Spirituality and well-being: an overview

K. Krishna Mohan

Introduction

The last two decades have provided evidence from a wide range of disciplines, that human potential for psychological growth and well-being is more than what had been previously estimated. Though spirituality is as much a part of human experience as any other normal form of thought and behaviour, until recently it has not been given due importance by researchers in psychology. This same opinion is echoed by researchers and therapists who report that the spiritual dimension of human experience has not been given the attention that it deserves in mental health (Adams, 1995; Canda, 1995; Ganje-Fling & McCarthy, 1996; Hall, 1995; Kane, Cheston & Green, 1993; King, Speck & Thomas, 1995; Lindgren & Coursy, 1995; Pargament, 1996; Sargent, 1989; Sinclair, 1993; Vesti & Kastrup, 1995; Weaver, Koeing & Ocherg, 1996; Wulff, 1996). Mental health professionals, in fact, have often viewed spiritual content as pathological (Larson et al., 1993; Post, 1992; Weaver et al., 1996).

Both religion and spirituality are universal and widespread phenomena, in that they are integral to numerous cultures, and influence people of all ages, socio-economic status, and educational levels. They continue to live because of, among other things, social influences and need satisfaction. Every aspect of life, particularly in the East, is more or less imbued with religious sentiments or perceived as part of religious life. It is estimated that 94% of the American population believe in God, 88% believe God loves them, 81% believe we will be called before God on Judgement Day, 71% believe in life after death. More people have confidence in organised religion than in any other social institution (Gallup & Castelli, 1989).

The aim of this paper is to show the close relationship between spirituality and well-being by presenting research based evidence that spirituality or a spiritual way of life has a bearing on well-being. In addition, it will show that ideas or concepts drawn from spirituality can be effectively applied to counselling and psychotherapy. But before presenting an overall view of the relationship between spiritual outlook and psychological well-being it will be appropriate first to define the basic concepts.

Spirituality: definition

Definitions of spirituality in the relevant literature usually include some version of the following words and phrases: feeling connected or belonging in the universe, believing in a power outside of one's self, searching for a sense of meaning or purpose, experiencing transcendence and immanence, seeking one's ultimate and personal truths, experiencing a numinous quality, knowing unity of the visible and invisible, having an internalized relationship between the individual and the Divine, encountering limitless love, and moving towards personal wholeness (Canda, 1995; Gaje-Fling & McCarthy, 1996; Decker, 1993; King et al., 1995; Wulff, 1996). However, Reese (1997) strips the term spirituality to its minimally necessary elements and defines it as “consistency of action with belief”. He argues that spirituality is, in behavioural-analytic terms, rule-governed behaviour in that the rules (beliefs) that govern this behaviour (action) are a part of a coherent system that defines “rightness”.

And additionally there is a functional definition of spirituality which has been adopted by the California state psychological association task force on spirituality and psychotherapy—“courage to look within and to trust”, implying that what is seen and what is trusted appears to be a deep sense of belonging, of wholeness, of connectedness and of openness of the infinite.

Though spirituality traditionally has been considered to be exclusively the domain of religion, it is now being conceptualized in terms that have no particular relationship to theology, and is at the same time being accepted as practical and intellectually respectable. Worthington et al., (1996) speak of three categories of people whose beliefs were classified to differentiate the religious from the spiritual; (1) those who may be spiritual but not religious in that they believe in and value a universal human spirit or an “elan vital” without holding religious beliefs to be true, (2) those who are religious but not spiritual holding to doctrines of a religious organization but not experiencing any devotion to a higher power, and (3) those who are both spiritual and religious and believe in valuing a higher power that is acceptable to and consistent with some organized religion. It may be said with some conviction that the majority of Hindu Indians may fall into the second and third categories, for most use religion to morally and spiritually guide their behaviour. This may be to a certain extent true of other religions.

Spirituality which has always been considered to be a natural part of being human, is an innate human capacity to transcend the egocentric perspective from which people constantly experience and evaluate their lives, opening them to a broader world view, a heightened capacity for loving, and an increased motivation to enhance the greater good (Chandler, Holder & Colander, 1992).

The definition of spirituality provided by the tenth edition of Oxford English Dictionary is as follows: “the equality or condition of being spiritual, attachment to or regard for the thing of the spirit as opposed to material or worldly interest”. The term spirituality refers to the individual's experience of a dimension of power and meaning transcendent to the ordinary sensory reality. Such spiritual experiences may be associated with a naturalistic occupation as well as with religious tradition and spiritual disciplines. According to Vrinte (1996) spirituality is inspired and sustained by transpersonal experiences that originate in the deepest recesses of the human being and they are but the natural manifestations of that domain of the human psyche that contain the greater depth of life.

