Spiritual Health

Continuing education online courses in Spiritual Health.

D20. Drug Abuse: Spiritual Health

Course Description: This is course was written to help you develop and foster your spiritual health. It is an intensely personal course in that it deals with your innermost values, thoughts and feelings. It is intended to help you focus your life within a larger external framework.

Objectives: At the end of this course, you will (1) develop an understanding of your spiritual life, (2) gain insight into your spiritual journey, (3) find resources for spiritual emergencies, and (4) face the possibility and meaning of your death.

Course Format: Online linked resources and lectures that you can use anytime 24/7. One multi-choice test.

Course Developers and Instructors: R. Klimes, PhD, MPH (John Hopkins U), author of articles on Spiritual Health and Wellness.

Course Time: About three hours for online study, test taking with course evaluation feedback and certificate printing.


Professor Rudolf Klimes, PhD, welcomes you to this online course. Keep going.

START the course here. TAKE the exam at the end. PAY after the exam.

Course Test: Click here for the self-correcting test that requires 75% for a passing grade.

D20   Spiritual Health, 3 CE hours


Course Outline & Introduction

1. SPIRITUAL LIFE and the meaning of a life of service with the aid of mediation/prayer.
2. SPIRITUAL JOURNEY from self-centeredness to the values of giving and forgiving.
3. SPIRITUAL EMERGENCIES and the unfairness of life.
4. DEATH and the meaning of death and grief and mourning.

Science is based mainly on logic, critical thought and objectivity. A person’s emotional, sexual and spiritual life is based more on intuitive and subjective considerations. All these matters effect health for either good or ill.

“Christ learned about his mission while he was cutting wood and making chairs, beds, and cabinets. He came as a carpenter to show us that — no matter what we do — everything can lead us to the experience of God’s love.” — Paulo Coelho in By the River Piedra I Sat Down and Wept

“I regularly ask my patients who are facing difficulties, be they physical or stress-related, whether or not they have any spiritual outlet,” says Judy Ann Bigby, M.D., Brigham and Women’s Hospital, Boston, Massachusetts. “We then talk about how they may use this outlet-a church, support group, or other avenue-to work through the problem. Being healthy is not just the absence of illness,” says Dr. Bigby. “For many people, being at peace and having a spiritual connection affects their overall well-being and feelings about their health.”



1. The Spiritual Life

In recent decades, the terms “spirituality” and “religion” have begun to acquire different meanings. Sociologists suggest that reasons for the distinction may include secularism and a general disillusionment with religious institutions at large (e.g., Sheldrake, 1992).

Currently “religion is viewed as being linked to formal religious institutions, whereas spirituality does not depend upon a collective or institutional context” (George et al., 2000, p 103). In fact, the National Institute of Healthcare Research (NIHR) has defined religiousness as a result of the search for the sacred both in and outside of the community context with a primary focus being on the validation and support individuals receive from an identifiable collective. Conversely, the NIHR has defined spirituality as ” the feelings, thoughts, experiences and behaviors that arise from a search for the sacred” (Larson et al., 1997, p.21). The NIHR definitions point to how spirituality and religion are viewed as two distinct points on a continuum. However, from a theological perspective the bifurcation that is made is an artificial one that cannot contain the wealth of either concept. Spirituality also contains elements of community and can arise from an experience with a collective. Likewise, religion can elicit feelings, thoughts, and behaviors that convey comfort and security through ritual. By Chaplain John P. Oliver, D.Min.

The spiritual life tries to impose a sense of purpose on the unpredictableness and seemingly randomness of life. The meaning of life deals with life purpose, inner peace, and the place of the person in the universe. It is an antidote to cynicism, anger, fear, anxiety, self-absorption and pessimism.

As you explore your spiritual life, you ask yourself:
1.1 Who is God?  How do I relate to God? Do I submit or reject/rebel?
1.2 Who am I?  How do I relate to myself? What do I value? What do I feel?
1.3 Who are the people around me? How do I relate to them?
1.4 What is my relationship to all creation and the environment?

The spiritual life overlaps with components of the emotional, mental, physical and social aspects of living. Guiding beliefs may include sets of principles. For many, they includes a belief in God or a higher power and the realization that the needs of others go before ones own.


God Others
I Creation


Service, to many is not only a social, but also a spiritual act of altruism. In service, individuals contact others, they volunteer, they network, they pace themselves, they become process-focused in their organized and random acts of kindness.

Meditation can include prayer, rituals, ceremonies and contemplation of things beyond the boundaries of our human existence. It deals with listening and speaking within the inner self and with supernatural forces. Some express their spirituality in art, service, organized religion, and nature.

