Spiritual Wellness
Human beings are members of a whole
In creation of one essence and soul
If one member is afflicted with pain
Other members uneasy will remain.
If you have no sympathy for human pain,
The name of human you cannot retain.
Bani Adam by Sa’adi Sherozi[1]
Although written in thirteenth century this poem has not lost its veracity and is applicable to many aspects of our lives as it, in a very simple but precise way, explicate the notion of holism, including of human nature. In order for the human to function to its full capacity and enjoy the life she should not only stay healthy physically and psychologically but also be at peace with herself or spiritually well. In fact, at times people consider themselves truly healthy for having solid spiritual ground and even if suffering from terminal illness have healthy attitude towards life (O’Brien, 2011). To achieve such level of spiritual wellness one must first recognize the connection of the body, mind, and spirit and understand the importance of spirituality within the holistic health care.
Spiritual wellness drives one “to create, love, question, contemplate, and transcend” which in turn positively impacts one’s physical wellbeing regardless of sex and ethnicity (O’Brien, 2011). This positive correlation has been reflected in numerous studies. For instance, when researchers examined spirituality in the context of religiosity they have identified that religious people are generically healthier and longer-lived than non religious people (Condon, 2004). It also has been revealed that they had lower rates of many diseases such as coronary artery disease, high blood pressure, ulcer and various types of cancer.
Furthermore, researches have showed that majority of patients would like health care providers to include religion and spirituality in their clinical approach and as many as 40 to 120 percent of 3,141 patients at a university hospital who had discussion on these denominations expressed high satisfaction with the health care provided (Moreira-Almedia, 2014).
Therefore, it is empirical to include such discussions into the nursing practice, as often times, it is uniquely the nurse who either literally or figuratively stands at the bedside and have the opportunity to interact with the patient on a spiritual level. Although generally most nurses express commitment to holistic care, minimal attentions has been paid to spiritual needs of the patient in practice (Konecny, 2012).
The strategy towards recognition of the spiritual needs of the patients through understanding of the meaning of spirituality and its existence within religion and apart from it as well as other forms of nontraditional spirituality available, attributes one should possess to attend own spiritual needs and stay healthy will be at the focus in the first part of this paper.
When approaching spiritual domain every person in some way conveys her own understanding of spirituality and spiritual wellness. Therefore, the second paragraph will include my personal perception of spirituality, answers to spiritual wellness query and conclusions I came to while discussing abovementioned points.
The final paragraph of this paper will address spiritual needs and wellness of women, and specific recommendation to nurses in attending to these needs.
The word spirituality is derived from the Latin word spiritus which is defined as something that “gives life to a person” (Condon, 2004). Although there is no ultimate definition of spirituality the major and wider concept of it incorporates the notion interconnectedness and transcendence, perceiving spirituality as “which inspires in one the desire to transcend the realm of the material (O’Brien, 2011).”
For many individuals, especially those who follow certain religion as Judaism, Christianity, and Islam transcendence transpire into belief in God. Thus, for these individuals to be spiritual is equal to be religious. Yet, more and more people describe themselves as “spiritual but not religious.” Such people now represent between 20 and 35 percent of the American population (Plante & Thoresen, 2007).
To avoid excluding this group by focusing only on patient’s religious practice a nurse has to understand the distinction of a religion and spirituality. Spirituality is viewed as an individual’s attitudes and beliefs in relation to transcendence or to the nonmaterial forces of life and/or nature. Religious practice is an individual’s belief and behavior in relation to specific religious tradition or denomination (O’Brien, 2011).
While until recently the notion of spirituality was mostly conceptualized as religiosity today spirituality exists apart from religion and may be expressed in the search of individuals for meaning and purpose in their life. It is also an attempt to connect the body, mind and spirit through commune with nature, music, meditation, and other non traditional therapeutic practices. One of these non traditional forms includes astrology.
Astrology in the modern form is a pseudoscience but in ancient times it was an integrated part of astronomy. Astrology studies the influence of the relative positions of the planets on people’s personalities and events in their lives (Penprase, 2011). Together with malevolent influences of the planets it is an important part of spiritual healing in the Chinese and Hindu cultures. For instance, Hindus believe that certain dates and times can be favorable (auspicious) or unfavorable (inauspicious) for major life events such as marriage and spiritual rituals. When confronted with a disease or a problem an individual may consult a priest to make sure that it is celestial forces (grahas) affecting her life. If it is confirmed then she will hold certain religious ceremonies or prayers to ward off the disease or any other problem (Bhagwan, 2012).
