After a sabbatical in 2018-19, part of which was spent on a fellowship at the Chicago Psychoanalytic Institute, I made a decision to resume the clinical training I abandoned in the late 1990s when the unexpected opportunity of teaching theology presented itself. Part of my decision was motivated by a genuine sense of vocation to be of service to the many Catholics suffering from the massive trauma of abuse that I have written about in a number of places.
As I started my training anew, I have noticed one big difference from the 1990s: the open, regular and repeated exhortations to clinicians today to have a regular and serious discipline of self-care to deal with what is called “vicarious traumatization” or “compassion fatigue,” which afflicts not just frontline clinicians but also clergy who are so often counseling others in great pain and attending to the sick, the dying and the grieving.
As someone who grew up during Pope St. John Paul II’s papacy, and who has long regarded his writings on self-gift (especially in Veritatis Splendor) as powerfully compelling, I admit that this language of “self-care” sits very uneasily amidst a Christian vocabulary more accustomed to speaking of self-sacrifice. I rather lazily assumed that the two could not be reconciled, but I have recently concluded otherwise based on conversations with several clinicians and after reading several contemporary theologians.
The necessity of self-care
My clinical supervisor was the first to impress on me the need for self-care, especially for those of us training to deal with major trauma. His words carry weight not just because of his position and long experience, but perhaps especially because he embodies Catholic care for others — particularly the homeless, refugees and victims of sexual exploitation — in ways that can only make St. Francis of Assisi proud. At the same time, his regular habits of self-care are done with such sang-froid as to make him a compelling martyr — that is (as the word in Greek means) a witness to refractory people like me struggling to accept a Christian case for self-care that is not contaminated by vestiges of neurotic guilt.
Other therapists I have interviewed have also born compelling witness here. One woman in particular powerfully impressed this upon me. I met her seemingly by chance on a flight some time back. We were en route to Belgium, where I was to give a lecture and she was to catch another flight to Uganda to work with traumatized children in one of Africa’s largest refugee camps. She was sponsored in this work by an international church group of which she was a part. On a 10-hour flight, we spent at least half of it engrossed in a memorable and moving conversation.
She was an American social worker and deeply committed Christian whose clinical experience was longstanding and impressive. More impressive still was her no-nonsense insistence on two practices. First, she has two close friends, and the three of them have an unbreakable commitment each month to meet for a couple of hours to check in, hold each other accountable and discuss difficulties and problems of a professional, personal and spiritual nature. Second, she goes regularly for long walks along the ocean where she lives, using the time to pray and meditate.
What became clear to me in our conversation is that “self-care” for her is a theological imperative and a spiritual discipline undertaken to preserve and strengthen the sense that each of us is a beloved of God. Rooted in that gift of love and dignity, we can find further gifts of strength to care for others. Self-care, thus, is about sustaining and increasing our capacity for self-gift, for service to others; but it also functions as an aide-mémoire, reminding me that I truly must love my neighbor as much as myself.
The will to train
In this light, we can dispel some facile notions that might glibly commodify self-care as little more than bourgeois luxury and self-indulgence — hoarding extra cartons of our favorite ice cream in the freezer to help us recover from doing our taxes or enduring a brutal annual performance review at work. Self-care needs to be considered as more than a superficial reward. Perhaps, then, we might see self-care as a synonym for asceticism — that is, a discipline of some depth and gravity.
Christians are on familiar ground in talking of asceticism, which we usually translate from Greek as “training.” Athletes train for the Olympics. Students train to be nurses or artists. And Christians also train, as St. Paul notes in both his letters to Timothy (cf. 1 Tm 6:12; and 2 Tm 4:7-8), for an eternal life that begins here and now.
Most Christians keep to some modest and deliberate period of training at least once every year in the period we call Lent. Many Christians also keep a “little Lent” almost every Friday with some training, usually of our carnivorous appetites. It is good to train, and to keep a schedule, and to exercise our bodies, which are temples of the Holy Spirit.
As it happens, the self-care literature is awash in recommending all three of the practices just mentioned — training, scheduling and exercising. These have been standard recommendations for some time, but now are nearly ubiquitous in every list of psychological self-care proffered to us in a time of pandemic.
