Living hope, chapter 1

Any Christian striving to give an 'accounting' of their hope needs first to reflect upon just what that hope is. Those who care for the dying would seek not only to 'explain' their hope, but to give it in some real way.

What then, is our Christian hope, and how might it be expressed? How might we go about the task of living hope?

The Christian pastoral carer does not have to look far to be reminded of the need for hope. The following scenarios will probably strike more than one chord of familiarity. They illustrate the multilayered concern for a hope that is real where the experience of dying can threaten to engulf people with utter despair.

Sarah, a young curate, is on her way to the local hospice to visit one of her parishioners. As she pulls into the car park she becomes acutely aware of her uncertainty over the situation she is about to enter. She feels very nervous. She is visiting because she wants to be of help, but she has been told that the person she is visiting is probably in the final week of his life and she wonders just what sort of help she can Provide. As she walks towards the building, each step takes her deeper into an indescribable sense of helplessness. What will she say when she arrives? What sort of prayer should she pray? How can her Presence be of any value at all when death is so near? Sarah longs to be of real practical help to this dying person, yet in her search for the tight things to say and do she feels an overwhelming sense of personal inadequacy.

Sarah is aware that pastoral care must never be driven simply by the urge to satisfy a personal desire to 'feel useful.' Such an approach would be seriously lacking in Christian integrity and, in any case, jt jg usually only a matter of time before others sense whether an individual is expressing care that is motivated by genuine compassion or is just trying to feed an appetite for feeling good about themselves. But Sarah is not merely pursuing her own personal agenda; she just wants a deeper confidence in her choice of words and actions — some assurance that they could make a positive difference.

How might a pastoral carer like Sarah approach their ministry to the dying with confidence? Sarah identifies hope as the very thing that she longs to bring to others. But how might she be assured that she really is nurturing hope through the things she says and does? This book will explore both the nature of Christian hope and how it might be fostered. We will examine what we hope for and how we might share it as a living hope.

Tom, 63, is a lifelong member of his local church. In that time he has served as a steward and an organist and has taught in the Sunday school. He rarely misses a service or church meeting. Although he occasionally frustrates others through his obstinate resistance to change in church life, he is respected for his faithfulness and reliability. A few weeks ago Tom felt acute chest pains. His wife Jenny persuaded him to go and see his GP. He was quickly sent to hospital for tests and, following an electrocardiogram (ECG), Tom was informed that he has cardiovascular disease and is at risk of having a major heart attack. He was told that he must immediately take appropriate medication and radically review his diet. No mention has been made of his life expectancy, but since receiving his diagnosis Tom has become very withdrawn. Jenny is desperate to talk about it but every time she raises it with Tom he either changes the subject or goes silent. Furthermore, Tom has insisted that Jenny must not tell anyone else about his condition. Eventually Jenny calls their minister and asks him to visit as soon aS possible. Jenny tells Tom what she has done. He briefly loses his temper and then retreats into a sulk. When the minister arrives, Jenny tells him everything while Tom sits in silence. Attempting to draw Tom into the conversation, the minister asks a few open-ended questions about how Tom might be feeling. Each question is answered by Jenny who, before long, ends up doing all the talking on Tom’s behalf.

An opportunity for the minister to converse directly with Tom emerges when Jenny leaves the room to make tea. After a few moments of silence Tom bursts into tears. He shares with the minister how he feels completely shocked by his news and that he is terrified by the thought of dying. He explains that he has always had a Christian faith, but right now feels so totally alone, distanced from God and from other

eople. He describes himself as 'spiritually frozen' — unable to pray or even think about God without feeling utter despair. When Jenny eventually returns to the room she also is in tears. She puts her arm around Tom, turns to the minister and asks, 'We will see one another again in the next life, won’t we?"

It is easy to assume that because a person has been immersed in church life for years, listened to thousands of sermons and familiarised themselves with all the language of worship and prayer, they must have grown to a spiritual maturity that is so robust and integrated that they can face anything. However, a lifetime of exposure to church culture is itself no guarantee that the Christian gospel of hope will have taken root in a person’s being in any meaningful way at all. Tom knows very well that the Christian message is all about eternal life — indeed, he could quote many Scripture verses to demonstrate this. But he has never appropriated these things personally — he has not 'owned' Christian hope. To Tom, the biblical passages and verses from popular hymnody which express hope of life everlasting at times sound hackneyed. For all his familiarity with them, they have not engaged with his personal struggle and, as such, they appear to him as glib reassurances and pious clichés.

A major challenge facing pastoral carers is to find ways of enabling people like Tom to explore the hope that the Christian gospel presents so that it might become 'real' and meaningful to them. Both Tom and Jenny have a sense of what they want to hope for - namely, eternal life and some kind of reunion beyond death — but the substance of the Christian hope has never really been unpacked and examined by them in a personal way. It has not become a living hope. That is the concern of this book.

