The Missing “P”: Strengthening Psychodynamic Thinking in Chaplaincy

One of the privileges of serving on certification panels is reading candidates’ theory of integration papers. These papers give us a window into how a chaplain brings together theology, personality, life experience, clinical practice, and the behavioral sciences into a coherent understanding of who they are as a professional caregiver. Yet there is one area that I often find underdeveloped: the psychodynamic dimension of the work.

That concerns me because psychotherapy is not incidental to the identity of the College of Pastoral Supervision and Psychotherapy—it is the final “P” in CPSP. We are not suggesting that every board-certified chaplain should function as a psychotherapist. They should not. Rather, a CPSP chaplain should possess enough psychological and psychodynamic fluency to recognize that something more is occurring in a pastoral encounter than the words being exchanged.

What is happening within the relationship? What is the patient bringing into the encounter from earlier relationships and experiences? What am I bringing into the room? Why does this particular patient evoke anxiety, protectiveness, frustration, sadness, or an unusual desire in me to fix the situation? Are transference or countertransference at work? What defenses might be protecting this person from an unbearable reality? Am I responding to the patient’s needs, or am I unconsciously responding to something within my own story?

These are profoundly important questions for clinical chaplaincy. Psychodynamic understanding invites us to listen beneath the words—to become curious about unconscious processes, defense mechanisms, attachment, relational patterns, boundaries, and our own use of self. It gives us another lens through which to understand the person before us while also requiring us to examine the person we bring into every pastoral encounter.

This emphasis is one of the important contributions CPSP brings to the larger community of professional chaplaincy. Our theological identity and pastoral skills matter deeply, but so does our capacity for psychological self-awareness. A theory of integration becomes much richer when a chaplain can articulate not only what I believe and what I do, but also what may be happening psychologically between the patient and me—and how I understand and responsibly use myself within that relationship.

I recently shared the following reading list with a certification candidate whom I encouraged to become more fluent in the “big P.” These are not books intended to turn a chaplain into a therapist. Rather, they are resources that can help chaplains think more psychodynamically, deepen their self-awareness, and develop a richer understanding of the therapeutic dimensions of pastoral relationships. Ultimately, that fluency does more than strengthen a theory paper—it helps shape one’s professional identity and practice as a clinical chaplain.

Suggested Reading List

Pamela Cooper-White, Shared Wisdom: Use of the Self in Pastoral Care and Counseling

• Probably the strongest recommendation.

• Explores the use of self in pastoral relationships, including transference, countertransference, unconscious dynamics, boundaries, and relational patterns.

• Helps chaplains understand what may be happening psychologically between caregiver and patient, not simply what is being said.

Howard Clinebell, Basic Types of Pastoral Care & Counseling: Resources for the Ministry of Healing and Growth

• A foundational pastoral-care text that integrates psychological theory, counseling, theology, and spiritual care.

• Particularly helpful for understanding how pastoral caregivers can facilitate growth while remaining within appropriate professional boundaries.

Irvin D. Yalom, The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients

• Very accessible introduction to the therapeutic relationship and the experience of being with another person in distress.

• Helpful for chaplains because of its emphasis on presence, listening, relationship, vulnerability, and attending to what is happening between caregiver and patient in the moment.

• Anything by Yalom is fantastic!

Nancy McWilliams, Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process

• More advanced, but excellent for developing a deeper understanding of psychodynamic and psychoanalytic concepts.

• Introduces defense mechanisms, personality organization, attachment, transference, countertransference, and unconscious processes.

• I would recommend Chapters 2, 5, and 6 first. Read these chapters not for the purpose of diagnosing patients, but to develop greater awareness of unconscious processes, defense mechanisms, relational patterns, and your own emotional responses within the pastoral relationship.