Spirituality and Healing John Mulder, MD Vice President of Medical Services, Faith Hospice Medical Director of Palliative Care Services MetroHealth Director, Grand Rapids Palliative Medicine Fellowship Program

Objectives Define our spiritual nature Understand the scientific basis for the role of spirituality in health and disease Understand the interrelationship between the spiritual, physical, and emotional aspects of our being Equip participants with techniques for dealing with spiritual issues with patients

“Few men make themselves masters of the things they write or speak.” -- John Selden, 1564-1654

“We are inclined to believe those whom we do not know because they have never deceived us.” -- Dr. Samuel Johnson, 1709-1784

What is Spirituality? “Spirituality is one of those words which is sort of like an old Barnum and Bailey circus tent; it covers so many various kinds of animals, events, acts and episodes that it’s hard to pin down.” -- Joseph Sittler, theologian/writer

What is Spirituality? -- The non-physical part of our being -- The part that motivates us to look for meaning Connects our experiences with sources of meaning Provides capacity to see beyond and rise above momentary experiences to find meaning and purpose in life

What is Spirituality? A vehicle for faith that provides a basis for prayer, meditation and worship Gives us a reason to love, forgive and seek reconciliation Values such as love, meaning, beauty, hope and truth guide our search for meaning in life and in its life’s experiences Brings clarity to personal concepts such as personhood, life, death, grieving, compassion, and life’s purposes

What is Spirituality? PHYSICAL BODY -- senses of sight, sound, hearing, taste, capacity for motion, experiencing pain and pleasure MIND -- capacity for having thoughts, holding beliefs, experiencing emotions SPIRIT or SOUL -- site of supreme values and ultimate realities; perception and understanding of God, love, meaning, hope, beauty, and truth

What is Spirituality? TWO DIMENSIONS: VERTICAL -- Our personal relationship with God, ultimate source of being; model for understanding life’s experiences; basis for coping with illnesses, pain, suffering, etc. HORIZONTAL -- Our personal relationship with others; basis for personal lifestyle or life story The “Human Moment”

What is Spiritual Healing? Spiritual healing is not a matter of God breaking the physical laws of nature. Spiritual laws co-exist with physical laws interacting constantly. Following spiritual laws directly affects the body and can influence disease and health Spiritual healing is a discipline to be practiced - a life style, not an event to be prayed for

“There is no cure for birth and death save to enjoy the interval.” -- George Santayana, 1863-1952

What is Health? Fitness and lifestyle Proper diet Proper exercise Proper sleep

What is Health? Fitness and lifestyle Fulfilling our calling

“An unfulfilled vocation drains the color from a man’s entire existence.” -- Honore de Balzac 1799-1850

“Unhappiness is best defined as the difference between our talents and our expectations.” -- Edward de Bono, 1933-

What is Health? Fitness and lifestyle Fulfilling our calling Forgiveness: Giving and receiving

“Science without religion is lame; religion without science is blind.” -- Albert Einstein, 1897-1955

Healthcare professionals have both an opportunity and an obligation to impact their patients’ spiritual as well as physical health.

Physician reluctance to endorse healthy spirituality: Most physicians not aware of data Many doctors specifically instructed to keep religion out of medical practices - don’t mix science and faith The possibility of opening “Pandora’s Box” unsettling for many physicians; untrained to address spiritual beliefs, practices, and experiences

Why Faith Heals . . . Social Support -- People who have strong religious commitment are more connected to each other Ritual -- Rituals in and of themselves have health benefits; they also give a sense of security Appreciation of Beauty -- Nearly everyone revels in nature’s beauty; the faithful are reminded to look up and enjoy the view

Why Faith Heals . . . Worship -- Through song, dance, uplifted hands or prayer, worship bathes us in a variety of healing faith factors (ritual, social support, beauty) Serenity -- In the midst of stress, forms of meditation create a relaxation response, reducing the damaging effects of that stress Confession -- Faith can drive us to make good on our guilt; confession and forgiveness allow us to learn from our mistakes and move on

Why Faith Heals . . . Temperance -- Most faiths take a negative view of risk factors for illness and disease: drunkenness, sexual immorality, smoking, overeating Hope -- Those with deep faith believe that God has their best interests at heart regardless of their circumstances; present worries pale in comparison to the wonder of God’s ultimate promises Unity -- An opportunity to gather and communicate bring healing into faith-based environments; accountability helps keep a focus on faith-based values

Why Faith Heals . . . Meaning -- The presence of hope, social support, and unity gives meaning and purpose to life Trust -- People of faith do what they are able with the strength, ingenuity and desire that God gives them, and trust Him for the results; a positive, health-preserving sense of peace results Love -- God’s love, and love reflected in behavior of friends and family, blunts the effect of physical and emotional trauma; healing power of love sometimes seen best when it’s lost

“Prayer does not change God, but it changes him who prays.” -- Soren Kierkegaard, 1813-1855

If God had designated an ideal place to bring down men and women’s emotional barriers, He could have designed no better environment than the doctor’s office or hospital.