Jane is in her late fifties. She is a great believer in the power of prayer. Several years ago she experienced the healing of a benign but nevertheless painful tumour following prayer with the laying-on of hands. Subsequently, Jane sought to develop a healing ministry within her local church. She helped to establish a group that meets weekly to pray specifically for the sick, as well as a monthly service in which, following the sharing of communion, prayer for healing and anointing with oil is offered. As a result of Jane’s own experience of healing and the vision and initiatives born out of it, healing has become an important theme in the congregation’s understanding of its life and ministry.

Six months ago Jane discovered a lump under her breast. Tests revealed that it was cancer. A mastectomy and an aggressive course of chemotherapy followed, but it soon became apparent that cancer was present throughout her body.

Jane has received prayer with the laying-on of hands in several church healing services. The prayer group prays for her every week with tremendous fervour. She assures everyone she meets of her faith that God has healed her before and will do so again. Eventually Jane is admitted to a hospice. One day, the same friend who prayed for Jane when she experienced healing several years ago visits her. Quoting Mark 16:18, she tells Jane that Jesus promises that those who believe 'will lay their hands on the sick, and they will recover.' With Jane’s permission, she then prays for Jane, 'claiming healing' in the name of Jesus. Two hours after her friend leaves, Jane dies.

Was it appropriate for Jane’s friend to pray for her in this way? On the one hand, Jane’s previous experience of healing was a genuine source of hope for her. To pray for further healing reminded Jane of the power of prayer that had strengthened and sustained her in the past. Such prayer was the natural expression of a faith that was real, vibrant and alive. On the other hand, ought her friend to have given greater emphasis to preparing Jane for death? Was it in any way misleading to nurture a hope for physical recovery when death was so near?

If the ministry of healing is to be approached holistically, it must be able to embrace the reality of death and dying. This in no way undermines a commitment to praying for healing. Rather, it challenges approaches to prayer that would define healing exclusively in terms of physical cure. Such constrictive understandings need to be refocused on the gospel of resurrection. It is, after all, the cross and resurrection to which all of Jesus' miracles point in the New Testament. ^[1] Christian faith is resurrection faith. This should be the foundation of any prayer for healing, and it is the basis upon which pastoral carers can seek to enable death with dignity.

Resurrection will be a central theme in this book. We will explore the dynamics of what it means to hope for resurrection. How might someone like Jane be encouraged to hope in a way that builds on a confidence in God’s power and promise to heal without shying away from the reality that death comes to us all at some point? How might the ministries of healing and palliative care be united in the same living hope?

David, 47, has worked in banking since he left school. For many years his ambition has been to set up his own business as an antiques dealer. Two months ago he tendered his resignation at the bank, having bought a small shop. His plan was to spend the next three months carrying out minor alterations to the premises before opening for business. However, just a few weeks before he embarks on this career change, David discovers that he has cancer.

Following a consultation at the hospital, David begins a course of radiotherapy. As soon as this has started, David talks incessantly about his intention to 'get back to the shop when this is all sorted out.' Despite his determination, further scans at the end of David’s course of therapy indicate that the cancer is still growing. More aggressive treatment follows. David remains insistent that he will soon be returning to work.

David’s family has a rather different outlook. They feel sure that David has less than a year to live, but they dare not challenge his thinking through fear of undermining what they describe as his 'positive attitude'. One day, during a conversation with his GP, David is told that it is unlikely that any further treatment will cure him. For the first time, he breaks down in tears. When he returns home he becomes very withdrawn and for the next few days says very little to anyone.

The silence is eventually broken when David announces to his wife that he wishes to make an appointment to see a local vicar. This surprises his wife, since David has not attended church in years. David explains that he wishes to get things in order for his funeral. Though a little perplexed by this, his wife feels some relief that David at least seems to be acknowledging the seriousness of his illness. However, it is not long before David seems to want to talk about nothing other than his funeral arrangements. His previous interest in the shop, as well as his longstanding fascination with reading about antiques on the internet and in books, is abandoned. By the time David and his wife go to see the vicar, David has convinced himself that he has only a couple of weeks left to live, and is panicking that there will be little time left to prepare for his funeral.

David’s story illustrates how hoping can be the very thing that keeps a person going. As long as he was able to sustain his expectation of setting up his antiques business, David had an interest in life. Yet his family felt awkward about this. They sensed that David’s hope lacked a reality base, that he was effectively denying his illness. In the event, they did not need to confront him over this concern, as it was of his own accord that he came to recognise that he was dying. But here is another 'unrealistic' response in David. If one form of denial is the non-acceptance that death is near, another is the refusal to see that there may still be living to be done. David displays a fatalistic resignation to death. This shows how hopelessness, as well as hope, can be unrealistic.

