Understanding Spirituality and Mental Health

Are Religion and Spirituality the Same Thing?

Spirituality and religion are not the same thing. Religion is a type of codified spirituality in which all followers practice the same faith and pray to the same deity. Religions have specific ceremonies and rituals, meeting places, and congregations. Religions also have rules with consequences for breaking them and tend to indoctrinate children from a young age.

Spiritual practices may also rely on such factors, but they do not have to.

Anyone who has ever stood on a mountaintop and felt awe at a view, marveled at ancient architecture, or felt a sense of profound fellowship at a meeting of Alcoholics Anonymous has encountered spirituality. It is accessible to all of us, even those who are uninterested in or who have had negative experiences with religion.

In essence, spirituality helps us interpret life. From love to hate, birth to death, success to grave injustice, spiritual practices guide us.

Regularly tuning in to the spiritual side can increase spiritual health—and in time, mental wellness, too.

What Is Spiritual Health?

As the ideas of mental health and spirituality have grown more mainstream, “spiritual health” is a term that crops up more often. Many people mistakenly use it as a synonym for spirituality, but it is actually quite different.

As a 2018 study explains, spirituality is a broader term referencing experiences or states of being that envelop a person, whereas spiritual health is something one can cultivate or work toward. Spirituality can take a different form for everyone. Spiritual health can apply to any type of spirituality or religion.

While spirituality is a source of potential that everyone can access if they wish, spiritual health is a spectrum on which everyone falls. Because of this, it is much more concrete.

Below are some common traits of spiritually healthy people:

• Reserved and thoughtful emotional reactions even to life’s great challenges
• A healthy ability to feel and express emotions where called for, especially when dealing with grief or loss
• Daily practices to help process hardships, changes, and emotions
• An ability to deal with the challenges posed by other humans with kindness and understanding
• Flexible beliefs that can adjust as needed to new circumstances or information
• Mindfulness and presence when eating, exercising, working, and enjoying time with loved ones
• The ability to explain one’s inner state to others, if necessary or desired

If you don’t recognize these traits in yourself, that’s okay. They take time to cultivate. A spiritual leader or mental health professional can help you find ways to strengthen them through practice.

How To Practice Spirituality

The ways in which spirituality manifests among the world’s many cultures are nearly endless. Spiritual practices may vary according to several aspects of a person’s life and surroundings, their religious upbringing or choices, their geographical location, their culture, and the way their mind works.

Spirituality can take countless forms. However, some of the most common approaches to spirituality include:

• Mindfulness practices, such as meditation, prayer, reflection, or yoga
• Reading rituals, which may include holy texts, self-actualization books, or literature
• Time spent with art, music, or other forms of media that increase your spiritual connection to the world and other people
• Time in nature, such as hiking, backpacking, kayaking, or hunting
• Religious services or worship, complete with rituals and ceremonies
• Creative practices of your own, such as painting or sculpting, writing, or welding
• Journaling or otherwise recording your thoughts

Deepening the Spiritual Mindset

Once people have successfully established a spiritual basis for living, they can deepen their spiritual mindset. This often requires looking inward through practices such as listening, stepping into others’ shoes, looking for the best in others, and cultivating compassion and forgiveness.

As other people form an integral part of an individual’s spiritual mindset, these practices are often people-centric. They might include:

• Community service or volunteering
• Helping others on their spiritual journey, such as leading meditation, yoga, journaling sessions, and similar practices
• Taking on a service position in a 12-step program or faith community
• Reading or writing literature about spiritual topics

Continuous attention to one’s spiritual health likely improves one’s connection to the world and the other beings who inhabit it. Such mindfulness also enhances one’s own sense of joy, community, and belonging. However, it is important to keep in mind that not all spiritual practices are healthy.

The Potential Downsides of Spirituality

Spirituality itself does not have many negatives. The ways in which others may use spirituality to their own ends can be dangerous, though.

Warning Signs and Balanced Beliefs

Young or emotionally fragile people, for instance, may prove vulnerable to people looking to increase a flock or start a cult. While this isn’t overly common, neither is it uncommon for spiritual individuals to try to “recruit” others to their way of thinking. It’s important to be cautious around self-described gurus or leaders.

