Chapter 1.
Spirituality & Health

Mary Lou, a faithful member of the church prayer team, seemed plagued by chronic illness. An automobile accident ten years ago had crushed several vertebrae, leaving her with nagging back pain. A lingering problem with endometriosis gave her constant abdominal pain. Then her blood pressure started rising, responding poorly to medication. Through it all, Mary Lou appeared serene and sweet-tempered.

Although most people in the church knew Mary Lou and deeply respected her for her strong faith, no one knew her well. Shy and reserved, she rarely attended church function other than the weekly prayer meeting and worship service. She explained that the hard chairs were too uncomfortable for her and that she had to watch her diet carefully. However, now that her blood pressure was up, she began to visit the parish nurse regularly to have it checked.

Kathryn, the parish nurse, asked Mary Lou if she would be willing to go through a health assessment with her. Mary Lou hesitated but then agreed. First they concentrated on the physical problems, which were many. It seemed that Mary Lou spent most of her time visiting medical specialists. She took thirty-seven different pills each day, some of them prescriptions but many of them over-the-counter vitamins and herbal remedies. Kathryn carefully listed each medication, intending to make sure there were no potential adverse effects or drug interactions.

Mary Lou's psychosocial history proved just as complicated. Abused as a child, she had been treated for depression sporadically since she was thirteen years old. Her two grown sons had left home soon after graduating from high school. She had not seen either of them for years and had never met her grandchildren. Her husband, Paul, was her only friend, and she felt she was a burden to him.

As Kathryn began the spiritual assessment, she hoped this would be one area of health in Mary Lou's life. But here she began to get to the heart of many of the other problems. At first she hesitated to use the assessment guide. It contained a checklist of spiritual disciplines and practices, including some that were rather unusual. Certainly Mary Lou wouldn't know about most of these practices. However, to Kathryn's surprise, Mary Lou checked almost every one, including swinging a pendulum, meditating on a mantra, consulting spirit guides and a wide array of alternative therapies. Finally Mary Lou looked up and said, "I desperately want to develop my spirituality—if it's spiritual, I've tried it."

Mary Lou is not alone. Recently, I attended a parish nurse support group meeting. Thirteen parish nurses from area churches were sharing how they help people in their congregations deal with stress. Ten of them were using some form of therapy borrowed from otter religions or the occult—yoga, transcendental meditation, tai chi, Therapeutic Touch, crystals, herbal therapies, diets and massage techniques designed to balance yin and yang, talking to "angels," worry stones, aromatherapy and various forms of imagery. As they discussed these techniques, they agreed that the role of the parish nurse should be to minister to the spiritual dimension, and they classified these activities as "spiritual." "What else do we have to offer?" one of them asked.

Spirituality is a hot topic today. Almost every magazine, newspaper and television program has featured it recently. The bookstore at the local mall has a section on spirituality five times the size of the religion section. Most of the books in the religion section are on religions other than Christianity. Just what is this spirituality that people are seeking? Why is there such a great interest in spiritual things?

"You have made us for yourself," prayed St. Augustine of Hippo, "and the heart never rests until it finds its rest in you." God created us to be spiritual beings—people who seek after something beyond ourselves to find context for our lives. The apostle Paul, preaching to the Greek seekers on Mars Hill, explained, "From one ancestor he made all nations to inhabit the whole earth, and he allotted the times of their existence and the boundaries of the places where they would live, so that they would search for God and perhaps grope for him and find him—though indeed he is not far from each one of us. For 'In him we live and move and have our being'; as even some of your own poets have said, 'For we too are his offspring'" (Acts 17:26-28).

Our culture's current fascination with spirituality should come as no surprise. That's the way God made us. The soul's deep longing to know God is a basic human need. However, the definitions of spirituality in the professional and popular literature today differ widely. We are not all talking about the same thing. Recently there has been a strong movement away from defining spirituality in religious terms. Religion is seen as narrow-minded, rigid and confining, while spirituality is open-minded, creative and freeing. On the other hand, there has been a trend toward investigating other religions, including Buddhism, Hinduism, Taoism, shamanism and Native American spiritualities. A pantheon of other gods has entered the American religious scene.

