I would like to take the opportunity at the beginning of the new year to add spirit to mind and body. Spirit, in addition to mind and body, is a crucial component in quality of life, satisfaction, sense of meaning and hope. Clearly these are important aspects of all lives, not just for those facing cancer. Cancer, or other serious physical illness, often changes the role of spirit in one's life or changes one's attitude towards it. I refer to spirit and spirituality in the broader sense. While there is overlap with organized religion, certainly organized religion is not always a part of spirit and spirituality.

While the following list certainly is not complete, I would like to discuss a variety of spirituality issues that may arise during a cancer experience. I would love to receive your comments, reactions and additions to this list.

Stages:
These may occur in any order, at any time, and in any combination. As well, you may experience none, some, or all of these issues.

Spiritual Denial:
This may occur in a number of different ways. When biomedical concerns are overwhelming, such as during initial diagnosis and treatment, or with pain or other physical symptoms, there simply may not be enough room to allow spirituality in. Spiritual denial is also a part of modern medicine's mind/body split, though the spirit is beginning to emerge as health care moves toward a new integrative paradigm.

Spiritual Doubt and Questioning:
Illness understandably throws one's world and world view into turmoil. No less than the meaning of life and death may be brought under scrutiny. We in the cancer treatment setting need to acknowledge this and provide support to those facing these issues.

Spiritual Guilt:
This feeling arises when you feel responsible for your own illness or feel badly about past aspects of your spiritual life. Guilt is a very uncomfortable feeling. Guilt may occur when blame is completely undeserved or, possibly, when blame is somewhat understandable, but guilt is felt much more strongly than it needs to be. Self-forgiveness for past real or imagined misdeeds is an important process for helping to work through guilt.

Spiritual Awakening:
This is the flip side of denial. When awakening occurs, long dormant (or even previously non-existent) exploration of spirit opens up. The spiritual traditions of the world have much to offer those suffering from physical illness. Spirituality can act as solace and provide meaning in difficult times. There is no better time than the present to allow the sense of spirit into your life.

Spiritual Reordering and Prioritizing:
Many faced by illness learn to reorder and reprioritize many parts of their lives. Concretely, illness throws all into disarray and work, family, and social commitments need to be altered to some degree. Along with the reordering of the everyday, is the opportunity for reordering of meaning and spirit. What in your life is truly important, sacred and meaningful, and how, in the midst of chaos, do you work toward a sense of inner peace? Certainly this is a challenge, but it is a challenge with much to offer as you continue on the journey of your life.

Spiritual Transcendence:
This is the feeling many of us hope to cultivate. Transcendence is a sense that the world represents a unified whole. Transcendence is a sense that life and death are part of a scheme larger than ourselves. Transcendence is an acceptance of the unchangeable, while still working to modify that which can be changed. Transcendence is inner peace, reached in any number of ways.

Clearly there are negative and positive aspects of spirituality. Exploration and openness to these issues is not always easy or well-timed. Awareness and dialogue are important tools to address these complex issues.

I wish Happiness, Health and Healing to all.

Burt