University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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Both religion and spiritual beliefs are a very important part of many people's lives 1 2, including the lives of people who are living with spinal cord injuries. (As the terms are used here, there is a slight difference between "spirituality" and "religion." Spirituality can be defined as "a way of being and experiencing that comes about through awareness of a transcendent dimension characterized by certain identifiable values in regard to self, others, nature, life," or as "both the existence and experience of interconnectedness of human and environment" 3. Religion might be defined as an organized way of exploring or expressing a particular belief about spirituality, or in God.) Although it is probably not possible to say that there is a definite link between spirituality and staying physically healthy 1 4, there is more and more evidence from the medical community and from the lives of people dealing with illness that there is a positive effect on people's quality of life when they explore the spiritual dimension of their lives 3 5 6.

One way spirituality can provide beneficial effects for the well-being of people with spinal cord injuries is providing comfort that helps the person cope with the fears, changes and pain that can be associated with a major illness 6. As stated in one study, "The struggle to find meaning in tragic and traumatic events appears to be a fundamental characteristic of human nature;" 7 spirituality can provide a philosophy to help this search. A spiritual person can find strength; with faith in a higher power, a person may believe they will come through this hardship and therefore might be more likely to accept their injury and deal with its consequences 8.

Spirituality can also lead people to get and stay involved in their community. For example, study participant Ken participated in activities at his church and made many friends at church that he stayed in touch with in person, on the phone or on the computer. Odel accompanied his parents to church, providing a bond with his father, who was ill with cancer.

It's useful to keep in mind that, after a traumatic event in a person's life, there may be changes in a person's beliefs about spirituality 5. For example, one of our participants, Alley, as a devout Catholic, wondered after a drunk driver hit her car how "God could do this to her." While it's common to question what has happened, but also can be common after questioning to create a new way of explaining "why" it happened. Alley, in fact, gradually came to a wider view of what happened to her. Similarly, study participants Frank and Robert each believed that God spared their lives for a reason, and that there is something meaningful for them to do with their lives. And our study participant Alma said about the accident that caused her spinal cord injury:

Why the accident? I don't know, but I can't really blame it on God. Maybe there's just some other bigger picture out there that I don't know about, but is there for a reason. I don't know what.... I don't think I would have been around unless He wanted me around.

If you found comfort in your faith or spiritual beliefs in the past but do not currently practice the beliefs that once helped you, it might be worth considering whether spirituality could provide you with support now. Is there a spiritual person you know, whether they are a clergy member (that is, a priest, pastor, rabbi, imam, monk, nun or similar person) or simply a friend, family member or community leader, whose support or advice you would like? These might be good sources of strength and wisdom. However, if you are worried that a particular person might be negative toward you - for example, if you think that someone might try to "blame" your injury on a "sin" or "bad deed" such as drinking or using drugs or gang activity - it might be better to explore your spiritual beliefs on your own, or with someone whom you know you can trust. You might also contact someone who has experience talking about spirituality with people who have a spinal cord injury. Most hospitals and many rehabilitation facilities and nursing homes have a chaplain on staff or on-call; usually, they also have a list of phone numbers or addresses of local congregations of many different faiths. If you don't have a particular spiritual belief but want to explore this subject more, a good term to keep in mind is nondenominational, that is, not attached to a specific religion.

Many people wonder if prayer can help people to get well. Although there have been studies on intercessory prayer (that is, prayers by a person or group for the well-being of someone else), some of those studies have shown positive results, most have shown negative results and some have shown no results, but most researchers agree that it is too hard to "prove" or "disprove" scientifically something that is as based on individual beliefs and interpretations as prayer is 9. What can be said for certain is that if your experience is that praying gives you a sense of calm or comforts you, it might be something that is worth doing simply for your own peace of mind. Some people who don't personally like to pray are sometimes asked by friends or loved ones if it would be all right if they said a prayer on their behalf; whether a person tells their loved ones it's okay to pray for them or not is up to that individual, but keep in mind that allowing loved ones to pray might help them feel good about doing something they think is important and meaningful.

