Patients' Spirituality Useful to Healing Process

Compassion, empathy, and the ability to reflect deeply and thoughtfully are the essentials of our profession, yet for many patients one often wonders how to approach the spiritual dimension, that is, the crucial link with a higher power. A recent patient of mine stimulated this discussion within myself, as I struggled to help the teenager cope while he went through an arduous wait for a cardiac transplant. We drew upon our inner beliefs, trying to explore together the meaning of life and the implications of impending despair for him.

When exploring the spiritual dimension with a patient, it is essential to understand that every individual has a value system, and these spiritual factors can become effective partners of science, bringing critical insight to assessment and treatment of various psychiatric disorders.

The key questions that need to be addressed as a psychiatrist considering the role of spirituality in a patient's life include how much does a psychiatrist support the patient's spiritual and religious practices, and what role does one's own spiritual belief play in therapy? The answers are not clear, but as psychiatrists we must not assert the primacy of our own world view, but rather should help the patient find a way to live in and with the world.

Spirituality may help some individuals by raising energy levels, inducing relaxation, and enhancing connectivity of an individual toward self, a higher power, and healing. A correlation between spirituality and better health has been suggested in prevention, coping, and recovery in a wide variety of chronic physical conditions, including hypertension, cerebrovascular and cardiac disease, increased survival time in AIDS patients, and improved coping with cancer. It is, therefore, imperative that psychiatrists and mental health professionals begin to understand the value that compassion, hope, faith, and spirituality can play in the process of healing for their own patients.

While spirituality may not be missing in the personal lives of the patients, their families, their psychiatrists, or the societal belief system, it is largely unaddressed in the modern mental health delivery system. Training in psychiatry provides limited guidance as to how to deal with spiritual matters, and often, as the trainee feels unskilled, he or she tries to evade or even dismiss these issues. Yet it is likely that many individuals with mental illness turn to spiritual beliefs to help them cope with their illness and move toward recovery.

During residency and as an early career psychiatrist, one should learn to be comfortable with taking a spiritual history. This history should address the patient's spiritual attitudes and value system, spiritual development, and sense of meaning and purpose spirituality may play in the patient's life, as well as acknowledge the role of spirituality in clinical decision making. At the same time, residents and early career psychiatrists should be aware of their own countertransference issues in response to such spiritual disclosures while maintaining sensitivity to, and tolerance of, the patient's values. This approach, along with the involvement of chaplains and pastoral care as appropriate, could constitute an effective spiritual prescription.

While the patient I mentioned earlier was fortunate enough to undergo a successful cardiac transplant, he said that the experiences he had as a sufferer and then as a beneficiary completely changed his view of life and strengthened his belief in humility, hope, faith, and compassion. As the treating team, we were left watching spirituality in action and pondering what Einstein had once so aptly said: “The most beautiful experience we can have is the mysterious—the fundamental emotion which stands at the cradle of true art and true science.” ▪