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What Do I Say?

Talking with Patients about Spirituality

Elizabeth Johnston Taylor

Health care professionals, clergy, chaplains, social workers, and others who counsel people in medical crisis often find themselves faced with deeply painful questions: Why is this happening to me? Am I dying? Why should I live? I'm just a burden to others.

Here is a workbook that suggests healing verbal responses to such expressions of spiritual pain. The accompanying DVD helps reinforce the lessons and exercises that integrate psychology, psychiatry, pastoral counseling, nursing, chaplaincy, and spiritual direction for whole person care.

The author, an internationally recognized expert in spiritual caregiving, points out that wanting to help is one motivation for learning these skills, but there are also evidence-based reasons: helping patients express their innermost feelings promotes spiritual healing; spiritual health is related to physical and emotional health; spiritual coping helps patients accept and deal with their illness; and patients tend to want their health care professionals to know about their spirituality.

Lessons, tips, and exercises teach how to listen effectively, with guidelines for detecting and understanding the spiritual needs embedded in patients' conversations. Suggestions are provided for verbal responses to patients who express spiritual distress, including tips for building rapport, using self-disclosure, and praying with patients. A FAQ section deals with frequently asked questions and miscellaneous information, such as:

  • What do I do when a patient talks on and on and I have to leave?
  • How do I answer a "why" question?
  • What do I say to a patient who believes a miracle will happen to cure them?
  • What if I'm not religious? How can I talk about it?

By practicing and using these healing techniques, Taylor explains, healthcare professionals will be able to provide patients responses to their questions that allow them to become intellectually, emotionally, and physically aware of their spirituality so they can experience life more fully.

Foreword / ix

Acknowledgments / xi

1. Let’s Begin! / 1

  • Why should I learn this skill? / 2
  • About this workbook / 4
  • Assumptions / 6

2. Preparing the Healer / 9

  • What are my spiritual pains? / 9
  • How do my spiritual pains affect my responses to patients? / 12
  • But if I’m always being wounded, won’t I die? / 14
  • Why do I disengage from patients’ feelings? / 16
  • Assumptions that silence / 17
  • What is a wounded healer like? / 19
  • Tips for how to survive in the clinical setting as a wounded healer / 21

3. Listening: Beginning the Healing Response / 25

  • Dimensions of listening / 27
  • What to listen for / 29
  • Tips for how to listen / 31

4. Making Sense of What You Hear / 41

  • What are spiritual needs? / 41
  • What does spirituality look and sound like? / 42
  • Tips for making sense of what you hear / 45

5. Verbal Responses to Spiritual Pain: Micro-skills / 53

  • Micro-skills: Goals and guidelines / 54
  • Micro-skill 1: Building rapport / 59
  • Micro-skill 2: Restatements / 61
  • Micro-skill 3: Open questions / 65
  • Micro-skill 4: Reflecting feelings and advanced empathy / 69
  • Micro-skill 5: Self-disclosure / 81

6. Verbal Responses to Spiritual Pain: Macro-skills / 85

  • Macro-skill 1: Story listening / 85
  • Macro-skill 2: Body listening / 90
  • Macro-skill 3: Nurturing resilience and reframing / 92
  • Macro-skill 4: Religious practices / 97

7. FAQs / 101

8. Putting It All Together / 119

  • Let’s practice! / 119
  • An encouraging word / 126

Answers for Exercises / 129

Notes / 139