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Caregiving, Self-Care, and Contemplation: Resources from Thomas Aquinas
Published online by Cambridge University Press: 01 January 2024
Abstract
In the last decade, the helping professions have increasingly recognized compassion fatigue, burnout, and secondary trauma as hazards integral to care-work, and in response, they have turned to self-care to build caregiver resilience. To examine the theological and ethical assumptions implicit in self-care literature, I turn to Thomas Aquinas's account of the active and contemplative lives in the Summa Theologiae. In correlating the two lives as meeting neighbors’ needs and beholding God, Thomas offers three competing accounts. Rather than synthesizing these differences, I argue that they map a range of interactions possible between one's own wellbeing and another's: care for the neighbor can hinder, prepare for, or be referred to contemplation and its consolations. While affirming self-care's recognition of human limits, my reading of Thomas also offers a correction, insisting that divergent experiences of caregivers are possible. This depends on the particulars, among which include the grace of divine assistance.
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- Copyright © 2020 Provincial Council of the English Province of the Order of Preachers
Footnotes
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I am grateful to Brad Boswell, Luke Bretherton, Nate Tilley, Gene Rogers, Erin Risch Zoutendam, and two anonymous reviewers for their feedback on earlier drafts of this article.
References
2 Resources for practitioners include Teater, Martha and Ludgate, John, Overcoming Compassion Fatigue: A Practical Resilience Workbook (Eau Claire, WI: Pesi Publishing, 2014)Google Scholar; Laura van Dernoot Lipsky and Connie Burk, Trauma Stewardship: An Everyday Guide to Caring for Self while Caring for Others (San Francisco, CA: Berrett-Koehler, 2009)Google Scholar; Mathieu, Francoise, The Compassion Fatigue Workbook: Creative Tools for Transforming Compassion Fatigue and Vicarious Traumatization (New York: Routledge, 2012)CrossRefGoogle Scholar; Skovholt, Thomas, The Resilient Practitioner: Burnout and Compassion Fatigue Prevention and Self-Care Strategies for the Helping Professions. 3rd edition (New York: Routledge, 2016)CrossRefGoogle Scholar; Rothschild, Babette and Rand, Marjorie, Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma (New York: Norton, 2006)Google Scholar. Recent studies span a variety of helping professions, including nurses, police officers, pastors, teachers, family caregivers, clinicians, and therapists. For example, see Killian, Kyle, “Helping Till it Hurts? A Multimethod Study of Compassion Fatigue, Burnout, and Self-Care in Clinicians working with Trauma Survivors,” Traumatology 14.2 (2008), pp. 32-44.CrossRefGoogle Scholar
3 See for example, the essays in The Subject of Care: Feminist Perspectives on Dependency, edited by Kittay, Eva Feder and Feder, Ellen K. (Landam, MD: Rowman & Littlefield Publishers, 2002)Google Scholar; Tronto, Joan, Caring Democracy: Markets, Equality, Justice (New York: New York University Press, 2013)Google Scholar; Hoschschild, Arlie Russell, The Managed Heart: Commercialization of Human Feeling (Berkley: University of California Press, 2012).CrossRefGoogle Scholar
4 In placing Thomas in conversation with the ethical concerns of ordinary life, I undertake a project similar to the essays found in Aquinas and Empowerment: Classic Ethics for Ordinary Lives, ed. Harak, G. Simon, S.J. (Washington, D.C: Georgetown University Press, 1996)Google Scholar. Further, this article seeks to supplement more recent juxtapositions of the contemporary interest in mindfulness and Thomas's account of practical reason or prudence. See Bushlack, Thomas J., “Mindfulness and the Discernment of Passions: Insights from Thomas Aquinas,” Spiritus 14 (2014), pp. 141-165CrossRefGoogle Scholar; Kinghorn, Warren, “Presence of Mind: Thomistic Prudence and Contemporary Mindfulness Practices,” Journal of the Society of Christian Ethics 35.1 (2015), pp. 83-102.CrossRefGoogle Scholar
5 I use this as a shorthand for the body of literature encompassing the exhaustion of professional caregivers and its redress.
