Article: Surrogate Decision Makers Mental Health

"Making decisions for loved ones in the ICU takes a toll on thousands of people everyday, said Regenstrief Institute Research Scientist Dr. Alexia Torke, who led the study. “I really think it's a public health crisis, how many, how much these experiences affect their mental health,” Torke said.

Torke said even non-religious study participants benefited from the enhanced chaplain services “because the chaplain is able to listen deeply, and reflect back what the person's own religion or spirituality might be. And I think people feel very respected and very validated when a chaplain can do that.”

Article:

Family Members of ICU Patients Could Benefit From More Intentional Chaplain Support

Pastor Anitta +

New Things A Brewin'

As a bedside chaplain, I am constantly educating others about my role and the requirements it takes to be in my role. For the sake of getting it down on paper, general requirements for holding my position include: a 4-year bachelors degree,  a 3-year masters degree, 1 year of post-graduate education via a CPE Residency, 1 year of full-time employment, and achieving board certification. My own journey took some detours from this route (Hello 5 year M.Div.), but for the most part this path to chaplaincy has been true for me. I began undergraduate in September of 2009, and became board certified in February of 2020. It took me 11 years to "arrive" in this field. (Just for reference - it takes approximately 10-14 years to become a licensed MD.) 

Some of you may remember 2016 as a year of massive loss for me. In 2016, I watched my seminary class walk without me, lost my brother to suicide, lost my mom to suicide, moved out of state, lost the job that I had moved for, applied for residencies in Iowa/Kentucky, spent my last pennies traveling between the hospitals for interviews - unsure if I would even be allowed to work in a healthcare setting, received job offers in both places, and relocated to a third state to begin trying to put my life back together. I came with whatever would fit in my Jeep, and thanks to some UMC connections found temporary housing as I navigated being homeless in a new place, separated from my Dog, trying to get some grounding underneath me. 

I share all of that again in this space, as a reminder to myself about where I've come from and how fucking hard I have had to work to heal. On top of my personal struggle, November of 2016 also brought the Reign of Trump, and planted the seeds of deep political divide in some of my most important relationships. While this is not the space to process those pains, they are present in the midst of this story, of my story. 

In the years since, I completed not one, but two years of post-graduate Residency work and was hired full-time into my ideal position. For the last 7 years, I have served as a dedicated Critical Care Staff Chaplain. In the onset of the Pandemic in 2020, I also took on a dedicated role within the Emergency Room and with the Trauma team. Alongside of the changing healthcare landscape in 2020, came the loss of our CPE program. And, with that loss, came a professional standstill for me. When I accepted my position in 2016, I had made it known that I had a desire to become a Certified Educator.

Perhaps it was coincidental, or divine timing, or whatever - that I had time to mature as a Spiritual Care professional during one of the most challenging seasons of working in healthcare. I took a master class in self-care, staff care and organizational chaplaincy, alongside of the incredibly tough clinical environments that I served. The last few years has been a slow and often painful rebuilding process for our department and in August of 2022, we welcomed our first residents back on campus. In addition, at the beginning of this year, I finally began the next step in my journey towards becoming a Certified Educator through the Association of Clinical Pastoral Education (ACPE). 

It is quite an odd thing to view oneself as both an expert and a novice at the same time. I'm grieving the transitions that are coming for me. Transitioning from direct patient care, to Educator is going to require a flexibility in me that is out of practice. I've gotten very comfortable being 'needed' by the teams that I have served. I've gotten comfortable in being an expert and clinical authority in my department. And, I am so stinking excited to learn all of the things that I don't know to be successful in this new role. I am so excited to contribute to the discipline, to impact future clergy and caregivers. I am excited to continue the legacy of educators, who built me up to be the expert I've become, by passing their wisdom to students of my own. 

As I work towards becoming a Educator, there is lots of reading/writing/reflecting to be done along the way. It is my hope to work through some of my process in this space - breaking open, what can often be a lonely and isolating educational journey. I know that you, beloved, may not always understand where we're going, but I am sure as hell grateful that you're here, cheering me on. 

Pastor Anitta +

The Arrival of Ramadan

Ramadan is here for our Islamic colleagues, friends and family. Give this great infographic a read - especially if you're in leadership and/or in charge of people. While, individuals may not disclose their faith to you, you can still do your part to be attentive and inclusive. ❤

Pastor Anitta +

On Being Nonbinary

Me: Hi. I'm Anitta, the Chaplain here in CCU. I understand that you've made a difficult decision today. 

Family: *insert meaningful story sharing* Well, should we have a prayer? 

Family 2: I think the Chaplain is on his way up. 

Me: Hi. That's me.

Family 2: Oh, I was expecting a tall good looking man. 

Family 1: 😳🤣

Me: I mean, I can get one for you, if you'd prefer. 😅

Us: Recites the Lord's Prayer, a single round of a Hail Mary and Psalm 23 in unison. 🙃

Pastor Anitta +

Working From Home

Working from home is so much better, with this one cheering me on in the background. I wish I could crawl into bed with her though. 😅

Burnout and Vicarious Trauma

 Reminder. 

Pet Therapy

Pet Therapy stopped by the ED to give some TLC to our staff today. It's Ruff out here, folks! Support your local therapy dogs! 🐾🐕‍🦺✨️

Rest Is Radical

In a recent virtual workshop I attended, Rabbi Elliot Kukla challenged the notion of "lazy". They invited participants to reframe and reimagine Laziness as a Spiritual Practice. I wish I could just make their webinar the whole blog post, because it was just THAT good. But, instead, I'll link it HERE. 

