HEALING: The Role Of Ritual by Nancy Kehoe

The Role Of Ritual by Nancy Kehoe

From Wrestling With Our Inner Angels: Faith, Mental Illness, and the Journey to Wholeness

One April day while standing in line waiting in Harvard Square, I heard, “Sister Nancy!”  I turned around to see Bill, a client whom I had known at the state hospital eight years earlier.  In addition to the Spiritual Beliefs and Values groups I initiated at the day treatment programs, I also led groups at one of the state hospitals from 1983 until it closed in 1989.  With the exception of some individuals like Bill, most of the men and women were lifers, doomed to spend the rest of their days in a psychiatric institution.

As I greeted him, he said, “Do you still do that thing with the matzo crackers and bitter herbs?”  He proceeded to tell me that he remembered the Seder service I had conducted for these very ill clients; it had meant a lot to him.  Sadly, I told him that we had to give it up because of a mandate from the Department of Public Health that barred overt religious symbols and ceremonies.  With a look of regret on his face, he said, “Too bad, Sister Nancy.  That was a great service you did for us.”

For me, the Jewish Seder had a long history.  In 1968, while teaching at the Academy of the Sacred Heart in Cincinnati, Ohio, I tried to broaden the outlook of the girls in my high school religion class by giving them a taste of different religious traditions.  At a time when our country was torn apart by dissension and turmoil, I wanted to help them become more tolerant and understanding of others.  As part of this initiative, I invited a rabbi from the Hebrew Union College in Cincinnati to conduct a Passover Seder for my class.

The Seder meal commemorates Jewish liberation.  The story in the book of Exodus recounts the journey beginning with the night on which the Angel of Death passed over the homes of the Israelites, whom God had warned to sprinkle the blood of the lamb on their doorposts.  The Egyptians, who did not display the saving blood, lost their firstborn child.  The following morning the Jews escaped from Egypt, commencing their long journey to the Promised Land.

But liberation was not achieved overnight.  The forty-year passage was filled with challenges, resistance, community disputes, rebellion, hunger, thirst, and despair.  The initial liberation and the arrival in the Promised Land were worthy of celebration, but as happens so often, the process tried the hardiest of souls.

In experiencing the Seder with the students, I realized that the Mass, as Catholics know it, is rooted in this ancient tradition.  The relationship between the Seder meal and the story that was told on the night of Passover had new meaning for me as an adult.  Growing up Catholic, during the Holy Week services we heard that Jesus was at a Seder meal when he offered himself to his disciples, saying with the unleavened bread, “This is my body,” and with the final cup of wine, “This is my blood, the blood of the new covenant.”

We listened to the story of the Exodus and how the Jews were liberated from the oppression of the Egyptians.  The Jewish liberation from the slavery of the Egyptians was linked to Jesus freeing his people from the oppression of sin, both original and personal.  But as a child, the story of Jewish freedom and any connection to sin meant nothing.  In fact, I didn’t really take in Jesus’s Jewish identity.

At the Seder I shared with my students, I grasped the connection between the Jewish and the Catholic traditions; but I didn’t see a more universal relationship for several years.

In 1976, when I was doing my postdoctoral internship in the psychiatry department of one of the Harvard teaching hospitals, the chair of the department invited me to a Seder at his home.  Expecting a solemn, silent, reverent, and restrained ceremony, I was prepared to pray with my head bowed and my mouth shut, as I had learned to do in Catholic rituals.

Much to my surprise, I found myself at a real celebration, at a table beautifully set with flowers and the family’s best china and silverware.  The gathering was at first somewhat chaotic as guests arrived, bringing various dishes and finding a space for them on countertops already laden with the symbolic dishes of hard-boiled eggs, matzo ball soup, haroset (a mixture of apples and nuts), matzos, and parsley.  Children argued over who would read the Four Questions and who would win a prize for finding the hidden matzo, called the afikomen.  Eventually, Rebecca, the mother of the family and the traditional leader of the Seder, announced that we would begin.

Solemnly, she lit the candles and said the first prayer, one that echoes back through centuries, a prayer said in times of persecution and in times of peace and abundance.  “Baruch ata Adonai,” it begins, like so many Hebrew prayers: “Blessed are you, King of the Universe.”