And yet those three — and many others — can often be difficult to implement and maintain. We often start zealously and determinedly (think back to the first days of January, if you made New Year’s resolutions, or the first few days of Lent), but quickly falter. Sometimes we restart perhaps in a reduced way (“I’ll go to the gym twice a week instead of every day”), and sometimes we despondently abandon the practices and retreat to the embrace of that perversely comforting companion called guilt.
The pull of guilt
Notoriously, Catholic Christians in particular seem to struggle with neurotic guilt, confusing vague feelings with malformed notions of “conscience.” The work of discernment becomes crucial here, and great spiritual writers from Ignatius of Loyola onward stress the need to focus not on ambiguous and ambivalent affect but on concrete realities, as three contemporary scholars have also done in helpful ways.
Writing back in 1974 in the Journal of Psychology and Theology, the psychologist Bruce Narramore dealt handily with the problem of guilt, sifting through a great deal of scriptural evidence to show rather emphatically that “not once in the New Testament is guilt used as an emotion.” Narramore later argues that “psychological guilt emotions are not induced by the Holy Spirit. They are the imbedded self-condemning attitudes originating largely in childhood experiences through the psychological process of internalization,” usually based on the projections and expectations of our family of origin.
Guilt about self-care, then, is not among the Spirit’s gifts to us. It is very often the product of our upbringing, which may tend to chastise us for focusing on ourselves — that is, for being supposedly selfish and solipsistic. But to understand the self, and thus self-care, in those terms is to overlook the fact that the self is always embodied and embedded in community.
This is the central insight of the theologian Leanna Fuller. In a 2018 article in the Journal of Pastoral Theology, she draws on central insights from feminist theology to argue that we can never see self-care solely in individualistic terms of private practices. Fuller’s essay rightly insists that our deep and abiding connections to each other mean that self-care is ipso facto caring for the community in which the self is embedded and lives: “self-care is necessarily relational and communal.” From this she goes on to reason that a “failure to practice adequate self-care can lead to serious communal effects because of the intimate connection between self and community.”
I count numerous parish clergy — Orthodox and Catholic — as close friends, and I can confirm Fuller’s observation in no uncertain terms. When the pastor is neglectful of self-care, the community suffers. The more the community demands — and the fewer opportunities he has for self-care — the more everybody will end up suffering.
Recognizing the need to prevent such pathological dynamics from taking hold leads Fuller to insist that “self-care actually constitutes an ethical obligation for caregivers” both for the sake of the community and for the sake of the person. In this light, then, as noted earlier, self-care is not self-indulgence. It is an obligation and, as our last author of note will make clear, an obligation commanded by God himself.
For the good of community
Writing in 2015 in the Evangelical Review of Theology, Jeffrey Gates argues that “self-care is a way to express our love for God. Self-care is a form of love to God in whose image the self is.” Like Fuller, he also recognizes that self-care is a form of community care as well, for the self is never isolated and alone but always part of the communion of believers and God. For this reason, he concludes that “God wants us to care for ourselves and to seek love from him and others. … Failing to care for ourselves is as bad as harming others or not caring for others because we are equally valued by God.”
While all three authors are Protestant — and it seems few Catholic authors have begun to treat this topic with any depth — that does not mean that Catholics are bereft of powerful examples. Both Scripture and hagiography, ancient and modern, abound with stories about men and women who needed time to train and look after themselves precisely in order that they might be instruments of God’s grace in the wider Church.
And now, when daily life is disrupted in ways none of us has ever lived through, self-care becomes crucial not just for frontline personnel in hospitals, but all of us dealing with widespread and massive anxiety. Like the saints who hid themselves atop some mountain redoubt or in some cave, our self-care, precisely insofar as it is hidden and withdrawn from others, is ipso facto a kenotic form of care for them and for the life of the world.
Adam A.J. DeVille is author of “Everything Hidden Shall Be Revealed: Ridding the Church of Abuses of Sex and Power” (Angelico Press, $16.95). He writes from Indiana.
