(A Dream at the Overstreets)

THE GATHERING, THOUGH LOOSE KNIT, nevertheless had great integrity. Each individual was completely present as a manifestation of the role he and she had become accustomed to living

throughout the years. Bennett was secretive and mysterious, though anything but withdrawn.

Metaphorically speaking, he held his cards closely, playing them knowingly and

carefully. He was deeply invested in his selective involvement with others, and nurtured

a leadership relationship with all he encountered. With those who obediently

followed; he liberally engaged in secretive, meaningful conversation.

The old lady had but one follower. She was elderly, and appeared to live exclusively

through the victories, defeats, whims and consciousness of her leader. The

matron was grandly and meticulously adorned, a string of pearls around her neck

with dark, subtle colors of amber and black upon loosely gathered attire. Her follower

in contrast, while attractive, was plainly dressed in a light blue cotton dress.

She did not present herself with the same assurance as did her idol. Though she was

the more visible and active of the two, she shadowed the actions and feelings of her

"other."

Each one in the dream was immersed in his or her own way of being. There was

neither room for reflection nor equivocation.

I cannot now remember how the dream began. I was aware of trying to become

involved with Bennett. But his off-handed, seemingly indifferent way of relating to

me frightened me, or at least made me uncomfortable and in turn caused me to

believe it would be hard to gain his confidence; to share in a relationship with him.

It resulted in my feeling discounted, as less desirable. Therefore I would be unlikely

to be successful in gaining his acceptance. Still I wanted to, but was momentarily

discouraged.

Meanwhile, I and several others—of a more non-aligned or non-accepted

nature, were drinking a dark beverage, perhaps something like red wine or a coffee

liqueur. The old matron was sitting at table, perhaps for supper with her follower.

Then the follower asked if I would like to join them (as for a drink).

While still attending to Bennett and his group (its members were shrouded and

I could not see them well), who were rather covertly engaged in conversation with

each other, I turned in response to the invitation and said, "I would be delighted."

Yet my heart was not truly invested in the idea. My response rather was an act of

cordiality for having received such an earnest invitation.

The matron without turning her head smiled subtly, being pleased with my

response, while her follower made a two thumbs up victory sign—(her hands

remaining on the table)… and said "yes" as if she had scored a goal. In truth, the

invitation was very well done and deserving of acceptance. But their response to it

belied a great unmet need which I had, at least temporarily, remedied. Still, I continued

to attend to Bennett and his followers and the rest of the milieu, while

intending in a moment or two to join them.

The dream reminds me of Sartre’s "No Exit," where all parties are inexorably

embedded in the banality of stylized socialization and the pandering for preference.

They reflect a poorly concealed rigidity and a plethora of needs beneath endless

portrayal that becomes the nexus of identity.

Upon waking I yearned for the time when people were so obvious and well

defined. It was possible to view them as a reality bourne out of a basic truth. The

truth of who they had become. They were not the result of a camera angle—or spin

doctoring. I immediately committed myself to the bringing upon us of a better day

wherein an integrity of one’s being exists, a healthy manifestation, enriching those

around. I also rather grandly committed myself to the elimination of contemporary

vacuousness.

Now the mask of identity is no longer worn. Rather it is a shifting blankness

molded by compliance, and the avoidance of detection of one’s nature and feelings.

The contrived manner of expression of those in the dream were masks that concealed

and at the same time displayed their identities. They could not be changed

or removed.

No matter. There is no going back through the development of some kind of

mask replacement therapy. Rather the masked ones and the faces of putty alike

might commit ourselves to a coming home into beingness. That requires a genuine

awareness of internal beingness, including our fundamentally healthy goodness, as

well as a comfortable and healthy co-relational involvement in life. It includes all

aspects of personal beingness and a life of growth to do this. It means being spiritually

alive.

Those of us who are spending our lives as medical and counseling practitioners

have the good fortune of being in a position to facilitate physical and spiritual

growth and health in others as well as in our selves. Yet the doing of these things

requires a deepening of our understanding as to how we might proceed.

Treating Spiritual Disorders with the subtitle Promoting Spiritual Recovery might

have been entitled "The Diagnosis and Treatment of Spiritual Disorders." That is

what the book addresses. But we are in a time of exploration and searching. It is too

soon for that certainty implied in the alternative title. But the time is right for what

we are doing. As a colleague suggested, "Spirituality is the next great frontier in

medicine."