A guest named Sam interrupted the silence accompanying the prayer.  He suggested that we skip the first few pages of the Haggadah (Passover prayer book) and get to the “good parts,” like the plagues.  One of the younger children wanted to get to the bitter herbs; another more observant adult wanted to do the whole service.

All the requests and preferences amazed me.  Initially, I was very uncomfortable with this energy and outspokenness, having been taught that reverence and restraint dictated proper behavior at religious ceremonies.  With effort I began to relax, after telling myself that this table fellowship was undoubtedly closer to the way Jesus celebrated the Seder.  As the blessing was said over several cups of wine, it made sense that a little raucousness should be a natural accompaniment.

In addition to the humor, the bluntness, and the reverent irreverence, what affected me was that everyone present related the celebration to current events.  We were not only remembering the Jewish deliverance from the slavery of the Egyptians but also present-day oppression and slavery all over the world, remembering it with anguish, longing, and prayers for the freedom of all people.  There was a heartfelt connection between the suffering of Jews thousands of years ago and the suffering of people today.  We were retelling the story but also adding a current one.

On my way home, I reflected on how much life was present in that celebration, how much history, how much community around the table, as well as a sense of community that extended beyond the confines of the home.  The value of ritual and the importance of remembering took on new meaning.

I had been participating in this Seder for several years before I started my first Spiritual Beliefs and Values group in July 1981.  The following spring I suggested to the director of the program that we have a Passover Seder.  This was a truly preposterous idea – to offer a ritual with a specific religious connection in a psychiatric day treatment program, to be conducted by a Catholic nun, no less.  To my knowledge, at that time nothing similar had ever been offered in a mental health setting.

In suggesting the Seder, I hoped to shed some light on the clients’ suffering, to give some meaning to their pain, so they would learn that they were not alone on the journey to freedom.  Even those clients who were involved in a religious community seldom saw a connection between their lives and the sermons preached from the pulpit or the altar.  In fact, because of their illness, most of them had stopped participating in any organized religious observance.

Fortunately, both the director and the assistant director, who was Jewish and one of the vociferous staff skeptics, liked the notion of a Seder.  They suggested inviting all the clients and staff, not just the members of the Spiritual Beliefs and Values group.  We made it very clear that participation was voluntary so as not to violate any church-state boundary.  Without reflecting on it, I was putting myself in the role of spiritual leader.

For two weeks prior to Passover, we discussed the Seder.  At that time there were three Jewish clients in the groups, including Betty, who had always been concerned that the Spiritual Beliefs and Values group was going to be too Christian.  Betty had had a very solid Jewish education, spoke fluent Hebrew, and knew her Jewish history.  She recounted to the other clients the history of Passover and explained the significance of the Seder.

Instantly, she was transformed from client to knowledgeable leader.  No one had ever drawn on Betty’s Jewish experience, nor had she attended a Seder for years because of her hospitalizations.  To think that we were going to have a Seder was as astonishing to her as it was to me!

For the sake of the Christians present, I explained that it was a Seder meal that Jesus had changed the bread into his body, what we have come to know as the Eucharist.  Historically, we were doing what Jesus, a Jew, had done.

On the appointed day, we gathered in the community dining room, where the table was neither set with fine china and silverware nor laden with rich food.  With a white tablecloth, flowers, candles, and the “Seder plate,” on which I had placed all the traditional foods – the lamb bone, the parsley, the roasted egg, the haroset, the matzos, and the horseradish – I tried to beautify an otherwise drab environment.  Paper cups and paper plates were our tableware.

As the clients drifted in, there were exclamations: “This looks beautiful!”  “What’s that bone doing there?”  “Are we going to eat all that stuff?”  “Are we going to have matzo ball soup?”

I began with a brief explanation of what we were going to do and asked for volunteers to read.  Since an authentic Seder is very long, I had shortened the ceremony and made some adaptations.