Keys to Influence Spiritual Health Influence requires professional competence Influence requires character Influence requires compassion

Physicians and nurses can be powerful spiritual forces for healing by being there with their patients, by being attentive, and by demonstrating caring, and professional and personal concern for patients.

Addressing Spiritual Self Care Needs “ . . . ‘you shall love the Lord your God with all your heart, and with all your soul, and with all your mind, and with all your strength.’ The second is this, ‘You shall love your neighbor as yourself.’ There is no other commandment greater than these.” Mark 12:30-31

Addressing Spiritual Self Care Needs Love God completely Love others compassionately Love yourself correctly

“There are two ways of spreading light: to be the candle or the mirror that reflects it.” -- Edith Wharton

How can health be evaluated? Objective data Independent observation (family, friends) Self-evaluation (questionnaire)

A Popular Platform Public media has turned an eye onto this issue, and the research findings: Time, McCall’s, Family Circle, Prevention, Self, NY Times, Chicago Tribune, LA Times, Cooking Light, ABC World News Tonight, USA Today, The Today Show, Good Morning America, Gentleman’s Quarterly, Omni, Reader’s Digest . . .

What the research shows . . . 95% of Americans express belief in God Nearly 3 in 4 claim that they base their approach to life on their religious beliefs 63% of patients desire to have their doctor address religious faith - only 10% of physicians do so Levels of religious practice are significantly related to health status, regardless of age, even after controlling for education, social class, and social membership

What the research shows . . . Less than 2/3 family physicians believe that God exists Less than 25% report believing in a personal God, believing in an afterlife, or having a close relationship with God More than 1/4 were atheists or agnostics Only 5% of doctors report that religious and spiritual issues were regularly addressed in their training As of April, 1996, ~20 medical schools include a course on addressing faith issues with patients

Application in Clinical Settings HYPERTENSION Persons who both attended church frequently and rated their religion as very important had lower diastolic blood pressures Findings even more impressive in smokers who rated religion as important and attended church at least once weekly

Application in Clinical Settings ARTERIOSCLEROTIC HEART DISEASE Risk of dying from heart disease was much less for men who attended church at least once a week; risk for frequent church attenders was only 60% of the risk for men who attended infrequently At least 6 community-based studies have shown that the religiously committed person, particularly the church attender, has a greater chance of living longer than do persons lacking a religious commitment

Application in Clinical Settings DRUG/ALCOHOL ABUSE 20 studies have examined relationship between religion and drug use Drug abuse is related to the absence of religious commitment in a person’s life In 10/11 studies, religious commitment protected against alcohol abuse

Application in Clinical Settings SUICIDE Persons who did not attend church were 4 x more likely to commit suicide than were frequent church attenders DELIQUENCY 12/13 studies found that religious commitment - particularly church attendance - played a protective role against delinquency

Application in Clinical Settings CORONARY CARE OUTCOMES Intercessory prayer for CCU patients, double blind Daily prayer for: rapid recovery, prevention of complications and death; other areas they believed to be beneficial RESULTS Fewer cases of CHF, fewer cardiopulmonary arrests, fewer cases needing intubation or ventilation, fewer cases of pneumonia in the group that was consistently prayed for

A Medieval Perspective . . . “For when the wretched man findyng all helpe of man not able to uphold him from perishing, being striken with the mightie hande of God, feleth him selfe unable to stande, no soundes in his bodye, no strength in his limmes, no helpe of nature to resist the violence of that disease that Gods displeasure hath laid upon him, seeth no signe of Gods grace in his soule, but the deep woundes that Gods anger hath left in his conscience, perceiveth no token to argue him th’elect of God and partaker of the death of his Saviour, hearyng pronounced that the soule which sinneth shall die, knowyng him selfe to have sinned, and felying him selfe dying: alas what helpe remaineth in this extremitie?” -- Anne Lock, 1560

Introductory interview questions Is religion or spirituality important to you? Do your religious or spiritual beliefs influence the way you look at your medical problems and the way you think about your health? Would you like me to address your religious or spiritual beliefs and practices with you?

Introductory interview questions Do you attend religious services? (If “yes,” how often do you attend? Which church?) Do you pray? (If “yes,” how frequently?) How important is religion to you? (If “very” or “somewhat,” go to next question?) Is your relationship with God more formal or personal?

Faith Stories PRINCIPLES They should fit as a natural part of conversation They should take no more than 2 minutes They should be about God/Bible/relationship to God, not about church or a book They should provide a glimpse of what it’s like to be God’s child

Faith Stories THEY SHOULD AVOID Religious jargon Pushing for a decision Becoming a sermon Identifying you as a member of a specific religious group or denomination Identifying faith as a reason for not doing something Attempts to convict