MENTAL & SPIRITUAL HEALTH

Spirituality and psychiatry - on the face of it, they do not seem to have much in common. But we are becoming increasingly aware of ways in which some aspects of spirituality can offer real benefits for mental health. 

What is spirituality?

There is no one definition, but in general, spirituality:

• is something everyone can experience
• helps us to find meaning and purpose in the things we value
• can bring hope in times of suffering and loss
• encourages us to seek the best relationship with ourselves, others and what lies beyond.

These experiences are part of being human - they are as clearly present in people with a learning disability and other conditions, such as dementia or head injury, as they are in anybody else.

Spirituality often becomes more important in times of distress, emotional stress, physical and mental illness, loss, bereavement and the approach of death.

All health care tries to relieve pain and to cure - but good health care tries to do more. Spirituality emphasises the healing of the person, not just the disease. It views life as a journey, where good and bad experiences can help you to learn, develop and mature.

How is spirituality different from religion?

Religious traditions certainly include individual spirituality, which is universal. But each religion has its own distinct community-based worship, beliefs, sacred texts and traditions.

Spirituality is not tied to any particular religious belief or tradition. Although culture and beliefs can play a part in spirituality, every person has their own unique experience of spirituality - it can be a personal experience for anyone, with or without a religious belief. It's there for anyone. Spirituality also highlights how connected we are to the world and other people.

What is spiritual health care?

People with mental health problems have said that they want:

• meaningful activity such as creative art, work or enjoying nature
• to feel safe and secure
• to be treated with dignity and respect
• to feel that they belong, are valued and trusted
• time to express feelings to members of staff
• the chance to make sense of their life – including illness and loss
• permission/support to develop their relationship with God or the Absolute.

Someone with a religious belief may need:

• a time, a place and privacy in which to pray and worship
• the chance to explore spiritual concerns
• to be reassured that the psychiatrist will not try to undermine their faith
• encouragement to deepen their faith
• to feel universally connected
• sometimes – the need for forgiveness.

What difference can spirituality make?

Service users tell us that they have gained:

• better self-control, self-esteem and confidence
• faster and easier recovery (often through healthy grieving of losses and through recognising their strengths)
• better relationships – with self, others and with God/creation/nature
• a new sense of meaning, hope and peace of mind. This has allowed them to accept and live with continuing problems.

A religious/spiritual assessment

A helpful way to begin can be to ask "Would you say you are spiritual or religious in any way? Please tell me how." Another useful question is, "What sustains you?" or "What keeps you going in difficult times?" The answer to this will usually reveal a person's main spiritual concerns and practices.

The future

What do the next few weeks hold for you? What about the next few months or years? Are you worried about death and dying, or about the possibility of an afterlife? Would you want to discuss this more? What are your main fears about the future? Do you feel the need for forgiveness about anything? What, if anything, gives you hope?

• Remedies

What kind of support would help you? How could you get it? Have you thought about self-help?

A spiritual assessment should be considered as part of every mental health assessment. Depression and substance misuse, for example, can sometimes reflect a spiritual void in a person’s life. Mental health professionals also need to be able to distinguish between a spiritual crisis and a mental illness, particularly when these overlap.

Spiritual practices

These span a wide range, from the religious to secular – which may not be obviously spiritual. You may:

• belong to a faith tradition and take part in services or other activities with other people
• take part in rituals, symbolic practices and other forms of worship
• go on pilgrimage and retreats
• spend time enjoying nature
• give of yourself in acts of compassion (including work, especially teamwork)
• spend time in meditation, deep reflection or prayer
• follow traditions of yoga,Tai Chi and similar disciplined practices
• read scripture
• listen to singing and/or playing sacred music, including songs, hymns, psalms and devotional chants
• spend time in contemplative reading (of literature, poetry, philosophy etc.)
• appreciate the arts
• be creative - painting, sculpture, cookery, gardening etc.
• make and keep good family relationships
• make and keep friendships, especially those with trust and intimacy
• join in team sports or other activities that involve cooperation and trust.

Spiritually-informed therapies

Over recent years there has been increasing interest in treatments that include the spiritual dimension. In addition to established 12-step programmes for alcohol and substance misuse, new approaches such as mindfulness-based cognitive therapy for the treatment of stress, anxiety and depression (MBCT) and compassion-focussed therapy are now being actively researched and supported.

Spiritual values and skills

Spiritual practices can help us to develop the better parts of ourselves. They can help us to become more creative, patient, persistent, honest, kind, compassionate, wise, calm, hopeful and joyful. These are all part of the best health care.

Spiritual skills include:

• being honest – and able to see yourself as others see you
• being able to stay focused in the present, to be alert, unhurried and attentive
• being able to rest, relax and create a still, peaceful state of mind
• developing a deeper sense of empathy for others
• being able to be with someone who is suffering, while still being hopeful
• learning better judgement, for example about when to speak or act, and  when to remain silent or do nothing
• learning how to give without feeling drained
• being able to grieve and let go.

Spirituality emphasises our connections to other people and the world, which creates the idea of ‘reciprocity’. This means that the giver and receiver both get something from what happens, that if you help another person, you help yourself. Many carers naturally develop spiritual skills and values over time as a result of their commitment to those for whom they care. Those being cared for, in turn, can often give help to others in distress.