A spiritually healthy person
1. Accepts guidance from God or higher power,
2. Is honest (does not lie, cheat, steal, gossip),
3. Serves others (does no harm) and
4. Is a steward of creation.

ERIC_NO: ED441568 Dealing with Your Kids’ 7 Biggest Troubles: Lying, Cheating, Stealing, Sexual Acting Out, Drugs & Alcohol, Suicide, Violence. A Boys Town How-To Book by Peter, Val J. 2000:

ABSTRACT: Noting that children want love and acceptance from trustworthy adults, this book reflects upon the destructive impulses that threaten the emotional, physical, and spiritual life of youth and families. The book identifies and describes behaviors that tempt adolescents with instant relief and gratification, but which ultimately lead to feelings of self-destruction and despair. Seven chapters address the following behavior problems: (1) lying; (2) stealing; (3) drugs and alcohol; (4) cheating; (5) sexual acting out; (6) suicide; and (7) violence.

Todd Maugans offered a mnemonic in the Archives of Family Medicine as a technique to assist students in framing an approach to spiritual history taking:

S  Spiritual Belief System
P  Personal Spirituality
I   Integration and Involvement in a Spiritual Community
R  Ritualized Practices and Restrictions
I   Implications for Medical Care
T  Terminal Events Planning (advance directives)

The mnemonic is of course suggestive of a broader line of questioning that may follow from open ended questions organized around the topics identified above.

 Spiritual Disintegration: Spiritual Integration:
Hopelessness  Hopefulness
Unsympathetic  Empathy
Unilateral power  Relational power
Unforgiving  Forgiving
Work as job  Work as vocation
Fear  Openness
Powerlessness  Creativity
Harsh  Merciful
Reactionary Responsive
Isolation  Community
Disrespectful  Respectful

Source: http://www.chausa.org/PUBS/PUBSART.ASP?ISSUE=HP9803&ARTICLE=D

Therapies that assist in decreasing physical and spiritual pain: cold or heat, distractions (TV, reading, crafts), environmental control, family support, exercises, imagery, massage and back-rubs,  music, positioning, relaxation and rest, drinking liquids, listening, deep breathing, sensory stimulation, reduced noise level, encouragement and prayer.

Source: http://www.chausa.org/MISSSVCS/MISSION/1660_PAIN.ASP

“In contrast to our concern with what other people think of us, Jesus did not compare himself to others. We cannot find a single instance in the New Testament where he clung to his divinity. He wasn’t obsessed with his image, as we so often are with ours. Instead, he was only concerned with: (1) trying to be who he was called to be (obedience); (2) being in solidarity with others (community); (3) doing everything in the right Spirit (love).”

— Robert J. Wicks in Snow Falling on Snow

Explore the Handbook for Mortals    What is a chaplain


2. The Spiritual Journeys

A spiritual journal takes you from your spiritual beginning or birth through spiritual adolescence toward spiritual maturity. It is the journey on which you:

2.1 Start because your are not sufficient for the task ahead,
2.2 Review your spiritual high and low experiences,
2.3 Unlearn selfishness in order to learn giving and forgiving,
3.4 Explore the ever unfolding wonder of God’s love.

Spirituality includes the capacity to love, to express compassion, empathy, to give and forgive, to enjoy life, and to find peace of mind and fulfillment in living. It deals with values that have their source outside of the individual.  

Spiritual journeys have a start, a time-line, a place or places, and often some milestones. They differ from an individual’s church, educational, vocational or family history in that it focuses on the higher power, or center of spiritual life.


Called to go Past spiritual lows & highs Giving & forgiving Toward life


THE PURPOSE OF THE Spiritual JOURNEY is to move from resentment to resolution,
from arms length relationships to intimacy, from compulsiveness to conscious choices, from self-destruction to service, from co-dependence to inter-dependence, from shame to  freedom , from conforming to transforming, and from half-measures to full commitment. Source: Your Spiritual Journey Weekend

Explore different approaches:  12 Steps For Christian Living | i Spy Dossier: Spiritual Journey |Bringing the Sacred into the Ordinary — Jacquelyn Small — HealthWorld Online – HealthWorld OnlineLaw of Integrity – HealthWorld Online |

My Spiritual Journey from focusing on MY NEEDS to centering on GOD’s WILL

God’s will is that

  1. I worship Him lovingly: Upreach
  2. I sustain myself unselfishly: Inreach
  3. I serve others faithfully: Outreach

I sustain myself with the things that meet MY NEEDS:

  1. a healthy lifestyle
  2. companionship
  3. money for shelter, food, clothing, transportation, education, etc.

My Spiritual Journey takes me generally

  1. from confusion to commitment
  2. from sickness to health
  3. from conflict to fellowship
  4. from lack to satisfaction
  5. from indifference to helpfulness.

