As I write (in January 2016), preparations for the Fourth International Conference of the British Association for the Study of Spirituality (BASS)Footnote1 are well under way and I am hoping that this present issue of the Journal for the Study of Spirituality (JSS) will be published in time to be available to conference delegates. As regular readers will know, there was an unavoidable delay to the publication date of the previous issue. This was because the journal became caught up in a web of circumstances, each of which on its own would have been problematic but which, taken together, created what one colleague referred to as a ‘Perfect Storm’.Footnote2
It began when the journal's publisher, Maney, was acquired by Taylor and Francis (T&F) shortly before JSS 5.2 was due to go into production. This resulted in the closure of the Maney offices in Leeds and relocation of several colleagues to Oxford – and inevitably caused significant disruption, requiring staff to get to grips quickly with new operating and production systems. After much hard work by the production team, we had hoped that most of the transitional difficulties had been resolved and that JSS 5.2 would be published by the year end. Unfortunately, that is when a real ‘perfect storm’ played its part in our metaphorical one.
On 2 December 2015, the state of Tamil Nadu in Southern India, including the city of Chennai, was devastated by what the Indian newspaper The Hindu,Footnote3 called ‘a perfect storm of meteorological conditions [which] combined to create Chennai's worst-ever deluge … exacerbated in no small part by civic infrastructure pushed to its limit and systemic dysfunction.’ Sreedhar Potarazu, on behalf of CNN News,Footnote4 reported that at least 300Footnote5 people had died when ‘rainfall of epic proportions triggered the region's worst flood in over 100 years, drowning a city of 4.8 million people.’ Ironically, as the report pointed out, ‘Millions were left without food and clean water and some of India's largest industries were devastated – all while the leaders of the world were talking about climate change in Paris.’ The CNN report questioned why the Chennai disaster had received such ‘remarkable inattention’ on the ‘global radar screen’, particularly since:
Chennai has always been the cultural capital of India, and hundreds, if not thousands, of artists who live there have dedicated themselves to preserving and advancing the nation's cultural heritage. Many of them had to be airlifted from their homes when over 12 feet of water came in. Hundreds of musicians and talented artists lost their homes, their instruments, their paintings, their sculptures. Some lost their lives.
But Chennai is proving resilient - not because of assistance from other countries or international charitable organizations, but because of the spirit and character of the community itself. It is creative, determined and passionate. Hindu, Muslim and Christian. The people of Chennai have come together to help each other.
In the midst of global calamities where people are truly suffering, Chennai's resilience demonstrates the power of the human spirit.
This is pertinent to JSS not simply because of the journal's explicit interest in the human spirit but especially because many of the T&F composition services are located in Chennai. I understand that all the T&F staff in the area are safe, and publishing work has been resumed. Nevertheless, in the context of the awful disruption to the lives of those who lost loved ones, homes and possessions to the storm, the frustrations here over a combination of delays in production take on a different perspective. It is a perspective that reminds us not only of the things that are truly important but of the nature of our global world and shared humanity. As John Donne wrote in 1624: ‘No man is an island/Entire of itself,/Every man is a piece of the continent,/A part of the main.’Footnote6
Currently, Stephen Daldrey's award-winning production of An Inspector Calls is touring in the UK.Footnote7 Written by J.B. Priestley in 1944 in the midst of the Second World War and set in 1912 before the turmoil of the First World War, it, too, refers to our shared humanity and moral responsibilities to and for one another. Believing that the only way to avoid future world wars was through co-operation and mutual respect between countries, Priestley was a strong advocate of the formation of the United Nations. From the 1930s, his writings and broadcasts stressed the need for political and social change: he believed passionately in social justice and the widening of democracy and became one of the founder members of the Campaign for Nuclear Disarmament. A vocal critic of the developing mass consumer society and deeply distrustful of a money-lending elite represented by the City and banking executives, he contributed significantly to the idea of the Welfare State and National Health Service.Footnote8
Such themes are implicit throughout An Inspector Calls. The play opens on a dinner party in the home of Arthur Birling, a self-important and rather loathsome mill owner. The party is to celebrate the engagement of Birling's daughter to the son of a rival businessman. Over a cigar and glass of port, Birling begins to expound his complacent and anti-socialist views, saying:
the way some of these cranks talk and write now, you'd think everybody has to look after everybody else, as if we were all mixed up together like bees in a hive—community and all that nonsense. But take my word for it … a man has to mind his own business and look after himself and his own—and— (CitationPriestley [1947] 1992, 10)
He is interrupted by the arrival of the Inspector who says he is investigating the suicide of a young girl, Eva Smith, in which it gradually becomes clear that everyone at the dinner party has been complicit, though hitherto unaware of that fact, through their selfish, uncaring and prejudiced actions.
