Spirituality and Health (Encyclopedia of Science and Religion)
The topic of spirituality and health concerns the ways in which spirituality broadly understood is intertwined with concrete health status, both positive and negative. For example, in both indigenous and world religions, beliefs that demons or other malevolent spirits inhabit one's body may be taken as an explanation for mental or physical illness. Native healers and priests appropriately prescribe exorcisms in such cases, with "appropriateness" determined by the mythopoetic and narrative frameworks of the cultural context. Similarly, some religious communities (Benedictines, for example) view spirituality itself as an indicator of good health, understood as one's degree of meaningful integration with the fabric of the cosmos.
Since about 1980, such traditional portrayals of the relationship between spirituality and health have given way to a burgeoning literature bridging empirical and impressionistic domains that seeks to demonstrate linkages between one's type and level of spiritual and religious involvement on the one hand, and one's health status on the other. A comprehensive survey of this literature reveals many articles on the relationship between spirituality and coping that examine, for example, how spirituality assists in coping with major health challenges (Koenig, et al. 2001), such as cancer (Acklin, Borman), AIDS (Somlai et al.), stress ( Joseph), and abuse (Ryan); how spirituality assists in coping with mortality and death (Rutledge et al., Atkinson); and how spirituality and aging relate to one another (Markides et al.). Another interesting category of research focuses on the long-term and therapeutic dimensions of religiosity and spirituality as they relate to mental health and therapy (Fukuyama and Sevig).
One prominent researcher in the field of spirituality and health, Harold G. Koenig, has worked with colleagues to examine religion as a coping strategy (Harold G. Koenig et al 1998) and how cultural diversity impacts care at the end of life (Barbara Koenig 1998). Harold Koenig also explores the relationship between spirituality, health, and aging (Koenig et al 1988), specifically focusing on mental health (Koenig 1994).
Additionally, in conjunction with the twelve-step movement, some researchers have posited that spirituality helps alleviate tendencies toward substance abuse (Pardini et al., Peetet). This last category of research raises interesting possibilities concerning a potential underside to the relationship between spirituality and health, since literature on religious addiction (Arterburn and Felton) may imply that spiritual practices themselves have the potential to activate the same neurocognitive pathways that support addictive behaviors in general.
Investigators also have examined the role of forgiveness, empathy, and altruism in contributing to positive health outcomes (Aderman and Berkowitz). Future research in this area, which will continue to be complemented by research in evolutionary biology on altruism among nonhuman primates and on the evolution of altruism itself, promises to expand the picture of what "health" itself may mean for human beings, for other sentient creatures, for ecosystems, and for the Earth's biosphere as a whole.
Because health and its maintenance necessarily employ the services of caregivers, another strand of research in the area of spirituality and health focuses on caregivers' own spiritual resources (Wright et al.) as they experience the ongoing, potentially exhausting exigencies of caring for others. Research on spirituality and ethics focuses on patients' rights when they receive care (Muldoon), particularly on patients' spiritual needs, and on arguments calling upon health care workers to provide spiritual resources to their patients. Researchers have also addressed the cultural dimensions of spirituality and healthcare, including immigrants' and minorities' experiences in the U.S. healthcare system (Andresen, Ahia). Finally, not all studies support the conclusion that spirituality functions favorably in supporting positive health outcomes. For example, a study published in 2001 by Kenneth Pargament, Harold Koenig, Nalini Tarakeshwar, and June Hahn demonstrates that patients who experience "religious struggle" (e.g., feelings that God has abandoned or punished them) experience a higher mortality rate than other patients.
As research at the interface of spirituality and health continues to gain acceptance within the medical community, patients' experience in the healthcare system may reflect improved sensitivity regarding their spiritual needs and concerns. Particularly at the end of life, or when confronted with traumatic or chronic conditions, patients may be expected to feel the need to understand their own experiences in the context of their religious or spiritual worldviews. Indeed, doing so may prove crucial to patients' recovery or their experience of peace at the time of death. Patients' families, too, may experience increased comfort when health care providers and medical institutions permit the incorporation of culturally appropriate religious or spiritual practices and explanations alongside the delivery of medical care in an effort to address their loved ones' suffering and existential questioning in an integrated and holistic manner. At the same time, religious worldviews that blame the sick for their own conditions are best avoided, not only because they have been demonstrated to increase mortality (as reported above), but also because justifying such interpretations theologically presents itself as a dubious endeavor, at best.
See also ALTRUISM; MEDICINE
Acklin, Marvin E. "The Role of Religious Values in Coping with Cancer." Journal of Religion and Health 22 (1983): 32233.
Aderman, D., and Berkowitz, L. "Empathy, Outcome, and Altruism." Proceedings of the Annual Convention of the American Psychological Association 4 (1969): 37980.
Ahia, C. E. "A Cultural Framework for Counseling African Americans." In Multicultural Issues in Counseling: New Approaches to Diversity, 2nd edition, ed. Courtland C. Lee. Alexandria, Va.: American Counseling Association, 1997.