Thus my worship of God becomes more creative,
my sustaining of my needs more realistic,
my service to others more effective. (Based in part on Romans 12:1-5, James 1:27, Acts 2: 42-47)

ERIC_NO: ED344222, Composing (as) Power, by Daniell, Beth, 1992:

ABSTRACT: A striving for something beyond ourselves is one way of defining spirituality, and, although spiritual and religious motives have traditionally impelled students to learn to read, the intersection of literacy and spirituality has gone largely unrecognized by scholars. Six women were interviewed about how they use literacy in their spiritual lives. All were members of Al Anon, aged 35-55, ranged from GED (Graduate Equivalency Degree) to masters student. Al-Anon, patterned after Alcoholics Anonymous, utilizes the “Twelve” Steps and is biased toward literacy. The women in the study wrote many different kinds of documents which were studied, including fourth steps, journals, “Dear God” letters, poems, stories, etc. Two of the subjects, Jennifer and Tommie, represent all of these genres and display a rich complexity of voice. Extensive quotes from their individual writings document their separate experiences. Three stages in their similar spiritual journeys can be outlined as follows: (1) “The healing came,” associated with the “fearless moral inventory” of the fourth step. (2) “I had to let go of it being perfect, and then it became perfect,” referring to the release of expectations; and (3) “We can’t carry our message if we don’t have our own language,” which entails discovering the true power of each individual’s own words. This last stage of attaining a personal language is similar to Bell Hooks’s notion of “coming to voice.” For both, the intersection of literacy and spirituality involves empowerment.

ERIC_NO: ED440311, Spirituality and Multicultural Counseling: A Generic Model and Discussion. By Lemire, David, 1999:

ABSTRACT: Spirituality is an important aspect of counseling. This paper identifies spirituality as a task that is a journey universal to human beings. It presents a taxonomy of spirituality/consciousness developed by Render and Lemire, postulating five levels of taxonomy: self, others, groups, the world, and cosmic. These levels apply across cultural, racial, and ethnic lines and are used to conceptualize the spiritual journey as a five-step process. Step One–Describe the Wound–refers to the counseling issues that are still affecting the individual. The counselor acts as a coach, teacher, mentor, and surrogate parent in the healing relationship. Step Two–Outline the Journey–describes the direction of the path to individuation. Step Three–Attempts to Individuation–explains the efforts and outcomes of initiatives. Step Four–Struggles–involves the understanding of the struggles that take place in life and how the outcomes occurred. Step Five–Individuation/Individuating–refers to how resolutions were made of the struggles. Counselors dealing with multicultural issues can use the five-step model since this approach to spirituality crosses ethnic, cultural, national, and gender lines. The model describes a process with principles of growth and healing for all human beings.

“It seems obvious that people familiar with Jesus looked upon Him as just an ordinary person. He didn’t “put on the pious,” as my Irish friends used to say. And it is rather interesting that nowhere in the gospels do any of the Evangelists describe Jesus as religious. “— Joseph Girzone in A Portrait of Jesus

“Tips to Enhance Your Spiritual Health:

  • If you do not currently have a spiritual outlet, consider revisiting your childhood faith or another group that interests you.
  • If you plan to see a doctor regarding a physical problem, be sure to mention any major life events that you may be experiencing, such as menopause, divorce, or the death of a loved one. This may be affecting your health and may influence the course of treatment your doctor recommends.
  • Build quiet, contemplative time into your daily or weekly schedule. Slowing down can help soothe even the most restless spirits.” Source: http://www.4woman.gov/pypth/articles/aa_benefits_sp_health.html


3. Spiritual Emergencies

Spiritual Emergencies is a (a DSM-IV category) test an individual’s inner structure and his or her access to outer spiritual resources. A spiritual person can bring supernatural resources to crisis situations.

For some, life has fallen apart. Their troubles make no sense. They blame whoever seems handy, including God. They expect life to be fair and they find it very unfair. One of the first step in healing in a spiritual emergency is an acceptance of the fact that life at present is not fair.

The whole millennium culture may be a popular spiritual response to impose order on time. Thus the coming of the year 2000 may create an epidemic of spiritual problems and emergencies. Many who are looking forward to the end of an unreasonable millennium and and the start of a new, more reasonable one, may be disappointed.

Spiritual Emergency Journal  Spiritual Emergency Resources

Religious or Spiritual Problem is a new diagnostic category (Code V62.89) in the Diagnostic and Statistical Manual-Fourth Edition (APA, 1994). While the acceptance of this new category was based on a proposal documenting the extensive literature on the frequent occurrence of religious and spiritual issues in clinical practice, the impetus for the proposal came from transpersonal clinicians whose initial focus was on spiritual emergencies–forms of distress associated with spiritual practices and experiences. The proposal grew out of the work of the Spiritual Emergence Network to increase the competence of mental health professionals in sensitivity to such spiritual issues. This article describes the rationale for this new category, the history of the proposal, transpersonal perspectives on spiritual emergency, types of religious and spiritual problems (with case illustrations), differential diagnostic issues, psychotherapeutic approaches, and the likely increase in number of persons seeking therapy for spiritual problems. It also presents the preliminary findings from a database of religious and spiritual problems.

