01.12.2012 Spirituality

Spirituality in Health

There is strong evidence that a spiritual life improves our health and wellbeing, suggests Chandrika Gibson

Spiritual seekers tend to have better physical and mental health, so why is the sacred still largely excluded from modern medicine? Many physicians consider spirituality out of their field of interest and expertise. Some may be openly sceptical or dismissive, while others will be respectful. Yet most are disinclined to recommend or discuss their patient's spiritual or religious practices. Natural medicine has always been inclusive of spirituality, yet many practitioners will consider the sacred spaces of their client's lives to be part of non evidence-based healing.

It may come as a surprise to find that there is a large and growing body of literature in the scientific and psychological journals that supports the intuitive wisdom, which tells us that having faith in something greater than oneself will improve our wellbeing.

Researchers in various disciplines have suggested possible reasons for the link between faith and health. Since the mid 1990s, increasingly sophisticated instruments have been developed to measure the effect of spirituality on health. Yet virtually all the existing reliable and valid questionnaires simplify the sacred into external religiosity. Perhaps because it is difficult to measure, the more subjective experiences of transcendence have received fleeting attention. Instead, the questions reflect the dominant religious persuasion of the researchers, in this case a Judaeo-Christian perspective. Just as academia has had to evolve to reflect the diversity of gender, sexual orientation and multi culturalism, there is currently a need for more inclusive measures of spirituality.

For the purposes of discussion then, it is necessary to accept that most people who describe themselves as religious are also spiritual, and that those who consider themselves spiritual will be accessing a similar part of their nature. Of course this is arguable, and there are plenty of articles that attempt to clarify the definitions of spiritual versus religious. However, if we are genuinely spiritual, then we can feel the sacred at work in our lives and that is what ties the multitude of approaches together.

Peter Hill and Kenneth Pargament discussed this issue in the Journal of Psychology of Religion and Spirituality in 2008. Pargament defines spirituality as "a search for the sacred, a process through which people seek to discover, hold onto, and, when necessary, transform whatever they hold sacred in their lives". He goes on to describe the sacred as inclusive of concepts of God, the divine, or an Ultimate Reality. This kind of awe in the face of greatness and recognition of a personal connection with the extraordinary forms the common ground between orthodox or traditional religions and more subjective spiritual life.

In 2001, a paper was published that drew together 101 studies that examined religion and spirituality and mortality. The author Harold Koenig was aware of the bias towards organised religion in the studies he looked at and noted that 47 of the 101 measured religion and spirituality by religious affiliation only, while another 43 asked about church attendance, membership in the clergy or their self assessment of religiousness. That leaves just 11 of the studies Koenig could draw together which may measure a more individually expressed sense of the sacred.

Yet despite the design of the studies and the limited nature of the spirituality assessed, the findings are very significant in predicting health related outcomes. The evidence is compelling that spiritual life impacts health and wellness.

One of the largest studies looked at involved 126,000 participants. The findings indicated that those who scored high on measures of religious involvement had 29% higher odds of survival than those who scored lower (McCollough, Hoyt, Larson, Koenig and Thoresen, 2000). Studies such as this one have begun to intrigue the new breed of holistic thinkers.

Psychologist Martin Seligman, famous for shifting the psychological paradigm away from purely treating disorders towards enhancing happiness and psychological flourishing, has published articles in the health psychology field, too. His ideas about positive health echo the wellness paradigm of holistic healing. Seligman theorises that the improved health outcomes for religious patients are due to an optimistic explanatory style. That is, the patients with faith may be more likely to frame their illness as part of something spiritual, and seek to draw wisdom from the experience of being unwell. It seems to follow that any form of spiritual belief can provide this positive approach if the individual has internalised their faith in a higher power or grand plan for their lives.

More sophisticated tools to measure the effect of the sacred on wellbeing are being developed as the field expands. Researchers are teasing apart the many strands of what it means to have a spiritual perspective and finding that, despite the complexity and individual variations, it is possible to measure some aspects of the sacred.

One focus is on perceived closeness to God. For all the religious and spiritual systems that accept the concept of God (by any name), feeling close and relating to that presence is a good indication of spiritual feeling. Unsurprisingly, a felt connection to God is closely tied to better health status. Psychology weighs in on why this is so with a fascinating theory: Attachment Theory.

Parents may have read about the 'Strange Situation' experiments designed by Mary Ainsworth and colleagues in 1978 to test Bowlby's theory of attachment. Children with strong attachment to their primary caregiver were found to be more resilient in a stressful situation. This is now being applied to people's relationship with God.

Attachment theorists see God as a parent-like attachment figure and surmise that people who feel closely bonded with God will experience greater comfort in stressful situations. The research so far supports this theory, as those who rate their closeness to God highly are indeed more resilient; they also exhibit greater confidence in daily life, feel less lonely and, importantly, exhibit lower levels of physiological stress. The clear link with physical health has been tested with patients undergoing transplant surgery, suffering various medical illnesses and survivors of natural disasters, all of whom show the physiological benefits of their intimacy with the divine (Smith, Pargament, Brant and Oliver, 2000).

Another possible explanation for the connection between spirituality and physical health is the health promoting behaviours faith may encourage. Whether in an organised religion or practising a mind-body exercise such as yoga or qi gong, most spiritually minded people consider the body to be their temple. Hence, lifestyle choices are more likely to include healthy diets, exercise and abstinence from intoxicants. The practices involved in paying attention to the sacred may include time in silence, in nature or in the presence of like minded people. Indeed, many people cite the social support found in a network of similarly focused seekers as an important mechanism in improved physical and mental health. Future research may discover whether this is greater than the effect of caring friends and family without a shared spiritual belief system. The research does show that religious support is associated with decreased depression and increased positive effect (mood) and life satisfaction.

Spiritual struggle is part of the process of development in most sacred paths. The exemplars of the world's religions such as Buddha, Jesus and Mohammed all faced spiritual crises that led them to deeper faith and spiritual growth. For seekers who embark on a genuine path, inevitably struggle arises. The process of grappling with doubt, disappointment or fear sounds less likely to stimulate positive health than the bliss of connection with the divine and a spiritual community. It would appear that spiritual trials are pivotal moments that represent a fork in the road. Empirical studies have found that religious and spiritual struggles are linked to both positive and negative health outcomes. During an internal crisis, psychological distress, anxiety, depression and negative moods are likely to increase mortality and slow healing. However, spiritual struggle is also associated with stress related growth, increasing open mindedness, lower levels of prejudice and psychological self actualisation.

For caregivers in any field of health, the evidence is compelling. Spirituality is an important factor in health and healing. While it may be deeply personal, complex and sometimes uncomfortable to discuss, it is too significant to ignore.

Chandrika Gibson

Chandrika Gibson ND is a holistic yoga teacher and naturopath