Krippner and Welch (1992) say that the word “spiritual” is used to describe aspects of human behaviour and experience that reflect an alleged transcendent intelligence or process, and is associated with several “identifiable values”: Among the values a spiritual person experiences are: (1) a transcendent dimension conceptualized as a supreme being, a “greater self”, or simply as “something more” from which a person shows a sense of personal power, (2) meaning in life when an authentic meaning and purpose in life fills an “existential vacuum” (3) mission in life where there is a purpose in one's vocation which may be felt as a “call” or “destiny” to fulfill, (4) sacredness of life where life is not divided into sacred and the secular but all experience is sanctified and is suffused with awe and reverence (5) ultimate satisfaction wherein a person may take pleasure in material things but the ultimate basis for their happiness and satisfaction lies in their spiritual value (6) altruism which propels one to respond to the needs of others as connectedness between all persons is felt, (7) idealism where a commitment to the betterment of world through not only meditation and prayer but also through concrete actions is felt (8) realism where facts of tragedy, suffering pain or death deepens one's appreciation of life and strengthens the commitment to make a difference in the world (9) fruits of spirituality such as compassion, courage, joy, devotion have a positive effect not only on the spiritual person but also on others and the world around them (10) healing effects that draw others to the spiritual person who is viewed by friends as an empowering resource in a relation.

Further Krippner and Welch distinguish spirituality from religiosity and maintain that spiritual people may or may not engage in formal religious practice and religious people may not embody spiritual values. They say that people who have internalized an institutionalized common set of beliefs, practices and rituals (as dictated by religion) regarding spiritual concerns and issues are not always spiritual. This view is elaborated by Vrinte (1996) who says spirituality is distinct from religion in that spirituality is more related to authentic mystical experiences whereas religion is more associated with normative practices (laid down by a prophet or a religious group). In fact Keen (1994) observes that millions of people who are unmoved by established religion as well as disillusioned with a secular view of life, are yet looking for some “missing value”, some absent purpose, some “new meaning” and some “presence of the sacred”—all of which indicate becoming spiritual in one's orientation.

Attempts to define spirituality as an innate characteristic which develops in a manner roughly corresponding to psychological development defined by Freud and Erikson (who said that normal crises precipitated by external or internal changes of life send us from one stage of psychological development to the next), has led Fowler (1981) to propose six stages of spiritual development. The first stage begins with the age of two to seven when a child's spirituality is fantasy based. Next is school age when belief becomes more literal and concrete as in seeing God as anthropomorphic. The third stage is adolescence governed by a community aspect of spirituality. Then comes the stage of the early twenties when individuals tend to relocate authority within themselves and rely mostly on rationality. The fifth stage is midlife when there is a shift toward a concept of God as a cosmic flow of life or light within, and finally one reaches the sixth stage of universalizing faith with a devotion to a transcendent vision not of one's own making. Further, Fowler has also pointed out that in spite of effective articulation there are serious limits to the observations of spiritual states as opposed to the observation of routine or ordinary psychological phenomena. It is not possible in this present paper to cover comprehensively this aspect.

To summarize so far, from the above discussion spirituality may be understood as an innate human capacity to transcend the egocentric perspective from which people experience and evaluate their lives and in the process to attain full enlightenment. They have thoughts and feelings of connectedness with the universe and a sense of moving towards personal wholeness by experiencing transcendence and immanence.

Psychological well-being: definition

Since recorded history, philosophers have always considered happiness to be the highest good and ultimate motivation for human functioning, but it is only recently that excellent reviews of the history and philosophy of happiness have begun to appear in psychological literature (Diener et al., 1999; Chekola, 1975; Culberson, 1977; Willson, 1967). There have been many attempts to describe psychological health in ideal terms which give us a list of qualities that constitute a mature, healthy, fully functioning, self-actualizing person. It is important to examine the definitions provided by some health psychologists who have, in their attempts to define a healthy individual, spelt out a list of specific characteristics, mostly based on research and observation, that could be associated with an individual who is psychologically healthy and experiences a state of well-being most of the time.

In her analysis of many definitions Jahoda (1958), says positive mental health is based on the following: (1) Attitudes towards the self which include the accessibility of the self to consciousness, a correct self-concept which is one's sense of identity and the acceptance of one's self. (2) Growth, development and self-actualization (3) Integration (4) Autonomy (5) Perception of reality and (6) Environmental Mastery which includes abilities to work, love and play, adequate interpersonal relationships, the ability to meet situational requirements, adaptation and adjustment, and efficiency in problem solving.