As I sat at the head of the table and looked around the room at the twenty-five clients and staff, I thought of our commonality.  Clients and staff alike, we all wanted to move from whatever oppressed us to freedom.  For most of those present, their personal journeys were truly like forty years in the desert, years of wandering in and out of mental hospitals, halfway houses, and day treatment programs.  But no one had provided them with a context for the journey.  In celebrating the Seder, these clients were no longer the marginalized “mentally ill.”  They shared a kinship with all the others trekking along the path to freedom.

To center ourselves and to calm the hubbub, I suggested that we spend a moment in silence before the beginning.  With great dignity and pride, Betty stood up to light the candles and said in a clear strong voice, “Baruch ata Adonai. . .,” reciting a blessing she had not said in public for over twenty years.  When she sat down, there was an unplanned moment of silence.  Then Joshua and Andrea, the other Jewish clients, took turns saying the blessing in Hebrew over the matzo and the grape juice substituting for wine.

The Christians also took turns reading.  We all dipped our parsley in the saltwater and ate the bitter horseradish with the haroset, remembering that life has bitterness and sweetness.  One client passed on the horseradish, saying, “No, thanks.  My life has enough bitterness in it already.”

At one point I invited everyone to name other nations and peoples who also longed for freedom.  The homeless, children with AIDS, South Africa, Northern Ireland, people with addictions, and Israel were some of the places and people cited.  Betty ended the Seder with the final Hebrew blessing, no longer concerned that I was going to “make her Catholic.”

Thus we established a new tradition.  Yearly, we celebrated the Passover Seder, which became a salutary event eagerly anticipated by both clients and staff.  Once a year, in this simple but meaningful ritual, the sufferings of the clients, their struggles, and their perseverance, were seen in a universal perspective.  In his classic book Man’s Search for Meaning, Victor Frankl says:

Whenever one is confronted with an inescapable, unavoidable situation, whenever one has to face a fate that cannot be changed, e.g., an incurable disease, such as inoperable cancer, just then is one given a last chance to actualize the highest value, to fulfill the deepest meaning, the meaning of suffering.  Suffering ceases to be suffering in some way at the moment it finds a meaning, such as the meaning of a sacrifice.

The week before celebrating our seventh Seder, I encountered an unexpected problem.  As usual, I explained the significance of the Seder and discussed its relationship to the Christian tradition.  When I had finished, Sarah, a new Jewish client, burst out, “That’s the trouble with you Christians!  You are always taking something that is ours and making it yours.  Count me out.”

Taken aback by her anger, I tried to give an explanation based on historical fact, but that didn’t calm her.  Though the group members spoke of the Seder’s importance to them, she was not persuaded.  Although we told her that participation was always voluntary, she took offense at the very idea of the ceremony.  In her outburst, Sarah voiced one of the recurrent difficulties that shadow religious discussions.  The overemphasis on what belongs “to us,” rather than on what we have in common, can often lead to bitterness and resentment.

The following week, just before we settled around the table, Sarah approached me and asked if she could say one of the Hebrew blessings.  Afterward, she said, “I really liked that.  When we did the Seder at my house, I always thought it was too long and had no meaning.  I got bored.  But I really like this one.  It makes me get something about my life.  Are we going to do it again next year?”  I assured her that we would.  With each celebration, the clients deepened their appreciation of the Seder’s significance for their lives.

Then one year, much to my dismay, a representative from the Department of Public Health appeared.  Responding to a client’s complaint about the presence of a menorah (the eight-branched candlestick used at Hanukkah), the DPH representative came in to assess whether we honored religious freedom in both the day treatment program and in the Social Club program, an afternoon and evening program that shared the same space.  The client was a member of the latter.

In less than two hours, after interviewing only the day treatment staff and the Social Club staff – not me – he said categorically that all traces of anything with religious significance had to be eliminated.  He did not interview a single client to assess reactions to the presence of the menorah, of a Christmas tree, or of the Seder celebration.  By totally disregarding the clients, he could not ascertain if they felt that their religious freedom was being compromised, nor did he gain any understanding of the Seder’s importance to them.  Since attendance at the service was voluntary, the clients were absolutely free to participate or not.

