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Community Mental Health: The Role of Church and Temple by Howard J. Clinebell, Jr., (Ed.)

Howard J. Clinebell, Jr., is retired professor of Pastoral Counseling, School of Theology at Claremont, California. Published by Abingdon Press, New York, Nashville, 1970. Used by permission. This material was prepared for Religion Online by Ted & Winnie Brock.

Chapter 14: Pastoral Care and the Poor by Don S. Browning

To raise the question of the pastoral care of the poor at this point in history is something of an embarrassment for the pastoral psychology movement. To raise this question now necessitates the confession that the pastoral psychology movement has not heretofore adequately given it the attention that it deserves.

This book and the essays within it are a product of the so-called pastoral psychology movement. The pastoral psychology movement is a consequence of the relatively self-conscious and systematic attempt to strengthen the ministry of the church by making use of the insights and expertise of the social and psychological sciences. It has concerned itself with many issues and problem areas -- the church’s ministry to marital discord, alcoholism, youth, the elderly, the emotionally disturbed, and the delinquent. But little attention has been given to the poor.

There are specific reasons why the pastoral psychology movement failed to direct its attention to the problems of those afflicted by poverty. The reasons are more sociological than ideological. From the beginning the pastoral psychology movement attached itself to principles which, if consistently applied, would have brought it to an early and fruitful confrontation with the special situation of the economically deprived. But, because of certain reasons related to the sociological origins of the movement, it was often not faithful to its own best motivations and insights.

The pastoral psychology movement was developed by sincere and far-sighted churchmen who were, for the most part, members of the mainline, middle-class denominations in the United States. The first classes in pastoral psychology were taught in those more progressive and liberal seminaries where both the professors and the students espoused middle-class attitudes and values. Its companion disciplines were primarily clinical psychology, psychiatry, and social work, and pastoral psychology itself soon took on the trappings of quasi-professionalism with its emphasis upon the white collar, appointments, structured interviews, and so forth. Much of this was for the good, but it unwittingly led the pastoral psychology movement to isolate itself from the lower classes. Whether we are speaking of pastoral psychology as a more or less loosely organized body of principles which informed the daily work of increasingly larger numbers of ministers educated in the better seminaries, or whether we are talking about pastoral psychology in its more professional manifestations in the form of institutional chaplaincies or church-related counseling centers, the sociological origins of the movement tended to render it ineffective in relating to the specific problems and life-styles of the poor. Just as the ground-breaking book of Hollingshead and Redlich entitled Social Class and Mental Illness demonstrated that the helping professions of psychiatry and clinical psychology, were likely to be less attentive to and less effective with people from the lower socioeconomic strata of our society, a similar book and a similar indictment could be written about the pastoral psychology movement.(A.B. Hollingshood and F.C.Redlich, Social Class and Mental Illness [New York: John Wiley, 1958]). Today, pastoral psychology, just like clinical psychology, psychiatry, and even social work, must admit that it faces a crisis in self-definition -- a crisis which must be resolved before it can break through the barriers which have been limiting it from becoming a positive force for the betterment of the poor of our nation.

From the beginning, the pastoral psychology movement concentrated on the principles of working with individuals and small groups. It borrowed freely from the knowledge about individual counseling, group dynamics, and group therapy which the secular disciplines of psychology and psychiatry had discovered. It transposed, not always uncritically, into its own setting a variety of therapies which had yielded some success in secular psychiatric and psychological clinical settings. Most of these therapies emphasized "talk," "insight," and the so called structured interview. From the beginning it was recognized by the more discerning leaders in all the helping professions that some people did not seem to be able to make much use of these "talking therapies." But this was often thought to be their problem and not necessarily an indictment exposing the implicit shortcomings of these therapies. The poor, the uneducated, the activistic, were often judged to be poor prospects for therapy or counseling. Such people seemed to have high resistances against gaining self-understanding or insight. They seemed unable to keep regular appointments. They often tended to externalize their problems -- something which all good counselors guarded against. They often said such things as "What good does it do to talk about it?" As a consequence, such people were often written off as poor investments for the counselor’s time and energy. Only gradually was it recognized that the talking therapies were really more consistent with the introspective and verbal styles of the middle-class and upper middle-class people they were originally developed to help. It slowly was recognized that lower-class people were less verbal, less introspective, less abstractive and more concrete than most middle-class persons. But this did not mean that the poor could not be helped; it simply meant that help had to come in a different form than most psychological, psychiatric, and pastoral counselors were accustomed to providing.

The question must be asked: who are the poor? This question is a large one and cannot be handled adequately in this essay. Our purpose here is to make a few generalizations which will help us orient ourselves toward a concrete understanding of what pastoral practices with the poor might involve.

