Author Archives: joshtmo

Grasping at Hope

Hope is a word that is so familiar that it becomes unfamiliar… We all sort of know what it means, but sort of don’t. We hope in stuff and for stuff, but that is still only a grasp of all that is hope. My theological-man-crush Jürgen Moltmann looks into the future for hope, differentiating between futurum and adventus (riffing on the German Zukunft). The former defines what happens in the present as a result of the past. Adventus hope is that which comes.

This is a helpful framework for hope. It will be sorted in the end. The second coming of Jesus (parousia) is the fulfillment of the Kingdom of God, therefore the now/not yet is now the now. This might not help people answer the why questions of suffering, but it does help by answering the what question: namely, what is God doing about my why question. Although we cannot answer the why questions in those critical and liminal moments between life and death, we hope that we will understand it all at the end. I appreciate this understanding and use it in my own theological understanding of hope. This view of hope is chronologically focused.  Life sucks now, but just you wait for the future!

However, what do you do in those why moments? What do you say in those moments when eschatology is inappropriate? I want to talk about topological hope.

Topological hope comes from the Greek topos or place (and is not to be confused with tapas, those Spanish delicacies that we all hope for…). Hope is located in events, locations, and places. This understanding of hope gives the person some agency in the moment. I see this type of hope often in our hospital’s (pediatric) hematology and oncology (Hem/Onc) unit. Cancer has been the proverbial dark passenger (any Dexter fans read this?) for most of this patient’s life (and family). Cancer sets the boundaries, determines the calendar, and reckons when its ready. Topological hope stands in the face of this.

My PhD advisor, Duane Bidwell, describes five pathways to hope (mentioned here), and I think this touches on a lot of what I experience as topological:

  1. Realizing connection
  2. Maintain identity
  3. Claiming power
  4. Learning wisdom
  5. Attending to God

I have ministered to patients and their families as they come to grips especially with numbers two and three. A topological hope allows a patient to maintain identity and stand in autonomy. The young adolescent who is admitted for chemo every five weeks is not defined by their prognosis; instead, they want to talk about prom or why the Chiefs just might do it this year. This isn’t denial, though. The patient is fully competent and aware of their prognosis, but this topological hope allows them to claim some power in the face of a disease that will take everything. Topological hope is resilience in the present.

Topological hope is more practical for the spiritual caregiver to highlight. A conversation around the present allows the patient to claim what they want these remaining days, months, or years to be like. This, once again, is not a denial of the illness; the spiritual care provider still addresses chronological questions (e.g., why is God doing this? What will happen to my parents? Why won’t I ever get married [really the question is always why won’t I be able to have sex?]), but topological hope allows the individual to emphasize what they want.

A couple of posts ago I discussed how to talk about death, and this is a great avenue to explore. That is the powerful aspect of number four above: learning wisdom. Help your child claim power, allow them to make decisions in their care (at least educate them), allow them to live as much as possible. You can begin talking about death by addressing things topologically. What do you want these years to look like; what sort of places/people/events/memories do you want to do (think bucket list).

Moral Injury and the Role of a Chaplain

What is moral injury? How does it compare, and differ from PTSD? Similar to PTSD, moral injury is grossly under reported. It is a phenomenon that has been around as long as war, but like most psychological war wounds, is not addressed. It has been lumped in with PTSD, but this is  ultimately unhelpful. It was not until the Vietnam war that Dr. Jonathan Shay, a physician and scholar, began to classify and define moral injury.  Recently, Rita Brock has discussed the spiritual aspect of moral injury. Basically, moral injury is the result of making decisions that go against one’s moral/spiritual fibers. For the purposes of this post (and my research interests overall) I want to focus on those decisions that occur in a combat setting. Moral injury, like trauma, stays with the individual. In 2009 the V.A. defined moral injury as:

perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations. This may entail participating in or witnessing inhumane or cruel actions, failing to prevent the immoral acts of others, as well as engaging in subtle acts or experiencing reactions that, upon reflection, transgress a moral code. (“Moral Injury and Moral Repair in War Veterans: A Preliminary Model and Intervention Strategy”)

It is easy to identify a few potential decisions that go against one’s moral fibers. This article in GQ highlights the new trauma effects on drone pilots. However, it could be the transition and psychological impacts of killing. This typically startles people, aren’t you trained to specifically do this? There is still a psychological and physiological impact resulting in taking another life. I have counseled numerous people who can still remember everything about that day: the smells, the tastes, the visuals. Although it may be a “good kill” this doesn’t always eradicate the feelings. This is where, I think, the role of the chaplain can be of use.