David Seedhouse (1995), introspects that the term “well-being” as used in present day health promotion literature is an extremely vague notion. While psychologists believe well-being is constructed out of three components: (1) Life-satisfaction (2) Positive affect and (3) low Negative affect, the author concludes that judgements of well-being are irreducibly subjective and that the meaning and content of the term are seen to fluctuate, depending on who is using it and why it is being used. Myers and Diener (1995) in their paper entitled “Who is happy?” define high subjective well-being as frequent positive affect, infrequent negative affect and a global sense of satisfaction with life.

Based on the above discussion an operational definition of well-being may include the following: Firstly it may be understood as a scientific sounding term for what people usually mean by happiness. Secondly, it refers to what people think and feel about themselves i.e., the cognitive and affective conclusions they reach when they evaluate their existence. Thirdly, it involves the individual's entire condition i.e., psychological, social, and spiritual aspects of one's existence, and fourthly well-being is a relative state of affairs—relative to the situation as well as to the values of the particular culture one belongs to, such as the traditional “Indianness” of avoiding extreme and maintaining equilibrium, of having good health and practicing self control, self-realization and dissolution of the self.

Research studies

For the purpose of this review of studies relating spirituality with psychological well-being, studies involving religious influence have also been considered as they are closely related to spirituality.

Spirituality and well-being

From time immemorial it is believed that spiritual experiences and practices have a therapeutic value in so far as they are capable of establishing an integrated personality. A report (Culligan, 1996) of a 1995 conference held at Harvard University reflects the new collaborative attempts of religion and medicine wherein there is a recognition of the power of religion and spiritual practices in medical treatment. The conference explored the relationship between spirituality and healing in medicine, with reference to the major world religions, and it provided a platform to discuss the physiological, neurological and psychological effects of healing resulting from spirituality.

Several recent studies (Allman et al., 1992; Elkins, 1995; Shafranske & Malony, 1990) have shown that the majority of practicing psychologists though not involved in organized religion, consider spirituality important not only to their personal lives but also to their clinical work. In a study Sullivan (1993) reports findings from a larger qualitative study that is seeking to discover factors associated with the successful adjustment of former and current consumers of mental health services. The study concludes that spiritual beliefs and practices were identified as essential to the success of 48% of the informants interviewed.

Vaughan (1991) explored the relevance of spiritual issues for individual psychotherapy among those motivated by spiritual aspiration and concluded that spirituality underlies both, personal impulses to growth and healing, and many creative cultural and social enterprises. Spitznagel (1992) and Sweeney and Witmer (1992) discussed the spiritual element in the well-ness model approach to work-adjustment and rehabilitation counselling and said that this holistic concept of working with clients is generally centred on faith, belief and values. Westgate (1996) in her review proposed four dimensions of spiritual wellness: (1) meaning in life (2) intrinsic value (3) transcendence and (4) spiritual communality. The paper also discussed the implications of these dimensions for research, counselling and counsellor education.

In a two year exploratory group study of participants in spiritual healing practices, Glik (1986) found that the healing which occurred is related to various measures of psychological wellness defined as the construct of subjective health. Fehring et al., (1987) correlating studies that investigate the relationship between spirituality and psychological mood states in response to life change, found that spiritual well-being, existential well-being and a spiritual outlook showed a strong inverse relationship with negative moods, suggesting that spiritual variables may influence well-being.

Over the years numerous claims have been made about the nature of spiritual/mystical and Maslow's “peak experiences”, and about their consequences. Wuthnow (1978) set out to explore findings regarding peak experiences from a systematic random sample of 1000 persons and found that peak experiences are common to a wide cross-section of people, and that one in two has experienced contact with the holy or sacred, more than eight in ten have been moved deeply by the beauty of nature and four in ten have experienced being in harmony with the universe. Of these, more than half in each have had peak experiences which have had deep and lasting effects on their lives. Peakers are more likely also, to say they value working for social change, helping to solve social problems, and helping people in need. Wuthnow stressed the therapeutic value of these experiences and also the need to study the social significance of these experiences in bringing about a world in which problems such as social disintegration, prejudice and poverty can be eradicated. Savage et al., (1995) provided clinical evidence to suggest that peakers produce greater feelings of self-confidence and a deeper sense of meaning and purpose. Mogar's (1965) research also tended to confirm these findings.

