Spiritual Issues Spiritual Care On Your Journey
I'm not a spiritual person -- at least I don't think I am. What is spirituality, anyway? What does spirituality have to do with cancer?
Spirituality is playing a bigger part in healthcare today. There’s a growing recognition that good outcomes require more than tending to physical needs – patients' spiritual needs have to be addressed, too. Emerging research demonstrates that spirituality helps people cope with illness, suffering and death, and influences end-of-life decisions. But what is spirituality, anyway?
Here's one answer. The healthcare community crafted a definition of spirituality at a 2009 National Consensus Conference convened to address the need to improve spiritual care in palliative care. It reads:
"Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred."
During difficult times, like a cancer journey, people who may not have a connection to organized religion, or any spiritual practices at all, often look for greater meaning to help them understand and cope with their experience. This section offers an overview of some common spiritual questions.
Maybe you consider yourself an atheist, someone who has books like Richard Dawkins' The God Delusion or Christopher Hitchens' God Is Not Great stacked on the night table next to your bed. Or maybe you consider yourself an agnostic – you’re not willing to deny the existence of God but you're not sure God really exists, either. Maybe as an atheist or an agnostic, you respect the beliefs of people with faith. Maybe you're even a little envious. Believers, you think, seem to find comfort and meaning in their beliefs. I wish I could do that, too. But I just don't believe in God. It doesn't make sense to me. There’s no proof, and I can't believe in something without some type of evidence. Or maybe you think the entire God enterprise is complete hogwash, a type of "opiate for the masses."
Now you are newly diagnosed with cancer. Or maybe someone you love has just received a diagnosis. You're in shock. Your world is turned upside down. Nothing seems right. You're not sure how you're going to be able to cope. You don't know what to think. It's always been very clear to you. You don't believe in God. You don't believe in prayer. You stopped going to church or synagogue when you were a child. Maybe you have never set foot in a worship space at all. But now your belief system is conflicted. Maybe your cancer is, for you, definitive proof of the nonexistence of God. Perhaps it is just as definitively proof that God does exist, even proof of God’s benevolence. For most people, though, a cancer diagnosis creates more questions than answers. Things don't look as clear to you as they once did. What's going on?
Crisis does that to people. Cancer, illness, suffering and death can cause crises of faith in believers and nonbelievers alike. In times of crisis, most people want to believe that there is a reason that things happen the way they do, especially bad things. That's just the way we are hardwired. So it's not surprising that atheists and agnostics sometimes feel shaken up and unsure of themselves when they are in the midst of a cancer experience. It's also common for people to say, "I didn't believe in God before, so I can't really change my beliefs when I need something." Not true. If you think that exploring a faith tradition might help you or your loved one cope with cancer, be open to it. Read a book, talk to a chaplain, call your local clergy. Gather information. What you find might confirm you in your original ideas, or open you up to some new ones.
When you or a loved one is newly diagnosed or coping with cancer, your world is turned upside down. A common feeling in these moments is some level of disillusionment and betrayal. You may feel that you’ve been hoodwinked. You might feel a sense of injustice. You, or your loved one, did what was right. She regularly went to worship services. He exercised and ate right. She’s good and kind and never spoke a nasty word about anyone. He spent his vacation time building schools in poor countries. I’m too young. My kids are too young. This isn’t how the world is supposed to work.
These feelings might resonate even more strongly with people who identify with a particular religion or who are active in their faith tradition or communities. After all, there are explicit promises in Scripture that God will care for and protect people. If you live your life according to the strictures of your faith community, why would God abandon this promise? If you believe God is all-powerful, why would God inflict you with cancer? Doesn't religion teach us about a loving and merciful God? Even if you believe that you have sinned, doesn't your tradition teach about repentance and atonement? What about forgiveness for transgression?
These are not easy questions. Philosophers and religious thinkers have wrestled with these types of questions for hundreds of years. In particular, most faith traditions have grappled with ideas about God's role in human suffering. These debates and explorations are encapsulated in a single word, "theodicy." Theodicy asks the question, "If God is good, why do bad things happen to good people?" It might be helpful to you to explore some of the ideas and teachings about theodicy in your own religious tradition.
It also may be helpful to you to give voice to these feelings of outrage. Reach out to your clergyperson, or find someone to speak with you if you don't attend services regularly. When you're angry with God, though, you may be thinking, "Seriously?! The last thing I want is a 'God person' preaching at me." If that’s not an option, is there someone else you can talk to? You may find it difficult to find someone who is able to hear your anger without trying to talk you out of it. Your pain may frighten them, and they may shush you, tell you there’s a plan to the world that we cannot ever understand. They may be right, but their reactions may not be helpful to you in the moment.
A chaplain or another trusted counselor can be a useful confidant in times like this: chaplains understand the position of faith from which you have begun, and are prepared to bear witness to your anger. They will not try to dissuade you from feeling your feelings, but they will accompany you through them.