— Gregory Sims

1

IT APPEARS THAT AS WE LOOK AT LIFE, we are often at a loss in

understanding what our needs are, and what pathways we should take in

order to grow. This is particularly true in the areas of medical and psychological

treatment. There are any number of choices: choice points and

opportunities to make decisions that are perhaps in our best interest. Yet these decisions

sometimes come with a price. If one is to elect surgery there are the costs—

physical, mental, emotional, financial. What does one do when depressing events

become depression?

In spite of costs and confusion we seek assistance with our problems because

they are so difficult we cannot manage them on our own. That of course is not

always the case. Individuals with vocational and educational problems often address

them through personal, social and community efforts. Exercising, vitamins, careful

watching of one’s eating, consciously making an effort to get enough sleep, and

joining with others who are attempting to accomplish goals for healthy living all

give us opportunities to intervene in our own lives. But at times, whether or not we

go to the physician or counselor, it feels better to go to someone who might help

us with these problems.

Recently, I had an opportunity to observe people in the waiting room of an outpatient

clinic. My son-in-law was then a resident in family practice medicine. I sat

there for approximately two hours. During that time I had an opportunity to watch

several patients come and go. There seemed to be an identifiable pattern, and I realized

I had been seeing this for decades. People came in, with or without children,

sometimes quite scattered and unfocused. As they sat down, if they had children,

there was an effort to engage the child in some storybook, coloring or interesting

activity. The waiting room was, as usual, quiet. The adult then picked up a magazine

and rather mindlessly leafed through it or became engaged in some random

article. These people then became part of an invisible group. By that I mean all of

the people were obviously in sight of the others, but were only indirectly related to

each other, and as a group were waiting for their turn for treatment. Each one had

a story, problems and needs. When the child of the adult was called, both went into

the examination room. There was a conference, followed by an examination, perhaps

blood tests, and some kind of determination. Identifying data had already been

presented to the receptionist who managed the business part of the contractual

arrangement. Following the medical intervention, people returned to the waiting

room, perhaps picking up an item or two, and left.

It appeared to me something in addition to medical assistance was occurring.

First there was a real investment that was obvious. And within the context of that

investment was some degree of trust, belief and acceptance. Following the interventions

it appeared that individuals left in a much calmer, more pleasant, more satisfied

state than what they brought with them when they came in. That may not

have been true for patients receiving bad news, and the temporary resolution may

have dissipated very quickly as the individual walked across the street, a car honked,

or some distraction occurred, causing some reaction or problem.

That calmness, peacefulness, that the professional environment encourages,

runs through the waiting room into the hospital, skilled nursing facilities, and the

offices of psychologists, counselors and professionals of all kinds. For individuals

who have difficulty focusing, understanding their problems, identifying their problems,

knowing what kind of sequence of events must occur, who may even need help

in maintaining an effective continuity in their lives, this visit is rewarding. It is a little

island. It’s a place where the external environment takes into account the needs

of the individual by being set up in such a way so as to promise, not only that there

will be a supportive, calm acceptance, but that each person in this temporary community

will have his or her turn to be individually identified. As a person experiences

the doctor or therapist identifying problems, it enhances one’s own sense of

being able to identify oneself; in part, through the identification, treatment and

involvement in one’s own problems and needs.

There is a recognition of characteristics, and the recognition verifies the individual’s

identity. This is why a diagnosis is so important to some. If I am flawed and

I clearly suspect that there is something wrong with me, I go to the doctor. I might

be hoping that there is something wrong with me that the doctor can identify,

because then the two of us will have this information. As partners in the doctor-

patient relationship we can work together to make me better. It may be that the

things the doctor identifies as being wrong aren’t at all or are very indirectly related

to what is more deeply going on within my psychological or even my physical

environment—the possibility that I am using certain physical experiences for psychological

purposes. That may take some time to surface, only after a number of

contacts.

I thought as I watched these individuals come and go; I thought how nice it

would be if they had the opportunity upon leaving to go into another room where

there could possibly be refreshments, and an educational program geared to the

general illnesses and problems people have. Perhaps they could sign up for a broader

community based support system directly on the heels of the medical intervention.

How nice it would be for them to take the good feelings, the calm, integrated

professional and skilled way that the medical program offers, and find the means

through which to begin to introduce those ways into their own lives.

