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Have you heard of Clinical Pastoral Education? Affectionately abbreviated CPE, it’s a common part of the seminary experience for many. It’s often required for Episcopal seminarians (like me!), and the bulk of my rising-middler classmates are completing it this summer. What does it look like? For me, in a summer intensive, it looks like forty hours per week (Tuesday–Saturday) spent at the hospital, in a mixture of class time (about fifteen hours) and clinical time (about twenty-five hours).

I have a cohort of fellow summer-unit students, a mixture of Christians and Jews, and we spend time together in class, but much of my time is spent on my own, practically functioning as a hospital chaplain. I thought I had respect for chaplaincy before CPE, but after experiencing it my admiration has expanded exponentially.

I expected CPE to be really difficult, and it is—but not for the reasons I expected. I anticipated emotional distress from spending so much time around critically ill people, including a substantial number of children. In fact, though, being with patients and families often leaves me inspired, amazed, and filled with hope. The problem is, it also leaves me exhausted, anxious, and grouchy.

See, I’m happily introverted, and most of the time that’s fine and dandy. The last decade of my life has mainly involved lots of time in higher education, which is pretty introvert-friendly, along with a brief stint getting paid to spend all day with a pre-verbal toddler and sitting at my computer copy editing papers for people with whom I interact solely through a comment thread.

So to spend an entire day inviting myself into incredibly intimate moments in people’s lives, introducing myself to them, and being available for potentially heavy conversations does not promise to keep my energy stores filled. Heck, I’m tired just having a handful of shallow conversations and then excusing myself to go in the women’s restroom where I can finally be alone and quiet for a few minutes.

I realized, concurrent with all of this, that my ways of relating to people (i.e. hiding from them—that’s a joke, but also not) are connected to the ways I relate to God. For a recent CPE assignment, I was asked to imagine a conversation with God/the divine/a religious or cultural figure around some issue I was wrestling with in my chaplaincy experience. I was excited at first, as I tend to be about creative assignments, but I wound up stymied. My typed-up conversation with Jesus was more stilted and awkward than most of the conversations I have with patients, and I just felt frustrated.

Part of the problem for me, I realized, was that I don’t listen for God’s voice verbally. I don’t expect to have a conversation with God in this way.I speak to God conversationally, sometimes, but mostly just to get something off my chest—to rant, often as not. God usually speaks to me, though, in quiet things—in a novel, or a poem, or an essay I’m writing. In friendship and music and the damp, humus-y smell of the forest floor.

And in turn, this way of relating to God reflects on ways of relating to people. Sometimes (especially, I would argue, in many hospital settings), there just aren’t a lot of words—and sometimes, that’s okay.


First a question: who is the introverted CPE student, Staci or Alissa? Since that was unclear, my personal response to a very personal post will need to be addressed:

To whom it may concern :)

I really appreciated your candid sharing of the challenge you felt when forced to be outside your comfort zone. My own CPE experience, now almost 40 years ago, was similar in that I, an extrovert, had been placed (deliberately, it turned out) in a wing of the psychiatric hospital occupied with mostly elderly, non-verbal, senile patients, where my excellent verbal skills were of little or no use. My best pastoral presence required quietly holding someone's hand, supporting someone walking down a hospital hallway, or helping to spoon feed someone no longer able to feed himself. You might have felt right at home there, but a full day of this left me "exhausted, anxious, and grouchy".

And therein lies the professional pastor's conundrum. Because it is a rare pastoral position where we always get to decide which type of pastoral interaction we need to be engaged in. In fact, it is a rare personal relationship where we are permitted to always operate within our comfort zone. For me, it will always be a challenge to "shut up and just listen". For you, it appears to be a challenge to verbally interact, face to face, with the people around you.

I appreciate that in your post you underscored that even in our conversations with God our personality style is revealed. Over time God has proven Himself quite patient, listening to my verbal meandering, but at times He has found it necessary to use drastic measures to get me to shut up and listen. I won't go into the details, but it wasn't pretty.

I also appreciate that God can get through to you in ways other than verbal. God is pretty cool that way! And I am sure that there are many people who would greatly appreciate your soothing, quiet presence at a time when in every other way they are surrounded by chaos and turmoil.

But what of the people who need you to say something, or even to have a Crucial Conversation with you, at the end of what for you already was a long day of people, people, and more people? You are already exhausted. You are already beginning to feel anxious. How do you keep from sounding grouchy?

My wife wants to know.

Hi, John,

Thanks so much for your thoughtful comment, and sorry it took so long for me to reply—it turns out the last couple of weeks of CPE are even more all-consuming than the earlier portion!

In writing about one slice of my CPE experience and my personality, I highlighted and maybe even exaggerated the moments of silence. I like to think that when the time comes to say something, I can (and do). In fact, I actually like engaging people in "crucial conversations" (though I'm new to the book/concept, and look forward to checking it out), and a good conversation can override my exhaustion. What I think is different for me is that I prefer having such a conversation when I've already begun cultivating a relationship. The most difficult—and exhausting—part of CPE for me was that many, even most, of my visits were "cold calls," uninvited visits to patients/families who may or may not want to talk to someone about their spiritual well-being, support networks, etc. The newness and unfamiliarity of the relationship would make me feel anxious, and all those introductions would deplete my energy stores.

I don't have good a solution for how to keep going in that situation—and if you do, I'd love to hear it, because I could sure use something during the introduction phase in a new church. In CPE, I usually responded by doing some work that didn't involve human interaction (e.g. charting, planning a service). If that wasn't an option, I might try to eat something, as I've found that "hangry" is a real emotion for me, and sometimes even a quick snack can move me from grouchy and overwhelmed to at least something approaching stable.

All to say, I think there is a place for conversation and words—I enjoy writing and reading immensely; I'm not about to give up verbal communication. I've also seen the pain that can come when one is not able to communicate verbally and wants to—that is a huge loss. However, I also think there is a place for silence, and I think that silence can be as meaningful as words.

Thanks again for writing!


Staci (and Alissa),

Thanks for posting this thoughtful reflection on the value of CPE, especially for those who are thinking of preparing for chaplaincy (or the parish ministry, but want to be better prepared to do quality pastoral care). The combination of intense pastoral care exposure and repeated reflection with a supervisor and small group has a remarkable ability to grow one's self-awareness and effectiveness as a pastoral caregiver (aka: agent of God's love in difficult situations). And thanks to John for broadening the perspective from a different personality type. I hope some of our current and/or prospective CRC chaplains see this and comment on their CPE experiences.

Thanks for your comment, Ron. I'm one of those in the parenthetical category (preparing for parish ministry). I'm actually seeking ordination in another denomination (The Episcopal Church), and I, along with the majority of my classmates, was required to take one unit of CPE as part of my seminary studies. One of the staff chaplains at the hospital noted that there's a difference in the tenor and attitude of those who are electing to take the unit vs. those who are required, which seems obvious, but still struck me as an interesting observation. We talked a fair amount about introversion/extraversion in my group, and noted how each of us had different areas of comfort/discomfort (for instance, while I had a great deal of discomfort and anxiety around cold-calling, I felt virtually none of that in responding to arrest pages, which in turn caused discomfort and anxiety for others). While there are times I think it would be handy to be a tad more extraverted, I think it's pretty great that the Church is filled with so many people who have so many unique gifts.

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