Spiritual Care Journey

By embracing psychological flexibility, individuals can remain calm and adaptable in the face of challenges, shift perspectives to meet the needs of others, and remain true to their own values. This not only strengthens relationships and teamwork but also creates a more inclusive and harmonious work environment.

Spiritual care is a deeply human-centered practice that requires the ability to be present, to listen deeply, and to hold space for patients experiencing some of the most challenging moments of their lives. Through my clinical psycho-spiritual education (CPE) journey, I have learned valuable lessons about the role of a spiritual care provider, the importance of deep listening, the tension between hope and truth-telling, the necessity of psychological containment, and the significance of professional adaptability.

Reflecting on these experiences has helped me understand the complexity of spiritual care-not as a role of fixing or providing easy solutions but as a practice of accompaniment. This essay categorizes my key learnings and incorporates theoretical insights, real-life encounters, and relevant literature to explore the deeper dimensions of spiritual caregiving.

The Role of the Spiritual Care Provider: A Necessary Disturbance

Ali Shariati, a prominent Iranian sociologist, and Islamic Thinker, once stated, “I have come to disturb you.”[1] He used this phrase to challenge his community to rethink their faith, identity, and social responsibility. I found myself reflecting on this statement when considering my own role as a spiritual care provider in a hospital setting. As a spiritual care provider, I enter patient rooms, intimate and vulnerable spaces where people are grappling with pain, fear, and existential questions. My presence itself can be unsettling, not because I intend to cause discomfort, because spiritual care might bring hidden struggles to the surface. Patients who have avoided difficult questions-about mortality, meaning, regret, and faith -suddenly find themselves face-to-face with these realities when engaged in spiritual care conversations.

Some patients reject my presence immediately, waving me away with statements like, “I am not spiritual.” However, I have come to believe that all people engage with spirituality in some form, whether they recognize it or not. Spirituality is not limited to religious belief; it includes fundamental human questions: “Who am I, where did I come from, where am I going?” Bediuzzaman Said Nursi says “Human is a traveler. This exile and journey proceed from the realm of spirits, through the mother’s womb, childhood, youth, old age, the world, the grave, continuing towards an eternal life.”[2] These questions above are the ones that, I believe, everyone must respond to find a meaning in their life and hold onto this meaning at the hardest time of their time. So, the rejection by saying “I am not spiritual” sounds to me that I do not want to go in these areas, which I respect that. Understanding my role as a disturbance has helped me reframe moments of discomfort as necessary steps toward self-discovery for patients. It is not my job to impose meaning but rather to hold space for their unfolding journey.

Compassionate Listening: The Foundation of Spiritual Care

There are many therapy techniques that I am in the process of learning; the base line of them is compassionate-empathetic listening, which are acknowledging speakers’ presence and distress, ensuring that emotional content of their words is understood, and summarizing their situation without judgment. At the beginning of my practicum, I often felt the need to “fix” situations, believing that my usefulness as a spiritual care provider (SPC) depended on providing solutions.

However, through supervision and reflection, I realized that this impulse stemmed from my own need to feel helpful rather than the actual needs of the patient. However, when I focus on fixing on the situation rather than listening compassionately, it can have several unintended consequences both for me as a SCP and patients. Even though my intention is well-meaning, it can undermine the spiritual care process. When a spiritual care provider focuses on fixing a situation rather than listening compassionately, it can lead to unintended consequences. This approach may diminish trust and connection, as individuals can feel unheard or invalidated when their emotions are overlooked in favor of quick solutions. It also risks disempowering the person, implying they are incapable of finding their own answers, and may overlook deeper emotional or spiritual needs.

Additionally, the practitioner may experience burnout from the pressure of solving every problem, while missing opportunities for transformative healing that arise from simply being present with someone in their pain. I experienced this burn out when I feel I could not do something for the patient who has a very severe pain in the ICU and constantly wanted to have relief from his pain. He was given enough pain medication and was not spiritual. He frequently said that “Rush, do not wait, go tell others. I want relief.” Even though I asked a few times if there are ways that he found relief, he repeated the same sentence above. I sat there for 20 minutes in silence, then I felt so useless myself after leaving the room. Through supervision and reflection, I realized that this impulse stemmed from my own need to feel helpful from the actual needs of the patient. Personally, I became aware of that I did the same thing in my relationship with my children. I mostly focused on the solutions rather than listening to them. Fixing can reduce the sacredness of the process, turning it into a transactional interaction rather than a relational one, and may lead to culturally or personally insensitive responses. In contrast, compassionate listening creates a safe space for individuals to explore their emotions, feel empowered, and experience deep healing. By prioritizing presence over solutions, a spiritual care provider honors the humanity of those they serve and foster meaningful, holistic care.