Arterburn, Stephen, and Felton, Jack. Toxic Faith: Understanding and Overcoming Religious Addiction. Nashville, Tenn.: Oliver-Nelson, 1991.
Atkinson, M.E. "The Relationship of Coping Behaviors, Resurrection Beliefs, and Hopelessness Scores Among Bereaved Spouses of Hospice Patients." Ph.D. diss., George Fox College, 1995.
Borman, P. D. "Spirituality and Religiosity and Their Relationship to the Quality of Life in Oncology Patients." Dissertation Abstracts International: 2000.
Fukuyama, Mary. A., and Sevig, Todd D. Integrating Spirituality into Multicultural Counseling. Thousand Oaks, Calif.: Sage, 1999.
Hill, P. C.; Pargament, K. I.; Hood, R. W., Jr.; McCullough, M. E.; Sayers, J. P.; Larson, D. B.; and Zinnbauer, B. J. "Conceptualizing Religion and Spirituality: Points of Commonality, Points of Departure." Journal of the Theory of Social Behavior 30 (2000): 51-77.
Joseph, Mary. "The Effect of Strong Religious Beliefs on Coping with Stress." Stress Medicine 14, no. 4 (1998): 21924.
Koenig, Barbara. "Cultural Diversity in Decision Making About Care At the End of Life." In Approaching Death: Improving Care at the End of Life, ed. Marilyn J. Field and Christine K. Cassel. Washington, D.C.: National Academy Press, 1998.
Koenig, Harold G.; Kvale, J. N.; and Ferrel, C. "Religion and Well-Being in Later Life." The Gerontologist 28, no. 1 (1988): 188.
Koenig, Harold G. "Religion and Prevention of Emotional Disorder in Later Life." Abstract published as part of the Symposium on Spirituality and Aging, 47th Gerontological Society of America Annual Scientific Meeting (Atlanta, Ga.; November 201, 1994). Published in The Gerontologist 34 (1994; special issue).
Koenig, Harold G.; Pargament, K. I.; and Nielsen, J. "Religious Coping and Health Status in Medically Ill Hospitalized Older Adults." The Journal of Nervous and Mental Disease 186, no. 9 (1998): 51321.
Koenig, Harold G.; Larson, David B.; and Larson, Susan S. "Religion and Coping with Serious Medical Illness." Annals of Pharmacotherapy 35, no. 3 (2001): 35259.
Markides, Kyriakos. S.; Levin, J. S.; and Ray, L. A. "Religion, Aging, and Life Satisfaction: An Eight-Year, Three-Wave Longitudinal Study." The Gerontologist 27 (1987): 66065.
McCullough, M.; Pargament, K.; and Thorenson, C., eds. Forgiveness: Theory, Research, Practice. New York: Guilford Press, 2000.
Muldoon, M. H. "Spirituality, Health Care, and Bioethics." Journal of Religion and Health 34 (1995): 32949.
Pardini, D. A.; Plante, T. G.; Sherman, A.; and Stumpe, J. E. "Religious Faith and Spirituality in Substance Abuse Recovery: Determining the Mental Health Benefits." Journal of Substance Abuse Treatment 19, no. 4 (2000): 34754.
Pargament, Kenneth I.; Koenig, Harold G.; Tarakeswar, Nalini; and Hahn, June. "Religious Struggle as a Predictor of Mortality Among Medically Ill Elderly Patients: A Two Year Longitudinal Study." Archives of Internal Medicine 161 (2001): 1881885.
Pargament, Kenneth, and Maton, K. "Religion in American Life: A Community Psychology Perspective." In Handbook of Community Psychology, ed. J. Rappaport and E. Seidman. New York: Kluwer-Plenum, 2000.
Pargament, Kenneth I.; Poloma, M.; and Tara Keshwar, N. "Spiritual Healing, Karma, and the Bar Mitzvah: Methods of Coping from the Religions of the World." In Coping and Copers: Adaptive Process and People, ed. C. R. Snyder. New York: Oxford University Press, 2001.
Peteet, J. R. "A Closer Look at the Role of a Spiritual Approach in Addictions Treatment." Journal of Substance Abuse Treatment 10, no. 3 (1993): 26367.
Rutledge, C. M.; Levin J. S.; Larson D. B.; and Lyons J. S. "The Importance of Religion for Parents Coping with a Chronically Ill Child." Journal of Psychology and Christianity 14, no. 1 (1995): 507.
Ryan, Patricia L. "Spirituality Among Adult Survivors of Childhood Violence: A Literature Review." Journal of Transpersonal Psychology 30, no. 1 (1998): 391.
Somlai, A. M.; Kelly, J. A.; Kalichman, S. C.; Mulry, G. W.; Sikkema, K. J.; McAuliffe, T.; Multhauf, K. E.; and Davantes, B. R. "An Empirical Investigation of the Relationship Between Spirituality, Coping, and Emotional Distress in People Living with HIV Infection and AIDS." Journal of Pastoral Care 50, no. 2 (1996): 18191.
Wright, S.; Pratt, C.; and Schmall, V. "Spiritual Support for Caregivers of Dementia Patients." Journal of Religion and Health 24 (1985): 318.