PHILIPPINES

My journey into chaplaincy began with my love of good stories. As a child, I was fascinated with stories that stirred my imagination: my oldest brother’s creative sci-fi themed storytelling, the radio shows which were spoken in my native tongue (Bisaya), and the numerous trips to the movie theaters. I was captivated by human stories, biographical stories, ancestral stories, stories of survival and hope. My parents shared with me how my great great grandfather escaped persecution from the ruling Spanish government; how my grandfather prepared for the incoming Japanese occupation; and how my maternal grandmother searched for her lost son during World War 2.

I was born and raised on the island of Negros in a city called Dumaguete - a small university town in central Philippines. Both of my parents were teachers. My father, initially a United Church of Christ pastor, later became a professor at Silliman University, the oldest and only American-founded university in the Philippines. My mother was a committed elementary school teacher who found opportunities to teach wherever my father followed his call in ministry. Both of my parent’s professions in teaching would profoundly influence my career path.

In spite of the economically tumultuous times of the 1980’s, my childhood felt largely safe and secure. My family lived in faculty housing on university grounds, a haven that shielded me from broader societal anxieties. My life was punctuated by the simple joys of innocent exploration, and fun memories of adventurous bike rides with friends in the beautiful green college campus abound. However, intense political drama served as a backdrop to my carefree childhood, permeating adult conversations and news reports. Even as a child, I couldn't help but notice the undercurrent of tension, and the palpable sense of concern for events unfolding beyond our sheltered academic enclave. I also have distinct memories of witnessing adults, individuals I knew and respected within our university community, actively participating in street protests in response to the political violence of the Marcos dictatorship. 

​Complementing these observations of the external political landscape, my spiritual formation during this formative period played an equally crucial role in shaping my understanding of the world and my place within it. My upbringing within a church deeply influenced by liberation theology provided a unique lens through which to view social issues. The theologians within our congregation placed an emphasis on the social gospel, advocating for a faith that was not confined to personal piety but actively engaged with the realities of social injustice, a faith that necessitates a commitment to working towards a more equitable and humane world. 

UNITED STATES

In 1991, shortly after my high school graduation, my life took a significant turn when my father accepted a position as an ACPE supervisor and educator at the Medical College of Virginia (now VCU Medical Center) in Richmond, Virginia. Unlike myself who tend to be more of a homebody, my dad Lucio was a very adventurous man. His decision to move across the globe had its challenges: the early years were financially challenging.  To supplement his part-time ACPE role and make ends meet, he launched and established a Filipino UCC church-start. He and I lived in small apartments in the not so safe areas of Richmond, and for a few months we lived with generous church friends. However, this immigrant experience also yielded advantages. I became a cultural hybrid, fluent in English and two Filipino languages. And I learned early on to embrace liminality while finding myself in between cultures, which made me become comfortable at being a cultural translator and bridge. This skill remains invaluable in my current work as a chaplain within the diverse and religiously varied landscape of American culture.

COLLEGE & GRADUATE SCHOOL

Driven by my fascination with art, culture, and mythology, I pursued higher education at Virginia Commonwealth University, where I majored in Religious Studies and minored in Painting. Following my undergraduate studies, I enrolled at Pacific School of Religion in Berkeley, California, seeking to further synthesize my diverse interests. My choice to focus my M.A. thesis on the spirituality of Vincent Van Gogh, a mental health patient, proved to be an unexpected precursor to my present role as a chaplain in Behavioral Health.

SYLVIA

Meeting Sylvia in seminary marked a profound turning point in my life. Sylvia and I have been married for twenty-three years and have three children (20, 16 and 14 years old). Over the years, we both have found ourselves in the unique position of being continuous co-learners within our respective professional vocations. While Sylvia’s dedication lies within the multifaceted realm of church ministry, my journey has often found me walking alongside her, particularly in areas where my skills and passions could offer support, most notably in the environment of youth ministry. A genius in her field, she is a brilliant practical theologian, preacher, and church leader; and much of the practical knowledge and theological understanding I possess has been cultivated through this enriching and collaborative partnership. Moreover, our growth in ministry also coincided with our vocation as partners and parents. Our personalities, learning styles, ethnicity and culture are different, but we both share the same deep values. Our cultural and personality conflicts in our marriage have been opportunities for mutual learning and a deeper appreciation for one another's perspectives.

CPE

My journey into the field of chaplaincy began somewhat unexpectedly, yet it was also subtly guided by the influence of my father's professional life. Following my graduation from theological seminary, a pivotal moment arose when a friend, an alumnus of a hospital chaplaincy residency program in San Francisco, encouraged me to consider applying. Intrigued, I decided to take the leap and was subsequently accepted into their year-long residency program. Beyond this invitation, my interest in Clinical Pastoral Education (CPE) had been steadily growing, fueled by the frequent discussions my father had about his work as an ACPE supervisor. This combination of a timely suggestion from a friend and a long-standing curiosity sparked by my father's career path set me on the course that would eventually lead me to embrace the calling of chaplaincy. 

STUDENT SERVICES

Fresh out of seminary, newly married, and in my late twenties, my year as a CPE student was a period of significant personal and professional development. Then I took an unexpected hiatus for nine years, during which I served as a campus chaplain. As a student services staff member at my graduate school (eventually becoming the Assistant Dean of Students), I continued to cultivate skills in active listening and mindful presence. My focus shifted from patients to academic students and seminarians navigating their degrees. Notably, a significant aspect of my work in academia involved providing pastoral care to students facing mental health challenges, a foreshadowing to my current role in Behavioral Health. Although my ministry took place outside of a healthcare environment, I remained committed to the CPE action-reflection learning model. For many years, I engaged in close collaboration with a therapist, focusing on enhancing my professional skills as well as my roles as a husband and a parent.

Following the economic challenges the Great Recession of 2008 brought to higher education, I concluded my academic career. In 2013, I was ready to move on to something different and left my job in higher education for good. The subsequent two years involved a period of exploration, and juggling three different roles. I became a stay-at-home dad for my children, then aged 3, 5 and 9 – a truly cherished chapter of my life as a parent. Concurrently, I enrolled in pre-nursing science courses at San Francisco State University, briefly considering a career in nursing before deciding to discontinue my studies after a few semesters. Additionally, I worked part-time at a senior care facility, providing support to individuals living with dementia.

ALBUQUERQUE

In 2015, my spouse and I decided to relocate to Albuquerque, New Mexico, eager to build a life closer to our extended family (my in-laws have resided here since 1986), and to escape the exorbitant cost of living in Berkeley and the wider Bay Area in favor of greater economic stability. Fortuitously, after our arrival in Albuquerque, a hospice position became available. This felt like a meaningful return to my healthcare roots after a thirteen-year break, bringing my professional healthcare journey to a full circle.

HOSPICE

As a Bereavement Coordinator in hospice, I rediscovered my passion for listening, supporting, and guiding individuals, particularly those in grief. This role also reignited my interest in facilitating support groups, a skill I previously utilized while supporting seminary students. Eager to excel in grief support, I actively sought out learning opportunities from various agencies in the Albuquerque area to understand and integrate best practices. Upon joining the regional office, I spearheaded the development and implementation of both virtual and in-person grief support group programs for grieving families, establishing a resource that had not existed before my arrival.

PRESBYTERIAN HOSPITAL

In June 2021, I secured my current hospital chaplain position. This move wasn't driven by a desire to leave grief support in hospice. I applied for an open chaplain role with the hope of passing my grief support position to a friend, who had moved from California to New Mexico and underwent a prolonged unsuccessful job search. Fortunately, things unfolded as I envisioned: Presbyterian Hospital hired me, and my friend found a job. Although hired, I was unexpectedly assigned to Presbyterian's smaller "Kaseman" campus, known mainly for its Behavioral Health inpatient unit and some outpatient services, rather than the main hospital campus with most of the inpatient units, where I had anticipated working.

