Spiritual Care: A Guide for Caregivers (15 page)

Another woman came to Jesus with "a spirit that had crippled
her for eighteen years. She was bent over and was quite unable to
stand up straight. When Jesus saw her, he called her over and
said, 'Woman, you are set free from your ailment.' When he laid
his hands on her, immediately she stood up straight and began
praising God" (Lk 13:11-13).

In the context of these healings, Jesus told his disciples, "Very
truly, I tell you, the one who believes in me will also do the works
that I do and, in fact, will do greater works than these, because I
am going to the Father" (Jn 14:12). However, he did not use
touch only for healing. When the disciples were overcome by fear,
"Jesus came and touched them, saying, 'Get up and do not be
afraid"' (Mt 17:7). Touch communicates tenderness, affection,
strength and acceptance. The psalmist cried out, "Do not be far
from me, for trouble is near and there is no one to help" (Ps
22:11). Touch lets a suffering person know that someone is near.

When touch is absent, a person may feel alone and abandoned.
The psalmist complained, "You have caused my companions to
shun me; you have made me a thing of horror to them. I am shut
in so that I cannot escape; my eye grows dim through sorrow.
Every day I call on you, 0 LORD; I spread out my hands to you"
(Ps 88:8-9). When we are afraid or in pain, the natural response is
to reach out and touch another person for support. And the psalmist reminds himself, "For he will command his angels concerning you to guard you in all your ways. On their hands they
will bear you up, so that you will not dash your foot against a
stone" (Ps 91:11-12). We want to be touched by other people, by
God and, when we are desperate, by angels.

Touch also keeps us in contact with reality. When Jesus
returned from the dead and appeared to the disciples, he told
them, "Look at my hands and my feet; see that it is I myself. Touch
me and see; for a ghost does not have flesh and bones as you see
that I have" (Lk 24:39). In the same way, touch can often help a
person who is afraid or disoriented to relax and feel comfortable
in strange surroundings.

Everybody needs physical touch. "During the nineteenth century," writes anthropologist Ashley Montagu, "more than half the
infants in their first year regularly died from a disease called mar-
aemue, a Greek word meaning 'wasting away.'" This disease was
characterized by a gradual loss of muscle and strength for no
apparent reason. Montagu goes on to say that as late as the 1920s
the death rate for infants under one year of age in various foundling institutions in the United States was nearly 100 percent. The
cause of marasmus was not identified until after World War II,
when research showed it was due to a lack of nurture. Both physically and emotionally, a child needs to be carried, caressed and
cuddled.'

Nursing has traditionally incorporated touch into routine care:
assisting a patient with bathing, offering back rubs during evening
care, supporting an unstable person while walking, providing skin
care, positioning a patient in bed and giving an occasional gentle,
caring touch. Many of these practices are getting lost in the cur rent high-tech health care environment or being relegated to assistive personnel.

Touch communicates caring and intimacy. A gentle hand on the
arm or shoulder, a pat on the back or holding a hand will usually
provide strength and encouragement to another person. Healthy
friendships also involve touch that is nurturing and comforting
without being erotic. The importance of touch for healthy emotional development is now commonly understood. It communicates involvement, concern, responsibility, tenderness and awareness of the needs and vulnerabilities of the other. We do not lose
that need for touch as adults; in fact, it is those adults who are feeling alone and lacking intimacy who seem to be most at risk for an
emotionally dependent relationship.

Pastor Michael Phillips explains, "When someone is hurting,
affection is more than a warm fuzzy or a mild turn-on. Intimacy is
the bonding of comfort, the balm of closeness, the first and greatest expression of understanding."2 Sadly, touch is often misinterpreted in our culture. People who have been sexually abused may
shrink from physical touch. Others may assume it communicates
more than intended, responding sexually. However, while recognizing the dangers involved in expressing affection, Phillips insists
that "intimacy is not an enemy" and sets some guidelines. He
avoids showing affection when his own emotions are unstable,
when the other person turns away and when it does not express
true relationship. However, he finds it appropriate in the face of
loss, in times of discouragement and when a person is feeling
rejected.'

