Atheism, spirituality, religion, disability and healthcare

Spirituality is arguably an essential component to the daily lives of human beings, and it is one of the things that separate the human animal from other kinds of animals. Spirituality can be very loosely defined as a personal search for transcendent understanding (Yuen, 2007), where transcendent means beyond the world, beyond human understanding, or beyond the self. It is the essential search and understanding of and for meaning and purpose in ones life through relationships with entities outside the self (McColl 2000), and the search for meaning and purpose of the individual. Spirituality was defined by Johnstone (2006) as an internal experience of cultivation motivated by interest in experience of meaning, purpose and significance.

Individuals with traumatic chronic disabling conditions (such as a stroke, spinal cord injury, etc) are thrust into unanticipated life-changing events. Traumatic disability is a unique experience which brings forth a unique dimension to spirituality. Five themes of spirituality and disability according to McColl (2000) are: Awareness and appreciation, closeness and intimacy, trust as related to the need to depend on others, purpose and life and purpose of the injury itself, and vulnerability and awareness of one’s own mortality. Many people with chronic disabling conditions report changes in their sense of spirituality after the onset of their disability.

While a sense of spirituality can and does exist without religion and the supernatural, religion is inseparable from spirituality. Polls and surveys consistently show that most people (89%) indicate that religion is fairly or very important in their lives (Johnstone, 2006). As such, an understanding of the ways religion can influence one’s sense of spirituality must be taken into account in general, but especially in the light of disability. There are many studies indicating that people who are religious have better mental health, greater social support, and less substance abuse (Johnstone, 2006). This is largely related to the social support network associated with religious practice. As such, if an individual is already religious, the social support network they have built up around their religious community may be able to help them cope with their disabling condition.

As individuals try to make sense of their own disabling conditions, they often question not only their own purpose after acquiring a disability, but the purpose of the disability itself. Virtually all people with chronic disabilities use some type of spiritual coping method. (Matheis, 2006). In this study, of 75 participants who were interviewed by telephone, quality of life was highest among participants who used a more secular spiritual coping rather than a religious spiritual coping.

Because spirituality is so essential in the coping and adjusting process for people with disabilities, it is important for those in the healthcare field to recognize the spiritual changes and spiritual issues that an individual may have. Disability raises many questions about order and purpose in the universe, reminding individuals that they are not in control, and challenging concepts about higher powers. Disability may cause spiritual issues to go unaddressed because disability often removes people from their social support systems and other resources for dealing with spiritual crises. (Ross, 1995). At the same time, disability can open up an individual’s life to meditation and new kinds of relationships with others. (Young, 1993)

It is important to note that while at times it is hard to separate spirituality from religion and belief in the supernatural, the two are not intrinsically connected. While a healthcare practitioner (such as an occupational therapist) might feel that a devoutly religious individuals needs might be best met by clergy or religious figures, he or she may be in the best position to meet the spiritual needs of the non-religious. People without religion such as atheists, agnostics and humanists have an equally deep need for meaning and purpose in their lives. (Kier, 2004). They may have similar sets of unanswered questions regarding spirituality. The fact that atheists and agnostics have been shown to have unaddressed spiritual needs in the healthcare field points to the fact that spiritual needs are universal in the human animal, and traumatic disabling conditions almost universally causes questions regarding spirituality to arise, and new ideas about spirituality to be formulated.

References:

Johnstone, B., Glass, B., Oliver, R. Religion and disability: Clinical, research and training considerations for rehabilitation professionals. Disability and Rehabilitation (2006) 29(15) 1153-1163

Kier, F. Unaddressed Problems in the Study of Spirituality and Health. American Psychologist (2004) 53-54

Matheis, R., Tulsky, D., Matheis, R. The Relation Between Spirituality and Quality of Life Among Individuals With Spinal Cord Injury. Rehabilitation Psychology (2006) 51:265-271

McColl, M., Bickenbach, J., Johnston, J., Nishihama, S., Schumaker, M., Smith, K., Smitsh, M., Yealland, B. Changes in Spiritual Beliefs After Traumatic Disability. Arch Phys Med Rehabil (2000) 81:817-23

Ross L. The spiritual dimension: its importance to patients’ health, well-being and quality of life and its implications for nursing practice. bit J N&s Stud 1995;32:457-68.

Young C. Spirituality and the chronically ill Christian elderly. Geriatr Nurs 1993; 14:298-303.

Yuen, E. Spirituality, Religion and Health. American Journal of Medical Quality (2007) 22:77