A significant spiritual injury is considered to be present if the person states that he/she experiences any of the following feelings “often” or “very often”:

  • Guilt over past behaviors
  • Grief or bereavement
  • Life has lost its meaning or purpose
  • Despair and hopelessness
  • Anger and resentment blocking peace of mind
  • Doubts or disbelief in God
  • Fear or worry about death
  • Life or God has treated you unfairly.  By Chaplain Everette L. Wright  (307) 672-1633


4. Death

Explore https://www.nlm.nih.gov/medlineplus/endoflifeissues.html

Death is not meaningless. People with a spiritual life find solace in their grief. Meanings of death may be outlined as follows:
4.1    Physical life for man is an event, starting with birth and ending with death.
4.2    Life for God is not set in time, with Him there is no start and no ending.
4.3a  (Choose a or b): Death is a normal event and is final.
4.3b  Death is not a normal God-designed event and is only temporary. The God without end wants to welcome your fellowship without end.

The 5 steps in grieving, according to Kubler-Ross, are denial, anger, bargaining, depression and acceptance.


  • I have the right to be treated as a human being until I die.
  • I have the right to maintain a sense of hopefulness, however changing its focus may be.
  • I have the right to be cared for by those who can maintain a sense of hopefulness, however changing this might be.
  • I have the right to express my feelings and emotions about my approaching death in my own way.
  • I have the right to participate in decisions concerning my care.
  • I have the right to expect continuing medical and nursing attention, even though “cure” goals must be changed to “comfort” goals.
  • I have the right not to die alone.
  • I have the right to be free from pain.
  • I have the right to have my questions answered honestly.
  • I have the right not to be deceived.
  • I have the right to have help from and for my family in accepting death.
  • I have the right to die in peace and dignity.
  • I have the right to retain my individuality and not be judged for decisions that may be contrary to the beliefs of others.
  • I have the right to expect that the sanctity of the human body will be respected after death.
  • I have the right to be cared for by caring, sensitive, knowledgeable people who will attempt to understand my needs and will be able to gain some satisfaction in helping me face my death.

ERIC_NO: ED266353, Psychotherapy with Older Dying Persons, Dye, Carol J., 1985:

ABSTRACT: Psychotherapy with older dying patients can lead to problems of countertransference for the clinician. Working with dying patients requires flexibility to adapt basic therapeutics to the institutional setting. Goals of psychotherapy must be reconceptualized for dying clients. The problems of countertransference arise because clinicians themselves are not prepared for death. In therapy the clinician too is caught up in waiting for the death of the client. The sights and smells of terminal illness may be repulsive to the clinician. Therapy with dying clients and their families must be time flexible; therapists are needed at irregular times. Therapists should assist clients in the productive use of defense mechanisms in the dying process. A therapeutic relationship is best established as soon as the client knows he or she is dying. The therapist can help clients to determine the best use of remaining life and aid them in reviewing their life constructively. Dying people need to retain as much control of their lives as possible, especially in the face of medical intervention and pain. As the client becomes more isolated from people, therapists can provide needed support. The therapist should remember that clients have little energy for emotional therapy. Finally, all dying people are not in need of therapy; many already have their own personal philosophies which help them cope with death.




  1. What is the meaning of your life?
  2. How has your spiritual journey been so far?
  3. What resources did you or could you bring to a spiritual emergency?
  4. What would a short eulogy of yourself look like?
  5. How would you foster spiritual health in a client or friend?

A spiritually healthy Christian may regularly reviews helpful answers to these questions

  • How do I experience the presence of God in my daily life? Isa 6:1-8, Ps 51, 100, Acts 7:30-34.
  • How does God answer my questions through the Bible? Ps 119:97-105, 2 Tim 3:14-17.
  • What is the meaning and purpose of my life? Esther 4:13-16,  Ps 28:12-18, Mat 5:13-16, Acts 26:12-18.
  • How do I relate to God in prayer? Dan 9:17-21, Mat 6:5-15.
  • In what ways do I love, respect and help my neighbors? Lev 19:11-18, I Cor 13:1-13.
  • How does God heal my anger, fears and disappointments? Isa 41: 8-14, Eph 4:25-32.
  • What shows that I have joy and inner peace in my life? Isa 26:1-4, Phil 4:4-9 and other sources.


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