The experience of living hope is essentially a process. The person who hopes is one who is moving forward, living and growing, as well as dying. It is a process of discovery and negotiation, where some aspirations are attained as others are laid to rest. David illustrates this organic nature of hoping, which can be a painful struggle at times. An important question for pastoral carers is what sort of things should we look for when striving to discern what is 'realistic' in the hope we seek to nurture? Our exploration of living hope will consider this concern fora reality base, as well as what might be meant by the term 'realistic' itself.

Sue serves as a part-time voluntary lay assistant on the chaplaincy team at her local hospital. One day, having just' visited and prayed with a patient who requested to see her, Sue is beckoned over by a young woman on the other side of the ward. She introduces herself as Angela, and tells Sue that she overheard her praying. She asks if Sue could pray for her also.

It soon becomes apparent that Angela is very anxious. She is due to have surgery later that day. Angela is deeply worried that she may not regain consciousness after the operation. Sue asks if she has a faith. Angela replies, 'Oh no, I’m not at all religious. I went to church as a kid, but it was all very boring.' A conversation develops in which Angela describes Christianity as 'irrelevant to today’s world'. She tells Sue that she believes in 'something spiritual', but is not sure what that 'something' is. For all her apparent scepticism, Angela nevertheless wants Sue to pray for her. She grasps Sue’s hand, and with a look of desperation on her face she says, 'I don’t know what to ask you to pray for, but just say something for me, will you?'

In some ways Angela reflects what might be described as the postmodern context of contemporary Western culture. The term 'postmodern' is perhaps often used more readily than it is understood. Because of the breadth of its application, it has a tendency to lack analytical clarity at times. Indeed, it is a term that can be used to say something about everything, resulting in saying nothing about anything. Nevertheless, the term does denote certain cultural trends which cannot be ignored by a book that seeks to identify ways in which pastoral carers can foster a living hope in people who find themselves in despair in today’s world.

First, Angela is quite dismissive of Christianity as a 'religion'. A defining feature of postmodernity is its 'incredulity towards metanarratives'. ^[2] In other words, any kind of 'grand story' that is claimed as authoritative and ultimately true is regarded with suspicion. It is considered that metanarratives denote institutions, formalism, organised religion and authoritarianism, which all produce dominance, limit choice and restrict freedom. With this suspicion goes a predisposition towards individualism. The postmodern mind stresses the importance of personal choice from the plurality of options available. Special value is given to pragmatism in the making of choice: 'Does this work for me?' Something of this can be seen in Angela. Though she would discard Christianity as irrelevant, she knows that she desires 'something' from this person she has overheard praying, and that she wants her to 'do' some prayer 'for' her.

Angela’s request for prayer from Sue highlights another important hallmark of postmodernity: personal spirituality. While church attendance Statistics may suggest a contemporary decline in commitment to 'organised Christianity', the surge of interest in New Age and varied forms of eastern mysticism evince an intrigue with the spiritual. Again, this is commonly approached in a highly individualistic, privatised way. Postmodern culture regards spirituality, like everything else, through consumerist eyes: the individual must be free to pick and choose from the plurality of spiritual traditions that are out there to be had', and so tailor something that best accords with personal taste. th wary people we meet will be like Angela - reluctant to identify themselves with 'Christian' hope, yet longing to find a way of hoping i in and for 'something' that is transcendent. How might Christian pastoral carers go about the task of living hope in a spiritually thirsty world?

The questions we are raising are utterly practical and profoundly theological. They can be summarised in the following way: what is Christian hope, and how might we nurture it in others?

It was not long after I began my training as a Christian minister, several years ago now, that I found myself focused on these questions. As I reflected upon them with growing intensity I sensed a twofold curiosity. On the one hand, what might those who work with the dying say — the doctors, nurses and hospice workers? After all, these are the palliative care professionals, whose insights would come out of their own hands-on experience of working with life and death. On the other hand, as a minister, or more fundamentally, as a Christian, I believe that life and death points us beyond human science to something more ultimate: God. Thus I resolved that whatever may be learned from nursing and palliative health care, whether anecdotal or research- based findings, it must all be brought into a critical conversation with the voice of Christian theology. Unless my practice is theologically grounded, I am left wondering what makes my work ministry. The quest then, is for a practical theology of hope for the dying.