The role of a chaplain may be of more use than a traditional clinician? Why? I think a big reason for this is the chaplain’s ministry of presence. This fancy parlance is used often to mean the chaplain is where the Soldiers are. If a Soldier is deployed in a foxhole then the chaplain is also there. This level of involvement earns the chaplain’s place as a trusted ally who has been there – or at least knows enough about the structure to support. It is precisely this reason that I still think clergy need to be in the military – uniformed chaplains – instead of what some propose in having civilian clergy minister. It is not that the civilian clergy are bad per se, but there is an element of the system that a chaplain lives and understands.

This seems like a good place to stop for today. I am working on a piece about ideology and trauma. How does a tattered view of freedom affect not only the Veteran but also the community? What does the community do with Veterans? What do they do when the Veteran doesn’t fit the overall projection of what a “Veteran” should be. The effects of PTSD and moral injury are directly related to the ever increasing homeless population among our Veteran community, and the church for one should have something to say about this. Until then, peace.

Talking to Children about Death

Now that this semester is (for all intents and purposes) complete, I want to dedicate some effort to the blog. I have ideology critique on my mind as I have been reading a lot of Slavoj Žižek for a paper I wrote about ideology, irruptions of the Real, and interreligious care (who doesn’t love an alliteration!?), and there is another strand of Žižek that I have been thinking about and that is fetish disavowal with his apt comparison to belief in Santa Claus (there will be Christmas spoilers!). In the latest Journal of Psychology and Christianity there is an article about talking to children about death (“Talking to Children About Death”), which is going to be my focus today. There is nothing like talking about dying children to drive up blog traffic…

Full disclosure: I don’t have kids, so I am not suggesting how to parent or how not to parent. I am drawing on my experience as a pediatric chaplain that has dealt with numerous dying children from a myriad of illnesses ranging from cancer to neurological brain death. This is written from those conversations and those patients. I do not pretend to know how to parent; I am only offering my perspective on talking to children as they approach death.

The main premise of the article (I can send it to you, I think… I am not sure on those legal ramifications, but I am a millennial so since I’d burn you a CD… you get the picture) is that there is a correlation between talking to children about death and death anxiety. The article lays out the three ways to approach these conversations: Biological, religious/spiritual, and irreversibility of death. I am not as interested in those categories today, but I am interested in the how faith and anxiety affect our conversations about death.

I have sat in numerous family meetings with parents that are adamant that talking to their (adolescent) child about death will take away their hope and therefore speed up an already impending death. That is the parents perspective though. What about the child? What about the sixteen-year-old with cancer who has fought through chemotherapy for years? Both my experience and the peer-reviewed research show that children not only want to talk about it, but they already know at some level that something is different (whether they cognitively understand lab cultures or tumors, for example, is another blog!). Kids are incredibly perceptive and make meaning out of their environment whether or not they are informed directly. I am constantly amazed at what a child understands about their condition only through interpreting reality. So, where does Žižek come in? Although I might be reading Žižek against Žižek (i.e., I may be getting him WAY wrong), his example of how our belief in Santa Claus functions is helpful here.[1] Žižek’s critique is that, at some point, the child knows that Santa Claus is not real, but a creation of their parents, but they play along in order to uphold a level of belief to keep their parents happy; or, as Žižek said:

In short, they transfer their belief onto another. We do the same with our children. We go through the ritual of Santa Claus, since our children are supposed to believe in him and we do not want to disappoint them. They pretend to believe so as not to disappoint us and our belief in their naivety.[2]

There is a denial working on two levels: First, the child knows the reality but doesn’t want the parents to know that they know, and second the parents know but don’t want the children to know that they know.

