Spirituality and mental health

While chatting to Dave Webster last weekend I came across the Royal College of Psychiatrists leaflet on mental health and spirituality. That in turn spurred me to look again at a set of guidelines on spirituality for staff in acute care services available for download from Social Care Online.

Now I do have some issues with the RCP leaflet:

"Although culture and beliefs can play a part in spirituality, every person has their own unique experience of spirituality - it can be a personal experience for anyone, with or without a religious belief. It's there for anyone. Spirituality also highlights how connected we are to the world and other people."

Of course one can be connected to the world and other people in a totally material way, no need to invoke the spiritual in order to feel a sense of belonging and connectedness.

"Spiritual practices

These span a wide range, from the religious to secular – which may not be obviously spiritual. You may:

• belong to a faith tradition and take part in services or other activities with other people
• take part in rituals, symbolic practices and other forms of worship
• go on pilgrimage and retreats
• spend time in meditation and prayer
• read scripture
• listen to singing and/or playing sacred music, including songs, hymns, psalms and devotional chants
• give of yourself in acts of compassion (including work, especially teamwork)
• engage in deep reflection (contemplation)
• follow traditions of yoga, Tai Chi and similar disciplined practices
• spend time enjoying nature
• spend time in contemplative reading (of literature, poetry, philosophy etc.)
• appreciate the arts
• be creative - in painting, sculpture, cookery, gardening etc.
• make and keep good family relationships
• make and keep friendships, especially those with trust and intimacy
• join in team sports or other activities that involve cooperation and trust."

Some of those practices are not obviously spiritual because they are not spiritual at all, and I do not see the need to invoke spirituality to explain why some of those practices are a good thing.

Finally;

"Spiritual skills include:

• being honest – and able to see yourself as others see you
• being able to stay focused in the present, to be alert, unhurried and attentive
• being able to rest, relax and create a still, peaceful state of mind
• developing a deeper sense of empathy for others
• being able to be with someone who is suffering, while still being hopeful
• learning better judgement, for example about when to speak or act, and  when to remain silent or do nothing
• learning how to give without feeling drained
• being able to grieve and let go."

Which I agree are a useful set of skills for anyone I don't particularly see the need to label them as spiritual skills.

However, despite some misgivings about the RCP's stance on spirituality it is clear from their position statement (link to pdf download) that the patient's right not to have spiritual beliefs is also respected. I do believe that for those people with religious or spiritual beliefs it is right that such beliefs are addressed especially when doing so may benefit them in clinical practice.

When I post on the Positive Psychology virtue of transcendence, with its associated character strength of spirituality I might show quite so much equanimity. Nor am I happy about the guidelines published by the Social Care Institute for Excellence.

These guidelines were drawn up by Peter Gilbert, Professor of Social Work and Spirituality, Staffordshire University, CSIP NIMHE National Lead on Spirituality and Mental Health.

My main objection is the sweeping over definition of spirituality.

"We all have something inside us which makes us tick: a spark of
motivation for why we get out of bed in the morning, and why we do the
things we do; a light which guides us when the going gets tough. This
spark is our Spirituality, which can be defined in many ways..." Gilbert, 2008, p3)

Most of us, most of the time, may have a spark of motivation (although we wouldn't have had before the 1904 when the term as an inner psychological state was introduced and it wasn't until the 1920s that the term came into general use). I do not, however, see the need to claim that as a uniquely spiritual rather than material state of affairs.

I am concerned that this publication doesn't include a case study of someone like me, a materialist who rejects the notion of spirituality. Although it does include someone who is spiritual but not religious, one case study where religious or spiritual beliefs is not mentioned, and five case studies involving religious and spiritual beliefs (seven cases in total).

I might react quite badly to someone insisting that I need to look after my 'spiritual dimension' and to those who insist on relabeling human activity as spiritual.