Psychology And Psychiatry In Nursing HW

CHAPTER 25 Faith and Prayer

Prayer indeed is good, but while calling on the gods a man should himself lend a hand. Hippocrates

“You’re being religious when you believe in Jesus or Buddha or any other truly holy being, but wow, you’re being spiritual when you become the loving compassionate, caring being they all inspire you to be.”

by Robert Thurman.

Health care sciences have begun to demonstrate that spirituality, faith, and religious commitment may play a role in promoting health and reducing illness. Nurse clinicians and researchers, as well as others, are becoming more interested in the connection between religious faith and survival. Increasingly, people are beginning to recognize that faith is good medicine. Spirituality is that part of individuals that deals with relationships and values and addresses questions of purpose and meaning in life. Spirituality unites people and is inclusive in nature, not exclusive. It is not loyal to one group, continent, or religion. Although spirituality is not a religion, being involved in a particular religion is a way some people enhance their spirituality. Yet, people can be very spiritual and not religious. Spirituality involves individuals, family, friends, and community. Individual aspects are the development of moral values and beliefs about the meaning and purpose of life and death. The development of spirituality pro- vides a grounding sense of identity and contributes to self-esteem. Spiritual aspects relating to family and friends include the search for meaning through relationships and the feeling of being connected with others and with an external power, often identified as God or a Supreme Being. Community aspects of spirituality can be under- stood as a common humanity and a belief in the fundamental sacredness and unity of all life. It is that which motivates people toward truth and a sense of fairness and justice toward all members of society. Spiritual health is expressed through humor, com- passion, faith, forgiveness, courage, and creativity. Spirituality enables people to develop healthy relationships based on acceptance, respect, and compassion.

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Religion can be described in a number of ways. The definition chosen for this text is one developed by Mickley, Carson, and Soeken (1995), three nursing researchers. They believe that religion develops and changes over time and is composed of people’s beliefs, attitudes, and patterns of behavior that relate to the supernatural God, the Divine One, the Great Spirit, Creator, and so forth. Religion usually includes a group of people who hold similar beliefs, have sacred texts, share religious symbols, and participate in shared traditions or rituals. Many people may say they are spiritual but not religious, while most religious people also identify themselves as spiritual (Carson & Koenig, 2008; Young & Koopsen, 2011). Psychology And Psychiatry In Nursing HW

Faith refers to one’s beliefs and expectations about life, oneself, and others. In a religious context, faith refers to a belief in a Supreme Being who listens and responds to people and who cares about their well-being. In a spiritual context, faith is thought of as the power to accept the nature of life as it is and live in the present moment. It is a sense of letting go of the need to control while trusting and waiting for the moment when answers come (Carson & Koenig, 2008). Prayer is most often defined simply as a form of communication and fellowship with the Deity or Creator. The universality of prayer is evidenced in all cultures’ having some form of prayer. The Hindus speak of the thousand names of God, and surely there are a hundred ways to pray. Imagine a circle or wheel with many spokes leading to the center or Supreme Being. Each spoke is a different religion with different prayers, but they all lead to the center. Prayer has been and continues to be used in times of difficulty and illness, even in the most secular societies. Prayer for self and prayer for others are the most frequently used forms of alternative therapies (Young & Koopsen, 2011). A common image of prayer in the United States is something like this: “Prayer is talking aloud to yourself, to a white, male, cosmic parent figure, who prefers to be addressed in English” (Dossey, 1997, p. 10). This cultural view of prayer fails to encompass how prayer is regarded by many other people throughout the world. For some, prayer is more a state of being than of doing; for others, prayer is silence rather than words; for some, prayer is a thought or a desire of the heart; others pray to a female Goddess or a Divine Being who looks like they do. Buddhists do not believe in a personal God as creator and ruler of the world, yet prayers offered to the universe are central to the Buddhist tradition. Prayer may be simply being still and knowing that God is God. Prayer is part of many religious traditions and rituals and may be individual or communal, public or private (Young & Koopsen, 2011). Larry Dossey (1997) provides a broad definition of prayer: “Prayer is communication with the Absolute. This definition is inclusive, not exclusive; it affirms religious tolerance; and it invites people to define for them- selves what ‘communication’ is, and who or what ‘the Absolute’ may be” (p. 11). According to a Sufi saying, prayer is when you talk to God, and meditation is when God talks to you. In this definition, meditation is thought of as passive and receptive, and prayer as active and engaging. The boundaries between meditation and prayer, however, are often blurred.

