The Pastor as Enabler
Kathleen Rusnak, M. Div.Lutheran Medical Center
ABSTRACT: Out of a personal struggle to understand and help a chronically ill friend the writer evolves a view of the pastor as enabler. The definition of "enable," the role of the "enabler," and the problems which prevent many from being "enabled," are discussed. These definitions are illuminated by the Biblical perspective of Elihu in the book of Job. The pastor who sees himself as enabler is able to bring perspective, clarity, empathy, compassion, and concrete help to the person in need.
Although phlebitis is not a rare diagnosis for a young woman, acute and chronic phlebitis is. A close friend of mine, Melissa, learned from her doctor that there was no solution to her recurring phlebitis and resulting thrombophlebitis (blood clot in the deeper vein). Instead it was chronic and acute. She entered a state of denial about her illness and walked on her leg as if it were normal. She grew accustomed to the pain and therefore discerning when the phlebitis was getting worse became difficult for her. Only when the pain became so great that the leg became discolored, swollen, and impossible to walk on, was she willing to admit that the phlebitis had reached the acute stage, and hospitalization or confinement to bed necessitated.
Because Melissa denied the seriousness of her illness, I found myself in a state of "unadaptive grief," envisioning at any moment the clot might break lose and she would be gone. My own desperate needs took precedence. Consequently, I failed miserably in my attempts to help because my love and concern expressed themselves in wanting to take responsibility and control over her behavior -- to "shake some sense into her." She was being pressured from all sides to "take care of herself." I became one more influential person in her life who unintentionally added more pressure, more demands, and more guilt.
I executed as much manipulative power as I could to force her to do what I thought was best for her. She rejected what the doctor said about her condition, and felt that she had to be active on her feet because of her responsibility for two small children. She also argued that the children had been through enough emotional loss and grief already with her hospitalizations and that she would not go in again. I rebuked her, saying that, ironically, the very way to make sure she could not take care of her children or to cause them more grief would be to walk on her leg until she ended up in the hospital. When the doctor told her that she would have to quit her job without hope of ever working again, she remained on the job without his knowledge. I scolded her for this, knowing the phlebitis would get worse.
When I would not acknowledge her feelings about responsibilities or the grief of her children, she sought other reasons to justify her feelings and actions. These included guilt towards her immediate and extended family because of the grief and anxiety her hospitalizations had caused them, and eventually she resorted to the cost of hospitals, doctors, blood tests, and expensive medication. Further, she insisted that she could control the phlebitis on her own, contrary to past experience.
I did not recognize the grief she was experiencing over losing aspects of her role as mother, or the self-esteem that she would lose by not being able to work. Out of my own needs I intimidated her and placed guilt on her. I blamed her when she became ill, accusing her of not being responsible to her family and friends, or taking into consideration what they were going through because she wanted to be the working woman and active mother she was before becoming ill. I was countering her "feelings" of loss with "reasons" and accusations, not recognizing that she had to consider the quality of her life under her new circumstances. I was unintentionally depriving her of the right to love herself in a way she found appropriate.
Being well-intended, but insensitive to her feelings, I tried to show her that staying on her feet would eventually cause the very things she wanted to fight against: further time in the hospital, spending more money on her health, and guilt feelings towards herself and her family.
Finally, acknowledging that I had failed to help Melissa, yet because I cared for her, I became very introspective, searching out personal feelings that had been stirred in me that prohibited me from "enabling" Melissa to put her illness in perspective. I needed to rethink some of the presuppositions behind my "strategy" that caused me to fail so miserably. From my failures, already, I had learned the first aspect about enabling. To enable Melissa meant finally allowing her the freedom to make decisions on her own.
For me, this meant an agonizing sense of powerlessness and helplessness, with the realization that enabling is not playing God, but relying on God and trusting in my friend. Enabling is not dictating appropriate behavior or prescribing a cure! And this can be a devastating reality to accept when you love someone and feel "sure" about what is best for them. It was painful to learn that true enabling required me to "let go" of trying to control my friend and forcing my agenda on her.
