referred to the team from CAMH programs because they are grieving a loss or may be pre-occupied with religious thoughts. On a proactive basis, the team provides spiritual care groups across many CAMH programs. The team attends rounds, offers education and advice to clinicians, and educates the next generation of spiritual care providers.
The team’s approach is client-centred and “evidence-based, rather than faith-based,” says Shawn. That has evolved from the traditional model of hospital chaplain, which may have been more closely linked to a particular faith or religious denomination.
Taking an evidence-based approach means understanding where the client is at. “Emotions don’t lie,” Shawn says. “A client’s fear is real, even if a particular belief behind it may not be. We try to help clients unpack those emotions and underlying factors; we give them permission to talk about things.” In the case of religious pre-occupation, that might involve separating out religious beliefs, or a transcendent/spiritual experience, from emotions or beliefs that may be influenced by mental illness.
The spiritual care journey can involve three key elements:
- Understanding personal beliefs
- Purpose and meaning.
Once a client is aware of the emotions and underlying factors, spiritual care providers may explore the client’s beliefs, says Shawn: “Is the world a safe or dangerous place? Is there a God? Where is my place?”
Ultimately, the work of the team centres on a quest for purpose in clients’ lives. That might be a concrete goal such as regaining independent living, or a broader goal such as helping others.
Shawn’s role also encompasses medical-pastoral education. He teaches clergy, seminary students, and spiritual care students the tools of psychotherapy, spiritual assessment and inquiry. These students will go on to work in hospitals, nursing homes, prisons, or in their faith communities.
Shawn also coordinates spiritual care volunteers at CAMH representing different faiths. Some faith groups, including Muslim, Catholic, Ecumenical and Jewish faiths, also offer religious services at CAMH. A faith leader may become part of a client’s care team.
Nazila Isgandarova says her mission is to “help people cope with their
major life transitions, comfort them, and walk with them through some of the
hard moments of their lives.”
Working as a Spiritual Care Provider both at CAMH and at two GTA nursing homes, she seeks to contribute to clients’ well-being and recovery though compassion and respect. That’s especially true “when the client is suffering due to losses, mental and physical illnesses.”
As a young woman growing up in the Soviet Union, she pushed back against social injustice, including the second-class status she felt as a young woman. “Often people would use religious arguments to justify oppression of women. I started asking a lot of questions. Why would a just God create a cruel environment for women? I wanted to explore different religious traditions to find answers. I bring a social justice and feminist perspective to my work.” She also became a Muslim, after a non-religious upbringing in which she saw Islam subverted by the Soviet system.
A registered psychotherapist, she uses the Maslow hierarchy to asses a client’s needs, starting with basic physical needs, and moving through family and spiritual needs. Because many of her clients are on longer-term stays, she gets to know them and reaches out to support them. “Patients have a yearning for companionship, to talk to someone, to share what they are going through. I can add a different dimension to the treatment they are receiving.”
She also involves faith leaders, such as a Catholic Priest who was called upon for a client sacrament.
“It’s important to understand faith factors in a client’s recovery – both positive and negative. Likewise, faith leaders in the community often need to learn more about the psychotherapeutic process and the mental health care we provide at CAMH.”
A personal journey
When it comes to the focus on client emotions, Shawn comes by it honestly. He has struggled with depression and addiction, and worked on his own self-awareness. “I was in seminary for the United Church and I had this fear of death. My mother had cancer for many years and she died when I was 20. I knew the only way I could confront that was to work in a hospital, so I got a placement at St. Michael’s Hospital on a medical unit.
“I remember I got called to my first death on the unit. I was on lunch at the time, and literally my knees started knocking. I said this little prayer in the elevator: ‘Please help me.’ I just remember walking into the room and it was like walking in to a state of grace and I was able to offer some words to the patient and the family. A couple of days later I looked up the patient’s obituary and the family had quoted me verbatim.”
This is part one of a series dedicated to CAMH Communications Specialist Joan Chang, a talented and passionate communicator who appreciated the value of spiritual care. Joan developed a story framework to shine the spotlight on spiritual care at CAMH, and completed some interviews for the series. She died suddenly in June, 2015. A tribute to Joan is included on the CAMH Foundation website.
Also in the Spiritual Care Series: