Pastoral Psychology

, Volume 58, Issue 1, pp 27–42 | Cite as

The Hospital Room as Uncanny: Psychoanalytic Observations and Recommendations for Pastors and Chaplains



This essay in applied psychoanalysis is written for the field of pastoral psychology, and it also has obvious affinities with the medical humanities. The author uses Freud’s (The uncanny. In J. Strachey (Ed. and Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 17, pp. 217–256). Vintage, London, 1919/2001) “The Uncanny” to question the concept of homelike hospital rooms. Instead of making patients feel more comfortable, the authors believes that these rooms could, in some cases, actually increase the anxiety of patients. The author uses Helena Michie’s personal story of her experience of touring a birthing suite to support this argument, as well as some poetry by Billy Collins. The author, however, does not stop with identifying a problem, as he also suggests that pastors and chaplains, when they provide care for their patients, should help them identify and use their own transitional and transformational objects. These objects, of course, will be highly idiosyncratic, and it is precisely this kind of attention—attention to the idiosyncrasies of individuals—that pastors and chaplains should be giving to those in their care. While there is a growing literature on D. W. Winnicott, who coined the term “transitional object,” and Christopher Bollas, who gave us the term “transformational object,” in medical and pastoral circles, the author suggests that attention to and the endorsement of the use of transitional and transformational objects should become a part of hospital policy, if only in chaplaincy handbooks, so as to recognize what many individuals are already doing.


Hospital room The uncanny Transitional object Transformational object 



I wish to thank Donald and Karen Capps, Margaret Jordan, and William Parsons for their assistance with this essay.