First of all, the poor are people without money, or at least, without enough money to live adequately within the context of Western society. But there is more. The poor are also those without power. By this I mean that they have less control over their lives, less latitude in decision-making, and less influence over political, educational, and economic institutions which impinge upon their lives, than is the case with people in the middle classes. It is becoming increasingly clear that to help the poor is not only to solve their shortage of money, it is also to help them develop more responsible control over the direction of their own lives. This last point has great significance for the strategy of pastoral work with the poor.

There are other things to be said about the poor. Certain distinctions should be made. There are different types of poor people. There are certain important differences between rural and urban poor, be they black or white. There are crucial differences between Puerto Rican poor and Appalachian whites. Herbert Gans has developed a typology of the poor and draws distinctions between (1) so-called maladjusted, (2) the routine seekers, (3) those who are striving to get into the working class or into the middle class, and (4) those who are action seekers striving to maximize excitement and gratification within their present status.( Herbert Gans, "A Survey of Working- and Lower-class Studies" in Mental Health of the Poor, ed. by Frank Riessman, et al. [New York: The Free Press, 1966] , Pp. 119-27. Mental Health of the Poor will hereafter be referred to as MHP.) And of course, there are both important similarities and differences between the lower-class poor and the lower-income working class.

In spite of these differences, there are some important general characterizations of the poor which can be made. We will look at these features of the poor both from the standpoint of how they may constitute liabilities for the poor and, at the same time, implicit strengths which can be used in their behalf by the sensitive minister trying to be of help.

Social scientists have learned a great deal about the language patterns of the poor. Certain facts are clear. Their language is more directly attached to concrete action and to practical and immediate problems of everyday living than is the case with the middle-class.( Daniel Miller and C. Swanson, Inner Conflict and Defense [New York: Henry Holt, 1960] , P. 24; Basil Bernstein, "Social Glass, Speech Systems, and Psychotherapy," in MHP, pp. 194-209. Frank Riessman, The Culturally Deprived Child [New York: Harper, 1962]) This is why middle-class talk therapies are inadequate and why the poor may not do well in middle-class- oriented school systems which emphasize verbal skills, abstract reasoning, and knowledge for knowledge’s sake.

Although the language of the poor is more concrete, more action-oriented, and more bound to pragmatic and utilitarian concerns, it is not necessarily more limited. Frank Reissman points out that the language of the poor may be rich and flexible, quite capable of expressing the experiences and attitudes that are real to the poor.(Riessman, The Culturally Deprived Child, pp.1-25.) It is a language somewhat different from that of the middle-class; and middle-class teachers, therapists, and ministers may not be able to understand it. Yet Riessman believes that this language, if taken seriously, can be used to the advantage of the educational and therapeutic process if the proper methods and sensitivities are used.(Ibid., p. 14)

Many poor people have a different attitude toward time than do middle-class people. The poor tend to live more in the present and the past, are less able to tolerate delay, and are less inclined to plan for the future. (John P. Spiegel, "some Cultural Aspects of Transference and Counter-Transference," in MHP, p. 308.) On the other hand, middle-class people tend to live almost completely for the future and have considerable capacity to make sacrifices today in the hope for a better tomorrow. This emphasis upon the present and the past among the poor may be born of a lack of hope; but in some cases it may be a product of an honest cultural difference indicating a more self-accepting and less acquisitive style of life, a style which should be respected and not automatically deemed inferior to the more ambitious future-oriented activities of the middle classes.

Many of the poor are more likely to use and be responsive to punitive and physical expressions of authority than is true with the more permissive middle class.(Melvin Kohn, "Social Class and Parent-Child Relationships: On Interpretation" in MHP, p. 166). They are likely to be more sensitive to the demands of the extended family and are more likely to stay within its jurisdiction. One the other hand, there may be, among the lower classes, more mutual helpfulness between members of the same extended family or even between friends and neighbors.(Riessman, The Culturally Deprived Child, p. 48.) Although this may be true, the effects of this stronger family solidarity are often nullified by the general disorganization of the neighborhoods in which the deprived live and their general reluctance to give political expression to their grievances.

Let us conclude by listing some principles and describing some strategies which should be kept in mind when ministering to the poor.

1. Pastoral work with the poor should take place in the context of a well-integrated total program designed to both (a) integrate the poor into the larger society and (b) transform society to better respond to and encourage the unique contributions which the poor can make to the rest of society. The poor need individual attention and assistance. But individual pastoral care is most meaningful when it takes place in the context of a larger attempt to analyze and correct the social forces which perpetuate poverty. More than this, individual and direct attention to the personal problems of the poor should proceed simultaneously with an effort to stimulate them to become active in analyzing and correcting the conditions which have created and sustained their poverty.