My current role has surprisingly become my ideal job, a confluence of my diverse life skills and experiences. I had previously believed that my personal and academic passions—mythology, art, and music—were relegated to the realm of hobbies, separate from my professional life. However, in my present position, these interests and abilities seamlessly integrate. Within the Behavioral Health spiritual care support groups I lead, I've successfully created a robust curriculum that blends narrative wisdom with multi-sensory learning methods, incorporating music, art, and mindful movement.

My ability to lead spiritual care support groups aligns with my spiritual vocation. Recognizing that some patients may be wary of overtly religious individuals, I strive to embody an impartial and open-minded spiritual presence. Conversely, for patients who connect with explicit Christian expression, my deep roots in the Episcopalian and United Church of Christ traditions offer reassurance of my theological foundation and integrity. Individuals identifying as agnostic, atheist, or having no religious affiliation who join my support groups relax, lower their defenses and become receptive to receiving support once they understand my pluralistic perspective and exposure to diverse religions and spiritualities. I have cultivated the spiritual care support group as a neutral and supportive space where people from diverse backgrounds—religious and non-religious, theist and atheist, Christian and non-Christian—can connect. Within this nurturing environment, participants find common ground in their shared human experiences while respecting and valuing their distinct spiritual and religious beliefs.

LUCIO (DAD) - THE CPE SUPERVISOR

The definitive confirmation of my calling to hospital chaplaincy, as opposed to roles such as university professor, pastor, or nurse, occurred in May 2021, at the conclusion of my father's battle with cancer. To provide context: In 2010, my parents returned to the Philippines, my childhood home, for their retirement. Ironically, my father’s retirement plan at the age of 72 was to establish a Clinical Pastoral Education (CPE) program at the university where I grew up. As the pandemic began in 2020, I regularly spoke with him virtually to learn about his CPE teaching and supervision at Silliman University Medical Center. As his energy was waning, he expressed relief that his supervision sessions had transitioned online, and he appreciated being spared by the daily commute to the hospital. When he was eventually hospitalized, we learned that his liver cancer was advanced. In his final days, I called him daily via Zoom, offering spiritual care to a man whose life was dedicated to chaplaincy. He reflected on his life journey, recounting how he, the youngest of twelve, had defied his parents' expectations by leaving farm life to pursue education, become a minister and academic, and to work in the United States for twenty years to pursue his passion. In his final hours, my brothers and I sang to him, including a favorite lullaby which he sang to us during our childhood. His passing illuminated what a profound gift it was to provide spiritual care to someone so devoted to chaplaincy. It felt as though my long path toward this vocation reached a critical moment at my father’s death bed. Supporting him in his final moments affirmed my readiness to embrace his legacy and dedicate my life to chaplaincy. My father was a compassionate and selfless man who never pressured me to follow his career path. Consistent with his role as a CPE supervisor, he guided me gently, allowing me to explore, struggle, and discover my own way. Ultimately, I found a vocation akin to his, yet uniquely my own. May it be so.

Effective spiritual care support groups thrive on participants connecting through shared human experiences of struggle and crisis, rather than diverging into personal opinions. Myths and parables, rich with universal archetypes, offer a powerful means for individuals to contextualize their personal struggles within a broader narrative, gaining new perspective and meaning. These meta-narratives provide a framework for understanding the profound emotional and existential challenges individuals face, allowing for a collective exploration of human vulnerability and resilience. By tapping into these universal patterns of human experience, spiritual care providers can facilitate a more profound and empathetic connection among group members.

Consider the common archetype of a journey with unexpected obstacles, leading to feelings of being lost, stuck, helpless and disoriented. This theme resonates deeply with spiritual care group participants and fosters empathy (as highlighted in my previous blog "4 Spiritual Themes for BH") because it gives the support groups participants the opportunity to hear others share stories of how they have navigated similar challenges. The initial sense of isolation that participants experience in their mental health struggle transforms into a powerful realization from "No one understands the journey I’m going through” to “through our shared communal reflection on this spiritual theme, now I see we're on this journey together and can support each other." This shared understanding cultivates a sense of peace, safety, connection, and hope, enabling participants to listen to each other's stories with empathy. Thus, the journey archetype offers a powerful metaphor for life's unpredictable twists and turns, allowing individuals to see their current struggles not as isolated events, but as integral parts of a larger, shared human narrative that life’s journey is rarely (or never) a straight line, and that getting stuck and disoriented is a part of the human condition. This recognition can be incredibly liberating, shifting the focus from isolated, subjective individual experience to universal human experience.

However, some spiritual care curriculums err by allowing participating patients to dictate topics, sometimes leading to theological opinion discussions, such as "Is suicide a sin?" While such a question might be important to the person bringing it up, such discussions are often counterproductive in a support group setting. They can quickly devolve into opinion-based discussions and arguments, which are not the purpose of spiritual care support groups. The goal of spiritual care support groups is to foster connection and provide support through shared experience, not to engage in theological disputes. When a group veers into personal theological interpretations and opinions, it often creates divisions rather than connection, potentially alienating members with differing beliefs and undermining the very foundation of empathetic support.

As a chaplain, I would argue that such theological or religious belief-specific questions are better addressed in one-on-one chaplain visits and conversations. A one-on-one visit with a patient allows chaplains to explore the underlying existential distress prompting the question, and to offer "theo-empathy." If/when called for, chaplains can then provide alternative theological frameworks that provide spiritual nourishment, agency, and freedom, ultimately helping patients move towards flourishing and thriving. In a private visit, chaplains can delve into the nuances of an individual's spiritual worldview, offering tailored guidance and support that is sensitive to their unique needs and beliefs. This personalized approach ensures that complex theological inquiries are met with compassionate understanding and healthy reflections, leading to genuine spiritual growth and insight rather than superficial debates.

Closing Remarks
Facilitators of spiritual care support groups should prioritize using time effectively to foster connection, empathy, insight, calm, and safety. One practical way of avoiding conversations getting enmeshed in debates and opinions is to not let the participants become “run-away trains” in support groups. It is vital for facilitators to claim their pastoral authority and redirect the group from superficial, opinion-based chit-chats towards communal sharing of their human experience. Utilizing spiritual themes and archetypes, such as the journey archetype, to reflect on universal human struggles is a far more beneficial use of group time than debating personal religious beliefs (e.g., the existence of God, the sinfulness of suicide, opinions about the afterlife, "I believe in this particular interpretation of scripture"). An effective spiritual care support group empowers diverse expressions of spirituality and religiosity, highlighting their potential as healthy coping mechanisms for participants to explore. By focusing on the shared human experience of suffering and resilience, and by utilizing the universal language of archetypes and stories, spiritual care support groups can create a truly inclusive and transformative environment where individuals feel seen, understood, and supported on their unique spiritual journeys. This approach not only strengthens individual coping mechanisms but also cultivates a profound sense of communal belonging and shared purpose.

Because mythology (as meta-narratives) transcends our individual struggles, they provide a wide lens or framework to view of the intricate landscapes of our lives, illuminating the highs and lows, the peaks and valleys, the challenges and the triumphs, the winding paths and unexpected detours that we encounter. By recognizing these universal patterns within the stories, we can connect our personal struggles to a larger narrative, gaining a higher perspective or a newfound vantage point allowing us to contextualize our experiences within a broader tapestry of meaning, and find the language to articulate our experiences, giving voice to the often ineffable emotions and anxieties that accompany a spiritual crisis. In other words, the language of these stories, imbued with archetypal symbolism, gives voice to our existential wrestling with profound questions of isolation, mortality, freedom, and purpose. It tames the wildness, chaos and uncertainties of life.

