Counseling People with Cancer, by Jann Aldredge-Clanton

December 1, 1998

By Jann Aldredge-Clanton, Counseling People with Cancer. (Westminster John Knox, 154 pp.)

Jann Aldredge-Clanton has taken seriously the challenge of the Westminster/John Knox's series to which her book belongs: to combine counseling and pastoral theology. Her stated counseling thesis is that cancer is devastating, but chaplains pastors and pastoral counselors can "help persons cope with the diagnosis and experience of cancer." Her stated pastoral-theology thesis is that pastoral intervention is necessary in helping persons cope with cancer. Her unstated pastoral-theology thesis is that it is important, and probably necessary, to replace masculine images (including words and stories) with feminine images, since feminine images are both better healing facilitators and better theology. I agree with her counseling thesis. I disagree with, but appreciate, her pastoral theology theses.

Cancer is a highly spiritual illness that is almost always treated (especially by medical personnel) as if it were only a physical disease. It is easy for pastors, awed by the enormity of the cancer diagnosis and of the medical response to it, to accept the disease facet of cancer but ignore its personal, spiritual and social facets. After I was diagnosed with cancer, I was amazed at the number of pastors whose approach was, "Now don't worry; those doctors will have you fixed up in no time." I needed someone to walk with me to the head of "that lonesome valley," not someone to assure me that the engineers were doing a good job fixing the road.

Certain spiritual questions are constants: How can I have hope? What's the difference between true hope and false hope? Am I guilty of something? Am I being punished? Where is God in all this?

Aldredge-Clanton does a good job of reminding pastors and other Christian caregivers to concentrate on these questions. In a clear style that is sometimes a bit too dispassionate and academic for such a frightening subject, she uses examples and verbatims from her own counseling experience to demonstrate the power of sacred images and stories in dealing with issues that all cancer patients face. She knows well the potholes and stumbling blocks patients encounter. One of the strongest features of the book is the stories of patients. The stories will help pastors who have had no personal experience of cancer to understand better the strange, overwhelming and isolated world of the cancer patient and the patient's family.

I am uncomfortable with the author's use of the term "pastoral intervention." Intervention really is different from listening or support. Cancer is a highly individual illness and resists any agenda a caregiver brings to it. In my own experience as a patient and pastor, I've come to respect the ability of patients to move from where they are to where they need to be, emotionally and theologically. Listening and support facilitate that movement better than intervention does.

In walking alongside many patients, I have found that people's gender doesn't determine whether masculine or feminine images will be useful to them. Many women use and appreciate combative visualization techniques, going after cancer cells with tanks, planes, bazookas, Pac-Man and any other handy weapon, while many men eschew such aggressive visualizations. Emmett Kelly, the sad-faced clown, went through my body each day with his diminishing-spotlight broom, sweeping cancer cells away. Wise counselors help patients search their quivers for any arrows that will find the healing mark, be it those of Mars or Cupid.

The book is intended as a tool for pastor-to-patient counseling. Since, however, patient-to-patient support is so important, the book could be strengthened by including more on how pastors can be involved in brokering support from one patient to another through groups and through the use of spiritual exercises and worship/healing events. It does include a ritual for mourning loss and claiming power to use in women's breast-cancer support communities.

Whether one agrees or disagrees with some of Aldredge-Clanton's views, Counseling People with Cancer is a thoughtful and helpful book. It details the cancer experience, draws a clear and useful map for those who would guide patients toward spiritual wholeness, and advances the dialogue between pastoral care and theology.