In terms of human development, how can a chaplain stand in the gap? How can we talk to a child about his/her death, while honoring the parents wishes as guardians, and taking the patient’s developmental progress into account and still uphold the integrity of the family system? First, I think it is important to acknowledge that these conversations look differently to different people or different religious communities and differing ages of the patient. I have talked to late adolescents differently than a seven-year-old about death. Or I have learned what not to say through conversations with a Muslim family from Pakistan instead of Morocco. Don’t assume!

My favorite part of the article states, “the results indicate that parental death anxiety and belief in an afterlife played a unique role in parents choosing to use religious/spiritual explanations.” Yes! I can think of a specific example as I wind this post down. We had a patient that was nearing death. He had asked questions and expressed his fear of dying, but his family was clear that we were not to talk about death. Legally, we honor the parents/guardians, but ethically it was very difficult to essentially allow the patient to spiritually/emotionally suffer because the parents were against it. In my opinion, in that instance, the level of disavowal with the the parents. This story ends in death, and other stories end with parents beginning a conversation with the assistance of a chaplain, social worker, or another staff member.

I have had to learn to respect the process and respect where each family is on their specific journey. It does no good for me to destroy an existing family structure to do something that I think is important (what I think as a white, middle class, straight, Protestant… you get the picture…). My practice? I continually listen to families and encourage them to have the conversation. This conversations BEGINS before having the conversation. Think about death now parents! It is like the sex talk, be prepared because when emotion and anxiety enter the frame it will look different. I encourage words/phrases to use to begin a conversation and explain what they might receive in response. I am ready to have that conversation, but coming from a parent – or another trusted adult family member – is of more importance, in my opinion.


[1] Developed in Violence: Six Sideways Reflections (New York, N.Y.: Picador, 2008); and The Puppet and the Dwarf: The Perverse Core of Christianity (Cambridge, Mass.: The MIT Press, 2003).

[2] Violence: Six Sideways Reflections, 96-97.

How Poor Exegesis Impairs Healing

I planned to blog about a basic overview of moral injury & PTSD; however, this video continually speaks to me and has remained a specter on my life ever since. Here is the article and the video:

The gentlemen take Numbers 32:20-22 and discuss how this passage states that Christians, simply, cannot have PTSD.

Numbers 32 states:

20 Then Moses said to them: “If you do this thing, if you arm yourselves before the Lord for the war, 21 and all your armed men cross over the Jordan before the Lord until He has driven out His enemies from before Him, 22 and the land is subdued before the Lord, then afterward you may (the video uses “shall”) return and be blameless before the Lord and before Israel; and this land shall be your possession before the Lord.

That highlighted portion is where these exegetes focus their attention. Their two points are:

1. You shall return

2. You’re guiltless before the Lord and the nations

Disclaimer up front: I am not saying that one must experience a layer of combat stress or fatigue during a deployment; however I am emphatically saying to those that do return with these wounds this sort of advice is salt in a wound. Moving on…

These gentlemen fail to acknowledge:

1. The power of shame and guilt this sort of theology creates

Practically speaking, can you imagine hearing this as a sort of pastoral care?! Can you imagine coming home from nine months of involvement in a combat zone and hearing that you have nothing to worry about! Whether or not one returns with moral injury or PTSD, I firmly believe that time in combat changes people and that nasty “p” word the gentlemen hate – psychology – supports this. However, after you hear this exegesis from two gentlemen (who have not been to Afghanistan, I presume) telling you that PTSD does.not.exist I cannot imagine the feeling of confusion.

2. The poor reading of scripture on a 21st century context far removed from Numbers

I don’t have much to do here. If you think modern warfare that deals with drone pilot PTSD, multiple deployments, dirty wars, or just the daunting reality of a post 9/11 world at war is comparable to the context of Numbers 32 I don’t know what to say to change your mind. It is an issue of hermeneutics.

3. The poor understanding of PTSD, moral injury, or any psychosocial ramifications of combat

This video fails on every level to acknowledge the psychological aspect of combat. At around 50 seconds he looks into the camera and states, “you get rid of that right now.” Sweet, thanks –  hadn’t thought of that!

I will begin my next post on point number 3 and a better understanding of moral injury, PTSD, and the difference between the two.

Coming Attractions

Hello all! I hope you are well. I have been pretty busy juggling work, school, reserves, and family life, so forgive me.