Supposedly his role was to act on behalf of the clients and carry out the mission statement of the Department of Public Health.  Earlier in this book, I described why mental health providers omitted any discussion of religion in treatment.  But the DPH representative showed up in early 1992, when a growing body of research indicated that religious beliefs and religious affiliation could be beneficial to those who suffered with mental illness.  Though the DPH rep may have been unaware of the research, he should have known that the 1992 standards for the JCOHA (Joint Commission on Hospital Accreditation, today known simply as the Joint Commission) state that the spiritual needs of the clients must be respected.  Although the day treatment program was not a hospital, the fact that the JCOHA, a government agency, was addressing the spiritual needs of the clients should have made him pause before making his decision.

If the Seder service had been mandatory, if proselytizing were occurring in the community, if diversity were not respected, the DPH representative would have been acting on behalf of the clients.  But in this case he made a decision that was in direct opposition to what was meaningful, life-affirming, and community-building.  The actions of this bureaucrat suggest that he saw the clients as unable to discern between religious freedom and coercion.  Again, the clients were victims of the stigma of mental illness; their thoughts and feelings were suspect.

Since nothing like a Seder was being done elsewhere in a mental health setting, the staff representative could appeal to no precedents.  In attempting to safeguard the rights of an individual, the DPH allowed one client to impose her nonbeliefs on an entire community.

When the clients heard that we were forced to cancel the Seder, they were more outraged than the staff.  Bud was among the angriest.  Deprived of one of the most meaningful events of the year, they wanted to protest, but the director of the center felt that doing so could jeopardize our funding.  So we acquiesced, once again with a sense of powerlessness, an all too familiar feeling for those who suffer from mental illness.

I find it curious that when national tragedies occur, such as the Columbine shootings, the Oklahoma bombing, 9/11, Hurricane Katrina, or the shootings at Virginia Tech, rituals that offer meaning, connection, and solace are held for people of all religious persuasions.  It is assumed and understood that rituals are appropriate; government officials do not object.  But when a ritual that can offer meaning, connection, and solace is held for those who suffer from mental illness, a government agency objected.  In this instance I wasn’t able to influence the decision, nor was I given the opportunity to educate the representative.  The education of mental health professionals has been an ongoing challenge for me.

The Seder was not the only service I have initiated.  During the first year I worked at the state hospital on a locked ward, one of the patients committed suicide.  Because these patients were restricted to the ward unless they had earned privileges, they could never attend a religious service in the chapel when a patient died.  Having spent years together, the patients were like family to each other, yet at the time of a death, they had no ritual by which to focus their grief.  Apparently no one, not even the hospital chaplains, ever thought of acknowledging a patient’s death on the locked wards.  I suggested having a memorial service on the ward for the person who had killed herself.

When I proposed the memorial service at a staff meeting, the faces of those present registered shock.  This reaction was similar to the reaction when I proposed the Spiritual Beliefs and Values group at the day treatment program.  Some staff members gulped audibly.

One person said, “Are you serious?  With this population?  They won’t be appropriate” (a term the clients detest).

Another chimed in, “Too many are delusional.”

Someone else contributed, “We have never done anything like this before.”

“Many of the clients here are suicidal,” voiced another, naming the real fear.  “What if the service prompts someone to kill himself or herself in order to have a service and gain some recognition?”

Some of the staff had worked with these men and women for twenty years.  What did I know about leading a service for people who were “crazy”?  I was just a nun-psychologist, an outsider, who dropped in once a week.  But for me, being “crazy” didn’t exclude having normal feelings about death, about losing someone you had known for years, about the need to mourn.

Though a suicide was endlessly processed from a psychological point-of-view in therapy groups at the hospital, a service was unheard of.  With many unknowns and more than a little trepidation, the staff agreed to the service.  They planned for sufficient coverage to control any outrageous behavior.

A week later, a terribly hot day in August, staff and clients gathered in the community room, a large room with cream-colored walls that had not seen a paintbrush in years.  We sat in ugly institutional chairs with torn vinyl seats that were scattered throughout the room.  A blaring TV, barred windows, and a pervasive cigarette odor completed the décor of this less than sacred space.

Some patients talked to themselves or to their inner voices; some sat and stared; some thumbed through magazines, just as they always passed their endless minutes, hours, and days.  No great cathedral, this – more like the trenches, an unseemly place in which to hold a service and remember a life.