Recent polls seem to bear out these observations. A 1997 Yankelovich Partners poll showed that significantly more Americans are dabbling in spiritualism, astrology, reincarnation and fortunetelling than did in 1976 (see figure 1). The Gallup polls, which have been tracking Americans' religious beliefs for more than fifty years, have consistently found that over 90 percent of those polled say they believe in God. However, in 1976 the question was changed to "Do you believe in God, or a universal spirit?"

In 1992 the question was broken down, with some interesting results. While all but 2 percent believed in some sort of spirit, God or life force, only 83 percent claimed to believe in a personal God. Further questioning of this group revealed a "dazzling array of New Age spiritualists who were 'significantly more likely than those who believed in God... to say they believe in such things as astrology,

ESP, psychic or spiritual healing, déjà vu, ghosts, visits to earth by extraterrestrial beings and reincarnation.'" However, the division between those who believe in a personal God and those pursuing other spiritualities is not clear-cut. If 83 percent say they believe in a personal God, but 52 percent believe in spiritualism, a significant portion of those believers are dabbling in other beliefs as well.

The apostle Paul observed the Athenians' serious pursuit of a vast array of gods and spiritualities in Acts 17. Then he went on to explain that he could tell them about the Unknown God they were seeking. Our own culture's fascination with spirituality presents us with a similar challenge. But we need to be sure we know what kind of spirituality we should be pursuing! In this book, we will view spirituality as the whole person in dynamic personal relationship with God. When we compare that to the definitions in recent literature and the communications media, we may find ourselves in conflict. Part of the problem comes from the fuzzy reasoning we experience as we find ourselves floundering in the midst of shifting paradigms and clashing worldviews.

Spirituality and Worldviews

The modern worldview comes to us out of the Enlightenment, a movement beginning in the seventeenth century that initiated the modern period of European culture. Although it had its roots in Protestant Christianity and was strongly influenced by pietism, empirical science replaced God as the primary authority. Rationalism, materialism and democracy characterized Enlightenment thought. Most of us have been so immersed in this worldview that we don't realize how deeply we are influenced by it. We assume that if we can't prove something by empirical research, it isn't real or true. God, though usually acknowledged by modernists, is seen as distant, benign and disengaged from the world. Spirituality, for the most part, is viewed as superstition, and religion as a private matter that shouldn't be discussed in intelligent company.

While the modern worldview set the stage for science and technology to flourish, people increasingly began to realize that something was missing. Modernism separates the mind from the body and does not leave room for interrelationships between emotions, beliefs, environmental influences and physical health. On the other hand, it has contributed amazing advances to health care. None of us would want to return to premodern days—before antibiotics, immunizations, anesthesia or modern surgical techniques. But there is a new movement afloat today.

The postmodern worldview has begun to replace the modern worldview. It grew out of an attempt by twentieth-century philosophers to deconstruct the assumptions of the Enlightenment and modernism. The effects of postmodernism now permeate many aspects of our culture, and it has radically transformed the prevailing understanding of spirituality. The trends in recent literature show a spirituality increasingly devoid of content and divorced from religious faith. It is based in experience—feelings and techniques. Many are quick to explain that "this isn't religious." Consequently, this spirituality is open to everything, for there is no absolute standard of truth. Any spiritual practice that brings comfort, strength or apparent healing is considered equally good and can be incorporated into health care.

To some extent we have all become enculturated into postmodernism, which values tolerance, "political correctness" and multiculturalism. We hesitate to offend people by being judgmental—almost to the point where we don't make ethical distinctions. Although we may think that our Christian beliefs are right for us, we may also consider other religions equally valid and true. Interest in evangelism and missions is waning. Many Christians have forgotten that the gospel is good news and that the Bible insists that following other gods will lead us into bondage.

