Pastoral Care and the Sick

OUR day is a transitional period in Christian pastoral care, characterized by confusion as to the nature, purpose, and function of the pastor. . .

-Chaplain at New England Memorial Hospital, Stoneham, Massachusetts, at the time this article was written

OUR day is a transitional period in Christian pastoral care, characterized by confusion as to the nature, purpose, and function of the pastor.

Modern man lives in a time when there is an inexhaustible resource of troubles and predicaments. Also, we see in our confusing age widespread religious uncertainty. In the mind of modern society it appears that Christianity as practiced by our grand mothers has little relevance for today.

A genuine and overriding concern of our society is the desire to find peace, to accomplish man-to man reconciliation. However, the traditional Christian emphasis on man's reconciliation to a personal God seems irrelevant or at least far down the scale of twentieth-century concerns. No matter how much we Adventist Christians may deplore or decry these developments, these concerns are present in the lives of most modern men and women.

Although pastoral care for troubled persons remains the concern of the Christian pastorate, in modern society profound doubts have arisen as to whether the resources of the Christian faith can provide the means to help. All too often pastors tend to place too much emphasis in the helping professions of medicine, psychiatry, social work, education, penology, counseling, and others.

But just as these other helping professions have periodically reappraised their traditions so must the profession of pastoral care. Perhaps by looking at pastoral care in a historical setting and an examination of pastoral functions we can better reappraise our goals and objectives as Christian pastors.

Pastoral Care in a Historical Setting

Christian pastors through the centuries, men from all communions both sophisticated and simple, have sought to help troubled people overcome their problems. Early pastors in the first centuries were concerned with sustaining souls through the problems of a pagan world that was believed to be coming to an end swiftly. The church during the third and fourth centuries was under severe oppression, and thousands faced martyrdom. Their parents labored hard in attempting to reconcile troubled people to one another and to God.

As Christianity became accepted, legalized, and popularized, pastoral care developed around a well-defined sacramental system that in effect depersonalized the act of caring for people.

The Reformation and Renaissance periods, while producing enlightenment in most areas of knowledge, produced no such advance in pastoral care. As a result, there began to develop helping professions and organizations dedicated to doing the personal work the pastor of the early centuries had been so effective in performing. Psychiatrists, psychologists, social workers, lawyers, and doctors all represent professions that in one form or another sprang from the role of the Christian pastor.

The pastor in today's society has to a great degree allowed specialists to usurp his divine commission of ministering to the individual.

The Functions of Pastoral Care

Historically, pastoral ministry to the individual has been in the form of four special functions healing, sustaining, guiding, and reconciling. These four functions are performed in the context of eternal values and against the background of the return of Christ.

1. Healing. Healing is a pastoral function that aims to overcome some impairment by restoring a person to wholeness and by leading him to advance beyond his previous condition. The wholeness that pastoral healing seeks to achieve is, therefore, not simple restoration of circumstances that prevailed before impairment began. It is hoped that the person will have moved to a higher spiritual level than before.

A man whose gall bladder is diseased and requires surgery can be restored to the normal condition that prevailed before the organ was removed. In the pastoral understanding of healing, healing is more than mere restoration. The man who has had his gall bladder removed may be challenged by the dangers of illness and surgery, and can find a new depth of under standing of life by drawing on his Christian resources.

Healing as restoration and advance has always been an important function of pastoral care. Historically, there have been a variety of instrumentalities and methods of healing. In the early centuries anointing with oil, or unction, was popular. By the ninth century extreme unction was becoming preparation for death.

An interesting aspect of the early healing ministry was healing through contact with relics, generally claimed to be a part of the body of a saint, or perhaps clothing or wood from the cross.

Exorcism--driving away malevolent spirits by means of sacred works and holy rites was used for centuries. Even today it has limited use in Roman Catholicism. Also certain types of prayers, adorations, ritualistic arts, and consecrated portions were used as remedies. Christian incantations, rituals, and holy objects were used to reinforce the healing power of herbal unguents and medicines.

Today there are certain pastors with a renewed interest in spiritual, or faith, healing. Some faith healers have repudiated the worth of medical healing in an effort to recapture a ministry now largely conducted outside the church.

