As health care professionals assess the lessons of the COVID-19 global pandemic, one unexpected message may be the importance of including spirituality in overall patient care. Even before the pandemic, a growing movement argued that patients’ religious and spiritual beliefs are a key—and all too often, overlooked—element in effective health care.
A pioneer in that movement is Dr. Christina Puchalski, founder and executive director of George Washington University’s Institute for Spirituality and Health. GWish asserts that spirituality, broadly defined, can be “the source of healing for many people” and “a fundamental part of treating the whole person: body, mind, and spirit.” Puchalski says the coronavirus pandemic has highlighted why this type of care is so crucial.
ReligionUnplugged.com contributor Kim Lawton interviewed Puchalski about spirituality, healthcare and COVID-19. This interview was edited for clarity and length.
Kim Lawton: Why is it important that patients’ spiritual beliefs and practices be integrated into their health care?
Christina Puchalski: It is critical that we address all the needs of patients, not just the physical. Healing is more than the physical. Our aim is to integrate interprofessional spiritual care into health systems globally as an integral part of patient care. For centuries, it was the shamans and the healers and the Native American medicine men and women and the religious leaders that were very involved in the care of human beings. But there was a dissociation that happened in the early part of last century as science became more prominent. I totally respect science, but it seemed that we moved away from that more holistic approach. There’s a coming back to that. Ultimately, I think the foundation of a healthy healing system of care is spiritual.
Lawton: When you talk about a patient’s spirituality, what do you mean?
Puchalski: Spirituality is the way we search for deep meaning, that ultimate meaning, purpose and transcendence — how we connect to the significant or sacred, however we understand that. It’s faith, broadly defined, or spirituality, broadly defined, and their influence on how people care for themselves, make health care decisions and cope with their illness.
Lawton: How does it work to include that in the health care setting?
Puchalski: Every patient gets some sort of spiritual assessments. If we find out about people’s resources of strength, say their faith is important or they meditate, or mindfulness is important, that gets written in the chart and gets supported. If it’s someone who is dealing with a lot of suffering and distress, then that gets identified and attended to. Ideally, there should be ready access to spiritual care professionals in the outpatient as well as the inpatient setting. It’s the choosing of our words carefully, and it’s accompanied by our gestures of support and love. That’s what I think we need to bring in. Spiritual care is ultimately respectful care. It’s at the core of respectful care.
Lawton: What led you to this work?
Puchalski: I was inspired to look at how spirituality plays a role in the life of patients when I did some volunteer work before I entered medical school. I was doing research and actually had a major loss in my life and was part of a woman’s bereavement group. We were all from very, very diverse backgrounds. And in my own life, I recognized how my inner life was so important to coping and healing and moving forward. When I went to medical school, I was struck by the absence of that realm in patient care. And I just started building on that until, eventually, we started working on guidelines on interprofessional spiritual care.
I’m Catholic, and I’m a contemplative Catholic, but my faith is enormously impacted by the people around me and my experiences. My practice as a doctor is a spiritual practice. I just recognize that this work in spiritual care is a calling.
Lawton: Why do you say the COVID pandemic has highlighted the need for spiritual care?
Puchalski: COVID is causing all of us a lot of distress in many different ways. Some more than others, but none of us are walking away from this unscathed. We’ve all experienced what some might term spiritual distress — others might term existential distress, psychological distress. It’s a terrible time: the grief, the unfinished business, the fear of what’s next and then all of the uncertainty. It’s that deep suffering in our soul, which is very difficult to understand. It’s very difficult to quantify, but it sure hurts. It hurts a lot. And it is actually during this time that people are finally beginning to recognize the importance of spiritual care and spiritual issues.
Let’s say that even now we feel a little better. We’ve gotten vaccines. We might not die from COVID, but there’s a lot of uncertainty. And I think it’s triggered a lot of reflection about what matters most. Maybe the upside of COVID is, maybe our focus will be sharpened on what matters most. The spiritual domain is not just about distress, but there is such a concept as spiritual health, you know, joy. And I think ultimately, the kind of care we’re talking about holds a space for that.
Kim Lawton is a journalist fellow with the Spiritual Exemplars Project.