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Harvard Divinity School, Harvard University, Cambridge, MA 02138, USA, Adibhat Foundation for Integrating Medicine
and Spirituality, Greater KailashI, NewDelhi, India
ABSTRACT
Background: Of various spiritual care methods, mindfulness meditation has found consistent application in clinical
intervention and research. Listening presence, a chaplains model of mindfulness and its transpersonal application in
spiritual care is least understood and studied.
Aim: The aim was to develop a conceptualized understanding of chaplains spiritual care process based on
neurophysiological principles of mindfulness and interpersonal empathy.
Materials and Methods: Current understandings on neurophysiological mechanisms of mindfulnessbased
interventions(MBI) and interpersonal empathy such as theory of mind and mirror neuron system are used to build a
theoretical framework for chaplains spiritual care process. Practical application of this theoretical model is illustrated
using a carefully recorded clinical interaction, in verbatim, between chaplain and his patient. Qualitative findings from
this verbatim are systematically analyzed using neurophysiological principles.
Results and Discussion: Chaplains deep listening skills to experience patients pain and suffering, awareness of his
emotions/memories triggered by patients story and ability to set aside personal emotions, and judgmental thoughts formed
intrapersonal mindfulness. Chaplains insights on and ability to remain mindfully aware of possible emotions/thoughts in
the patient, and facilitating patient to return and rereturn to become aware of internal emotions/thoughts helps the patient
develop own intrapersonal mindfulness leading to selfhealing. This form of care involving chaplains mindfulness of
emotions/thoughts of another individual, that is, patient, may be conceptualized as transpersonal model of MBI.
Conclusion: Chaplains approach may be a legitimate form of psychological therapy that includes inter and intrapersonal
mindfulness. Neurophysiological mechanisms of empathy that underlie Chaplains spiritual care process may establish
it as an evidencebased clinical method of care.
Key words: Chaplain, empathy, healing, mindfulness, mirror neuron, religion, spiritual
INTRODUCTION
Spiritual care is reportedly provided in various forms
such as prayers by religious/spiritual(r/s) care providers
in hospital settings,[1,2] faith healers at religious places of
Address for correspondence: Dr.Ramakrishnan Parameshwaran,
Center for Study of World Religions, 42 Francis Avenue,
Cambridge, MA 02138, USA.
E-mail: par469@mail.harvard.edu
DOI:
10.4103/0019-5545.148511
21
Figure 1: Schematic representation of the intra and transpersonal model of mindfulness in a chaplains spiritual care process
24
ACKNOWLEDGMENTS
I am deeply indebted to my CPE supervisor, Dr.Rev. Garrett
Starmer, for his patient guidance and his Socratic-teaching
skills which helped me understand the spiritual care process
in an experiential way. Special thanks goes to my colleagues in
the CPE residency group for their continued critical as well as
validating feedback that helped me understand my strengths
and growing edges. Iwould like to thank the entire faculty
especially, Chaplains Kathy Olson, Paula, and Jane Profont at the
Spiritual Care Department of Franciscan Health System group for
compassionate and wayside lessons in spiritual care. Igreatly
appreciate Ch. Judy Klontz, Ch. Glori Schneider(my chaplain
supervisors), Dr.Kevin Flannelly,(Chaplain and editor of JHCC),
Dr.Pratima Murthy(Professor of Psychiatry, NIMHANS) and
Dr.David Vago(Instructor, Functional Neuroimaging lab, Harvard
Medical School) for their valuable inputs.
REFERENCES
1.
27
2002;13:22336.
65. Monshat K, Khong B, Hassed C, Vella-Brodrick D, Norrish J, Burns J,
Herrman H. A conscious control over life and my emotions: mindfulness
practice and healthy young people. A qualitative study. J Adolesc Health.
2013;52(5):572-7. doi: 10.1016/j.jadohealth.2012.09.008.
66. RossiEL, RossiKL. The neuroscience of observing consciousness and
mirror neurons in therapeutic hypnosis. Am J Clin Hypn 2006;48:26378.
67. CorradiniA, AntoniettiA. Mirror neurons and their function in cognitively
understood empathy. Conscious Cogn 2013;22:115261.
68. HallCW, RowKA, WuenschKL, GodleyKR. The role of selfcompassion
in physical and psychological wellbeing. JPsychol 2013;147:31123.
69. GermerCK, NeffKD. Selfcompassion in clinical practice. JClin Psychol
2013;69:85667.
70. BraadbaartL, de GrauwH, PerrettDI, WaiterGD, WilliamsJH. The
shared neural basis of empathy and facial imitation accuracy. Neuroimage
2014;84:36775.
71. PuchalskiCM. Spirituality in the cancer trajectory. Ann Oncol
2012;23Suppl3:4955.
72. LutzA, BrefczynskiLewisJ, JohnstoneT, DavidsonRJ. Regulation of the
neural circuitry of emotion by compassion meditation: Effects of meditative
expertise. PLoS One 2008;3:e1897.
73. GrepmairL, MitterlehnerF, LoewT, BachlerE, RotherW, NickelM.
Promoting mindfulness in psychotherapists in training influences the
treatment results of their patients: A randomized, doubleblind, controlled
study. Psychother Psychosom 2007;76:3328.
74. KabatZinnJ, LipworthL, BurneyR. The clinical use of mindfulness
meditation for the selfregulation of chronic pain. JBehav Med
1985;8:16390.
75. TeasdaleJD, SegalZ, WilliamsJM. How does cognitive therapy prevent
depressive relapse and why should attentional control(mindfulness)
training help? Behav Res Ther 1995;33:2539.
76. RosenzweigS, GreesonJM, ReibelDK, GreenJS, JasserSA, BeasleyD.
Mindfulnessbased stress reduction for chronic pain conditions: Variation
in treatment outcomes and role of home meditation practice. JPsychosom
Res 2010;68:2936.
Appendix 1: Following is the verbatim(qualitative data) of clinical encounter between the chaplain
(spiritualcareprovider) and patient
Verbatim: Clinical encounter between
chaplain(C) and patient(P)
28
Appendix 1: Contd...
Verbatim: Clinical encounter between
chaplain(C) and patient(P)
S29: Iwas happy that she was able to say that her
emotions are painful
29
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