Authored by John Bell, M. Div.

Early on in my career, I used to stress over hospital visits.  I didn’t mind going to the hospital.  Growing up, I saw hospitals as helpful and caring places.  My stress about making hospital visits had more to do with my role as clergy.  I worried about encountering the unexpected and having to think on my feet; having to know what to say or do or what not to say or do.

To me, what is challenging about hospital visits is having to respond to the possibility of a highly anxious person and the challenge of regulating my own internal reactivity to an anxious situation.  It is hard to think on my feet when I’m anxious.

To address my own level of anxiety, a few years ago, I started asking myself a couple of questions before I enter the hospital.  “What is my purpose for this visit?  What is my role?  What is important to me about this visit?”  These questions moved my brain towards thinking about the work that I am doing.  This focus on what I believe about my vocational identity helped me be less reactive to the anxiety others were expressing during my visit.  It allowed me to stay focused on being a thoughtful presence.  What I discovered initially is that I lacked clear beliefs about my purpose in doing hospital visits.

In his book Family Therapy in Clinical Practice (page 158), Dr. Murray Bowen said, “The term emotional refers to the force that motivates the system and “relationship” to the ways it is expressed.”  Bowen’s genius was recognizing that we all to some degree react automatically to the behavior of others.  It is within these interrelated reactions that a system of predictable responses is created.  As a clergy person, who is potentially entering a highly anxious hospital room, I can easily slip into a reactive mode: having my functional level shift into a mode of under-functioning or over-functioning.

In the under-functioning mode, there is the potential to not be responsible for self as a clergy person.  Religious leaders can be a wonderful resource to those going through a life crisis.  They can provide a perspective which brings opportunities for healing in different ways.  There is research to suggest prayer, beliefs, and the presence of family member can make a significant impact on recovery.  To under-function is to miss out on these opportunities.

In the over-functioning mode, there is the potential for taking too much responsibility for others.  If not careful, leaders can take over and begin telling people what they need to do.  Like under-functioning, this is an anxious response to the situation that has more to do with how internally uncomfortable the congregational leader is to the presence of an anxious other.

These two responses to anxiety are not just driven by an individual’s internal reactivity; they are also elicited by others.  Under-functioning and over-functioning are automatic responses to the perceived functioning of others.  If one’s tendency is to over-function, when they encounter a patient in a hospital room who is under-functioning, they may automatically step in to help make decisions.  This response is always seen as helping but it may take away an opportunity for the individual to step up and do better in the face of challenge.

One way to become more aware of these tendencies is to study one’s family of origin.  By observing how individuals function in relationship to each other one can see more clearly their part.  Having a coach or participating in a family of origin group can be useful in doing this important work.

This blog post is an excerpt taken from “Meetings: What’s the Purpose?” The entire blog can be found on the blog site Thinking Congregations with Reverend John Bell.