On discussing this with my son in law, I found that he too was aware of the fact

that much of medicine is indirectly a system of psychotherapeutic support. This, of

course, is not new information. Most physicians realize that a large part of what

they do offers at least temporary support for individuals who are not able to find

their way in life very well. In fact, one of the problems physicians face is that some

portion of their practice is comprised of individuals who have become addicted to

getting this kind of "fix." They begin to invent things that are wrong. They begin

to describe symptoms that are almost impossible to get at—medically. Many

patients, clients, do the same with psychologists and counselors. What these people

are saying is that there is a profound disorder. They are aware of it, they feel it, they

know it, they live with it, but many of them have not recognized it and confronted

it directly. Rather, there is the tacit assumption that nothing can be done. There is

something that is so deep and so penetratingly wrong that the next best thing is

simply to deal with a whole host of rather superficial symptoms and problems in

order to try to get themselves through this chaotic and very long life that offers not

a great deal of ongoing satisfaction. Rather than being able to get to the root of the

problem, such individuals are often superficially satisfied from time to time

throughout the day with habits, practices, things that appeal to them, a morsel of

food, television program, conversation, or a doctor’s visit. The hope is to get as

close to breaking even as possible. Then there is the large group of people who take

various psychologically altering substances, legal and illegal, in order to maintain.

As practitioners we, to a certain extent, do provide a world view for our patients

and clients. Physicians have been doing this for thousands of years. Psychologists

and counselors who have in the past been described by other titles, also do it. Our

task has been to provide patients with a contrast between sick and well, needing

cures and being cured, reacting to problems or intervening in them. We also help

people to get better or we give them some hope of being able to make it from visit

to visit. Some part of what we offer patients and clients is a perspective from which

and through which, not only to view their problems, but to view life. Because as we

assist people in seeing the patterns of healthy behavior, or self-destructive behavior,

or the growth of unwanted tissue, or the biochemical imbalance that’s occurring in

the body we orient them to a way of looking at unfamiliar territory.

Reneé Descartes (1596-1650) believed scientific inquiry requires that we begin

with the investigation and subsequent acceptance of the simplest and most evident

truths. To that end he set out to establish rules and methodologies which would

allow us to deepen our awareness of the design in the fabric of creation. In Part IV

of his "Discourse on the Method of Rightly Conducting One’s Reason and Seeking

Truth In the Sciences", he introduces a method which serves as the basis for the null

hypothesis: this being the presumption of no significant difference between effected

experimental data and random occurrence. In Descartes’ application, he presumed

that all information he had come to accept was of no value. He then went on

to test these hypotheses against the fundamental truth which (as he concluded) reason

offered.

Yet, as with all great thinking, it is possible to refine matters further, thus eliminating

problems that may exist. Descartes’ method of beginning with that which is

most simple ignores the reality that complexity has been built into our thinking.

And, as children we came to admire those studies that were complex enough to

challenge us. Thus our first task in applying this method must be to forsake our reverence

for complexity and accept only those complexities that are necessary.

Secondly, we must look more closely at the phrase "I think, therefore I am" and

realize that the thinking of which Descartes wrote was very close to what is

expressed through the word "I." The fact that he included the word "therefore"

does not necessarily imply sequence (as the result of). Rather, "I" is (in and through)

thinking.

In order for this proposition to help us, we must refine it to a simpler truth. We

may do that first by eliminating our dependency upon the concept of identity and

conceptually replace the word "I" with "human beingness." In this manner the misunderstanding

that thought is central to who we are can be avoided. We can then

offer thinking its proper place in our evolving. Human beingness inexorably

includes thinking.

More specifically, undifferentiated thought is integrally entwined in our presencing.

It is the simplest of phenomena yet it is not the most evident. Much of our

spiritual nature is hidden as the result of complex living and thought which obscures

undifferentiated awareness. And while this particular focus is upon thought, undifferentiated

awareness also includes physicality, relatedness, love, movement, stillness

and unity.

Foresaking identity becomes more desireable when we begin to realize that

what was passed for "identity" includes momentary reactivity, in conjunction with

thought, emotion, behavior and experience which through circumstantial conditioning

has become a vaguely identified mish mash. For many it has been subject to

a wide range of unforward events and problems of no one’s choosing. It is a repository

of great unclarity, a mound of preconceived notions in a sea of expectations;

some met many resulting in disappointment. It is indeed fascinating to contemplate

the discovery and use of effective and appealing methodologies that accomplish a

process of release, restructuring and refinement. We propose that thought has a

significant role in our evolution. According to Descartes thinking = human beingness.

