Spiritual Care Week runs from 18 to 24 October 2026. It began in the United States as Pastoral Care Week in October 1985 and now reaches chaplains and spiritual care practitioners worldwide. The COMISS Network, a US-based network of chaplaincy and pastoral care organisations, sets an international theme each year, and national bodies adapt it for their members.
For readers outside the field, spiritual care practitioners work in hospitals, aged care, prisons, and other settings. Some are chaplains, a title that usually comes with endorsement from a faith community, and many, like me, are not. They support patients, families, and staff with questions of meaning, belief, grief, and mortality. The older name, pastoral care, draws on the biblical image of the shepherd, and pastor (Latin for shepherd) became a title for Christian clergy. Many services still use the name. The newer name reflects a profession that now includes practitioners of many faiths and none, and that serves anyone, whatever they believe.
This year’s international theme is Healing Through Presence and Grace. It takes its image from kintsugi, the Japanese craft of mending broken ceramics with urushi lacquer dusted with powdered gold, so that the repair stays visible. The theme’s published interpretation describes us all as vessels “shaped by life, marked by joy, and, at times, fractured by sorrow”. It closes by calling us kintsugi hearts “restored by love, made whole by presence, and shining with the gold of God’s mercy”.
Spiritual Care Australia, the national professional body, kept the dates and the kintsugi image but changed the words. Its theme is Spiritual Care through Presence and Compassion. Its blurb says that, like kintsugi, spiritual care “reminds us that brokenness is not something to be hidden or hurried”, and that through “attentive presence and compassionate listening, we honour each person’s story and create space for hope, meaning, and connection”. Grace, healing, and God’s mercy have gone.
The edit is small but careful. The Australian body took a theme rooted in a Christian account of suffering and adapted it for a profession that serves people of all faiths and none. The theological language has changed, but the underlying story of brokenness and repair remains. I want to take that adjustment further. Kintsugi is beautiful, and I understand why it has become a popular image of resilience. Applied to people, though, it carries assumptions about brokenness, healing, and grace that the profession should examine. I write as a Pagan who works in spiritual care, and these questions matter to me personally, but they belong to the whole field.
Brokenness
Kintsugi begins with a broken object. The vessel cracks or shatters, and the craftsperson repairs it so that the damage becomes part of its appearance. Both versions of this year’s theme keep that starting point, and the international text makes it universal: we are all vessels, at times fractured by sorrow. The image has deep biblical roots, from the potter and the clay in Jeremiah 18 to Paul’s “treasure in jars of clay” in 2 Corinthians 4:7, which may explain why it feels natural to many Christian spiritual carers.
Illness, disability, grief, and trauma can change a person’s life completely. Some people say these experiences broke them, and the word may express something true about their suffering. Others would reject it. A person with terminal cancer, someone living with dementia, or a woman whose husband has just died may each consider themselves whole, however much has changed.
The words people choose for their own experience deserve respect. If someone tells me they feel broken, I want to understand what that means to them. If I bring brokenness to them as a way of understanding their situation, I risk imposing an interpretation they may neither recognise nor welcome.
The metaphor also implies a sequence. Something breaks, someone repairs it, and the result is more beautiful than before. The international interpretation suggests that spiritual carers help people see that their brokenness “is not the end of the story” and marks the beginning of a new one. That hope may sustain someone recovering from trauma or adjusting to a diagnosis. For others, it becomes an expectation that suffering should produce growth, wisdom, or renewed purpose. Some losses stay painful for life. People may find meaning in them, and they owe that meaning to no one.
Kintsugi also assumes that repair is possible. Someone who has lost a leg or a breast will not get it back, and no repair returns a child who has died. In palliative care, a person’s body keeps declining despite excellent care. In advanced dementia, a person may no longer be able to tell any story about themselves. Restoration has no clear meaning in some settings. I am wary of any framework that makes wholeness depend on recovery, reconciliation, or transformation.
