Post on 31-Jul-2020
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
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.
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
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
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
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.
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
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.
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.
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
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?
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 http://www.contemplativemind.org/programs/cnet/contorgs.pdf., pg. 58
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 http://www.contemplativemind.org/programs/cnet/contorgs.pdf., pg. 58
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 http://www.contemplativemind.org/programs/cnet/contorgs.pdf., pg. 58
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.”
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.”
“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.”
STUDENT REFLECTIONS