Does being “spiritual” help you to be physically healthy?

Does being “spiritual” help you to be physically healthy?
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Can our spiritual and religious beliefs affect our health? Research indicates they might, at times, in different ways. An article referenced the definition of spirituality from a panel of experts at the National Institute of Healthcare Research as ‘‘the feelings, thoughts, experiences, and behaviors that arise from a search for the sacred’’ (1), while religion can be defined as “the commitment or devotion to religious faith or observance; or a personal set or institutionalized system of religious attitudes, beliefs, and practices” (2). Regardless of whether these feelings and behaviors stem from a particular religion or from the humbling conviction of a greater power, they have the potential to influence health outcomes.

For instance, spirituality may positively affect several aspects of an individual’s life including having a sense of meaning in life, being at peace with oneself, engaging in compassionate and giving social relationships, and practicing forgiveness (3). Forgiveness, in particular, is commonly emphasized in several religions, from Christianity to Hinduism (4). It could then be argued that some of the health benefits of religious practices may be partly due to forgiveness.

Correlation studies have found that forgiveness is positively associated with improved well-being (5) and reduced levels of depression, anxiety and anger (6). Additionally, forgiveness has also been linked with less negative emotions, fewer reports of physical ailments, less medication use, reduced fatigue, better sleep quality and fewer physical complaints (7). Hostility, on the other hand, is associated with harmful health habits (such as smoking, overeating and excessive alcohol consumption) and increased risk of coronary heart disease, reduced social support and prolonged stress response (8; 9; 10). Forgiveness may be the antidote to hostility.

One study (4) looking at the relationships between religion, forgiveness, hostility and health found that participants who were more religious were significantly more likely to be forgiving. The study, which consisted of a structural equation analysis of data collected from a national survey of 1,629 participants, also found that greater forgiveness was associated with less hostility, which in turn was associated with greater subjective physical health. Although religion had only a relatively small indirect effect on health, the researchers argued it still has significant positive health consequences.

Prayer is another form of spiritual practice. Direct-contact intercessory prayer has been associated with clinical improvement of individuals with chronic rheumatoid arthritis, even after 1-year follow up (11). Similarly, among a group of depressed patients, some of which also suffered with anxiety, it was found that series of six weekly prayer intervention sessions resulted in less depression and anxiety, more optimism, and greater levels of spiritual experience than did the pre-prayer measures (12). The beneficial effects were still present after 1-year follow up.

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One potential limitation, however, is the fact that the participants actively sought to be part of the study indicating their liking towards prayer as a healing modality, thus suggesting the placebo effect. While this may hamper the generalization of the findings, it could be argued that individuals who believe in prayer as means of improving health can adopt this modality as part of treatment to increase chances of success. After all, praying has no side-effects.

As expected, not all science supports the benefits of spiritual practices, particularly when it comes to cardiovascular health. A study conducted with postmenopausal women enrolled in the Women’s Health Initiative Observational Study revealed that a self-reported higher frequency of private spiritual activity was associated with increased cardiovascular risk (13). However, there are several reasons why that might have been the case.

The study was conducted with a large population of community-dwelling postmenopausal women, including women with history of diabetes, liver disease, dialysis, asthma, emphysema, lupus, Alzheimer's disease, multiple sclerosis, Parkinson disease, ALS, and some forms of cancer. Furthermore, it measured spirituality/religiosity based on frequency of meditation, prayer, or reading of religious texts as opposed to measuring traits characteristic of spiritual individuals, as previous research has done. Finally, the information was collected via self-reported questionnaires and time spent on spiritual practices was reported retrospectively based on the prior year’s spiritual/religious activities. The authors also commented on the findings stating that the prevalence of severe, chronic comorbidities in the participating women was associated with a higher frequency of private spiritual practice likely as a coping mechanism in the face of declining health and advancing age (13).

If you’re wondering whether the health benefits of spirituality go beyond religion the answer is yes. While both concepts are related, we’ve seen they have distinct definitions. You don’t have to be religious to be spiritual. Elements of spiritual well-being such as meaning, forgiveness, compassion, peace and faith can be found in both spiritual and religious individuals (3).