Some cancer patients and their families find that their experience doesn't shake their faith in God. What it does do is make them furious at God. Am I even allowed to be furious at God?! Absolutely. And you are just the latest in a several-thousand-year-old line of people, a very long line of people, that have been infuriated, enraged, and just plain mad at God. Listen to the Psalmist in Psalm 10 calling out in anger, maybe even shaking his fist, asking, "Why, O Lord, do You stand aloof, heedless in times of trouble?" Or look at Psalm13, where the Psalmist asks, "How long, O Lord; will You ignore me forever? How long will You hide Your face from me?" These are not people who mince their words. They are furious at God. Kicking and screaming and howling mad. You can be, too.
It might help to think of God as a parent. If you're a parent yourself, think about what you do when your child is angry with you. You don't disappear, do you? Part of your job as a parent is to absorb the anger and try to comfort the child. If you're not a parent, think about relationships in general. Even the best friendships, the best marriages, suffer at times with anger and turmoil. What's important is not to abandon the relationship. It takes time and patience to cultivate and maintain relationships. When you're angry, you don't run away. Instead, you talk, you seek help, you look for ways to work through the anger. Try to do the same thing with God.
If you are a member of a faith community, you may find a conversation with your religious leader to be helpful during this time. He or she can help you understand exactly what your tradition teaches about how one should deal with anger towards God. It’s true that if you’re feeling ambivalent about your relationship with God, the idea of talking to a person whose role is explicitly religious may not be appealing. A chaplain or another trusted counselor can be a useful confidant in times like this.
Sometimes, people receiving treatment for cancer are advised by their medical team to take steps that the patients or families believe conflict with their religious tradition. This might be surgery that requires receiving blood, or a medical device crafted from a religiously prohibited material. You may understand that your tradition requires you to “do everything” to sustain life. On one hand, you want to do everything possible to minimize symptoms and prolong life. On the other, you take your faith very seriously and you don't want to transgress any of its doctrines. What can you do when there's a conflict?
Most important, make sure that a conflict actually exists. You may not understand the religious rules completely or correctly, or there may be other rules that supersede the ones you know about. This is a time to call on clergy or ask for pastoral assistance. In many cases, clarification can erase the problem entirely. It's often true that, when consulted, clergy tell you, "This is what the law says, but this is how we interpret it." Most religious tradition is life-affirming, and clergy/chaplains may be able to help you and your medical team find a way to do what's needed without violating any religious rules.
Being part of a religious community can be helpful in times of crisis -- or not. People who have cancer or other serious illnesses may find their religious community particularly challenging. Many people find it more stressful than anticipated to be the object of a community's prayers. This is something that is not often discussed, and it can be a major source of guilt. There can be a lot of pressure to be upbeat, positive, espouse appropriate theology and so on. Sometimes there's a tendency to gloss over the details of the illness so people don't know just how bad things are. In a religious community, that can get amplified. God is good, so things can't really be that bad, can they?
Sometimes your cancer diagnosis can cause others to question their faith. They see you as a good person, and they don't understand why this is happening to you. They struggle to reconcile their good health with your suffering. What are you supposed to do with that? Their struggles might leave you with feelings of guilt. Wait a minute: they're supposed to be helping you in your time of need; you're not supposed to be helping them. Now you want to avoid attending services at all cost. Who has the energy to deal with all these well-meaning people? In a situation like this, talk to your clergyperson. Perhaps he or she can help.
Maybe you don't consider yourself a religious person. You're not interested in worship, or prayer, or especially sermons. You're suspicious of clergy, or simply uninterested in conversing with them. You say things about yourself like, "I'm good but not religious," or "My faith is in my heart, not my mouth."
But you do consider yourself spiritual. You believe in karma, or the universe, or in a Higher Power. You believe that there is something bigger than ourselves in the world, even though you don't think it's God and you're not sure what it is. There have been times in your life that you felt deeply and profoundly connected. Maybe that happened when you were skiing down a pristine mountain after a fresh snowfall on a quiet afternoon. Maybe it happened when you were in the playground with your children or grandchildren. Maybe it's the feeling of falling in love, or spending time with friends. Maybe you feel connectedness when you sing, or read poetry or novels, or walk in the park or play with your dog or cat.
Look back at that definition of spirituality created by the healthcare community: "Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred."
It might be helpful to ask yourself the question, "What gives my life meaning and purpose?" Do I want to get back to work? Are there upcoming weddings -- of friends or family -- that I want to attend? Have you always wanted to visit Paris, Jerusalem, or Beijing? Do you find meaning in helping others? What keeps you going is highly individual. It doesn't need to be God or religious community. It can be primary relationships, or a career, or an unfinished task.
Talking to others in times of crisis also can be helpful. The simple act of giving voice to your fears and concerns often brings comfort, even when you ask questions that don’t have answers. You may not want to burden your friends and family -- but they may be looking for ways to help you, and listening can be one of those ways. You might want to consider talking to a professional chaplain. A chaplain will neither lecture nor judge. They will, however, listen, and a good listener may be hard to find if your loved ones are also grieving and struggling to make sense of things. You can contact a chaplain through this website at ChatwithaChaplain. Chaplains are also available in many healthcare settings.