SPIRITUAL ISSUES- GROUP ASSIGNMENT 2.4.
BPC 1211- SPIRITUAL AND CULTURAL ISSUES
STUDENT NAMES; CATHERINE MLENGA CHISUNKHA, MAWOGOLE
JOHN, CHEPKEMOI DEBORA, MANSUR SOWE.
It is true that religion and spirituality can be a source of stress and strain at times including times
of upheaval. Major life crisis can affect people not only psychologically, socially, and physically
but as well as spiritually. In the last 25 years, religious/spiritual issues have begun to receive
attention from researchers and practitioners. This growing body of work indicates that
religious/spiritual struggles are an important part of human experience, one that holds significant
implications for health and well being. There are many spiritual issues but this writing focuses
mainly on issues discussed below.
Fear of death, Mohammad Mahboubi et al (2014). Explains that death is one of the events that
come to men and is unavoidable. Different analyzes done in this topic of death shows some
belief that death is one of thelife’s stages and others have called it the end of life. If fear is
anatural emotion in mind it can be positively said that the fear ofdeath is natural.Fear of death is
a common phenomenon in the generalpopulation. A study has reported that 16% of people
areafraid of death and 3%, have panic disorder in this regard andshowed that women have more
fear of death than men do. It wasalso observed that with the increasing level of education,
economic and social status; fear of death is less experienced. More studies show that women
have a higher deathanxiety than men and peoplewith intrinsic religious motivation have less
death anxiety, alsostronger belief about life after death is associated with lowerdeath anxiety.
Spiritual crisis along with chronicillness threatens the confidence and faith,
personalcommunication is disrupted due to the uncertainty of the future,adaptation mechanisms
seem insufficient, and person may beinduced to feel lonely and appears in spiritual crisis.
Amongthe chronic diseases that can be studied in this context arechronic renal failure and
irreversible and progressive impaired renal function. However, due to hemodialysis, their
survival hasincreased but the disease has affected their lives, impairedfunctional status and
changed their quality of life in advancedstages .Spiritual turmoil causes grief in patients, can
destroyhealth and positive motivation. Because patients are moredistressed and anxious they may
have more sufferings and developproblems such as pain, low self-esteem, loneliness,
fatigue,frustration, and fear of death. Death anxiety /fear is defined as the dread of death, the
horror of physical and mental deterioration, the ultimate feeling of aloneness. The ultimate
feeling of separation anxiety, sadness about eventual loss of self and extremes of anger and
despair about a situation over which people have no control. According to another definition
death anxiety means a set of negative emotional reactions with variable severity due to loss of
one’s existence. The relationship between death anxiety and religious beliefs seems too complex
to provide patterns of understanding. Chaggaris and Lester (1989) reported that death anxiety
was not related to afterlife, or the subject of going to heaven by church attendance, or whether
the subject considers himself to be a spiritual person. Fear of one’s death was related to fear of
‘hell’. Denis Yoshikawa, a shin buddhist , explained that according to shin teaching, ‘ to solve
the problem of death, one must first solve the problem of life, living life. If one is able to do that,
to live a truly human life, then there is nothing to be feared by the experience of death, because
the experience of death is a natural part of life. It has been shown through results of various
studies that a strong sense of religion in a person’s life can be related to a lower sense of anxiety
towards death. Death anxiety tends to be lower in individuals who regularly attend religious
meetings or gatherings. In short the more religious you are,the less anxiety you are about death
because you may associate death as another beginning of life that is promised through many
religions.
Desire for forgiveness, Hospice professionals bear witness to the pain of unresolved conflict and
the power of forgiveness at end of life on a daily basis. They watch as agitation recedes when an
estranged family member reaches out to hold their terminally ill loved one’s hand. They also see
the heartbreak when a loved one refuses to take their dying relative’s call. Sometimes, the
reasons for refusing to forgive are understandable like past abuse, addiction issues, or
abandonment. Yet even in these difficult situations, there is value to the wounded party in
offering forgiveness at end of life. Forgiveness is a spiritual practice common to most world
religious groups. While there is a shared belief that the ability to forgive is a virtue, depending on
its context, opinions vary on its definition and its contribution to well being. Forgiveness is a
way for adults to make meaning of an offense perpetrated against them. Some choose to forgive
so that they in turn receive God’s forgiveness, others tend to forgive as a way of releasing
negative emotions and feelings of retaliation. Alexander pope (1727) quoted a famous quotation
,” to err is human,to forgive is divine”, which provides some insight into one's relationship with
the sacred factors of the forgiving process. Christians and or those with religious affiliations have
a more of a forgiving attitude and place more value on forgiveness but necessarily ‘foaster
forgiveness to any greater extent, meaning that religious peo[le are more open to forgiving but
don't necessarily forgive. Forgiveness appears to be basically acceptable yet at times it's privately
challenging when feelings of anger and revenge are opposite to what is spiritual acceptance.