Spirit Play (or Godly Play) storytelling facilitates this expanded perspective. By physically interacting with the story as it unfolds on the floor, participants are invited to observe its contours and landmarks, ​but from a safer distance, a kind of a ​bird's-eye view. The gap between the observer and the narrative creates space for reflection, allowing individuals to identify with elements of the story while maintaining a healthy distance from their own thoughts, feelings, and reactions. In essence, they learn to distinguish between the self and the experience, recognizing that they are not merely their reactions but also the silent watcher who observes them. Therefore, Spirit Play helps participants to move beyond a survival-oriented response to pain, towards a place where painful stories can be retold within a larger, more inclusive narrative. This process facilitates the metabolization of pain transforming it into something that can be utilized for one's learning, growth and healing. 

​Below are some of the few significant archetypal patterns that BH patients reflect on in spiritual care support groups that I facilitate.  

(1) The Journey Archetype
In Behavioral Health, many patients find resonance with the ancient and universal archetype of the journey, particularly its theme of overcoming obstacles. This resonates deeply with them because the human experience, especially when navigating mental health challenges, often mirrors the struggles and triumphs of the character who is journeying through a life struggle.

​Within this mythological framework, the traveller frequently encounters a "threshold" – a liminal space where they may feel temporarily stuck, lost, disoriented, or profoundly overwhelmed by the weight of their circumstances. This threshold represents a critical juncture, a point of significant challenge and potential transformation. To successfully navigate this crucial threshold and progress on their personal quest, the traveler in the archetypal narrative typically benefits from the support of a guide or helper. In the context of behavioral health, this "guide" can manifest in various forms: a therapist, a supportive family member, a spiritual guide/mentor, a community resource, or even an internal awakening of self-awareness. The support may include any of the following: physical support, encouraging words, helping the traveler recall their inherent strengths, fostering self-wisdom or insight, helping the traveler see by revealing readily available tools, or broadening their perspective beyond a narrow focus to illuminate the path towards clarity, and renewed inner strength and agency.

(2) Darkness to Light Archetype (Not Seeing to Seeing)
The journey from darkness to light is a universal human archetype, deeply rooted in mythology. It mirrors our progression from ignorance to understanding, from not perceiving the complete picture to finally seeing the full scope of possibilities. This transition often brings anxiety and discomfort as we venture into the unknown. Stepping into new, expansive territory demands adaptation to a transformed landscape. It signifies a movement from stagnation and lifelessness towards growth, flourishing, and vitality.

However, this is a process that cannot be rushed. Attempting to accelerate it is counterproductive. Instead, one must allow the process to unfold naturally, at its own pace and in its own season. The key is to lean into the inherent flow of this natural transformation and truly embrace the journey of becoming.

(3) The Archetypes to Represent Fear
Therapists often highlight the amygdala as a vital part of our ancient brain, a friend that keeps us safe during moments of danger. However, repeated exposure to intense threats and danger can cause it to continue firing signals of potential danger even when we are safe. This overactivity is a common struggle for many behavioral health (BH) patients, who are often overwhelmed by fear and anxiety. Consequently, archetypes embodying the amygdala and fear resonate deeply with them.

In mythology, the amygdala is frequently symbolized by raw, animalistic representations: predators like tigers, wolves, reptiles like snakes or crocodiles, or mythical creatures such as dragons (reptiles with wings). More modern interpretations of this character portray humans transformed into monsters, driven by predatory and primal impulses (like the undead: zombies & vampires). 

Therefore, learning to tame and regulate the amygdala is an essential skill. When fight-flight response hijacks our body, we are unable to see the whole picture. Our attention narrows and is hyperfocused on the perceived threat. So what are our to-do’s when anxiety and fear are loud, overwhelming our senses? Who do we go to for support and guidance? What wisdom do we need to avoid being paralyzed by fear?

(4) The Storm Archetype​
Our struggles with emotional and mental health are often invisible, felt primarily within our bodies. They can overwhelm us, occupying our minds and hearts like uninvited guests with free rent space. The archetype that is readily accessible to BH patients is that of a storm because it best describes this experience. With the storm archetype, one is encouraged to face the storm rather than retreat. It means openly welcoming the storm, embodying patience and then allowing it to pass. It includes the skill of bending and flowing; hence any rigid attempts to resist, cling tightly, or wall ourselves to control the flow will ultimately lead to negative consequences.

Facilitating support groups within the realm of behavioral health (BH) presents a distinct set of challenges and opportunities, primarily stemming from the neurodivergent nature of the participants. This unique composition often leads to a spectrum of engagement, ranging from highly vocal and active participation to quiet and minimal interaction. Effective facilitation in this environment requires a nuanced understanding of these dynamics and an adaptive approach that prioritizes participant autonomy and a truly safe space.

At the outset, it is worth noting that having the support of behavioral techs and volunteers is invaluable in my role as a support group facilitator. This logistical assistance allows me to fully concentrate on leading the group, as I can delegate other concerns, such as restroom breaks or assisting a patient who needs to return to their unit or room, to the BT and/or volunteer.

Highly Engaged Participants
In many BH support groups, facilitators will encounter individuals (perhaps in manic episode) who are highly talkative, sometimes to the point of monopolizing the conversation. These "run-away trains" can be frustrating for facilitators who are accustomed to neuronormative communication patterns in groups, wherein participants are capable of tracking the time length of their sharing. In such instances, proactive and empathetic intervention from the facilitator is not just beneficial, but crucial for maintaining group cohesion and ensuring equitable participation.

To manage highly engaged participants effectively, facilitators should employ these strategies:

• Utilizing a Talking Object: Implementing a designated talking object, such as a stress ball or a small decorative item (such as an electric candle), can serve as a powerful visual and tactile cue. Only the person holding the object is permitted to speak. This tangible rule provides a clear boundary and helps to slow down the pace of conversation, allowing others to prepare their thoughts and find their voice. 
• Reinforcing Group Guidelines on "Shared Conversation Space": From the outset, group guidelines should explicitly emphasize the concept of a "shared conversation space." This means reminding participants that everyone deserves an opportunity to contribute and that no single individual should dominate the discussion. When a participant becomes overly talkative, a gentle but firm reminder, such as, "Thank you for your valuable insights. Let's ensure everyone has a turn in our shared conversation space," can be effective.
• Intentionally Ensuring All Participants Have an Opportunity to Share: Beyond simply setting boundaries, facilitators must actively create opportunities for quieter members to speak. This might involve directly inviting individuals to share their thoughts, "Sarah, we haven't heard from you yet, would you like to add anything?" or setting a timer for each person's sharing time. It's important to do this in a way that feels supportive rather than pressuring, always offering the option to pass.

Low-Functioning Participants
Conversely, some BH support groups may be non-conversational, exhibiting a pervasive quietness, with participants sharing minimally or even declining to speak when directly invited. This can stem from various factors, including participants being in the midst of a depressive episode, experiencing heightened anxiety, experiencing psychosis, catatonia, or simply being in a state of low functioning due to their neurodivergence. It's crucial for facilitators not to interpret this silence as a lack of engagement or disinterest, but as a valid form of presence and processing given their current mental state. 

Autonomy: Redefining "Good Participation" in BH Support Groups
In BH support groups, it is absolutely vital to discard traditional, neuronormative expectations of "good participation." In conventional settings, this often translates as assumptions that participants should be capable of stillness, articulate and coherent sharing, deep self-reflection, and strict adherence to the topic at hand. While neuronormative group discussions may sometimes still happen in BH support groups, neurodiverse contexts demand a much wider and more inclusive spectrum of participation, acknowledging that engagement manifests in varied and unique ways.