A study (1) conducted with 100 highly religious men and women looked at how spiritual well-being influenced physiological measures such as 24h blood pressure (BP), inflammation, fasting glucose, and blood lipids. The study examined the possibility that spiritual well-being may be linked to greater church attendance, but it turned out to be unrelated. Instead, it was found that higher spiritual well-being was linked to lower levels on multiple cardiovascular risk factors, suggesting a cardioprotective effect. Specifically, higher spiritual well-being was associated with significantly lower inflammation, fasting glucose, systolic and diastolic BP, as well as greater systolic BP nocturnal dipping.

In the above mentioned study, the constructs measured as part of “spiritual well-being” included dimensions of meaning, peace, faith and additional spiritual concerns, such as connection to a higher power and to others, gratitude, and forgiveness. One may hypothesize that it is through these key characteristics that spirituality exerts its positive functions on physiology ultimately resulting in improved physical and psychological health.

While the seemingly arcane concept of healing from a disease or fostering health through a spiritual practice may appear esoteric and hard to grasp, science has been elucidating this mystery into measurable outcomes. And while we cannot reduce all constructs into a single variable that can be isolated, studied, measured then validated or rejected, at least these studies help us understand the role - and power - of believing in something greater than oneself. This belief results in specific thoughts, feelings and behaviors that are conducive to health, while also optimizing our physiology in salubrious ways. You don’t have to be a believer to acknowledge its benefits; but you might want to become one in order to experience them.

References

(1) Holt-Lunstad, J. et al. (2011). Understanding the connection between spiritual well-being and physical health: an examination of ambulatory blood pressure, inflammation, blood lipids and fasting glucose. Journal of Behavioral Medicine. (6): 477-88.

(3) George, L. K., Larson, D. B., Koenig, H. G., & McCullough, M. E. (2000). Spirituality and health: What we know, we what need to know. Journal of Social and Clinical Psychology. 19, 102–116.

(4) Lutjen L. J. et al. (2012). Religion, forgiveness, hostility and health: a structural equation analysis. Journal of Religion and Health. 51 (2):468-7.

(5) Toussaint, L., & Friedman, P. (2009). Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. Journal of Happiness Studies. 10(6): 635–654.

(6) Thompson, L. Y., Snyder, C. R., Hoffman, L., Michael, S. T., Rasmussen, H. N., Billings, L. S., et al. (2005). Dispositional forgiveness of self, others, and situations. Journal of Personality. 73(2): 313–359.

(7) Lawler, K. A., Younger, J. W., Piferi, R. L., Jobe, R. L., Edmondson, K. A., & Jones, W. H. (2005). The unique effects of forgiveness on health: An exploration of pathways. Journal of Behavioral Medicine. 28(2): 157–167.

(8) Miller, T. Q., Smith, T. W., Turner, C. W., Guijarro, M. L., & Hallet, A. J. (1996). A meta-analytic review of research on hostility and physical health. Psychological Bulletin. 119(2): 322–348.

(9) Smith, T. W. (1992). Hostility and health: Current status of a psychosomatic hypothesis. Health Psychology. 11(3): 139–150.

(10) Vandervoort, D. J. (2006). Hostility and health: Mediating effects of belief systems and coping styles. Current Psychology. 25(1): 50–66.

(11) Matthews, D.A., Marlowe, S. M., MacNutt, F.S. (2000) Effects of intercessory prayer on patients with rheumatoid arthritis. Southern Medical Journal. 93(12): 1117-1186.

(12) Boelens, P. A. et al. (2012). The effect of prayer on depression and anxiety: maintenance of positive influence one year after prayer intervention. International Journal of Psychiatry Medicine. 43(1): 85-98.

(13) Salmoirago-Blotcher, E. et al. (2013). Frequency of private spiritual activity and cardiovascular risk in postmenopausal women: the Women’s Health Initiative. Annals of Epidemiology. 23(5): 239-45.

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