A religious prescription

Where should we place religion and spirituality in healthcare?

“Healthcare carried out in a secular manner is an experiment and we are experiencing some of the negative consequences of doing that in the US,” says Prof Harold G Koenig of Duke University

“Healthcare carried out in a secular manner is an experiment and we are experiencing some of the negative consequences of doing that in the US,” says Prof Harold G Koenig of Duke University


An American professor who will lead a seminar about spirituality and healthcare research in Dublin next month suggests the secularisation of healthcare is an “experiment”. Harold G Koenig, professor of psychiatry and behavioural sciences at Duke University in North Carolina, says that since the time of the monasteries, healthcare has been provided by religious communities.

“Healthcare carried out in a secular manner is an experiment and we are experiencing some of the negative consequences of doing that in the US,” says Koenig. These consequences, he says, include “more drugs and alcohol problems because religion is [no longer there] as a form of self-control and social control”.

Through his extensive research into religion or spirituality and health, Koenig is convinced religious people have better health outcomes than those who aren’t religious, and notes that being spiritual without being part of an established religious community has a negative impact on health.

“Religious belief and practices provide people with a way of coping with adverse life situations, and religion gives people a way to derive meaning from negative life events which otherwise would be meaningless,” says Koenig, in advance of his seminar at Our Lady’s Hospice, Harold’s Cross, Dublin.

The second beneficial factor, according to Koenig, is the social support network and social interactions that religious communities provide for people who are ill.

And thirdly, he suggests religious beliefs “promote health behaviours such as limiting alcohol intake, not smoking cigarettes and not having sexual relationships outside marriage”.

Through his research, Koenig has found that “the frequency of attendance at service is the most powerful predictor of mental and physical health” ahead of praying, reading scripture, volunteering and giving money for religious reasons. (Irish church leaders with declining congregations might wish to use these scientific findings as a marketing device.)

However, Koenig is keen to point out the more recent trend to describe oneself as spiritual but not religious provides no particular health benefits.

“We have found that those who describe themselves as spiritual but not religious have a higher risk of major depression,” he says. “Spirituality divorced from religion loses its ‘oomph’ factor. The power of spirituality is in the religious beliefs and practices.”

At Duke University, Koenig is the director of the centre for spirituality, theology and health. He is also the visiting professor in the department of medicine at King Abdulaziz University of Jeddah in Saudi Arabia and is writing a book on health and wellbeing in the Islamic tradition.

He was brought up a Catholic, fell away from religion during his college years and medical training, but then returned to religious practice in a Protestant tradition.

“When I worked as a doctor, I became intrigued by how older adults said religion was so helpful in coping with illness. I gradually returned to religion in my mid-30s. I have found my religious faith very helpful at difficult times such as during a divorce and now coping with chronic pain syndrome.

“People go through terrible suffering and derive meaning from it through their religious beliefs. For some, it’s life-transforming and illness can result in a spiritual transformation, to the point that they say they wouldn’t have wanted to continue the life they had before their illness.

“Religious faith gives people the motivation and desire to take care of themselves. Others ask themselves, ‘Why survive? Why make any effort to get better?’ People who are not religious don’t have the same health as those who are. We have more than 3,000 studies about this,” he says.

Spiritual needs
In terms of end-of-life medicine, Koenig says health professionals ignore patients’ spiritual needs at their peril.

“There has been a series of studies at Harvard assessing the spiritual needs of 400 people with end-stage cancer. Three-quarters of the patients were found to have deep spiritual needs. If these needs were not met, they suffered from more depression; they were less satisfied with their care; and they demanded far more expensive treatments.”

But can religious belief be harmful at times? Can it threaten people’s physical and mental wellbeing? Koenig prefers to invert the question, asking instead, do people who are harmful grab on to religion?

“Some people use religion as a tool to express hatred or as a means to exert power or control,” he says.

He also notes religious delusions can be a significant part of some mental illnesses. “Some 25-30 per cent of sufferers of bipolar conditions and schizophrenia have religious delusions.” Ultimately, Koenig claims the value of religion lies in striking a balance between “loving thy neighbour” and “loving thy God”.

“Some people use religion to justify actions but, really, it’s the balance between both these aspects that helps with health, combined with modern medicine and psychological interventions,” he says.

Prof Koenig’s seminar is on Saturday, May 17th, at the Education and Research Centre, Our Lady’s Hospice & Care Services, Harold’s Cross, Dublin 6.
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