Accepting forgiveness reduces negative emotions, helps healing physically and emotionally and
enhances a peaceful death ( Schultz,Tallman, Altimaie;2010).
The act of forgiveness provides rewards for both the mental and physical health. Despite the
cliché of “forgive and forget,” it’s not realistic in most cases. Forgiveness doesn’t mean
forgetting or justifying major transgressions. But it does mean letting go of the resentment,
anger, and bitterness those actions have brought to your life. Forgiveness isn’t always easy. You
may need support from a therapist or spiritual leader to help navigate the complex emotions you
feel. You may need to forgive many times. But letting go of that negativity can: Lower blood
pressure, Reduce anxiety and stress, Reduce symptoms of depression, Provide better immune
system, Foster improved mental health and Allow for healthier personal relationships. When the
person who hurt you is approaching end of life, time becomes a factor. If you are able to offer
forgiveness, you may find it benefits you more than them as you are freed of the resentment and
possible future guilt over leaving things unsaid.
While forgiveness benefits all sides, it also can’t be rushed. Individuals who were harmed need
to come to forgiveness on their own terms. You can start on the path to forgiveness by sincerely
apologizing to the person you hurt and taking responsibility for your own actions by offering an
explanation of why it happened and how you would like to make amends. It is important to give
the person who was wronged the chance to express how the situation affected them. This can be
difficult to hear, but it is a necessary part of the process.
Even if you make a heartfelt apology and try to make amends, the person who was hurt may not
forgive you. While this is a difficult experience, forgiveness is a journey and it may come at a
later time. You should follow the lead of the person who has been hurt and give them the space
they need. You may also be in a situation where you are unable to speak directly to someone you
have hurt with your actions. This happens for Veterans who carry guilt from their actions in
wartime, but it can also be true if a person you hurt refuses to communicate with you. In this
case, you need to seek self-forgiveness. We are only human. We make mistakes – sometimes
huge mistakes. Individuals can forgive. God can forgive. You can forgive. Speak to a therapist,
chaplain, or social worker about how your mistakes are impacting your life. They can offer
guidance on how to move forward and find forgiveness at end of life.
Fear of loneliness/ abandonment, Having a life-limiting illness and the thought of impending
death is an ugly experience (Rando, 1984). It is not only distressing but it comes with the feeling
of loneliness and abandonment for both the patient and the care giver. (Chentsova- Dutton et al).
The patient spent most of their time in and out of hospital and this makes them feel they are a
burden to the family and they tend to become worried that their care givers can get tired and
abandon them.The limited interactions with community and affiliate religious groups due to the
nature of the disease can bear devastating effects on the spiritual well being of the patient and the
family. They can develop self alienation as a reaction to loneliness and the impending death.
Health care research shows loneliness to be an emotion which often accompanies dying
Loneliness of dying refers to at least three different conditions. Firstly, it may refer to social
loneliness, which is the feeling of sadness and longing that results from a lack of an engaging
network. Social loneliness often occurs in dying due to a decline in health, a decreased network,
loss of social roles, and loss of partner and family. Secondly, loneliness of dying may refer to
emotional loneliness, which is the feeling of utter aloneness even in the presence of others and
which results ultimately from a lack of an attachment figure. Emotional loneliness relates to
dying as people may have great difficulties in understanding and expressing their emotions
concerning their approaching death. Thirdly, loneliness of dying may refer to existential
loneliness. EL is understood as an intolerable emptiness, sadness, and longing, that results from
the awareness of one’s fundamental separateness as a human being. EL is mostly experienced in
life-threatening situations. Because it is in the confrontation with death that one is most aware of
one’s own fundamental aloneness. This loneliness can be nullified neither by the presence of
others nor by an adequate dealing with feelings—the isolation of having to die alone remains. EL
is therefore claimed to be essential to the understanding of the loneliness of dying. This basic
form is usually specified as a condition of human existence; one is always and fundamentally
separated from others. One becomes especially aware of this fundamental separation in the case
of frightening threats to being. Secondly, EL is characterized as a septic form of loneliness
articulated in terms of an experience, including the experience of a total absence of any
relatedness. Thirdly, EL is characterized as a process in which the negative experience of man’s
lonely nature is transformed into a positive one. Hence, people who face a personal crisis may be
confronted with EL and, from that, forge more meaning in their lives. This process of inner
growth is the result of man’s possibilities as a human being. Adopted from Eric J, (2010).
Non-acceptance of death and disability;Death and disability are very sensitive issues in regard
to spirituality and religion. In African cultures, death and disability are perceived as a curse or
punishment. The news of a diagnosis of life-limiting illness can lead to spiritual distress and
denial.The thought of being disabled or loosing a part of their body can plunge the patient into
denial which can affect their spiritual wellbeing and the delivery of care and treatment.Religious
patients tend to develop a hope for miraculous cure despite the extent of the disease.It’s therefore
very crucial to ensure spiritual wellbeing of patients and family is well taken care of as it affects
the wholesome health and quality of life.
