May 2001 Table of Contents

BALANCING ACT

Spirituality and Your Practice



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A renewed openness to spirituality is occurring in medicine. It can provide sustenance, both to you and to your patients.

Fam Pract Manag. 2001 May;8(5):60.

As a pastoral counselor and facilitator of weekly physician support groups for the past 18 years, I've recently seen a radical change in physicians' awareness of their need for spiritual sustenance. The physicians in two weekly groups I facilitate now readily discuss religion and spirituality, often in response to the loss they feel as a result of managed care. Their interest isn't surprising, since crisis sometimes opens us to receiving support and prompts a more intentional search for meaning.

What exactly is spirituality?

Ask five people to define spirituality and you'll probably get five different answers. It isn't always a function of religion, as some people believe it to be. In my view, spirituality involves a deepening connection to oneself or to others, to God or a higher power, or to nature. It often produces a deep sense of peace and satisfaction that may facilitate physical healing. Spirituality may evolve over time, or it may come unexpectedly, triggered by a spectacular scene in nature, an intimate moment between a parent and child, a sudden and unexplained healing or a response to an outstanding artistic performance. Spiritual experiences are unique and deeply personal.

For a physician in one of my support groups, spiritual growth occurred after being sued by a patient. Two weeks after the first lawsuit ended, he was sued again. He was seriously considering leaving medicine when, during an office visit, a patient expressed her profound appreciation for the care he provided to her during a difficult time. For him, this patient interaction, in its depth and timing, was spiritual.

An antidote to burnout

Deeply connecting with your peers and others can help you prevent the emotional isolation that causes many physicians to feel burned out. It's very difficult to do.

Several years ago I attended a conference where physician and well-known author Rachel Naomi Remen, MD, spoke. She recalled talking to a group of about 100 physicians and asking them whether, during their careers, they had observed a healing that didn't fit with their medical training or thinking and could be considered a “miracle.” Every physician in the room raised his or her hand. When she then asked how many of them had shared the experience with a colleague, not one hand was raised.

If you think your colleagues may be cynical about the role of spirituality in their lives or their profession and you feel too uncomfortable talking about your spirituality with them, I hope Dr. Remen's story will help you feel more connected to them.

Your patients' spiritual needs

Over half of U.S. medical schools offer courses in spirituality and healing, so many of you may have received training in talking to patients about their spiritual needs. However, I know many of you have not. It may help you to know that many patients want you to ask them about their spiritual needs. Even “nonbelievers” appreciate being asked in a sensitive way if they have religious or spiritual beliefs they think could help them cope with their condition.1

Connecting with patients requires no knowledge of their religious orientation. All you need is to be accepting, empathetic and understanding. You can do this – regardless of your own beliefs – by being a caring, interested presence and by listening rather than trying to provide them with spiritual answers.

Formal training is not required, but it may help to ease any discomfort you feel about offering your patients spiritual support. The Association of Clinical Pastoral Education (www.acpe.edu) and the College of Pastoral Supervision and Psychotherapy (www.cpsp.org) accredit clinical pastoral education chaplain supervisors throughout the country who can be resources for you. The American Association of Pastoral Counselors (www.aapc.org) certifies pastoral counselors who can also help. Contact these accrediting agencies to find resources in your area.

Dr. Zeckhausen is a pastoral counselor in Laconia, N.H., and a diplomate of the American Association of Pastoral Counselors.

1. Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med. 1999;159:1803–806.

Copyright © 2001 by the American Academy of Family Physicians.
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