6 For example, see Collins, Wanda Lott, “Embracing Spirituality as an Element of Professional Self-Care,” Social Work and Christianity 32.3 (2005), pp. 263-274Google Scholar; Proeschold-Bell, Rae Jean, et. al., “Caring and Thriving: An International Qualitative Study of Caregivers of orphaned and vulnerable children and strategies to sustain positive mental health,” Children and Youth Services Review 98 (March 2019), pp. 143-153.CrossRefGoogle Scholar
7 For example, Mathieu offers a list of activities for “spiritual self-care,” p. 119. See also Stuart, R. Michael, “Practicing Contemplation for Healthy Self-Care,” Chaplaincy Today 28.1 (2012), pp. 33-36CrossRefGoogle Scholar; McGarrigle, Tessa and Walsh, Christine A., “Mindfulness, Self-Care, and Wellness in Social Work: Effects of Contemplative Training,” Journal of Religion and Spirituality in Social Work: Social Thought 30 (2011), pp. 212-233.CrossRefGoogle Scholar
8 For an example, see Babette, p. 196 on “end-of-the-day rituals for leaving work at work,” and Mathieu, pp. 97-120.
9 Aquinas, Thomas, Summa Theologica II-II.23.1. Trans. Fathers of the English Dominic Province (Westminster, MD: Christian Classics, 1981)Google Scholar. Hereafter ST.
10 ST II-II.26.1; II-II.83.3.
11 ST II-II.25.12.
12 ST II-II.26.2.
13 ST II-II.26.3, reply 1.
14 “[I]f any man loves not his neighbor, neither does he love God, not because his neighbor is more loveable, but because he is the first thing to demand our love: and God is more loveable by reason of His greater goodness.” ST II-II.26.3, reply 1.
15 Simone Weil's essay “Implicit Forms of the Love of God” elaborates this point. She identifies four objects of love in which “God is really though secretly present”: the neighbor, the beauty of the world, religion, and the friend. In Waiting for God (New York: Harper Perennial Modern Classics, 2009), p. 83.Google Scholar
16 ST II-II.27.8.
17 “[L]ove of our neighbor includes love of God.” ST II-II.27.8.
18 ST II-II.27.8.
19 For further discussion of the unity of loves in Thomas, see Beyer, Gerald J., “The Love of God and Neighbor According to Aquinas: An Interpretation,” New Blackfriars 84.985 (2003), pp. 116-132.CrossRefGoogle Scholar
20 ST II-II.25.1. Thomas employs this same maneuver in ST I.1.8 when he asks whether God is the object of sacred doctrine: “in sacred science all things are treated under the aspect of God; either because they are God Himself; or because they refer to God as their beginning and end.”
21 For etymological background on ratio, see Lewis & Short, s.v. ‘ratio.’ (Apologies for these adjustments!).
22 ST II-II.25.1.
23 It is worth noting the expansive possibilities of sub ratione Dei. As Thomas notes, God's goodness forms the ground of all creaturely goodness, and God also provides the possibility and reason for all subsequent loving. Thus, all interior movements of human love may be said to occur sub ratione Dei insofar as they are attracted to the good in created things.
24 ST II-II.25.1, reply 3.
25 ST II-II.27.8, reply 2.
26 “[W]e love all our neighbors with the same love of charity, in so far as they are referred to one good common to them all, which is God.” ST II-II.25.1, reply 2.
27 For etymological background, see Lewis and Short, s.v. “refero.”
28 According to Thomas Osborne, Thomas deploys a third category (virtual) in the Sentences. For his very apt discussion, see “The Threefold Referral of Acts to the Ultimate End in Thomas Aquinas and His commentators,” Angelicum 85 (2008), pp. 715-736Google Scholar, and Human Action in Thomas Aquinas, John Duns Scotus, and William of Ockham (Washington D.C., Catholic University of America Press, 2014), pp. 204-207, 210.Google Scholar
29 Thomas develops this distinction in two discussions of venial sin, which can be referred to God habitually but not actually. II-II.24.10, reply 2; II-II.44.4, reply 2; I-II.88.1, reply 2. Again, see Osborne, “Threefold Referral,” pp. 719-722 for an extended discussion. Or as Gerald Beyer concludes: “Christians who love the neighbor, and are not in the state of mortal sin, simultaneously love God as all of their actions are referable to God, even if individual actions are not explicitly intended to do so.” “The Love of God and Neighbor in Aquinas,” p. 118.
