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1 SPIRITUAL WELL- BEING: EXPLORING HOPE Patricia Cadle, MRE, BCC Oncology Chaplain UNC Health Care Pastoral Care Department What is Hope? The Greek and Hebrew that translates to hope speak of: certainty; a strong confident expectation; a supernatural certainty Scriptural: a supernatural certainty based on a belief (Christian Scriptures: Ps. 42:5-6; Ps. 119:114; Romans 15:4) Hope in the Christian Scriptures Why am I discouraged? Why is my heart sad? I put my hope in God! I will praise Him again, my Savior and my God! (Ps. 42:5-6) You are my refuge and my shield; your word is my source of hope. (Ps. 119:114) Such things are written in Scriptures long ago to teach us. And the Scriptures give us hope and encouragement as we patiently wait for God s promises to be fulfilled. (Romans 15:4) For use for educational purposes ONLY. 1

2 Modern idea: an intense, cherished desire for a certain outcome to occur with the expectation of fulfillment (but without the certainty of fulfillment) the elevated feeling we experience when we see in the mind s eye a path to a better future. (Groopman, 2004, The Anatomy of Hope) Hope Myths Hope equals optimism (a mindset that sees something positive in all situations; based on what is the glass is half full vs. hope that knows no matter how bad a situation seems, ultimately all will be well) Hope cannot be had outside of a faith tradition (Hope lies at the core of all human initiative it moves us to a new perspective, enabling us to see the present and all its possibilities for success in light of some future good) Hope is not a choice (you either have it or you don t have hope or fall into despair) Hope is come by easily and takes no effort on our part (it is a spectator s sport) Hope is always present (it cannot fade and we cannot lose it all together) Once lost, hope cannot be rekindled/reignited; we can never find hope again For use for educational purposes ONLY. 2

3 Hope Misunderstood Hope is often wishy-washy and filled with doubt (ex. Is your telephone working? I hope so. not for sure, maybe and maybe not) We often use hope when we really mean hopelessness (camouflaged despair) (ex. Well there is nothing left for us to do but hope. = We might as well give up, it s hopeless. ) There are those that use hope in situations not worthy of hope (ex. I hope I win the lottery. I hope I can get a reservation. I hope I can find a parking place. ) 3 Basic Ideas of Hope To hope is to acknowledge: What I hope for I do not have and cannot see What I hope for may be difficult to obtain I can have hope; It is possible for me to hope. Lynch is: Calling us to persevere Inviting us to use our imaginations ---William Lynch, Jesuit author When we seem to be stymied by circumstances, there is a fact and a possibility that is not yet in, that there is a way around our troubles and that the boundaries of the possible are wider than they may seem. Importance of Hope Brings strength, comfort, peace, courage/boldness, joy, endurance, resilience, confidence, faith Makes one s present (difficult) moment(s) less difficult to bear Gives a better perspective on the struggles in life. Hope allows us to increase our belief in a world where good things can happen Helps us persevere when things are not going as planned; help us get through the trials and tribulations life can bring Invites the individual on a journey. Gives strength and focus to start working toward goals For use for educational purposes ONLY. 3

4 Lifts us out of depression -- the kind we fall into when we experience the world filled with sad stories, stories that break our hearts and leave us wondering, What s the point of it all? Changes one s outlook on the future seeing a vision of something better helps achieve it; start with hope and transform it into a plan of action, which will help make the vision a reality Helps us believe that we are able to create self-fulfilling prophesies. With hope we are paving the way towards something positive and good for ourselves we set ourselves up for greatness Brings like-minded people together (in a cause) Inspires others More about Hope Hope is a more dynamic concept than just wishful thinking; it is the ability to imagine a future goal and understand the steps necessary to accomplish it hope not only changes one s outlook on the future, but also helps to shape it. Hope is like oxygen, we can t live without hope When we re excited about what s next, we invest more in our daily life, and we can see beyond current challenges. -Shane J. Lopez, Ph.D., Gallup Senior Scientist, author of Making Hope Happen, and leading researcher of hope According to Lopez Only half of us measure high in hope Fortunately hope can be learned Hopeful people share four core beliefs The future will be better than the present I have the power to make it so; I am able to take action Pick good goals that you are excited about pursuing and align with your strengths Know how to make them happen (agency/resources) Seek pathways that will move them forward There are many paths to my goals None of them is free of obstacles For use for educational purposes ONLY. 4

