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In our bones we have a sense of the sacred, of a relationship to a power greater than ourselves that is archetypal and prehistorical.  Jean S. Bolen, M.D.

Persephone, the daughter of Zeus and Demeter, went out onto the plain of Enna one sunny morning innocently gathering wildflowers.  Hades, the god of the underworld, who coveted Persephone as his bride, chose this moment of unprotected innocence to rise up through a huge gap in the earth. Riding in his chariot he abducted Persephone back into the murky depths of the underworld.  Demeter, the goddess of fertility and growth withdrew in mourning for the loss of her daughter causing the earth to turn barren and cold.  As famine spread across the land, Zeus sent Hermes, the messenger of the gods, to rescue his daughter.  Hades agreed to let her go but for only part of the year during the seasons of growth and harvest.  During the winter, Persephone must return to the underworld to live.

Unlike Persephone, the Sumerian goddess of the outer world, Inanna, chose to enter into the underworld of her own accord to visit her sister Ereshkigal.   Descending through a series of gateways into the dark unknown, she surrendered pieces of clothing and jewelry at each threshold.  Finally, bowed and naked, she entered the final gates of the underworld alone, frightened and without any of the trappings of her outer world existence.

The underworld motif found in myth and religion is an apt metaphor for the world the patient enters when undergoing treatment for a life-threatening illness or emergency trauma.  Whether snatched like Persephone against her will into the confusing turmoil of the emergency room due to a sudden accidental trauma or, like Inanna, deciding with purpose to descend into the complexities of a treatment program for a serious disease or condition, patients enter the dark underworld often accompanied only by fear and pain.  In myth, the underworld was not only considered a place where mortals entered after they died, but also a place for the living as well, whose souls were doomed to wander in the shadows of a surreal existence outside of the norm.

Like Persephone and Inanna, bewildered and stripped of their outer world personae and attachments, patients descend through the various gateways of medical tests, operations and treatments into the underworld of a trauma one hospital.  Faced with the dark unknown, patients often experience pain, fear and anger at the loss of control that comes with the new frightening and unfamiliar surroundings.  This is usually the point at which the chaplain enters a patient’s life as a presence of compassion but also as a symbol of the sacred journey towards healing and wholeness.  Chaplains are companions of brief duration in this frightening environment offering a willing ear and open heart.  Some patients do not return from this journey but those who do are, like Persephone and Inanna, forever changed by the experience.

As a trauma one hospital chaplain, I saw the gamut of accidents and diseases that brought patients in for emergency care.  During the progression and treatment of a life-threatening illness or sudden life altering accident, a patient’s psychological defenses start to crumble revealing inner truths which have long been ignored.  Sometimes these truths are too painful to fully acknowledge.  A mother who has always put the needs of family members first now feels empty when they fail to respond in like manner.  A successful businessman fights to maintain the mask of control amid bouts of panic and fear.  A cancer patient, experiencing the shock of a terminal diagnosis after recently returning from the cruise vacation of a lifetime where all was right with the world, is numb to any words of consolation.

The chaplain’s ministry often provides a safe haven for patients to explore the frightening journey they have undertaken in an effort to regain their physical and emotional well-being.  Prayer and ritual are powerful traveling companions.  During these devastating times, connecting to symbolic archetypes through these powerful mediums allows patients a safe mode of transport into the depths of their anguish.

During this healing journey, former identities along with physical and emotional support systems are severely challenged as an impersonal hospital setting and a personal life-threatening catastrophe strip away any pretense and protective masks used to navigate the everyday world.  Truth becomes a nebulous commodity as absolutes fall by the wayside during crisis.  Only the personal clarity gained from authentic connection is of importance.  If truth is to be found at all, it lies not in a particular religious doctrine but in the stories, symbols and rituals that reflect models of meaning in patients’ lives.  Through the embodiment of or connection to these role models, patients find a sense of purpose, control and comfort even if life is nearly at an end.

So what are these archetypal roles?  Archetypes are masterpieces of metaphoric communication and as such are accessed first by the unconscious mind which communicates only in symbols.  Therefore, interaction with these metaphoric roles almost always occurs just below the threshold of conscious awareness.  The wise man/woman, the great father/mother, trickster, visionary prophets, priests, heroes/heroines, warriors and healers are all images emanating from the stories of our mythological and religious heritages.  These symbolic images often resonate with patients during their healing journey.  At the trauma one center where I interned, my ministry expanded to recognize the particular archetype expressed by a patient’s behavior or as a needed spiritual symbol necessary for healing purposes.  This recognition allowed me to honor a patient’s personal story and religious tradition while enabling me to be more fully present and emotionally available.

