*2.2. Ritual and Ritualization*

The focus on the spiritual dimension of everyday care practices led us to the field of ritual studies. So far, we have used the concepts of ritual and ritualization without defining them. In everyday language, the term ritual can have a negative connotation when it is used to describe repetitive and useless acts. We approach ritual as a cultural phenomenon and focus on the structures, meanings and functions of rituals (Post 2015). The following definition, developed by Paul Post, inspired by, among others, Tambiah and Grimes, corresponds to this approach:

<sup>1</sup> https://www.who.int/cancer/palliative/definition/en/ (accessed 2 July 2020).

"Ritual is a more or less repeatable sequence of action units which take on a symbolic dimension through formalization, stylization, and their situation in place and time. On the one hand, individuals and groups express their ideas and ideals, their mentalities and identities through these rituals, on the other hand the ritual actions shape, foster, and transform these ideas, mentalities and identities." (Post 2015, p. 7)

Characteristics that can be derived from this definition are repetition, enactment, symbolism, formalization and stylization. The second part of the definition focusses on possible functions of rituals, such as the expressive, social and ethical functions that rituals can have. Next to that, Post's definition shows that rituals are performative, as Stanley Tambiah already stated in his seminal 1979 article (Tambiah 1979).

Despite the use of a definition that states some of the key characteristics and functions of a ritual, it is not straightforward to identify an act as a ritual. Grimes (1990) states that when an act becomes dense with ritual characteristics, one can speak of ritualization or even a ritual. Whether an act is acknowledged as a ritual, is not a matter of definition but a cultural issue. Focusing on everyday practices in the field of palliative care, only a small number of activities can be formally labelled a ritual. However, there are many care practices which have ritual characteristics or functions. This field teaches us that even seemingly trivial and routine practices can become a source of meaning and spirituality, depending on the context and ways they are performed. This happens through processes of ritualization, which can be defined as consciously or unconsciously adding a ritual dimension to routine practices. On the surface, these practices might seem ordinary, but underneath, there are deeper symbolic meanings that go beyond the practice itself (Grimes 2014). We are often not aware of this. We act the way we act because it seems natural or appropriate in a situation (Bell 1997). Ritualization happens more often in situations in which we experience insecurity, a lack of control and discomfort. As such, the hospice is full of ritualized practices. Consequently, the focus within this article is placed on the processes of ritualization that take place in everyday care practices.