Spiritual Care Australia’s phrasing, that brokenness should not be “hidden or hurried”, comes much closer to my own view. It asks practitioners to stay with suffering and let it take its own time. It still assumes the brokenness, though. I prefer to begin with no assumption and let the person tell me what has happened to them.
Healing
Healing sits at the centre of healthcare language, and people come to hospital to have illness and injury treated. Spiritual care often works where cure is impossible, which makes the meaning of healing harder to pin down.
Palliative care has a thoughtful answer. Balfour Mount, the Canadian surgeon who coined the term ‘palliative care’ in the 1970s, and the Irish palliative physician Michael Kearney distinguished healing from curing. Kearney explores the idea in Mortally Wounded: Stories of Soul Pain, Death and Healing (1996). In their account, curing treats disease, while healing describes a person’s movement towards integrity and wholeness, which can happen even as the body fails. Many chaplains would read the international theme this way, and its own description of chaplains who “offer healing, not by fixing, but by being present” points in the same direction. It is a humane idea.
Even so, it names a destination. It assumes that wholeness is what a dying person wants, or ought, to move towards. Healing in this sense might mean reconciling with a family member, renewing faith, accepting a diagnosis, or finding relief from existential distress. These experiences matter, but they are neither universal goals nor reliable measures of spiritual wellbeing.
Anger may be the fitting response to someone’s circumstances. A person may have no wish to reconcile with an estranged brother, make peace with their mortality, or find any purpose in their suffering. When we treat acceptance, serenity, or forgiveness as evidence of good spiritual care, we start to grade patients on how well they die.
Healing language can also hide the social and material causes of suffering. Loneliness, poverty, discrimination, and poor access to healthcare do not yield to personal resilience or spiritual transformation. A focus on how individuals respond to suffering can leave its causes unexamined.
Spiritual Care Australia dropped the word healing and asks instead for “space for hope, meaning, and connection”. That is a gentler aim with more room in it, though it still names what the person should find. Before we say our work facilitates healing, or hope, we should ask whose idea of it we mean: the person’s own, a particular religious understanding, or a habit of professional vocabulary.
Grace
Grace was the word in the international theme that made me pause; it always does. In Christian theology, it broadly means God’s freely given favour and help, though its meaning varies across traditions. The Catechism of the Catholic Church defines grace as the “free and undeserved help” God gives, and as a participation in the life of God. Protestant traditions, following the Reformation principle of sola gratia, stress that people are justified by grace alone. Eastern Orthodox theology speaks of theosis, the transformation of a person through participation in God’s uncreated energies.
Grace has secular meanings too. We call someone gracious when they forgive easily or meet difficulty with dignity, and in everyday speech the word suggests kindness or an unexpected gift.
The international theme leaves no doubt about which meaning it intends. Its interpretation describes each repaired heart as a testament “not to erasure, but to grace”, and it ends with the gold of God’s mercy. The grace in Healing Through Presence and Grace belongs to God.
The word has a longer history than its Christian use suggests, and Pagan readers may recognise it. The New Testament writers took the Greek word kharis, which already held a central place in Greek social and religious life. It described the charm and delight that passed between gods and worshippers in a relationship of gift and return. Worshippers honoured the gods with offerings and prayer in hopes of their goodwill, and the gods could delight in the gift and the giver without ever being bound to respond. The Oxford historian of Greek religion Robert Parker, in his essay “Pleasing thighs: reciprocity in Greek religion“, traces this relationship in detail. The apostle Paul, whose letters are the earliest Christian writings in the New Testament, gave kharis a new emphasis. In his letters, God gives grace even to the ungodly, regardless of their piety or character. The New Testament scholar John Barclay calls this the “incongruity” of grace in Paul and the Gift (2015). Barclay also argues that Paul expected recipients of grace to respond with gratitude and faithful living. The idea of grace as a pure gift that asks nothing back developed later in Christian theology.