Jonathan* was a seriously ill patient suffering from liver disease, Hepatitis C and skin cancer.  Speech was labored and clearly a huge effort.  He lay in the hospital bed ashen and immobile as every movement was a painful endeavor.  Due to his weak and infectious condition, I had to “gown up” with gloves and mask to go into the room where he lay.  It is difficult to see patients covered up like this.  I always felt removed when holding a patient’s hand through plastic gloves. This necessary but cumbersome precaution did not seem very comforting to me.  Nevertheless, there I was listening to his halting voice telling me the story of his illness and emotional disconnection from his family.  Suddenly his stopped too tired to continue.  I waited for him to catch his breath. When he was able to speak again he said, “Do you have a rosary?  I was brought up Catholic but I have not been to church much since I was a kid.”  I answered that I would get a rosary from the pastoral care office and be right back.

When I returned, Jonathan looked even more exhausted than when I left him—eyes closed,  breathing shallow.  “Here Jonathan,” I whispered.  “I have the rosary.  I’ll put it on your chest so you can hold it.”  Jonathan nodded and grasped the beads with both hands.  “Would you like me to pray the rosary with you?  He nodded again.  Even though I am not Catholic, I knew the Hail Mary and began to say it softly repeating it over and over like a mantra. “Hail Mary, full of grace.  The Lord is with thee…”   Jonathan joined in every few words as his strength allowed.  Finally he sighed deeply, whispering, “That’s good.  So peaceful, thank you Jesus.  Thank you, Mother Mary.”  I stayed with Jonathan a little while longer then quietly left his room.

Needless to say, the mother archetype resonates at a very profound level in all of us.  Our mothers are the first human contact we have and at a subconscious level the nurturing love and peace experienced in the womb is longed for in times of distress and turmoil.  Jonathan found that nurturing peace through the mother archetype of Mary from his Catholic upbringing that no amount of talking and reassurance could have given him.

Jung described archetypes as deep and abiding patterns in the human psyche that remain powerful and present over time.  According to Jung, the subliminal world of dream imagery provides a method to explore an archetype’s metaphorical significance in the psychological makeup of the dreamer.  This archetypal language of dreams is then used as a means for analysis and healing. Archetypes haunt our subconscious dreams ready to be revealed.  But unlike archetypes of the psyche needing to be deciphered at the next therapy session, spiritual archetypes are already known at a deep core level waiting to be rediscovered in times of need.

Although understanding the significance of archetypal symbols in dreams can be useful for psychological analysis, I am a minister by training and have a greater affinity towards the mythical/spiritual archetypes laid out by the noted comparative mythologist, Joseph Campbell.  Through his vast study and understanding of comparative mythology, Campbell writes eloquently about the archetypal roles, which are expressed repeatedly in mythology and religion throughout time.  According to Campbell, these archetypal roles have evolved from the tribal survival mindset to a spiritual transcendent understanding of our life’s journey, which he calls the hero’s journey.  Archetypes, found in both mythology and religion, are powerful forces of transformation and healing, reminders of our common humanity resonating deeply in our personal and collective psyches.  Whether we embody the archetype or relate to that embodiment in others or in sacred images of our respective religions does not matter; we are moved, comforted and transformed through immersion in and connection to these universal roles of meaning.

Richard was an affable man in his mid fifties diagnosed with terminal colon cancer.  I received a request by a young medical intern to visit Richard.  The intern was deeply concerned by Richard’s refusal to admit the seriousness of his illness.  In addition, Richard’s wife did not want the doctors to tell her husband the extent of his illness because in her words, “He would give up hope and die.”  Richard’s wife, playing the protector/mother, wanted to ease her husband’s potential anguish and fear for as long as possible.

During a private conversation with Richard, I learned realized he was choosing to embody the warrior to fight the cancer. “The doc says I can fight this with chemotherapy and I’m ready to go for it.”  On a return visit a few days later, after the oncologist had explained to Richard that his disease was terminal, he was as determined as ever to take on the mantle of the warrior, saying in an upbeat voice, “I felt the presence of Jesus within me and I know I’ll be all right.”

Some would view Richard’s attitude and faith as a form of denial or at the very least misplaced optimism.   But the warrior, who strives to conquer and survive in the face of great odds supported by deep faith in God’s divine providence, is a powerful archetype.  The biblical story of David and Goliath is a well-known example of the hero warrior overcoming insurmountable odds and resonates strongly within the Christian faith. Inherent in the warrior archetype is a sense of pride and dignity as well as nobility.  Fighting the good fight, especially against cancer, is viewed by many as a noble effort regardless of the odds.  Western medicine is geared to support the warrior in the good fight and doctors are loathe to tell a patient he or she has a terminal condition.  As a unit nurse once said to me, “You never know.  Miracles happen.”

When people are in crisis, they tend to return to the God of their childhood, where safety and emotional connection can be found.  When archetypes are invoked during a critical situation, patients are more interested in drawing an emotional and symbolic self-portrait, not filtering their connection to their God through an intellectual analysis of religious doctrine.  During these rare moments, patients are no longer held hostage in their heads. Rather, they are able to remove the worldly adult censor from self-expression when delving into their deepest needs and desires by allowing the archetypal images to speak to and for their souls as they did when they were children.