2. To stimulate the poor toward active participation in finding a solution to their own problems means starting where the poor perceive themselves to be. This means taking their everyday problems very seriously. Their problems may vary. For some, their problems may be expressed around difficulties in providing child care for mothers attempting to pursue part-time work. For others, it may involve problems in dealing with the complexities of a welfare system upon which they are dependent but which they cannot comprehend. Other problem areas may center around skill deficiency, substandard housing, household management, and may necessitate job training programs, tenant unions, or homemaking assistance. These are strategies presently being tried in various places with differing degrees of involvement by representatives of the church. The pastoral care movement should be able to add a new dimension to these efforts. Not only is there great promise in such programs for stimulating the poor to increase their own potential for dealing with their problems, (For stimulating discussions of how social action can help develop the human potential of those who participate, see the following articles: Peggy Way, "Community Organization and Pastoral Care: Drum Beat for Dialogue," Pastoral Psychology, March, 1968 pp. 25-36; Rudolph M. Wittenberg, "Personality Adjustment Through Social Action," in MHP, pp. 378-92.) they also provide both an opportunity and a meaningful supportive context for more direct and personal pastoral care if the minister is there to help handle the frustrations, disappointments, and anger which will undoubtedly surface. This is what is often missing from some social action strategies -- the sensitive handling of the personal substratum of meaning and conflict which often is brought to and precipitated by such action. Of course, social action on the part of the poor can be ego-building and therapeutic in itself. But just as ego therapy must generally be accompanied by some attempt to handle deeper anxieties and conflicts, so must social action and the kind of therapy that it provides be accompanied by auxiliary resources to handle the deeper human problems which an unsophisticated program of social action can unwittingly repress and deny.

3. Therapies which emphasize role-playing, dramatic action, and concrete problem-solving are generally more consistent with the cognitive styles of the lower classes. Although the pastoral care of the poor should take place in the context of larger strategies of social action such as community organization efforts, tenant unions, job-training programs, and the general politicization of the poor, there is clearly a place for more direct and person-oriented work with small groups and individuals. As Frank Riessman writes, "low-income people tend to work out mental problems best when they can do things physically." (Frank Riessman "Role-Playing and the Lower Socio-Economic Group," Pastoral Psychology, March, 1968, p. 51.) In his important article entitled "Role-Playing and the Lower SocioEconomic Group" Riessman gives several examples of the successful employment of role-playing in working with the poor. For instance, role-playing can be used to rehearse how an unemployed person might learn to relate to a new employer. It has been used successfully with juvenile delinquents to help them work through problems of handling authority. It has proved exceptionally beneficial in the training of indigenous nonprofessionals who are being used with increasing frequency to help bridge the gap between educational or social service projects and the communities they are attempting to serve. Role-playing involves the total person in a learning process and appeals to cognitive, kinesthetic, emotional, and experiential levels of human existence. For this reason, it is nicely adapted to the more action-oriented, motoric, and concrete styles of the poor. In addition, it can often be used in "marginal situations" in the very midst of other more or less non-therapeutic activities as a learning interlude which should help increase the capacity of a person or group to deal with current problems. It can be used in the context of discussion groups or talk-oriented therapies as the subject matter of group reflection.

Games can also be used with therapeutic efficacy. Rachel Levine tells of her use of family games as a device to stimulate family interaction. (Rachel Levine, "Treatment in the Home: An Experiment with Low Income, Multi-Problem Families," MHP, pp. 329-35.) Pathological or self-defeating patterns of interaction can be readily elicited and identified by such an approach and then can become topics for fruitful discussion and clarification.

In general, the so-called behavior therapies and ego-building therapies, which emphasize decision-making, integrity, and the active synthesis of conflicting impulses, seem most congenial to the styles and needs of the poor.( Howard Clinebell, Basic Types of Pastoral Counseling, pp. 189-205, 222-43; William Glasser, Reality Therapy (New York: Harper, 1965) Perry London, The Modes and Morale of Psychotherapy [New York: Holt, Rinehart, and Winston, 1964]) Any program of individual and small-group counseling with the poor should attempt to minimize red tape, needless professionalization, and other types of structural frustrations often accompanying more standard services -- frustrations such as complex and frightening diagnostic interviews, excessive use of referrals, and delays in the availability of the sought-for service.

4. Whenever possible, structural professional counseling with the poor should be sanctioned and guided by the poor themselves. The poor should have seats on the boards of the counseling centers, be they religious or secular, which attempt to serve their communities. For example, the Woodlawn Mental Health Center on the southside of Chicago has sitting on its board of directors representatives of all the major groups within this predominantly lower-class Negro neighborhood. Although the Center is staffed by highly competent professionals, the basic goals, philosophy, and procedures of the Center are worked out by representatives of the Woodlawn community. In this way, the Center becomes an integral part of the community itself and not just another agency coming in from the outside, competing for power and clientele and in this way further fragmenting an already badly disorganized community.

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