Perichoresis, Pot Plants, Prayer Cards and Poiesis: A renewed pastoral paradigm emerging out of care of those with a dual diagnosis and conversations with midwives and obstetricians

Abstract

This research arose from my experiences as a curate in England’s Northwest seeking to embody God’s love in the pastoral care of men with addiction and mental health issues (dual diagnosis), reflecting a wider societal issue around the care of people with that combination of problems, and the under-recognised role of clergy as unofficial ‘front-line mental health workers’. This is a role that clergy get little training to discharge effectively, and so the research methodology employed was that of a Constructivist Grounded Theory as I’ve attempted to use insights from a variety of disciplines to act as a ‘scaffold’ in order to work out what clergy could meaningfully and consistently offer. Treatment for those with a dual diagnosis is difficult and often unsuccessful because it requires a collaborative relationship between patient and carer where often there may be a lack of acceptance that the issues exist. Insights were sought then from a related, but different field, namely midwifery and obstetrics, engaging with intrauterine death – where the mother may not have completely accepted the realities that they face. Interviews were conducted with clergy in the field, midwives and obstetricians. Accounts of the experiences of dual diagnosed individuals were sought through existing evidence in the public sphere to minimise the risk of harm for research subjects. Analysis of the research data revealed that pastoral care in those situations of complex bereavement are about embracing the tension between absence and presence, and helping people through that liminality, to reappropriate their grief and expectations of what life ‘should be’ to ‘how life is’ and ‘how life might be in the future’. The significance of the role of objects is explored with particular emphasis on ‘memory boxes’, and their nearest equivalents in the field of dual diagnosis. These insights are connected to the academic study of the Doctrine of the Trinity, particularly focussing on the work of Sarah Coakley, with a thorough exploration of the metaphor of dance that has evolved around the concept of ‘perichoresis’ with connections made between doctrine and modern insights from dance studies. The result is a renewed pastoral paradigm that is collaborative, dynamic, liminal, and with an acceptance that care is not simply about ‘being present’, but about resourcing people for ‘absence’ as well through a poiesis that emphasises the freedom of the cared for, whilst encouraging and seeking what will motivate them to enter into the liminal space, a movement through which will enable their greater flourishing. This paradigm has implications beyond those with a dual diagnosis, and can be extended into pastoral care in its widest sense.