We hypothesize that thinking = human beingness. Rather, human beingness inexorably

From this proposition it is evident that we must involve ourselves in considerable

preparation to be able to live the simplest of lives and to draw that simplicity

into complex situations. we must learn how to open ourselves to undifferentiated

thought within the context of presencing. For example, there are many reasons why

life does not seem to offer enough. One may be because we didn’t get "enough"

during some significant developmental period. But it is more complicated than that.

To wit: when basic needs are not met, there is an increased intensity of need, and

when satisfaction—gratification does occur, the intensity of the satisfaction/gratification

is greater. This sets up a need for this level of intensity for fulfillment to

occur. Thus when our needs are met promptly, after this beginning—they’re never

enough until we experience the level of intensity that we are seeking. This requires

deprivation which we do not want, imbalance, and even when that is achieved it

precludes true fulfillment.

From this destabilization, individuals may have the feeling of something being

wrong and translate that into feeling unsatisfied, or being unequal in the imagined

or actual presence of another (others). This is the result of maintaining identity

through a process of defensively based deflection. The destabilization of homeostatic

health is translated into a defensively based identity. Fundamentally this is based

upon reacting in infancy and early childhood to the physical presence of another.

These are others who are not those particular ones with whom attachments have

been established, through which a complete sense of comfortable beingness in a

dependent fashion exists.

Here it is possible to see then that basic physiological, psychological and social

problems beset us. Bringing them to our attention without an ability to manage the

information and find solutions does little more than to pronounce a judgment that

suggests we are perpetually unhealthy. It is important that we find ways to use this

information so that through it there can be solutions and growth. Let us look at the

proposition based upon our modification of Descartes’ view, that undifferentiated

thought within the context of presencing is a crucial resource in establishing a

healthy way of living. Let us also examine why to date thought has not provided the

avenue of growth we might have expected.

The way in which events happen causes us to identify tangible and complex

mechanical and functional properties of nature. In and through our inventions we

create a very (and unnecessarily) complex environment. This requires specific complex

responses. For the complexities to be a healthy product of integrative beingness

they must be founded upon, and as the result of a robust ongoing presencing

deriving from the metabolic simplicity of fundamental life experience. One may

quibble with the description of metabolism as simple, since we find it highly complex

and our most complex sciences cannot create it. The simplicity is in and

through its fundamental availability. In the same manner that water is simple, so too

is the truth of healthy metabolic experience. The closer undifferentiated thought

can come to being in continuous process with healthy metabolism, the more our

thinking will reflect the true physical nature of our being. We will then have a much

more reasonable foundation through which not only to view but understand experience

in its simplicity. This will provide us a much more solid foundation upon

which to build the more complex discoveries, inventions and ways of living that

inexorably present themselves to us.

Recently I was asked by an individual who is nearing the end of his life to do an

independent assessment as to whether or not he is capable of managing things. He

wanted me to do this in part so that he would have evidence that suggested he was

capable, of managing his life. He wanted me to confirm which path to take. To some

extent my approach was to help him organize his choices, seeing his abilities and

options. This process is not uncommon, and to some extent determines what people

will do. It also at times becomes a significant factor in the decisions of social

workers and the courts.

Physicians who advise an individual as to whether or not they should have a radical

prostatectomy may make suggestions or very strongly indicate an opinion as to

what should be done. No matter what approach is taken, the patient’s life is changed

as the result of the information that has come from the PSA and how the physician

interprets it. Whether the individual engages in a conservative program of watchful

waiting or a more radical procedure, that person is now experiencing new

dimensions in life. These changes can be very positive. Rather than having vague

fears about what might be going wrong, much of the patient’s concern, rightly or

wrongly, will be focused on information related to this problem. He may choose to

engage in many new activities, i.e. support groups, literature exploration, etcetera.

These will also have an influence upon his life and the lives of his family members.