• Self-Regulation through Body Movement (Stimming and Walking): Many neurodivergent individuals utilize movement, known as "stimming" (self-stimulatory behavior), as a crucial self-regulation mechanism. This might involve fidgeting, rocking, or even walking around the periphery of the group. Facilitators should recognize these behaviors not as disruptive, but as essential tools for participants to manage sensory input, anxiety, or internal states. Rather than attempting to suppress these movements, a supportive environment embraces them, understanding that a comfortable and regulated participant is more likely to process information and feel safe. (Also, work with you BH team to see if a particular patient needs a self-regulation object or sensory tool, and how that person can access it while participating your group session).
• When Sharing Goes Off Topic (Tangential Sharing): In neurodiverse groups, sharing might veer off-topic. What may seem like a "tangent" to a neuronormative observer can, for a neurodivergent individual, be a highly relevant connection or a necessary pathway to expressing a core feeling or experience. In their intervention, facilitators should adopt a calm, non-judgemental and affirming tone: 

                  (1) Acknowledge and Affirm: "Thank you for sharing that, I appreciate you opening up." Or “Thank you so much
                        for your sharing - that seems to be very important to you.”
                  (2) Gently Redirect: "That's an interesting point. Bringing it back to our topic of coping strategies, how does that
                        relate to what we're discussing?" This approach validates the participant's contribution while gently guiding
​                        the group's focus back to the conversation.

• Quiet, Non-Conversational Participants: Perhaps one of the most significant shifts in perspective for facilitators is understanding that participants have the absolute autonomy to decline to speak. Their silence does not necessarily signify a lack of internal processing, engagement, or benefit from the group. For some, merely being present, listening to others' experiences, and feeling a sense of belonging is a form of participation and healing. As a facilitator, it is crucial to emphasize that their mere presence is sufficient. A gentle phrase like, "It's perfectly okay if you don't feel like sharing today. Your presence here is valuable, and perhaps you're here to simply listen, and that's just as important," can be incredibly affirming.
• When the Group is Silent During Reflection/Sharing Rounds: On occasion, you as a facilitator, may get a silent response from your group. When this happens you may continue to encourage participants in this manner: “I encourage you to continue to reflect on this particular theme, either through the worksheets, or by checking in with me in a 1-on-1 visit. Also, you could always return to this story and theme at a later time in your journey - even after you get discharged.”
• Freedom to Choose Where to Sit: While participants are encouraged to sit in a group circle, they have the agency to choose where and how to sit in the meeting space. Some may find sitting on the floor more relaxing and grounding, while others might feel safer outside the circle. For those who opt for distance, I always check in: "You're welcome to stay where you are. Can you hear me and the group from that distance? I want to ensure you can see and hear the conversation or activity." Moreover, during reflection rounds I make sure to invite them to share/speak even if they are outside of the circle. This approach respects individual comfort and safety needs while maintaining inclusivity.
• Choice to Exit - Self-Care as a Priority: BH support group participants should have the agency to prioritize their well-being above all else. If a participant feels unwell, overwhelmed, or triggered, they should be free to exit the group. The choice to exit should be viewed and framed not as a failure or a sign of weakness, but as a vital act of self-care. Facilitators can communicate this proactively by stating, "Remember, if at any point you feel the need to step out and take a break, please feel free to do so. This is a space for self-care, and sometimes that means knowing when to step back." Bear in mind that a participant's decision to leave a behavioral health support group doesn't necessarily reflect on your abilities as a facilitator. BH patients are often dealing with internal (mental-emotional) illnesses that have non-physical or invisible symptoms.

Validation and Affirmation to Create Safe Space
Creating a truly "safe space" is paramount in BH support groups. This extends beyond merely setting boundaries and involves cultivating an atmosphere of radical acceptance and non-judgment. Group guidelines should explicitly state the importance of mutual respect. Put-downs, derogatory language, or any form of invalidation are never acceptable. While unforeseen triggers can occur despite best efforts, facilitators are crucial in clarifying miscommunications and facilitating reconciliation if necessary.

Beyond the "safe space" boundary, facilitators must actively avoid judging participants' sharing based on its perceived relevance to the topic or its level or depth of self-reflection. In a neurodiverse setting, literal interpretations, abstract connections, or seemingly unrelated sharing are not only acceptable but expected. Every unique thought process, every individual experience, and every distinct way of communicating is to be respected and affirmed. This unconditional acceptance is the bedrock upon which trust is built and healing can occur.

Avoid Exclusively Relying on Intellectual Discussions
In the diverse neurobiological landscape of BH, I strongly encourage facilitators to move beyond the exclusive reliance on intellectual discussions and traditional group reflections as the primary methods of engagement. While these approaches undoubtedly hold a place in therapeutic settings, their singular focus can inadvertently exclude or limit the participation of many BH patients. For individuals with neurodevelopmental differences, trauma histories, or various cognitive processing styles, verbal processing and analytical reflection may not always be the most accessible or effective avenues for expression and healing.

Instead, it is paramount to create opportunities for BH patients to engage in a variety of ways, fostering a more inclusive and effective support group environment. This multi-modal approach acknowledges that healing and connection can manifest through various forms of expression and sensory experience. Consider integrating the following tools and modalities:

(A) Music: The power of music transcends words, offering a direct pathway to emotions, memories, and a sense of shared experience. Facilitators can utilize music in numerous ways:

• Thematic Songs/Music: Playing selected pieces that resonate with common group themes, encouraging participants to reflect on how the music makes them feel or what it brings to mind. In my sessions, I invite people to choose a song based on a few options or selections related to the spiritual theme. 
• Informal "lectio divina": After a song is sung or played, invite your participants to share a word of phrase that resonated with them based on the lyrics, and if they would like, briefly share why that world/phrase might be meaningful to them.
• Rhythmic Engagement: Incorporating simple rhythm exercises or drumming circles to promote grounding, connection, and a sense of unity.
• Native Flute: Sometimes playing a musical instrument (like a native flute) for short minute helps ground and regulate the whole group emotionally.  

(B) Poetry: Poetry, with its evocative language and metaphorical depth, can provide a powerful yet often less direct means of communication.

• Shared Readings: Reading poems aloud that touch upon themes relevant to the group (e.g., resilience, grief, hope, self-discovery).
• Writing Prompts: Encouraging participants to write their own short poems, haikus, or free verse on a given theme, without pressure for perfection or performance.
• Informal "lectio divina": After reading a poem, invite your participants to share a word of phrase that resonated with them, and if they would like, briefly share why that world/phrase might be meaningful to them.

(C) Art: Visual arts offer a potent non-verbal language that allows individuals to externalize internal experiences, emotions, and thoughts without the need for linguistic articulation.

• Drawing/Journaling: Providing materials for free drawing or structured art prompts to reflect on the focused spiritual theme(s) of the session.
• Collage: Utilizing magazines, newspapers, and other materials to create visual representations of feelings, goals, or challenges.
• Sculpture/Clay Work: Engaging with tactile materials can be particularly grounding and expressive, allowing for the formation of three-dimensional representations.
• Process, Not Product: Emphasize that the value lies in the creative process and expression, not in producing a "good" piece of art.

(D) Meditative Breathing Tools: These techniques are foundational for self-regulation, grounding, and cultivating present-moment awareness, which are crucial for emotional well-being.

• Guided Breathwork: Leading participants through simple breathing exercises like diaphragmatic breathing, box breathing, or alternate nostril breathing.
• Mindful Awareness: Focusing attention on the sensation of the breath as an anchor to the present moment, helping to reduce anxiety and intrusive thoughts.
• Body Scans: Guiding participants to bring awareness to different parts of their body, noticing sensations without judgment, which can be particularly helpful for individuals with trauma.
• Singing (Meditation) Bowl: When facilitating breathing exercises, I have found the meditation bowl effective in inviting participants to take a deep breath. It serves as a gentle reminder to return to their breath after intellectual reflections or conversations.

In my groups, when appropriate I insert in between reflection rounds a non-cognitive activity (say, a song, or a breathing tool using a meditative bowl, or a flute). This gives the group the opportunity to pause and move away from intellectual analysis mode. Integrating these diverse modalities makes the support group space inclusive to neurodivergent participants whose natural and preferred ways of participation often do not fit neuronormative expectations. By offering different engagement options, facilitators can ensure that every individual has the opportunity to connect, process, express, and heal in a manner that honors their unique neurological wiring and personal comfort level, ultimately fostering a more supportive, empathetic, and effective therapeutic environment. This approach recognizes and celebrates the inherent diversity in human experience and expression, moving beyond a one-size-fits-all model to truly meet participants where they are.

