Cultivating Spiritual Wellbeing: Why, and How?

Matthew Fritts, MPH, Wellness SpecialistDecember 10-11, 2019

Agenda/ Learning Objectives1. Definitions: spirit, spirituality, and

spiritual wellbeing2. Discussion: What do spirituality and

spiritual wellbeing mean to you?3. Why does spiritual wellbeing matter?: A

broad overview of research on spirituality and health

4. Seven components of spiritual wellbeing5. Reflection and discussion: How can I

cultivate spiritual wellbeing in my daily life and work?

Initial Thoughts• The spiritual dimension is deeply subjective• There is no single, authoritative definition of spirituality• To assert that one particular meaning of spiritual concepts is correct, while

dismissing others, would be unscientific• In a public institution of higher learning, adopting policies and endorsing

viewpoints that favor one spiritual tradition over another, would be inappropriate• Spiritual wellbeing is not (yet) a formal component of Hoos Well programming• We seek to develop UVA partnerships to explore the possibility of developing

collaborative programming and resources to enhance spiritual wellbeing

• There are many conceptual frameworks for spiritual wellbeing

• This presentation is based on the “spiritual fitness” component of a holistic "Total Force Fitness" framework for the U.S. Armed Services, on which I collaborated

• Multidisciplinary working group called by the Chairman, Joint Chiefs of Staff in Dec 2009 to develop a conceptual framework and metrics for total force fitness

• A diverse “Spiritual fitness” working group was composed of academic experts, chaplains representing each service, and representatives of other DoD components

Publication and DoD policy directive:

Conceptual framework for this presentation

• Hufford D, Fritts M and Rhodes J. “Spiritual Fitness.” Military Medicine 175_suppl_8 (August 1, 2010): 73–87.• Policy directive: CJCSI 3405.01: Chairman's Total Force Fitness Framework,

www.jcs.mil/Portals/36/Documents/Library/Instructions/3405_01.pdf

1. Definitions:

What is spiritual wellbeing?

How does it interface with religion and psychology?

• The unity of power and meaning…. spirit appears fully only in humanity, in freedom, self-transcendence, morality, rationality, creativity, selfhood….”

• Paul Tillich, among the most influential of 20th century theologians.

The essential core of the individual; the deepest part of the self, which includes the human capacities of• Self-awareness • Hope• Joy• Meaning & purpose• Connection• giving and receiving love, • Appreciation of beauty • caring and compassion for

others

Definitions: Spirit

Theological PracticalLexical

• from the Latin word spiritus(soul, courage, vigor, breath)

• “The animating principle in humans and animals; the immaterial part of a corporeal being.” (Dates to Middle English, 11th-15th centuries CE)

• 24 separate meanings for the word are listed in the Oxford English Dictionary

• emphasis on subjective experience

• includes the beliefs and values that give a person a sense of transcendent meaning and purpose in life.

• incorporates personal growth or transformation, often in a context separate from organized religious institutions.

“That which allows a person to experience transcendent meaning in life. This is often expressed as a relationship with God, but it can also be about nature, art, music, family, or community–whatever beliefs and values give a person a sense of meaning and purpose in life.”

• Christina Puchalski, MD (George Washington University, one of the leading researchers in spirituality and health.)

Definitions: Spirituality

Clinical Modern

“… The sum of all the uniquely human capacities andfunctions: self awareness, self transcendence, memory,anticipation, rationality (in the broadest sense), creativity,plus the moral, intellectual, social, political, aesthetic, andreligious capacities, all understood as embodied.”

Theological

• The ability to find meaning, purpose, a sense of connectedness, hope, and general well-being through belief in concepts that transcend the self

• a continuing journey of seeking out answers and connections and seeing things in new ways.

• an individual's or group's ability to maintain beliefs, principles, and values needed to provide support in times of stress & hardship

Spiritual wellbeing includes four sets of relationships:

1. relation with self, (Personal domain)

2. relation with others (Communal domain)

3. relation with the environment (Environmental domain)

4. relation with transcendent Other (Transcendental domain)

Definitions: Spiritual WellbeingExample definitions Relational domains

• Perspective (worldview)• Core values• Ethical foundation• Embracing diversity• Finding and staying

aligned with your purpose• Personal qualities (from

religious, philosophical, or human values) that form the basis for character, disposition, decision making, and integrity.