The Inspector's well-known final speech is somewhat apocalyptic. He declaims:
But just remember this. One Eva Smith has gone - but there are millions and millions and millions of Eva Smiths and John Smiths still left with us, with their lives, their hopes and fears, their suffering and chance of happiness, all intertwined with our lives, and what we think and say and do. We don't live alone. We are members of one body. We are responsible for each other. And I tell you that the time will soon come when, if men will not learn that lesson, then they will be taught it in fire and blood and anguish. (CitationPriestley [1947]1992, 56)
Students of English literature studying the play are advised to question who, or what, the mysterious Inspector might be, and what he represents.Footnote9 Some might say that he is a voice of prophecy that is already manifest in the world in which we now live.
The forthcoming BASS conference provides an opportunity to explore whether/how spirituality can have a transformative effect in that world. The articles in this issue of JSS contribute to the exploration by offering a number of insights into how understandings of spirituality, and how to work with these in practical ways, play out in various professional contexts and relationships. Many professional settings are increasingly being shaped by a materialistic audit culture where the temptation to follow Arthur Birling's advice to ‘mind your own business and look after yourself’ can be strong, and opportunities to discuss spiritual matters scarce: as Janice Jones and her colleagues note in this issue, ‘Practising in a reductionist, task-orientated, target-driven environment can create tensions for health professionals … challenging their professional core philosophies, codes of practice and ethical values.’ BASS conferences are designed to address such matters by facilitating what CitationJohn Swinton (2011, 13) has called ‘hospitable conversations’, internationally and within and across professions and academic disciplines.
Thus, the first article in this issue provides a timely reminder that, even in the most open conversations, there are subtle dynamics in operation which can have profound implications for the way in which meaning emerges and is shared and understood. David Crawley, in a contribution from New Zealand, draws on Bakhtin's work to highlight the dialogic character of all meaning-making and, especially, to illuminate the interplay of meaning and authority in spiritual direction conversations. Crawley uses the notion of ‘authority’ in order to draw attention to, as he puts it, ‘that aspect of authority in conversation which concerns the directee's position as an author of their own narrative.’ Crawley emphasises the fact that ‘[i]n the collaborative context of spiritual direction, having authority does not imply disregard for another's point of view, but the ability to participate fully and freely in the conversations from which the meanings of one's life emerge.’
How to initiate and conduct conversations concerned with spirituality and life meaning, and whose responsibility it is to do so in professional contexts, are questions that lie at the heart of all the studies in this issue. Philip Austin, Roderick Macleod, Philip Siddall, Wilf McSherry and Richard Egan (working variously in Australia, New Zealand and the UK) report on the findings of a pilot study using an online cross-sectional survey to determine understandings of spirituality and spiritual care among clinical and non-clinical staff caring for people with chronic and terminal conditions. They show that, while staff can identify definitions of spiritual needs, their ability to recognise and meet these needs in their patients is uncertain. Austin and his colleagues argue not only that spiritual care training for hospital staff is essential but that evidence-based models of education and training in spiritual care require further study.
Reporting on a concept analysis of spirituality in occupational therapy practice, Janice Jones, Annie Topping, John Wattis and Joanna Smith also draw attention to a gap between theory and practice, and a need for further training. They argue that focussing on a description of ‘spiritually competent practice’, rather than on the contested concept of spirituality itself, may be a helpful way forward. To this end, they present a framework that offers practical guidance to occupational therapists on the process of incorporating spirituality into their practice. It could almost certainly be adapted for use in other therapeutic relationships but, as Jones and her colleagues point out, the time required for developing effective relationships is often scarce in the current culture of health care organisations.
In their study of the perceptions of physiotherapists in relation to spiritual care, Helen Turner and Christopher Cook highlight similar issues: confusion over the role of physiotherapists in spiritual care provision; a lack of training or experience; uncertainty over managing spiritual issues; and lack of time. They note that there seems to be a discrepancy in the perceived importance of spirituality/spiritual care and the actual delivery of such care. Turner and Cook conclude that physiotherapists need guidance and training in this matter and that referral pathways to specialist spiritual care services, such as chaplaincies, should be made clearer and more accessible.
