November 2002 Articles of the Month
Chaplain Supervisors and Research:
Koenig, H. G. "Religion, congestive heart failure, and chronic pulmonary disease." Journal of Religion and Health 41, no. 3 (2002): 263-278. [In this pilot study (since continued with NIH finding), 196 patients with congestive heart failure or chronic pulmonary disease were assessed for physical health, social support, mental health, religious activities and attitudes (i.e., attendance, prayer and scripture study, intrinsic religiosity). Findings included (from the abstract): Religious practices were widespread; 98% had a religious affiliation; 48% reported attending religious services weekly or more; 70% reported praying or reading religious scriptures at least daily; and over 85% consistently indicated intrinsic religious beliefs and attitudes. Religious activities and attitudes were inversely related to measures of physical illness severity and functional disability, and were less common among patients with prior psychiatric problems, hospitalizations for depression, drinking problems, and those currently taking psychotropic drugs. Religious activities (especially religious attendance) were associated with greater social support, but were only weakly related to less depression.]
Iler, W. L., Obenshain, D., and Camac, M. "The impact of daily visits from chaplains on patients with chronic obstructive pulmonary disease." Chaplaincy Today 17, no. 1 (Summer 2001): 5-11. [This study of fifty patients with Chronic Obstructive Pulmonary Disease shows (from the abstract): the relationship between daily visits from the chaplain and several measured variables: anxiety level at time of discharge, length of stay, overall satisfaction with stay, and willingness to recommend the hospital to others.]
COMMENTARY: There is a lot of bad research going around. One can open almost any journal, even peer reviewed journals, and find reports of research projects that are of dubious value, weak in their assumptions, and dependent on over-stated claims.
I have had the good fortune to have been initiated by some experts into the requirements for doing research, though I am still trying to perfect my own skills in order to stay out of the ranks of those referred to above. I have learned some of the basic considerations about undertaking research, and I am going to describe them. I will use the language of the neophyte, because that is what I consider myself to be. I hope that others in the ACPE, like myself, will feel that they too can enter these interesting lands of uncharted territory and return with stories that will enrich us with new insights and new discoveries.
From my first professor, Hugh Parton, I learned the value of observing and entering into dialog with those who had done similar work before me. He took a small group of us--we were his senior students--into the department library and said that he would believe that he and his faculty had done a good job if, by the time we graduated, all we learned was to be able to find our way around in the library, as we were learning to do, observe, and think, and not necessarily always in that order.
From my friend and colleague William McGaghie, I learned that when one ventures into new research territory, it is of fundamental importance that the territory one passes through be fully described. The preparations for the journey, as well as the journey itself, have to be recounted. This is not just so that others can check whether thoughtfulness and careful attention to detail went into the planning and completing of the journey. The descriptive material is of fundamental importance because it allows a reader somewhere else to make their version of the same journey if they wish, in order to be able to compare their journey with the original. Consider, for example, a recent article by Harold Koenig: "Religion, congestive heart failure, and chronic pulmonary disease," in The Journal of Religion and Health 41, no. 3 (2002): 263-278. He describes in detail the procedures that were used and the measures employed in the project concerning religion, physical health, social and mental health, as well as the statistical analysis. There is as much text in the methods section as there is in the results section. The bottom line is that anyone who now wishes to do that study will be able to do so with a high degree of confidence that they are doing what Keonig and his colleagues did.
It is also with McGaghie that I experienced again the value and the challenge of doing research with persons who work in fields other than my own. The different ways of looking at the same territory, often as a result of different professional backgrounds, and certainly as a result of differing personal approaches to issues, makes for rich dialogue and interesting outcomes. As a novice in the fields of health and social psychology and academic medicine, of necessity I ask comparatively "simple" questions which, because they are seriously entertained by my colleagues, sometimes lead us into new paths, which in turn can lead us into clearer ways of articulating ourselves.
At times, depending on the type of research project being undertaken, there may be need for someone with expertise with figures and statistics. A good example of this would be the article by Bill Iler, et al., published in Chaplaincy Today. Iler made full use of a statistician to help validate the relevance of the data that he and his partners had collected. (See "The impact of daily visits from chaplains on patients with chronic obstructive pulmonary disease," by William L. Iler, Don Obenshain, and Mary Camac, in Chaplaincy Today 17, no. 1 (Summer 2001): 5-11.)