Some researchers in the recent past have found that life satisfaction correlated positively with mystical / spiritual experiences, and these experiences were further found to relate positively to one's life purpose (Kass, et al., 1991). In fact researchers are of the view that a positive relation between positive affect and mystical experiences may not be surprising given that intense positive affect is often considered to be one of the defining characteristics of these experiences (Noble, 1985; Spilka, Hood & Gorsuch, 1985). The few studies that investigated well-being measures, spirituality and spiritual experience have found that people who have had spiritual experiences are in the normal range of well-being and have a tendency to report more extreme positive feelings than others (Kennedy, Kanthamani & Palmer, 1994; Kennedy & Kanthamani, 1995).

Spiritual experiences are also considered to be exceptional human experiences at the upper end of the normal range such as creative inspiration and exceptional human performance, and can be life changing. Fahlberg, Wolfer and Fahlberg (1992) interpreted personal crises from a developmental perspective that includes the possibility of self-transcendence through spiritual experience / or emergency. The authors suggest that health professionals need to recognize, facilitate and support positive growth experiences.

A study by De Roganio (1997) content-analyzed and organized into a paradigm case examples found in themes of 35 lived-experience informants and 14 autobiographers who represented a wide range of people with physical disability and chronic illness. It was found that the combined elements of spiritual transformation, hope, personal control, positive social support and a meaningful energetic life enabled individuals to improve themselves and come to terms with their respective conditions. These experiences led many people to realize their own interest, sense of wholeness and unity, and to experience and integrate a deeper meaning, sense of self and spirituality within their lives.  

Some studies have offered a spiritual approach to addiction problems. Caroll (1993) found that 100 members of Alcoholics Anonymous (AA) benefited from spirituality which was found to correlate positively with having a purpose in life and the length of sobriety. Frame and Williams (1996), in their study of religions and spiritual dimensions of the African-American culture, address the role of spirituality in shaping identity, and conclude that reconnecting AA clients to their powerful spiritual tradition may be a crucial catalyst for personal empowerment and spiritual liberation. The finding was confirmed in a later study by Wif and Carmen (1996). Another study reported by Green et al., (1998) described the process of spiritual awakening experienced by some persons in recovery during the quest for sobriety. The data suggested that persons in recovery often undergo life altering transformations as a result of embracing a power higher than one's self i.e., a “higher power”. The result is often the beginning of an intense spiritual journey that leads to sustained abstinence.

In the last few years investigators in the rapidly growing field of mind-body medicine are coming across findings that suggest that an attitude of openness to unusual experiences such as spiritual, transcendental, peak, mystical may be conducive to health and well-being. For example, Dean Ornish, a heart disease researcher, believes that “opening your heart” to “experience a higher force” is in an important component of his programme for reversing heart disease (Ornish, 1990, chapter 9). There are also studies that relate illness with spirituality: Reese (1997) found in her study of terminally ill adults aged 20-85 years that, (1) they had a greater spiritual perspective than non-terminally ill hospitalized adults and adults, (2) their spiritual perspective was positively related to well-being and (3) a significant larger number of terminally ill adults indicated a change toward increased spirituality than did non-terminally ill or healthy adults.

Further, McDowell et al., (1996) investigated the importance of spirituality among 101 severely mentally ill and chronically dependent in-patients, and 31 members of the nursing staff who treated them. It was found that both the patients and the staff who treated them were equally spiritually oriented, and that the patients viewed spirituality as essential to their recovery and they valued the spiritual programme in their treatment more than some of the more concrete items.

Numerous studies have found positive relationships between religious beliefs and practices and physical or mental health measures. Although it appears that religious belief and participation may possibly influence one's subjective well-being, many questions need to be answered such as when and why religion is related to psychological well-being. A review by Worthington et al., (1996) offers some tentative answers as to why religion may sometimes have positive effects on individuals. Religion may (a) produce a sense of meaning, something worth living and dying for (Spilka, Shaves & Kirkpath, 1985); (b) stimulate hope (Scheier & Carver, 1987) and optimism (Seligman, 1991); (c) give religious people a sense of control by a beneficient God, which compensates for reduced personal control (Pargament et al., 1987); (d) prescribe a healthier lifestyle that yields positive health and mental health outcomes; (e) set positive social norms that elicit approval, nurturance, and acceptance from others; (f) provide a social support network; or (g) give the person a sense of the supernatural that is certainly a psychological boost-but may also be a spiritual boost that cannot be measured phenomenologically (Bergin & Payne, 1993). It is also reported by Myers and Diener (1995) that people who experience a sustained level of happiness are more likely to say that they have a meaningful religious faith than people who are not happy over a long period of time.