It’s also good to be aware of religious groups that immediately try to convert you to extreme ways of thinking. If your faith pits you against every friend and family member you knew before encountering it, that is a red flag.

Good spiritual practices do not encourage division; they seek wholeness for every individual. The same is true if someone is disparaging a faith or spiritual practice that feels true to you.

Lastly, if you or a loved one experiences mental illness, bear in mind that spirituality should not conflict with seeking treatment. Anyone can get help from medical professionals and walk a spiritual path.

Moreover, any form of spirituality that characterizes mental illness as “the devil’s work” likely doesn’t have a person’s best interests at heart.

Spiritual Struggles

Though spirituality can benefit one’s mental well-being, spiritual struggles can worsen or even cause mental health distress, especially among those with a psychiatric disorder.

Spiritual struggles can involve perceptions of gods or evil forces, personal struggles linked to beliefs, morals, and life’s purpose, and conflicts with others over faith or spirituality.

These kinds of struggles often predict substantially greater depression and even suicidality. Understanding and addressing spiritual struggles is important in mental health care to help prevent and manage these challenges.

Exploring beliefs, seeking guidance from trusted mentors or religious leaders, engaging in practices like meditation or journaling, and connecting with supportive communities can help navigate and overcome spiritual struggles.

Mental Wellness and Spirituality’s Role

The concept of mental health refers to emotional, social, and psychological wellness. Our thoughts, feelings, and actions all fall under the category of mental health, including:

• The choices we make
• The ways we interact with others and treat relationships
• How we handle stress
• Moods and the behaviors associated with them

Mental health applies to every stage of life, from the early years to older adulthood. Depending on the individual, their genetics and brain chemistry, their upbringing and experiences, and their current circumstances, their mental well-being will fall somewhere on that spectrum of good (they have strong mental health) to compromised (they experience mental illness).

Spirituality can help maintain or bolster mental health in the following ways:

• Creating a sense of purpose and meaning that helps to deal with challenging life situations
• Serving as the base of a supportive community
• Outlining specific practices to help you work on your relationship with yourself and others
• Providing a foundation on which to build purpose, hope, and self-esteem
• Giving you tools to self-advocate and ask for what you need

Spirituality and Mental Health in the Workplace

Work and home life are in constant conflict these days, which is why “work/life balance” has become such a buzzword. Unfortunately, an imbalanced work life genuinely does lead to poor mental health.

Fortunately, instilling spiritual practices in the workplace shows promising results. Greater engagement with work and higher job satisfaction, both of which follow mindfulness, may also lead to reduced absenteeism, increased productivity, and higher morale.

The Spirit-Body Health Connection

It is no secret that a healthy spirit leads to a healthier mind and body. Studies show that spiritual health is correlated with greater peace living with HIV and healthier lives in patients with asymptomatic heart failure.

Spirituality decreases depression and anxiety in those with traumatic injuries and improves quality of life in cancer patients. Since physical and mental health are correlated (as one degrades, so does the other, and vice versa), improving physical health will only improve mental health.

If you think it would be helpful to add a spiritual component to your current mental health treatment, ask your provider about including one. They may suggest that you complete a spiritual health assessment.

The Spiritual Health Assessment

Assessments are a part of any mental health diagnosis. Spiritual health assessments are less frequently used to assess emotional well-being, but the practice is gaining traction.

Religious and spiritual health assessments help mental health professionals learn about patients’ worldviews, personal histories, and potential coping mechanisms.

Many mental health organizations now require clinicians to assess patients’ spiritual health during the intake and treatment process.

In the first stage of a spiritual assessment, clinicians can explore the topic of spirituality among other factors in the patient’s life, including the nature of the patient’s social history, family history, and the presenting problem.

If spirituality plays a significant role, clinicians can move on to a comprehensive assessment in order to learn more about the patient’s spiritual beliefs and how beliefs and practices may relate to the patient’s problems and treatment.

According to “The APA Handbook of Psychology, Religion, and Spirituality,” multiple spiritual assessment tools can help therapists understand the role of spirituality in patients’ lives.