Over the last two years, I've taken my Rest pretty seriously. I've guarded my time, been selective about who I share space with and have only pursued relationships which renew me. But, I've done all of this for the purpose of maintaining my minimum in order to keep producing Good Works.

In a Capitalist society, being a healthcare chaplain is a queer experience. We are one of the few service lines that does not produce income for the facility we're employed by. We're like - the Costco Chickens. Hospitals employ us because we add value to the healthcare team and the patient experience. But, they lose money on us and we know it. We are not measured by the income we produce, but the Good Works we contribute. Prior to the Pandemic, I watched Spiritual Care departments and Clinical Pastoral Education programs being removed from hospital budgets. Spiritual Care as a discipline stepped up during COVID, often at a cost to ourselves as providers.

Being a Chaplain during the Pandemic has been *LITERALLY* the hardest. I share in my covenant circles about the days that impact me the most. But, I don't really get to share the details. And, in some cases, I don't get to know the outcome of cases I'm involved in. Working in an environment, of which I can only share vague glimpses, is isolating. However, to have the broader public reject my lived experience as "Fake News" - is a whole other kind of crazy making. To be honest, I have only barely started the processing needed recover from the last two years.

Once we overcame the increase of COVID cases due to holiday gatherings, my hospital began to relax restrictions around visitation and masking. For the first time in two years, I'm seeing the full-face of people that I've been in the trenches with. I've heard my colleagues describe feeling 'overwhelmed' and 'overstimulated' as masking has relaxed. I've felt much of the same.

It seems impossible that after two years, my little world feels like it's breaking back open. Perhaps the Universe knew that this message from Rabbi Kukla was exactly what I needed to hear going into the next season. Even as the world appears to be reopening, I am entitled to Rest simply because I'm *human* and I *exist*. Rest does not have a Pandemic prerequisite. It also does not have to be connected to my ability to produce - whether that is profit or Good Works.

You, Beloved, also deserve to Rest. Not for the purpose of Labor. Not because we've been in a Pandemic. Not because you're feeling some sort of way as the world reopens. Rest because it is radical. Rest because it's necessary. Rest because it is your Divine right. 

Pastor Anitta +

I was there when your child wasn't breathing.

"They told me he's going to die," a father says to me, right before crumbling to the floor in a barren hallway. We sat on the ground for a bit, and eventually moved to a nearby bench. We'd been talking for weeks about this possibility. I remember wiping his tears from my shoulder. I remember wiping my own tears for his child. Today, I got to reintroduce myself to that child and hug that father, and, yes, there were tears, so many tears.

This is the fruit of "stranger ministry" in an acute care setting, over multiple years. Stranger Ministry is hospitality, it is raw and unpredictable, ungated and real. I don't have the privilege of long term, relationship building, pew sitting, small group attending parishioners.

Instead, I have years of living and working in the same community. I have bedsides, hallways and elevator meetings, generational losses and stories of communities who "remember before this wing was built". I have your name loosely in my back pocket because I was there when your mother-in-law died, when your son broke his leg, when your husband OD'd. I sat with your children in waiting areas, I called the local police department looking for your pets, I provided you a boxed lunch. I gave you clothes when you came in partially dressed because clothes were not a priority when your child wasn't breathing. I was there when your child wasn't breathing.

Sometimes I think to myself I can't do this. (I'm sure we all think this on occasion.) Just last week, I exclaimed to my fiancé, "It's like the world has conspired to find new ways to traumatize me." And then small affirmations are placed in my path, like a crying father, to remind me that I'm exactly where I'm called to be.

This job is *frankly* weird as hell. And yet, I wouldn't want to be anywhere else. 

Pastor Anitta +

Doing December Differently

We are T-14 days until Christmas morning. I’m not sure if you’ve all been counting, but I sure have! For many folks, the weeks leading up to Christmas morning are often filled with traditions such as decorating a tree, returning to spiritual practices and spending time with loved ones.

Last night, I was watching the Christmas version of the show Sugar Rush on Netflix. In Sugar Rush, bakers compete for a cash prize while being judged on their cupcakes, confections and cakes. In the episode I was watching, one judge described a white chocolate cupcake as “One Note”. One note, meaning that there isn’t depth to the one flavor profile of white chocolate. This judge was inviting the baker to get creative in their use of other flavors and textures to make the white chocolate stand out.

As I’ve reflected this year on my life, my calling and my purpose, I’ve come to realize that I desire, at the core of who I am, to do December Differently. To finds ways to make Christmas pop against its one note flavor profile. Unlike many of my peers, I am not preparing a Christmas experience for children. I am disconnected from my family of origin and I’m living in a state where I have minimal, mutual relationships. People like me are often forgotten in Christmas plans. I suspect, that I share this identity with some of you, and a portion of our hospitalized patients as well. We exist in a marginal space that often goes unacknowledged during December. As I was preparing for chapel this morning, I found myself struggling for what to say, to acknowledge the disconnect that I feel, and I suspect others feel, from Hallmark’s Christmas. I came across this poem by Helen Jesty. It’s called:

Let the bells jingle by Helen Jesty

Let the bells jingle but make time for the tears to fall.
Eat, drink and be merry but do not go hungry in that inner place.
Rest, reflect and remember. Be true to yourself.
Many of us can’t play happy families at this time of the year.

December is for a difficult diagnosis as well as dreaming of a white Christmas.
December is for divorce as well as decorations.
December is for death and dying as well as discos and dancing.
December is for distances that separate us from people,
     even those in the same room. 