On Spiritual Care Notes for Epic
While I strive to foster an environment of radical welcome, inclusivity, and acceptance in spiritual care support groups, it is also important to observe patient behaviors during sessions that can offer valuable insights to physicians for their mental health assessments. Positive behaviors are straightforward to document in Epic. However, when challenging behaviors warrant particular attention, I detail them in my notes, such as these examples:

• "The patient exhibited disruptive tendencies, frequently interrupting others, but was receptive to redirection."
• "The patient's physical actions indicated active engagement with their hallucinations."
• "The patient shared very little, declining opportunities to speak during group reflections."
• "The patient departed from the group well before its conclusion."

When appropriate I also include notes about the participants healing intentions and goals. 

Closing Remarks
I have seen low functioning patients in psychosis dance and sing to the song and music related to the reflection theme. A patient who was very quiet and non-conversational produced a vibrant and colorful reflection drawing of the session's spiritual theme. A patient with increasing anxiety in his body stepped out of the group circle for a couple of minutes to self-regulate using tai-chi movements. While having disorganized speech, a patient diagnosed with schizophrenia expressed appreciation for the songs and music, especially the native flute. During the day of his discharge, a seemingly disinterested teen, who consistently kept his distance from the group circle, requested a brief meeting to share his appreciation for the wisdom stories he heard during the support group sessions.

This means that embracing these values and adopting these facilitation techniques enhances a facilitator's ability to lead groups in the neurodiverse environments of BH. This approach goes beyond mere tolerance; it actively empowers neurodivergent individuals to participate authentically, without the pressure of conforming to neuronormative social expectations and standards. For facilitators, these principles offer a liberating opportunity to release ingrained assumptions about "correct" behavior and instead embrace the rich tapestry of human experience and expression that defines neurodiversity. By fostering environments where every individual feels seen, heard, and valued for who they are, we can truly unlock the transformative power of behavioral health support groups.

As I reflect on my journey in chaplaincy, I have noticed that much of my understanding of foundational skills, specifically, cultural competency, is shaped by my bicultural experience as an immigrant to the United States, my marriage and my academic studies. I am a preacher's kid who grew up in the United Church of Christ both in the Philippines (UCCP) and, after immigrating at the age of 17, the UCC in the United States. As an immigrant, I am a cultural hybrid who is able to speak three languages fluently. I am in an interracial and intercultural marriage after marrying an American Episcopalian priest who grew up in the Evangelical Lutheran Church in America (ELCA) tradition. Hence, I can easily swim back and forth between low church culture and high church culture. While continuing to be rooted in Christianity, I am fortunate to have studied and explored different global faith traditions, first, as a Religious Studies major in my undergraduate studies, and second, in graduate school. All these experiences of crossing boundaries of culture, religious and theological frameworks have shaped my understanding of the significance of cultural competency in my work as a chaplain.

Chaplaincy is a very fascinating work in the realm of spirituality and religion in that while a chaplain might have their own spiritual (or religious) belief that shape their understanding of their life and the world, a chaplain's encounter with someone in emotional-spiritual struggle is person-centered. This means that while the spiritual caregiver needs to be fully aware of the spiritual-religious and cultural lenses that have shaped them and that they carry into the conversation, the chaplain's main job is to empathize as best they can with the spiritual-emotional world of the person in crisis. Subsequently, this means that the chaplain needs to have some level of cultural competency in providing spiritual care by entering into the spiritual-religious framework of the patient, and supporting them in drawing out resources from the patient's own spiritual well. In other words, the chaplain's role is to be open and curious companion-guide in helping the patient articulate their spirituality whatever that may be so the struggling person can find their bearings in a time of emotional-spiritual vulnerability and disorientation. 

In my work as a hospital chaplain, two metaphors - that are shaped by my experience and social context ​- help me frame the skill of cultural competency: food & the chameleon.

THE APPRECIATOR OF DIVERSE CUISINES
If spirituality is a source of nourishment like food, then the diverse spiritual and religious practices and beliefs are the cuisines. However, chaplains do not dictate or enforce what people should consume. We are not proselytizers of cuisines (i.e., religions). We are there mainly to be present and understand what cuisine(s) people use to nourish themselves to thrive, or what flavor(s) they prefer. When the person has allergies, and the food (or cuisine) is making them ill or not helping them thrive, then I bring this up to their attention.
​
While it is certainly impossible to learn all cultural cuisines (i.e., religions, spiritualities and theologies), chaplains who have more exposure to the diverse flavors of spiritualities and religions are the ones who are more able to  meet the spiritual needs of a population in a religiously pluralistic context. When a chaplain understands the spiritual lingo of a person in emotional pain, it is much easier to connect by using “spiritual” or “religio-theological” empathy. The general contrasting flavors that I, as a chaplain, pay attention to in the spiritual-religious menu in North American context include, but are not limited to, the categories below (NOTE: These categories are not strict binaries; rather I see them as a spectrum, and would go so far as to say that some spiritualities and religions may not fit these categories at all - there are aspects of spirituality/religion that are too complicated to categorize in a box):

Contrasting flavors (a few categories):​​
          1) High Church vs. Low Church
          2) Eastern Spirituality vs. Western Spirituality 
          3) Theist vs. Non-Theist/Atheist/Agnostic (Article #1, #2 )
          4) Religious vs. Spiritual But Not Religious (Article #1, #2)
          5) Christianity: High Christology (Christ as divine) vs. Low Christology (Christ as human)
          6) Mono Spiritual/Religious vs. Poly Spiritual/Religious​

The journey through grief is often disorienting, a swirling vortex of sadness that can be overwhelming. In the first year following the loss of my dad and brother, the pain was acute. Like many in the early stages of grief, I couldn't fathom a life of thriving without them.

Reaching out to grief counselors and support groups was essential. These guides normalized my experiences, validating the continual shock and disbelief that felt like waking up to a recurring nightmare. They affirmed my grief symptoms, and at the right times, gently encouraged me to broaden my perspective, to see the larger landscape of life's journey.

They reminded me that we are all sojourners on this earth; life has a beginning and an end. There are hellos and goodbyes. Wisdom stories and mythologies offer maps for those times when we're ready to see beyond our immediate pain.

The moment of glimpsing that wider landscape beyond the darkness of grief is truly a moment of grace. It is akin to the experience described in the hymn "Amazing Grace" — a transition from lost to found, from blindness to sight. Grief can feel like being lost in a dark valley, but with support and guidance, it's possible to find a path forward. The journey may be long and arduous, but moments of grace and glimpses of a wider perspective can sustain us along the way. These guides, or "sherpas," help us navigate the challenging terrain of grief, reminding us that even amidst the deepest sorrow, there is hope for healing and a future filled with meaning.

Compass & Maps
Spiritual crises can be profoundly disorienting, shaking the foundations of our beliefs and leaving us adrift in a sea of existential doubt and feeling alone. However, the wisdom embedded in these ancient tales reminds us that we are not alone in our questioning and that countless others have grappled with these same profound questions throughout history.

In the face of such turmoil, wisdom stories, parables, and mythology can serve as invaluable compasses and maps, guiding us through the storm of our personal odysseys. When the ground beneath us feels unsteady and the horizon uncertain, these narratives offer a lifeline, connecting us with a larger story, a meta-narrative that transcends our individual struggles. This wide lens or framework helps provide a view of the intricate landscapes of our lives, illuminating the highs and lows, the peaks and valleys, the challenges and the triumphs, the winding paths and unexpected detours that we encounter. By recognizing these universal patterns within the stories, we can connect our personal struggles to a larger narrative, gaining a higher perspective or a newfound vantage point allowing us to contextualize our experiences within a broader tapestry of meaning, and find the language to articulate our experiences, giving voice to the often ineffable emotions and anxieties that accompany a spiritual crisis. In other words, the language of these stories, imbued with archetypal symbolism, gives voice to our existential wrestling with profound questions of isolation, mortality, freedom, and purpose. This spiritual vocabulary do not make life's uncertainties and unpredictability disappear, but through this language it gives life's sojourner agency, thereby making the chaos less of a threat.