There are countless examples where the lives of individuals are very profoundly

shaped by practitioners providing these services. In the first example, the world

view of the individual will be effected by a general assessment and discussion of

cognitive abilities, affective stability, interactive potential (including language

usage), depth of relational contact, identification of commonly known information,

and the rest of what is included in a mental status examination. These are psychological

and social structures by which we live, which most people take for granted

until something starts to go wrong. In the second instance, the individual is faced

with information about organic changes. What should he do given the fact that

there is indirect evidence that a carcinoma may be present in his prostate? The

biopsy confirms this and then the second question is the same as the first. What

should he do? Both individuals have been taken into a world with which they may

be but vaguely familiar. To that extent there is an opportunity to learn, grow, develop,

and to organize life in a more conscious fashion.

The structures, approaches, and the material for discussion—which also are

much of what comes from the reality of the individual’s life, can be identified as

being directly or indirectly organic. Secondly, much of the information is shaped

around the current level of our scientific understanding and clinical practice. While

we certainly interweave human elements of caring, social practices, concerns, and

individual attention, within the context of our medical and psychological findings,

the bottom line, as profit is for business, within the health care professions is science.

There is no doubt that many individuals take scientific information and add

humanistic, altruistic, religious and spiritual considerations to it. These additional

qualities are not always main factors in our treatment schema. This is the realm of

personal, family and community involvement rather than being under the aegis of

the medical and psychological practitioner. To be sure, we offer people ways of

looking at life and relating to others that include both life appreciation and the realities

of their circumstances (as we have defined them). And our suggestions may

include looking at spiritual issues. But that is not yet our province.

It appears that as we look at life, there are also those bright opportunities for

happiness and growth. Most of us can remember wonderful times in our youth

when we reflect upon what has happened to us. If we are fortunate those wonderful

times continue throughout early adulthood into middle age and into our senior

years. A goodly number of people live an enriching, positive, satisfying life and die

in a state of understanding and acceptance. While this is true for many, it does not

describe the lives of the majority of Americans. Because, even though we seem to

have a robust economy at the present time, and we are not caught up in terrible

wars, as has been the case for previous generations, for many there is a malaise, a

dispirited wandering, searching, wanting, looking for more, needing more, yet

resisting change. Many but not most people who live this life of "not enoughness"

seek counseling, psychotherapy, medical assistance—sometimes they seek a diagnosis,

looking for something that they can point to as being wrong. And many times

we can indeed accommodate them. But we rarely include in our accommodations

discussions or descriptions of spiritual disorders, spiritually related problems and a

need for spiritual beingness that is hypothesized to exist in all of us. The Diagnostic

and Statistical Manual of the American Psychiatric Association contains four lines (out

of some eight hundred pages) devoted to spiritual problems. And these lines deal

with individuals struggling to make religious or spiritual choices or those who are

facing a religious or spiritual problem.

DSM IV: V 62.89 Religious or Spiritual Problem: "This category can be used

The problem with this cursory diagnostic reference, in addition to it being a

minimalist approach, is that the entire area of spiritual disorders and their treatment

remains undiscovered by the general populace and unexplored by the treatment

communities. It offers nothing in the way of specifics for diagnostic explication

as being both medical and psychological in nature.

This is a case history composite. It is no single individual, but is comprised of a

number of threads of clinical material that are associated with actual cases. Eric is a

fifty-eight year old Caucasian male who has been married since age twenty-three to

his wife Emily, who is fifty-six. He has worked as a business manager for a relatively

small corporate firm that has participated in the distribution and sale of goods.

He has had but one marriage and has been relatively successful in his business,

working himself up to a position of on-site management. Eric had three years of

college, and his wife completed two. He is the father of two children, John and

Paula. Paula also did not graduate from college. They have been relatively successful

in their economic and social lives. John, the oldest child, age thirty-two, is

unmarried. Paula, age twenty-nine, is married and has two children. The family has

not moved, has remained in the community and become stable, well-known and

respected. The children did well in school and participated in extra-curricular activ-

ities. There have been no significant problems in their lives. Eric and Emily did suffer

a personal tragedy in that their last child was stillborn.

Through most of their married life, Emily has not been a full-time employee.

She was content to be a homemaker, mother and wife. When times were a bit difficult,

she worked full time for several years. There have been no major marital conflicts

in their lives. Additionally, the children seem to have grown up well. Their son

appears to be searching to find a more solid foundation, but not desperately. The

children have both attended some college. Their son graduated with a Bachelor’s

level degree in Communications.

