The Emerging Face of Spirituality in Minnesota Healthcare

Alan L. Pritz
Reviewed by Jim Hart, M.D.

The approach to and practice of health care has changed significantly in the past twenty-five years. In addition to many outstanding diagnostic, surgical, and pharmacological advances, one of the most significant developments is an evolving relationship between empirical medical science methodology and an old/new domain, spirituality. Throughout history people have invoked spiritual aid to remedy illness or disease by petitioning a Higher Power. From a faith standpoint this makes perfect sense. Yet in medicine, scientific proof is the cornerstone of quality practice. Accordingly, the question of whether religious belief and prayer have true healing power is currently being explored with rigor. Because many people nowadays incorporate spiritual themes into diverse aspects of their lives, it should come as no surprise that this element is manifesting in the medical arena as well. But spirituality for many physicians elicits responses ranging from confusion, rejection, indifference, curiosity, to investigation and implementation. This article seeks to shed light on the phenomena by reviewing its historical development, defining spirituality for a medical context, looking at physician responsibility, if any, to include spirituality in clinical practice, and highlighting local/regional forums dedicated to pursuing these issues further.

The emergence of spirituality in modern medicine, on both a local and national scale, had its roots in the early wellness movement. The wellness paradigm clearly addressed health concerns in a holistic fashion, touting a triune model of body, mind, and spirit. During the slash and burn economics of the 70’s and 80’s industries found themselves confronted with the distasteful by-product of their own machinations. Prolonged stress associated with ongoing economic upheaval caused rampant employee burn out and attendant financial “inconveniences” like increased absenteeism, medical leave, and heightened re-training costs. Growing research in behavioral sciences and psychoneuroimmunology (PNI) showed that physical fitness and positive attitude could reduce healthcare expenses by mitigating the negative impact of stress. Enter a corporate platform for physical health via various wellness programs.

In 1975 Dr. Herbert Benson, a Harvard cardiologist, pushed the wellness envelope further by writing The Relaxation Response. He demonstrated that certain meditative practices produced a “Relaxation Response” effect lowering blood pressure without medicinal agents. Given Benson’s prestigious background, his work catalyzed gradual acceptance and use of mental tools like focus words, guided imagery, and visualization in clinical settings to promote physical health. Subsequently an array of books addressing related topics began being published by various MD’s and notable individuals.

A small but significant sampling of such works includes:

Anatomy of an Illness (1979) by Norm Cousins describing his victory over cancer through laughter and humor; Minding the Body, Mending the Mind (1987) by Joan Borysenko; Full Catastrophe Living (1990) by Jon Kabat-Zinn citing the beneficial use of mindfulness meditation and hatha yoga with chronic pain patients; Reversing Heart Disease (1990) by Dean Ornish, MD also uses yoga and meditation in conjunction with strict diet modification; Healing Words: The Power of Prayer and the Practice of Medicine (1993), a landmark work by Larry Dossey, MD, citing abundant evidence that prayer can positively affect humans and, to mitigate placebo effects, references studies using mice, chicks, enzymes, fungi, yeast, bacteria, and cells of various sorts, with similar results. Dossey also raises ethical considerations regarding using prayer as a healing agent. The Faith Factor (1998) by Dale Matthews is another book that explores the specific benefits of religious commitment, albeit from a Christian perspective.

In attending to the question of defining spirituality versus religious belief, it is fair to say they’re compatible though not identical, and, they may or may not co-exist. Spirituality typically allows for and supports religious beliefs while the reverse isn’t always so. Here are two sets of definitions to consider.

Spirituality:

¨ “A process by which one discovers inner wisdom and vitality that give meaning and purpose to all life events.” Mayo Spirituality in Healthcare Committee

¨ “The essence of all traditions, the Truth hiding behind and within every form. It is the medium through which individuals establish direct communion with God, regardless of formal orientation. Spirituality is both the immediate experience of That-Which-Is-Holy, the Higher Power by whatever name, and living by those principles and practices which foster this relationship.” Pocket Guide To Meditation (1997).

Religion:

¨ “A formalized system of beliefs and practices shared by a group.” Mayo Spirituality in Healthcare Committee

¨ “The organization of spiritually based rules, rituals, and doctrine surrounding, and developing from, the life and teachings of a Founding Individual or Revelatory Source.” Spirituality in the Workplace

In clinical settings, it is crucial to exercise extreme tolerance and appreciation for the healing potential inherent in and relevant to the spiritual paradigms of an ideologically diverse and vulnerable patient population.