Awareness at a Higher Vantage Point
Instead of just staying in survival mode, merely running and auto-piloting, seemingly serving as a cog in the machine or feeling like we are the mercy of the disorienting twists and turns of life's terrain, wisdom stories give us the space to notice and become aware of the topography and geography of our life journey. Rich with archetypal themes and symbolic narratives, they can serve as guiding maps for our personal odysseys. They offer a bridge: by engaging with these stories we transcend mere reactivity to life's circumstances, choosing instead to cultivate a mindful curiosity towards the unfolding adventure that is our existence.

Rather than simply reacting to life's circumstances or being consumed by daily stresses, these stories provide a space for conscious observation. We avoid getting hooked into the immediate emotional reactions that might otherwise control us – the panic, the resentment, the fear. Instead, we become curious observers of our own thoughts and emotions, recognizing them as fleeting experiences rather than defining characteristics.

In this way, wisdom stories cultivate a sense of awareness. We become more than just our thoughts and emotions; we become the conscious observer of these experiences. This shift in perspective allows us to navigate life's journey with greater clarity, understanding, and resilience. We can face challenges with equanimity, appreciate joys with gratitude, and embrace the adventure of life's unfolding with an open heart and a curious mind.

As the Ancient One sagely notes in Dr. Strange, "We never lose our demons, but we can learn to live above them." This metaphor of elevation speaks to the transformative power of perspective. By gaining a wider view, we can transcend our immediate struggles and see them within a larger context. This doesn't mean that our problems disappear, but rather that we gain the ability to navigate them with greater clarity and resilience.

​Practices like Spirit Play (or Godly Play) harness the power of storytelling to facilitate this expanded perspective. By physically interacting with the story as it unfolds, participants are invited to observe its contours and landmarks, 

​but from a safer distance, a kind of a ​bird's-eye view. The gap between the observer and the narrative creates space for reflection, allowing individuals to identify with elements of the story while maintaining a healthy distance from their own thoughts, feelings, and reactions. In essence, they learn to distinguish between the self and the experience, recognizing that they are not merely their reactions but also the silent watcher who observes them.

​This observational stance echoes the strategic mindset of a chess player who surveys the board from a higher plane, anticipating moves and consequences. Similarly, it mirrors the respite of a long-distance runner who pauses on a hilltop to regain bearings, the panoramic view offering clarity amidst the disorienting maze of trails. ​

A Tool to Help Metabolize Painful Experiences
In visual art school, I learned the art philosophy of deconstruction, inspired by the French philosopher Jacques Derrida. Deconstruction involves the breaking down of established visual elements, such as lines, shapes, colors, and compositions, to create new and unexpected meanings. This process encourages viewers to question their assumptions and interpretations of established forms and meanings, opening up a space for multiple and even conflicting readings of the artwork. Something similar to this process happens in Spirit Play when participants reflect on their personal experiences of crisis through the multivalent lens of symbols and themes. When participants use metaphors from human mythology (per Joseph Campbell) as tools for reflection, it gives them the creative space to rearrange and reconstruct their experience, leading to new insights. 

Annette Gildemann, in Advancing Holistic Healing: An Integrated Spiritual Assessment, Intervention and Documentation Model for Healthcare Chaplains, (p. 25-29) highlights Narrative Theory as a process that allows individuals to move beyond a survival-oriented response to pain, towards a place where painful stories can be retold within a larger, more inclusive narrative. This process facilitates the metabolization of pain transforming it into something that can be utilized for one's learning, growth and healing. The process of widening one's perspective involves a shift toward a symbolic and metaphorical narrative that is grand in scope and encompasses a spiritual and/or religious perspective. Spiritual themes, symbols, metaphors and archetypes help "tame" the wildness (aka life's chaos and uncertainties) of our lived experience. 

Expanding on this notion of the narrative process, it's important to note that it also entails a creative deconstruction and reimagination, which gradually increases the complexity of one's cognitive structure in terms of both differentiation and integration (*See C. Daniel Batson, Patricia Shoenrade and W. Larry Ventis’ Religion and the Individual: A Social-Psychological Perspective, p.92). This increase in cognitive complexity mirrors the way in which we catalyze knowledge, as described by Michael Polanyi in Personal Knowledge: Towards a Post-Critical Philosophy (p. 195-196). It involves a deep dive into one's internal worldview and beliefs, followed by a sudden expansion into a broader, more complex, and heuristic perspective.

This process of neural restructuring can be likened to the creation of a new footpath or nature trail. Initially, the path may be faint and uncertain, but with repeated use, it becomes more established and well-defined. Similarly, as we repeatedly engage with new perspectives and insights, we strengthen the associated neural pathways, making them more readily accessible and integrated into our daily lives.

Through this intentional cultivation of new neural pathways, we can foster a greater sense of well-being, resilience, and purpose. We can make choices that are aligned with our deepest values and aspirations, leading to lives that are not merely surviving, but truly thriving and flourishing.

​When our personal narratives are disrupted by a spiritual crisis, these archetypal stories can provide a framework for deconstruction, reintegration and renewal. They offer a language for expressing our experiences, a community of shared struggles, and a path towards a more expansive and meaningful existence. In essence, these wisdom stories, parables, and myths serve as a lifeline in the turbulent waters of a spiritual crisis. They remind us that we are part of something larger than ourselves, that our struggles are not unique, and that there is wisdom to be gleaned from the collective experience of humanity. By engaging with these narratives and integrating their archetypal themes into our own stories, we can emerge from the crisis with a renewed sense of purpose, a deeper understanding of ourselves, and a more profound connection to the world around us.

​After getting hired as a chaplain for BH patients about three years ago and noting that there were no readily available curriculums in the chaplaincy world for spiritual care support groups, I immediately knew the approach I was going to use: Godly Play (or Spirit Play). For many years I have accompanied all of my three kids for Godly Play at our church, with me mostly serving as a “Godly Play door person” and keenly observing diverse facilitation styles of the trained Godly Play teachers. I have seen the effectiveness of the pedagogy grounded on Montessori theoretical frameworks which was very inclusive to different types of participants (age and mental capacity). While the Godly Play approach was sound, the only problem was that the selection of stories were limited by Judeo-Christian mythological narratives, which was limiting for my context as a chaplain in a secular hospital.

However, looking for stories beyond the Judeo-Christian framework was right up my alley. In college, I was a Religious Studies major exposed to the diverse mythologies of cultures around the world. Early on, through the work of Joseph Campbell (influenced by Carl Jung), I was hooked on the universal archetypes.

On top of being a world mythology geek, I have learned the significance of music after working with dementia patients. As also know the value of visual arts after serving as an art teacher and organizer of a summer arts camp program for inner city youth.  