The most common form of comprehensive assessment is a spiritual and religious history, in which the clinician asks a series of open-ended questions about a patient’s past, present, and future spirituality, as well as how a patient experiences and expresses spirituality.

When assessing patients, therapists can also use lifemaps, in which patients depict their lifelong spiritual journey; genograms, in which therapists and patients chart the role of spirituality through several generations of the patient’s family; and eco-maps, through which patients explore their current relationships with spirituality.

Health professionals must take care when addressing spirituality with patients. They should strive to be culturally competent and check with patients that it is okay to discuss spiritual matters.

By understanding a patient’s spirituality, therapists can better help patients develop strategies throughout the course of treatment to weather life’s difficulties and heal past wounds.

Spirituality in Mental Health Treatments

Spirituality can play a role in any mental health condition in both helpful and unhelpful ways.

In some cases, spirituality may negatively affect a person’s mental wellness. For example, they may have grown up in a strict and punishing religious environment. Because of this, they may never wish to explore spirituality again. They may shut themselves off from concepts or practices that could potentially be helpful.

A person’s past experiences with spirituality and religion can affect the way they think about mental health. For example, someone could consider their depressive symptoms a punishment from God.

Some people have experienced trauma related to spirituality, such as abuse from a religious leader, or exclusion based on their sexual orientation.

Therapists can help patients work through the meaning of such thoughts and feelings without interfering with patients’ personal beliefs.

Moreover, therapists can also help patients tap into their spirituality to develop healthy coping skills, find meaning, and develop human connection—all hallmarks of good mental health.

Multiple spiritually based treatments exist for every disorder and can be used in conjunction with standard therapy. In cases in which a patient’s spiritual needs are beyond the scope of therapy, the therapist can refer the patient to a spiritual leader according to the patient’s tradition. Therapists and spiritual/religious leaders can also collaborate in a patient’s care.

Although not an exhaustive list, the following is an overview of how some mental health conditions are affected by spiritual beliefs and practices, as well as treatments that include spiritual components.

Addiction

Addiction is sometimes referred to as a spiritual disease. People who experience substance use disorders face feelings of emptiness, shame, and isolation. Spiritual beliefs and practices can give patients a sense of purpose and connection that aids in their recovery.

Many people with mental health challenges first encounter the concept of spirituality when they join a recovery program. Many of these programs are based on the original 12 Steps, first outlined by Alcoholics Anonymous and since adapted to issues involving narcotics, overeating, or being the family member or friend of someone who has a substance use disorder.

Regardless of the condition it addresses, each 12-step process uses a spiritual underpinning in which participants give challenges over to a higher power. This situates the individual within a spiritual framework that helps them overcome their present addiction and live a meaningful life.

Mindfulness is another spiritual practice that can be helpful in treating addiction. People often use substances to avoid pain. By learning to practice mindfulness, people can change their relationship with the present moment.

Instead of reacting to distress by turning to alcohol or other substances, they can respond with more awareness. In doing so, they can cultivate acceptance of unpleasant sensations, thoughts, and feelings. For example, they can more easily recognize that cravings are temporary. They can consider alternate coping methods, such as going for a walk or calling a friend.

Mindfulness-based relapse prevention (MBRP) is a treatment that combines mindfulness meditation with cognitive-behavioral relapse prevention. Treatment consists of eight weekly, two-hour sessions. Participants focus on awareness of triggers and cravings, mindfulness in daily life, and mindfulness in high-risk situations.

Depression

Several studies show that spiritual beliefs and practices can alleviate depression. Spiritual coping strategies, such as finding meaning in stressful situations, giving up control to one’s higher power, and seeking support from clergy can reduce despair.

People with spiritual and religious beliefs may also more frequently experience positive feelings of awe, compassion, and hope. In addition, they may be more likely to adopt healthy behaviors that can impact depression, such as exercising, eating healthfully, and abstaining from drugs and alcohol.

