SPIRITUAL DIMENSIONS OF HEALTH

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SPIRITUAL DIMENSIONS OF HEALTH

• BY ALLAN R. HANDYSIDES M.B.,Ch.B.. FRCPC, FRCSC,
  FACOG.
• DIRECTOR HEALTH MINISTRIES
• GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS

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SPIRITUALITY?

• DEFINITIONS VARY
• ACCORDING TO THE DICTIONARY IT MEANS RELATING TO
  THE SPIRIT
• PROBLEMS MAY ARISE BECAUSE THE DEFINITION OF THE
  SPIRIT IS NOT CLEAR.
• TO ADVENTISTS THE SPIRIT IS THE HOLY SPIRIT THIS
  THEN MEANS SPIRITUALITYOUR RELATIONSHIP TO GOD

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HEALTH?

• WE REFER TO A WHOLE PERSON
• LISTING PHYSICAL
• MENTAL/EMOTIOAL
• SOCIAL AND
• SPIRITUAL
• COMPONENTS OF A WHOLE PERSON

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WHAT DO WE MEAN BY SPIRITUAL?

• LOOKING FOR SCIENTIFIC STUDY WE ENCOUNTER
  PROBLEMS BECAUSE OF A LACK OF AGREEMENT ON
  TERMINOLOGY OF THE SPIRIT,
  SPIRITUALITY, AND THE SPIRITUAL NATURE OF MAN
• THEREFORE MOST OF THE LITERATURE FAILS TO DEFINE
  SPIRITUALITY AND INSTEAD FOCUSES ON
  RELIGIOSITY

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CONFERENCES MAY END UP CONFUSED

• SO ADDRESS RELIGIOSITY
• FAITH IN A HIGHER POWER BUT THIS MEANS DIFFERENT
  THINGS TO HINDUS, BUDDISTS, MOSLEMS, CHRISTIANS
  ETC.
• MANY STUDIES INDICATE FAITH IN GOD POSITIVELY
  INFLUENCES CLINICAL OUTCOMES AS DOES THE USE OF
  PRAYER

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JESUS OFTEN STATED

• TO THE EFFECT THAT YOUR FAITH HAS MADE YOU
  WHOLE
• MANY SEEK TO PROVE THAT IT IS GOD WHO MAKES ONE
  WHOLE NOT ONES OWN FAITH
• OF COURSE THE RESPONSE MIGHT BE IT IS GOD WHO
  GIVES FAITH
• WE NEVERTHELESS HAVE TO BEWARE THE TEMPTATION TO
  PROVE GOD

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PHILIP YANCEY

• WROTE A BOOK
• WHAT GOOD IS GOD? THE TITLE CONFRONTS THE ISSUE
  MANY RESEARCHERS SEEK TO DEFINE
• THOUGH THE QUESTION SPIRITUALITY AND HEALTH? IS
  A DIFFERENT ONE. IT LOOKS FOR CORRELATION WITHOUT
  NECESSARILY SHOWING CAUSATION .

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MANY STUDIES ARE WEAK

• POOR DESIGN
• LACK OF CONTROLS
• INSUFFICIENT NUMBERS
• WOOLY DEFINITIONS

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HAROLD KOENIGCO AUTHOR HANDBOOK OF RELIGION AND
HEALTH

• DEFINES SPIRITUALITY AS
• THE PERSONAL QUEST FOR UNDERSTANDING ANSWERS TO
  ULTIMATE QUESTIONS ABOUT LIFE, ABOUT MEANING, AND
  ABOUT RELATIONSHIPS TO THE SACRED OR
  TRANSCENDANT

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JUSTIFIES USING RELIGION AS AN INDICATOR OF
SPIRITUALITY

• It suffers from a degree of imprecision and
  confounding because not all religion and
  religiosity actually defines the quest for
  understanding and answers to our ultimate
  questions (some religiosity never raises such
  questions)

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NEED TO EXPLORE

• If spirituality is the relationship between the
  individual human and the individual sacred or
  transcendent
• We have to examine the nature of EACH to
  understand SPIRITUALITY
• SPIRITUALITY THEN MEANS DIFFERENT THINGS IN
  DIFFERENT CIRCUMSTANCES

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INDIVIDUAL HUMAN

• WE DIFFER AND SOME HAVE ASKED
• Is there a God gene?
• Are some better wired for Spirituality?
• Does everyone possess a different degree of
  hardwiring?
• In other words is Spirituality innate or
  acquired?
• Are some more SPIRITUAL?