Spirituality can be expressed in any of a number of forms, even by people who would not typically be thought of as "religious." It can be a source of tension or a source of peace. It can be a very private experience, or a shared one. Whether spirituality will be a part of your life, or what role it will play, is up to you.

The Internet has many resources available for people who want to learn more about a specific religion, or about spiritual beliefs in general. Craig Hospital in Denver, Colorado has a page that discusses the topic of Spirituality, including meditation and prayer, without mentioning specific religious beliefs. Buddhism Plus Disability: One "Step" Closer to Nirvana is a helpful article on the website of New Mobility magazine online. The article was written by Richard Louis Bruno, who has used a wheelchair for many years and practices Buddhism. While the main article is about the philosophy of Buddhism, a second part of the article interviews people with disabilities from a number of faiths, including Christians and people with strong, but non-specific, spiritual beliefs. The same magazine also has Faith in action: Joni and Friend(s), an article written about Joni Eareckson Tada, a woman who received a spinal cord injury at C-4/C-5 in a diving accident at age 17, whose faith in Jesus Christ supported through her initial hospitalization (which included a number of pressure ulcers - which means the same thing as "pressure sores" or "bedsores") and led her to found a ministry with a focus on people with disabilities. Keeping the Faith, a third article in New Mobility, interviews a number of ministers who also have disabilities, and recommends a list of books for further reading. Also highly recommended is a wonderful book about calling on spiritual strength to cope with unhappy life events, When Bad Things Happen to Good People, which was written by Harold S. Kushner, a rabbi in the Conservative branch of Judaism, who more recently wrote the inspirational book about faith, The Lord Is My Shepherd: Healing Wisdom of the Twenty-third Psalm. Rabbi Kushner's books are widely available at bookstores and libraries; bookseller's website allows visitors to read a few sample pages from books, including this one, at no charge. There is also an article by Jon Carpenter in the print edition of the September 2004 issue of New Mobility magazine titled "Moving Ma'rwa," telling the story of a 13 year-old Islam girl who received a spinal cord injury when she was hit with shrapnel in a mortar attack on her hometown in Iraq, and the American soldiers who helped her get medical care in Iraq and the United States; although that article is not available online, another article about Ma'rwa, called American Soldiers Reunite with Iraqi Child Medically Evacuated to US after Accidental Mortar Attack, is on the website of PRNewswire.

1 Powell, L. H., Shahabi, L., & Thoresen, C. E. (2003). Religion and spirituality: Linkages to physical health. American Psychologist, 58, 36-52.

2 Miller, W. R., & Thoreson, C. E. (2003). Spirituality, religion, and health: An emerging research field. American Psychologist, 58, 24-35.

3 Riley, B. B., Perna, R., Tate, D. G., Forchheimer, M., Anderson, C., & Luera, G. (1998). Types of spiritual well-being among persons with chronic illness: Their relation to various forms of quality of life. Archives of Physical Medicine and Rehabilitation, 79, 258-264.

4 Sloan, R. P., Bagiella, E., & Powell, T. (1999). Religion, spirituality, and medicine. The Lancet, 353, 664-667.

5 McColl, M. A., Bickenbach, J., Johnston, J., Nishihama, S., Schumaker, M., Smith K., Smith M., & Yealland, B. (2000). Changes in spiritual beliefs after traumatic disability. Archives of Physical Medicine and Rehabilitation, 81, 817-823.

6 Kloosterhouse, V., & Ames, B. D. (2002). Families' use of religion/spirituality as a psychosocial resource. Holistic Nursing Practice, 17, 61-76.

7 Reidy, K., & Caplan, B. (1994). Causal factors in spinal cord injury: Patients' evolving perceptions and association with depression. Archives of Physical Medicine and Rehabilitation, 75, 837-842.

8 Gill, M. (1999). Psychosocial implications of spinal cord injury. Critical Care Nursing Quarterly, 22, (2), 1-7.

9 Carey, B. (2004, October 10). Can prayers heal? Critics say studies go past science's reach. The New York Times. Retrieved October 10, 2004.