Pastoral Care Givers – Denial: Is it Dangerous?

Pastoral Care Counselors and Dealing with Denial of Patients

The initial reaction of denial to horrible news is our body's  natural way of coping with stress
The initial reaction of denial to horrible news is our body’s natural way of coping with stress
Elizabeth Kubler Ross identifies denial as the first response to grief.  She considers it to be a natural reaction to sudden and horrible news.  In her seminar on the dying, she hoped to share with pastoral care counselors, health care professionals and ministers the necessity of denial in the progress through grief.
While not everyone follows the same pattern of grieving, pastoral care givers can be assured to witness many cases of denial.  The looming question, however, is when can denial become dangerous, if it ever even can be?
Kubler Ross experienced one case of a woman who was diagnosed with cancer.  She attended a faith healing service and proclaimed she was healed despite everything medical science proved otherwise.  Her behavior was consistent till the very end insisting she was healed.  Nevertheless, she continued her treaments, medications and visits to the hospitial.  During that time, she would joke of the foolishness of these treaments only till her body finally broke down and she had to come to the heart breaking conclusion of her dire situation.
Kubler Ross never contradicted her denial explicitedly.  Instead, she would never confront the woman on the issue of the supposed healing or say otherwise.  Her primary concern was that the woman continued to take the prescribed medications necessary.  Through simple requests to continue to take one’s medication, Kubler Ross implicitedly resisted the denial.
This type of denial was far from dangerous but critical to the woman’s coping of her physical situation.  It allowed her to carry on day by day.  As long as the woman did not resist the medications or therapies, then the denial was not dangerous.
Cases where denial become dangerous are when the person refuses treatment or carries on doing activities that are harmful to their health.  Some people and their denial will even lead them to insane adventures and spending sprees.
The primary lesson for pastoral care givers to learn from Kubler Ross is to react to most denial in an implicit way that does not damage a person’s coping.  Merely ensure the denial does not damage them health wise.
If you are interested in Pastoral Care Certifications, please review the program.
Mark Moran, MA

Pastoral Care and Dealing with the Angry Patient

Pastoral Care Giving Is Love and Understanding

Understanding the emotions of the terminally ill is key to pastorally treating them
Understanding the emotions of the terminally ill is key to pastorally treating them
Elizabeth Kubler Ross in her writings spoke of the five stages of grief.  In particular, her studies dealt with the reactions of terminally ill patients and the phases they went through.  Pastoral Care Giving involves an intimate connection of communication between care giver and patient.  In many cases, the care provider supplies the horrible news that someone will soon die.  Within this there will be a multiude of reactions.  One such reaction is anger.
So how does a nurse or pastoral care giver deal with the angry patient.  Ultimately with love and understanding!  The care of a terminally ill patient is more than just caring for his or her physical needs but is a caring for the totality of the human person.  In this regard, emotional symptoms must be treated as if physical symptoms.
Kubler Ross asked the question, why is the patient angry?  The only way to know is through communication and care.  Avoidance and frustration with a patient’s anger will not endear him or her to you nor will it make matters better.
Many patients may be upset over a variety of reasons.  Is their death premature or expected?  Is the death blamed on God or another doctor or treatment?  Is the anger a source of regret of how a person lived his or her life?  Is the anger due to the fact you never notice any family members coming to say “goodbye”.  Is the anger over a loss of control?  Is the anger over how the patient was treated the previous night by a different nurse?  Is the anger over the fact the person cannot die at home?
The realm of possiblities is endless and this is again why Kubler Ross insisted one cannot ignore the patient who is angry.  Instead, one must discover why the person is angry.
In one case study, Kubler Ross noted that an elderly man simply wished to have his side gate of his bed down so as to move his legs.  He feared the casket like formation he had to endure and it reminded him of death.  His nurse instead refused for fear of him falling.  She was more interested in reading her book by the bedside chair.  Maybe it was due to her own fear of facing death that she distanced himself from this poor man.  Regardless, the man would be frequently angry.
Another case study was of a man who always controlled his life, whether in his successful business or his command of his family.  His anger was a result of the loss of control to the nurses and other health related decisions.  Simply by identifying this and giving him options, he became less angry.  In fact, he always had a say or input in the course of action directed, but under the guise he had a “control” in the matter.
So as one can see, pastoral care is more than just taking one’s blood pressure or taking checking various readings, but it is also understanding the emotional dynamics that take place within the human mind.  Anger is merely a manifestation of something that is deeply wrong;  it shoud not affect health care professionals to the extent they ignore the angry patient, but instead push them to finding out why and alleviating it.
If you are interested in Pastoral Thanatology Certifications, please review the program.
Mark Moran, MA