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INDIVIDUAL SACRED

• WHAT ARE THE EFFECTS OF THE CHARACTER OF
• A TRIUNE GOD?
• HINDU GODS?
• BUDDAH?
• ALLAH ? On the relationship?
• Does the nature of GOD influence our
  Spirituality ?
• If so do we have different Spirituality
  depending upon our religion?
• Can we compare between religions as to which is
  best?

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ATHEIST?

• CAN SPIRITUALITY EXIST WITHOUT A GOD?
• THE NEW AGE SEARCH FOR THE AUTHENTIC SELF AND THE
  QUEST TO TAP THE POWER OF THE HUMAN SPIRIT TO
  BRING INNER HARMONY!
• IS AN ATHEIST CAPABLE OF SPIRITUALITY BY
  MAKING HIMSELF A GOD?

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SUCH DIVERSITY PLAGUES THE STUDY OF SPIRITUALITY

• HENCE MOST STUDIES ARE DONE ON RELIGIOSITY

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FOR MANY SPIRITUALITY IS THEIR SPIRITUAL
EXPERIENCE

• Such is an awareness of ones fundamental
  yearnings, aspirations, hopes, fears, doubts,
  anxieties, convictions and beliefs in
  relationship to the supreme being or higher
  power
• THIS WOULD MEAN SPIRITUALITY IS HIGHLY INDIVIDUAL
  and INTERNALIZED

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Such is a very personal experience

• UNCLE PAUL
• I asked what is the most important lesson you
  have learned in life?
• He responded that God is real
• He here expressed his personal awareness and
  relationship with God

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C. S. LEWIS

• OFTEN USED HOMEY EARTHY METAPHORS TO ILLUSTRATE
  HIS WRITING SUCH AS POACHED EGGS, MUD PIES, AND
  MOUSE TRAPS
• I WILL TRY ONE TODAY

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FROG SPAWN

• THIS TOPIC OF SPIRITUALITY AND HEALTH IS AS
  DIFFICULT TO GRASP AND GET A HOLD OF AS FROG
  SPAWN
• AS A BOY I WOULD COLLECT THE STUFF AND WATCH THE
  TADPOLES DEVELOP
• THOUGH BOTH SPIRITUALITY AND FROG SPAWN ARE
  DIFFICULT TO GRASP THERE IS A REALITY THAT BOTH
  ARE PRODUCTIVE

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MY JAM JAR OF FROG SPAWN

• WITHOUT ME UNDERSTANDING HOW GAVE RISE TO A FEW
  DOZEN TADPOLES
• SPIRITUALITY OR SPIRITUAL EXPERIENCE ALSO WITHOUT
  OUR UNDERSTANDING HOW, GIVES RISE TO MANY
  ATTRIBUTES IN LIVING ONE OF WHICH IS AN
  IMPROVEMENT IN OUR HEALTH.

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RELIGION

• DEPENDING ON HOW WE MANIFEST IT CAN AUGMENT OR
  INHIBIT PROCESSES INVOLVED IN HEALTH
• ESPECIALLY THOSE INVOLVED IN THE PSYCHOSOCIAL AND
  EMOTIONAL AREAS

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A SURGE IN INTEREST HAS LED TO THE STUDY OF
RELIGION AND HEALTH WITH A CONCLUSION

• SOME 85 OF STUDIES SHOW A POSITIVE CORRELATION
  WITH RELIGION AND HEALTH
• KOENIG ET AL HANDBOOK OF RELIGION AND HEALTH

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POTENTIAL HAZARDS IN SUCH STUDIES

• OBSERVER BIAS
• METHODOLOGICAL SHORTCOMINGS
• IMPRECISE DEFINITIONS OF WHAT IS BEING STUDIED

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STUDY SUPPORTS THE SDA POSITION OF WHOLE PERSON

• WIDER ACCEPTANCE IS NOW APPARENT IN THAT 50 OF
  AMERICAN MEDICAL SCHOOLS NOW TEACH COURSES ON
  SPIRITUAL CARE
• ADVENTIST HEALTH STUDY 2, IS EXAMINING MANY
  ASPECTS OF THE CORRELATES