As we arranged the chairs in a circle, we reminded people of the occasion and invited all who were interested to come and join us.  Eventually, about thirty people assembled.  Seated at a table with an attractive yellow cloth, a vase of flowers, a basket with a beautiful loaf of challah, a tape recorder, and a candle, I welcomed each one.

“Today we are going to have a memorial service for Libby,” I said.  “I know that many of you have known her for a long time, so we want to honor her today and grieve her death.  We’ll begin with some music.”

A voice from the back row called out, “Are you going to play a John Denver song?  She loved John Denver.”

“No,” I replied.  “I didn’t know she loved John Denver.  I didn’t know Libby very well.  She only came to my group a few times.”

Trying to remain steady and calm but feeling very anxious, I continued, “Thank you for sharing that about Libby.  We’ll have time later in the service to share more memories of Libby, but right now, I’d like to explain the rest of the service so that everyone knows what we are going to do.

“We’ll begin with some music, followed by a reading form the New Testament, because Libby was a Christian.  Then there will be a few moments of silence and time to share our feelings about Libby.  After this, we will break bread as a sign that we all need to be nourished in the face of loss.  We’ll end with some music, and then we’ll have juice and cookies.”

Another voice yelled out, “Can we begin with the juice and cookies?”

One of the staff quietly explained that the food would come at the end.

As “Spring,” from Vivaldi’s Four Seasons, played, I sat there hoping that more voices, either internal or external ones, would not interfere with the music.  With a sense of poignancy, I looked at the faces of the patients, faces that were empty, faces that were anguished, faces that seemed lost, faces suffused with a surreal serenity.  I wondered about their lives and their histories, about what had brought these patients to this point and what had brought Libby to end her life.  When the music stopped, two of the patients who had sat still for three minutes, exceeding their normal limit, got up quietly, walked to the back of the room, and began pacing.

One of the staff read the passage from the Gospel of John where Jesus comes to his disciples and says, “Peace be with you.”  I’d chosen that passage with the dual hope that Libby would now have peace and that this service would bring some peace to the clients and staff.

“Now we’ll have a minute of silence, and then I’d like to invite you to share whatever you want to about Libby.”  Much to my surprise, we really did have a minute of silence.  Upon this ordinarily agitated, noisy environment, a sense of quiet descended.

Not wanting to push my luck, after a minute or two – which seemed like ten – I said with my heart in my mouth, “Now anyone who wants to can speak about Libby.”

“Libby liked John Denver.  I gave her one of my John Denver tapes when we lived in the halfway house together.  She was in love with him.  I wish she hadn’t killed herself.”

From the corner of the room, another patient said, “She was a really kind person, but she was very sick.  She’d share her cigarettes with me.”

“But she shouldn’t have killed herself.  Didn’t she know what that would do to the rest of us?  Makes me f— angry that she did that.”

A staff person, trying to lower the bar, said, “She tried very hard all the years I have known her.  She was in a lot of pain.”

“We’re all in pain,” another said.  “But we keep going.  I did like Libby.  She watched out for people.”

“I think it’s really sad that her life ended that way.  I am going to miss her.  She had a nice smile.”

Sensing that no one else wanted to speak, I moved on: “In many religious traditions, people break bread as a sign of their togetherness, a sign of community.  So now we will take this bread, and after I break it and give each person a piece, we will all eat it together.”

This was like telling little children not to eat any candy from their Halloween bags until they got home.  To my surprise, as I passed the bread, each person held it.

When I returned to my seat, we all ate.  One or two people piped up: “Can we have another piece?  That’s good bread, better than the white cardboard we get here.”

I assured them that after the service they could have more.  Vivaldi’s music filled the room.

What impressed me was that despite years of medications, of hospitalizations, of living in inner darkness, those who spoke did so with disarming honesty and clarity.

At the conclusion of the service, some of the staff that had been most anxious approached me.

The first person said, “That was amazing.”

Another said, “I was really touched.”

The staff psychiatrist said, “I have never seen the patients so attentive.”

The last one chimed in: “Thank you.  You took a big risk.”