Includes:

• Religions are community institutions based on spirituality

• Spirituality is necessary for religion, but religion is not necessary for spirituality.

• For many, spiritual belief and practice lie within the framework of their religion.

• Others (20–30% of Americans) find spiritual connection largely or entirely outside of religion-- through nature, art, family, community, and other sources of inspiration.

• One quarter of Americans say they attend services of at least one faith other than their own (Pew Forum survey, Dec 2009) Spiritual and religious pluralism, the norm in the US since Colonial times, is increasing

Spirituality ≠ Religion

Interface with Religion and Psychology“Psychospiritual”

• Refers to this larger realm where spirituality intersects with psychology

• Acknowledges that the psychology/spirituality distinction will be drawn very differently by different people.

• For example: belief, meaning, and purpose are words often associated with spirituality that also have purely nonspiritual meanings.

Discussion:What do spirituality and spiritual

wellbeing mean to you?

Why does spiritual wellbeing matter?

• The scientific study of spirituality and health is a new field.

• Research has established strong links between spirituality and physical, psychological, and medical health

• Healthy spirituality promotes overall physical well-being.

• Spirituality has also been shown to promote better mental health among previously healthy individuals subjected to serious illness or injury.

• Evidence suggests that improving spiritual wellbeing has positive implications for health, happiness, inspiration, and resilience for dealing with the struggles of life.

A Broad, Sweeping OverviewResearch on Spirituality and Health

Benefit Examples Ref (page no.)

Hope and Optimism 80% or more the studies reported a positive association between religiousness and greater hope or optimism. No studies showed the opposite.

215

Less Depression Of eight clinical trials located, five showed that religious interventions increased the speed of recovery from depression.

216

Less Anxiety 80% of the prospective cohort studies and 86% of the clinical trials showed less anxiety & fear 217

Fewer Suicides the vast majority found an inverse relationship between religiousness and suicide. 217

Less Alcohol & Drug Abuse

88% of studies reported significantly lower alcohol & drug use or abuse among more religious subjects, and none reported the opposite

218

Greater Marital Stability

More than 90% of studies show greater marital happiness, lower rates of divorce and separation, and greater family stability among the more religious.

220

Less Risky Behavior general association between religiousness and less risk taking. Note: Risk avoidance more strongly associated with some spiritual traditions than others

358-381

Longevity “When the religious variable was operationalized as religiousness 75%n = 39) of the studies found that those who were more religious survived longer….”

386

Koenig et al.’s analysis of 1,200+ studies on health effects of spirituality and religiosity: Selected Results

(Koenig HG , McCullough M , Larson DB : Handbook of Religion and Health. Oxford University Press, New York, 2001)

• Published yesterday (12/10/19) in the Journal of Clinical Psychiatry, a new study found the presence of meaning in life is associated with better physical and mental well-being, while the search for meaning in life may be associated with worse mental well-being and cognitive functioning.

• Three-year, cross-sectional study examined data from 1,042 adults, ages 21 to 100-plus

• The presence and search for meaning in life were assessed with interviews, including a meaning in life questionnaire

New research on spirituality & health is emerging daily: One example

"Those with meaning in life are happier and healthier than those without it… When you find more meaning in life, you become more contented, whereas if you don't have purpose in life and are searching for it unsuccessfully, you will feel much more stressed out.”-- senior author Dilip Jeste, MD (UC San Diego School of Medicine)

Awais Aftab et al, Meaning in Life and Its Relationship With Physical, Mental, and Cognitive Functioning, The Journal of Clinical Psychiatry (2019). DOI: 10.4088/JCP.19m13064

7 components* of spiritual wellbeing

*These components are traditional, rather than scientific

• Beliefs are ideas held to be true.

• Belief in a non-physical dimension of life is a defining element of spirituality

• Belief in the existence and goodness of God, and belief that the human spirit is real and survives death are central to most traditions.

• Spiritual beliefs are basic to many peoples’ understanding of the world and their place in it.

• These beliefs provide support in times of stress, and threats to these beliefs cause anxiety

• Spiritual wellbeing requires not only positive and helpful beliefs, but also that those beliefs be stable under stress.