I received a request to visit Howard who, while in severe pain, refused to take his medication to ease his suffering.  The nurses were at a loss as to what to do and thought a chaplain might be able to help Howard.  Howard seemed pleased and relieved to see me when I walked into his room.

“So what’s going on with you, Howard?”

“Oh, I’m in a lot of pain, but otherwise ok.”

“I understand you aren’t taking your medication.”

“That’s right.  The devil is working through all the doctors and nurses.  I don’t trust them.”

“How so Howard?”

“They’re trying to trick me into taking the wrong medicine.  It’s the evil work of the devil.”

“Why don’t we find out exactly what medicine they have for you?”           Howard nodded in agreement.

While we waited for the nurses to come in and to explain the pain medication to Howard, he told me about his abusive childhood of neglect and how he had to fight constantly to get what he needed and wanted in life.  I listened without comment.  What Howard needed most of all was to be heard through his emotional pain and honored as a survivor.  The devil was a powerful metaphor for his lack of trust and deceit by others in his past resulting in an unforgiving anger that followed him into adulthood.  The doctors and nurses in the metaphor of the devil were viewed as only wanting to still the voice of indignation—a voice Howard needed to express at this critical moment in his life. Together we talked and later prayed for God’s strength and loving presence in Howard’s life and sorted out the medication issue so he would finally receive some physical as well as emotional pain relief

During my residency as a hospital chaplain, I was often called onto the floors of the ICU units for end of life ministry for withdraw of life support.  Family members ran the gamut of reactions and coping mechanisms to deal with this defining event—from bizarre jocularity to numbing immobilization.  Huge transitions of loss can’t be made entirely on the conscious level.  The pain and the fear are too great for most people to be fully present.  Those types of transitions are informed by hidden realms; contact with something “Other” outside ordinary perceptions of consensus mundane reality.  The portal is the spiritual archetype—the God of the protective father or unconditional loving mother.  Invoking archetypes through spontaneous prayer after anointing the dying family members provides a brief but sacred ritual which honored the loss while bringing more comforting closure to their earthly life than simply disconnecting the medical life support.

For the most part, family members assumed that I knew what to do to help a patient transition from this earthly life to a heavenly one.  For me this was a very humbling experience knowing that they were so open, trusting and willing to share this deeply sad and painful moment with a virtual stranger simply because I wore the title of chaplain.

When I first entered the room, the family was usually gathered around the patient’s bed.  The machines were beeping and blinking measuring oxygen intake and the heartbeat.  I tried to move the family away from the technology and into the moment of transition for their loved one by informing them that hearing was the last sense to go and they could say their goodbyes as moved to do so.  Immediately, family members leaned in and began speaking with their loved one, the bells—the sounds of technology receding into the background.  At that moment, they became their own healers consoling each other while expressing their final words of farewell.

I then offered to anoint the dying loved one and through spontaneous prayer commended the soul to God.  This was a simple but effective ritual for lessening the enormity of the loss.  Oftentimes the medical staff would also attend these end-of-life rituals.  The enactment of this ritual used the archetypal symbols of the healer and priest for bringing the mysterious unknown “Other” into the known world.

Spontaneous prayer is really a combination of prayer and guided meditation. As a minister, I can say in prayer through archetypal images what I can’t say in conversation.  This type of prayer is not recited by rote but instead speaks specifically to a patient’s need and guides them to a deeper, more meaningful and peaceful understanding of their situation.  Spontaneous prayer acknowledges the patient’s condition, fears, concerns and worth by giving voice to God’s presence in their lives.  Archetypes used in spontaneous prayer, allow patients to move beyond the everyday masks with which they shield themselves in order to excavate deep recesses of the soul they are incapable of reaching on a conscious level.

Linda had suffered from a nervous disorder since she was seventeen that kept her body in a constant state of contorted movement.  In between the nervous spasms which mainly affected her head and upper body, she told me her story and of the distress she felt undergoing tests to discover the reason for an unrelated stomach disorder.  At the end of my visit, I asked if she would like me to pray with her.  She said that would mean a great deal to her.  She closed her eyes as I began to pray. Instantly all of Linda’s movements came to a halt.  I asked for the healing grace of Mother Mary to ease her condition and the protective arms of God to surround her.  At the end of the prayer, she opened her eyes and once again began to move in awkward spasms.

What appears to be happening on the surface of our lives is often just a small part of the story.  Spontaneous prayer bypasses the ego and speaks to the soul where connection to our God occurs.  Using spiritual archetypal symbols as an outward acknowledgement of the deeper inner meaning in patients’ lives has provided them with a stronger sense of peace and security while enabling me to grow in my ministry in ways I could not have imagined.  Knowing I can help patients like Linda access their hidden reserves of strength through prayer and ritual invoking sacred archetypes of meaning has given my work as a hospital chaplain an added dimension of healing grace.

* All patient names and diagnoses have been changed to protect their privacy.

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