1. Van Byssum, Doris M.

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Spiritual care can be complicated by our history of woundedness. One never knows when or how another person will set off the unconscious transfer of feelings and attitudes from a past experience to the present circumstance. The transference of patient's feelings and attitudes from long ago onto the current situation has the potential of interfering with the level of spiritual care the patient is able or willing to accept from the clinician. This can be confusing to the clinician who has no way of knowing what past hurts lie in the unconscious recesses of the patient's mind and confusing when the patient responds with an attitude that seems unwarranted (whether positive or negative).

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Patients are not the only ones with a history of woundedness. The countertransference of clinicians' past experiences imposed onto the current person or situation impacts the level of spiritual care clinicians are able or willing to give patients. Avoidance or coldness toward a patient can serve as a signal of a clinician's unresolved issues brewing inside. The "difficult patient" may be mirroring the clinician's own impatience or bitterness projected onto their patients. It can be difficult for clinicians to determine whether their response to a patient is revealing something about the patient or themselves.


Nurses owe it to themselves to become familiar with their own imperfections and woundedness. "For until we realize that we are in need of healing ourselves and recognize in the weakness of our patients a weakness not unlike our own, we will never be very good healers" (Sulmasy, 1997, p. 123). The relationship with self requires constant work, with inner healing being drawn from our relationship with God. Our sense of wrongdoing and attempts to maintain our ego is constant, for "the heart is deceitful above all things and beyond cure. Who can understand it?" (Jeremiah 17:9, NIV).


"Difficult patients" are patients who commonly receive cursory care. No one wants to go to the challenging patient's bedside, and yet, often he or she is the one who most needs spiritual presence. It may be through some of the most difficult patients we care for that God offers us healing, showing us insight into ourselves. God tells us, "Truly, I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me" (Matthew 25:40, NIV). It can be healing when we are able to treat others with the grace God has granted to us.


"Wounded healers do not ask their patients for help, but recognize the unity between their own neediness and the needs of their patients. Wounded healers issue an invitation to patients to enter into the space of the healing relationship" (Sulmasy, 1997, p. 50). God opens up windows to the souls of others, allowing each person a glimpse of his/her own woundedness. It is not until we can recognize self and the weakness in ourselves that we can begin to connect with the neediness of patients.


Caring for others in some ways is like caring for one's self. God may be coming to us again and again, offering us healing through a cast of despicable characters-all representing parts of ourselves. When a clinician makes a projection onto a patient, and then recognizes that the darkness belongs not to the patient but to the clinician, healing can begin.


God loves us just as we are "for we are God's handiwork" (Romans 12:19, NIV). When we accept ourselves and acknowledge our imperfections, we can accept others and truly show them God's love. It is "in our own woundedness, we can become a source of life for others" (Nouwen, 1972, cover page). This enables us to transcend into a sense of community and connection with fellow humans, allowing us to provide better spiritual care. "Every Christian is constantly invited to overcome his neighbor's fear by entering into it with him, and to find in the fellowship of suffering the way to freedom" (Nouwen, 1972, p. 77). When we as wounded healers connect with others who are wounded, we help make God's healing intent visible.


Nouwen H. J. M. (1972). The wounded healer. New York, NY: Doubleday. [Context Link]


Sulmasy D. (1997). The healer's calling. New York, NY: Paulist.