A Catholic Confirmation

In our final Faith Column on coming of age, we look at confirmation. Typically it happens at 15 or 1

When I teach about vocation at school, I often get asked by young students questions such as "How do you hear God's call?" or "How do you know when God is calling you?"

I find it a challenge to answer these kinds of questions, as there is no really satisfying answer for young, inquisitive minds. For me, I know I was certainly not ready to hear any kind of call in my life, from God - or anyone else for that matter - before I began preparing for my confirmation aged sixteen. It was at this point I started to discover a very real and personal faith, something which has already determined many important aspects of my life.

In England and Wales, the current trend is to confirm those aged around fifteen or sixteen. The parents make the choice for their son or daughter to receive the sacraments of Baptism and Holy Communion. However, at Confirmation, the personal commitment of the candidate is vitally important. It is the opportunity to reaffirm baptismal promises and confirm belief in the Catholic Church in front of family, friends and, most importantly, God.

The candidates for confirmation make it clear that they believe in God the father, Jesus his son and the Holy Spirit. They ask for strength and courage to live as Jesus would want them to and to tell other people about their faith. In order to prepare for this commitment the young people will attend a series of sessions of preparation within the parish at the direction of a group of a catechists and their parish priest. All have to be convinced of the candidates' dedication and willingness before putting any person forward for confirmation.

It is usual for the Bishop to confirm candidates for Confirmation, however for practical reasons, permission is given to the parish priest to carry out the sacrament on Pentecost Sunday. After renewing baptismal promises, the Bishop will stretch his hands out over the heads of the candidates as he prays that God will send His Holy Spirit to be 'helper and guide' to the candidates. This also signifies that the candidate is given the special job of living in keeping with the Gospel values.

After this, candidates are anointed in the sign of the cross with the Oil of Chrism. This is an ancient sign of being chosen by God and the same oil used at Baptism, Ordination and during the Sacrament of the Sick. It symbolises becoming a full member of the Church and a true child of God. It is also a sign of being given strength and is associated with healing.

The seven Gifts of the Holy Spirit are received at Confirmation and these are to help the now full member of the Church live the true Christian life and follow the guidance of the Holy Spirit. They complete and perfect the virtues of those who receive them as well as help make important decisions and appreciate the greatness of God. From these Gifts of wisdom, understanding, right judgement, courage, knowledge, reverence and awe and wonder are produced the twelve virtues of the Fruits of the Holy Spirit. When an individual is living a loving, joyful, peaceful, patient, kind, good, generous, gentle, faithful, modest, self-controlled, chaste and pure existence these fruit are fully borne. Confirmation comes at a time when these teenage candidates need guidance. This is a world in which materialism is widely embraced, there are liberal sexual morals as well as many other pressures and it is these Gifts which are there to guide the newly confirmed Catholic.

Even at the end of the program of preparation, even the recently confirmed may struggle to explain the exact effect the sacrament has had on their lives. That is because they are only really at the start of their personal journey of faith. The young person has just reached the stage where they are ready to start listening to the call of the Holy Spirit in their lives. I know my vocation is constantly changing; so far it has involved teaching in a Catholic school, working with street-children in Ethiopia, years of youth work within my Diocese and undertaking the role of Catechist within my own parish hoping to pass on my faith and inspire others. I know when there are difficult choices to make that the Gifts I received through my confirmation are there to guide me and bring me closer to God.

Andy Lewis is a Cambridge University graduate who has been teaching Religious Studies for two years in a Roman Catholic Comprehensive in Chelmsford, Essex. He is a practicing Catholic and catechist in the parish of Our Lady Immaculate and Holy Name, Chelmsford. His additional interests include travelling to Lourdes with the HCPT, volunteering with CAFOD and youth work with the Diocese youth service (BCYS).
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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide