Conference on Faith and Health in Secular Societues 18th of May 2010

1. Belief and Hope in Hospitals –The Work of Chaplains and Imams in a Secular ContextPhD Student Hanne Bess Boelsbjerg University of Southern DenmarkFunded by the Danish Cancer Society Conference on Faith and Health in Secular Societues 18th of May 2010

2. A Qualitative Study Related to the PhD Project The Religious Resources of Muslim and Christian Cancer Patients in Palliative Care Conference on Faith and Health in Secular Societues 18th of May 2010

3. Mapping the way Interviews with patients relatives & professionals Observations of the cancer patients’ conversations with the chaplain or the imam Test of religiosity with Q Sort-Faith Comparison of religious coping strategies Conference on Faith and Health in Secular Societues 18th of May 2010

4. The existential concerns and religious needs of cancer patients what do we mean by ‘existential concerns’ and ‘religious needs’?’ what do we know about Danish cancer patients and their needs? what needs are the chaplains and imams working with? • what do we mean by ‘existential concerns’ and ‘religious needs’?’ • what do we know about Danish cancer patients and their needs? • what needs are the chaplains and imams working with? • how do they approach the patient’s belief and hope? Conference on Faith and Health in Secular Societues 18th of May 2010

5. Existential conditions • We all must die • In decisive times we are alone • We have the freedom to choose • our life • We struggle to find meaning in life • (Yalom, 1980) Conference on Faith and Health in Secular Societues 18th of May 2010

6. Dilemmas of life Happiness vs suffering Love vs aloneness Good vs bad luck Fear of death vs engagement in life Freedom of choice vs obligations Purpose vs meaninglessness (Jacobsen, 2009) Happiness vs suffering Love vs aloneness Good vs bad luck Fear of death vs engagement in life Freedom of choice vs obligations Purpose vs meaninglessness (Jacobsen, 2009) Conference on Faith and Health in Secular Societues 18th of May 2010

7. ‘Existential concerns’ and ‘religious needs’ What is important to the existencein relation to hope, meaning, purpose and values If these concerns are related to a religious meaning system, the needs (for support, guidance, consolation ect.) will be rendered as a religious 7

8. Existential needs of Danish cancer patients Kræftpatientens verden. En undersøgelse af hvad danske kræft- patienter har brug for. Grønvold, M. et al. (2006). Bispebjerg: Forskningsenheden Pall. Med. Afd. Existential thoughts and religious life of Danish patients. Ausker, N., la Cour, P. et al. (2008). Ugeskrift for Læger, 2008 May 19; 170 (21): 1828-33. Palliative Needs in Danish Patients with Advanced Cancer. Johnsen, A.T. (2008). PhD project. Copenhagen: University of Copenhagen. Conference on Faith and Health in Secular Societues 18th of May 2010

9. Who supports existential and religious needs? Responsible for keeping time Pollock, K. et al BMJ 2002;325:687 Talk with the chaplain: 23% No contact person: 20% Want talk with the doctor: 37% Büssing et al. Pain Med 2009 MAR; 10(2):327-39. ’How did you decide which patients to visit this week?’ Fitchett, G. & Risk, J.L (2009) Conference on Faith and Health in Secular Societues 18th of May 2010

10. Frequent question posed to chaplains Meaning/story of life. Death and dying. Illness and pain. Relationships. Religious issues. Other questions. (Strang & Strang 2002) Conference on Faith and Health in Secular Societues 18th of May 2010

11. Existential vs religious needs The patients do not contact the chaplains primarily to discuss spiritual or religious questions, but rather to discuss question about their love for and care of their families and about the meaning of suffering. (Wright, 2001) Within a patient group of colorectal cancer, 93% of the questions dealt with the meaning of life and its value in general terms. (Klemm et al., 2000) Secularized values founded on the rationality of science, have to a large extent replaced religious beliefs in Sweden as well as in many other secularized countries. (Kallenberg, 2000) Conference on Faith and Health in Secular Societues 18th of May 2010

12. Pastoral care and psychotherapy Psychotherapy kind of treatment professional educated therapist orientation towards problems or symptoms choice of therapeutic approach criteria of succes (Wickstrøm 2001) Pastoral care support of psychic and spiritual growth practiced by religious professionals focus on the individual religious institution behind religious worldview no criteria of succes Conference on Faith and Health in Secular Societues 18th of May 2010

13. Muslim pastoral care Islamic concepts: Ikhlaq/-iat Having a good character Iyadah Visit the ill Rifq Examplaric care Conference on Faith and Health in Secular Societues 18th of May 2010

14. The chaplain’s approach ’The coffee is terriable and those kind of things, but AAB (a football team) lost again, so... And the family that came to visit and their pain. And sometimes we end up with something that has like a religous content. And then you can say that I look at my role as a chaplain, as a way to be a chaplain in the way that people need it. So if Peter wants to talk about those things because it is easy, this is what we do!’

15. Talking about values ’We don’t talk with people about their values. They don’t say ’Now my values are broken down!’ But they say: ’I’m affraid to loose my children, I’m affraid to die from my children, I’m affraid not to be able to manage my job, I’m affraid of...’ And that is to talk about values! Values are not something abstract, they can be understood as abtractations, but you don’t talk about it abstractly, you talk about it as something concrete.’

16. Belief and guidance It goes without saying that when people come to me, it’s not because they want me to give them some pills! I try rather to give them what I believe they are looking for, namely a way of entering that unseen dimension that surrounds faith, and faith’s way of addressing sickness and the self. My starting point is what people want from me, otherwise they won’t seek me out. And I have to take it from there. And, having come a long way, I have to say that my impression is that it is working pretty well.

17. If it is just, then it will be a punishment and then it will be really bad! So therefore it shouldn’t be some kind of justice when you loose a child or someone dear to you. You can find a meaning in the situation, but there isn’t a God-given meaning with it. Belief and meaning-making 17

18. Belief and hope I once was sitting with my own daughter in fact, who was just diagnosed with ancer. And that day she was diagnosed, she went quiet for a few seconds, and then she said: ”Alhamduallah! I tanhk Him who created me”. She was sixteen or seventeen art that time. And I was so happy that she said that! Because I knew then that she would be able to deal with it! When she handled things in this way and her immediate response was ”Alhamduallah”, so she was ready. 18

19. The importance of belief And that is one of the most vital things in a person’s struggle with sickness and with the healing process, that they have inside of themselves, exactly what they need. If they don’t have it, then even a relatively minor disease can bring down a strong person. But if one has it, then even a major disease cannot bring down a smaller person.

20. The roles of the chaplains and imams Endure meaninglessness Stimulating hope Streghten beliefsystem Supply worldview

21. Thank You for listening!