The importance of this quest is highlighted by three practical

theologians in particular, who in different ways have all wrestled with similar concerns as those raised here, drawing from both psychology and theology. The first is Donald Capps, whose Agents of Hope: A Pastoral Psychology takes up the issue of confidence in pastoral care. This is the very concern of Sarah, above, in her longing for some reassurance that her ministry might make a positive difference to someone who is dying. While Capps himself does not explore death and dying at length, he does argue that it is in 'the role that pastors play as agents of hope' that Christian pastoral care in general is distinguished from other 'helping professions'. He writes, 'Where other professionals may offer hope as a byproduct of what they do, the offer of hope is central to what pastors do. Oftentimes, it is all that they can offer.' ^[3] Perhaps it is because hope is essentially intangible that it can be difficult to grasp some kind of concrete reassurance that it really has been offered and that a positive difference has been made in the lives of people who would otherwise be in despair.

A second book to highlight the importance of hope is Bruce Rumbold’s Helplessness and Hope: Pastoral Care in Terminal Illness. This also engages with the feelings of inadequacy that threaten to engulf a pastoral carer in Sarah’s position. Rumbold describes a desperate sense of 'nothing more to do' that can overwhelm those who care for the dying. He suggests that it is precisely out of this experience of helplessness that hope is born, for it is only when we behold the stark reality that makes us feel so helpless that we can properly engage with it, break out of denial and work towards a mature hope. ^[4]

The issue of denial and the concern for a 'realistic' hope reminds us of David, above. David’s resolve to start an antiques business illustrates how vital it can be to sustain a meaningful sense of future if we are to carry on living in hope. Andrew Lester, in his Hope in Pastoral Care and Counseling,r emphasises just this point. Lester explores how hopelessness represents the loss or breakdown of a personal future story. Effective counselling, he argues, can restore hope by deconstructing stories of despair and creatively envisioning future narratives. ^[5] Like Capps and Rumbold, Lester stresses just how important hope is as a practical and theological concern. We will return to these writers later in the book, as they have each made a significant contribution towards the search for a ministry of hope.

Hope is a very profound subject, and I would be suspicious of any attempt at a neatly packaged 'how to' formula for pastoral care. That said, it was very early in my experience of pastoral ministry that I became aware of the serious need to find practical ways of nurturing hope. As such, I developed a growing fascination with both the psychology and the theology of hope. As I explored this deeply, and began to experiment with it in pastoral care, it became clear that it is possible to identify certain dynamics of hope as well as strategies for developing it.

This book is born out of that fascination.

In this book a summary will be given of both the psychology and the theology of hope. These fundamental sources will then be drawn from in order to offer a practical theology of hope for the dying. Here, dying refers to the pastoral context; hope itself is the topic.

A practical theology that is truly grounded in the experience of hope in a palliative context is one that takes seriously the research of those who have studied hope in the face of death as a fundamental human experience. For this reason we will begin by exploring the psychology of hope.r Then we will turn to the theology of hope, in order to identify some of the key theological concerns that relate to the meaning of Christian hoping. The chapter that follows this constitutes the core of the book, offering a definition of the dynamics of Christian hope and discussing its spirituality, drawing on the psychological and theological insights set before us. Practical suggestions for pastoral care will then be made as reflection is given to strategies for cultivating hope in others. Finally, consideration will be given to the wider implications of the practical theology of hope offered here for pastoral care in general.

The book thus takes an interdisciplinary approach. It expresses the conviction that a practical theology of hope for the dying must listen to the voices of both the psychology and the theology of hope. Prioritising either one of these disciplines over the other is not intended. A practical theology that is truly adventurous is one that is conscious of the danger of getting the balance wrong but takes the risk nevertheless. The precise relationship between theology and the human sciences presents questions that lie beyond the scope of this book. Stephen Pattison has pointed out that on the one hand:

At the same time, 'the theological tradition has been extensively ignored or forgotten about by those involved in pastoral care on both sides of the Atlantic. ^[7] What is offered here is an attempt at a creative and critical dialogue between sources.

The core argument that will be presented is that the most profound experience of hope, according to psychology and nursing science, is a mysterious sense of anticipation that transcends specific goals. It will be argued that while hope is a basic human phenomenon, it finds its most complete, holistic expression in resurrection, which is the heart of Christian hope. Only such a hope is sufficiently all encompassing and robust to engage with the reality of death.

The title Living Hope conveys something of the double-barrelled nature of this work. 'Living' expresses both an adjective and a verb. As an adjective, the meaning of the content of Christian hope will be explored - what makes it a living hope? But at least as important are the actual dynamics of hoping. In this respect something of an emphasis will be given to the verb - how might we live hope? We are concerned for the practicalities of ministering Christian hope to the dying, and so we will return to the issues raised by the pastoral encounters outlined in this introduction as we reflect upon how we may give 'an account of the hope' that is in us (1 Peter 3:15).

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