Another nontraditional form of spirituality that features ability to choose specific deity for certain worship is Hinduism.  In Hinduism people are different and thus may use multiple ways to reach God (Bhagwan, 2012). Since Hindus believe in emerging of three different gods and their consorts or goddesses from the Supreme Being people might worship different gods and goddesses. For instance females tend to reach out more to the goddesses as “they represent the lifegiving power of the universe (Bhagwan, 2012).”  Spirituality in Hinduism is interconnectedness of human with universe –other beings, the planet, animals and inanimate objects.  All beings are a manifestation of Divinity and the absolute is not “up there” but within all beings. Divinity and spiritual transcendence are integral to Hindu psychology and therefore, an individual may explain life solely through spiritual language and karma (Bhagwan, 2012).
Additionally, an ancient healing practice, yoga, strives to bring the mind, body and spirit into balance through breathing exercises, postures, and concentration. Numerous studies have revealed the beneficial effects in form of emotional wellbeing and spiritual fulfillment for those who experience anxiety, depression, stress and self-esteem issues.
A different form of nontraditional spirituality is meditation. It encourages physical relaxation and positive emotional state through concentration and focus on the internal and external feelings which can be done in sitting position with the eyes closed and chanting a word or a phrase. Meditation is helpful in promotion of spiritual wellness and is often used as a prevention method against stress, anxiety, depression, insomnia, pain. “Many meditation techniques are utilized within the religious and spiritual framework ultimate goal of which are: spiritual growth, personal transformation or transcendental experience (Konecny, 2012).”
Whether to choose traditional versus nontraditional forms of expression of own spirituality according to Henry Dreher, who studied and analyzed the correlation of the immune system and spiritual wellbeing, an individual needs to develop seven traits that will help him stay healthy and further enhance the positive effect of the abovementioned modalities. These traits by helping to strengthen the spirit and mental state of the person also reinforce the immune system.
For example, the higher is the ACE factor, the first Dreher’ trait, the strongest and most balanced is the immune system of that person (Condon, 2004). ACE factor is ability to pay attention to one’s needs, connect them with bigger picture in one’s life, and express one’s emotions. People with low ACE factor, those who cover up their negative emotions have decreased immune function that affects their physical condition. For instance, repressive copers or those who suppress their negative emotions have elevated blood glucose, higher blood pressure and are generally more prompt to diseases than those who are aware of what they need and why they need it.
The second Dreher’s trait is assertiveness and it is reflected in the capacity of one to stand up for himself while respecting others rights and interest. Assertive people by satisfying one’s needs strengthen their immune system. However, over expression as well as lack of assertiveness tend to influence immune system. For instance, people who express too much assertiveness tend to trigger hyperfunctioning of the immune system resulting in progression of such diseases as rheumatoid arthritis. Same is true to under expression of the assertiveness which tends to lower the response or underfunctioning of the immune system resulting in such diseases as AIDS and cancer (Condon, 2004).
It is not a secret that patients with such diseases as AIDS and cancer along with physical manifestation of the disease experience a huge psychological and emotional pressure. One of the characteristic that helps many of such patients and positively affects the length and quality of their lives is hardiness. Patients who see the disease as a challenge that they should overcome, find the meaning and purpose, let’s say in fighting the disease, and believe and have control over how it affects their lives have higher immune response in comparison to those who have shown helplessness (Condon, 2004).
Additionally the quality of life of these patients and many others will improve if they show or are shown affiliation. Affiliative trust or in other words trusting loving relationship without expectations positively correlates with the immune system; however, if the relationship lacks trust, proposes expectations or manifests cynical attitude the immune response will be weak. Although affiliative trust may be compromised by abuse, abandonment or dishonesty earlier in life, it can be acquired later through spiritual based, stress reduction or other motivational programs (Condon, 2004).
Not less important characteristic one might possess is altruism. Altruism is helping others without any prospect. Researchers have identified that by helping other people especially strangers one might experience “an euphoric sensation- warmth, energy and emotional wellbeing at the first stage and peace, self-worth, and optimism over a period of time (Condon, 2004).” Also it was revealed that whether altruism as a personal characteristic is a biological based empathy or influenced by experience it reflects in general health improvements of the altruists.
The last trait that was highlighted by Dreher for healthy state and mind is self-complexity. Humans by nature play multiple roles in their lives which keep them from depression and stress. The broader are the roles one play at home and in the society the happier and consequently the healthier is that person. While fulfilling different roles a person might boost her self-esteem and spirit which in turn boosts the energy, strength of the immune function (Condon, 2004).
In order to develop and incorporate these traits in own life an individual first of all should analyze her inner side, own perception of spirituality, and degree of spiritual wellness.
Spirituality, in my understanding, is an integral part of the human nature which is strongly affected by the degree of mental wellness of an individual and the environment. For instance, spiritual state of an individual may be compromised if her mind is affected by certain disease.
