Intentional and Inclusive: Crushing Pressure Pastoral Care

Written by Dr. Patricia Williams

Dr. Patricia Williams, ACPE Psychotherapist, SIP Trainer and Member of the Anti-Bias Work Group, shares this insightful essay in honor of Suicide Prevention Awareness Month.


“Intentional and Inclusive: Crushing Pressure Pastoral Care”

By Patricia Williams, ACPE Psychotherapist & SIP Trainer

            When the mind, body, and spirit of humanity reach the ultimate toleration level, existence may assume a meaning that places life at risk. Stressors contributing to mental, emotional, and spiritual boiling points sometimes create unbearable despair. A label commonly ascribed to this disparaging condition is the dark night of the soul. The dark night of the soul is clinically defined as spiritual depression, hopelessness, disconnection to meaningful relationships, purposelessness, and lack of a sense of belonging. These conditions are descriptive of overshadowing dismay, which can cause one to question the value of life and entertain ideas of suicide.

            Shepherding the disquieted spirit, a role pastoral care may assume, can be daunting. Whatever one’s spiritual belief system, there is possibly an opposing reality for the dark night of the soul. In some religious traditions, this opposing concept is the light of life. Consequently, when pastoral care meets the demand of a shattered, suicidal soul, there is crushing pressure with which one must contend. The shadows of hopelessness require replacement views, feelings, and executive functioning, such that misery is exchanged for hope; and emotional regulation that manages suffering becomes essential.

            In this space with suicidal contenders, there is an intensity of demands which may crush the spirits of pastoral care practitioners, such as chaplains, pastoral psychotherapists and other spiritual care providers. During this month of emphasis on suicide prevention, reminders to embrace intentionality in building caring communities and to demonstrate inclusive consideration for all who seek one’s offerings of support can regulate disparity in the pressure of serving the suffering.

            To frame the process of the clinical pastoral ministry and regulation of engagement in a just community, self-reflexive activity is useful. There is a term in the French language that can serve as an acronym, and which has a connotation that will motivate intentionality and inclusion. It is tous, which means whole or all. If one were to apply terminology to each letter in this term, it might result as follows: Tenderhearted, Open, Understanding, and Sensitive.

            When one is a paraclete to someone experiencing the dark night of the soul, the self-reflexive process is important to examine one’s beliefs about conditions that may enter the lives of people of diverse distinctions. It may become necessary to search one’s own narratives seeking experiences that determine mindset concerning tenderheartedness toward those aging, the physically challenged, those with diverse gender-orientations, and the racially varied population. In a situation already stigmatized, be it suffering in a state of suicidal ideation or desire to commit suicide, the pressure to meet needs can become besetting. It is therefore paramount for the pastoral care provider to possess self-awareness concerning biases, so that “all” may receive unbiased and ‘whole” care. The tension between one’s own convictions and the needs of the care receiver can compromise the quality of the care.

            In this pressurized situation, openness to bear with those different from oneself in an understanding manner can produce mutual benefits of sensitivity. This is a powerful triad of humane traits. Openness is a pliable trait which allows one to learn of others for their benefit and to self-regulate for one’s own growth. Understanding is declared, at least in one spiritual tradition, the fountain of life. This flow of life-encouraging power in a situation of suffering can provide comfort and reframe perspective. Sensitivity is a gift from one human being to another, representing a willingness to elevate another’s concern and interest over one’s own. With these intentional and inclusive traits employed in increasing measure, crushing pressure may be mediated in a challenging care situation; and reduction of struggles with suicidal ideation and a decrease in incidents become more probable.

Selected Resources

Holleran, Levi and Poon, Gabrielle. “Dying in the Shadows: Suicide Among the Homeless.” Harvard Public 

               Health Review 20 (Fall 2018): 1-5. Suicide 


Mason, Karen. Preventing Suicide: A Handbook for Pastors, Chaplains and Pastoral Counselors. Downers

               Grove, Illinois: InterVarsity Press, 2014.