Counselor Lori Rentzel offers some suggestions (while warning
that there is no quick fix) for times when sexual attraction does
become a problem and affection becomes manipulative. First, we
need to be honest with ourselves and God about the problem, acknowledging the inappropriate aspects of the relationship.
Next, it is important to be honest about the problem with another
person who can counsel and pray with us. Then we must gradually begin separating from the relationship.4

Although touch is essential for healthy relationships, each person
perceives touch differently. The toucher's intentions may be misinterpreted-either positively or negatively. Some basic guidelines
will keep touch appropriate and helpful.

❑ Ask permission before touching. "May we hold hands while we
pray?" "May I give you a hug?" A gentle touch on the arm or
shoulder might be okay without asking permission, but if the person pulls back or stiffens, consider that a no! Remember that the
other person may sense an imbalance of power and fear rejection
on saying no, so be alert for body language.

O Consider the cultural background of the other person before
touching. Asians are generally more reserved and may be
offended by touch from a stranger. A Chinese friend once confessed to me that she felt terrified when her Western friends
greeted her with a hug. Latinos are usually open and demonstrative. However, stereotypes don't always fit, so ask.

❑ Be careful where you touch. The breasts, genitals, buttocks
and thighs are off-limits. The arms, shoulders or back are usually
safe places to touch. Avoid any suggestion of sexual touch. Long,
tight frontal hugs, fondling or caressing are always inappropriate
in a helping relationship. Even light touch or quick hugs between
the sexes can be interpreted as flirting. If you or the other person
feel uncomfortable with the touch, avoid it.

❑ For the most part, avoid touching when you are alone with a
person, especially in a counseling situation. While it would be quite appropriate to hold the hand of a terminally ill person if you
were alone at the bedside or to give a quick hug of greeting to a
shut-in, beware of prolonged or frequent touching in situations
where no one else is around.

❑ When you are counseling with someone, it is wise to leave the
door ajar so that caring touch will not be misinterpreted. If you
suspect that the other person (either male or female) may be
growing overly dependent or attached to you, avoid touching in
private situations.

❑ Be careful not to make the person feel cornered or forced to
accept your affection.

❑ Tickling or playful aggression are usually inappropriate.

Sexual abuse is a serious problem in our society. Sometimes
touch that begins as innocent, caring gestures can escalate into
sexual behavior. When the person initiating the touch is in a position of power, such as a nurse, pastor or other caregiver, the other
person may be afraid to object or stop it. The person who feels
violated may then feel responsible for causing the problem; shame
and long-term emotional distress can follow. People who have
been touch-deprived may misinterpret touch or respond sexually
when the one touching simply intended to communicate compassion.

Sexual misconduct is not the only abuse of touch. Many new
"touch therapies" are appearing on the health care scene and are
being offered as "alternative" or "complementary" therapies. Both
health care professionals and the general public are being misled
by the media and by respected health care institutions.

For example, Mary Palumbo, in the late stages of ovarian cancer, deeply appreciated the support and practical assistance of her hospice nurse, Sue Mason. Sue had worked with Mary until her
pain was under good control, and she enabled Mary and her family to talk about her impending death together. However, Sue
sensed a restlessness in Mary that nothing seemed to touch.

The hospice had recently provided an inservice education program on Therapeutic Touch, and Sue decided to try the technique
on Mary. Sue explained the procedure to Mary as a form of what
the church has always practiced as the "laying on of hands." Mary
felt uncomfortable with the idea, but consented.

First Sue "centered" herself by sitting quietly and practicing
some meditative techniques, including deep breathing and imagery. She had begun to use these techniques for longer periods at
home on a daily basis. Once she felt centered, she began an assessment of Mary's "energy flow" by moving her hands slowly from
head to foot, a few inches above the skin. When Sue sensed a congestion of energy, she used a sweeping motion to "unruffle" the
congestion, then shook her hands as if to rid them of the energy.
Next she intentionally "redirected" Mary's energy through visualization and feeling her own energy pass into Mary. Finally, she
stopped and "evaluated." Her goal was to restore balance to
Mary's "energy field." The entire procedure took about fifteen
minutes.

