Body-Mind-Spirit: The Vital Connection David J. Fetterman, B.A., M.Div., M.Ed. Director of Education & Community Outreach Coordinator June 17, 2007 Bridging the Gap between Behavioral Health & Physical Health. The 17 th Annual Case Management Center for Healthy Aging Department of Epidemiology Graduate School of Public Health University of Pittsburgh A Centers for Disease Control Prevention Research Center The University of Pittsburgh s Center for Healthy Aging is a member of the Prevention Research Centers Program, supported by the Centers for Disease Control and Prevention cooperative agreement number DP000025-01 1
What is spirituality? 2
Exercise: Write your personal definition of spirituality. 3
Meaning Value Spirituality Becoming Transcendence Connecting Martsolf, D. S., & Mickley, J. R. (1998). The Concept of Spirituality in Nursing Theories: Differing World-views and Extent of Focus. Journal of Advanced Nursing, 27(2), 294-303. 4
Why do I exist? What is the purpose of my life? What would I miss most if I couldn t have or do it? Meaning How do I make sense of life? Why do bad things happen to good people? 5
What do I believe? What standards guide my decisions? Value What/Who is important to me? What constitutes truth, beauty, and worth for me? 6
What exists beyond me? What/who is greater than me? Transcendence What gives me hope for tomorrow? What gives me confidence that I m not all that there is? 7
How is my relationship with...... others?... myself? Connecting... a higher power/god?... the environment? 8
Who am I? What/How am I continuing to learn? Becoming How do I contribute to life & others? Is my life unfolding as I d like? 9
Meaning Value Spirituality Becoming Transcendence Connecting 10
Exercise: What gives your life meaning? What is something an idea or belief that you value above all else? What gives your life a sense of transcendence? What helps you to stay connected? How are you creative? 11
Spiritual Care Our clients & their loved ones. 12
Vignettes from life 13
Vignettes from life: Ron The value of a broad definition 14
Vignettes from life: Anna Optimistic while trapped in her body 15
Vignettes from life: Donna A constant sense of quest 16
Common Spiritual Questions esp. in crisis: Why is this happening? What do I believe? What will happen to me after I die? Why would God (or Allah or Buddha ) let me suffer? Will I be remembered & missed? What does life mean? How can I have hope? What is hope? 17
Spiritual Care involves: Forging meaningful connections. Respecting choices for managing their living & dying. Eliciting stories from them. Understanding their own unique & personal spiritual needs. 18
Spiritual Care involves (cont d): Searching for ways to cope with impending death. Exploring issues related to meaning, forgiveness, reconciliation, & hope. Navigating a sometimes bumpy emotional terrain that may include anger, grieving over things lost & to be lost, calm, peace, anxiety, happiness, etc. 19
Each person s unique, individual personhood needs to be cherished & respected in Spiritual Care. 20
British psychologist, Tom Kitwood, defines Personhood: A standing or status which is bestowed on one human being, by others, in the context of relationship and social being. It implies recognition, respect, and trust. Killick, J. (2006). Helping the Flame to Stay Bright: Celebrating the Spiritual Dimension in Dementia. Journal of Religion, Spirituality, and Aging., 18(2/3), 73-78. 21
Tom Kitwood describes a place affirming personhood. The ambience here is expansive and convivial. It is not simply a matter of special occasions, but any moment at which life is experienced as intrinsically joyful Celebration is the form of interaction in which the division between caregiver & cared-for comes nearest to vanishing completely. The ordinary boundaries of ego have become diffuse, and selfhood has expanded. In some mystical traditions this is the meaning of spirituality. Killick, J. (2006). Helping the Flame to Stay Bright: Celebrating the Spiritual Dimension in Dementia. Journal of Religion, Spirituality, and Aging., 18(2/3), 73-78 22
Sometimes finding this place requires looking for the spark buried deep down in the person under the haze of cognitive decline or situational anger or depression or stress or but Spiritual Care needs us to look for that place. 23
Burning Bright Poem by an American woman with early dementia Sometimes I picture myself like a candle. I used to be a candle about eight feet tall burning bright. Now every day I lose a little bit of me. Someday the candle will be very small. But the flame will be just as bright. Killick, J. (2006). Helping the Flame to Stay Bright: Celebrating the Spiritual Dimension in Dementia. Journal of Religion, Spirituality, and Aging., 18(2/3), 73-78 24
Guidelines for Helping Persons Experience Their Own Spirituality. Burkhardt, M.A., & Nagai-Jacobson, M.G. (1985). Dealing with Spiritual Concerns of Clients in the Community. Journal of Community Health Nursing, 2(4), 191-198. 1. Know yourself as a spiritual being. What gives your life meaning? What is especially frightening? 2. Remember that being aware of the presence of God does not depend on being able to define or describe God. 3. Remember that each person is the expert on his/her path we can help them recognize and explore their uniqueness. 4. Understand assessment as an on-going process within the context of a relationship. 5. Be aware that the need to be, to be with, and to bear painful feelings is as significant as the need to do and do for persons experiencing spiritual distress. 25
Guidelines for Helping Persons Experience Their Own Spirituality (cont d). 6. Help the person and yourself find goals, hope, and pleasure for the present moment. 7. Encourage reminiscing and share in life review, a process during which persons remember and often resolve or understand old pain and conflicts from a new perspective. 8. Allow persons to grieve for themselves and those around them. 9. Know that by being present we can decrease the separation and aloneness which are so often what persons fear. 10. Remember and know that you are helping a person toward wholeness in this moment, now even when pain and limitation are parts of the moment. 26
Exercise: Recall an experience in which you felt you were truly present with another. How would you describe what presence looked like and felt like in this experience? What helped you be present with the other in this way? Burkhardt, M. A., & Nagai-Jacobson, M. G. (2002). Spirituality: Living Our Connectedness. Albany, NY: Delmar. 27
Spiritual Care Ourselves. 28
Some questions to consider: What is most difficult for you in maintaining your spirit/spirituality as a caregiver? How can your spirituality enhance your professional practice? How can your spirituality enable you to better cope with professional challenges & stresses? 29
Exercise: Write your personal definition of spirituality. 30
Ritual: Part of Life. 31
Rituals important ways to express spirituality. Why is ritual important? What are examples of rituals that people may perform? What is required for a ritual? 32
A Closing Ritual 33