Since that first service more than twenty years ago, I have held numerous memorial services in various settings for men and women who have died due to natural causes, such as cancer or heart attacks, or to suicide.  Memorializing a person who committed suicide has never led to another suicide.

All of us want our lives to be recognized by someone, to have a sense that we have made a difference, even to one person.  One of Ralph Waldo Emerson’s definitions of success is “to know that even one life has breathed easier because you have lived.”  Over the years I have learned how the Libby’s of the world have brightened someone’s day with just a cigarette, a kind word, or a smile and how crucial it is to acknowledge the ways in which a person has made a difference.

One year we had an unusually high number of deaths, most, but not all, due to cancer and heart attacks.  To offset the services for mourning, I thought we needed to have a service that focused on life.  Aware that the holidays are a painful time for many individuals in the day treatment programs, I designed a service that focused on light.  We could thus honor the Jewish holiday of Hanukkah, which centers on lighting the menorah over an eight-day period of time; Christmas; the Solstice, with its rituals of light to drive out the darkness of the shortest day of the year; and Kwanza, the African American celebration of values.  By focusing on the universal significance of light, I hoped to avoid another clash with the Department of Public Health.

For the light service, I invited each person to take a candle, place it in one of the wreaths, and name someone who had been a source of light for him or her in the past year.  “My mother,” “my boyfriend,” “the staff,” “John,” “Janet,” “my coordinator,” “Beverly, who died,” “Nancy,”. . . .  The clients surprised me with their courage and kindness.

All the comments were from the heart.  Quietly we sat together, observing the light and all it represents.  We concluded with lines from Susan Cooper’s poem The Shortest Day:

And everywhere down the centuries of the snow-white-world
Came people, singing, dancing,
To drive the dark away.
They lighted candles in the winter trees;
They hung their homes with evergreens;
They burned beseeching fires all night long,
To keep the year alive.

Eggnog and cookies concluded the service.

This service has become a focal point of the year for the clients, for it eases the pain of the holidays.  To replace the Seder, I’ve also composed a “service of new life” for spring.  Instead of the wreath and candles, we have flowers.  As each person puts a flower in a vase, each one names some new life found in the past year or a person who has been a source of life.

“I have been sober for the years,” said one client.  Others added: “I have moved out of the shelter into an apartment of my own.  My poems were published in Spare Change.  My therapist; Bob; I started a volunteer job; Gail; AA.”

Although the clients and staff enjoy the spring service, it has never replaced the Seder.  It doesn’t link them symbolically, as the Seder did, to generations of men and women who have journeyed through life, moving from a place of bondage to a place of freedom.  I have rethought the value of religious traditions.  When they truly serve us, they take us out of ourselves and link us to something transcendent, fostering a sense that we are part of a larger whole.

For years as I conducted these services, I was extremely self-conscious.  My voice was a little artificial.  I prepared my script.  I was in a role.  I didn’t feel totally comfortable in my own skin.  Maybe this was due to my discomfort with my role as a nun in a setting where I wanted to be recognized primarily as a clinical psychologist.  Maybe it was my uneasiness about the task at hand, as I never knew what would emerge from the gathered assembly.  Maybe it was that I was still trying to find myself.

Who was I?  A psychologist, a nun, a minister to the community – “Doctor Kehoe,” “Sister Nancy,” or just “Nancy”?  However I might describe or define it, I was vaguely ill at ease as I led the services.

Curiously, it was only when I led the memorial service for Bud that I was aware of feeling completely relaxed and at one with myself.  I sat in the middle of the sofa, in the same physical place where I had been sitting for years at all the other services; this time, however, I was in a completely new place inside my head.  I recognized that I was the spiritual leader of this little community and had become comfortable with that role.

The image that comes to mind is that of a little girl who wears her mother’s high heels and dress-up clothes.  Then one day the shoes and the clothes are her own.  They now fit.  These men and women had become my little congregation, and I was their shepherd.  I had become ordained, not in the sacramental sense but in the sense in which the early Christian community used the word – called forth by the community to serve the community.

In thinking about this, I looked up the meaning of ordination.  The word ordain comes from a Latin verb meaning “to order or arrange.”  I had helped bring some order into the lives of these men and women, and they in turn helped me reorder my own inner life.