Religiously integrative cognitive behavioral therapy (RCBT) is a form of treatment in which clinicians utilize patients’ spiritual beliefs and behaviors as a basis to identify and challenge distorted thoughts. RCBT encourages patients to identify spiritual resources according to their individual faith, meditate on sacred texts, and become involved in a spiritual community.

Suicidality

Certain aspects of spirituality and religion can protect against suicidality.

Spirituality helps with hopelessness and impulsivity. Religious faith encourages the idea that things can get better even when someone is going through a tough time.

Religious beliefs can help an individual reflect on one’s highest values before making a decision or succumbing to a desire.

In a study of approximately 100,000 men and women, attending religious services every week projected a 68% lower risk of ‘deaths of despair’ (suicide, drugs, and alcohol) among females and a 33% lower risk among males.

Research shows that belief and faith in God can be associated with significantly lower suicidality, even among those not aligned with any religion. Recognizing purpose and meaning in life can significantly predict a person’s overall well-being.

If you are suicidal or are a danger to yourself or others, please call 9-1-1 or visit your nearest emergency room immediately.

Eating Disorders

Some aspects of spirituality and religion have been shown to lessen or prevent eating disorder symptoms.

Research has shown that people who value spirituality are more likely to use prayer and meditation to cope with distress related to body image.

One study found that religious women who read affirmations about God’s love and acceptance of their bodies were less affected than peers when viewing images of “thin ideal” fashion models.

Other studies, like this one on the effects of social comparison on people with eating disorders, report that a secure attachment to God can reduce disordered eating and behaviors.

Spiritual treatments help patients with eating disorders reject the notion of a perfect body and instead focus on connections with fellow humans and the sacred. Interventions include meditation, contemplation, prayer, journaling, and 12-step groups.

Psychotic Disorders

Incorporating spiritual treatment with people with psychotic disorders can be complicated. Symptoms of psychotic disorders, such as delusions, can be confused with religious experiences and vice versa.

Research has found that spirituality and religion do not contribute to psychotic symptoms, however. On the contrary, as with other mental health conditions, cultivating spiritual beliefs and practices in patients who wish to do so can be helpful.

Spirituality can enhance a person’s positive sense of self, provide meaning to mental health challenges, lessen the severity of symptoms, and provide a framework for social behavior.

Several forms of spiritual group therapy have been shown to be effective for people with psychotic disorders.

In one model, members of a therapy group discussed spiritual concepts, listened to spiritual music, and were encouraged to offer emotional support to one another. Within six months, all 20 participants in the group achieved their treatment goals.

Obsessive Compulsive Disorder

Spiritual and religious beliefs can be helpful in treating obsessive compulsive disorder (OCD). For example, mindfulness strategies can help people recognize obsessive thoughts and resist getting caught up in such thoughts. They can also help people recognize when distressing thoughts are not true.

People with OCD can also tap into their spirituality when engaging in exposure and response prevention (ERP) therapy, a standard treatment for OCD. For example, patients often struggle to engage in the exposure aspect of this treatment, as it involves facing their greatest fears. However, connecting with spiritual values can be one way to engage in exposure.

A 2018 article on the topic gives the example of a patient whose obsessions and compulsions may involve germs, but who also values nature. The patient can focus on their desire to protect nature by curbing the frequent handwashing and long showers they have been using in their compulsions to avoid germs.

It is important to note that a form of OCD, scrupulosity, involves religious or moral obsessions. According to the International OCD Foundation (IOCDF), common obsessions seen in scrupulosity include excessive concerns about blasphemy, purity, and going to hell.

People with scrupulosity may have behavioral compulsions that can include acts of self-sacrifice and repeatedly seeking reassurance from religious leaders. Mental compulsions of scrupulosity may include excessive praying, repeating passages from scripture in one’s head, and making pacts with God.

The IOCDF points out that scrupulosity can affect people from any faith tradition and can make it harder for those who experience it to practice their religion.

The same therapies used to treat other forms of OCD are used for scrupulosity.

However, members of a person’s faith community may be involved in treatment. A therapist may ask community members to learn ways to help a patient in the recovery process, including clarifying an institution’s stance on particular religious issues relevant to the patient’s symptoms.