Disappointments in December are especially hard to bear.
Sometimes the light no longer shines in the darkness.
The desolation swallows us up and we die a little.
Yet a kindly word, a bird in flight, a tree alive with hoar and hips
can drown out despair and kindle determination to move on.
Dig down deeper than the tinsel to the place where hope is found.
Maybe, just maybe, the flickering flame will be fanned gently into fire.

I’m going to reread the portion of this poem that is lingering inside of me.

December is for a difficult diagnosis as well as dreaming of a white Christmas.
December is for divorce as well as decorations.
December is for death and dying as well as discos and dancing.
December is for distances that separate us from people,
     even those in the same room.

I often wonder, if my position as a Chaplain in this context, predisposes me to be attentive to the darkness that lingers in times of joy. Or, if this predisposition is one of the giftings that I bring to this work. Jetsy is able to capture the duality of this season which always exists, but often goes unnoticed, pushed aside or ignored. December has an intricate flavor profile. It is not the one note of a white chocolate cupcake. It is the caramel bourbon glaze, for those of us who feel a bit bitter and the sweet nutty filling for those of us who have found or made meaning, surrounded by the white chocolate cupcake, which holds us both simultaneously.

One of the ways that I’m Doing December Differently this year is by recognizing the complexity of this month for the people in my life. Instead of thinking about creating an experience or providing gifts for others, I am showing up and offering my presence as a present. As you engage in your own traditions and work over the next two weeks, what is one way that you can Do December Differently this year? In what ways can you deepen the flavor profile of this month, for yourself and those around you?

Beloved, December is for heart ache and joy, for despair and jubilation, wherever you find yourself today, know that you are welcome by me exactly where you are. Go in peace.

National Coming Out Day

I led Chapel on October 15th. This is the second message in a 2 part series related to National Coming Out Day which was October 11th. I am fortunate to be in a place where I can claim my faith alongside of my sexuality -- a privilege that was denied to me for FAR TOO LONG. 👏👏👏 Check out what I have to say about my own coming out and the ways in which it can inform and challenge the heteronormativity of patient care.

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Jeanne-Hoff Goodwin Chapel
UnityPoint Health - Des Moines
October 15, 2019

Here is your designated content warning that our time together today is going to engage with queerness. Queer can mean many different things – it can mean odd or strange; queer can be a verb – to take something and look at it through a lens that turns it over, or troubles it in some way; it can be the name of a community; it can be the name of an identity. Queerness, is a word, that in and of itself, is queer.

Before we really began today, I want to do an exercise together. Take your right hand and place it on your right hip. Drop your right hip. Take your left hand and turn it upwards so that you resemble a tea kettle, palm side up. Now turn your palm on your left hand palm side down. Hold.

The reason that I’m beginning our time together today with this body exercise is because I’m talking about queerness and queer bodies. For those representing the cisgender or heterosexual identities, there is often an disconnect between “knowing” about different identities and “feeling” the identities. Conforming your body to a given set of instructions is – difficult. One’s body is so integral to how we understand and make sense of ourselves and our world. Now, imagine if you were required to remain in the current position for the rest of the day. Or, even the rest of your life. You’d be incredibly uncomfortable. However, you know that if you break this posture, the rest of this cohort is going to shame you for not sticking it out, not what the norm expects. So, you hang on, you hang on even though your muscles burn, you feel awkward, pain forms in your back and frankly, you become obsessed with wanting to adjust your position. But, you don’t exactly know how.

Okay, you can drop your posture and take a seat.

October 11th was a milestone day for many folks within the queer community. It was National Coming Out Day – a day in which the queer community is invited to come out, celebrate, connect and live authentically. It is also a day when those of us who live closeted lives grieve, lament and guard ourselves from suspicion and persecution from those around us.  National Coming Out Day is – complicated. Given our current political climate, coming out is a compromised experience. As a member of the queer community – I wanted to share with you a little bit about my coming out experience, the difficulty of being in my role as a queer person and the ways in which my experience might invite you into a different awareness for the ways in which you engage with and offer care to those within the queer community here.
My initial coming out was the least dramatic part of my journey. I was 14. I had a parent who expressed a never ending faithfulness to show up for me and love me, regardless of my orientation and identity. I was also fortunate to be the third person in my family to come out. As I navigated my teenage years into young adulthood – it wasn’t my immediate or extended family that perpetuated my closet experience – it was the Church.

Feeling called to serve; I knew that I was in a denomination that perpetuates the claim that “homosexuality is incompatible with Christian Teaching”. This duality extended my closet experience for nearly 14 years. I went from being the president of my Gay Straight Alliance in high school back to being in the closet throughout college in an attempt to “Straighten Out” for the purpose of service to the church. Near the end of college, I had begun the work to accept myself as queer and believed that living a celibate life was going to be the loophole that I needed in order to maintain my integrity and church life.

And then, 2015 happened. In 2015 – I was in my very first clinical pastoral education experience. I identified myself as queer in an introduction. It was the first time that I had claimed this part of my identity outside of my personal network and in front of other faith leaders. I was terrified. And, no one batted an eye. We ended our session and moved on. This huge, momentous thing for me seemed like everyday conversation. And then two weeks later, marriage equality passed and I found myself in the same setting again – fuming. I named with my peers that I was new to claiming my identity out loud alongside of my faith and I couldn’t help but be angry at marriage equality – not because I thought it was a bad thing – but because I knew that my church would never allow me to marry. I kept thinking “Great. Now everyone can marry, except for me.” Over the next year, I grew into my identity – I named it, claimed it, and celebrated getting to know myself in this new way.