It hasn’t just been the services that have helped individuals gain some order in their lives and enabled me to accept my role with them.  Many who suffer from mental illness live with a personally defined dual diagnosis: “mentally ill” and “sinner”; they have two “disorders.”  Some, having had troublesome experiences with religious professionals, hesitate to seek out a priest or minister for forgiveness.  Conversely, the mental health professionals deal with the illness of the clients but not with their sense of sin.  Searching for peace, acceptance, and forgiveness, some have sought me out to make their “confession.”  The middle of a corridor in the day treatment program or outside in the designated smoking area is an unlikely place to hear someone’s confession, but that is what has happened to me on repeated occasions.

One day after a group meeting, a client named Martha asked if she could speak with me.  Martha is an attractive woman in her forties.  Always impeccably, stylishly dressed, her hair pulled back in a French knot, her clear hazel eyes enhanced by just the right amount of makeup, Martha looks as if she works at the Gap or a trendy women’s store.  In the group, she brings up probing, philosophical questions that consume many of her waking hours when she is not overcome with feelings of self-hate, anger, guilt, and depression.

Just as her external appearance suggested a “tied-together” life, her family history also seemed solid, but there was an undercurrent, not visible to others, of emotional abuse, rivalries, and isolation.  Scarred by this early history and searching for acceptance and love, Martha has led a tumultuous life.  Numerous relationships, moves, and hospitalizations have taken their toll.

When she approached me, I didn’t know much about her background other than what she had shared in the group.  But she wanted to speak with me, to tell me some of the awful things she had done.  She wanted to know if she could be forgiven.  Her striking eyes were filled with pleading.  Am I a real sinner?  Will God forgive me for what I have done?  How can I forgive myself?

I had no magic words; I didn’t even have sacramental words.  But what I had was a heart that went out to this woman.  For her I was a representative of God.  I could hear what she was saying, and I could respond from the bottom of my heart: “Martha, I believe that God forgives you.”

She was close to tears as she said, “Thank you.  That brings me peace.  You don’t know how long I have felt like such a sinner, such a no-good person.”   Months have gone by since this encounter, yet she comes back to it, both in the group and when we meet.

On another day, Sam, who towers over me at six foot three, asked if he could speak with me.  Sam has come to the group only sporadically but often talks to me as I come and go from the program.  The first time I really connected with Sam was following a memorial service held for one of the clients at the Social Club.  Sam had written a poem to express what Barry meant to him.  The poem’s simplicity, warmth, and humor captured Barry in nutshell.  Afterward I told Sam how impressed I was with his piece.

“Really, Nancy?  Gosh, that’s good of you to say that.  I don’t think what I do is worth much, so it means a lot to me that you say that.”

Months after this service, Sam became a member of the day treatment program.  One day after the group had concluded, he took me aside and said, “Could I talk to you sometime?  I am really troubled.”

“Sure, Sam,” I replied.  “I have some time right now.”

We walked away from the smokers, and he leaned toward me with anguished eyes, and asked, “Do you think I am going to hell because I am a Jew?  My brother has become a born-again Christian, and he says that anyone who doesn’t believe in Jesus is his Lord and Savior is going to hell.  I know I have done a lot of bad things in life, but do you really think I will go to hell if I don’t believe in Jesus?  Would God do that?  My brother also doesn’t get mental illness.  He thinks if I believed in Jesus, I would be OK.  This is so upsetting to me.  I wonder if I am possessed by the devil.”

With some anger in my heart at the way religious messages can cause such anguish, I said, “Sam, Jesus was Jewish.  You won’t go to hell for being faithful to your Jewish beliefs.  Since your brother doesn’t understand mental illness, maybe it’s better not to get into these discussions with him.”

“Thanks, Nancy; it’s a relief to hear you say that.  You know, one time I tried to be Christian, but it just didn’t work.  I am Jewish.”

“You have to be what you are, Sam, and no one can tell us what we should be.”

A smile came over his face as he said again, “Thanks.  I may need to hear that again, but right now I am less afraid.”

I walked to my car, feeling that I had heard yet another person’s confession.

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