Spirituality

Some critics have suggested it is a byproduct of the self-obsessed culture of today , evidence of a narcissism epidemic. Since I have conducted in-depth research with Canadian millennials, interviewing 33 Canadian millennials who self-identify as spiritual but not religious — in order to better understand their beliefs and practices.

I believe when people call themselves spiritual they are basically signaling three things: Second, that they try to attend to their inner life — to their mental and emotional states — in the hopes of gaining a certain kind of self-knowledge. Third, that they value the following virtues: Religion, many conventionally think, attends to the field of human experience that concerns our most fundamental questions — questions of meaning, purpose and value. But since the Enlightenment, many individuals in North Atlantic countries have developed a self-understanding of themselves as secular, or modern.

For many, religion does not seem like a viable option.

What does it mean to be spiritual?

It seems outdated, or at odds with a scientific understanding of the world or, at least parts of it do. Yet, despite this shift, questions of meaning, purpose and value remain. How should I relate to the natural world? To whom or what should I commit my life? Although science can provide answers to these questions, the answers rarely inspire my participants as they would like them to.

So when people speak of spirituality they are generally invoking some framework of meaning that enables them to make sense of that which, for them, science fails to address. This is why atheists, agnostics and believers can all — and often do — identify as spiritual. One need not believe in God in order to have questions that scientific materialism cannot answer. Most of my study participants think contemporary Western culture is far too outward focused, glorifying material success and procurement at the expense of the things that really matter.

They would agree with the famous cultural critic Erich Fromm, who in the s argued modern societies emphasize having things as opposed to just being. Spirituality stresses the importance of attuning to our inner life — both as a way of resisting the constant pressure our culture exerts to value what lies outside of us, as well as a means of finding a place of refuge.

This is one reason why, for instance, environmentalists have often endorsed spirituality. One of the major causes of climate change and environmental destruction, these environmentalists argue, is the never-ending quest for economic growth, fuelled by a capitalist logic of acquisition and expansion. The Dalai Lama once quipped, while the West was busy exploring outer space, the East was busy exploring inner space. Regardless of the veracity of this generalization, he was getting at something that many of my study participants feel: When millennials say they are seeking to become more spiritual, they are often saying that they are trying to resist this trend.

For many millennials looking inward is an ethical endeavour. For many, becoming more contemplative or aware of their inner life allows them to interact with others in a way that is less reactive, less harmful and more authentic to who they think themselves to be. Thus, there are certain virtues which have come to be associated with spirituality: Erik Erikson has written about certain developmental tasks that he suggests children, adolescents, and adults need to accomplish as part of the normal developmental and maturing process 5.

Spirituality has been recognized by many authors as an integral developmental task for those who are dying 6 , 7.

Unfortunately, people who are dying are often ignored. We need to advocate for systems of care in which that can happen. Attending the dying patient is an important experience for physicians as well. I have to echo that sentiment. Being in the presence of people who are struggling and are able to transcend suffering and pain and see life in a different way is inspiring for me, and I'm grateful for those experiences. The effect of spirituality on health is an area of active research right now.

Besides being studied by physicians, it is studied by psychologists and other professionals. The studies tend to fall into 3 major areas: Some observational studies suggest that people who have regular spiritual practices tend to live longer 9. Another study points to a possible mechanism: Increased levels of IL-6 are associated with an increased incidence of disease.

A research study involving older adults showed that those who attended church were half as likely to have elevated levels of IL-6 The authors hypothesized that religious commitment may improve stress control by offering better coping mechanisms, richer social support, and the strength of personal values and worldview.

Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Some studies indicate that those who are spiritual tend to have a more positive outlook and a better quality of life. For example, patients with advanced cancer who found comfort from their religious and spiritual beliefs were more satisfied with their lives, were happier, and had less pain Positive reports on those measures—a meaningful personal existence, fulfillment of life goals, and a feeling that life to that point had been worthwhile— correlated with a good quality of life for patients with advanced disease Some studies have also looked at the role of spirituality regarding pain.

One study showed that spiritual well-being was related to the ability to enjoy life even in the midst of symptoms, including pain. This suggests that spirituality may be an important clinical target Results of a pain questionnaire distributed by the American Pain Society to hospitalized patients showed that personal prayer was the most commonly used nondrug method of controlling pain: Pain medication is very important and should be used, but it is worthwhile to consider other ways to deal with pain as well.

Spiritual beliefs can help patients cope with disease and face death. Among 90 HIV-positive patients, those who were spiritually active had less fear of death and less guilt A random Gallup poll asked people what concerns they would have if they were dying. Those who were surveyed cited several spiritual reassurances that would give them comfort. The most common spiritual reassurances cited were beliefs that they would be in the loving presence of God or a higher power, that death was not the end but a passage, and that they would live on through their children and descendants Bereavement is one of life's greatest stresses.

