The Improvising Chaplain

By Mark A. Feldbush

An improvisational approach to pastoral care allows the chaplain to provide support in line with the patient’s own spirituality.

Clinical Pastoral Education (CPE) is a ministry training program that is frequently offered in hospitals. Students who enroll in CPE include congregational clergy, seminary students, and lay people interested in pastoral care ministry. I am a Certified Educator and I coordinate a CPE program in a pediatric hospital.

Hospitals are disorienting places. Consider the patient who feels like a foreigner in a strange land. Due to their illness or injury, they have to leave home. They sleep in a strange bed. They wear odd clothing—a thin cotton gown that closes up in the back. And the food they eat is nothing like home cooking. It is hard to get sleep. Nurses and other medical team members barge into the room to give medicines or take vitals. In this disorientation, the patient often asks spiritual questions. Why is this happening to me? Did I do something wrong? Where is God?

Hospitals are also disorienting places for student chaplains in CPE. They, too, are like foreigners in a strange land. They have to learn to find their way through the maze-like halls of the hospital. Understanding the new medical terms is confusing. The soundtrack beeps and whirring sounds of the IV pumps and ventilators is a strange musical score. Then the student encounters people with diverse religious beliefs, ethnic backgrounds, sexual orientations, gender identities, and socio-economic statuses. In this disorientation the CPE student also asks questions. Can I do this? How do I provide spiritual care to someone who holds different beliefs than I do?

As the student chaplain learns to navigate this disorientation, they “want to get it right.” They do not want to “mess up” during the ministry encounter. In this disorientation, students often assume that a controlling approach to spiritual care will be the right way to minister. This directive approach often includes reading scripture, praying, and sharing their faith. These practices function like a script that says, “If you want to have peace with God, you should believe and practice your faith like I do.” This script approach is supported by a theology with a controlling view of God.

This drive to be “perfect” often comes from a “fear of falling short of an impossible external standard,” says pastoral care professor Edward Wimberly. One of my students wrote a weekly reflection about the fear of going into a hospital room to visit the patient and not knowing what was going to happen. This student chaplain wished for a script to tell them what to say and do at the right moment.

The improvisation website shared a Venn diagram in 2014 that describes theatrical improvisation (improv) as the place where joy and fear overlap. Chicago improv pioneer Del Close understood the value of affirming fear. He “always said to follow the fear in your work. It is good to be uncomfortable; otherwise there is no danger, no excitement, no growth,” writes Charna Halpern. This improv principle of “following the fear” is consistent with the pastoral formation process of CPE.

CPE students are typically drawn to the work of ministry for the joy and satisfaction it gives them to serve God by helping people in need. The clinical context of working in a hospital and facing trauma, death, and crisis can be a scary experience as it takes the pastoral care student out of their comfort zone and challenges their skills and competence. An improvisational approach to pastoral formation in CPE invites the student pastoral care provider to be present with their own fear and anxiety, to follow it and to listen to it as an ally in their formation journey. By following their fear on the path of pastoral formation, the CPE student will learn how to be present to the emotional and spiritual needs of the care recipient and to allow the appropriate spiritual care to arise out of the pastoral relationship.

My experience as a chaplain and educator is that there is no script for pastoral care ministry. Rather, I understand pastoral care as an improvisational process. This improvisational approach to pastoral care calls for being with people in the here and now. Through conversation, the chaplain assesses and understands the needs of the patient. Then the chaplain offers empathic support by helping the care recipient to draw on the practices and beliefs of their own spiritual orientation. This improvisational approach to spiritual care is informed by an uncontrolling view of God’s love. It recognizes that God is already present in the spiritual tradition of the patient, no matter what that spiritual tradition is.

The art of improvisation is a creative act. While it may appear that improvisers engage in creatio ex nihilo (creation from nothing) or simply making it up as they go along, they actually participate in what I have called creatio ex materia (creation from existing material.) Theologian Peter Heltzel uses the language of creatio continua to describe this phenomenon while discussing jazz music.

While driven by spontaneity, freedom, and innovation, improvisation is never so unstructured… that it could be considered creatio ex nihilo…. Rather, it is a creatio continua, a continual creation drawing on existing materials to make music in new ways. Improvisation is the creative deployment of traditions and forms that are at hand; the dynamic involved in improvisation therefore can be understood as a constant negotiation of constraint and possibility” (p.18).

Improvisers work in relationship with the ideas and emotions (the material) presented by their stage partners to create a scene. Improvisation is about discovering what exists in the context of a relationship and allowing the relationship to become something more. The art and work of improvisation is guided by several maxims, the first of which is typically: “Yes, and…” This maxim comes from a place of hope and courage. It opens a world of possibility and action to the improviser as they develop relationships among the other improvisers. This sense of building relationship is key for those developing the art of pastoral care.

In my work of improvisational clinical pastoral supervision, I begin with the relational nature of the God of Hope (Romans 15:13). As a Christian, I understand that the one God exists in the community of the Trinity. Because I believe that the God of Hope exists in community, I also believe that hope flows outward into God’s interactions with humanity. Andrew Lester says, “Since hope is rooted in God’s love, and love implies relationship, then hope must happen in community whether between human beings or between human beings and God.” Because I believe that we are people created in the image of God, I also believe that our human relationships can be sources of hope for one another in the midst of our brokenness. We experience this kind of hope and support in community.

This theology of improvisational hope does not require each pastoral care encounter to move through pain and suffering to hope. What it does mean is that because I have hope, grounded in my own experience of suffering, I can be a hopeful presence. When someone experiences disorientation and struggles, I can be with them. In my improvisational pastoral care, I can be a visible demonstration of God’s uncontrolling love for that person.

Mark A. Feldbush is an ACPE Certified Educator and APC Board Certified Chaplain serving at Nationwide Children’s Hospital in Columbus, OH. He earned his Doctor of Ministry degree at Ecumenical Theological Seminary in Detroit. His dissertation is titled The Improvising Pastor: Following the Fear on the Pastoral Formation Journey. Mark is an avid listener of spiritually informed rock-n-roll.

To purchase the book from which this essay comes, see Love Does Not Control: Therapists, Psychologists, and Counselors Explore Uncontrolling Love