After the procedure, Mary felt a new sense of closeness to Sue.
What is more, Sue felt a deep satisfaction. She had been able to
bring comfort in a situation where no further medical or psychological intervention was likely to help. In fact, many Therapeutic
Touch practitioners advocate the technique as much for what it
does for the nurse as for its effect on patients.

Nurses who practice Therapeutic Touch usually began for
some very good reasons. Today's health care system leaves both
patients and nurses highly dissatisfied. When cost-effectiveness becomes the ruling factor, the first services to be cut are those that
provide the most job satisfaction to nurses--caring measures that
take time and adequate personnel to enable them to happen.

Most nurses entered the profession with a desire to serve God
and help other people, and they often feel that the ability to do so
has been taken away by the current health care system. Therapeutic Touch is one attempt to restore the personal, hands-on
approach that both nurses and patients seek.

Most patients today find the changing health care scene confusing, impersonal and frustrating. Drastically reduced time spent in
hospitals-and even in follow-up home visits--leaves people
alone with their deep fears of suffering and death. Furthermore,
many people in our culture are starved for physical touch and intimate relationships. Touch therapies fill those voids by offering
extended presence and hope for healing, even in the face of
chronic disease or impending death.

Furthermore, Therapeutic Touch seems to work. Anecdotal
evidence has convinced a rapidly expanding number of people to
try it. Proponents also cite research to confirm the positive effects
of Therapeutic Touch. Most major medical centers are beginning
to talk about "restoring the mind-body connection," and Therapeutic Touch inevitably becomes part of the picture. What was
only recently considered alternative therapy is now becoming
mainstream throughout the country.5

But Therapeutic Touch and other energy therapies present
Christians with some serious problems. Although some Christians
do advocate energy-based theories and may practice these therapies with good intentions, they do so naively. The issues include
spiritual, ethical and practical concerns.

Dabbling in the occidt. In contrast to the biblical worldview, the
underlying worldview of most touch therapies involves a belief that impersonal energy can be manipulated and controlled. While
in theory the energy is impersonal, many practitioners claim to be
in contact with spirits in their meditation time. The therapies
themselves are sometimes seen as manipulation of spirits. Some of
these therapies claim to be channeled by spirit guides, angels or
other entities; others come from roots in Wicca or occult traditions. Christians who were converted out of these belief systems
are usually the most adamant against dabbling in them.6

Mydticiem gone awry. Many proponents of Therapeutic Touch,
after practicing the meditative techniques required for the discipline, criticize Christians for ignoring the mystical traditions of
the church. The Christian church does have a rich mystical tradition, which became suppressed with the rise of science. We can
affirm that there is much in this tradition that should be restored
and enjoyed. Mysticism unchecked, however, frequently leads to
serious heresy and corruption in the church and blurs the uniqueness of the Christian gospel. Psychologist Elizabeth Hillstrom
points out that mystical writers from Maharishi Mahesh Yogi to
Christian mystics like St. John of the Cross all warn about the
dangers of "madness, demonic deception or possession for those
who venture into the mystical path."' Richard Foster describes the
goal of true Christian mysticism:

In Meditative Prayer there is no loss of identity, no merging with
the cosmic consciousness, no fanciful astral travel. Rather, we are
called to life-transforming obedience because we have encountered
the living God of Abraham, Isaac, and Jacob. Christ is truly
present among us to heal us, to forgive us, to change us, to
empower us.

The Bible is the central reference point in Christian mysticism.
The mystical experience must always be tested by the Scriptures, not the other way around. When mysticism moves beyond biblical
limits, it ceases to be Christian, even when Christian terminology
is retained.