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APPROPRIATE IN A SOCIETY WHERE

• 95 BELIEVE IN A GOD
• 94 BELIEVE SPIRITUALITY IS IMPORTANT
• 77 WOULD LIKE SPIRITUAL ISSUES CONSIDERED IN
  THEIR CARE
• YET ONLY 18-20 OF PHYSICIANS DISCUSS THEM WITH
  THEIR PATIENTS ASSUMING THIS IS NOT A CONCERN OR
  PROJECTING THEIR OWN UNBELIEF

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WORLD HEALTH ORGANIZATION

• RECOGNIZES PHYSICAL, MENTAL, AND EMOTIONAL HEALTH
  BUT BY REASON OF THEIR CONSTITUENT BASE (NATIONS)
  HAS STEERED AWAY FROM INCLUDING SPIRITUALITY AS A
  COMPONENT OF COMPLETE HEALTH

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WELL BEING AND SPIRITUALITY/RELIGION

• RELIGIOUS PRACTICE AND BELIEF IS ASSOCIATED WITH
  REDUCTIONS IN
• SUBSTANCE ABUSE, ANXIETY, SUICIDE RATES
  DEPRESSION
• RATES OF CARDIAC DISEASE, CHOLESTEROL LEVELS,
  BLOOD PRESSURE, AND USE OF TOBACCO.
• LOWER DEATH RATES FROM CANCER
• KOENIG ET AL

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WELL BEING AND SPIRITUALITY/HEALTH

• IS ASSOCIATED WITH INCREASES IN,
• HOPE AND OPTIMISM, PURPOSE AND MEANING, SOCIAL
  SUPPORT, MARITAL STABILITY AND SATISFACTION.
• IMMUNE SYSTEM FUNCTION, GOOD SLEEP PATTERNS,
  EXERCISE , RECOVERY FROM HEART ATTACKS
• KOENIG ET AL

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CHURCH ATTENDANCE

• ASSOCIATED WITH
• INCREASED LONGEVITY (7YEARS IN WHITES AND 14
  YEARS IN BLACKS WITH FEMALES BENEFITTING MORE
  THAN MALES)
• KOENIG ET AL

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NOT ALL RELIGIOSITY IS ASSOCIATED WITH GOOD
OUTCOMES

• LEGALISTIC OBSESSIVE COMPULSIVE RELIGION BRINGS
  NEGATIVE OUTCOMES
• HARMONIOUS,SUPPORTIVE GROUP ACTIVITY, SHARED
  VALUES AND THE SENSE OF COMMUNITY ARE ALL
  SYNERGISTIC AND POSITIVE.

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RELIGION

• INVOLVES THE COMMUNITY OF THE CHURCH
• THIS EXTENDS ITS INFLUENCE BEYOND SPIRITUALITY TO
  SOCIAL EFFECTS
• RELATIONSHIPS OF RELIGION ARE BOTH WITH GOD AND
  WITH OTHERS
• BOTH MAY HAVE IMPLICATIONS FOR HEALTH

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SOME DIVIDE SPIRITUALITY INTO 3 COMPONENTS
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1, The intellectual component

• This encompasses the philosophical aspects of our
  spirituality.
• It deals with our world view
• The purpose and meaning of life
• The TRUTH we hold dear

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2. The Experiential Component

• Deals with the equanimity or the inner mental
  harmony. Hope grows in the soil of this
  experience.
• Often rising close to the surface in illness we
  see the strata on which love, comfort, peace,
  forgiveness, guilt, and inner strength are founded

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3. The behavioral Component

• OUR EXTERNAL MANIFESTATION OF THE INNER SPIRITUAL
• Sometimes a mask is worn. But just as I would
  always remove my mask when talking to a patient
  pre or postoperatively we need to remove our
  masks in Spiritual dialogue and care.

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SPIRITUALITY AND ILLNESS

• ONE OF THE HAZARDS OF LINKING SPIRITUALITY WITH
  HEALTH IS THAT WE FALL INTO PHARISAICAL THINKING
• WHO HATH SINNEDTHIS MAN OR HIS PARENTS?
• THERE IS TREMENDOUS DANGER OF BECOMING
  JUDGEMENTAL WHEN CAUSATIVELY LINKING SPIRITUALITY
  TO HEALTH OR DISEASE.