Through years of personal experience and observation I came to a conclusion that in most cases the higher the intelligence of the person the richer is her spiritually. Therefore, spiritually rich people to me are those who possess high morals and values such as honor and pride, respectfulness and tactfulness, patience and kindness, who are at peace with themselves and the universe.
Often times the form in which one might express her own spirituality may be affected by the environment. For example, if a person is born in religious family she may choose to search the answers to her questions in religion. While in other case when raised by atheist parents an individual may choose nontraditional form of spirituality.
Conclusion
Spiritual wellness is the important domain of holistic health. Spirituality whether it is conceptualized as a religious belief or as an essence of spirit positively affects physical and mental state of an individual. It may be, then, expressed through either traditional system of belief as religion or nontraditional form such as astrology, Hinduism, yoga and meditation.
In order to achieve the higher level of spiritual wellness an individual may need to possess higher ACE factor, hardiness, capacity to confide, affiliation and altruism. She may also need to take on multiple roles and have a balanced state of assertiveness.
To better provide spiritual care a nurse should first recognize and attend own spiritual needs which can be identified by answering certain set of questions that include but not are limited to the following: what is the purpose of life?, what do you hope for?, who do you love?
Spirituality has been shown an effective mean of coping for women “recovering from breast cancer, dealing with the death of children, recovering from substance abuse, leaving battering relationships, and surviving childhood sexual abuse (Gill et al, 2010)”.
Having an important role of a mother woman carries responsibilities not only to herself but her children. They generally set the tone and mood of the entire family. In order to be able to create and maintain a healthy environment for her children and in a household, the woman must be in peace with herself. Likewise, for a woman to be a successful and productive member of society, she must not only be physically healthy, but also spiritually rich.
Historically women have been excluded from religious rituals and symbols and described inferior to men in Christianity, Islam, Judaism and Buddhism. This historical injustice and inequity may affect women when she forms her relationship, family structure and work environment in a patriarchy. Anger may rise from such relationship that may lead to depression, anxiety, mistrust and social isolation. The nurse should recognize and validate such feeling in a woman and try to direct it to “quest for nurturing forms of spirituality (Briggs & Dixon, 2013).
Additionally, Briggs and Dixon identified that for women relationships are central to the psychological development, well being, and decision making process (2013). Spirituality is more like a long term process or journey to understanding of the purpose of life and spirit rather than a goal –oriented, liner approach of men. Therefore, women should be encouraged to utilize different forms of spirituality to honor spiritual connectedness through paradox (i.e., ups and downs of the spiritual life).
Moreover, women frequently rely on their intuition to make sense of their world and to make decisions about important life issues. A nurse may direct such patients to utilize meditation, journaling, breath work, and yoga to analyze their spiritual intuitiveness (Brigs & Dixon, 2013).
Overall, it is very important to remember that helping women honor their inner voice in the exploration of their own spirituality is a crucial part of spiritual healing and development.
Reference
Bhagwan, R. “Glimpses of Ancient Hindu Spirituality: Areas For integrative Therapeutic Intervention.” Journal of Social Work Practice. 26.2. (2012): 233-244. Web.
Briggs, M. K., Dixon, A. L. “Women’s Spirituality across the Life Span: Implications for Counseling.”Counseling and Values 58.1 (2013): 104-20. Web.
Condon, Marian. Women’s Health: Body, Mind, Spirit: An Integrated Approach to Wellness and Illness. Prentice Hall, 2004. Print.
Gill, C. S., Barrio Minton, C. A., Myers, J. E. “Spirituality and Religiosity: Factors Affecting Wellness among Low-Income, Rural Women.” Journal of Counseling & Development 88.3 (2010): 293-302. Web.
Konecny, L.M. Meeting Responses in the Spiritual Domain. Power Point Presentation, 2012. Slide 5.
Holistic Health. Power Point Presentation, 2012. Slides 9, 10, 11, 12, 13, 14.
Moreira-Almeida A, Koenig H. G., Lucchetti G. “Clinical implications of spirituality to mental health: review of evidence and practical guidelines.” Rev Bras Psiquiatr. 36.2 (2014):176-82. http://www.scielo.br/scielo.php?scrip…
O’Brien Mary Elizabeth. “Spirituality in Nursing.”  Sudbury: Jones and Bartlett Learning, 2011. Print.
Penprase, B. “The power of stars how celestial observations have shaped civilization.” New York: Springer, 2011. Print.
Plante, T. G., Thoresen, C. E. “Spirit, Science, and Health: How The Spiritual Mind Fuels Physical Wellness.” Westport: Praeger Publishers, 2007. Print.
[1] Saadi Sherozi was the prominent Iranian poet of medieval period. The poem Bani Adam is included in his classic work Gulistan where he emphasized a unity in mankind and interdependence regardless of social barriers. Bani Adam is inscribed on the entrance gate of the United Nations building. Translation by M. Ayranpoor.
