AN EXPLORATION AND ADAPTATION OF ANTON T. BOISEN’S NOTION OF THE PSYCHIATRIC CHAPLAIN IN RESPONDING TO CURRENT ISSUES IN CLINICAL CHAPLAINCY by Christopher E. De Bono A Thesis submitted to the Faculty of Theology of the University of St. Michael’s College and the Pastoral Department of the Toronto School of Theology in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Theology Awarded by the University of St. Michael’s College © Christopher E. De Bono, 2012 An Exploration and Adaptation of Anton T. Boisen’s Notion of the Psychiatric Chaplain in Responding to Current Issues in Clinical Chaplaincy Christopher E. De Bono Doctor of Philosophy in Theology The University of St. Michael’s College and The Pastoral Department of the Toronto School of Theology 2012 Abstract The author of this dissertation responds, within the context of pastoral theology, to clinical chaplaincy’s increasingly isolated and diminished place in contemporary North American health care delivery. The dissertation explores what is particular about clinical chaplaincy by focusing on its origin: that is, it analyzes the life and work of Anton T. Boisen (1876-1965), with specific attention to both Boisen’s mental health context and his explicitly pastoral and theological intentions. The author argues for a contemporary and adaptive retrieval of Boisen’s original innovation: the specific position of the clinical psychiatric chaplain. Literary research is used to analyse Boisen in critical dialogue first with the historical insight of clinical psychologist Paul Pruyser (1916-1987) that the innovation of the psychiatric clinical chaplain as a member of the multi-disciplinary team is rooted in Boisen’s fascination with his own life. Second, this author analyses the hitherto mostly archived, understudied, and largely unpublished doctoral efforts of Boisen’s seminal contribution to chaplaincy by pastoral theologian Henri Nouwen (1932-1996). Nouwen strategically recasts this contribution by linking it to Boisen’s experience of alienation, an effect of his mental illness. Third, the author engages the work of practical theologian John Swinton (b.1957) as a contemporary echo of Boisen’s commitment to an ecclesiological dimension for mental health care. Fourth, the author uses Charles Taylor’s (b. 1931) recent philosophical work to suggest that Boisen’s pioneering contributions may continue to inform, in significant ways, the contemporary search for God among those living with mental health issues. ii The author concludes the dissertation by offering a conceptual framework which makes room for a religiously spiritual clinical chaplaincy within the multi-disciplinary team: the ‘re- membering God’ model, based on Nouwen’s insights into Boisen and on the anthropological work of Barbara Myerhoff (1935-1985). The dissertation applies these findings in the specific context of Catholic sponsored mental health care, suggesting that the ‘re-membering God’ model is not only significant for the future of chaplaincy as a professional discipline, but also has important pastoral implications for mental health care ministry. iii Acknowledgements Although my name appears as the author, and indeed I am ultimately responsible for its success and failures, this dissertation is more than just mine. I am especially indebted, as Anton T. Boisen would say, to the “living human documents” who shared with me their journey into that not so faraway “little-known country” of mental illness. It was by listening to the spiritual lives of psychiatric patients, especially while I worked at the Mental Health Centre Penetanguishene (now Waypoint), that I first began to ponder the uncertain status quo of clinical chaplaincy. I thank foremost my doctoral director, psychologist Joseph Schner SJ, of Regis College, who critically guided the ideas you read here. Special thanks to Anne Anderson CSJ, President of St. Michael’s College in the University of Toronto, who served on my dissertation committee. Joining these two scholars, the following academics assembled for the defence of this dissertation: the Rev. Dr. Pam McCarroll, Assistant Professor of Pastoral Theology and Director of Theological Field Education at Knox College; Gilles M. Mongeau, SJ, Associate Professor of Systematic Theology and Director of the Master in Divinty Program, Regis College; and Dr. Michael W. Higgins, Vice President for Mission and Catholic Identity, Sacred Heart University (USA). These experts