And then, 2016 happened. Over the last four years, I alongside of the queer community have watched our rights being systematically attacked and removed. We’ve witnessed the refusal to acknowledge us on the federal census, we’ve been erased from federal websites, we’ve fought for marriage licenses, cakes, and in 2019 – we’re still witnessing groups of heterosexuals make decisions about how we’re treated. As Chaplain Emily mentioned last week -- the Supreme Court entertained arguments on whether the civil rights laws barring workplace discrimination based on gender also applies to gender identity and sexual orientation. Decisions were made ABOUT US – which we’re not privy to. The issue pertains to whether Title VII of the federal Civil Rights Act of 1964, which prohibits sex discrimination, also protects LGBTQ people from discrimination at work. Title VII does not explicitly mention LGBTQ people, but federal appeals courts in Chicago and New York recently ruled that gay and lesbian employees are entitled to protection from discrimination.

Members of the LGBTQ (lesbian, bisexual, gay, transgender, and queer or questioning) community who aren’t out of the closet in the workplace report isolation, depression, and exhaustion. 46% of LGBTQ Americans remain closeted in the workplace, according to a 2018 report by the Human Rights Campaign Foundation. Workers surveyed cited variety of reasons for not coming out to colleagues: 38% said they hid their sexuality because of the possibility of being stereotyped, 36% said they didn’t want to make people feel uncomfortable, and 31% said they worried about the possibility of losing connections or relationships with co-workers.

The struggle is unique for different identities, the report noted. From my personal experience – I identify as non-binary, meaning I do not identify as a man or a woman and ask people use the pronouns they/them or she/her when addressing me. I’ve put my pronouns in my email signature as an indirect way of coming out, but very few people have respected the pronouns. Most people default to “she” because of how I appear. And while, that’s okay and I’ve given permission for people to use this particular pronoun, I can understand because of my gender presentation and name why people don’t use the entirety of my pronoun variety. And yet, even that part of my coming out has been a journey.

As a queer employee in this place – I am consistently in a battle about whether to, when to, and where I can “come out”. I recall coming to the hospital for the first time for my interview – touring the Spiritual Care spaces and hearing a now-colleague refer to the upstairs balcony office as a “Closet”. I shrugged the remark off because I wanted to be here – I wanted to work with a supervisor with a similar identity to my own – a queer – gender expansive person. I wanted to see the ways in which they understood their calling in light of their faith and glean whatever vocational confidence that I could from them. So, despite the closet remark, I accepted a residency position. After coming on, I cannot tell you how many times – even in this space – I heard jokes about being locked in the closet. The closet that I have to enter in and out of to prepare this space – that I am forced to orient towards, every time I lead chapel. When I came on as fulltime a year ago – I was assigned my primary office space – to be the upstairs closet referenced earlier. This office space was so infrequently used by me that a current student who entered the space without me literally thought that I had abandoned and forgot about the space. The closet – for me – is directly tied to shame and faith. I do not take for granted that as a queer person – I’ve made it to this platform – behind this podium – ordained and beloved. But, I still fear the closet.

So, what? What is the point of naming all of this with you – the care providers, family members, patients and loved ones? The point for me is that we all have closets that we are forced into or choose to live in. The queer identity is one of many marginalized identities that we engage and identify with - the sick, chronically ill, ethnically or racially variant, the differently abled, the female, the identities that we come to inhabit – often are not choices that we make for ourselves.

As a chaplain in this space – I do what I can to help patients and families feel comfortable in my presence. However, my title is often something that comes with a preconceived notion about what my opinions will be. I have heard time and time again people “blaming the gays for this or that”, listening intently for the spiritual needs underlying their harmful opinions or beliefs. I have heard the preconceived notions come out at the bedside of patients and families within my care – trans patients wondering if I will accept them hard stop, families whose loved ones are HIV+ wondering if I will accept them hard stop, sex workers and trafficking victims wondering if I will accept them hard stop, individuals in modern relational structures wondering if I will accept them hard stop – all because of my title of Chaplain, Reverend, Christian.

One of the ways in which I communicate my love and acceptance is by Coming Out with these families and patients – not for my own need to be seen and known – but for the ones in my care to know that they are seen and known. I wear rainbows. I hang trans visibility posters. I create spaces for patient’s to own their own identities and experiences with me. As staff in this place – I wonder how you can come out as queer, allies or, at the very least, safe and competent? As you think through your normal routines – how would you show up differently for a female patient who asks for a urinal? How would you advocate for patients that are partnered, but not married? How can you resource them to make future hospitalizations more tolerable? How do you challenge your own internal feelings about the validity of queerness and queer life? How do you queer your care, challenge it, turn it upside down?

I realize that I’ve asked you many questions in a row. Beloved, I invite you to show up with your full range of skill, heart ready to receive and eyes open difference. As we close together, I have one more expercise for us to engage in. On the count of three, I invite you to say out loud the word queer. Ready, 1.2.3. Queer. Practice using the queer vocabulary out loud. It can only benefit you and your patients.

Pastor Anitta +

The Silent Scream of Pain

Yesterday afternoon, I was sitting at lunch with several of our Patient Access employees. These are the folks who register people here in the hospital. They are busy from the moment they arrive, until they leave – not unlike many of us, in our own positions. I have been intentionally working to build relationship with this group of people over the last few months and one way that I have done that is by sharing a meal. While at lunch, I often hear statements such as, “I could never do your job.” I’m sure that you’ve heard this statement as well, at some point, from someone. While, I understand the intent behind the statement, I have also been reflecting about what it would mean for someone to ACTUALLY be unable to provide care in this position.