Speaking of colleagues, the field of research makes use of--and honors--those who have preceded us in the fields where we seek new insights. It is rare that in any field of research, including pastoral supervision and pastoral care, one is doing such ground-breaking work that no one has been in the vicinity before. The best research reveals an awareness and a recognition of those who have at least contemplated the same research journey, or have even made a scouting journey into the territory. In what is considered by some to be the most influential book concerning the history of science: Thomas Kuhn's The Structure of Scientific Revolutions, first edition, 1962; revised edition, 1970 (Chicago: The University of Chicago Press), Kuhn notes that most of what we think of as research is "puzzle solving" and "mopping up" (pp. 23-24). That is, we are trying to fill in the pieces of a puzzle to help draw together what we want to understand of a bigger picture. (An excellent outline and study guide for Kuhn's book has been prepared by Frank Pajares of Emory University and can be found on-line at http://www.emory.edu/EDUCATION/mfp/Kuhn.html). Kuhn's point underscores our need to be aware of those around us as we do research, and to be in dialogue with them.
From my friend and wife, Judith Miles Brown, I learned the importance of writing the story of one's work in a way that tells a story. As she has reminded me over the years, the purpose of publishing is to share one's discoveries and insights with others, not to make them suffer in the process of sharing our insights and discoveries. Her field of expertise is one of the "hard" sciences, an area that does not easily lend itself to story-telling, and perhaps that is why she keeps telling her students, herself, and me, that keeping the story-line in focus is so important.
From my own experiences, I have learned that there are different ways of doing research. My training as a scientist--I was trained as a chemist--left me believing that there was only one way to discover new knowledge, and that was the particular way of the scientist in the laboratory, where it is possible to control all of the variables in order to determine the cause of whatever one is studying. This, of course, remains one way of making new discoveries, and an important one. But this was before the work of Thomas Kuhn, to whom I referred above. His work at M.I.T. from 1979 to 1991 dramatically changed the understandings that we have about the ways new knowledge is discovered, and the ways those discoveries affect the development of human knowledge. Prior to Kuhn's remarkable book, it was generally accepted that the development of new knowledge using the scientific method was a steady progression where new theory improved upon old theory until ultimate truth and certainty concerning any subject was reached. Science, it was believed, progressed by the accumulation of true facts and the discarding of inadequate theories.
Kuhn showed that science, and the processes involving research, were really much more complicated than this. He distinguished between two kinds of science: normal science, which is the kind that most of us engage in; and crisis (or revolutionary) science, the science that leads to new "paradigms." Yes, Kuhn popularized that word in this essay. Normal science, and the research that supports it, is pursued by a community of people who share a paradigm. A paradigm is a consensus among a community of practicing researchers who are in agreement about certain matters in their field. They agree about the meanings of certain words and concepts, and they agree about the methods that should be used in order to gain new insights, or discoveries. However, it had come to be believed that there was only one way to discover knowledge that could really be counted as truth, and that was the way of the scientist in the laboratory. Normal science was to be intellectually isolated from "outside" influences, including the models of other scientific fields, and certainly non-scientific values and events.
Kuhn's ideas challenged the stranglehold that empirical science had at that time on the "non-scientific" world. Before him, psychologists could not be scientists, the structure of the then scientific method made what they did impossible to be labeled as science. Meditators could not study meditation as scientists because they could not be "objective" about the practice of meditation. Folklorists could not be scientists when they studied stories, because so-many variables would be involved. The essence of Kuhn's legacy has been best described by Malcolm Gladwell: "Kuhn will be remembered because he taught that the process of science was fundamentally human, that discoveries were the product not of some plodding, rational process but of human ingenuity intermingled with politics and personality--that science was, in the end, a social process."
As we begin the 21st century, it is now largely agreed that there are a variety of ways of creating new knowledge, that traditional empirical science is not the only way, and that it may not even be the best way of doing research into some aspects of our world. Ken Wilber, the transpersonal philosopher, has argued--and I believe successfully--that the general principles of the scientific method apply to all types of empirical evidence. He makes the case for a methodological basis for sciences of sensory experience, mental experience, and spiritual experience--sciences of the eyes of the flesh, mind and spirit. There are three ways to obtain valid knowledge within each of these three categories. (See his discussion of "The three strands of valid knowing," in Eye to Eye: The Quest for a New Paradigm (Boston: Shambhala, 1996). He describes the three components in any scientific quest for knowledge--injunction, illumination, confirmation--and shows how these components in any research are used by a person with a microscope, a person wanting to understand why people make decisions in the ways they do, and even persons in contemplative traditions who wish to develop their understandings of meditation.
I believe that we need to be reminded that we do not have to do traditional (a.k.a. empirical) science research in order to benefit our profession greatly. A willingness to observe and to think, to keep detailed notes, to work with colleagues or other professionals when that is possible, to do background work (e.g., reading, talking), and then to present the results as an interesting story--these are ultimately the most important requirements for doing good research.
Kuhn, T. The Structure of Scientific Revolutions. Revised edition. Chicago: The University of Chicago Press, 1970.
Wilber, K. Eye to Eye: The Quest for a New Paradigm. Boston: Shambhala, 1996.
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