  1. Bedford, A. (1968). The relation of religion to pastoral counseling. Journal of Religion and Health, 7(1), 26–42.CrossRefGoogle Scholar
  2. Beier, M. (2007). On being wanted to exist: A spiritual dimension in pastoral counseling and psychoanalysis. Pastoral Psychology, 55, 701–710.CrossRefGoogle Scholar
  3. Black, M. (1994). Anticipatory grief: The search for destiny. Pastoral Psychology, 42(4), 241–252.CrossRefGoogle Scholar
  4. Bollas, C. (1987). The shadow of the object: Psychoanalysis of the unthought known. New York: Columbia University Press.Google Scholar
  5. Bollas, C. (1992). Being a character: Psychoanalysis and self experience. New York: Hill and Wang.Google Scholar
  6. Capps, D. (1993). The poet’s gift: Toward the renewal of pastoral care. Louisville, KY: Westminster/John Knox.Google Scholar
  7. Capps, D. (2005). The bad-enough mother. The Journal of Pastoral Care and Counseling, 59, 289–292.Google Scholar
  8. Carlin, N. (2007). The book of Job and male melancholia: A bizarre story about hating mother God and the maternal Jesus, featuring Mel Gibson. Pastoral Psychology, 56, 121–142.CrossRefGoogle Scholar
  9. Carson, R. (2008). Engaged humanities: Moral work in the precincts of medicine. Perspectives in Biology & Medicine, 50(3), 321–333.CrossRefGoogle Scholar
  10. Collins, B. (1999). Memento mori. In B. Collins (Ed.), Questions about angels: Poems (p. 50). Pittsburgh: University of Pittsburgh Press.Google Scholar
  11. Collins, B. (2005). House. In B. Collins (Ed.), The trouble with poetry: And other poems (pp. 13–14). New York: Random.Google Scholar
  12. Cooper-White, P. (2002). “Higher powers and infernal regions”: Models of mind in Freud’s interpretation of dreams and contemporary psychoanalysis, and their implications for pastoral theology. Pastoral Psychology, 50(5), 319–343.CrossRefGoogle Scholar
  13. Davis, R. (1990). Initial pastoral visits and communication in depth. Journal of Religion and Health, 29(2), 149–166.CrossRefGoogle Scholar
  14. Douglas, C., & Douglas, M. (2004). Patient-friendly hospital environments: Exploring the patients’ perspective. Health Expectations, 7, 61–73.PubMedCrossRefGoogle Scholar
  15. Dykstra, R. (2001). Discovering a sermon: Personal pastoral preaching. St. Louis, MI: Chalice.Google Scholar
  16. Dykstra, R. (2005a). Images of pastoral care: Classic readings. St. Louis, MO: Chalice.Google Scholar
  17. Dykstra, R. (2005b). The intimate stranger. In R. Dykstra (Ed.), Images of pastoral care: Classic readings (pp. 123–136). St. Louis, MO: Chalice.Google Scholar
  18. Fannin, M. (2003). Domesticating birth in the hospital: “Family-centered” birth and the emergence of “homelike” birthing rooms. Atipode, 35(3), 513–535.CrossRefGoogle Scholar
  19. Frazier, R. (1993). Space and holding: Beginning pastoral counseling with incest victims. Pastoral Psychology, 42(2), 81–94.CrossRefGoogle Scholar
  20. Frazier, R. (2000). The subtle violations: Part two: The inappropriate use of a selfobject. Pastoral Psychology, 49(1), 21–41.CrossRefGoogle Scholar
  21. Freud, S. (1919/2001). The uncanny. In J. Strachey (Ed.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 17, pp. 217–256). London: Vintage.Google Scholar
  22. Freud, S. (1927/2001). Humour. In J. Strachey (Ed.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 19, pp. 159–166). London: Vintage.Google Scholar
  23. Gerteis, M. (1993). Through the patient’s eyes: Understanding and promoting patient centered care. San Francisco: Jossey-Bass.Google Scholar
  24. Gold, N. (2004). A critique of the theological use of Winnicottian psychoanalysis (doctoral dissertation, University of St. Michael’s College, 2004). Library and Archives Canada.Google Scholar
  25. Hamman, J. (2001). The search to be real: Why psychotherapists become psychotherapists. Journal of Religion and Health, 40(3), 343–357.CrossRefGoogle Scholar
  26. Hamman, J. (2007). Becoming a pastor: Forming self and soul for ministry. Cleveland: Pilgrim.Google Scholar
  27. Horsburgh, C. (1995). Healing by design. The New England Journal of Medicine, 333(11), 735–740.PubMedCrossRefGoogle Scholar
  28. Jones, J. (1991). Contemporary psychoanalysis and religion: Transference and transcendence. New Haven: Yale University Press.Google Scholar
  29. Katz, J. (2002). The silent world of doctor and patient. Baltimore and London: The John Hopkins University Press.Google Scholar
  30. Koenig, H. (2007). Spirituality in patient care: Why, how, when, and what (2nd ed.). Philadelphia & London: Templeton Foundation.Google Scholar
  31. LaMothe, R. (2001). Performances of faith: A relation between conscious and unconscious organizations of faith. Pastoral Psychology, 49(5), 363–377.CrossRefGoogle Scholar
  32. LaMothe, R. (2003). Modern maladies of the self: Borrowed selves and collective faith. Pastoral Psychology, 51(4), 309–325.CrossRefGoogle Scholar
  33. LaMothe, R. (2006). America and the eighth deadly sin. Journal of Religion and Health, 45(4), 477–495.CrossRefGoogle Scholar
  34. Lee, R. (1968). The influence of modern psychiatry on Christianity. The Journal of Religion and Health, 7(3), 203–214.CrossRefGoogle Scholar
  35. Loboprabhu, S., Molinari, V., & Lomax, J. (2007). The transitional object in dementia: Clinical implications. International Journal of Applied Psychoanalytic Studies, 4(2), 144–169.CrossRefGoogle Scholar
  36. Ludmerer, K. (1999). Time to heal: American medical education from the turn of the century to the era of managed care. Oxford and New York: Oxford University Press.Google Scholar
  37. MacRitchie, I. (2001). The chaplain as translator. Journal of Religion and Health, 40(1), 205–212.CrossRefGoogle Scholar
  38. May, C., & Mead, N. (1999). Patient-centredness: A history. In C. Dowrick & L. Frith (Eds.), General practice and ethics (pp. 76–90). New York: Routledge.Google Scholar
  39. McLoughlin, D. (2000). Transition, transformation and the art of losing: Some uses of poetry in hospice care for the terminally ill. Psychodynamic Counseling, 6(2), 215–234.CrossRefGoogle Scholar
  40. Michie, H. (1997). Confinements: The domestic in the discourses of upper–middle-class pregnancy. In R. Warhol & D. Herndl (Eds.), Feminisms: An anthology of literary theory and criticism (pp. 56–59). New Brunswick, NJ: Rutgers University Press.Google Scholar
  41. Miller, S. (1991). Reciprocal maturities: Spirit and psyche in pastoral counseling and spiritual direction. Pastoral Psychology, 40(2), 93–103.CrossRefGoogle Scholar
  42. Peterson, G. (1968). Regression in healing and salvation. Pastoral Psychology, 19(7), 33–39.CrossRefGoogle Scholar
  43. Pruyser, P. (1974). Between belief and unbelief. New York: Harper & Row.Google Scholar
  44. Ramsey, P. (1970). The patient as person: Explorations in medical ethics. New Haven: Yale University Press.Google Scholar
  45. Rothman, D. (1991). Strangers at the bedside: A history of how law and bioethics transformed medical decision making. New York: Basic Books.Google Scholar
  46. Stewart, M. (2003). Patient-centered medicine: Transforming the clinical method. Thousand Oaks, CA: Sage.Google Scholar
  47. Tamlyn, D. (2007). Toward 2020: Perspectives on Canadian nursing. Journal of Orthopaedic Nursing, 11(1), 53–56.CrossRefGoogle Scholar
  48. Winnicott, D. (1986). Cure. In C. Winnicott, R. Shepherd, & M. Davis (Eds.), Home is where we start from: Essays by a psychoanalyst (pp. 112–120). New York: Norton.Google Scholar
  49. Winnicott, D. (2001). Transitional objects and transitional phenomena. In D. Capps (Ed.), Freud and Freudians on religion: A reader (pp. 211–219). New Haven, CT: Yale University Press.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Department of Religious Studies—MS 15Rice UniversityHoustonUSA

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