One of the reasons that I think people shy away from believing they could do this work is because of their relationship with pain and suffering. Several weeks ago, I attended Embracing U training, a program designed to help facilitate supportive peer relationships across this organization. While there, one of the leaders spoke about the hospital as a “Suffering Rich Environment”. I have worked in hospitals for several years, but the way that she described this environment hit me in a new way. Most people come to the hospital seeking healing from physicians, nurses, techs – from the folks who have calculated formulas and criteria for attending to specific health problems.

MY ROLE in this environment is to navigate the hidden wounds. People who suffer loss feel an often unspeakable pain. At times, it almost seems unbearable. And loss, is as common of an experience as having a cold. Loss comes in the form of death, expectations, transitions, growth, dreams. I once heard an author described pain as being a gift – a sign that we are alive.

Pain is a gift because it shows we have a capacity to feel, whether pain in the body or pain in the soul. Physical pain demonstrates the capacity we have in our senses to experience the negative side of life in the world. Our nerves give us messages about the world, warning us of its dangers as well as informing us of its delights. What is true in the body is also true in the soul. The pain of loss is severe because the pleasure of life is so great; it demonstrates the supreme value of what is lost.

The last time that I led chapel, I exposed a significant vulnerability. I allowed you to meet me behind the pulpit in the midst of my grief. I shared with you stories of my mom and brother and how their deaths still impact me, three years later. The screaming pain I feel at the loss of my mother and my brother reflects the pleasure I felt in knowing them. I cannot have one without the other, for both show what the soul is capable of feeling, sometimes simultaneously.

Loss is often accompanied by an experience of anxiety and depression. Clinical psychology has a vocabulary to describe depression, and it provides techniques and drugs to combat it. However, some folks find a spiritual image more helpful to connect. The Spanish mystic, John of the Cross, wrote about something he calls “the dark night of the soul.” He defines it as a depressed spiritual state into which one slips and, turning to traditional remedies—emotional fervor, spiritual discipline, rational analysis, worship, service—finds in them absolutely no help and comfort. All props are stripped away. One is left utterly alone and helpless. It is the darkness visible that Styron describes. One enters the abyss of emptiness—with the perverse twist that one is not empty of the tortured feeling of emptiness. If anything, this kind of emptiness fills one with dread and despair.

This experience rarely follows immediately after the loss. It occurs at the end of the fight, after the denial yields to reality, the bargaining fails, the binges lead to emptiness, and the anger subsides. Then there is no will or desire left to resist the inevitable and undeniable. One is left only with deep sadness and profound depression. The divorce is final, and there is nothing to be done to win the partner back. The abuse or rape really happened, and the memory will remain for a life-time. The cancer is terminal, and no medical miracle is going to change that. The disability is permanent, and no amount of physical therapy is going to alter the condition. The job is lost and will never be won again.

At the core of loss is the frightening truth of our mortality. We are creatures, made of dust. Life on earth can be and often is wonderful. But in the end all of us will die. The losses that we experience set off silent screams inside of us that are deafening.

I’ve not been known for ending chapel messages on a positive note. Today is no different. It is not my role to fix the anxieties of patients, families or staff here in the hospital. However, it is within my role to sit in the ick – in the midst of the silent scream – with you. I could understand why some people wouldn’t want my job. However, I believe that we are all capable of holding space for others. If you’re here and need space today – find me or another chaplain after the service.

Pastor Anitta ❤ +

Adult Children of Alcoholics/Addicts

In the midst of finishing up my Mdiv, I'm also on a bit of a personal journey. On this journey, I'm attempting to reconcile with the parts of my self, deeply impacted by the disease of alcoholism and addiction. Although I am not an addicted person, I am the adult child of alcoholics/addicts.

Over the last two weeks, I had the fortune of doing some training with the Powell CDC staff. During this training, I went through two weeks of intensive, outpatient rehab. While in the program, I completed most of the required assignments. One of the things that I took away from this learning experience, is that the disease of alcoholism and addiction stole my childhood, held my loved ones hostage and re-ordered my life. As a result, I realized that just as my loved ones NEED a 12-step program for recovery, so do I.

Today, I attended my first ACoA meeting. As the steps for recovery were read, I found myself invited into a familiar place. Growing up in and out of Ala-teen, Al-anon and AA rooms, I became used to and, likely, somewhat desensitized to the disease's impact on myself. In my head, I had categorized the disease as my loved one's problem. However, as the meeting opened and The Problem was read, I saw myself:

Many of us found that we had several characteristics in common as a result of being brought up in an alcoholic or dysfunctional household. We had come to feel isolated and uneasy with other people, especially authority figures. To protect ourselves, we became people-pleasers, even though we lost our own identities in the process. All the same we would mistake any personal criticism as a threat. We either became alcoholics (or practiced other addictive behavior) ourselves, or married them, or both. Failing that, we found other compulsive personalities, such as a workaholic, to fulfill our sick need for abandonment.

We lived life from the standpoint of victims. Having an overdeveloped sense of responsibility, we preferred to be concerned with others rather than ourselves. We got guilt feelings when we stood up for ourselves rather than giving in to others. Thus, we became reactors, rather than actors, letting others take the initiative. We were dependent personalities, terrified of abandonment, willing to do almost anything to hold on to a relationship in order not to be abandoned emotionally. Yet we kept choosing insecure relationships because they matched our childhood relationship with alcoholic or dysfunctional parents.