A second insight I gained about enabling is that I had previously assumed that knowing the "truth," or being told the answer would stimulate the "right" course of action from the person seeking help. After all, didn't God create us with a free will so that the right, wrong, or expedient compromise could be made? But relating to Melissa the physical dangers of walking with acute phlebitis, or the ultimate devastation to her family and friends should the clot break loose, did not alter her behavior! The possibility of losing her leg or the danger of death was imminent. This was not speculation. These were harsh words from her doctor, but his words did not make a difference. My personal experience with Melissa taught me that something more than the "truth" is needed to "set us free," to hear, to see, and to respond constructively to our present situations. Even the scare she had earlier with a pulmonary embolism was only temporarily effective. Was she dealing with loss of identity or self-image? Was she in a state of denial? Was there perhaps some deeper psychological problem, or was she in fact just being stubborn? What was I to do in order to enable her? Of what did I need to be aware?
Because of the situation with Melissa, I reflected on a previous experience with a troubled woman and was able to reappropriate the reality of that experience based on my new insights. I realized that many who are in need of being enabled are in emotional binds that only allow them to react to their situations in powerless ways.
One reacts when another controls his behavior so that he is not doing what he himself wants but what the other person wants. To respond, on the other hand, means that the other person's position is taken into account but is not the cause of one's own behavior. It is the difference between being manipulated and being free. A central aim of Bowenian therapy is to enable a person to get to a position where he can respond to a system and not just react, that is, get caught in the system.1I saw an example of this as a chaplain in a hospital. A white, 21 year old woman was admitted to the hospital. She was the mother of two children and married to a Puerto Rican man. Besides marital difficulties, there were numerous in-law quarrels over the mixed marriage. This young woman did not know how to get out of the mess she was in. She was so caught up in emotional entanglements with her immediate and extended families that she could not even allow herself to consider the solutions of divorce, or a new life. She was being consumed by her negative situation. It may have been very easy for an outsider to suggest divorce or a gradual rebuilding of a new and positive life, but for her, even the answer was no answer. Hers was a case where the solution (cure) seemed to her more of a curse than the problem (disease).
In reflecting on this past situation, I realized another necessary aspect of enabling that could perhaps help me with Melissa. To effect solutions involves a long process of "bridge building" that enables one to cross step by step from one side to the other. To have simply suggested divorce for this woman would not be enabling, even if it were the "right" course of action. Similarly, for Melissa, merely knowing the truth or "what to do" would not necessarily enable her to take remedial action or to be free. Advising her to act in her own best interest, even if she knew such action to be in her best interest, is negative advice if it ignores those emotions that bind her to contrary actions, even at the possible cost of her life.
Melissa had to be enabled to make a decision about what she wanted in life. The woman in the hospital may have chosen divorce, but merely to state the solution without first enabling, is asking her to "jump canyons," not to "build bridges." For the truth to set one free, truth must often unfold itself in a slow experiential process -- truth that can be recognized and activated.
Making "correct" or "incorrect" choices in life cannot always be attributed to our freedom to choose consciously what is right or wrong for us. One may not be able to obtain what he wants in life because what often determines our choices is deeply rooted in emotional attachments, or learned emotional responses. For example, in a racist society, the emotional roots of hatred find their foundation in socialization. One does not choose to be a racist, but has never been enabled to see humanity in perspective. Emotional conflict and confusion arises when a fragment or glimpse of a different reality is experienced. An attempt to break from the learned and socially accepted world view would represent a significant emotional break from family, church, and friends. Can one muster what it takes to accomplish such differentiation even at the cost of ostracism? Pressures from significant others in one's life can be paramount, and an individual needs to choose a friend or counselor who can enable him to find his own identity and inner strength to live an authentic life. A person who cannot live out his true identity because of expectations from others will find life taken by illness, problems, or even death, as the young woman of my example evidenced.
It becomes clear what Jesus meant when he said that one must hate mother and father if one is to follow Him, and St. Paul's statement about doing that which he does not want to do, and not doing what he wants. So strong are our emotional attachments and reactions to life situations, that Jesus spoke of hatred as a brutal way to differentiate one's self from them, finally to be free to respond to life instead of reacting to it.
A goal of enabling is to give back to a person the power to prevent him from being raped by the emotional systems of significant others or significant institutions in their lives. Often, we are severely imposed upon by the thought and behavior systems of those closest to us. For example, a certain look or tone of voice from parent to child is enough to cause appropriate behavior. Not all of our socialization process is bad; in fact it is necessary until it violates us and prevents us from developing into independent and free individuals with unique identities, or robs us of ever realizing or experiencing the power we own.
Enabling aims to reclaim that power and to put the person into a process whereby, like the prodigal son, he can "come to himself." Enabling attempts to differentiate an individual from others, so the person can make decisions about his own life based on his own assessment of himself and his life situation.
