ATTENDING WITH BODY, SPEECH AND MIND: THE PRACTICE OF BASIC ATTENDANCE

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Jemima Campbell
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1 ATTENDING WITH BODY, SPEECH AND MIND: THE PRACTICE OF BASIC ATTENDANCE Elaine Yuen, PhD Associate Professor Master of Divinity Program Department of Religious Studies Naropa University Association of Professional Chaplains Orlando, Florida, June 28-30, 2013

2 PRESENCE IN THE CLINICAL ENCOUNTER Patients who are ill must often face difficult clinical decisions with uncertain outcomes. Spiritual practices have the ability to articulate this uncertainty Provide a context where anxieties may be faced, felt and understood. These understandings may support patients and their families increased clarity of clinical facts, diagnoses, prognosis Increased acceptance of emotional content in decisions.

3 THE KNOWN AND THE UNKNOWN Key to spiritual practice is the inclusion of the unknown or liminal space within the clinical encounter. In healthcare encounters, we often deny we are standing at the threshold of the unknown. Steps for accessing an applied spirituality which allows practitioners to attend to this liminal space are described

4 U-Process: 1 Process, 5 Movements 1. Co-initiating: uncover common intent stop and listen to others and to what life calls you to do 5. Co-evolving: institutionalize the new in practices by linking micro, meso, macro change 2. Co-sensing: observe, observe, observe connect with divers people and places to sense the system from the whole 4. Co-creating: prototype the new in living examples to explore the future by doing 3. Co-inspiring: connect to the source of inspiration and will go to the place of silence and allow the inner knowing to emerge

5 THE PRACTICE OF BASIC ATTENDANCE Utilizes a contemplative practice of mindfulness and awareness. This practice supports observations of physical, communicative, and cognitive aspects of the client/patient as well as one s own personal perceptions. By engaging in this way, a greater appreciation and understanding of the physical, emotional and environmental aspects of a pastoral encounter can be developed.

6 BASIC ATTENDANCE: ESTABLISHING AN ENVIRONMENT OF SANITY Attentive care Based on needs at hand Not necessarily a solution or a fix Experiences of patients and their families Moving/thinking at different pace slowing down Memory loss / confusion Uncertainty and fear Creating a sane atmosphere Physical aspect: reflects personality and possessions Emotional aspect: where patient could let go - experience full texture of emotions

7 THE WINDHORSE COMMUNITY Basic Attendance is a fundamental skill practiced by Windhorse clinicians Boulder CO and Northhampton MA Team approach Attending during daily, ordinary activities Focuses awareness on the immediate needs of the moment. Has the integrative effect of gently grounding attention in physical reality and strengthening the empathic bond between client and staff. Cultivates moments of clarity, humor, and relaxation found in even the most confused states These "islands of clarity", when recognized and valued, become the seeds of recovery.

8 CLINICAL PRACTICE OF BASIC ATTENDANCE Subtle combination of being with the person skill and understanding of a pastoral caregiver warmth and empathy of a friend. Engaging with the person in ordinary activities of daily living. accomplishing problematic tasks expanding into areas of interest scheduling sane rhythms of activities furthering personal awareness. In groups / teams of caregivers or by sole team member.

9 ROLES OF THE CHAPLAIN: BEING AN ALLY Acknowledge reality of situation comfortable with clinical details Mitigate harshness Ability to enter patient s world rather than impose ours on them Sensitivity to own physical approach, emotions Awareness of own limits not pretending to be benevolent

10 OBSERVING BODY, SPEECH AND MIND Patient, family, as well as own perceptions Individuals as well as energetic quality of environment(s) Body: physical descriptions Appearance, ethnicity, gait and movement, family, living situation Speech: communicative qualities Verbal and emotional expression, relationships Mind: cognitive aspects How s/he sees and understands the world, are thoughts organized, confused, colorful, dull?

11 TEN SKILLS OF BASIC ATTENDANCE: DISCOVERY AND OBSERVATION 1. Being Present: Basic mindfulness-awareness in the present moment. 2. Letting In: Deep empathic resonance. Cultivated through tonglen practice. 3. Bringing Home: Basic synchronization of body, mind, and environment. 4. Letting Be: Dropping therapeutic ambition and accepting a person as they are. Duerr, Maia. Creating the Contemplative Organization. (Center for Contemplative Mind in Society, 2004), pg.58 pg. 58

12 TEN SKILLS OF BASIC ATTENDANCE: CONNECTING WITH INSPIRATION 5. Bringing Along: Inviting and encouraging a person to venture out into the world/community. Can include sharing our own world (i.e. family, home) with client. 6. Recognizing: Noticing and encouraging "islands of clarity". Everyone has a basic spark of intelligence and wakefulness and a history of expressing it. We can focus on this rather than pathology and failure. 7. Finding Energy: Finding a passionate point of sensory contact with the world. Opening to beauty. Duerr, Maia. Creating the Contemplative Organization. (Center for Contemplative Mind in Society, 2004), pg.58 pg. 58

13 TEN SKILLS OF BASIC ATTENDANCE: COMPASSIONATE ACTIVITY 8. Leaning In: Encouraging people to take responsibility for their own lives. Discipline and exertion. 9. Discovering Friendship: Relationship becomes genuine, more than just therapeutic. We call this the "therapist-friend dilemma". 10. Mutual Learning: Doing basic attendance is not just a way to help others recover. It provides opportunities for our own personal growth and recovery. Duerr, Maia. Creating the Contemplative Organization. (Center for Contemplative Mind in Society, 2004), pg.58 pg. 58

14 STUDENT OBSERVATIONS M is spacious and elegant. She is not necessarily organized, but she is light. In everything she does, the gestures she makes, expressions, conversation, etc there is a lightness, indeed, a buoyancy. She smiles often and is prone to laughter given the appropriate cues. She likes to laugh, and even when the language gap is perhaps to far to breach, she laughs anyway because she has the keen sense to know that something worth laughing about is taking place, because she would like you to feel comfortable, or otherwise because her sense of humor defies the boundaries of language and after all, she knows what you mean.

15 STUDENT OBSERVATION & REFLECTION When I arrived at her house I noticed her body posture right away because she was sick. She was bundled up and drinking tea. I could tell by her tight body language and droopy facial expressions that she was feeling well. We sat in her home for a while, and soon I noticed that every time asked her a question she immediately was asking me a question first. Although flattering at first, I began to feel a little nervous because I felt like her quick speech and rapid fire questions were keeping me from being able to get to know her or do my basic attendance work....i felt some stiffness in my shoulders as I worried that wouldn t be able to get to know her.

16 STUDENT REFLECTIONS Shifting between each level of interaction seemed to flow easier when I would become aware of a rise in my own internal dialogue, stop and breathe fully, and return to attending [my partner] with this process of body, speech and mind. Beginning with breath, then body, then speech and finally to mind and meanings gave a much richer context for exchange. I was aware that this exercise was not unlike meditation in its use of moment to moment awareness, breath, distraction, awareness, acknowledgment, release and returning.

This is a large part of coaching presence as it helps create a special and strong bond between coach and client.

This is a large part of coaching presence as it helps create a special and strong bond between coach and client. Page 1 Confidence People have presence when their outer behavior and appearance conveys confidence and authenticity and is in sync with their intent. It is about being comfortable and confident with who