These symptoms of the family disease of alcoholism or other dysfunction made us "co-victims", those who take on the characteristics of the disease without necessarily ever taking a drink. We learned to keep our feelings down as children and kept them buried as adults. As a result of this conditioning, we confused love with pity, tending to love those we could rescue. Even more self-defeating, we became addicted to excitement in all our affairs, preferring constant upset to workable relationships.

This is a description, not an indictment.

As I continue on my own path of recovery, I'm inviting ya'll in. This is tough work; probably tougher than anything I've undertaken before. However, the reward of self-knowledge, confidence, joy and peace will be so worth it. As I work through my own experience of reconciliation, I hope that it helps me to become a more honest leader and pastor to the reconciled community.

Happy Easter.
Be Blessed.

Pastor Anitta +♡

God Loves the Gays

Some of you may be wondering what I've been up to in my life of ministry, outside of the hospital. Well, I'm finally ready to tell you. When I moved to Des Moines a year ago, I had a packed car, $30 in my pocket and a whole lot of pain. I found myself seeking home, community, friendship, and affirmation. I tried to find these things in some of the local churches; however, I had become unable to make meaning in a space that used to feel so familiar. I could go on for pages about my struggle with God, faith and the Church over the last year; however, there's a time and place for everything and this is neither!

In the midst of my seeking, part of what I realized was that I needed to be connected to another part of my identity, so... I searched. I searched for a connection to the queer community through pride centers, gay bars and strangers. When my searching turned up fruitless, I created.

With the help of a friend, I created a Facebook group to help queer women, womyn, non-binary and trans folks across Iowa to connect, celebrate and understand one another. Over the last 9 months, this group has grown to 836 members, with more being added everyday. In an average month, we interact over 20k times through posts, comments and reactions.

As a group, we host monthly in-person meetups, an online book club, and other social events to get together and get talking. In the upcoming year, we're launching a coffee/social justice forum in three cities that will meet once a month, a queer prom and so much more. I couldn't do this or keep it going without an amazing leadership team of people who volunteer their time and energy. These are truly the patron saints of the queer community here in Iowa!

Some people may disagree that this is ministry because we don't talk about God everyday. However, the God that I believe in is unequivocally for me and the community that I represent. God shows up in community, in relationship and in the radical hospitality of strangers. God is for the creation of spaces in which the oppressed can be their true selves, share their pain and celebrate their joy.

This is my ministry, and I am so freaking proud of it. ♡

Pastor Anitta +♡

Chaplains Grieve Too

Let me tell you a story about healthcare, because apparently I have a lot to process tonight.

When our patients die, we grieve. Sometimes, we hold ourselves together just long enough to bid farewell to families. Other times, we don't. We crumble, getting caught in our feelings about this loss. And then, we dust off our knees, compose ourselves and walk into the next room. We introduce ourselves to the next person, before we've completely recovered from the images of mangled bodies, tears and grieving loved ones. We do our best to empty ourselves in order to make room for the person in front of us. Yet, we still hold on to the memories of those that we couldn't save... and the rest of the show goes on around us. 

There’s times when we run, and rush, and hurry, and skip eating, and go 12 hours without urinating, and we'd give our firstborn for a cup of water. We get covered in phlegm, urine, feces, blood, infectious drainage, sweat, and tears. 

Health care is a life of fighting, defending yourself, sacrificing yourself, working weekends, missing holidays, and sometimes things like losing a patient makes you want to throw up your hands and say, “Fuck it, I’m out.”

But, you can’t. You do it because you love it. 

Pastor Anitta +♡

Let's Talk About Shame, Baby

What words come to mind when you think about shame?

Fear? Anger? Disappointment? Disgust? Secret?

These are the words that come to mind when I think about shame. Shame, as I have understood it, is different from guilt. I would define guilt as feelings of remorse as the result of an action. Shame reaches beyond the action. It is more than the feelings of doing something wrong -- it's the bold, hushed, loud and soft voices inside of us that tell us that WE are wrong. Shame tells us that there is something deep within us that makes us inherently wrong as humans. Brené Brown defines shame as the "intensely painful feeling that we are not worthy of love or belonging." In her TED Talk on Shame, Brené Brown identifies the ingredients for shame as secrecy, silence and judgment. These three ingredients breed an environment in which shame thrives and becomes lethal. Brené offers a solution to dissolving shame. She states that empathy creates an environment that is hostile to shame. Empathy, is the ability to understand and share the feelings of another. It is being able to take on another persons perspective and emotions as if they are your own -- remembering the as if part.

This is relevant to both my ministry, and me personally. At the bedside, I hear stories of past experiences from 15, 20, 30 years ago which still causes pain for my parishioner. These stories of lost loves, offenses, wrongdoings and deaths remain hidden from most people in their lives. They feel as if no one wants to talk about these encounters, that they are all alone in their feelings and longings to return to a time before the events. As a chaplain, I am privileged into these sacred spaces -- acknowledging old wounds as I care for the current ones. Many times, the greatest gift that I provide to my parishioner's is an open ear, non-anxious presence and space in which their stories can be told.

As a person in ministry, I am often told that part of my own self-care is having somewhere to put these secrets. Furthermore, self-care also calls me to do something with my own secrets. Theologically, I connect with Nouwen's image of the Wounded Healer. The Wounded Healer is someone that simultaneously attends to their own wounds, while attending to the wounds of others. In the parable that Nouwen shares, he speaks to healing as being a process - one in which the healer unbinds and binds each individual wound on their body, instead of unbinding them all at once. By unbinding each individual wound, attending to it, and rebinding, the healer remains in position to be an aid to those around them.