Over the next couple of months I am going to blog through some of my (preliminary) research questions for my dissertation (granted I am only one semester in…).

I will reflect on:

PTSD, moral injury, and the difference between the two.

Reflect on a couple of articles that really pushed my buttons this week

The daunting number of Service Member suicides

The spiritual dimension of moral injury

The role of the chaplain, battle buddy, and community in care

I also want to blog and reflect on the specific role of the hospital chaplain (not in a military context)

Oh yeah, I plan to add photos too! I thought my blog would be cool if it was simple, like my “content” was good enough to support no photos! I have been prodded to add photos, and I will!

Hope to post later today!

What We Do in the Meantime: Spiritual Care and Caputo’s Nihilism of Grace

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This is my contribution to the Homebrewed Christianity Blog Tour of John Caputo’s new book, The Insistence of God: A Theology of Perhaps. First, a big thank you to Homebrewed Christianity and Indiana University Press for a copy of the book. This post will cover chapter 11, “A Nihilism of Grace,” and to get caught up with the thoughtful and critical discussion go over to Homebrewed Christianity. For my part, I want to have some fun and reflect on the text differently (Hopefully, Blake will do proper justice to this chapter).

I did not go to the Subverting the Norm conference but I followed the conversation and have continued to wonder if, in fact, this sort of theology (what Caputo describes as “radical”, “theology of perhaps”, “theopoetics”, and still his “theology of the event(s)”) can live in churches (the subtitle of the second conference). So, although I am late to the party, I want to read this chapter through the lens of spiritual care and counseling and specifically hospital chaplaincy (my context). I had patient visits this month in which Caputo’s “impermanence intensifies existence” (227) remained with me as I watched the fear of a loved one’s death bleed into regret. I wondered if a theology of perhaps could actually help real people encounter real pain, but I am getting ahead of myself.

[Side note: I think Caputo would like spiritual care as chaplains are typically on the outside of mainstream theological conversations – those conversations with “seminary-trained ventriloquists” (62).]

We must start with the meantime… This is always our starting point, this world, this plane of immanence. We can set our coordinates eschatologically and hope against hope, but this doesn’t necessarily help in the meantime. Caputo’s nihilism of grace embraces the cold dark reality of our cold dark reality. No filter, just reality. No Secret, just reality. I had a Hebrew Bible professor at Fuller, Dr. Goldingay, say that he has faith in the end time, but needs faith in the meantime, and I think this is an apt way to begin looking at Caputo’s understanding of meantime and his nihilism of grace. Caputo’s early move is to embrace life; embrace our roles and embrace the event:

We should not confuse the call of the event with any mundane vocation, for these vocations belong to the passing form of the world (225).

We remain in the meantime focused on the event and, borrowing from Deleuze, therefore live lives worthy of the event that has happened to us. Caputo wants to talk about ethics, but I am more concerned with what happens when the event that has happened to us is tragedy: suffering, loss, and death.

As you would safely assume, a hospital chaplain is consistently asked, why. Why cancer? Why this car accident? Why has it metastasized? Why did I stub my toe? I hear that question with more vehemence as I have shifted my focus to pediatrics; parents desperately want to know why this as opposed to that has happened to their child. To the why question, Caputo states that “life is more important than any why” (226). I agree, in theory, but this needs unpacking before one rushes in and exclaims this philosophical gem.  When we verbally engage in this it comes off as end time understanding instead of meantime living – and doesn’t it sound eerily like a strong theology forcing its way into our psyche?  Parents do not get this hindsight view in the midst of hell, and unfortunately they typically get pithy statements of orthodoxy – once again from that very strong confessional theology that Caputo seeks to haunt!

This is something you get to say before an event has happened to you, or once you have a hindsight’s view. It is not uttered in meantime. So how can a nihilism of grace work in the church (or what I am referencing in a spiritual care relationship)?

I understand much of my role as re-authoring myths, and theological myths can be the most insidious: “God needed another angel”; “God gave me cancer to slow me down”;  “God is in control” and “there is a good reason.” Entrenched in some tragedies is the guilt or the perception of sin punishment; God is punishing me, us, or my child because of “x” sin.