The biblical worldview looks at spirituality differently from either modernism or postmodernism. Actually, the term spirituality doesn't appear in the Bible at all. God doesn't tell us to develop our spirituality, because the spiritual is always personal in the Bible. We develop spiritual relationships, and we are given a choice—either to accept God's offer of a relationship with him through Jesus Christ or to turn to other spirits. The spiritual world is real, not a psychological projection or a primitive superstition. It is not a neutral world. God has warned his people repeatedly to avoid colluding with any other spirits (gods), not because he wants to limit our freedom but because it is dangerous. These spirits are enticing, deceptive and manipulative; "even Satan disguises himself as an angel of light" (2 Cor 11:14).

Too often we approach spirituality from the worldviews that have shaped us, rather than from a biblical worldview. We are pragmatic modernists when we rationalize that we should not talk about religion—particularly Christian witness—in public. On the other hand, we are relativistic postmoderns when we assume that we should encourage any kind of spirituality, seeing it as benign or even good.

As we look at the prevailing trends in spirituality, we need to keep firmly rooted in the solid grounding of Scripture, for it is only God who heals us and satisfies that deep spiritual longing within us. If we truly hope to meet the spiritual needs of those in our care, our spiritual care must be focused on bringing people to Jesus so they can experience that healing personally.

How Does Spirituality Affect Oar Health?

The research shows that religion is good for your health. Recent medical research at respected institutions such as Harvard and Duke has appeared in both the professional literature and. the popular media. It indicates that regular church attenders live longer; have a lower risk of dying from arteriosclerosis, emphysema, cirrhosis of the liver and suicide; and recover faster when they do get sick. Their diastolic blood pressures are lower than nonattenders, their mental health is better and their marriages are more stable. Furthermore, studies show that prayer "works."

Christians are expressing delight over current medical research on prayer that seems to prove what we have known all along. But here we must exercise caution over our faith in science. Does research prove or disprove God? How can we measure God-at-work? Does prayer work only if we get our way? God wants us healthy and instructs us to pray for healing, but he doesn't answer according to our criteria.

The real question we need to ask is What does the Bible say about health and healing? We will examine several biblical concepts. First, the definition of health in the Bible is holistic and broad. It has more to do with healthy relationships than with the absence of disease. Next, healing was a major focus in the ministry of Jesus. Finally, Jesus instructed us to "go and do likewise."

The biblical understanding of health is closely linked with the Hebrew concept of shalom. Often translated as peace, it is much more than an absence of conflict. Shalom refers to a God-centered community where people live in good relationship with their neighbors, caring for one another's physical, emotional and spiritual well-being, economic welfare, social interaction and environmental safety. There is a strong relationship between shalom and righteousness. That righteousness is found only through a faithful relationship with God. A righteous life leads to shalom and results in joy and flourishing (Isa. 49:17-20; 51:11-16).

The biblical concept of health is also closely related to the concept of salvation, for the goal of salvation is to bring us into the shalom of God (Isa. 63:4-6; 61:1-4; Jn 14:27). The Greek word sōzō means both "health" and "salvation." We see examples of this in Matthew 9. First Jesus healed a paralytic by forgiving his sins; then he demonstrated that healing had occurred by telling him to get up and go home. Then a woman who had suffered with a hemorrhage for twelve years touched the fringe of Jesus' clothing, believing he would heal her. He turned to her and said, "Your faith has made you well [sōzō] (Mt 9:22). In both of those situations, the persons healed found more than relief from physical symptoms. They were restored to the worshiping community. They received both salvation and physical healing.

Linsey provides a contemporary example of this holistic healing. Grossly overweight, Linsey's blood pressure soared far above safe levels. Medication did not adequately control it, and a battery of tests could not locate a physiological cause. Linsey also suffered numerous other health problems and seemed unable to lose weight. While praying with a friend one day, Linsey remembered some serious problems from her childhood that had left her angry with God. She was able to picture the scenes in her mind and see Jesus present with her through the terrifying situations. As she began to sense God's love and care for her, she suddenly began feeling better physically and to steadily lose weight. Her blood pressure gradually returned to normal.