So... what? What am I trying to say? I suppose this is the part of the story where I tell you how each of these pieces connect - the shame, the self-care, the theology. To be honest, I'm figuring this out as I write, so.. bare with me. It's no secret to most people who are reading this that this last year has been -- hard, to say the least. I have done a lot, been through a lot and somehow I still wake up every morning. To be honest, I'm not sure how sometimes.

In CPE, we talk about shame, about that feeling of not being worthy of love or belonging. I believe that it's easy for us to think no - that's not me, I know that I am worthy of both of those things! But, if this is a space in which I am looking to seek empathy from ya'll, I have to be honest with you. When I look at where my life is, I have doubts about both of those things -- being worthy of love and belonging. I hold an internal expectation about what my life SHOULD look like. Should, of course, is a shaming word. It is a word that implies that I am somehow less than this image of myself that I want to present to the world. Frankly, I'm tired of shaming myself for where I am, what I've been through and I'm ready to face it all - with you - trying to believe each of you love me with a love fierce enough to accept me just as I am. So, here is a list of 5 things that I shame myself about and how the shame impacts me:

1. Body. I am a fat bodied person. Surprise! I know, you're all shocked. I can't quite describe my shame around my body. It's like, walking around in the most beautiful thing you own, and everyone else thinks you look like a clown. I love my body, I do. But, it's fat... which in turn, means I am fat. If you want to know what it's like to live in my shoes imagine questioning whether you can buckle a roller coaster seatbelt, sit comfortably on a plane or being stuck in a crowd of people because there is no way you're going to be able to 'squeeze' between people. Oh, also, being fat means that I automatically get to wear clothes that look like they were cut out of those rainbow tarps that we all use to run under as children. So, cool.

2. Gender. I don't fit other people's expectations about what it means to be female. Those who know me best, know that I don't fully identify as female. I don't identify as male either. Honestly, this is probably related to my body issues above and my sexuality. As a fat bodied, queer identified person - I walk a balancing act between being over-sexualized and under-sexualized at every corner. I don't fit other peoples expectations about what it means to be human and that terrifies and excites me.

3. Money. Because money. I have a difficult time paying the important bills, which means things like my credit card... don't get paid. As a result, I feel as if I am single handedly crashing my own credit into the ground. Also, I entered repayment for my student loans in November and have been too poor to pay them. So, awesome. And, I think my car is tied in here too because I've been talking about getting a new one for YEARS, but I can't afford it.

4. Life. Because things haven't quite turned out like my peers. I didn't graduate from seminary last year. I probably won't graduate from seminary this year. I was homeless. For the last three months, I have had to rely on the generosity of strangers for a place to lay my head, for meals and for emotional support. My brain tricks me into thinking I should be just as good, in the same place as, or even better than my peers and colleagues. And, when I'm not, I experience shame.

5. Faith. In the midst of all of this, my faith has been shaken - despite working so hard to be a spiritual rock for those around me. Right now, my experience of the Divine, is limited. I believe part of that limited experience comes from feeling unstable and unsettled. What does it mean for me, if the times when I feel closest to the Divine, is the times when I feel most in control? How do I let go of that and live comfortably in the midst of where I am? Beats me - I don't quite have my M.Div. yet. (haha).

Sorry for the book. I hope you still love me.

Pastor Anitta +♡





Life, Actually.

I am completely dumbfounded by the way life happens. I get lost trying to follow the chain of events that allow for seemingly heathy people to have normal mornings and evening deaths. In my own life, I can't describe how one minute I can feel sane and secure, and the next unbalanced and bat shit crazy. Regardless of the blocks  and boundaries we put up to help us maintain an illusion of 'perfection', all it takes is one phone call... one text message... one sideways glance to change the minute, day or life that we have planned. 

(I'm about to get real here, so please stop reading if you don't want your image of who I am ruined.)

I believe that life actually happens in between our plans. Take me for instance: I planned on graduating with my Master of Divinity in 2016. I planned on being commissioned, beginning a residency, moving to a new state, meeting new communities. I planned, so well, so that I could have security and stability for myself. And then, it all fell apart.

My mental health prevented me from graduating, it interfered with my preparation for District Committee, one of my brothers died, one of my mothers died, I lost my job, I moved to a new state, I became homeless and I fell in love and had my heart broken twice within a three week period.

This last year has had so many ups and downs, twists and turns, sweet and sours.. that I can hardly list them all. I can't list how many times someone looked at me lovingly, held my hand, sent me "I love you" messages at the right moment, bought me ice cream, laid on the grass admiring the sun and then the moon with me. I can't count the puppy kisses, the long walks, the grains of sand that I've shaken from pairs of shoes.

The difference between what I can list, and what I can't... is curious to me. All of those ups, the I love you's, the kisses, the long walks... those are what life actually looks like for me. Those weren't planned, couldn't be planned. Frankly, when I look at these two lists.. the planned and the planned nots, there's only one that I'd want to experience over again.

So, here's to a year of life actually. Here's to a year of being present with myself, with those around me and those within my community. Here's to throwing specific plans out the window, meeting under the sky somewhere and being alive with one another.

Pastor Anitta +♡

Happy Belly Button Birthday, Ma!

I am the adult child of alcoholics.