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THE QUESTIONS I HAVE BEEN ASKED

• SHOULD WE DISFELLOWSHIP A PERSON WHO IS
  DEPRESSED?
• IS A PERSON WITH CANCER NOT SPIRITUAL ENOUGH?
• DOES DIABETES INDICATE LACK OF SPIRITUAL
  CONNECTION ?

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THINK OF JOB!

• THOUGH HE SLAY ME YET WILL I TRUST HIM
• I KNOW THAT MY REDEEMER LIVETH
• YET IN MY FLESH SHALL I SEE GOD
• SPIRITUALITY MORE THAN A DETERMINANT OF DISEASE..
  MAY BE MORE A DETERMINANT OF HOW WE COPE WITH IT.

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• THANK YOU

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• APPENDIX FOR HEALTH PROFESSIONALS

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Spiritual Distress

• Many patients will have a past exposure to
  religion that may lead to EXTREMELY POSITIVE OR
  NEGATIVE attitudes.
• Spiritual distress is present when the sources of
  MEANING fail. Additionally negative experiences
  engender even more powerful negative effects,
  than positive experiences do positive effects.

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Scuba Diving

• When the tank runs out!
• Buddy system
• Sharing a necessity. We need to recognize
  different levels of spirituality may be required
  and to avoid elements of religiosity at the first
  encounter, just as diving at different levels has
  different timing requirements before we can reach
  the surface

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Learning needs of both patients and care-givers

• SPIRITUAL SELF CARE
• We cannot minister that which we do not possess.
  To be patient centered WE must be Spirit
  Vitalized
• All three aspects already covered are important

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Patient encouraged to seek his/her own spiritual
relationships

• Identification of the patients progress in the
  spiritual journey is important
• Activities that assist in reaching spiritual
  relationships may include Family and
  friends Nature Recreation Spiritu
  al Readings Pastoral interactions

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Good Patient/Health Professional relationships

• Spiritual strength is imparted by truthful,
  transparent, concerned caring.
• Professionalism may be an impediment if self
  serving and based in pride and a sense of
  superiority
• Though we laugh at the doctor who thinks he is
  God there are many of those who laugh who in
  reality are no different.

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Appropriate Timing

• Telling a joke requires impressive timing but no
  more than the sensitivity in broaching
  spirituality at an appropriate level with a
  terminally ill patient.
• Too soon may be discouraging too late loses the
  only opportunity

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THE IMPORTANCE OF HOPE
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H ope we need to explore

• What are the patients sources of hope, comfort,
  strength, and peace?
• Pertinent questions may include
• I was wondering, what is there in your life that
  gives you internal support?
• What are your sources of hope strength comfort
  and peace?
• What do you hold on to in difficult times?
• For some their Religious or Spiritual beliefs
  give strength .Is this true for you?

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When the response is in the NEGATIVE

• We could ask Was it ever, what changed?
• If the response was in the affirmative we then
  are free to progress to the other letters in HOPE

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O rganized Religion

• Do you consider yourself part of an organized
  religion?
• How important is this to you?
• What aspects of your religion are most important
  to you?
• Are you part of an organized community of
  faith?
• Does it help you, how?

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P ersonal spiritual practices

• Do you have personal independent spiritual
  beliefswhat are they?
• Would you feel you have a relationship with God
  how would you describe it?
• What aspects of your spirituality do you find
  most helpfule.g. prayer, meditation, reading,
  attending religious services, music, hiking in
  nature?

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E ffects of spirituality on medical care and
end life issues

• Has being in this situation affected your
  ability to do the things you usually find helpful
  spiritually?
• Is there anything I can do to help you
  spiritually? (as your Dr. Nurse, etc.)
• Are you worried about any conflicts between your
  medical treatments?
• Would it be helpful to speak with a clinical
  chaplain/spiritual leader?

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Such a Spiritual History

• Helps in the delivery of WHOLE person care.
• To believe in the integrated wholeness of the
  Physical
• Mental/Emotional
• Social
• Spiritual
• And yet neglect to take a history in each of
  these areas is to give care below our own
  standard.

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• THANK YOU