The family has been active in the local Lutheran church, the only one in the

community of approximately 15,000. All of the family have made the church a central

part of their lives. There has not been an inordinately strong interest in doctrine

or teaching, although the question of liturgy and ritual (i.e. how much, what

kind), has come to the surface on two or three occasions. At one point Eric flirted

with the idea of going to school and entering the ministry. It would have required

a significant life change for him and the family and he contented himself with participating

in lay activities.

Several years ago he had a number of intense sessions with his pastor which

seemed to be opportunities to express his disapproval of the direction the minister

was taking the parish, discussions about the building fund, Christian education. As

time went on, it became more and more clear that Eric was feeling a sense of discontent

and unfulfillment through his religious involvement. He began to question

his involvement in practices associated with formal religion. His attendance became

more sporadic, as his children left and established their own lives. His wife continued

to attend church without him, expressing at times disappointment that he chose

to watch television and putter around the house.

For the last two years he had entertained the possibility of retiring. Although it

would have been best for the family if he had continued to work for approximately

five more years, when his retirement plan would mature, it was possible for him and

his wife to live on a limited income. He had been having difficulty motivating himself

and appeared to be in the early stages of a mid-life crisis. He had become less

productive at work and his employer generously offered him an early retirement

package, which he accepted.

Eric now spends longer periods of time by himself. He is less talkative with his

wife, and participates less in family gatherings as well. He appears to have less interest

in working around the house and taking care of the yard. Some aspects of his

hygiene have begun to suffer, although he still showers several times weekly. He

isn’t as interested in his clothing, the style of his clothing, and is less careful about

putting things away. His wife noted that he has much less interest in intimacy: warm

hugging and closeness as well as sexual intercourse.

At Emily’s behest he has begun taking a regime of vitamins. He does not feel

that he needs medical attention and perhaps secretly fears that something serious

might be wrong. Upon urging, he submitted to a thorough physical examination

one year ago and the results were negative. His wife brought his change in affect

and mood to the family doctor, who suggested counseling and a program of medication

for depression. Eric was particularly bothered by the suggestion that he

might benefit from the use of psychotropic medication. He insisted there was nothing

wrong with him, that the doctor had had an opportunity to look him over, and

that he was "just fine."

Over the past year, his condition has worsened. He rarely goes to church, except

for baptisms, marriages and special events. He spends an increasing amount of his

time at home, doing some reading, watching of television, but appears to be

increasingly lost in his inner world. Now at home and an increased amount of time

on his hands, he has become picky and bothersome in the household. As a result,

his wife has taken a full time job, partly to avoid having to deal with him.

Since Eric’s condition has affected his lifestyle and employment, as well as his

interpersonal relationships, he can be seen as having either a dysthemic disorder,

300. 4, a major depressive disorder, 296.31, or 311 Depressive Disorder NOS. One

might also diagnose him as having an adjustment disorder, 309. 0, with depressed

mood—it should be specified that with passage of time it has become chronic.

There are no evident features of personality disorders. With regard to the V codes

(additional conditions that may be a focus of clinical attention that are not considered

to be diagnosable psychological disorders), there has appeared to be some age

related cognitive decline that is within normal limits. This may have affected him

and caused him to feel less capable and confident. He has not reported having such

concerns. He appears to have had religious and spiritual problems, V62. 89, in that

he has had a questioning of spiritual values related to his involvement in his

church—which has been a major part of his life.

It’s interesting to note here that the V codes, which "are not considered to be

diagnosable psychological disorders," are not codes for which therapists can normally

charge. Thus if we are treating problems of a "spiritual" nature, we can do so

within the accepted practices and procedures of therapists and physicians. In order

to bill for our services there needs to be a problem that can be described in other

ways. The truth of the matter is that anybody who is having marital problems, spiritual

problems, or problems around any of the V codes, may have personal reactions

that qualify that individual for "treatment." To me this seems quite backward.

Spiritually related issues—including definitions, problem areas and treatment,

should be addressed through the use of a model (models) that is (are) consonant

with the behavioral and medical sciences.

We haven’t made much of an effort to separate religion and spirituality in our

own searchings. And this has been a problem. Medicine, psychology, and the other

allied health professions have long struggled with the issue of spirituality. There was

a time when, especially within the field of medicine, religiosity so dominated science

and medicine that it was very important to try to escape from that kind of

mental oppression which made it so difficult to make health-related decisions on

behalf of the human population. Now we have quite the opposite situation.