Other than fixing urge of mine during patient’s visits, I also feel uncomfortable when there is silence in patients’ room. They are coming from the same source, where I feel myself useless. Henri Nouwen (1991) in The Wounded Healer describes deep listening as an act of hospitality, stating, “Listening is a form of spiritual hospitality by which you invite strangers to become friends, to get to know their inner selves more fully, and even to dare to be silent with you.”[3] Silence, rather than being uncomfortable, can be a sacred space where emotions surface and are acknowledged. Imam Al-Ghazali says "The first step to self-knowledge is to silence the tongue, for the tongue is the interpreter of the heart. When the tongue is still, the heart speaks, and when the heart speaks, the soul listens. True listening is not with the ears but with the heart, for it is in the heart that the divine presence resides."[4] I found useful these quotes in my practicum. Silence is a daring to be silent with patients while self-discovering mutually.

In Islamic tradition, deep listening is a profound act of compassion and spiritual hospitality, exemplified by the Prophet Muhammad (peace be upon him), who listened with full presence and heart, making others feel valued and respected. The Qur’an emphasizes attentive listening as an act of worship, as seen in Surah Al-A’raf (7:204), where Allah instructs believers to listen with humility to receive mercy. Silence also holds sacred significance, serving as a space for reflection and divine connection, as demonstrated by the Prophet’s retreats to the cave of Hira. Imam Ali’s wisdom reminds us that true listening comes from the heart, inviting others to share their inner world and find solace in our presence. Deep listening, therefore, is a spiritual practice that mirrors Allah’s attribute of As-Sami’ (The All-Hearing), honoring the humanity of others and reflecting divine mercy and love in our interactions.[5]

One encounter that solidified this learning was a conversation with a patient recovering from addiction. Initially, I instinctively asked solution-oriented questions, such as “What would help you stop using?” However, I later realized that the patient was not looking for a solution but was simply seeking to be heard. Had I focused more on reflective listening— “Do you feel hopeless?”—rather than trying to problem-solve, I could have provided better spiritual care.

The Dilemma of Telling the Uncomfortable Truth

Another challenging but essential lesson I learned was the tension between offering hope and delivering difficult truths. The tension between offering hope and delivering difficult truths is a delicate balance that spiritual care practitioners must navigate with sensitivity and wisdom. On one hand, hope is a vital source of strength and resilience, offering individuals the courage to face challenges and envision a brighter future. On the other hand, difficult truths—whether about a terminal diagnosis, a personal failure, or an irreversible situation—must be communicated with honesty and compassion to honor the individual’s reality and dignity. Striking this balance requires deep listening, empathy, and an understanding of the person’s emotional and spiritual capacity. It involves acknowledging the pain of the present while gently opening doors to possibilities, whether they lie in healing, acceptance, or finding meaning in suffering. The goal is not to avoid the truth or offer false hope, but to walk alongside the individual with authenticity, helping them integrate both the light and shadow of their experience into a cohesive narrative of hope and resilience.

One of my patients had lost the ability to walk. Despite extensive physical therapy, there was little chance of improvement. However, the patient held onto an unwavering belief that they would regain mobility. Their family reinforced this hope, avoiding any discussion of alternative possibilities. The medical team had conveyed the prognosis indirectly, but the patient remained convinced of their eventual recovery. I was advised to help the patient engage with the reality of their condition without taking away their sense of agency. I approached this conversation carefully, asking, “What if walking is not possible? Have you considered how life would look like in that case?” At that moment, I saw fear in their eyes, and I felt an instinctive urge to retreat, to reassure them. However, I resisted this urge because I understood the necessity of truth-telling. Later, my preceptor confirmed that the patient remembered this conversation as a pivotal moment, saying, “At least someone was honest with me.”

Pema Chodron (2016) in When Things Fall Apart states, “Only when we know our own darkness well can we be present with the darkness of others.”[6] This experience taught me that spiritual care sometimes involves stepping into uncomfortable spaces and offering reality in a way that is compassionate but firm.