Sophie MacKenzie's article reiterates several of these points. As part of her doctoral study exploring stories of spirituality with people with aphasia, she conducted interviews with members of a small multidisciplinary team of allied health professionals on an acute stroke ward. Coincidentally, the team included both an occupational therapist and a physiotherapist as well as someone in MacKenzie's own field of speech and language therapy. Seeking to understand how they view spirituality in the context of their respective roles, she, too, found some confusion over therapists’ remit in spiritual care. Nevertheless, she identifies a number of strategies for use with patients whose difficulties in understanding and/or expressing language make communication about spiritual issues particularly challenging. MacKenzie concludes with a plea for professionals working in this field, including chaplains, to share best practice.
Communication with patients and families in challenging circumstances is also central to the article by Wilf McSherry, Steve Suckling and Adam Boughey. Drawing on a qualitative evaluation of a Dementia Leadership Programme (DLP), it focuses specifically on the spiritual aspects of dementia care. The authors found that, despite attending a DLP, many of the health and social care professionals in the study drew upon knowledge and skills from their existing practice when assessing patients’ spiritual needs. The philosophy of holistic, person-centred care was of paramount importance to participants. In providing such care they recognised the need for a review of their patient's personal narrative, biography and history in order to identify the life meaning that had shaped the spirituality and personal identity of the person now suffering from dementia.
It would appear that, despite difficulties associated with professional practice in ‘reductionist, task-orientated, target-driven environments’ that are often inimical to explorations of spirituality, the researchers and practitioners involved in all the studies reported here have scant regard for Arthur Birling's self-centred approach to life and relationships. Rather, they are already fully engaged in what John Swinton describes as ‘[t]he core task for those of us who are interested in spirituality’ – a task that is ‘deeply practical: to learn what it means to treat people as human beings.’ (CitationSwinton 2011, 16, original emphasis).
In the Forum article in this issue Christina Puchalski, Robert Vitillo and Najmeh Jafari provide information on the Global Network for Spirituality & Health (GNSAH). Echoing a theme that runs through this issue, they note that, all too often,
clinicians are faced with increased burnout and depression. Part of that phenomenon has resulted from working within systems of care that do not value the transformative potential of the clinician-patient relationship, and that do not value the importance of service to others as a fundamental component of healthcare practice.
The GNSAH was formed in the belief that ‘clinicians, patients, and therefore health systems, can be transformed in order to achieve more compassionate, holistic, effective care and healing.’
It is to be hoped that this and similar initiatives, events such as the BASS conference, studies of the sort reported in this journal – and JSS itself – may ultimately combine to create the ‘perfect storm’ that will help to transform not only healthcare – but our world – for the better.
Notes
1 ‘Can spirituality transform our world: New frontiers in understanding and exploring contemporary spiritualities’, Manchester, UK, 23–26 May 2016 (http://www.basspirituality.org.uk) [accessed 20/01/2016].
2 The use of this phrase goes back to the early eighteenth century but was popularised by Sebastian Junger's (1997) book, The Perfect Storm, and the subsequent film (Warner Bros., 2000). Based on a storm that hit North America between 28 October and 4 November 1991, it features the crew of a fishing boat, the Andrea Gail, caught up in the confluence of three different weather-related phenomena. A ‘perfect storm’ is now generally used, as above, to refer to a difficult situation that is made significantly worse by a rare combination of circumstances.
3 S. Rukmini & B. Aravind Kumar, ‘Freak weather whipped up a perfect storm’ (07/12/2015) (http://www.thehindu.com/sci-tech/energy-and-environment/chennai-rains-freak-weather-whipped-up-a-perfect-storm/article7955477.ece) [accessed 19/01/2016].
4 Sreedhar Potarazu, ‘Chennai floods a climate change wake-up call for world’ (19/12/2015). (http://edition.cnn.com/2015/12/19/opinions/potarazu-chennai-flooding/) [accessed 19/01/2016].
5 It is now known that the death toll was over 400 and that 1.8 million people were ‘displaced’.
6 Meditation XVII: Devotions upon Emergent Occasions.
7 Details at: http://aninspectorcalls.com/ [accessed 20/01/2016].
8 Further information at: http://www.jbpriestleysociety.com/for-students-and-teachers/ [accessed 28/01/2016].
9 See for example: http://www.bbc.co.uk/schools/gcsebitesize/english_literature/dramainspectorcalls/2drama_inspector_charrev6.shtml [accessed 30/01/2016].