The young woman of my example was severely trapped by familial ties. She was trapped by the limited alternatives she could perceive, and thus not free to respond to life, but only to react to it. She did not consciously commit suicide, nor did family and observers think of her death as such. Yet the choice to live or die was hers.
My insights were furthered by looking into the Biblical character of Elihu in the book of Job. As I listened to a lecture about the purpose Elihu played in Job's life, I turned my hopes, energies, and research to the Bible.
Job, too, was trapped. He was trapped by his own narrow view of suffering and God and was also unable to respond to his life situation or to his three friends. He also was trapped by a system of thinking that he had bought in part and not know how to get out of.
Job only reacted to his friends and their theological system of thinking. Job as part of the system did not know a way out of it, and being half in and half out of the system, could only react. By reacting, he lost his power. The friends did not try to enable Job to respond to the theological system of thinking, but they tried to manipulate and control Job by and with the system (quite like I tried with my friend), knowing already he was "hooked" into the system and thus, undifferentiated from it. Job continued to react as each "friend" progressively tried to pull him deeper into the system.
Walter Michel, an Old Testament Professor at the Lutheran School of Theology at Chicago, in his unpublished manuscript, "Job's Submission," says that Job and his friends
wanted God to be what they wanted God to be. It is true that Job was dissatisfied with the socalled traditional ways of speaking about God, and especially with the doctrine of retribution, of punishment and reward. Meanwhile the Friends, unperturbed by the evidence of life and experience, spouted forth the "partyline," the socalled accepted system. Still Job did not come to the point, as yet, of accepting God on God's terms, until the end of the book, when he is finally able to hear God, when he is encountered by the theophany.Elihu, on the other hand, was perceptive enough to get behind Job's words to the real problem. It was not the problem of suffering that bothered Job but the question of God's guilt. Elihu attempted to put life in perspective for Job, to clarify the situation, even by carefully quoting Job's own words (i.e. chapter 33:8ff) to show that he had been listening to what Job was saying. Elihu wanted to enable Job to respond in freedom to what he was saying, and even asked Job to answer whenever he had something to say. He was not trying to manipulate Job into any system of thinking or behavior, but wanted to free Job to hear whatever it was that God had been trying to tell him.The Friends get angrier and angrier with Job. They again and again, restate the moralist and socalled standard theology of the Bible, hardly listening to the counterarguments made by Job. They neglect him and his miserable existence. They even insult him by dreaming up all kinds of sins Job must have committed, saying that otherwise he would certainly not suffer so much. It is quite obvious, then, that the Friends are scared to see their system crumble. Amid all this, Job can neither accept their system nor can he completely free himself from it2.
Elihu knew that Job was a smart man who had his wits about him, but that his situation was slightly out of perspective. I am struck by a quote I read some time ago which deals with a person in crisis. "Whether a person will emerge stronger or weaker is not necessarily determined by his 'character' or his 'inner strength' but by the kind of help he gets during the trouble."3 Certainly this was true of Job. He had character and inner strength, but needed the perspective and clarity from an outsider who could enable him to respond. It was not that Elihu knew what God had told Job or knew what Job would hear in this theophany. But Elihu attempted to enable Job to respond in freedom to what he had to say, and thus to what God had to say.
To always react is to never be in control of one's self but always to be manipulated. How could job hear God unless he re-claimed his power to respond -- until he re-claimed that freedom?
Job found himself in a double bind; a situation that appeared to have only two alternatives, neither of which allowed him to "win." Job maintained that he was innocent of any wrongdoing. If he claimed innocence, what other conclusion could he draw but that God was guilty of injustice in his situation?
The friends also found themselves in a double bind, which may be the reason they could not help Job. They claimed too that suffering came from sin, but concluded that Job, instead of God, was in the wrong. Instead of enabling Job, they insulted him and accused him blindly, since they also were caught in a system that did not allow for response.
Elihu, on the other hand, brought Job the kind of help he needed. He gave him the perspective he sought: a third alternative! First, he set aside Job's argument that a righteous man should not suffer. Job had not even thought of this! This possible insight gave Job more room to breathe and more reason to continue to listen to Elihu. Elihu won the ear and silence of Job in the first moments of encounter. He was then in a position to enable Job.