were exactly what I needed in the cross-disciplinary work before you: a work in pastoral theology which connects the practice of psychiatric chaplaincy with Catholic sponsored mental health care. Writing the dissertation also made me grateful for the many academic and mental health care colleagues I have met along the way. Each of them has been critically important with inspiration and/or feedback: I thank Ron Mercier SJ, the first person I remember explicitly encouraging me to become a theologian. This invitation made sense I think, thanks to the early influence of Professors Janine and the late Thomas Langan, who guided my undergraduate work in Christianity and Culture/Philosophy. I thank the late Joan Whelan GSIC and the Reverend Bob Sinclair, who first introduced me to clinical health care ministry, and Jim Hannah and Jan Kraus, for their passionate CPE supervision. iv I am also indebted to Mary Rowell CSJ, Blair Henry, Jim Huth, Trustee and Literary Executrix of the Henri Nouwen Legacy Trust Sue Mosteller CSJ, Henri Nouwen archivist Gabrielle Earnshaw, Assistant Archivist Jessica Barr, Michael Stoeber, George Webster, Steve Abdool, JJ and Anna Schocking, Frank Morrissey OMI, Carol Lambie, Alison Vallance, Kate Storey, Ruth Cameron, my MHCP spiritual care team (Glenn Robitaille, Pat Mannion, John Rice, and the late Ted Vellenga), Mort Menuck, Debbie Collins, Jimmy Zammit OFM, Jack Costello SJ, Nancy Bol, Marvin Shank, Greg Beath, David Pereyra, Doug Longstaffe, John McLaughlin, Cicily Tang, Emil Iruthayathas, and Carmen Cachia along with the entire Kelly Library staff. Special thanks to the late Digby Wolfe, writer, who died mere weeks before this dissertation’s submission. He always reminded me that the moral challenge of writing is to courageously place one’s ideas up for public critique. I wish to express a very particular thanks to my editor Kevin Burns. His thorough editing corrected the weaknesses in my style. He was a thoughtful listener in between revisions. Generous financial support came from a variety of sources through my studies: The Mental Health Centre Penetanguishene (now Waypoint), The Redemptorist Scholarship Fund for doctoral work in ethics and health care, The Ontario Government Scholarship program, The Catholic Health Association of Ontario’s Bishop Tonnos Award, and Regis College’s Lupina Fellowship. A variety of travel scholarships including those from the Advanced Degree Students’ Association and the Canadian Theological Society permitted me to test my ideas at a number of conferences. Special thanks to my father-in-law William Johnson and his wife Carol Bream for their longstanding financial and personal commitment. This funding helped me concentrate on the one thing: the completion of this work. I owe a deep debt to my family. I thank my brothers Angelo and David for their genuine and at times amusing curiosity about what I had been thinking about all these years. I recognize my brother Reno’s example of being the first in our extended Maltese immigrant family to study for the PhD. The fact that all my brothers pursued higher education owes much to my parents’ determination their children might have what was denied them. My father, Francis, a skilled v electrician, left Malta for Canada in 1952 at the age of 22 with the dream of a better future. My mother, Rena, followed in 1961. My father saw only the beginning stages of this dissertation, having died in 2007. I remember fondly how, even in the midst of advanced Parkinson’s, he read my early course work papers. Both of my parents have shown me that with disciplined human effort, God’s grace, and time, something new and beautiful is possible. Finally, this dissertation would have been impossible without my wife, Susannah Johnson. She has been with me every step of the way. My need for quiet study has taken me away from her for longer periods than I would have preferred. I especially thank her for reminding me when the inevitable doubts surfaced during the long loneliness of doctoral work, why I started out on this re-creative writing pilgrimage in the first place: A dissertation must reflect one’s deepest passion. What follows is certainly mine. vi Statement Regarding the Use of Inclusive/Unbiased Language All of the original writing contained in this dissertation reflects the policy of The Toronto School of Theology and The University of Toronto regarding inclusive and unbiased language. Nevertheless, most