Spirituality and Healing
The use of prayer and other spiritual practices to improve health dates back thousands of years, to Hippocrates and also to Maimonides. The incorporation of spirituality into ancient medicine seems not to be simply because of the lack of diagnostic and therapeutic tools available during those times (vastly different from our modern day technology), but also because spirituality provided a way for doctors to approach care for fellow humans.
Maimonides wrote, "May I never see in the patient anything but a fellow creature in pain."
The sentiment of this statement points to the need for humility in medicine and the willingness for doctors to be equal to those they are treating—medicine as a partnership, an ancient concept which is gaining new recognition, respect, and understanding. The acknowledgment of the influence of spirituality on healing and on the healer may help restore a balance and sense of humanity where it may be lacking in the modern practice of medicine.
For certain cultures, such as Native Americans, the use of prayer and spiritual practices has been a constant part of medical care. In fact, one author on the subject writes that "intuition and spiritual awareness are a [Native American] Healer's most essential diagnostic tools."
The concept of prayer and spirituality seems, in some ways, to be at the crux of mind-body medicine, of how thoughts and energy may influence health and healing. Many different types of practices may help a person develop a spiritual connectedness and a balance of energy; some examples include prayer, ]]>meditation]]>, journaling, ]]>yoga]]>, and tai chi, among others.
What all these practices seem to have in common is that they allow a person to achieve some degree of internal clarity and emotional balance with each session, while the most profound effects may occur as these techniques become part of a daily routine.
Prayer and other practices may be done alone or with a group or in a community. In a communal setting, prayer may help lessen feelings of isolation and strengthen feelings of connection and belonging as well as improve one's sense of personal identity and self-esteem.
What Are Prayer, Religion, and Spirituality?
Spirituality and religion are not necessarily the same thing. Religion is thought to be a belief in and deference to a God or other higher being. Prayer can be thought of as an act of profound awe, respect, even love for this higher being and generally takes the form of either confession, praise, or thanksgiving.
Spirituality is described as neither tangible nor material, with the spirit representing "the essential nature of a person." Spirituality is thought to pertain to the ultimate meaning and purpose of life. There may be a heightened awareness of and concern for such matters when a person is ill or facing death.
Prayer is often used in a religious context to connect to one's own spirit, to spiritual affairs, and to God or another supernatural being. But it's important to point out that prayer can be practiced outside of a religious context, and that the connection to one's spirit and to God may occur through processes other than prayer, such as those mentioned above, like meditation, yoga, tai chi, and journal writing.
How Might Spirituality and Prayer Help?
There are differing theories on how spirituality can enhance health. First, spiritual practices, including prayer, may give a person a sense of empowerment or control. That is, the person in need of healing is actively getting involved in his or her own care. In fact, even if prayer has no direct impact on the outcome of the specific medical problem, it may bring a sense of comfort that, for overall wholeness and well-being, is very important.
For example, a large percentage of women undergoing treatment for ]]>infertility]]> use a ritual such as prayer on the day of a scheduled procedure. While such a process does not increase the likelihood of becoming pregnant, it allows the women to feel subjectively better as they go through the process of trying to become pregnant.
Secondly, spiritual practices may make a person feel more at ease when facing death or other difficult circumstances. In one study, 13 people who used prayer prior to having ]]>coronary artery bypass surgery]]> were interviewed following successful surgery and discharge from the hospital to find out how prayer helped them through the process.
Without exception, they each said that their individual form of prayer helped them face uncertainty and the possibility of death; by the time of their surgery, they each felt accepting of whatever might happen. In addition, post-bypass patients who prayed experienced less ]]>depression]]>, a fairly common feeling after this procedure, following the surgery compared with those who did not pray.
Two other possible explanations for the healing effect of spirituality include the placebo effect and the relaxation response . In this context, the placebo effect refers to the person's belief that prayer will help him or her—just that belief may stimulate healing.
Prayer and other spiritual practices, such as those mentioned above, can elicit the relaxation response, which refers to a process in the body that reduces levels of circulating stress hormones. In turn, the heart rate is slowed, blood pressure is lowered, and immune function may even be improved.
Other studies have found apparent benefits with distance healing, people praying for hospitalized patients. However, these studies have been criticized for errors in design. Spirituality however may not be amenable to strict evidence-base criteria.
Spirituality is an important aspect of end-of-life care. Studies indicate that the majority of patients would like their spiritual issues addressed. Hospice movement has been developed based on the model of care, in which spiritual dimension (in addition to biological, psychological and social) is important in the care of patients. George Washington’s Institute for Spirituality headed by Dr. Puchalski is currently conducting a study on The Spirituality and will to Live in HIV/AIDS patients. George Washington is also one of the first medical schools to use chaplains as co-mentors in the Practice of Medicine course. This is a required course where students learn about communication skills and spirituality.
How Might Spirituality and Prayer Hurt?
There are instances, however, when inappropriate or unskillful incorporation of spirituality into healthcare can have negative effects. For example, some people with serious illnesses, such as cancer in particular, may feel that their prayers were not heard or that they did something wrong through their individual process of praying if there were negative outcomes.
For some people, the very thought or idea of prayer, religion, or spirituality brings up feelings of self-doubt, self-judgment, fear, or concern.
Therefore, you should only use spiritual practices to gain comfort or insight if this is a fitting and appropriate approach for you as an individual. It's important to remember that there is no right or wrong way to do any of these practices. It may, though, be a matter of finding a particular practice that fits and works best for you.
What accounts for the resurgence of interest in ethereal matters in medicine? Some say that managed care, which has reduced the time physicians can spend with patients has raised the desire to focus attention on matters that are of deep personal importance to patients. The thought, in part, is that if a person engages in conversations about spiritual beliefs with a physician, then this may help restore the more "old-fashioned" patient-doctor relationship and facilitate healing.
American Cancer Society
George Washington University Institute for Spirituality and Healing
Spirituality and Medicine
Southern Medical Association
Healthy Living Unit (Public Health Canada)
Puchalski CM. Addressing the spiritual needs of patients.Cancer Treat Res. 2008;140:79-91. No abstract available.
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Puchalski CM. Spiritual issues as an essential element of quality palliative care: a commentary. J Clin Ethics. 2008 Summer;19(2):160-2.
Puchalski CM. Spirituality and the care of patients at the end-of-life: an essential component of care.Omega (Westport). 2007-2008;56(1):33-46.
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Last reviewed April 2009 by ]]>Marcin Chwistek, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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