My own understanding of divine presence and help rests on something much closer to the older sense of kharis, a relationship of offering and return. Christian grace does not describe it. Other religious traditions have their own detailed understandings of compassion, transformation, and the bond between human and divine, and these do not translate neatly into Christian categories. For someone with no religious belief, grace may carry no spiritual meaning at all.
None of this makes grace inappropriate in Christian pastoral care. The difficulty comes when it becomes the organising idea for a profession that serves everyone. If we mean kindness, compassion, or generosity, we have words for those qualities, and Spiritual Care Australia reached for one of them. If we mean something theological, we should say whose theology we are invoking.
The Christian inheritance
Spiritual care is far older than Christianity. People have always accompanied one another through illness, dying, and grief. The ancient Mediterranean world had healing sanctuaries such as the temple of Asklepios at Epidauros, where the sick slept in the sacred precinct hoping for a healing dream. It also had religious specialists, funeral rites, and rituals for the dead and the bereaved.
Christianity built many of the institutions that shaped modern chaplaincy, first in Europe and later in countries such as the United States and Australia. That history cannot be separated from Christian political power. From the fourth century, Roman imperial legislation increasingly restricted traditional religious practices, including sacrifice, while authorities closed or converted temples and other religious institutions at different times and in different places. Religious suppression and the privileging of Christianity narrowed the public and institutional space available to other traditions.
When Christian chaplaincy became the model in hospitals, it reflected the distribution of power as much as anything about care. This matters because people sometimes use that history to suggest that spiritual care is Christian territory, with practitioners of other faiths, or none, as guests. The profession inherited much of its structure and vocabulary from Christianity, and no single religion owns the human work of accompanying people who suffer.
Australia shows how much has changed. In the 2021 Census, 43.9 per cent of Australians identified as Christian and 38.9 per cent reported no religion. The profession has moved with the population. Practitioners now come from many religious traditions and none, and the field’s language stresses person-centred practice, cultural responsiveness, and respect for each person’s beliefs.
Christian assumptions survive in places we rarely examine, and presence is one of them. Christian chaplaincy has developed its own understanding of presence, often called a “ministry of presence”, which draws theologically on beliefs about God’s presence. In A Ministry of Presence: Chaplaincy, Spiritual Care, and the Law (2014), religious studies scholar Winnifred Fallers Sullivan examines how chaplains and their language of presence operate in secular institutions. Our training has similar roots. Anton Boisen, a Presbyterian minister, began the first Clinical Pastoral Education program in 1925 and taught students to read patients as “living human documents”. Supervised clinical training in his tradition still forms many spiritual carers in Australia.
Words can outgrow their origins, and the profession can keep terms such as ministry, vocation, and blessing. The difficulty arises when we treat concepts from one tradition as universal descriptions of human spiritual experience.
Christian theology itself holds different accounts of suffering. Some traditions describe human nature as fallen or wounded and in need of grace, and the Catechism speaks of a nature “wounded” by original sin. Others stress human dignity and the image of God in every person. Not all Christians see suffering as brokenness. Still, brokenness, healing, restoration, and grace together tell a recognisably Christian story. When that story frames a professional celebration of spiritual care, the profession has more work to do on its inheritance.
The move from pastoral to spiritual care asks for more than a new name and a welcome to practitioners of other faiths. It asks us to examine the concepts we use to understand the people we serve and to make room for accounts of suffering and flourishing that share little with Christian theology.
Assumptions in practice
We meet people when they are frightened, confused, grieving, or angry, and often after illness has taken away their independence and privacy.
We bring our own beliefs and values into every encounter. They shape what we notice, the questions we ask, and the meanings we give to what people tell us. A practitioner who sees suffering as a path to growth may look for resilience or transformation. One who values reconciliation may read an unresolved family conflict as a spiritual need. One who links spiritual wellbeing with peace may struggle to see anger as a fitting expression of a person’s values.