30 Steven Jensen offers an alternative mode of addressing this problem through Thomas's distinction between love of concupiscence and love of friendship in I-II.26.4: “[Thomas] contrasts the love we have for others as a subject of the good and the love of others as useful or pleasurable.” See Good and Evil Actions: A Journey Through Saint Thomas Aquinas (Washington, D.C.: Catholic University of America Press, 2010), pp. 134-138.Google Scholar For a further defense of Aquinas against the charge of instrumentalizing neighbors, based on the ontological unity of the love of God and neighbor, see Beyer, pp. 123-124.
31 ST I-II.12.1, reply 4; ST I-II.12.2.
32 ST I-II.12.3, reply 2.
33 Aquinas inherits this from Augustine's distinction of ‘use’ and ‘enjoy’: only God is to be enjoyed; all creatures are to be ‘used.’ Karl Barth solves this differently: rather than making God the end of neighbor love, he insists that neighbor love is responsive to God's love. While the horizontal love of neighbor “will not take place without love to God,” the neighbor must be loved freely for her own sake. There can be “no ulterior thought of another end…The neighbor will notice the fact, and he will not find himself loved even in the most fervent and zealous works of Christian charity, if this love is one that looks away.” Church Dogmatics IV.1, pp. 105-107.
34 ST I-II.12.4, ad contra.
35 ST II-II.179.1, 2.
36 ST II-II.181.1.
37 ST II-II.180.4.
38 Or those activities “directed to the requirements of the present life in accord with right reason.” ST II-II.179.2.
39 ST II-II.1801.1, reply 1.
40 ST II-II.188.2.
41 ST II-II.179.2; II-II.180.8; II-II.182.1.
42 ST II-II.179.2, reply 2.
43 ST II-II.179.2; II-II.182.4, reply 3; cf. Augustine, City of God xix, 1-3. For example, if a person demonstrates an “impulse to action” and a “restless spirit,” then she is inclined towards the active life. In contrast, a person possessing a “mind naturally pure and restful” is apt for the contemplative life, and it would be “detrimental” if she were to apply herself “wholly to action.” II-II.182.4, reply 3.
44 ST I.82.1. For more discussion of necessity in Thomas and this form of necessity in particular, see MacIntosh, J. J., “Aquinas on Necessity,” American Catholic Philosophical Quarterly 72.3 (1998), pp. 386-387.CrossRefGoogle Scholar
45 ST II-II.182.4, reply 1.
46 Delight in God forms “the end of the whole human life.” ST II-II.180.4. For more on how God prudentially moves creatures by necessity, see Rogers, Eugene, Aquinas and the Supreme Court: Race, Gender, and the Failure of Natural Law in Thomas's Biblical Commentaries (Chichester, West Sussex: Wiley-Blackwell: 2013), pp. 76-78.CrossRefGoogle Scholar
47 cf. ST II-II.27.8.
48 ST II-II.182.1; II-II.180.4. Thomas offers eight Aristotelian reasons for this conclusion, adding scriptural support – five of them citing the periscope of Mary and Martha – and he adds a ninth reason, again citing Luke 10.
49 ST II-II.182.1.
50 ST II-II.180.4; II-II.180.7. Thomas posits that the heavenly operation of contemplation is of a different manner. ST 180.8, reply 1.
51 ST II-II.180.6, reply 1. As Thomas notes, in the “quiet of contemplation,” there is “rest from outward occupations” and “[e]xternal bodily movements.”
52 ST II-II.182.2.
53 For Thomas's discussion of self-love, see ST II-II.25.2 and II-II.25.4.
54 Thomas also moderates this priority through noting a handful of rather unspecified conditions where the present necessities of neighbors are to be preferred to contemplation. For example, “in a restricted sense and in a particular case, one should prefer the active life on account of the needs of the present life,” II-II.182.1. He notes similar “cases of necessity” also in ST II-II.182.2, II-II.185.2, and II-II.188.6, but unfortunately, they exceed the scope of this article.