Although the study of religious /spiritual issues has grown so dramatically, there is a need for
further research.
Concerns for loved ones left behind
Morris Psychological Group, (2017) reveals that,With more than 2.4 million deaths recorded in
the United States every year, that translates into many millions of loved ones left in pain and
sadness as they grieve – a process that, for some, can seem like a bottomless pit of despair. But
Hayley Hirschmann, PhD., a clinical psychologist and bereavement specialist at Morris
Psychological Group, reassures us that grief is a perfectly natural response to the death of a loved
one and can be made more bearable by recognizing the common feelings surrounding loss and
healthy ways to cope that can help us move forward.
A loved one’s death often causes the most intense type of bereavement, and the level of
emotional suffering typically matches the significance of one’s personal loss. Ultimately,
however, grief is a highly personal and individual experience, Dr. Hirschmann says.
“There’s no right or wrong way to grieve, but some forms of grief are less productive and can
lead to outcomes such as extended anxiety and depression,” she explains. “It’s important that the
bereaved understand that while they couldn’t control their loved one’s passing, they do have
some control in grieving in a healthy manner. This realization offers hope.”
Common feelings surrounding loss
Many factors affect how people grieve, ranging from the nature of the loss – which can be harder
for those losing a spouse, child, parent or sibling – along with personality, coping style, faith and
life experiences. Psychiatrist Elisabeth Kubler-Ross introduced what became known as the 5
stages of grief more than 40 years ago, acknowledging that experiencing all the stages isn’t
necessary or even a linear process. They include denial; anger; bargaining; depression; and
acceptance.
Keeping this framework in mind, it can be useful to understand what emotions to expect in the
days, weeks and months after a loved one dies. These include:
·
Shock and disbelief: You may feel numb or have trouble believing your loved one really
died.
·
Sadness: Emptiness, despair and yearning are common. So is crying or feeling jittery.
·
Anger: You may be angry with the doctors, yourself or God for not being able to save your
beloved.
Fear: You may worry about your own mortality or how you’ll live without your loved one.
Anxiety and insecurity are common.
“We often view grief as a strictly emotional process, but it can also involve physical problems
such as fatigue, nausea, weight fluctuations, aches and pains, and insomnia,” Dr. Hirschmann
points out.
Tips for coping
Wallowing in grief can be destructive, however, but not facing your feelings can be equally
damaging to your mental health, according to Dr. Hirschmann. She offers these tips for
managing bereavement in a way that leads you forward:
·
Lean on friends and family members: Others who care about you want to help during a
crisis. Tell them what you need, whether it’s emotional support, help with funeral arrangements
or meals for the near future.
·
Join a support group: Sharing your sorrow with others who have experienced similar losses
can help. To find support groups near you, contact local hospitals, hospices or counseling
centers.
·
Follow your faith: Meaningful spiritual activities and rituals such as meditating or praying
can offer solace. Talking to a clergy member about your feelings may also be comforting.
·
Plan for grief triggers: Holidays, anniversaries and other milestones can bring an emotional
punch to the gut when you’re missing the person you once shared them with. Be prepared for
these events and understand that your feelings are perfectly normal.
Talk to a therapist or counselor: If your grief feels like too much to bear, seeking mental health
expertise is a logical choice that displays strength, not weakness.
“An experienced psychotherapist can help you work through your intense emotions and
overcome obstacles to healing,” Dr. Hirschmann says. “If you aren’t feeling better over time,
your grief may have developed into a more severe problem such as depression. When you’re
grieving, it’s more important than ever to take care of yourself.”
References
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Depression, Coping Strategies and Daily Spiritual Experience .2019.
Rando, T. (1984). Grief, dying and death
Chentsova -Dutton, Y., Shucter, S., &Hutchin, S., et al . 2002.depression and grief in hospice care givers
Mohammad Mahboubi.PhD in Health Services Administration, Kermanshah University of
Medical Sciences, Kermanshah, Iran. Fariba Ghahramani MSc in Epidemiology, Shiraz
University of Medical Sciences, Shiraz, Iran. Zahra Shamohammadi Student Research
Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Shahpar Parazdeh
Midwifery, hospital Moatazedi, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Relationship between daily spiritual experiences and
fear of death in hemodialysis patients. J. Biol. Today's World. 2014 Jan; 3 (1): 7-11. Received:27
December 2013 • Accepted: 27 January 2014
2020 Crossroads Hospice & Palliative Care. https://www.crossroadshospice.com/hospice-palliativecare-blog/2020/october/30/the-importance-of-forgiveness-at-end-of-life/
Eric J. Ettema. Evert van Leeuwen.Louise D. Derksen. Existential loneliness and end-of-life
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Alexander Pope, 1827; Rape of the Lock p108-109
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