Psychological Containment: Holding Space Without an Agenda

I also learned the significance of psychological containment, which involves creating an emotionally safe space where patients can explore difficult emotions without fear of being overwhelmed. Psychological containment refers to the ability to hold and manage another person’s emotions, thoughts, or distress in a way that provides safety, stability, and understanding. It is a concept rooted in psychotherapy and caregiving, where the practitioner or caregiver acts as a "container" for the individual’s overwhelming feelings, helping them process and make sense of their experiences without becoming overwhelmed themselves. This process requires empathy, patience, and emotional resilience, as the caregiver must remain calm and grounded while absorbing the other’s anxiety, fear, or confusion. By offering a nonjudgmental and supportive presence, psychological containment allows individuals to feel seen, heard, and validated, which can foster healing and emotional growth. It is particularly vital in spiritual care, where individuals often grapple with existential questions, grief, or trauma, and need a safe space to explore their inner world without fear of judgment or rejection.

One patient I met had survived multiple suicide attempts and experienced severe trauma. Initially, I approached the conversation with the mindset of helping them process their trauma. However, I quickly noticed that each time I mentioned their past, the patient withdrew into silence. Realizing my approach was ineffective, I shifted my focus. Instead of asking about their trauma, I asked about their strengths. The patient shared their passion for writing and mentioned a soon-to-be-published book. At that moment, their demeanor changed—they spoke with enthusiasm, their eyes lit up, and they even read a passage from their book aloud. This moment reinforced that spiritual care is not about fixing or pushing an agenda—it is about creating a space where patients feel safe enough to explore their own paths to healing. Carl Rogers (1961) in On Becoming a Person describes this approach as “unconditional positive regard”—accepting patients without trying to shape their responses.

Recognizing My Own Grief

Through my journey, I also discovered that grief is not only about losing people—it can take many different forms. Grief is not just an emotional or psychological experience but a profound spiritual journey that invites individuals to explore deeper questions of meaning, purpose, and connection. Spiritually, grief can be seen as a transformative process that challenges one’s understanding of life, death, and the divine. It often brings individuals face-to-face with existential questions, such as "Why did this happen?" or "What is the meaning of my suffering?" These questions, while painful, can lead to spiritual growth, as they encourage reflection on one’s beliefs, values, and relationship with the transcendent. In many spiritual traditions, grief is viewed as an opportunity to deepen one’s faith, cultivate resilience, and find solace in the belief that loss is part of a larger, divine plan. Practices such as prayer, meditation, rituals, or community support can provide comfort and a sense of connection to something greater than oneself. However, grief can also test one’s spiritual foundation, leading to feelings of doubt, anger, or abandonment by the divine. A spiritually healthy approach to grief acknowledges these struggles while offering space for healing, acceptance, and the possibility of finding new meaning during loss. Spiritual health in grief involves honoring the pain of the present while remaining open to the potential for transformation, connection, and hope, even in the face of profound loss.

During one of our group sessions, I verbalized something for the first time: I have been grieving the past ten years of my life. As an immigrant adjusting to a new country, culture, and language, I have faced numerous challenges—not just for myself but also for my children. David Kessler (2019) in Finding Meaning: The Sixth Stage of Grief states, “Grief must be witnessed to be healed.” This realization helped me connect with my patients on a deeper level, as many of them were grieving not just lost loved ones but lost identities, independence, and a sense of normalcy.

Professional Growth: Adapting to Different Personalities

Spiritual care is not just about engaging with patients—it also involves navigating relationships within the healthcare team. Professional growth relies on psychological flexibility—the ability to adapt to different personalities and situations with openness and resilience. This skill involves emotional intelligence, empathy, and effective communication, allowing professionals to navigate diverse communication styles, work habits, and problem-solving approaches. By embracing psychological flexibility, individuals can remain calm and adaptable in the face of challenges, shifting perspectives to meet the needs of others while staying true to their own values. This not only strengthens relationships and teamwork but also fosters a more inclusive and harmonious work environment.

Initially, I felt apprehensive about working with a preceptor with whom I had previously had disagreements. However, by opening a dialogue, we resolved misunderstandings and developed a stronger working relationship. This experience reinforced that adaptability is a critical skill in spiritual care.

Spiritual care is a deeply human-centered practice that requires presence, compassion, and the ability to hold space for individuals navigating life’s most challenging moments. Through my Clinical Pastoral Education (CPE) journey, I have learned that spiritual care is not about fixing problems but about accompanying others with empathy and authenticity. Key lessons include the importance of deep listening, the delicate balance between offering hope and delivering difficult truths, and the necessity of psychological containment to create a safe space for healing. These experiences have not only shaped my professional approach but also deepened my personal growth, helping me recognize my own grief and vulnerabilities. By embracing psychological flexibility, I have learned to adapt to diverse personalities and situations, fostering stronger relationships and a more inclusive environment. Spiritual care is a sacred practice that honors the humanity of others, reflecting divine compassion and love in every interaction, as I continue to walk alongside those in need with presence, understanding, and hope.