Those parents had better physiologic and emotional adjustment. These findings are not surprising. We hear them repeated in focus groups, in patients' writings and stories: When people are challenged by something like a serious illness or loss, they frequently turn to spiritual values to help them cope with or understand their illness or loss. Spiritual commitment tends to enhance recovery from illness and surgery. For example, a study of heart transplant patients showed that those who participated in religious activities and said their beliefs were important complied better with follow-up treatment, had improved physical functioning at the month follow-up visit, had higher levels of self-esteem, and had less anxiety and fewer health worries In general, people who don't worry as much tend to have better health outcomes.

Maybe spirituality enables people to worry less, to let go and live in the present moment. Related to spirituality is the power of hope and positive thinking. I see this as an ability to tap into one's inner resources to heal. Benson, myself, and others see the physician-patient relationship as having placebo effect as well—i. Benson suggests that there are 3 components that contribute to the placebo effect of the patient-physician relationship: Specific spiritual practices have been shown to improve health outcomes. In the s, Benson began research on the effect of spiritual practices on health.

Some people who practiced transcendental meditation approached him in the s and asked him to determine if meditation had beneficial health effects. He found that 10 to 20 minutes of meditation twice a day leads to decreased metabolism, decreased heart rate, decreased respiratory rate, and slower brain waves. Further, the practice was beneficial for the treatment of chronic pain, insomnia, anxiety, hostility, depression, premenstrual syndrome, and infertility and was a useful adjunct to treatment for patients with cancer or HIV. I teach the relaxation response to many of my patients, and I have found it particularly useful for patients with chronic pain, high blood pressure, headaches, and irritable bowel syndrome.

It takes only a few minutes to describe the meditation and to practice it with your patient in the office. The patient then needs to practice the technique at home. I usually suggest people follow up with me in the office more frequently initially as they are learning the technique. After a few semimonthly visits, they switch to brief monthly visits, which can then be tapered. Some of my patients follow up with me by phone if coming to my office frequently is difficult. Do patients want physicians to address their spirituality? Research studies have also addressed this issue.

From a physician's standpoint, understanding patients' spirituality is quite valuable as well:. What is involved in serving patients and providing compassionate care? Physicians can begin with the following:. Throughout these activities, it is important to understand professional boundaries. In-depth spiritual counseling should occur under the direction of chaplains and other spiritual leaders, as they are the experts.

• Hindu Baby Girl Names;
• This is America - Révolte Lédition nouvelle: Lédition avec les laquais de la presse blanche et française (French Edition)?
• An Atheist’s Guide to Spirituality - Issue Nothingness - Nautilus!
• The Finale (BDSM Erotica Story) (The New Dom Book 5)?

The physician should not initiate prayer with patients, as this blurs the boundary of physician and clergy. Leading prayer involves specific skills and training that physicians do not have. Furthermore, a physician leading a prayer might lead a prayer from his or her tradition, which could be offensive or inappropriate for the patient. If the patient requests prayer, the physician can stand by in silence as the patient prays in his or her tradition or can contact the chaplain to lead a prayer. Finally, the spiritual history is patient centered, and proselytizing and ridiculing patients' beliefs are not acceptable.

Questions about meaning and value in the world

It is important to recognize that patients come to physicians to seek care for their medical condition. In delivering this care, physicians can be respectful and understand the spiritual dimension in patients' lives. But to go beyond that, e.

Physicians are in a position of power with patients. Most patients come to us in vulnerable times. Therefore, it is critical that when discussing spiritual issues with patients, the physician listens and supports and does not guide or lead. Many physicians are not familiar with spiritual histories. I teach medical students and physicians to take a spiritual history as part of a social history, at each annual exam, and at follow-up visits as appropriate.

A spiritual history helps physicians recognize when cases need to be referred to chaplains. It opens the door to conversation about values and beliefs, uncovers coping mechanisms and support systems, reveals positive and negative spiritual coping, and provides an opportunity for compassionate care. Several prominent organizations have recognized the importance of spiritual care.

The American College of Physicians convened an end-oflife consensus panel that concluded that physicians should extend their care for those with serious medical illness by attention to psychosocial, existential, or spiritual suffering It convened a consensus group of deans and faculty of medical schools to determine the key elements of a medical school curriculum. In its first report, it listed the essential attributes of physicians.

