Research into the relationship between religiosity, spirituality, and health is a growing field that has gained significant attention in academic literature. Many studies now show that people who describe themselves as religious and/or spiritual also demonstrate a positive association with attributes such as a sense of meaning and purpose, peacefulness, psychological well-being, and social connections.
However, concerns have been raised that some measures of religiosity and spirituality (R/S) may be contaminated with indicators of mental health in the research questions, leading to tautological associations. One way of envisioning this problem is to mistake a reflection for the reality it represents and then be surprised by the coincidence that the reflection and the reality resemble each other so closely.
Some confusion arises from the difference between practice and research. 1) Spiritual and religious care practices concerning the whole person include physical, mental, and social well-being. Care is provided through concern that connects through compassionate presence and conversation. In contrast to spiritual and religious care, 2) research into the specific functions and modalities of religiosity and spirituality (R/S) focuses on the unique contribution of religious and spiritual practices, perspectives, and attitudes informed by religious, wisdom, philosophical, or spiritual traditions.
This problem is explained in a recent article by Harold Koenig (Professor of Psychiatry and Behavioral Sciences at Duke University School of Medicine) and Lindsay Carey (Associate Professor (Adjunct) with the Palliative Care Unit, School of Psychology and Public Health, in the School of Health, Science and Engineering at La Trobe University).
Koenig and Carey note that some religiosity and spirituality research scales do not clearly distinguish between different R/S factors and their connections, effects, and causes on health outcomes, mainly mental health, meaning and purpose, connections with others, peace, and existential well-being. Their article discusses concerns about R/S measurement scales, identifies examples of contaminated measures, and recommends uncontaminated measures for future studies.
It is necessary to separate the extrinsic spiritual and religious care provided to a person by a spiritual carer from the intrinsic religiosity and spirituality held by the person themselves.
It is necessary to separate the extrinsic spiritual and religious care provided to a person by a spiritual carer from the intrinsic religiosity and spirituality held by the person themselves. Once separated, it is then possible to evaluate the extent to which a person is enlivened and sustained by religious and spiritual practices, perspectives, beliefs, rituals and communities. Such religiosity or spirituality is more than a community belief or set of doctrines; it is held personally and is present already, or emerging, becoming an integral part of their person, functioning more like a spiritual endoskeleton than an exoskeleton.
A key feature of spiritual and religious practices is that they are not coping mechanisms although they may help a person cope. Religious and spiritual outlooks provide insights and evolving perspectives that engage topics as wide-ranging as life and death, suffering and injustice, mortality and divinity, good and evil, the sublime and the beautiful, guilt and forgiveness, concreteness and fleetingness, certainty and mystery, or finitude and infinity. Transformations happen through processes of prayer, contemplation, meditation, a sense of the mysterious or miraculous, gift or grace, a leap of faith or a journey into the unknown, or a willingness to take the road less travelled.
A religious or spiritual outlook may not necessarily change a person’s material circumstances. Still, it may provide an alternative perspective on events, which in turn reframes issues of meaning and purpose. Examples of religious or spiritual perspectives can be seen in the writings of Holocaust survivor Viktor Frankl’s Man Search for Meaning, a translation of a book written in German, with the original title, Nevertheless, Say “Yes” to Life: A Psychologist Experiences the Concentration Camp. Paul Kalanithi, a young neurosurgeon dying of a brain tumour, pondered the question of what makes a life worth living and wrote When Breath Becomes Air. Or the books of Kate Bowler, a sufferer and survivor of stage IV cancer, Everything Happens for a Reason: And Other Lies I’ve Loved or No Cure for Being Human: (and Other Truths I Need to Hear).
Roger Gottlieb wrote that we often think of spirituality as soothing music, peaceful countryside settings, or compliant love, however, spiritual teachings are quite radical. Jesuit theologian Walter Burghardt once described contemplation as taking a “long, loving look at the real.” Religious and spiritual practitioners practice long, loving looks at the ‘real’ holding another in a loving gaze, not a passing glance, and together, they explore the reality, caught only in shimmering and fragmentary reflections.
Pastoral Thinking 