With inclusivity as the main goal of my Spiritual Care Support Group sessions, I want to highlight in this blog why music, art and Godly Play (or Spirit Play) work as a method to facilitate support groups in BH:

WISDOM STORIES: Studies have shown that stories activate our brains. As soon as we hear a story, our brains naturally want to connect the story to our personal experience. That is why metaphors work. Thus, mythologies with universal spiritual themes/archetypes are fabulous tools to reflect about one’s inner life and struggle. These include stories of our experience of change and transformation: the human journey from darkness to light, from death to resurrection, from being lost to being found, from disorientation to some clarity, from chaos to stillness, from despair to hope, from emptiness to meaning & purpose, from dis-ease towards healing. It gives the person feeling lost and disoriented the opportunity to map themselves in the endless cycle of ups and downs of life. It gives the person in crisis the mental and emotional space to see the bigger picture, a lens with a much wider perspective, instead of a very narrow, reactive and blind-spot-laden lens to view one's experience. The brilliance behind Godly Play is that instead of the hearer merely imagining the story in the mind, one is also able to see and, if they like, touch the story in a tangible way through storytelling objects laid out on the floor. In Montessori understanding of learning, “What the hand does the mind remembers.” One patient responded to the method, which he experienced for the first time, in this manner: “I have heard this parable numerous times in my life, but witnessing this story unfold before me through these objects on the floor allows me to reflect on this story in a different way – a deeper way.” Lastly, wisdom stories allow participants to share their story in a way that's comfortable to them. While some might choose to be vulnerable with the group by sharing the details of the "dark" and "stormy" moments of their life journey, the participant can simply agree and point out that the archetype ("dark storm") was something that they went through.

​ART REFLECTION SHEETS: Like music, visual arts also invites us to move our hearts and minds in the affective dimension through color, lines, shapes and symbols. There are things that one can portray in shapes and color that may not be captured through words. This artist and mental health patient talks about how visual art has been an effective tool to express himself. ​

The Muslims of the Mutia family are Maranaos, descendants of Shariff Kabungsuan - the first sultan of the south (Footnote: The Maranao tribe - pejoratively known as “Moros” - are infamously known for their resistance towards Western colonization both by Spain and the United States - hence, they remained Muslim. The United States created the 45 handgun because of their fierce battles with the Maranaos). At this reunion, we learned how the Mutias eventually became Christian. During the Spanish times in the mid 1800’s, one ancestor (my great great grandfather) - fondly nicknamed “Tamak-Tamak” - converted from Islam to become a Christian after marrying a Christian woman. We learned that he was a merchant and never stayed in one place. He frequently travelled from town to town and travelled back and forth between Mindanao and Bohol.

​So I asked Dad, “So he seemed unable to put down roots and stay in one place. He was a wanderer. Doesn’t that sound like you?”

“You’re right,” he nodded in response. 

Growing up with Lucio as my dad, I always wondered why he could not stay in one place. Part of this of course had to do with his vocation. Clergy work often involves moving from one church to another. His confused older siblings (farmers deeply rooted to their land) shamed him: “We don’t understand your job - you’re constantly moving and you don’t have your own house. We might not have much, but we have dignity: we have our own house and land.” 

Dad, however, had no retort - he would just smile quietly. He understood their concern, but unlike his brothers who are anchored to the land, he was a sojourner. He was not phobic to novelty. If a new professional opportunity showed up, he would check it out and give it a try. 

An Ancestral Mythology of the Stormy Seas
Some years ago Dad shared an interesting ancestral story about one of Tamak-Tamak’s sons Eugenio (my great grandfather) and Eugenio’s son Francisco (my grandfather). One of Eugenio’s sources of living, on top of farming the land, was as a fisherman. One day Eugenio told his young son to paddle their only bangka (Filipino double-outrigger dugout canoe) into the deep waters because a massive storm was coming. Francisco didn’t have much time to ask why or protest, and simply did what his father commanded. Soon as he was out in deep waters, giant waves came, and my young grandfather carefully rode the bangka on the crests and troughs of the waves. 

​When the storm ceased, the young Francisco rowed his boat back to the shore only to see all of the bangkas on the shores destroyed by the giant waves that crashed the shores. 

I think that this story was a significant story for Lucio about his young father. Now and then he would retell this story to me, but I couldn't quiet understand why this story was meaningful to him until after his death.

Leaving the Farm to Pursue Education
Lucio was born on February 11, 1938 as the youngest of 9 children to a rural farmer and barangay captain (head official of the town) in Bato, Plaridel del Norte in Mindanao. Then at age of 14 young Lucio left the family farm with the adventurous spirit that would characterize his whole life. After quitting a week of work as a kargardor (cargo/baggage handler) at a ship port in Marawi, he found a job as a front desk clerk of a small hotel owned by a well to do Muslim man. This man was enamored by Lucio’s hard work ethic, and subsequently offered to financially sponsor his education and adopt him as his son but with one condition: Lucio must become a Muslim. The generous man even wanted to sponsor his trip to go on a hajj to Mecca. Dad could have easily taken that offer and reclaim back our Muslim ancestry, but he didn’t. Instead, he took an educational opportunity and scholarship at Silliman University’s Divinity school to pursue Christian ministry. 

Clergy Work to Full Time Teaching
After earning his education at Silliman in the early 60’s he became a young ordained UCCP minister (United Church of Christ in the Philippines) and served churches in Mindanao where he met my mom. In the midst of his church ministry he managed to create space and time to earn a Master of Theology. After his last church ministry in Ozamis City in 1978, he decided to return to Silliman after about 15 years of church ministry to become a full time university instructor at the Philosophy and Religion department.

He taught at Silliman for 13 years. This is where I hold most of my childhood memories. During this time, he went to Virginia for a year in 1986 to further his training in Clinical Pastoral Education.  ​

CPE in the U.S. and the Philippines
In 1991 he took off once again - this time to take a Clinical Pastoral Education supervisor position at the Medical College of Virginia Hospitals (VCU Hospitals). He also took up church start ministry with the United Church of Christ for the Filipino American community in Richmond, Virginia. Then after 19 years of ministry in the U.S., he decided to return to Silliman to develop a Clinical Pastoral Education program, which is a movement that continues to expand in the Philippines to this day. 

​Then I am reminded of the story Lucio shared about his dad, the young Francisco, who had to paddle out to the deep waters so that the giant waves would not crush their family’s bangka on the beach. Going out into the sea is deep faith.

Then I am reminded of Jesus, as someone who frequently hung out with fishermen was on a boat - Jesus did not find the depths of the sea intimidating especially during a storm. Jesus calls us to explore, not ankle deep, not chest deep - but out into the deep turbulent waters. 

God’s Abiding Presence
When Lucio was a clergy for Filipino American churches in Virginia, I remembered that certain biblical texts made him reflect introspectively. Psalm 139 was one of those readings. In deep contemplation, he would often close his eyes, and put his prayer hands in front of his lips.  

7 Where shall I go from your Spirit?
    Or where shall I flee from your presence?
8 If I ascend to heaven, you are there!
    If I make my bed in Sheol, you are there!

I believe that this is the text that gave my Dad ease and a sense of security in his new adventures. We cannot escape God’s abiding presence. God is in the here and now, in each step, in each breath, in each moment. With this knowledge, Lucio was able to venture into the depths of the Sea of Life, and allowed himself to be freely carried by its currents. He explored new territories, not with anxiety, or fear, but with curiosity and wonder.

Introduction
In the film "News of the World," Jefferson Kyle Kidd helps a young girl Johanna who has had so many losses and traumatic experiences. Kidd assures Johanna that their goal now is to journey forward and make new memories to replace the bad ones. But Johanna retorts: "To move forward you must remember first." Theologian Richard Rohr affirms this insight in his book Breathing Underwater when he writes: “You cannot heal what you do not first acknowledge.”

Since, as English author Neil Gaiman points out, 

The Challenge: First Two Tasks in Grief
In my blog on “Being A Good Host to Our Grief,” I reflected on the second task of grief - which is about experiencing the pain of grief (theorized by William Worden). In grief work, many grief experts phrase this skill as “feeling our feelings” or gently “leaning into our grief.” This work is not easy. There are normal bumps and complications that take place on the grief journey - after all, grief is non-linear. It twists and turns. It is labyrinthine. You take three steps forward, then you take two steps back. It oscillates nonstop between symptoms of loss and symptoms of restoration. 