In other words, understanding the why gets in the way of embracing life’s reality in the moment, which is the reality Caputo insists we embrace.

In order for this to live in the churches it must be modeled by others. Therefore, it is  I – as the caregiver – that lives as if life is more important than any why and I provide care from this vantage point. When I live as if life is more important than a why I am more likely to remain present in the face of tragedy and begin to journey with the family as they encounter reality and are able to also grasp that life is more important than any why. [I am, of course, not saying that a family couldn’t do this on their own, but I am saying that having a partner to accompany with throughout the journey is of value.]

Spiritual care providers, as Charles Gerkin said, are interpreters of stories. What are we interpreting? In each present encounter, we assist in interpreting meaning, and this is precisely where a nihilism of grace is of importance. I want to assist families in recognizing that “impermanence intensifies existence” (227). What this does, is eliminate some of the fear. There is the fear of death (there is no Pauline, “death where is your victory” just yet), the fear of guilt, but also the fear of regret. Is there enough time to tell you how I feel?! Is there enough time to seek reconciliation?!  The regret could be the fear of telling the loved one they are dying; and this disavowal prevents Caputo’s impermanence of intensifying existence.

The only way to live a life more important than a why is to confront and face death. While families are “hanging on by a prayer” – perhaps watching a heart rate monitor – they can live in that moment. Live into the intensity. Don’t turn your back. That precarious moment will pass away (it is impermanent), but it is of vital importance that the family confront that moment because “they know their love will not last forever” (227). What is permanent? What does last forever? This moves into Caputo’s definition of resurrection.

In Caputo’s final resurrection “body” narrative he discusses Jesus. It is Jesus’ actions on the cross, the extension of forgiveness, the refusal to command the angels to his side, and his refusal to fight back that is Caputo’s first understanding of resurrection. “Such forgiveness,” Caputo states, “is the way Jesus lives forever” (236). God is not found in the places of strong theology (e.g., not on the plane of transcendence or as a sovereign power that will raise the dead to slaughter all those Romans soldiers), but God is located “in the chance for grace, in the insistence of a chance for existence. God does indeed play dice, a game of chance with grace” (237).

Caputo concludes the chapter with an answer to the question of life’s meaning (I will provide you the answer, but still buy the book!): Life, because. The love of life in all its complexities, joys, and darkness is what Caputo urges the reader to come to grips with. A life that has a why supplanted on it will only damage it, or as Caputo himself eloquently puts it, “Life is undermined from the moment it is subjected to the economy of a ‘why” (241).

To answer my earlier question of this living in the churches, yes, this sort of theology can live (or haunt in Caputo’s vernacular) in the church (or in a ministerial context) as long as It lives in relationships. That is my main push back for Caputo. To live a nihilism of grace where God insists is helpful only in a setting in which dismantling a confessional “why” is safe.

My German Theological Mancrush

I hope to post something more original in a couple days, been pretty swamped. Until then enjoy this quote from my main man, Jürgen Moltmann. During my first unit of CPE I started reading Moltmann and completely attached to his view of the cross and a suffering God. This lead me to some open-relational and process stuff, but I still have a soft spot for Moltmann and his social trinity. Here he talks about theodicy, you will see why I like it (I’ll link the entire interview)!

You emphasise in your autobiography that you asked not ‘Why does God allow this to happen?’ but ‘My God, where are you?’ What is the distinction?
Well, the first question is asking for an explanation of the evil situation you are in; the second question asks how to get out of it. I don’t want it explained why I am in this misery, I want to be liberated from it, and therefore I cry to God: ‘Where are you? Save me!’
If you as a pastor visit a dying person and he asks you why he is dying and you ex­plain his situation, he will have you thrown out of the room. The question of theo­dicy is, to my mind, one asked mostly by the onlookers, not by those who are in a hopeless situation.

Does the question of theodicy not interest you?
No, it is only asking why there is evil if God is almighty and good. It doesn’t ask about God’s other attributes – for example, love, compassion – only power and goodness. And it is a very speculative question, a question ab­out the God of Plato and Aristotle. It is not a biblical question, or a personal question.

http://www.thirdwaymagazine.co.uk/editions/jun-2012/high-profile/look-forward!.aspx