Elihu was not caught in a system that prevented him from hearing what Job was saying. Elihu was able to get behind the surface of what Job was asking. Many times a person goes to a friend with a problem, thinking that the friend will sympathize and not confront or challenge his words. I recall in my first clinical pastoral education group complaining that one of the members of the group did not like me. I cited example after example that might add weight to my argument. I felt I had the support and sympathy of the other members, but one member spoke up who was "hearing" what I said. He looked at me and said, "Kathy, are you willing to take responsibility for the fact that you do not like X?" Like Job, I was silenced not only by shock but by insight and perspective!
Job's friends did not hear Job but attempted to argue with him based on his narrow rationale that he had not sinned, suffering comes from sinning, and therefore God was guilty. The friends, hearing only that Job refuted a sacred theology of theirs, did not understand what he was dealing with, but jumped immediately into a full blown argument -- Job sinned, suffering comes from sinning, therefore Job must repent. The friends lacked perception and any kind of empathy at all.
Elihu heard "God" as being Job's problem, even though Job kept talking about his suffering and God's guilt. I believe that Job was finally relieved that someone heard the questions of his inner heart, heard beneath his verbalized complaints. Elihu cared enough to draw Job out of his despair, to rescue him with love, concern, and risk. In chapter 33:24 the words, "having compassion... spare him," speak of Elihu reaching out for the other with that prevenient grace that does not allow another to sit in his own dirt!
The friends were more interested in condemning Job, hoping to push him deeper into despair so that he would be motivated to do what they wanted: repent!
The method Elihu used to enable Job will not necessarily work for someone else. But Elihu did help Job let go of his old way of thinking that trapped him and kept him from health, from hearing God. Elihu helped Job to see other options and to reclaim his power to change things.
This insight into Elihu and Job motivated me to continue searching for the right bridges to enable Melissa to discover herself, and to reclaim her power and personal truth. It is still easy for me to react, exerting manipulative power and telling her what to do, out of fear and desperation. I am burning fewer of those "bridges" now, for each failure helps me to understand the enabler (me) a little better and teaches me to "walk with" and accept Melissa instead of intimidating and rejecting her. I have found that positive power is really walking with another, as Elihu did with Job.
But "walking with" and bridge building are slow processes. Some bridges are built sloppily and are not safe to walk on. Others lead in the wrong direction. Some bridges must be abandoned mid-way, and some, luckily, seem to be strong enough to allow a few steps forward.
Then there are clients who will try to sabotage any new bridges with booby traps of denial (ie. of alcoholism, of bad marriage, of illness).
In such instances the enabler is tempted to say, "Since this person is being irrational, I can tell him so and show him what makes sense." If the helper yields he ceases to be an enabler, and becomes an "imposer." Time and again, this shift results in a tug of war between emotions (irrational) and logic (rational). One simply does not hear the other.
Irrationality, like denial, calls for a longer "walking period." An enabler must walk with the other through the storms of depression, denial, confusion and irrationality. A person is in these states because he needs to be, and when he has been there long enough (on his clock) the enabler or friend who stood with him will be the one in position to help.
I am walking slower than ever with Melissa. I am learning about patience, listening skill, the disappointing steps backward, the need for differentiation, perception, perspective, and most of all about the power of prayer, reliance on and trust in The Enabler; the Holy Spirit. Being an enabler is not easy. It is probably one of the hardest vocations one can choose, one of the most painful, and yet one of the most rewarding.
It is one of my greatest desires that, like Elihu, some of us know how to be a real friend to a sick person, to someone who suffers either from a physical, intellectual, or spiritual wound. Like Elihu we are able to bring perspective, clarity, empathy, compassion and concrete help to the situation and thereby enable the person to have nothing less than a theophany.4
References
1. Vincent D. Foley, An Introduction to Family Therapy. New York: Grune & Stratton, 1974, p. 115.
2. Walter L. Michel. Job's Submission: Philological, Theological, and Hermeneutical Remarks. Unpublished manuscript, The Lutheran School of Theology at Chicago, Chicago, Illinois, 1977, p. 12.
3. Vivian Cadden in Gerald Kapplan. Principles of Preventive Psychiatry. New York: Basic Books, 1964, p. 291.
4. Michel, op. cit., p. 21.
This material is reproduced with permission of Kluwer Academic/Plenum Publishers and is taken from PASTORAL PSYCHOLOGY, VOL. 28(1), FALL 1979, published by Human Sciences Press in 1979.You may not download, copy, print, or make available via any method, including use of the world wide web, the files, or any material contained within the files, for distribution to third parties - even for non-commercial purposes, or use these files for any commercial purpose.