However, there are situations when the person journeying through grief may feel stuck. For some it may feel like a nightmare that won't let up. For others it is a long-term feeling of being drowned by one or all of the many common (and normal) grief symptoms: anger, guilt, depression, meaninglessness, denial. When stuckness happens, it is important to reach out to a professional grief counselor for support. It is not recommended to go through grief alone. This is the healthy way to move forward: journeying through it with a companion(s) who know the process, and can witness and validate your experience, and mentor/model for you how to wade the waters of grief.

The Controversy​
In the grief world, complicated grief is a controversial topic. Some experts consider complicated grief a disorder that must be diagnosed and fixed. Others, on the other hand, believe that this phenomenon is a normal process of grief. Critics of "complicated grief as pathology" perspective claim that it supports misinformed and antiquated notions that (a) grief symptoms are a type of sickness that must be problem-solved, and that (b) there is a grief timeline and a right way to grieve. 

While the caution of those who critique ideas of complicated grief as a type of pathology is warranted, I also think it is important to note, at a minimum, what causes grief to be complicated - specifically, the experience of being stuck. The root cause goes back to the first two of Worden’s tasks of grief: 1. accepting the reality of the death, and 2. feeling our feelings. (See the illustration of the TEAR Model of Grief above). The tendency to deny reality and avoiding painful feelings is a normal human tendency that we all do at some level. But avoiding these two tasks at all cost - that is, dodging the task of accepting the reality of the loss and feeling the pain of the loss is, I believe, what causes complicated grief. It is OK to be tentative, but we still have to give dipping our toes in the waters of grief a try in spite of our fears and discomforts. Sometimes we may not have a choice: whether we like it or not, the tsunami waves of grief will wash over us anyway and we find ourselves trying our best to keep our heads above water. Whatever the case may be, the skill of learning to be in relationship with the waters of grief (i.e., emotional self-regulation) is crucial. This skill can be learned from others, say, from the loving support of a counselor or therapist.

​The following films below explore complicated grief. I invite you to view these films to get a sense of complicated grief and its patterns.

Released by Disney Plus, this film tells the story about Wanda Maximoff (from the Avengers) and her unresolved grief, including the death of her loved one, Vision. In this film, Wanda creates an alternate reality, a fantasy land, which keeps her in denial and out of touch with the pain of her many losses. Eventually, she is able to articulate the cause of her hesitation to do the first task of grief, which is to accept the reality of the death of her loved ones. She is terrified of being drowned by her grief.

​Vision replies with a few words of comfort: “It can’t all be sorrow.” He ends by saying, “But what is grief, if not love persevering.” This conversation is planting a seed of a different perspective in Wanda’s mind, namely, the possibility that “talking about [her grief] would bring [her] comfort.” Wanda learns that in order to move on with her life, she has to dismantle her fantasy world and let go of it in order to be able to do the second task: to feel her grief. 

Directed & written by Tomm Moore, ​the beautifully animated story of grief revolves around the family of a lighthouse keeper. After Conor’s wife dies, he avoids the task of feeling his pain. On the anniversary of his wife’s death, he goes to the pub to self-medicate his grief. The belief in avoiding grief at all cost is embodied by Conor’s mom “Granny” and Macha the Witch. To Granny & Macha, venturing into the sea or waters of grief is unsafe. The goal is to prevent those “terrible feelings” from “bubbling up”- one must bottle them up because these “nasty things” are “sick,” can “control you” and make you “feel so awful.” In this view, staying asleep from our pain by hardening our hearts into stone is “peaceful.” 

When Conor's son Ben realizes Macha's lie that by bottling up one’s pain “it will never hurt again,” he exclaims: “No, it doesn’t help at all. It just makes things worse.”  

​Leaning into our grief is a skill. It is about learning how to swim and wade without fear of being controlled by them, without the fear of drowning (like Wanda). In the end, what liberates Conor's family from feeling trapped is music through the magical shell given by Conor’s wife to her kids. The shell allowed them to sing the song of the sea. They are able to remember her through story and song, giving them the gift of wading and swimming into the waters.  

CONCLUSION
To close, the characteristics of someone with complicated grief include one or both of the following: (1) The desire to create an alternative reality that is not congruent with the reality of the loss. This human impulse, embodied by Wanda (in WandaVision) goes against Worden's task number one. Complicated grief also includes (2) the belief, held strongly by Conor and Macha (in Song of the Sea), in bottling up one's grief by making feelings and emotions suspect; here, emotions are not safe. This view prevents the griever from doing task number two of Worden's Tasks of Grief. These two actions cause the griever to feel stuck in their grief journey. Thus, getting unstuck requires one (like Wanda) to face one's fear of drowning in the sea of grief, and develop skills to open up oneself to be in relationship with one's feelings (gently leaning into grief) and learn to wade and swim in it. 

Occupying oneself with busy-ness is something that many people go through, such as those who are grieving or those who are burned out and going through compassion fatigue. Many want to return to the old norm by going back to work and just get busy. Many will say something like, “You know, I’m keeping myself busy. It really helps.” And it’s true. As a form of distraction, busying does help to some extent. In grief, for example, it is one of the things that we recommend to bereaved individuals especially if their grief is overwhelming. Sometimes we might say, “Do a fun project like gardening, or perhaps do an art work.” Distraction has its place.

But unfortunately, we can swing to the extreme with distractions. Instead of creating a balanced approach between feeling our feelings, and getting distracted through something that keeps us busy, we end up using busy-ness as a kind of a drug to numb ourselves from our feelings so that we don’t have to feel anything and become self-aware. 

Writer, Wendy Mogel, notes the danger of using busy-ness as way to numb ourselves from pain. She writes: 

"Busy-ness is the manic defense against despair. We speed up our lives unintentionally to escape feeling helpless. We’re not afraid of losing time but of having time to reflect. Without the usual distractions and interference, we may have to confront feelings of disappointment, loneliness, frustration, and our fear that we are not strong enough to make changes we need to make.”

So how do we slow down so we can become self-aware? How do we keep our brains from auto-piloting? How can we slow down so that we can take a deep breath and be fully present? How can we slow down so that we can be aware of our conditioned patterns of thinking and doing, so we can make the changes we need to make?

There is an ancient spiritual practice that might be a good antidote to busy-ness. And it might help us slow down. This practice involves walking a labyrinth. The labyrinth is an ancient symbol, an archetype. It is a divine imprint, found in all religious traditions in various forms around the world. If you are not familiar with labyrinths, see this video, and this handy guide on how to walk a labyrinth.

​A key principle in a labyrinth walk is to be in the present moment in each step that you take. There are 3 stages: (1) Release, (2) Receive, (3) Return. First, as you walk towards the center of the labyrinth, you release your thoughts and worries - anything that keeps you anxious and afraid. Second, when you arrive at the center of the labyrinth, you receive. At  the labyrinth’s center, we may bring up these wonderings: What insights have you gained? Perhaps it is something that you have learned about myself; perhaps a feeling of gratitude or a sense of peace; perhaps a deep sense of connection. Third, as you return and walk back out of the labyrinth, the goal is to integrate (or embody) the gift that you have received in your daily living.

Adapting the Stages to Your Work with Patients
Here’s the cool thing. While it is beneficial to do a meditative walk in a labyrinth, you can still integrate its main principles in your work. When you provide care for a patient, or someone in crisis, we do not have to default busy-ness to pass time with. Instead, we can turn these encounters into opportunities, much like walking a labyrinth. 

Release
On your way to see a patient or their family, let that be an opportunity to release your worries, fears and anxieties. Instead of closing yourself in worry or fear, name your intention, and open your heart. 

Receive
The second stage in walking a labyrinth is arriving at the center to receive. In your work, the labyrinth’s center is your interaction with your patient (and their family). Here you have the opportunity to receive a gift from this interaction even if that interaction might be challenging. After your interaction with you patient, pause. What insights have you learned about yourself? What does your learning from your interaction mean for your daily living? If any, what changes do you need to make in order to thrive and live more fully?

Return
The third stage is to return back to your daily living and integrate that insights that you have learned from your interaction.