Medicine, in a manner of speaking, has its own say about what the clinical practice

is and how the science should proceed. (Parenthetically, the health professions now

appear to be under attack from the business community.) Even though there is tacit

agreement there is an art to medicine, that what we’re really looking at are medical

arts and sciences, for the most part the focus is on science. As the physician practices

and matures over the years, that practitioner may become more attuned to the

art of medicine. And within the field of medical science there is little room for spirituality.

Physicians refer patients to the chaplain, to the religious practitioner of

their faith, or recommend that they find some support along those lines.

Occasionally a physician who has a religious or spiritual practice of his or her own

will draw from that practice, indirectly usually, so as to assist the patient with difficult

times. Sometimes people struggling with such difficulties are referred to a psychiatrist,

psychologist, or other therapist for treatment of adjustment reactions,

depression, or anxiety. While this practice has some merit, it does not seem to

encompass all of the possible opportunities for treatment available in the healing

professions.

Most of us who are actively involved in the treatment of medical, psychological

and social problems find ourselves addressing an increasingly complex array of concerns.

Broadly stated, we are either dealing with physical, psychological, community

and environmental difficulties, or are attempting to facilitate healthy practices in

these areas. We are dedicated to improving the human condition, human beingness.

We work in our own areas of specialty, whether that be upon the nephron unit of

the kidney, ossicles in the ear, or the effects of depression and abandonment upon

personal well being.

We function within the context of specific sources of information which allow

us to develop expertise and competence. Even though there are a plethora of cases

wherein we have limited treatment success, the fact that we have a deeply ingrained

discipline from which to proceed allows us to search for healing and health strategies

beyond our present approaches. Sometimes we reach back into the past and

rediscover approaches forgotten or put aside for the promises of new ones, which

over time show themselves not to be the panacea we had hoped for. The newest

approaches of promise need to have their chance to serve us and those whom we

serve. It is particularly important, as we address new areas to be included within the

broad parameters of the healing arts and sciences, that we work to establish some

goals. One goal is to learn how to address treatment, a fuller, more robust treatment

of the human condition. This is true for individuals, families and communities.

Broadening the parameters of treatment requires that we answer three basic

questions. First, is there a need not being met through our current definitions,

practices and resources? Secondly, is there a way to investigate approaches and

strategies to improve matters? Finally, what answers will be acceptable so as to allow

us to proceed? That process can be very formal, requiring years of research, the

expenditure of great amounts of money, the presentation of convincing quantifiable

data. Or it could be relatively simple, as with the introduction of a counseling technique

or approach that appears to have merit. When it comes to the investigation

of human spirituality within medical and psychological contexts, the latter approach

seems to be the means of adoption with alarming rapidity. It is undeniable that we

are undergoing something of a spiritual renaissance in all areas of public life. This

includes medicine, psychology, and related counseling and treatment programs. But

before hailing this as a welcome and much needed enhancement of our professions

and service delivery (which it potentially is) it is important to respond to the three

questions just presented.

Is there a need for physicians, psychologists, counselors, clinical social workers,

nurses, speech and physical therapists, and others in the health professions to

address and treat spiritual needs and disorders?

One might be tempted to react to the question with a resounding yes! Others a

resounding no! More to the point is the issue of creating a climate of well being for

individuals with medical and psychological problems that may extend beyond clearing

an infection or reducing a fear of heights. During the course of this book we

will outline the many ways ontology—the study of beingness, can help to move us

forward. By being pro-life—in the ontic sense—being attuned to the unfolding of

beingness, with concomitant spirituality, and avoiding being trapped by the stuckness

of rigid and unreasonable adherence to current-day practices, we are participating,

to a very small degree, in the evolution of being: ontic evolution. Within the

individual, this may help one to be more alive: the person may have more power,

greater vision, beyond the confines of limitation, affliction and depression through

forbearance. Ontic transformation is not linear, nor does it conform in a well known

manner to medical and psychological practice. It is also possible that if we as practitioners

are successful in integrating our methodology with spiritual exploration,

we can increase our positive effect upon individuals and more broadly upon a seemingly

quite dysfunctional society. In this author’s opinion, the answer to question

number one is a qualified "yes." The need is there, but we must answer questions

two and three satisfactorily before that qualification can be removed.