A study by Handway (1978) on religiosity concluded that religion is one potential resource in people's lives. More recently Myers and Diener (1995) in their survey of related studies observe that links between religion and mental health are impressive and that culture and religiosity may provide better clues to understanding the nature of well-being. Religious belief and practice play an important role in the lives of millions of people worldwide. A review by Selway and Ashman (1998) highlighted the potential of religion to effect the lives of people with disabilities, their families and care givers.

Research relating stress to religion indicated that religious and non-religious people tend to experience equal amounts of stress but religion may help people deal better with negative life events and their attendant stress (Schafer & King, 1990). A study by Maton (1989) supports the view that high level of stress individuals are likely to benefit from perceived spiritual support and is consistent with the stress and coping model based on religion proposed by Pargament. Anson et al., (1990) found that belonging to a religious community reduced stress whereas personal religious beliefs did not among 230 members of a kibbutzim. Similar findings were obtained by Williams et al., (1991) where for 720 adults religious attendance buffered the deleterious effects of stress on mental health. Courtenary et al., (1992) found a significant relationship between religiosity and physical health and that religion and coping were strongly related especially among the oldest-old.

With regard to coping Pargament (1996) cites five studies that show that religious forms of coping are especially helpful to people in uncontrollable, unmanageable or otherwise difficult situations. In the same lines Moran also believes that survivors of crisis or disaster may benefit by experiencing God as a refuge and as a reason to have hope (Moran, 1990). Patricia (1998) in her review shows how religion and spirituality help adult survivors of childhood violence.

Individuals with strong religious faith have been found to report higher levels of life satisfaction, greater personal happiness, and fewer negative psychological consequences of traumatic life events (Ellison, 1991). Anson et al., (1990) examined among 639 Jewish retirees over 60 years the relationship between self-rated religiosity, physical and psychological well-being and life satisfaction using data from a longitudinal study. Findings revealed religiosity was only weakly and inversely related to health and psychological distress, poor well-being at time 1 and a decline in well-being during the follow-up year led to an increase in religiosity. Ellis and Smith (1991) administered to 100 undergraduate students the Reasons for Living Inventory (RFL) and a spiritual well-being scale, and found a positive correlation between religious well-being and the total RFL score. Ellison's (1993) data from a national survey of Black Americans supported the hypothesis that participation in Church communities fosters positive self-perception.

There have been studies on the effects of religiosity. A study by Mookherjee (1994) found that the perception of well-being was positively and significantly influenced by, among other things, church membership and frequency of church attendance. Blaine and Crocker (1995) found that religious belief salience and psychological well-being were moderately positively correlated among Black students. Two-thirds of the panel reported a consistently positive attitude toward being religious when subjects attached importance to being religious even after 14 years later (Atchley, 1997).

Many psychologists who study religion distinguish between intrinsic and extrinsic religious orientation (Paloutzian, 1996). An intrinsic orientation involves internal religious motives within a person. On the contrary extrinsic orientation involves external motives outside of the religion, using the religion for unreligious ends. There appears to be a positive correlation between intrinsically religious people (religion as an end in itself) deriving substantial positive mental health benefit from their religion (Donahue, 1985). Intrinsic religiosity has been related to the following qualities characterising positive mental health: internal locus of control, intrinsic motivational traits, sociability, sense of well-being, responsibility, self-control, tolerance, and so on (Bergin, 1991).

A long standing misconception is that religion is a crutch for the weak. However, researchers in the psychology of religion have found that many religious individuals were competent. Payne et al., (1991) in their review on religion and mental health found that there was a positive influence of intrinsic religiosity on mental health in regard to well-being. In one study (Ventis, 1995) found that individuals with intrinsic religious motivation reported a greater sense of competence and control, as well as less worry and guilt than did individuals with extrinsic religious motivation. In another study by (Genia, 1998) it was found that intrinsically religious and pro-religious students reported greater existential well-being than extrinsic or nonreligious subjects.

As Indian culture has a long tradition of spiritual practitioners as well as authentic records of spiritual experiences it will not be out of place here to consider them briefly. In addition their contribution to well-being is not inconsiderable.

Well-being: Indian perspective

The schools of Hindu philosophy are abundant with rich, insightful, psychological treatises on well-being. Buddhism and Jainism represent a view of personality and describe methods for its growth into a particular form of perception. The various schools of yoga prescribe methods to help to reach a high level of consciousness and go beyond the limits of ordinary human experience. Well-being is equated with the integration of personality.

