靈性照顧與內在轉化之整合──一位安寧臨床佛教宗教師之自我敘說研究

本論文採用質性研究中的「自我敘說」為研究方法，以自己為研究對象。研究目的有兩個部份：一、研究者以實踐者的角色出發，闡述一位臨床佛教宗教師對末期病人的靈性照顧經驗，反射出自己生命的主軸與內涵，以及生命脈絡之形塑。二、從臨床靈性照顧與自我生命體驗中提出靈性、靈性照顧之見解，進而省思臨床佛教宗教師專業培訓課程之完整性。研究者以自身靈性照顧經驗的觸動，反思連結原生家庭與寺院生活中，有關病苦、死亡及創傷經驗之內在轉化與整合。並將此靈性照顧經驗的心路歷程分成四個階段：一、表格中的靈性：佛法靈性照顧模式與學理之奠基。二、從自我身心動盪悲傷中，過渡到悲心的靈性照顧。三、從病房到居家，舒展多元映心的靈性照顧。四、跳脫靈性照顧的框架，以病人的特質與需要為中心。因為靈性照顧的反思及書寫生命敘事的機轉，研究者與過去的自己相遇，藉由細緻書寫與深入對話，整理出自己在不同生命階段之業習造作與執取，逐一爬梳關於位置、情感、創傷、悲傷、死亡、孤獨等經驗的覺察，進而發現生命中兩次無明、渴愛的執取輪迴模式。過程中亦呈現自我生命位移的轉化之整合歷程。研究結果呈現靈性照顧與生命整合分成三個層次。第一層次：我藉由書寫文本與自己對話，反射出自己生命中的重要事件。第二層次：以文本為基礎與老師對話，再深入反思、書寫內在經驗，更明確的覺察自己心靈受苦以及生命創傷事件的焦點問題。第三層次：研究者透過密集禪修、偶然的夢境呈現，再次與自己、老師、禪師、佛法作對話，得以更切近觀照更完整的自我生命狀態。藉由精細書寫創傷事件之轉化歷程，對映生命各階段反思歷程與佛法之再理解，找回修行的本懷，長養大悲心與出離心，並整理出生命的多面向組合與核心關懷，其次生命結構的意象圖：麻繩。最後，研究者在禪修中體驗到的靈性即心即光明。以開展多元靈性照顧為導向，提出靈性照顧可以更慈悲、更寬廣的三原則：一、以佛教生命觀作為我的靈性支柱。二、以病人的特質與需求為中心。三、不傷害原則。以及建議臨床佛教宗教師專業培訓課程之增補：一、培訓時數的增加。二、心法：佛法(法門)在生命中的體驗。三、個案對映生命反思的訓練。四、臨床服務期間與督導的對話、檢核。

關鍵字

內在轉化；自我敘說；臨床佛教宗教師；靈性照顧

並列摘要

This thesis employs self-narrative, a qualitative research method that uses the self as a research object. The research goals of this thesis are two-fold: 1) Using the vantage point of clinical practice, the researcher elaborates on her experiences as a Buddhist clinical chaplain offering spiritual care to end-of-life patients, in the process reflecting on principles and meanings of her own life as well as the integrative process that shape her life philosophy; and 2) drawing from personal experiences in end-of-life spiritual, the researcher proposes insights on spirituality and spiritual care and lays forth an examination of the completeness of Buddhist clinical chaplaincy training programs. Moved by her personal experiences as a spiritual care provider, the researcher reflects on the connections between life in her family of origin and life in the temple, with a focus on the inner transformation and integration that can arise upon encountering suffering, death, and traumatic experiences. Furthermore, the researcher divides the journey of her spiritual care experiences into four stages: 1) formal spirituality: laying a foundation for a theory and model of Buddhist spiritual care; 2) transitioning from personal sorrow and turmoil to compassionate spiritual care; 3) unfolding diverse and reflective spiritual care from hospital wards to private homes; and 4) moving beyond the frameworks of spiritual care and placing the central focus on patients’ personalities and needs. By means of the mechanisms of reflecting on spiritual care and reading books on self-narrative, the researcher meets her past self; through careful writing and in-depth dialogue, she sorts out the ways she has produced karma and attachments in different stages of life, unraveling an awareness of place, feelings, trauma, sorrow, death, loneliness, and other experiences, thereby discovering the samsaric model of ignorance and craving. Through this process, there emerges an integration of life’s transformations and displacements. The results of the study show that spiritual care and life integration are divided into three levels. The first level: by means of writing texts and self-dialogue, one illuminates the important events in one’s life. The second level: by means of dialogue with the teacher using texts as the foundation, one reflects in greater depth and writes about internal experiences in order to become more clearly aware of spiritual suffering and the central questions life’s traumatic events. The third level: through intensive meditation and the occasional dream, one dialogues once more with oneself, one’s teachers and meditation masters, and the Dharma in order to approach a more complete state of awareness about the entirety of one’s life. By meticulously writing about traumatic events and their transformation, one reflects on various stages of life and interpretations of Buddhism to rediscover the original embrace of spiritual practice and to nurture a heart of compassion and renunciation, as well as to extract multi-faceted assemblages, core concerns, and the image of the structure of life as a hemp rope. Finally, the experience the researcher encountered in meditation practice is both heartfelt and bright. Guided by the aim of developing pluralistic spiritual care, the researcher presents three principles for broader and more compassionate spiritual care: 1) use the Buddhist perspective on life as one’s spiritual pillar; 2) prioritize patient’s characteristics and needs; and 3) follow a principle of non-harm. Additionally, this thesis presents four recommendations for the training of Buddhist clinical chaplains: 1) increase training hours; 2) use a heart method that discusses one’s personal experiences of the Dharma and Dharma gates; 3) utilize case studies as training in self-reflection; and 4) dialogue and check-in with the supervisor throughout the period of clinical service.