Historically, there was a close connection between spirituality and religion and healing. Sickness has been described as “a disturbance in relationships” with early people believing in a relationship between humans and the cosmos. A disturbance in this relationship required a healing role fulfilled by a shaman, thus demonstrating that “healing was a religious act” (Sulmasy 2002). Salmasy goes on to describe how “scientific healing” also restores relationships, but on a physical, “intrapersonal” level between body parts, organs, physiological functions, and biochemical processes within a mind-body context.
However, for the individual, illness can also cause a disturbance on the “extrapersonal” level, which includes not only the physical environment, family and social network, but also the patient’s relationship with the “transcendent.” Sulmasy (2002). Salmasy (2002:29) presents a diagram of a biopsychosocial-spiritual model including spiritual interventions for patients at the end of life, but the model can be applied in a wider sense to more types of health and mental health conditions. Physical and emotional distresses are usually the ones that generate the most attention. However, for some, spiritual distress can present as physical symptoms and the healing and support process may benefit from attention to this aspect as part of holistic care.
In a number of cultures, healing is viewed as restoring balance—balance within the individual’s body, balance between the individual and his or her community or balance of the community with the universe at large. The individual’s illness may be perceived as a sign of community imbalance or sin or misdeeds.
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