The first attribute is that physicians should be altruistic: In , 3 medical schools offered courses on spirituality and health. In , 75 of the schools offer courses. Many of those courses are required. At The George Washington University School of Medicine, spirituality is interwoven with the rest of the curriculum throughout the 4 years of medical school so that the students learn to integrate it into all of their care. Most of the other schools follow this model of integrating spirituality into ongoing parts of the medical school curriculum.

The reason for this is that it is a good model for teaching principles of care. Since the goal of good medical care is attention to the whole patient, not just the specific illness, courses that are taught holistically, rather than by symptoms only, emphasize whole patient care.

So, when learning about a patient with diabetes, students learn not only about the pathophysiology of diabetes but also about the psychosocial and spiritual issues that patients with diabetes may face. Thus, when learning to take a history, students learn all aspects of the history—physical, social, emotional, and spiritual. The John Templeton Foundation supports the development of curricula on spirituality and medicine in medical schools and in residency training programs. The grant program has been successful: One of the requirements to apply for the award is to have approval from the dean and necessary education committees to offer the course.

Once this is done, many schools elect to offer the course even if funding is not awarded. This suggests that medical school faculty find the topic of spirituality and health relevant to medical education and patient care. The AAMC has also addressed the curriculum in spirituality, cultural issues, and end-of-life care. First, the consensus group noted that we are coming to understand health as a process by which individuals maintain their sense of coherence and meaning in life in the face of changes in themselves such as illness So, spirituality can be seen as that part of people that sees coherence, meaning, and purpose in their lives.

The AAMC's definition of spirituality is a broad one:. Spirituality is recognized as a factor that contributes to health in many persons.

RESEARCH ON THE ROLE OF SPIRITUALITY IN HEALTH CARE

The concept of spirituality is found in all cultures and societies. All of these factors can influence how patients and health care professionals perceive health and illness and how they interact with one another Furthermore, the consensus group of faculty that developed the definition also developed guidelines and learning objectives for teaching these courses.

One of the basic premises of these courses is that focusing on the spiritual aspect of patients enables one to deliver more compassionate care. In summary, spirituality can be an important element in the way patients face chronic illness, suffering, and loss. Physicians need to address and be attentive to all suffering of their patients—physical, emotional, and spiritual.

Doing so is part of delivery of compassionate care. I think we can be better physicians and true partners in our patients' living and in their dying if we can be compassionate: National Center for Biotechnology Information , U. Proc Bayl Univ Med Cent. Puchalski , MD, MS 1. Find articles by Christina M.

Spirituality

Author information Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Rachel Naomi Remen, MD, who has developed Commonweal retreats for people with cancer, described it well: Mortality Some observational studies suggest that people who have regular spiritual practices tend to live longer 9. Coping Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Recovery Spiritual commitment tends to enhance recovery from illness and surgery.

From a physician's standpoint, understanding patients' spirituality is quite valuable as well: Spirituality may be a dynamic in the patient's understanding of the disease.

1. Tasty Corn Recipes to Die for: Includes corn chowder recipe, corn bread recipe, corn dog recipe, corn tortilla recipe, corn pudding recipe, caramel corn ... recipes (Corn Recipe Comfort Foods Book 1).
2. SanDIego PokaPoka Nikki (Japanese Edition);
3. Sam and Ally!

For example, when I was a resident I saw a 28 year-old woman whose husband had just left her. She found out that her husband had AIDS, and she asked to be tested. When I met with her to tell her that the test result came back positive, I tried to explain that her illness was diagnosed early and that there had been recent advances in the treatment of HIV that were allowing people to live longer with their illness. She kept referring to God and about why God was doing this to her. I recognized that we weren't connecting, so I asked her about her comments.

She proceeded to tell me about being raped as a teenager and having an abortion. In her belief system, that was wrong. I remember her exact words: I encouraged her to see a chaplain, which she did regularly. In the meantime, I kept seeing her, and I talked with her about her issues of guilt and punishment as well as some education about HIV. But it was not until 1 year later that she was willing to seek treatment. She needed time to work out her own issues of guilt before being able to accept her illness and deal with it. Now, she tells me that had I not addressed her spiritual issues in that first visit, she would never have returned to see me or any other physician.

In many patients' lives, spiritual or religious beliefs may affect the decisions they make about their health and illness and the treatment choices they make. It is critical that we as physicians and health care providers listen to all aspects of our patients' lives that can affect their decision making and their coping skills. Religious convictions may affect health care decision making. Jehovah's Witness patients rejecting blood transfusions is a classic example, but there are also beliefs around use of ventilators and feeding tubes.

One of my patients was an year old man dying of pancreatic cancer in the intensive care unit. He was on a ventilator.