Pastoral healing in a limited way continues in the church, but the healing function has become confused and often isolated from the other conventional healing arts. At a time when pastoral healing seems largely lost as a pastoral function, it is at the same time open to what the Seventh-day Adventist pastor has to offer.

2. Sustaining. Pastoral ministry was the most important function of the early Christian church. With the faith of the early Christians centered on the soon return of their Lord and facing the rigors of a hostile world, these people needed a vital and sustaining ministry. This sustaining ministry can be considered in four parts:

(a) Preservation. This is the first task holding the line against other threats or further loss. Helping the bereaved to work through grief. Supporting a desperate person facing a terminal illness. By a touch, a glance, a word, a gesture.

(b) Consolation. The second task in pastoral sustaining aims to relieve a suffering person of his sense of misery, offering hope in the specific time of trial.

(c) Consolidation. The third task enables the sustaining ministry to proceed with a regrouping of remaining resources despite loss. Suffering is put into perspective as the sufferer gathers himself together. The pastor helps the troubled person reconstruct his life.

(d) Redemption. The pastoral function of sustaining helps a deprived person begin to build an ongoing life. The loss is not restored. If it were, that would be the ministry of healing. But a positive attitude toward life is recovered; for example, the widow redeems her loss by becoming mother and father to her orphaned children.

3. Guiding. The pastoral function of guiding attempts to mobilize resources within the troubled person, focusing them on the heat of specific troubles and striving to arrive at a decision.

Modes of the ministry of guidance may be thought of as a continuum from advice giving on one end and listening and reflecting on the other. The advice-giving type of guiding seeks to lead the troubled person to reach his decisions in terms of his own set of values and frame of references. Another form of advice-giving attempts to shepherd the troubled person into a situation that will better his welfare. Evangelism is a related type of advice-giving.

Spiritual guidance through the snares and traps of sin is another form of guiding. No man ought to be alone against the wiles of Satan, therefore, pastoral guidance through the ministry of the Word and the fellowship of believers joining hands is a necessity.

4. Reconciling. The fourth pastoral function, the ministry of reconciliation, helps alienated persons to establish a renewed proper and fruitful relationship with God, self, and neighbors.

The reconciling function has an extraordinarily rich heritage in the church, and it remains a means of helping for which there is no nonpastoral substitute. It deals with the burden of guilt under which modern men and women live guilt engendered by alienation from fellow men that interprets it self also as alienation from God. Urban mobility and the resulting shifting of patterns of family life have produced parent guilt over children and later on, children's guilt over responsibility for aging parents. Modern marriage produces situations where more and more questions and burdens arise. Related matters of guilt, responsibility, relationship, alienation, and reconciliation are part and parcel of modern human troubles for which the reconciling ministry is peculiarly well suited.

Reconciliation takes place first of all through forgiveness. It can be a proclamation, an announcement, or even a very simple gesture indicating that in spite of the walls of pride and hurt that separate men something has occurred to reunite persons to each other and to God. Confession and a repentance may be considered necessary preconditions to forgiveness.

The Christian pastor with his concern for establishing and re storing relationships, declaring God's forgiveness of sin, and bringing relief from guilt is unique in modern society.

Pastoral Care—an Adventist Challenge

With the unique Adventist view of the nature of man and a theology of pastoral care that relates to that view of man, the Adventist pastor can minister to people in a complete and realistic way.

This sustaining function of the care of souls continues to be an increasingly important helping ministry. It is sufficiently versatile to be adapted to the circumstances of our inner-city ministry. In the concerns of a mobile society and the lack of support once furnished by close friends and longtime neighbors, the competent urban Adventist pastor can provide the support needed.

Perhaps the most unique contribution that the Adventist minister can make to pastoral care is in the function of healing. No other Christian communion possesses a more comprehensive view of this ministry. The massive commitment of the church to healing and our view of total health as including mental, physical, and spiritual dimensions provides a broad base on which a modern last-day ministry of healing may be revived.

The function of healing is closely allied with the ministry of reconciliation. Ellen White in The Ministry of Healing, page 141, states, "To make known . . . the message of ... grace ... is the first work of those who know its healing power."


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-Chaplain at New England Memorial Hospital, Stoneham, Massachusetts, at the time this article was written

March 1973

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