Psychological well-being to the Hindu means (1) integration of emotions with the help of an integrated teacher (a spiritual master, Guru), (2) acquiring a higher philosophy of life which helps to resolve inner tensions, (3) channelizing basal passion directing the emotions to ultimate reality, (4) developing an attitude whereby everything is viewed as a manifestation of ultimate reality (5) cultivation of higher qualities which replace negative qualities, and (6) the practice of concentration (Sinha, 1965).

The ultimate goal in Indian thought goes beyond self-realization or transcendence and seeks for a spiritual pursuit leading to the highest state of everlasting happiness, "nirvana ” or supreme bliss. The ultimate motive is spiritual pursuit with the aim of attaining union with the universal self or moksha or nirvana . The concept of well-being has also been elaborately given in C harka Samhita , the ancient treatise on the Indian systems of medicine which is called Ayurveda (the treatise on life). In this treatise the characteristics of happy and unhappy life have been elaborated. According to the sankhya philosophy, human personality is a product of the interaction between the spirit ( purusha ) and matter ( prakriti ). The influence of prakrit i on behaviour is emphasised in terms of the three Gunas or qualities called sattva or the element of knowledge, rajas or the principle of activity, which on the affective side is the cause of all painful experiences, and tamas or the principle of passivity that clouds our intellect thereby producing ignorance. It is said that the state of samyavastha or equilibrium of the three Gunas is that which holds the secret to an individual's well-being.

Seminal contributions to the concept of well-being have been made by one of the most widely acclaimed religious philosophical texts of the Hindus, the Bhagavad-Gita (1905) which focuses on the idea of avoidance of extremes and maintaining a kind of balance or equilibrium to enjoy a state of well-being. The concept of well-being in Indian (Hindu) thought is significantly characterized by a state of “goodmind” which is peaceful quiet and serene. The Bhagavad Gita speaks of being steady of mind (Sthitapragya ) and of performing ones duties without being lustfully attached to the fruits of one's action (karmayoga ) as representing a healthy person. The dissolution of the self or ego is considered the most evolved stage of mental health; further it is believed that the healthy mind acts but does not react and, therefore, is always watchful of the root cause of any disturbance. A mind which is free from conflicts and hence is clear about its duties which are performed with a spiritual mission, is a mind which enjoys well-being (Verma, 1998).

Besides “the steadying of mind” which is characterized by calm and poise in all situations, adverse or favourable, other features such as being friendly, not bearing ill-will for anyone, having compassion, forgiveness, being free from attachment and egoism and being balanced in both pleasure and pain are hallmarks of well-being according to The Bhagavad Gita (Chapter XII, Verse 13); self control, self-realisation which is the realisation that everything is totally interconnected, and the dissolution of the self by the expansion of the “self” beyond its personal boundary leads to a stage of the finest form of humanity where there are positive feeling for all things and beings. So according to Indian thinking, well-being unfolds at cognitive (rigorous self examination), conative (performance of duty) and affective (expression of self beyond the ego) levels.

From the above account it is clear that there exist differences about the concept of well-being in the West and the East, in that the conceptualizations made in the West revolve around the ability to satisfy one's needs, avoidance of frustrations and stress, and exercising certain amounts of control on the environment such that it enhances the satisfaction of personal and social needs. In the Indian tradition control over the senses is thought to be essential to well-being. Emphasis is on the maintenance of balance between extremes of satisfaction and denial (implying that needs need not be totally denied) and adoption of a path of moderation. Further, since frustrations, failure, successes and joys are considered inevitable in one's life, the essence of well-being lies in not being overwhelmed by either. While in the West the idea is to have control or exploit the environment since it is thought that environment provides the inputs that lead to need satisfaction, in Hindu spiritual thought the concept of “being in tune” with the environment is encouraged to be able to experience well-being.

Indian studies

In spite of the abundant and regular information available on the nature and effects of spiritual experiences, not many studies, in the empirical mode, have been carried out so far in India. The few studies carried out with the aim of looking into the relationship between spirituality/religion and well-being are reported here. A study conducted by Naidu and Panda (1990) on 465 Hindu adults aged 30-50 years, revealed that those low on the Hindu spiritual concept of non-attachment ( anasakti ) obtained higher scores on tests measuring stress and strain indicating that non-attachment reduces stress by eliminating negative emotions.

