By JUDITH EVANS
When Kelly Arora learned she had rheumatoid arthritis, an incurable autoimmune disease, she turned to a spiritual director, who helped her come to terms with the diagnosis and develop skills to cope with chronic pain and fatigue.
Arora went on to earn a doctorate in 2011 in religious and theological studies from the University of Denver and the Iliff School of Theology's joint Ph.D. program. Today, she is in private practice as a spiritual director whose focus is on people with chronic conditions and their caregivers. She teaches at Denver's Regis University and Iliff School of Theology, and the University of Colorado-Denver Anschutz Medical Campus. This spring she delivered the keynote address at a conference exploring spirituality in health care at the Hospital Sisters of St. Francis motherhouse campus in Springfield, Ill. The congregation sponsors Springfield-based Hospital Sisters Health System. Arora spoke with Catholic Health World about spirituality and the well-being of the chronically ill.
Q. How can spirituality help a person with chronic illness?
A. Spiritual practices like prayer and meditation can help people cope with pain; maintain their connection to God, the sacred; and frame their experiences in meaningful ways. Studies show that the ability to make meaning of illness experiences is particularly important and helps people experience a better quality of life, even as they live with incurable diseases. Spirituality is the context in which we understand the world and our role in it, so attending to spiritual questions is critical for people whose worlds have been dramatically changed by illness.
Q. When a person is living with a chronic illness, what are the barriers to spiritual well-being?
A. Two key barriers are disenfranchised losses and chronic spiritual struggles. Over time, people with chronic health conditions experience ongoing losses, such as the loss of relationships with family and friends, loss of independence and loss of physical function. Losses may also include the diminishment of spiritual beliefs that no longer make sense in the context of chronic illness and spiritual practices that the person can no longer participate in due to health limitations. When losses are not acknowledged — and this happens for a variety of reasons — a person does not grieve for them, and this can affect spiritual well-being. Another barrier is chronic spiritual struggles. Although stressful situations and spiritual questions can lead to positive spiritual growth, when people get stuck pondering spiritual questions without finding resolution, health and spiritual well-being are negatively affected.
Q. Is there a link between physical and spiritual well-being?
A. People are made up of mind, body and spirit. When any one of these dimensions is threatened, the balance and harmony of life is affected. Many of us can think of times when stress over a job or money affected our sleep, gave us an upset stomach or prompted us to pray for relief. In the past few decades, we've seen a dramatic increase in the number of research studies on the relationship between religion and spirituality and health and well-being. We know that links exist — for example, studies show that religious activity is associated with longer life span, less depression and less anxiety — but researchers have yet to put their finger on precisely how these kinds of relationships work.
Q. Have any studies found that when people living with chronic illnesses develop a deeper sense of spirituality, their sense of well-being increases?
A. Research on religious coping — relying on religious/spiritual beliefs and practices in times of stress — shows that a well-integrated spirituality is particularly helpful for restoring and promoting well-being. "Well-integrated" refers to spirituality that is broad enough and deep enough to respond to the diversity of life stressors, is flexible enough to handle ambiguity, is complex enough to consider multiple points of view, and is focused on goodness rather than punishment.
Q. When is it appropriate for health care providers to ask or counsel patients about spirituality?
A. There is an ongoing debate in the health care community about the appropriateness of health care providers talking to patients explicitly about spirituality. I believe that offering compassionate care to the whole person — mind, body and spirit — promotes healing, especially when caregivers respect the patient's unique beliefs and practices without imposing judgment on the patient. Even though health care providers are not religious/spiritual experts, asking about a person's spiritual beliefs and concerns demonstrates a compassionate commitment to the patient as a whole person, not just an affected body part or manifestation of a disease.
Q. How can people with chronic illnesses seek out appropriate help in developing their spirituality?
A. We can seek out spiritual communities where we can learn, practice and give. We can seek out spiritual caregivers to listen, guide and help us create and recreate our spiritual meaning-making systems in response to chronic illness experiences. Traditional faith-based organizations like churches, temples and mosques welcome people interested in spiritual growth and meaning-making. In addition, Spiritual Directors International is an organization that helps people connect with spiritual companions from many faith traditions. These spiritual caregivers can help people develop their spirituality in one-on-one and group settings. Within the health care context, we can seek out relationships with health care providers who attend to us as whole persons and respect the importance of the spiritual dimension in our illness experiences. On our own, we can develop and maintain a myriad of spiritual practices.
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