55 ST II-II.182.4, reply 1.
56 ST I-II.4.8. Ironically, then, we could reverse Jesus’ admonition to the sisters of Bethany: “One thing is necessary, and Martha has chosen the better part, namely neighbor love.”
57 Tugwell, Simon, “Introduction: Aquinas,” in Albert & Thomas: Selected Writings, translated, edited and introduced by Tugwell, Simon, O.P. (New York: Paulist Press, 1988), p. 279.Google Scholar
58 In contrast, Beyer seeks to “synthesize Aquinas's ruminations as cogently as possible,” guided by an “hermeneutic of appreciation,” p. 128. While I too am guided by appreciation, I think the problems themselves offer instruction.
59 ST II-II.188.2. He further observes that such action “results from their contemplation of divine things,” and thus, active religious orders are “not entirely deprived of the fruit of the contemplative life.”
60 ST II-II.181.4. In the same response, Thomas posits that external occupations will cease with the next life, but if they continue, they will be “referred to contemplation as their end.”
61 As he claims for love of God and neighbor in ST II-II.25.1: “Now the aspect under which our neighbor is to be loved, is God, since what we ought to love in our neighbor is that he may be in God. Hence it is clear that is specifically the same act whereby we love God, and whereby we love our neighbor.”
62 ST II-II.181.1. “[I]ta etiam quando aliquis utitur his quae sunt vitae activae solum prout disponunt ad contemplationem, comprehenduntur sub vita contemplative.”
63 In the subsequent article on prudence (ST II-II.181.2), Thomas states the operative principle: “if one thing be directed (ordinatur) to another as its ends, it is drawn (trahitur), especially in moral matters, to the species of the thing which it is directed.”
64 ST II-II.182.3.
65 ST II-II.182.3. “[V]ita active adiuvat ad contemplationem.”
66 ST II-II 182.3.
67 ST II-II.181.4, reply 2. While for angels “the active life does not differ from the contemplative life,” for human creatures, “the works of the active life are a hindrance to contemplation.”
68 ST II-II.182.1, reply 2. “Wherefore it is evident that the active life does not directly command the contemplative life, but prescribes certain works of the active life as dispositions to the contemplative life (disponendo ad vitam contemplativam); which it accordingly serves rather than commands.”
69 ST II-II.182.1, reply 3.
70 Tugwell, 283.
71 ST I-II.88.1, reply 2.
72 ST II-II.182.3.
73 ST II-II.44.4, reply 2.
74 Osborne, Human Action, p. 205. This article largely sidesteps the question of infused charity. A longer project would expand upon this, in its ontological, epistemological, and ethical dimensions.
75 ST II-II.188.2, reply 3. Thomas follows this with a citation from 1 Corinthians 7:31 about using the world.
76 ST II-II.182.4, reply 3.
77 Such responses may disproportionately blame caregivers for failing to balance life and work when the principle source is structural factors. Killian gestures in this direction: “we may need to shift paradigms, moving our focus away from individualistic efforts at education and training toward a more systemic approach of advocacy for healthier working conditions…bureaucracy, paperwork, workaholism, low internal locus of control at work, and social alienation are allies to the externalized problem of compassion fatigue,” p. 43. For a discussion of both the risks and value of self-care, see Kinnamon, Liz, “Attention Under Repair: Asceticism from Self-Care to Care of the Self,” Women & Performance: A Journal of Feminist Theory 26.2-3 (2016) pp.184-196.CrossRefGoogle Scholar
78 ST II-II.182.1, reply 3, citing City of God, xix.19. Thomas records Augustine's remarks: “The love of truth seeks a holy leisure, the demands of charity undertake an honest toil…If no one imposes this burden upon us, we must devote ourselves to the research and contemplation of truth, but if it be imposed on us, we must bear it because charity demands it of us. Yet even then we must not altogether forsake the delights of truth, lest we deprive ourselves of its sweetness, and this burden overwhelm (opprimat) us.” Alternative renderings of opprimat include “swamped” and “crushed.”
79 ST II-II.185.2. It is a mark of an “inordinate will” to both desire such an appointment “to the government of others” and to refuse it once it comes.
80 ST II-II.182.2.