This is not surprising information for most people. I am very open about my experience growing up, witnessing the ins and outs of addiction. Addiction, from my perspective, was an embodied part of my family. Not only did my parent's change when they were under the influence, my behavior changed as well. Addiction was the weird uncle who sat next to me at the dinner table, consuming more than its fair share of resources.

I recently had it reflected back to me that I am unlike other adult children of alcoholics. I was told that most of these children run from their past, keeping it secret because they grew up with a notion that revealing their inner world was unsafe. In a chaotic, unsettled life, their inner experience became a small area of control.

I have struggled with this reality. In the past, I have desired to disassociate, separate, define myself as different from my past experiences. I thought that these experiences somehow made me less of a person, less of a pastor.

However, another significant part of my story includes recovery. It includes sitting in Alcoholics Anonymous meetings, night after night. What was modeled for me in these meetings is people bringing their authentic, broken selves to a community. I was shown how to self-reveal, cry and be frustrated. In these meetings, I witnessed the full range of human emotions. These meetings and the people within them chose to love one another, and myself, as though we were family. In these spaces, we were all broken and hurting. We relied heavily on a higher power and we prayed, communally, for healing and support.

Through AA, counseling, spiritual direction, seminary training and clinical pastoral education I have come to understand my past experiences as being a gift. It is from this well of hurt and pain that I am able to relate best to humanity. It is in the midst of this brokenness that I am able to share in the common human experiences of loneliness, longing, depression and anxiety.

I would not be the pastor I am today without the AA community.

I think this has become apparent to me over the course of the last few weeks. After the loss of my mother, it is was both the AA community and my local church that went out of their way to show me an incredible amount of love and support. Although I do not wish the illness of addiction on any one, or their families, I am grateful for my parent's stories. I am grateful that AA gifted me with a mother over the last 16 years.

Despite my continued grief, I am celebrating ma's 54th belly-button birthday today.
I would not be the pastor I am without her in my life.

I will be saying the Serenity Prayer tonight, for her, for myself and for those of us who might need the extra serenity, courage and wisdom to make it through the night. I invite you to join me, on your own time.

In the Grip of God's Grace, 

Pastor Anitta +♡

Decidedly Disappointed

About a year ago, I got into a conversation with one of my colleagues. They were exploring the role of disappointment in leadership, consulting with a client.

Some of the questions they was encouraging this client to think about was:

1. How do you react to disappointment?

2. What is your capacity to be disappointed by family, work, church?

3. What does it mean to you to disappoint others?

These questions are sticking with me this week. Our opportunity for disappointment is great -- both as perpetrators and as victims. Disappointment sometimes reveals itself in the form of depression or despair. UCLA psychologist James C. Coleman lists several examples. "Shipwreck victims who lose hope may die after a few days," he says, "even though physiologically they could have survived many days longer." He notes that despair can contribute to suicide, while hopelessness bred by poverty might manifest as apathy. "Values, meaning, and hope appear to act as catalysts" for mobilizing energy and finding satisfaction. Without them, Coleman reports, life can seem futile.

Ministry, in and of itself, is people focused/centered. Everything that we do, reflects back on how we fellowship, lead, give and take care of one another. As a Christian, I believe that our relationship with the Divine provides the moral directive for being in these types of relationships. However, what happens when we, as leaders, disappoint ourselves and/or the people that we work with?

In the midst of disappointment, depression and despair -- how do we keep hope alive? How do we lead a community of believers in the midst of expectations held on both sides?

Resiliency: Hebrews 11:1

Hebrews 11:1 CEB

During the beginning process of my integrative paper, my classmates and I were asked to speak to our most important values. The three that I named to complete the assignment included authenticity, resiliency and humility.

The one that I want to speak about today is resiliency. I have understood resiliency to be the capacity of individuals and communities to withstand, respond to, recover from and/or adapt to disruptive events.

In both my personal life as well as my clinical work, I am often reminded that no one guaranteed that life would be easy. Many times, I am at a loss for words... mostly because there are none. There is nothing that is appropriate to comfort a mother that has delivered a still birth. In instances of tragedy and trauma, words fail. However, because these cases happen so often, it is necessary for the pastor to be prepared to provide care. Henri Nouwen believes that all pastoral leadership should be rooted in an intimate relationship with the incarnate Word, Jesus. It is in Jesus' life and ministry where we find a source for words, advice and guidance (Nouwen, 45). Scripture tells us that Jesus wept, prayed and comforted. As a pastor, I do each of these things on a daily basis both for myself and for others.

In my line of work, I am often asking, "What nourishes your soul?" Or, "What brings you hope?" Hearing folks respond to these questions, despite facing a terminal illness or life changing event, humbles my spirit. Hope is the definition of humanity's resiliency in the face of both physical and social sickness.

Resiliency is giving everything you got, putting it all on the line, losing it and waking up the next day. It's recognizing that life isn't easy. For most of us, there are no quick fixes or easy answers. Sometimes, we find ourselves needing to make a difficult decision between two option, both of which suck. But, we do it.

Nouwen writes that the leadership of a pastor is "not a leadership of power and control, but a leadership of powerlessness and humility in which the suffering servant of God, Jesus Christ, is made manifest" (Nouwen, 82). Part of our powerless, humble leadership is the recognition that we cannot care for our communities alone. Our relationship with the Divine, provides for us the framework for this leadership. It is in this relationship that we store our hope and find our faith --- even when things are pretty shitty.

In the Grip of God's Grace, 

Pastor Anitta +♡

Henri Nouwen, In the Name of Jesus: Reflections On Christian Leadership