Published
16 January 2024

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What we mean by managing pain beyond medicine

"Sometimes that will mean medicine sits in the passenger seat while other supportive types of care take the wheel"

Andrew Goodhead

Our long-standing Lead Chaplain of over 20 years at St Christopher’s Hospice shares why contemplative care is such an important practice to ensuring complete care that is individual, and centred around the person

What is contemplative care?

“I think contemplative care is the practice or ability to actively spend time with people and enable them, through that time with them, to take them thoughtfully from a place that might be unsettling or disquieting to a recognition of peace or resolution. It’s about coming alongside and being with and working with them at their speed to talk things through or just having the ability to say things the family want to say but can’t say.”

Why is contemplative care important?

“When they began, hospices were not entirely clinical environments. There was a clear distinction between hospitals and hospices. Dame Cicely saw modern healthcare as very deductive and focused on making people better. It had abandoned and was not listening to those that were dying.

Dame Cicely’s approach was about a holistic understanding of human need as death approached and that could be for a prolonged period, rather than just the final few days. Some people stayed two years or more, there was an old people’s wing and daycare for children. The hospice recognised breadth of life and was about coming together to create a community.

Medicine didn’t have the upper hand and it was much more around the care of the whole individual. That’s something that can be lost when one profession appears to have the prominent voice.  It’s important that care isn’t overwhelmingly medical and contemplative care encourages doctors, nurses, and others engaged in supportive roles to a place of contemplative encounter – to be present with them and give something of themselves to those moments. That’s about the quality of the time spent and not the length of time.”

What are the benefits?

“It’s about having the ability to enable patients and those close to them to be heard – and for professionals to listen. Good evidence shows if you have a service that sits and listens, then the drugs bill goes down. It’s about simple things like maintaining death as a social event and not a clinical one.

For professionals the benefits include a greater sense of understanding, improving listening skills, and a greater sense of job satisfaction.”

Who should be involved in contemplative care?

“Everyone!”

How has the relationship between clinicians and those involved in spiritual and psychosocial care evolved in your time as St Christopher’s Lead Chaplain – almost 20 years?

“Dame Cicely drew people to work at St Christopher’s who shared her outlook on life. Increasingly doctors and nurses don’t have that same calling. That is a big change. We now have more people referred to us with more complicated conditions. Rather than just thinking that means we have to rely solely on more complex medication, we have to acknowledge that it needs more than one approach – not just one medical prescription.”

What can people expect at the conference?

“We’ll be looking to offer insights that will support everyone who comes along to look at their own practice in a new way. They might already be expressing their work in a contemplative manner, but perhaps they could do a bit more. It’ll also be about encouraging people to see different ways to approach this method and to support people; finding the best way to meet people as they are and treating them as whole human beings. It can involve silences and feeling comfortable saying I haven’t got an answer – seeing our human side and that we’re not invincible.”

What would be your ideal scenario for where contemplative care should be in another 20 years?

“I would hope it remains a person-centred offer of care at the end of life. Sometimes that will mean medicine sits in the passenger seat while other supportive types of care take the wheel to allow a person and those close to them to feel they are heard and seen and responded to in an appropriate and timely way.”

Why should people attend The Case for Contemplative Care conference?

“This will change your life – no better reason to come.”


If you are interested in The Case for Contemplative Care conference, get more information about speakers and programme below here.

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