The question of how to viably address spiritual matters, or to what extent physicians should do so is still unresolved and under consideration. Some providers feel this domain is beyond their scope of training and hence, responsibility. Others believe spirituality comprises a vital component in the healing process and feel ethically responsible to include it as part of standard treatment protocol. In the latter camp, which is still very small, some clinics have begun acquiring relevant spiritual information during patient intake. While a significant step, it needs to be reinforced by training that facilitates getting the most benefit from such information.
What we see here is a serial progression of health-inducing practices that began with a physical focus, expanded to include the mind and finally, explores the Spirit. This process parallels social interest in such matters and Minnesota activity reflects that pattern. In a loose chronology of events, wellness programs initiated physical fitness training followed later by stress management programs that had a more body and mind orientation. With attraction to complimentary medicine rising and the institution of a NIH Office of Alternative Medicine mandated to explore same (1992), the presence of non-allopathic modalities became more prevalent. In 1993 Hennepin County Medical Center opened an Alternative Medicine Clinic using traditional Chinese medicine. Abbott NW’s Health Psychology Services piloted a Mindfulness Meditation program in 1995 modeled after Jon Kabat-Zinn’s work. Healthful agents like massage, yoga, meditation, therapeutic touch have become increasingly visible in chronic pain and cancer treatment facilities, the Virginia Piper Cancer Institute being an example. Now spiritual care and related matters command attention.

Amongst these latest developments, three stand out most notably. In 1996 The University of Minnesota’s Academic Health Center sanctioned the formation of a Center for Spirituality and Healing. Its cutting-edge mission: “to promote interdisciplinary education, research, and patient care that integrates biomedical, complementary, cross-cultural and spiritual aspects of care.” The Center has attracted national attention by investigating and working towards the transformation of modern healthcare. It offers a wide variety of progressive educational and experiential programs. Fairview Health System, under the stewardship of Spiritual Health Services director, Chaplain Chuck Ceronsky, has developed innovative internal pilot programs providing spiritual approaches to different health issues. Ceronsky is also current coordinator of the Minnesota Forum on Spirituality and Health/Healing (1997). Lastly, Mayo joined the fray in 1998 with its own Spirituality in HealthCare Committee, one similarly designed for education, research, and appropriate inclusion of spirituality in healthcare settings. Mayo’s committee sponsors monthly meetings, an in-house lecture series, a “Spirituality and Healthcare” presentation and is concluding a study on the affects of intercessory prayer (prayer for the benefit of others) on heart attack patients. Steve Kopecky, Mayo cardiologist, said a second study of similar scope for by-pass patients will begin soon. For additional information contact:

University of Minnesota Center for Spirituality & Healing or to be put on the mailing

list for the Minnesota Forum on Spirituality and Health/Healing: 612-624-9459.

Fairview Spiritual Health Services or to inquire directly about the Minnesota Forum on

Spirituality and Health/Healing: Chaplain Chuck Ceronsky at 612-672-4074.

Mayo Spirituality in Healthcare Committee: Dr. Paul Mueller at 507-284-2511.

On the national scene, questions about the healing value of spiritual/religious belief are undergoing increased study. In one example, Georgetown University School of Medicine evaluated numerous studies on the effect of religious belief on illness and recovery. At least 80% of these studies suggested religious belief reduces anxiety, depression, anger, high blood pressure, and drug/alcohol/cigarette use and increases survival rates.

In the context of particular practices, some research suggests prayer works, but why it works hasn’t been determined. Nevertheless, prayer has been shown to:

¨ Positively impact living organisms.

¨ Be most effective when done with love and faith.

¨ Work regardless of patient proximity.

In conclusion, medical science is investigating new spiritual frontiers. The challenge is to accept the possibility that certain domains of reality exist beyond the scope of modern measures, and that these may indeed be highly useful when treating patients. While incorporating prayer, faith, and worship with traditional practice may enhance results, this is still a very personal practice style. Opportunities exist to explore this dimension in a professionally favorable light and it may well forecast an unusual yet positive shape of things to come.

Alan L. Pritz is author of Pocket Guide to Meditation and co-author of Training for Tough Topics (for the American Management Association) and Founder / President of Inner Resource Enhancement consulting services. Alan has taught “Spirituality in the Workplace” as an adjunct faculty at the University of St. Thomas Management Center and has addressed the National Wellness Association on "Opening Doors to Balance and Spirituality." For more information about Alan, please click here.

Jim Hart, M.D., is an Internist with HealthPartners Physicians Clinic Ramsey.