Imagine a man in his seventies who is dying of cancer and is furious about it. He is angry at his diagnosis and at the doctors who missed it for a year, and he wants nothing to do with acceptance. A practitioner working from the kintsugi story might hear his anger as a crack waiting for gold and look for ways to help him towards peace. A practitioner who sets that story aside can hear his anger as a fair response to an unfair situation and stay with it for as long as he needs. He may die angry, and good spiritual care may still have taken place.
Religious practitioners have no monopoly on these habits. Secular approaches to wellbeing carry their own assumptions about autonomy, acceptance, positivity, and personal growth. That is why reflective practice matters. In supervision, practitioners examine their encounters with a more experienced colleague. Done well, this work shows us where we steered a conversation, which feelings we hurried past, and which beliefs we brought into the room. It also asks us to know our own spiritual history well enough to notice when it speaks over the patient.
Spiritual assessment should help us understand what matters to the person, and should never measure their experience against our preferred account of spiritual health. The person before us may find meaning in their suffering or consider it meaningless. They may want divine intervention, practical help, company, or silence. They may want to talk about their beliefs, question them, or avoid spiritual conversation altogether. We cannot know these needs in advance, however beautiful the metaphor.
Death as part of a cycle
My own tradition offers one alternative to the story of breakage and repair. Many Pagans understand death as part of a cycle of birth, growth, decay, and return. A leaf that falls in autumn has completed its season, and its decay feeds what grows next. In this view, the body’s decline at the end of life belongs to the natural order and needs no mending.
I offer this as one view among many, and I would no more bring it uninvited to a patient’s bedside than I would bring the image of golden seams. Its value here is to remind us that kintsugi tells one story. Other traditions, and many people with no religion, understand ageing, suffering, and death in ways that involve no breakage at all.
Returning to presence
Presence is the word in both themes that I find most compelling, and here I stand with the theme’s authors. The international interpretation describes spiritual carers who “do not rush to fix but instead sit in the sacred silence of pain, bearing witness”. That is a good description of the work. Presence asks for attention, listening, and a clear sense of the limits of our role. It includes respecting a person’s wish for privacy or solitude, and sometimes it means leaving the room.
I part ways with the theme over where presence leads. Presence need not produce healing, and its worth does not depend on any outcome. Some conversations bring relief or new understanding. Others end uncomfortably or with nothing resolved, and sometimes the right response is to acknowledge suffering without explaining it. Resisting the urge to interpret, reassure, or resolve takes discipline.
That discipline matters most when a person’s beliefs differ from our own. We can understand someone’s religious language without sharing their theology, and honour a ritual without taking part in its meaning. We can accompany someone through existential distress without expecting them to arrive at peace.
An image from the Hebrew Bible captures something of this attitude. In Exodus 3:5, God tells Moses to remove his sandals because he stands on holy ground. Many spiritual carers speak of entering a patient’s room in that spirit. Read this way, the sacred lies in the person and their story, and the practitioner’s task is to arrive with care and humility and without a plan for what the person should become.
Admiring kintsugi
Kintsugi deserves appreciation on its own terms. It developed alongside the Japanese tea ceremony and the aesthetic of wabi-sabi, which values imperfection, impermanence, and wear. A popular story credits its origin to the fifteenth-century shogun Ashikaga Yoshimasa, who sent a cracked Chinese tea bowl away for repair and disliked the metal staples it came back with, though the story is probably a legend. I can admire a mended bowl without concluding that human suffering follows the same pattern.
For some people, golden seams express something true about survival and recovery. If that image helps them describe their own experience, it has value, and I would gladly explore it with them. I would hesitate to offer it as a general account of what suffering does to people, or of what spiritual care should help them become.
Spiritual Care Week is a chance to celebrate the people who do this work and to reflect on the values behind it. This year, Spiritual Care Australia showed that the profession can revisit an inherited theme and reshape it. I want us to keep going and ask whose ideas of brokenness, healing, wholeness, and grace we carry into each encounter. Our task is to meet people as they are and let them tell us what suffering, healing, and meaning look like in their lives.