of the primary sources for this literary research were written before inclusive language became the academic norm for scholarship. In order to respect the integrity of works as cited, I have chosen to reproduce the original texts as they were written, refraining from the use of “[sic]”. Of course, in my critical reflections on them I follow the contemporary norm. An additional complicating factor in terms of language is the fact that Henri J.M. Nouwen’s archived manuscript material (which forms the core of chapter 2) was written primarily in English by a Dutch-born man. These unedited manuscripts are, in places, replete with errors in grammar and spelling, as well as the crossing out of texts with inserted rewrites. Except for obvious grammatical or spelling corrections, I have cited Nouwen as he appears in the original texts. As will be argued in that chapter, this record of Nouwen’s struggle to find the best English word is often helpful for better understanding his contribution to scholarship. Finally, it needs to be acknowledged that attention to unbiased language reflects a core feature of this dissertation: it intentionally reframes Anton T. Boisen’s critical writings about mental illness and religious experience, uncovering how historical trends marginalised his reported experience of living with mental health problems. Boisen, for his part, was well aware of the historical bias, writing in his 1960s autobiography, “as long as I remain a patient, I am by that very fact discredited.”* This dissertation proposes that Boisen’s critical texts—and his original voice— require a contemporary and unbiased hearing. * Anton T. Boisen, Out of the Depths: An Autobiographical Study of Mental Disorder and Religious Experience, 1st ed. (New York: Harper, 1960), 136. vii As chaplain in an institution for the insane, the writer is dealing constantly with the mentally ill. He is seeking to interpret the experiences of his patients not merely from the standpoint of current psychiatry but also from the standpoint of the student of religion. —Anton T. Boisen, “The Psychiatric Approach to the Study of Religion.” viii Table of Contents ACKNOWLEDGEMENTS iv STATEMENT REGARDING THE USE OF INCLUSIVE/UNBIASED LANGUAGE vii INTRODUCTION 1 Current Issues in Contemporary Clinical Chaplaincy 3 Purpose and Methodology of this Dissertation 18 An Auto-Ethnographic and Clinically Inspired Inquiry 19 Delimitations 24 Anton T. Boisen and the Mental Health Care Context 24 Roman Catholic Board Sponsorship 27 Key Terms 32 Organization of the Dissertation 34 CHAPTER ONE: ANTON T. BOISEN – LOST AND FOUND 38 Boisen’s Move to the Periphery in CPE’s Early History: 1922-1965 39 Boisen as a Psychiatric Chaplain in 1924: Sources 41 Boisen’s Central Thesis and the Distinctive Role of the Minister 46 Problems with Boisen’s Central Thesis 51 Seminal Beginnings, Divisive Endings: 1922-1942 53 Boisen’s Lonely but Productive Retirement 1942-1965 63 A Future Marginalisation: CPE and Corporate Religious Mission 67 Preliminary Conclusions 68 Paul Pruyser: Reclaiming Anton T. Boisen’s Innovation of the Psychiatric Chaplain 69 Pruyser’s Essential Writings in Regard to Boisen 70 ix Pruyser’s View of Boisen’s Breakthrough as “Perspectival” 73 Pruyser’s Portrait of Boisen as a Diagnosing and Organizing Minister 77 CPE’s Early Complications with Boisen’s Diagnostic Perspective 83 Boisen’s Religiously Corporate Perspective at Risk 87 Pruyser’s Portrait of Boisen in Pastoral Care’s Search for its Own Identity 91 Conclusion 101 CHAPTER TWO: ANTON T. BOISEN AND HENRI J.M. NOUWEN 103 Boisen in Existing Studies of Nouwen 104 Boisen in Material Published by Nouwen (1968 to 1977) 113 Boisen in the Henri J.M. Nouwen Archives and Research Collection 127 A Revealing Letter 129 Two Key Unpublished Documents 131 1. “Anton T. Boisen and the Study of Theology through “Living Human Documents” 131 2. Pastoral Supervision in Historical Perspective 135 Doctoral Outlines and Related Documentation 142 1. Documentation referring to Doctoral Outline #1 142 2. Documentation referring to Doctoral Outline #2 146 The Boisen Interview: A “Basic Suffering” 155 Conclusion: Nouwen’s Essential Portrait of Boisen 164 CHAPTER THREE: CHAPLAIN AS FRIEND: IMPORTANCE, VULNERABILITY, AND RELEVANCE 171 John Swinton’s Pioneering Work on the Friendship Model 173 On Being Human: Made in the Image of God 173 On Defining Mental Health 176 A Role for the Church in Mental Health Care 178 x