Spirituality and CAM
Spirituality is increasingly recognized as a vital element within complementary and alternative medicine (CAM), which encompasses a variety of healing practices outside conventional medical approaches. Many large-scale surveys indicate a strong correlation between spirituality and the utilization of CAM modalities, with individuals often seeking these alternatives for diverse health issues, including mental and physical ailments. Prayer, viewed as a spiritual practice, is notably the most commonly employed CAM modality in the United States, highlighting its significant role in personal healing. This includes various forms of prayer, such as solitary prayer and group intercessions, which many practitioners and researchers consider integral to the healing process.
In addition to prayer, other spiritual practices like faith healing, meditation, yoga, and Tai Chi often incorporate spiritual elements. While some studies suggest that spirituality can enhance the effectiveness of these modalities in alleviating symptoms and improving overall well-being, research on their efficacy remains preliminary and complex. The relationship between spirituality and health care is nuanced, as some practitioners may feel unprepared to address spiritual concerns, leading to potential conflicts with patients. Overall, an increasing emphasis on holistic care underscores the importance of integrating spiritual considerations into patient treatment plans, fostering better communication and understanding in the patient-provider relationship.
Spirituality and CAM
DEFINITION: The use of spirituality, one’s sense of meaning in life and relationship with the transcendent, as part of healing in complementary and alternative medicine.
Overview
Spirituality plays an integral part in complementary and alternative medicine (CAM) across the world. Large-scale surveys conducted in the United States, Europe, and other parts of the world show that spirituality is associated with higher levels of CAM usage and with the use of a wider variety of CAM modalities to treat many illnesses, including depression, headaches, back and neck pain, gastrointestinal problems, allergies, diabetes, and cancer.
Prayer and other Modalities
Spirituality is considered by some researchers and practitioners to constitute CAM practices per se. Some CAM modalities, such as prayer, are explicitly spiritual in nature, while other modalities, particularly mind/body therapies, often have a spiritual component. The most prominent example of spirituality as CAM is that of prayer, an active process of appealing to a higher spiritual power. Prayer as CAM includes solitary and group prayer on behalf of oneself or others. Based on data from the 2002 National Health Information Survey, the National Center for Complementary and Integrative Health (NCCIH) reported in 2004 that prayer for oneself was the most widely used CAM modality among Americans. (It was endorsed by more than 60 percent of survey respondents.) Prayer for others was the second most commonly used modality, and prayer in groups was the fifth most commonly used modality. Older adults, women, and ethnic and racial minorities were more likely to use prayer as CAM.
The NCCIH, however, no longer considers prayer a form of CAM, a change that has led to much controversy. For example, considering prayer a form of CAM leads to increased estimates of CAM usage. Excluding prayer from the definition of CAM, however, does not reflect the true numbers of CAM users.
Another spiritually based CAM is faith healing. This includes therapeutic approaches based on religious faith. Faith healing is most commonly associated with some Christian denominations and is typically conducted in religious communal settings. The therapeutic powers of faith healers are attributed to their evocation of divine or supernatural influences, which may bring about miracles. Relatedly, other cultural and religious traditions feature spiritual healers, such as shamans and curanderos, whose healing powers are largely spiritual in nature. Many traditional cultures do not draw clear distinctions among physical, mental, and spiritual health. In addition to explicitly spiritual modalities, other CAM modalities, such as meditation, yoga, Tai Chi, qigong, and Reiki, often have a spiritual component.
In addition to the importance of spirituality for CAM patients, research indicates that a practitioner's spirituality impacts the treatment plans they choose for their patients. For example, oncologists who reported attending weekly spiritual gatherings and self-reported as a spiritual person were more likely to recommend CAM treatments to their patients. However, though spirituality and CAM are inextricably linked for many patients, some practitioners feel ill-equipped to offer their clients spiritual advice. Additionally, spiritual differences may cause conflicts between patient and practitioner.
Effectiveness
Evidence regarding the effectiveness of spirituality-based forms of CAM is preliminary, given the many limitations of research and the complexity of the issues. For example, the most common spiritual CAM modality, prayer, is complex and can take many forms, including conversation, intercession, contemplation, and ritual; these different types of prayer may have different effects on health and well-being. Research suggests that some types of prayer can be beneficial to the person praying and can include the alleviation of emotional distress and pain. Such effects have been attributed to increased relaxation, less distraction, an increase in positive emotions, and divine intervention. Research indicates that most people who use prayer as CAM find prayer to be helpful.
More controversial is distance or intercessory prayer, which involves the influence of praying for the health of another person independent of that person’s knowledge of the prayer. Intercessory prayer has received much research attention, including attention from researchers using large, randomized control trials. In the aggregate, results are inconsistent, and the interpretation of findings remains hotly debated.
Evidence of the effectiveness of faith healing, for example, is sparse. A small but growing body of literature suggests, however, that CAM modalities such as meditation and yoga are more effective in alleviating pain and improving functioning when they include an explicit spiritual component.
Although people rarely discuss their reliance on spirituality as part of their approach to personal health with healthcare providers, evidence suggests that such communication may facilitate understanding and promote better care. Practitioners who exhibit greater cultural competence and consider their patients’ ailments from a whole-person perspective generally have better relationships with their clients. Approaches to integrative medicine now emphasize the need to pay attention to the spiritual issues and concerns of one’s patients.
Bibliography
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Barnes, P. M., et al. “Complementary and Alternative Medicine Use Among Adults: United States, 2002.” CDC Advance Data Report, 2004, p. 343.
Heller, Tabitha, et al. "Complementary and Alternative Medicine Is Positively Associated with Religiousness/Spirituality." Journal of Complementary and Integrative Medicine, vol. 18, no. 1, 2020. De Gruyter, doi.org/10.1515/jcim-2018-0023. Accessed 19 Nov. 2024.
McCaffrey, A. M., et al. “Prayer for Health Concerns: Results of a National Survey on Prevalence and Patterns of Use.” Archives of Internal Medicine, vol. 164, no. 8, 2004, pp. 858–62.
Powers-James, Catherine, et al. “The Influence of Spirituality and Religiosity on US Oncologists' Personal Use of and Clinical Practices Regarding Complementary and Alternative Medicine.” Integrative Cancer Therapies, vol. 19, 2020. doi.org/10.1177/153473542094576. Accessed 19 Nov. 2024.
Roberts, L., et al. “Intercessory Prayer for the Alleviation of Ill Health.” Cochrane Database of Systematic Reviews (2009): CD000368. Reviews findings regarding intercessory prayer and describes the limitations of research on this topic. Available through EBSCO DynaMed Systematic Literature Surveillance at www.ebscohost.com/dynamed.
Tippens, K., K. Marsman, and H. Zwickey. “Is Prayer CAM?” Journal of Alternative and Complementary Medicine, vol. 15, 2009, pp. 435–38.