5 Hope in Healthcare Hope has the ability to help people heal faster and easier Individuals who maintain hope, especially when battling illness, significantly enhance their chances of recovery When healthcare providers recognize the importance of hope in the recovery process they can instill hope in their patients, enabling them to develop healthy coping strategies and therefore improve their physical and emotional well-being Hope has strong psychological benefits, helping them cope more effectively with their disease Hope motivates people to pursue healthy behaviors for recovery Patients who maintain high levels of hope have improved prognosis for life threatening illness and an enhanced quality of life Belief and expectation, which are key elements of hope, block pain in patients suffering from chronic illness by releasing endorphins and mimicking the effects of morphine --Charles R. Snyder and K. A. Herth (Psychologists) The Changing Face of Hope: Moving from Cure to Care Hints for Healthcare Providers Present realistic odds; avoid false hope Name those odds in an encouraging way: You have a good chance at surviving this, which makes the treatment worthwhile. VS Only 25% of people survive after 5 years from onset regardless of treatment. With new drugs now available, the tumor can shrink and you can go into long term remission, living a productive life. VS We cannot cure it, we can only shrink it temporarily. It will grow back and eventually our drugs won t work anymore. The Dangers of False Hope Denies patient the opportunity to evaluate options, plan, problem solve, and engage for the search for meaning Violates trust (dishonest) Patient suffers from doubt in isolation as few will listen to their concerns and a Stiff Upper Lip Our cultural bias is stoicism Decreases HCP s or caregiver s anxiety while raising the patient s Denies patient s opportunity to share concerns (talk about death) Fosters loneliness in illness and death experience For use for educational purposes ONLY. 5

6 When cure is not possible, where is the hope? Comfort (to be free of pain) Time with loved ones Understanding and comfort from those around Ability to cope Reconciliation Meaningful existence Afterlife Ultimate hope is a transcendent virtue [the object of which] must be located beyond the limits of our finite, corporal, individual existence. This transcendent virtue finding ultimate meaning and is one of the major spiritual tasks of the dying. Structuring an Environment for Hope: Interpersonal Skills in the Search for Hope Contain your own anxiety Examine your own beliefs and allow ownership without a need to share them Create an environment of trust and availability Answer questions honestly, but with tack Provide cure hope when appropriate Shift your role from cheerleader of cure to facilitator of searching for meaning; provide an environment in which the ill or dying person can engage in the search for meaning Help patient shift focus from cure to enhancing quality of life that remains; encourage the fulfillment of yet unrealized desires Allow discussion to turn to death (at patient s lead) instead of insisting on positive thinking; talk of death will not interfere with chances for life (can foster avoidance) Guide the patient in their search through their lives and find that which is meaningful. Provide thoughtful questions, rather than advise from your own world view. Tell me about your life and what you perceive as your major accomplishments? How were you able to cope with setbacks and failure? What is it that you cherish most in the world? Of your relationships, which have been most meaningful? Have you used a belief system to guide your life? (and if so) How does that belief system help you to make sense of what is happening to you now? Be present As much as possible sit facing the patient, at eye level Hold hands if the relationship warrants Be attentive and listen For use for educational purposes ONLY. 6

7 Final Words about Hope Hope is not always present Hope can fade away or we can lose it all together We can always find hope again Hope can be reignited simply by hearing a child laugh or in the gentle embrace of friends Maintaining hope takes effort on our part, but it is worth it Hope can be so strong that it inspires those around us What one hopes for shifts in Illness and Death The activity of hoping, deals with things we can t see or haven t received yet, or both There is hope despite circumstances Where there was no human reason for hope, there she was. --Wendy M. Wright HOPE CONTINUES TO BLOOM --by Joyce Rupp For use for educational purposes ONLY. 7

8 Writing Exercise: What do you hope for? How do you get there? Share with one other person For use for educational purposes ONLY. 8