Another recent study by Krishna Mohan (1999) looked into the effects of the spiritual experiences of 200 respondents aged 20-70 years, belonging to 13 various spiritual organizations based on Hindu Philosophy. The subjects were administered the Life Experience Questionnaire (LEQ), Index of Changes Resulting from Experience (ICRE) and Checklist of Effects of Experiences (CEE). The findings revealed that after the spiritual experiences they were generally happy, cheerful and at peace most of the time, and rarely downhearted or depressed. Among the values and motivations which give them meaning in life, they reported that the need to achieve personal growth and maintaining close relationships with loved ones who are important gave them a purpose in life. The majorities of the respondents reported having excellent health, and were satisfied with the meaning and purpose they found in their lives. A significant number of respondents said that the spiritual experiences they had were valuable or beneficial to them. It was also found that most of the experiences contained references to the spiritual leader, God and a “Higher power”. Further they have reported an increase in areas reflecting humanistic and spiritual concerns, and a decrease in negative feelings and beliefs.

Spirituality and well-being: a contemporary scenario

Spirituality and religion, despite their significance for individuals and institutions, have mostly been neglected by psychologists and other mental health professionals in this century. In more recent years, however, there have been signs of renewed interest in the study of spirituality and religion. In the earlier days of psychology there were many influential thinkers in the field who included religion and spirituality in their theories e.g., Freud, James, Jung, Erikson and Maslow (Wulff, 1996). But gradually interest in this area faded out with rise of behaviourism as a legitimate and respected field of study for psychologists (Dennis, 1995).

Many researchers have argued the need for a spiritual and religious component in counselling and psychotherapy in recent years. Scolled, (1993) expressed distress over contemporary psychology and many contemporary psychotherapeutic approaches which express the perception of human beings as cut off and isolated, not only from nature and from individuals, but more significantly from activities of cosmic purpose. While stressing the importance of spirituality in psychotherapy, Bergin (1980) suggests that contemporary psychotherapy has much to gain from a world view that reconnects human beings with one another and with universal and spiritual purposes.

Recent years have witnessed encouraging developments in research interest in the interaction of spirituality and mental health and this interest is currently growing (Adams, 1995; Hall & Hall, 1997; Wulff, 1996). Another encouraging sign in this direction is that the recent psychiatric literature and contemporary socio-political developments are suggesting a need to reconsider the place of religion and spirituality in psychiatry (Turbott, 1996). Further, it appears that science and spirituality are no longer considered as being diametrically opposed or mutually exclusive (Neil, 1995). For example, Helminiak (1996) argues that spirituality can meet the demanding criteria that qualify it as a science, a specialisation within psychology. There is also a renewed effort in psychology to embrace spirituality (Dennis, 1995) and a recognition that there was a serious oversight all these years to have ignored the role of spirituality in the development of the psyche (Gopal-McNicol, 1997).

There is a growing evidence for increased interest in psychology of religion and spirituality in Western society as a whole (Hill, 1999). This can be seen in the steep increase in the number of articles published in mainstream journals and workshops on spirituality. Pargament (1999) a leading researcher in the area of religion and spirituality observes that the field is beginning to emerge in coming years as a leading sub-field of psychology. Even in research the trend is changing where respect and under-representation of research in the area of religion and spirituality which was present in the past is slowly beginning to fade. To sum up, the growing interest, as religion and spirituality are importantly related to, in a number of domains, has led to a great interest among psychologists and other related professionals in recent years.

Much of the credibility established by the field in the recent years can be attributed to the literature showing the relationship of religion and spirituality with mental health (See Gartner, 1996; Ventis, 1995) and physical (see McCullough, 1999, Dull & Skokan, 1995; Hill & Butter, 1995) health, which substantially established the link. Though the relationship is complex, with religion and spirituality correlating both positively and negatively with mental and physical health, the positive benefits of religion and spirituality seem to outweigh the negative (Bergin, 1983; Payne et al., 1991). From the compelling evidence based on literature it can be said that spirituality and religion are a potent force in society, shaping both individual and institutions.

Given its concerns with the individual-in-context and systemic change, spirituality has many implications for mental health in particular and psychology in general. Further, considering religion and spirituality as a cultural phenomena which has relevance and meaning to its practitioners, it can be understood in a secular frame drawn from the West. It opens a new area of significant study in understanding human dynamics of non-European cultures. It also hold the key to understanding the behaviour patterns and modes of thought which westerners often find either amusing or puzzling.

Realising the role of culture in understanding behaviour and using culturally based knowledge in mental health interventions in recent years has further broadened the scope for the study of religious and spiritual issues. The first part of this paper presents studies showing positive effects of spirituality and religion on psychological well-being. While drawing implications, the second part of the paper attempts to look into the possibility of spirituality as a cultural alternative to Western psychotherapies in an Indian context.