Many people would simply say that Linsey's health problems were "in her head." Jesus would probably say that they were in her heart (Mt 13:15). However, that does not negate the reality of the physical symptoms, nor does it indicate that all physical illness is caused by sin. The point is that we cannot separate people into body, soul and spirit (or any other compartments), dividing the aspects among various specialists. While doctors, nurses, counselors and clergy may each focus more intensely on one dimension, all have to work together toward healing. Health and salvation are ultimately flip sides of the same coin.

Some Christians are convinced that the role of the church is to deal only with "saving souls." They fear that too much involvement in social issues might divert us from a concern for salvation. However, salvation and healing are both social issues. True health means living in dynamic relationship with God as fully functioning members of the body of Christ Jesus never separated health and salvation. Throughout the Gospels we see Jesus teaching, preaching, healing and casting out demons—all at the same time (Mt 4:23-25). Through his healing ministry Jesus verified that he was truly the Messiah (Mk 2:10; 3:11; Jn 11:4).

People flocked to Jesus because he offered healing for physical illness. Often it was only after their physical needs were met that they began to understand Jesus' message. Consider the story in John 9 of the man born blind. At first even the disciples did not treat him with compassion, but merely as an object lesson. The Jewish leaders believed that all suffering was caused by sin, and apparently the disciples did too. However, through his healing, Jesus made the man a much greater illustration of his love.

First, Jesus delivered the verbal message: "I am the light of the world" (Jn 9:5). He was talking about his power to bring salvation. Then he demonstrated his power by applying mud made with his own sputum to the man's eyes, resulting in his healing. The man's faith then grew as he related to Jesus. The man demonstrated his initial faith in Jesus by going, as directed, to wash in the pool of Siloam. When he returned seeing, he immediately came up against opposition from the religious leaders. He fearlessly gave his testimony, calling Jesus a prophet. The attacks on him continued, but he refused to back down. As he defended Jesus to the authorities, his faith and understanding grew. Finally, he encountered Jesus again, asked questions to more fully comprehend who he was and what he had done, then confessed Jesus as Lord and worshiped him. His healing was complete—he could see Loth physically and spiritually—and that healing restored him to his rightful place in society.

Jesus' death and resurrection made this healing available to all of us. Isaiah tells us: "But he was wounded for our transgressions, crushed for our iniquities; upon him was the punishment that made us whole, and by his bruises we are healed" (Isa. 53:5). However, we live in a "now and not yet" kingdom. Jesus won the victory over sin, death and Satan on the cross, but we still wait for his return to reign in that power. This time of waiting may be filled with pain and suffering, but even now we experience glimpses of God's promise of healing (Rom 8:18-25). In the meantime Jesus gave us a mandate to care for the sick and needy (Lk 10:9, 37).

The early church took this command seriously. They cared for others, not only for the church members (e.g., Acts 6), but also for believers they did not know (e.g., 2 Cor 8) and those outside the church (e.g., Acts 2; 1 Tim 6:18; Jas 1:27). Throughout church history we see a pattern of reaching out to the total needs of people, intertwined with the proclamation of the gospel. Christian missions have always moved forward with a two-pronged approach, bringing health care to people in other cultures along with the gospel message, so they might experience the healing power of the gospel.

What Is Spiritual Care?

We have established that we are whole people who cannot be separated into unrelated components. So why must we talk about spiritual care as a specialized aspect of ministry? Although we cannot divide the person, we can make distinctions. There are different aspects to who we are and how we relate to the world.

