Gino Vitiello
Spirituality and illness are closer themes than they may seem. When we are in a good state of health, it seems to be the “natural” condition of existence, and it is … as long as it lasts. However, it cannot last uninterruptedly.
One of the fundamental aspects of the Buddhist view is impermanence: nothing lasts forever, everything is transformation. So even the physiological state of health, when it is there, cannot last forever, and we have to be prepared to accept that sooner or later we will suffer an illness, in a more or less severe form. The moment we discover that the body is ill, our whole being becomes ill, given the natural attachment we have to this body, that part of us with which we most easily identify.
How do we react when faced with a serious illness? Some people consider it as fate, some as divine punishment, still others as a form of injustice in life. All these reactions tend to shift attention away from the basic truth: an illness is the disruption of that balance of functions on which health depends, and which, for a variety of possible causes, has been broken, thus inducing the manifestation of some pathology.
A conscious presence of mind, which is the basis of many spiritual paths, can also help us to recognize it as a message, a signal, telling us to change something in our way of life. Dr. Eduard Bach, the discoverer of the flower therapy that bears his name, said that illness is often the last means that our soul, our deepest self, resorts to in order to make us recognize our mistaken behaviors or the way we deceive ourselves in life.
There is also a close interaction between body and mind. While it is well known that a physical ailment inevitably reflects on mood, an emotional malaise, prolonged depression or dissatisfaction with one’s life will also manifest with effects on the body, often through a behavioural and/or eating disorder, which in turn generates other health problems.
When an illness occurs, it is important to react, but it is particularly necessary to understand the cause, not just the superficial cause. There are many people who emerge positively transformed from a serious illness if they have been able to accept its existence and understand its meaning.
Sometimes medical therapies or the body’s ability to respond are not enough for healing. Then we need to find resources on a deeper level. To do this, however, we must have already developed a spiritual vision of existence. If, during life, we have only cultivated material things, it will be difficult to deal in the best way with the suffering that illness entails and even death, which, sooner or later, will come and find us unprepared. The relationship with our spiritual dimension, however, is not an easy thing to discover at the last moment, when er may be overcome by fear. If we do not start when we still have all our faculties, then it will be much more difficult. We should all train ourselves, at least when we get to a mature age, to regard our body as a home that we will inevitably have to abandon along with everything we have accumulated in life.
Belief in a compassionate deity can be of great help, and this is not only true of theistic religions. In Buddhism, too, there are manifestations of compassion, such as Tara, or others related to the potential for long life, and there are specific practices for receiving its benefits. Through meditative practices, Buddhist teaching, however, and particularly Dzogchen, guides us above all to train in awareness of impermanence and leads us to discover the true nature of our being, going beyond the limited aspect of that small ‘self’ with which we identify. Recognizing this original nature means coming out of the condition of ignorance from which conditioned existences arise and achieving ultimate liberation from the suffering of samsara.
As for the role of the physician, I think that his or her current training suffers from the modern dichotomous perception between science and spirituality. The practice of contemporary medicine is almost inconceivable without a specialized view. This has the undoubted advantage of training professionals who can constantly update themselves on the constant advances offered by scientific research. However, it has the limitation of examining increasingly limited aspects of the human person, and the aspect of spirituality has long since fallen outside the area of medical competence. Unfortunately, and less justifiably, the psychological aspect does not seem to fall within it either.
Fortunately, something seems to be changing: the field of medical ethics is increasingly sensitive to a view of the overall well-being of the person who is ill rather than focusing only on countering illness as an entity in itself. Legitimate questions have also arisen about the desirability of prolonging life at any cost without considering its quality. It should not be forgotten that there is a big difference between loving care and therapeutic overkill, which often covers up the physician’s denial of defeat, and is sometimes accepted by the patient under the illusion of avoiding the inevitability of death.
At this point it is perhaps important to clarify what is meant by spirituality. The dimension of spirituality is related to the idea of something that transcends the material aspect of life, something beyond the physical body and consequently far removed from the scope of medicine. But if the subject that medicine addresses is the human being in its entirety and complexity, is it possible to completely ignore the relevance of this peculiar aspect of human nature in the training of the physician?
Spirituality should not be confused with religion, to which it has long been delegated. If the human condition were purely material, perhaps there would not even be something that we could define as a spiritual approach. This, however, has characterized our existence since the first emergence of what we have defined as consciousness.
In ancient traditional medicine the role of the healer was likened to that of the priest in the intuitive perception that illness of the body involves all aspects of the person, including his psychic and spiritual condition.
Today, it is impractical to think of this totality of roles in a single professional figure, so in the face of serious illnesses, in the most advanced medical centers, the figure of the psychologist is sought alongside the physician for the emotional support of the person who is ill in his or her course of treatment. A great deal of evidence has been gathered on how the emotional response can positively or negatively influence the prospects for healing, and in this response the role of spirituality is of great value.
While this is true for those who are suffering, it is also reasonable to consider that a spiritual formation, not necessarily denominational, can be supportive to those who are caring for and coping with the condition of others with a serious or terminal illness.
I would like to point out a few points about the some of the possible benefits:
– Developing empathy and compassion in therapeutic work. These emotions on the part of the physician are always recognized by patients and promote their trust in the caregiver.
– Increased communication skills. If the physician truly perceives the sick person as a person with a definite identity and not just a clinical case in which to intervene, he or she will be able to create a better relationship with them, offer more effective support, and get patient to accept treatment by patients.more readily
– Preventing burnout. Working with critically ill patients can be emotionally very challenging for health care workers. Spiritual training can provide support in dealing with this stress and the risk of burnout.
– Openness to a holistic approach. Integrating spirituality into medical practice can foster a more holistic approach, leading to consideration of not only the physical aspects of health, but also the psychological, social, and spiritual aspects and cultural differences of patients, which is not a minor issue in an increasingly multiethnic society.
In conclusion, if we recognize that spirituality is an essential component of human nature, we should ask ourselves whether it is possible to exclude it from a relationship such as that between us and illness. Serious or terminal illness makes us face the fragile limits of our condition and pushes us to confront those questions to which we often avoid finding answers.
As for the physician, it is true that his or her task is above all to deal with the problems of the body, but in his work he will encounter human beings in a particularly fragile condition that will inevitably confront him with his own, and every means is valuable to support this mutual burden.
A student of Chögyal Namkhai Norbu since 1977, Gino Vitiello is a medical doctor and psychotherapist from Naples, Italy. He is a Yantra Yoga instructor and a meditation teacher as well as the author of various articles and lectures on Tibetan Medicine and the theme of death in the Buddhist tradition.
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