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Spiritual causes of physical pain


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Dr Tim Harlow, Hospiscare Consultant …

Dr Tim Harlow, Hospiscare Consultant
Spiritual causes of physical pain, presented at the Holy Living, Holy Dying conference held in Exeter on 2 November 2009

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  • 1. Spiritual Causes of Physical Pain Tim Harlow Caring in Devon
  • 2. Palliative Care
    • “ Active total care of patients whose disease is not responsive to curative treatment, where the control of pain, of other symptoms and of psychological, social and spiritual problems is paramount, and where the goal is the best quality of life for the patient and their family” Back, N. Handbook Palliative Medicine: 2001, p188.
  • 3. Doctor, why am I ill? Your heart valve leaks. Yes but why me? Wait, I’ll call the vicar. Bert Keizer 1996, Dancing with Mr D
  • 4. “ Total Pain”
    • Dame Cicely Saunders
    • Iceberg- Tip we see is physical pain, driven by many other things underneath
  • 5. One of those things underneath is spiritual distress
  • 6. “ When a man lies dying, he does not die from illness alone- he dies from his whole life” Charles Peguy (1873-1914) Basic Verities
  • 7. Does Spirituality matter ?
    • A significantly larger number of terminally ill adults indicated a change towards increased spirituality Reed 1987
    • Spiritual Well Being associated with decreased desire for hastened death, decreased hopelessness, suicidal ideation, depression McClain 2003, Nelson 2002
  • 8. Weathering the Storm: the “dark night of the soul” (St John of the Cross -1577)
  • 9. Yes- it really matters
    • We do see pain which is difficult to control but which is eased significantly by addressing the spiritual
  • 10. Spiritual?
    • The Quest for meaning
    • Deliberately wide definition- many non-Christians will use Christian context and language
    • Many will have a Christian Faith
    • Many of those who wish to help will come from a Christian background
  • 11. Meaning?
    • Despair is suffering without meaning (Victor Frankl, 1975)
    • Suffering is pain without meaning ( Nietzsche)
  • 12. Interpretations of Spirituality
    • “ Jesus is with me. So many people are praying for me, I will join the Lord when He wills it.”
    • “ It is not for us to know when it is written that someone will die, we must trust in Allah.”
    • “ It is the nature of existence to suffer, the suffering will be left behind when I leave this body behind.”
    • “ I am a grain of sand in the cycle of evolution.”
  • 13. Non Christians?
    • Many people will have an element of themselves reasonably described as “Spiritual”
    • Maybe specific faith- Christian, Muslim, Jewish, Hindu, Buddhist- may need to help them within that context
    • Maybe no formal faith- still have significant component of spiritual distress or insight
  • 14.  
  • 15. Deathbed conversions?
    • Faith is enhanced amongst those with a strong faith
    • Faith did not emerge in those without a faith initially- [great challenge for those attending with a strong faith themselves].
    • Spirituality increases over time and is greatest at death (Thompson, 2008, Strathcarron Hospice)
  • 16. Not just what causes pain
    • Pain in the context of fear and feeling out of control can be unbearable and overwhelming, whereas pain that is expected and for which there is known to be relief available, if wanted, is much more often bearable. Iona Heath 2008
  • 17. Tahir
    • 32year old man. Close family, exiles from homeland. Cancer affecting bones, multiple sources of pain- nerves, bones, back. Pain very difficult to control.
    • Often found his predicament unbearable.
    • Suffering, not good in itself but recognised as natural -guidance from Imam.
    • Times when Tahir seemed inconsolable but greatly eased by readings from the Qur’an
    • Medication vital but very far from enough.
  • 18. Nigel
    • Deep Christian faith, church very important part of his life such that his pain and painkiller requirements decreased significantly when he was able to get to the cathedral once more.
  • 19. Absolution
    • From many sources clergy, friends, family.
    • Very important need, can help the whole person, including their physical pain. Hidden experiences
    • Opportunistic- not see as our role?
  • 20.