We have physical bodies that define us. Paul tells us:

There are both heavenly bodies and earthly bodies, but the glory of the heavenly is one thing, and that of the earthly is another. There is one glory of the sun, and another glory of the moon, and another glory of the stars; indeed, star differs from star in glory. So it is with the resurrection of the dead. What is sown is perishable, what is raised is imperishable. It is sown in dishonor, it is raised in glory. It is sown in weakness, it is raised in power. It is sown a physical body, it is raised a spiritual body. If there is a physical body, there is also a spiritual body. (1 Cor 15:40-44)

Our bodies are extremely important. We are to care for our bodies (Eph 5:29) and for the physical needs of others (Lk 10:37) but not be obsessed with them (Mt 6:25). They are the temples of the Holy Spirit and a means for glorifying God (1 Cor 6:19-20). There is something beyond the physical body that is eternal. It is that aspect of the person that maintains our relationship with God throughout life and after death. God has been involved in shaping our bodies and every other aspect of our lives from the beginning (Ps 139; Isa. 43:1). He knows the emotional baggage that we carry and has walked through it all with us (Isa. 43:2). Our physical bodies, our emotions and our human relationships all interrelate, but there is something more (Phil 3:20-21; 1 Thess 4:13-18). It is the spiritual dimension that ties all the loose pieces of our lives together (Ps 16:8-9; Isa. 55).

That spiritual dimension is not a separate part of us, hidden deeply within our bodies, that flies away after death. Nor is it a vague, impersonal energy field that merges with the universe. It is the essence of who we are as persons, and it is centered in our relationship with God. The spiritual is always personal.

Spiritual beings—whether God, angels, demons or humans—have wills, intentions and character. Therefore, spiritual care involves facilitating relationships. Christian spiritual care focuses on helping others to establish and maintain a dynamic personal relationship with God by grace through faith. That is made possible through the death and resurrection of Jesus Christ and the work of the Holy Spirit. We serve as ministers of that grace and as representatives of the body of Christ, the church.

As our culture becomes increasingly pluralistic, for some people spiritual care may also mean facilitating relationships with other spirits. Christians need to be aware that for us to do so would be leading people astray. There is no such thing as "generic" spirituality. For a Christian to enter into a relationship with any spirit other than God is idolatry. To lead or even support others in questionable spiritual practices is to be a stumbling block to their faith. For this reason, we must also be careful about where we seek our spiritual direction and guidance. We should not be looking for spiritual techniques or healing practices from other belief systems. Many alternative/ complementary therapies fall into this category. The first rule of spiritual care should be the same as for any medical intervention—do no harm. Although these therapies may look harmless and inviting, before using them we must first investigate their spiritual sources and ultimate ends, as well as their safety and effectiveness.

Spiritual care for the Christian includes only those approaches that will deepen and enhance a person's relationship with God. It includes worship, compassionate presence, prayer, Bible reading, a vast treasure store of Christian literature, human touch, music and the love and support of the Christian community.

Spirit Touching Spirit

Why is spiritual care so important? First, because illness, emotional trauma and simple discouragement can cloud our relationship with God. A person in crisis is vulnerable and often desperate. Without the support of caring Christians, anything that promises to help will seem attractive. King Saul turned to a "medium at Endor" (1 Sam 28:7); Mary Lou turned to "spirit guides." Others try everything from shark cartilage to crystals. Good spiritual care keeps a person safely in the arms of Jesus.

It is not uncommon for people who are suffering intensely to feel that God no longer hears their prayers. Their attention span may be short, or their eyesight poor, so that reading Scripture for themselves does not bring comfort. They may not be able to attend worship services or other church events, so they feel cut off from the fellowship. They may feel helpless, hopeless and alone. Romans 12 instructs us to exercise spiritual care toward one another:

Let love be genuine; hate what is evil, hold fast to what is good; love one another with mutual affection; outdo one another in showing honor. Do not lag in zeal, be ardent in spirit, serve the Lord. Rejoice in hope, be patient in suffering, persevere in prayer. Contribute to the needs of the saints; extend hospitality to strangers.... Rejoice with those who rejoice, weep with those who weep. (Rom 12:9-13, 15)

By doing so, our spirits reach out and touch the spirits of others to encourage them in the faith. We represent Jesus to others. Spiritual care is the responsibility not merely of pastors and church leaders but of every Christian who supports others through illness and crises. It puts our physical care and emotional support into a context of faith and hope.