• Stable core beliefs lead to:• Greater acceptance of difficult situations • Construing positive meaning from difficult experiences• Opportunities for post-traumatic growth • Greater coping ability• Spiritual resilience.

Component 1: Spiritual Beliefs

• “Value,” from the Latin valere , to be worth, refers to that which makes something desirable.

• Human values are rules for making right decisions in life.

• Morality and ethics are sets of such values, varying from one culture or social group to another.

• Moral codes serve positive social purposes, helping to make interactions predictable

• Although morality is logically independent from religion, spiritual endorsement of particular values is universal and strongly motivating

• Spiritual values (from religious, philosophical, or human values) form the basis for character, disposition, decision making, and integrity.

Component 2: Spiritual Values

• Who am I? Why am I here? What is my purpose in life? What happens after I die?

• These enigmas about the meaning and purpose of life are ancient and powerful existential questions.

• From the materialist point of view, the answers are simple and obvious: the purpose of your life is what you make it, and after you die nothing happens.

• Spiritual beliefs (e.g., belief that spirit is real or that there is a Divine plan) offer more complex, and usually more consoling, answers.

• High sense of purpose correlates with 23% reduction in death from all causes (Meta-analysis by cardiologist Randy Cohen et al.)

• People with strong sense of purpose half as likely to develop Alzheimer’s after 7 years (neuropsychologist Patricia Boyle, JAMA Psychiatry)

Component 3: Core Beliefs: Purpose and Meaning

Discussion of first 3 components:Spiritual beliefs, values, meaning & purpose

• Spiritual practices are the behavioral expression of personal spirituality,

• They take varied forms that may or may not follow specific religious traditions.

• Spiritual practices from the Abrahamic religions (Christianity, Judaism, and Islam) include prayer, sacred scripture study, worship, music, fasting, practicing charity and service to community.

• Spiritual practices from nontheist belief systems include social activism, work, education, and mindfulness.

• Secular spiritual practices include mind–body techniques such as breathing exercises, positive mental imagery, systematic relaxation, meditation, yoga, and creative outlets such as art, music, or journaling.

Component 4: Spiritual Practices

• Transcendence is allegiance to something greater than oneself, not necessarily to a particular power.

• A transcendent view sees all humanity as interdependent and interrelated

• Naturally replaces insatiable drives to fulfill individual interests with a prosocial and compassionate attitude that cherishes the well-being and happiness of others, even more than personal happiness

• Transcendence need not be vertical, relying on a belief in God.

• Spiritual atheists often acknowledge relationships or nature as their higher power.

• horizontal transcendence has an outward focus that engenders citizenship behaviors, team spirit, and service for the collective good.

• Transcendence is closely related to developing meaning and purpose, since these usually arise through connection to something greater than oneself

Component 5: Transcendence/ Relationships Beyond the Self

• Introspection and self-awareness can be cultivated through contemplative practices from varied religions, as well as through secular techniques of meditation.

• One example is mindfulness training, which involves developing an objective awareness of one’s own thoughts and feelings.

• Cultivating and maintaining self-awareness, introspection, and reflection can require regular, focused practice over relatively long periods of time.

• By contrast, some meditative practices (such as mindfulness training and Christian prayers such as the Jesus prayer or the rosary) are very portable and may be done amid highly distracting situations

Component 6: Self-Awareness: Reflection and Introspection

• Exceptional spiritual experiences touch on areas outside the common-sense reality of our everyday world and can be deeply transformative

• Examples: a sense of enlightenment or certainty, a feeling of unity, or a state of flow

• This is a psychospiritual term including both spiritual experiences (e.g., “mystical experiences”) and psychological experiences (e.g., Csikszentmihalyi’s “flow” experiences).

• Spiritual experiences can be either interpretive or direct.

• Interpretive spiritual experience is spiritual “not because of any unusual features of the experience itself, but because it is viewed in the light of a prior [spiritual] interpretive framework.” (i.e., cognitive reframing of events as implicitly spiritual experiences)

Component 7: Spiritual Experiences

SECTION TITLETHANK YOU!Reflection and discussion:

How can I cultivate spiritual wellbeing in my daily life and work?

SECTION TITLETHANK YOU!Questions, comments, and/or desire to collaborate?

Matthew Fritts, MPHmjf5k@virginia.edu | 434.924.4748

www.hooswell.com