If you are here, I think it is fairly safe to assume that you have an interest in spiritual health, but what even is spiritual health? It would be helpful to know what we are talking about so that as we strive to support the children in our lives, we are ensuring that every aspect of their being is supported.
I started my informal look into this subject by asking a number of my family members how they define spiritual health. Some spoke of orthodoxy, having correct belief as in: I am spiritually healthy when I am not experiencing doubt around the doctrines I believe are important to adhere to. Others talked of orthopraxy, having correct practices as in: I am spiritually healthy when I am regularly practicing my religion in the correct way. Still others talked about having oneness or harmony in their lives, as in: I am spiritually healthy when all aspects of my life are in balance.
This was a decidedly skewed sample, as everyone I asked belongs to the same high demand religion. Still, it was interesting that even in a high demand group, there was a wide range of answers. If we were to survey a more diverse group, surely the answers would be even broader. For example, what does a Taoist or Buddhist or even an atheist see as spiritual health? So, I went to the literature.
The Four Domain Model of Spirituality
There have been a number of studies around spiritual health, and it seems that the most common framework for understanding spiritual health is what is called the “Four Domains Model” This model posits that spiritual health consists of personal, communal, environmental, and transcendental well being. Personal deals with issues of meaning, purpose, and values. This one looks most like mental health, things like self-esteem, fulfillment, patience, humility, etc. Communal well-being looks like love, forgiveness, trust, hope, and serving others. The environmental domain is connected with nature or creation. It’s what you feel when you stand on the top of a mountain and feel a sense of awe. Finally, transcendental well-being is summarized as faith. It might look like worship, but also a feeling of being in tune with God or being at one with the essence of the universe.
This final aspect is the most controversial because everyone has a different conception of God, what faith looks like, what proper worship constitutes, or even if there is a God at all! There is a debate, especially in white Western contexts (which we will look at in another episode), whether one can be spiritually healthy without a belief in God. One interesting thing to note about this four domains model is (1) that it does show clinical usefulness, ratings in these domains are useful to predict other outcomes such as mental health and pain tolerance reliably, so we aren’t just making things up and (2) that they are even more reliable and accurate when a person’s individual expectations around each dimension are taken into consideration. When study subjects are asked about what their perceived ideal is in each dimension and then their score is compared against that instead of an absolute score, the results are even more predictive of other well being outcomes. So, it matters less that you are strong on each measure, than that your beliefs and your lived experience coincide. In other words, those without a strong belief in God or no belief in God who do not feel like they SHOULD believe in God, fare almost as well as those that do believe in God.
Other Models of Spirituality
Other models of spiritual health have been proposed that might address a more universal, worldwide experience of spiritual health that isn’t centered around God. For example, Toaism and Buddhism both do not have a god or gods, but still ought to be considered as fully valid spiritual traditions. One model out of India frames spiritual health as having three aspects: self-evolution, an internal locus of control and living up to your potential; self-actualization, or having a sense from within that you have purpose; and transcendence, or considering oneself as part of a supreme whole, acting with love and not jealousy or selfishness. This was further broken down into 12 principles that the researchers found lead to the three aspects of spiritual health, namely self-evolution, self-actualization, and transcendence. They are:
- Self-awareness
- Spontaneity
- Being vision and value led
- Holism
- Compassion
- Celebration of diversity
- Field independence
- Humility
- Tendency to ask fundamental questions , “why?”
- Ability to reframe
- Positive use of adversity
- Sense of vocation
There is no mention of God in these, but seem to be a high level of general well being. This brings up the debate, is spiritual health just a reframing of mental health?
Spirituality and Mental Health
So, I looked into definitions of mental health, which I will not go through here, but I did find that there was often overlap depending on the definition. What I see as the difference in my work, is that mental health means that your mind will respond in a normative way to various situations. If you lose a loved one, you will feel deep grief but you will not experience depression or psychosis. If you are physically attacked, you will experience fear and maybe even shut down, but when you return to safety you will be able to adjust and not have flashbacks or crippling anxiety. Mental health workers give people the tools to stay in or return to normal functioning. Many of those tools are the same tools we need for spiritual health, such as ability to reframe and self-awareness. Spiritual health is more about questions of purpose than about functionality. In the past it was seen as a type of hierarchy, that we need physical safety and health first, then we need mental health, then we can worry about spirituality and those “higher” functions, but that hasn’t proven to be how it works. Yes, physical, social (which we haven’t talked about), mental and spiritual health all support one another, but it doesn’t need to be in that order, nor is it sustainable to have one without the others. If you focus on physical health at the expense of the others, waiting until you have reached some level of physical health before moving on to mental health, then waiting there to move onto spiritual health, you will never get anywhere.
I think an example of the differences between mental and spiritual health might be helpful. You might imagine someone who has no clinical symptoms of any mental health condition, but they are aimless and bitter and just seem stuck in life. Their mind and body may be working normally, but they haven’t harnessed them into a wider connection with the world or a sense of purpose. Conversely, it is easy to imagine a person with anxiety who struggles with panic attacks, but feels like God gave her this challenge to make her more compassionate and patient with others. Both individuals could benefit from therapy and may even be taught very similar tools, but they need and deserve different approaches. CBT may help the first individual challenge his beliefs around others and help with his bitterness. Talk therapy may help him work out his purpose. These are side approaches though, in the same way that feeling connected with creation or feeling God cares about and will protect her may help ground the anxious person during a panic attack but isn’t the most effective, best-practices treatment.
Spiritual Distress
Now I will admit that I am centering mental health around the lack of mental illness, which many would contend is too restrictive a framework. In fairness, let’s look at what spiritual health is by looking at what spiritual distress is. Just like mental health disorders are often grouped (anxiety disorders, psychosis disorders etc) I found spiritual distress sometimes conceptualized in the literature as falling within the following six dimensions:
- Divine
- Demonic
- Interpersonal
- Moral
- Ultimate Meaning
- Doubt
Let’s briefly go through what distress in each dimension looks like. Distress in the divine dimension has to do with how someone feels their relationship with God is. Do they feel accepted by God? Is God listening? Does God care? Distress in the demonic dimension is when someone perceives evil forces causing them trouble in their lives. They may describe this as persecution, temptation, or curses. Interpersonal distress is just what it sounds like. This is a good reminder that one of the most valuable aspects of religion is the community it can create, but it can make things difficult too. When you don’t feel you fit into your religious community, that can threaten your identity as a member in a way that having a conflict with a friend group wouldn’t. Also, since many people experience spirituality within the structure of a church, feeling uncomfortable at church can make people feel cut off from their spirituality in a big way. Moral distress happens when you have concerns over the morality of your actions or desires. Ultimate meaning distress is the big questions about the purpose of life or the meaning of struggles. Finally, doubt can cause distress. Just like interpersonal issues within spirituality present unique challenges, doubt in a religious context is different from other types of doubt. In other aspects of your life you might have doubts about something, you might seek out more information, then resolve those doubts. Sometimes those doubts cause you to change something about your life which can be hard, but there is a big difference between having doubts about your pediatrician and getting a second opinion or changing doctors, and having doubts about your religion. If you are part of a particularly high demand religion especially, resolving doubt and changing your beliefs can put you on the “outside” of your community and even your family. You may be vilified as lacking faith or even be accused of faking your doubts as an excuse to “sin”. Even without those unhealthy dynamics, it can be terrifying simply entertaining the possibility that there are issues with your previously held beliefs, beliefs on which you based major life decisions or even your religious identity itself. A lot of work of clergy members and counselors is to help people deal with these types of distress. If any of these resonated with you, know there is help to be found.