BACKGROUND

Until approximately two hundred years ago, medicine and religion were so thoroughly united that healers and priests were often the same individuals. The first hospitals were founded in monasteries by physicians who were usually monks. Today, many cultures throughout the world continue to regard their healers as a source for guidance in matters of faith and wellness. In the West, religion and medicine were fused until the end of the Middle Ages in the mid-1400s. Philosophers such as Descartes (1596–1650), Locke (1632–1704), and Hume (1711–1776) promoted the scientific basis of knowledge, believing that truth could be realized only through the examination of empirical data and the rational, scientific method. Centuries later, Western societies continue to experience the consequences of this split between religion and medicine. Western physicians are educated to think primarily in terms of what can be empirically proven in the laboratory. Discussions of spirituality and religion are considered by many physicians to be “off limits,” with such discussion relegated to spiritual or religious leaders. In the past, when arguments arose between religion and medicine, religion usually did not fare well. As nurses such as M. Dossey, Carson, Burkhardt, Nagai-Jacobson, Taylor, Winslow, Treloar, Koerner, Goertz, and Holt-Ashley and physicians such as B. M. Dossey, Matthews, Koenig, and Benson research and write more about the blending of religion and health care, the practice of their professions will evolve to, once again, include the forgotten “faith factor” in health care. In some situations, religion may have a negative impact on people’s lives. Religious participation can lead to more, not fewer, problems when unscrupulous leaders coerce or manipulate others to give up all personal autonomy. Problems also occur when religion fosters excessive guilt or shame or encourages people to avoid dealing with life’s problems. Some religious groups urge their members to avoid all conventional medical care, which can lead to life-threatening situations (Wachholtz & Pearce, 2009). Psychology And Psychiatry In Nursing HW

CONCEPTS

Universality of Faith

Throughout history and around the world, people have called on a Divine Being to sustain them. People are nourished by life-affirming beliefs and phi- losophies. They meditate and say prayers that elicit physiologic calm and a sense of peacefulness, both of which contribute to longer survival. Benson (1997) believes that a genetic blueprint makes believing in the Great Mystery part of people’s nature. Through the process of natural selection, mutating genes retain the impulses of faith, hope, and love, and faith is a natural physio- logic reaction to the threats to mortality that everyone faces. Benson (1997) went on to say that “according to my investigations, it does not matter which God you worship, nor which theology you adopt as your own. Spiritual life, in general, is very healthy” (p. 212).

Spiritual Crises

Serious illness presents a spiritual crisis. As long as people are well, they maintain their autonomy and their ability to function at home, work, or school. Their feelings of self-worth are supported as they find meaning and purpose in their many activities. Once serious illness occurs, some of these things change. Ill people may have to depend on others for personal care, and they may experience other radical lifestyle changes. Body concept changes may threaten self-esteem. In these situations, most people are forced to reevaluate life’s meaning and purpose. Religious people draw heavily on their resources of faith to see them through difficult situations like serious illness. Psychology And Psychiatry In Nursing HW

Positive religious coping involves such beliefs as “God will care for me.” One research study asked 345 patients with advanced cancer which of the two interventions they would prefer:

(1) interventions to extend life even though that would mean more pain or

(2) interventions to relieve pain even though it would mean they would not live as long.

There was a positive correlation between greater use of positive religious coping and wanting more aggressive end-of-life care near the time of death (Phelps et al., 2009).

Twelve Remedies Numerous studies demonstrate that religious involvement promotes health. It appears at this time that a number of religious “ingredients” promote health and well-being. Although some may be found in nonreligious settings, they are more commonly found operating together in religious organizations. Matthews and Clark (1998) termed these “religious remedies,” a listing of which appears in Box 25.1.

Religious Remedies

1. Relaxation response

2. Healthful living

3. Aesthetics of worship

4. Whole-being worship

5. Confession and absolution

6. Support network

7. Shared beliefs

8. Ritual

9. Purpose in life

10. Turning over to a Higher Power

11. Positive expectations

12. Love for self and others