There is a growing interest in spirituality in everyday life (Daniels, 1997; Forman, 1998; Gallup Poll, 1997; Moyers, 1993; Yankelovich, 1981), but also in disciplines ranging from philosophy and popular literature to psychotherapy, health psychology, medicine and science (Begley, 1998; Brown, 1994; Garvey, 1985; Goleman, 1993; Harris, 1997; Hunt, 1995; Roof, 1993; Vaughan, 1991, 1995; Walsh, 1997; Wilber, 1998; Wulff, 1997). Religiosity and spirituality were formerly used almost interchangeably but spirituality seems to be a more inclusive and abstract concept than religiosity (Mahoney & Graci, 1999). With the acceptance of some role of spirituality and religion in counselling and psychotherapy, the last decade has witnessed an increase in research attempts to look for the significant contribution being made by religion to counselling and psychotherapy.

Spirituality and psychotherapy

In a study by Heise and Steitz (1991) it was found that the philosophy of spiritual progress, which was promoted in many 12-step programs, proved more conducive to functional mental health and morality than did a philosophy of spiritual perfection based on a fundamentalist Christian focus. This was true for dysfunctional individuals, family systems and societies. Knoblauch (1985) reported his findings based on Taoist thought and 5 Taoist counselling constructs helped individuals begin to accept themselves as they are rather than providing an ego-based system of organized despair by increased self-esteem or helping them to be more rational or positive in their lives.

The need for mental health professionals to be sensitized to the role of religion and spirituality as coping mechanisms is being stressed (Jenkins & Pargament, 1995) and many believe that spirituality may be appropriate for inclusion in therapy if the client and situation warrant it (Kivley, 1986). On the same lines Ross (1994) argued that understanding and the judicious encouragement of religious practice can augment therapy and provide a basis for reframing, which can assist in treatment. Sappington (1994) calls for the development of a psychology of Christian living to help in Christian oriented counselling.

In fact a wide range of spiritual healing traditions emphasizes the central importance of the connection of all life to spiritual or cosmic realities. In these views, healing is usually seen as restoring a condition of wholeness or harmony (Carlson & Shield, 1989). Several investigators have studied the relative frequency of use of various religious techniques with counselling and psychotherapy. For example Ball and Goodyear (1991) and James et al., (1992) found that prayer has often been used by the religious counsellor for religious clients as an adjunct to counselling. In a study by Soderton and Martinson (1987) it was found that the 25 cancer patients' strategy for coping with cancer was through prayer.

In India one very often finds that a spiritually oriented person is also at the same time religious, more so if he/she happens to be a Hindu. To most Hindus religion is the source of their spirituality. It is interesting, to note that a survey (Gallup, 1988) reported that 98% of the population in India said that they believe in God. In India it is a common practice to use religious methods and spiritual concepts for both physical and mental well-being and it is now being increasingly recognized that psychotherapists would do well to incorporate spiritual dimensions of people not only in healing mental disturbances but in enhancing positive growth and well-being to the willing individuals (Rangaswamy, 1994). While reviewing the Atharva Veda, a sacred Hindu text, Balodhi & Chowdhary (1986) argued that the Atharva Veda has been an important tool of traditional healers over the course of history. They also suggested that it may prove useful, if modified, to fit within an Indian context of treating mental illness. This is corroborated by Holdstock (1979) who, while discussing the incidence of indigenous healing in South Africa, recognised that including the spiritual and emotional dimensions in psychotherapy yielded better results. Further he suggested that such an approach might provide an alternative to existing modes of Western psychotherapy.

Indian mental health professionals have attempted to apply the psychotherapeutic system evolved out of yoga, in addition to the Western methods, which may not exactly suit the prevailing cultural conditions (Rao P.V.K. 1998). Emphasising the strength of yoga and showing parallels with psychotherapy, Lerner (1971) affirms that yoga is basically spiritual in its thrust and suggests that Western psychotherapists might benefit from yoga knowledge as it has therapeutic and growth qualities. If adopted in psychotherapy, counselling and community programmes, this yoga knowledge might promote well-being.

Based on the research studies it can be said that spirituality as an individual and cultural phenomena has not received the due attention that it deserves in psychology. To study spiritual phenomena appropriate modalities and methods should be devised in order to have clarity and rigor. It can also be observed that spirituality offers an alternative and inexpensive method of psychotherapy aimed at strengthening the personality. Finally, spirituality can be studied as a part of cultural studies with specific reference to the Indian context where a long tradition of spiritual experiences and way of life has been authentically established.

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Acknowledgements

   — I wish to thank Dr. Shanthi V. Prasad and Dr. D. Peda Raju for their valuable suggestions and comments in the preparation of this paper.