A chaplain speaks with a young man who will die in the near future. The topics change: Why all this? What will become of my children? Why does my wife not want to talk when I bring up my death? Is it okay if I record a video message for my two boys so that later they can hear me say that I love them? Or would that be too much of a burden? Can you and your team still make it possible for us to go away as a family for one more weekend? I once made a big mistake that still weighs heavily on me.
From the outside, two men of the same age seem to be in a rather bumpy conversation. The thread appears to be missing, speechlessness often fills the room, and there is somehow no solution at the end.
Everything is communication, and communication is multilayered
When is a conversation a good conversation? How is successful communication measured, especially in a palliative situation? Do particularly clever questions make the difference? Who guides the conversation: patient or chaplain? The great communication theories of our time offer several approaches to this complex question.
Paul Watzlawick coined the well-known sentence: one cannot not communicate. This also applies to the situation described above. Words are in the room; chaplain and patient communicate through glances and gestures; even how the chaplain turns toward the patient, what closeness or distance he chooses and how he sits influences communication. Silence, too, belongs to it. There is indeed such a thing as eloquent silence or filled stillness that makes intense moments possible.
Since Friedemann Schulz von Thun, we know that sender and receiver communicate on different levels. A factual statement by the patient may be received by the chaplain on the relationship level or as an appeal - and vice versa. It becomes truly complex when we remember that we communicate not only outwardly. Patient and chaplain also speak with themselves in inner dialogues.
Different voices within us can influence communication. The chaplain might be confronted by inner drivers such as, "I must not make a mistake here." The patient may suddenly feel guilty because he has spoken negatively about his wife in front of the chaplain. At the same time, there are also gracious voices within us that contradict the critical ones.
Another difficulty for the chaplain may arise, which Sigmund Freud called countertransference. The patient may touch something in his conversation partner and trigger processes. Perhaps the chaplain suddenly becomes occupied with himself and sees, in the patient of the same age, a mirror of himself and his own limitations.
Because everything is communication, these impulses cannot be avoided. In conversations we are constantly confronted with people and their themes touching our worlds, entering them, and with the danger that we begin to play our own films. One of the most important competencies in communication - especially in spiritual care - is to notice these processes consciously, distance ourselves from them and turn back toward the patient and the patient's world.
Different worlds meet
If the chaplain succeeds in identifying his own films and setting them aside for the time being, he can try to see the patient's world through the patient's eyes and heart. This attempt will never succeed completely, but the constant effort is one of the greatest challenges of pastoral conversation.
It is about stepping into the patient's footsteps and sensing his view of the world, of his illness, of the hope that carries him or the hopelessness that makes him despair. Carl Rogers calls this competence empathy. Together with acceptance and congruence, it forms a communicative attitude that is indispensable for conversations within spiritual care.
Acceptance means appreciation. The chaplain meets the young father without regard to status or religion. He does not judge morally and does not condemn when the patient speaks of a mistake in the past. He is present at eye level, holds the situation with him and expresses respect for the uniqueness of the person he is meeting.
In this context stands the well-known sentence by Cicely Saunders: "You matter because you are you. You matter to the last moment of your life, and we will do all we can so that you may not only die peacefully but also live until the end." The attitude expressed here has consequences for communication: it should be free of prejudice, attentive, empathic, appreciative and genuine.
Genuine or congruent communication succeeds when the chaplain does not hide behind a role but exposes himself openly, authentically and truthfully to the suffering father. He does not have to know everything, answer every question, make every powerless silence impossible or function perfectly. It would be enough if he were simply there - as a conversation partner, as a chaplain, as a human being.
Client-centered conversation according to Carl Rogers declares the client - here, the patient - the expert of his own life. The themes of the young man who has only a short time left must be the themes of the conversation. The silence he chooses corresponds to the weight of the situation. Sometimes words are simply too banal.
The conversation is over. For a moment of their lives, the two men have met and communicated - perhaps awkwardly at first glance, perhaps without a thread and with many pauses. Two worlds have touched in this dialogue. Now both return to their worlds. Perhaps the conversation leaves traces there. Communication continues.
