There have been during this century, a number of psychological paradigms which may now be revisited with a view toward identifying their relationship to Spiritual Consciousness. There may be defined a three dimensional framework for religious experience:

Religion as means, as end, and as a quest.

Extrinsic (utilitarian & pragmatic) vs Intrinsic (consciousness enhancing) religious practice may also be defined.

Extrinsic practices create the appearance of being religious rather than being on the way of practicing religious focus.

Intrinsic is an internal orientation to the existential aspects or ontological aspects. Is integrative Allport's three dimensions of mature religion: 1) Interests beyond immediate physical needs, 2) objective self and as others see one, and 3) possession of a unifying philosophy of life. Whether a person is intrinsic or extrinsic appears to have significant implications for wellness, recovery from illness and quality of life in a number of areas.

The following quotes are found in Spilka, 1977:

"There is an extensive psychological literature that relates our views and behavior toward others to the kind of religion we hold. Persons who manifest and open minded quest religious orientation tend to be unprejudiced and respond to others more as individuals than simply as members of groups...In other words, their attributions toward others do not involve categorically based pre judgments. In contrast, an extrinsic utilitarian faith has been associated with negative and dehumanizing categorical attributions to others." (p-8)

"When intrinsic religionists are singled out the high sense of God control remains, but personal control increases along with evidence of psychosocial competence." (p-12)

"The implications remand that true intrinsic religion constructively unites internal and God control in an active person-active God Sense, and this combination pictures a faith that is truly functional...Demanding conformity and not individual thought and action the person becomes powerless regardless of the spiritual rhetoric that is employed." (p-12)

"A faith that supports false generalizations about groups of people is socially and personally dysfunctional-- socially, in that it works against cooperating and peace, and personally for its reinforcement of an unrealistic sense of vulnerability and insecurity by pitting person against person." (p-8)

McSherry et al (1987) has also concluded that the spiritual resources in the generation of elderly men have not been adequately nourished by their community so to develop their own intrinsically strong spiritual resources, thereby creating a condition that makes the spiritual contributions of prayer, which must be related to intrinsically in the Mystical Paradigm, all the more important during the hospitalization of such patients.

Examples of such faith group linkages have been found to have systematic correlation's with hypertension. Levin and Vanderpool (in Levin and Vanderpool, 1989, page 71,) have summarized a variety of studies that have demonstrated the correlations as shown in Table 1 below: Matthews, Larson and Barry (1993) have reviewed many religions and have concluded that many of the above studies had methodological flaws. Regarding the Adventist type data supporting the protective value of religious commitment, direct causal conclusions are to be avoided and more controlled studies are needed. Other measures that produced a positive correlation with religious commitment as measured by religiosity variables included greater protection against hypertensive illness among those who believed in "bewitchment," and greater religious attendance, and church membership than those who were less protected. Further the number of a father's years of Yeshiva preparation produced protective benefits against hypertension for the daughter's of such fathers. There are many studies that have examined the role of religious influence on aging patients, a category of patients highly salient for the mission of geriatric medicine. n an earlier study, Levin and Vanderpool (1987) also identified protective benefits for religious commitment under various definitions including: healthful cardiovascular patterns, negative pap smears, incidence of cervical cancer, risk of mortality due to neonatal mortality, total mortality, symptomatology and depression, cancer related risk factors, incidence levels, pain level and total mortality, subjective health, and alienation in dialysis patients. If simple involvement in religious practice can be salutary to a patient's recovery and outcome, what the are the implications when a Chaplain's or clergy's direct healing potential through spiritual empowerment is brought to the treatment protocol. In a recent report I have obtained (Koenig, 1991), the author states: "Research findings indicate that traditional Judeo- Christian beliefs may be related to adjustments and well being in later life."

The following factors are found in the literature which may be defined as correlates with Spiritual healing. In is 1990 article, Harold Koenig, a gerontological physician while at the VA hospital in Durham, now at Duke University, provides a summary of research data in support of the above claim of salutary health effects being correlated from religious variables, which allows for a possible exception to the trend of data when religious themes are found in psychotic illnesses. The confounding mechanism is not clear. Koenig, (1988) also reports that there is an increasing obsession by elderly and terminal patients with death related thoughts which create considerable stress that is dysfunctional for health. He finds that this stress is ameliorated when such patients are in a profile represented by strong religious variables, especially those associated with prayer being more potent than other religious variables. He notes however, that the accuracy of such variables as "church" attendance declines when patients become enfeebled or unable to travel or to enjoy social activities. Therefore such variables as simple association with church attendance become less valid measures under such conditions. Further more, he cautions that there are anomalies in such pro religion trends that need to be further investigated to understand the factors and reasons for such anomalies. In another 1988 study, Koenig, Kvale and Ferrel found that religious attitudes, activities and commitment tended to affect measures of health, while sociodemographic factors such as church attendance, group support and financial aspects, tended to more directly affect coping, morale and well being. The authors conclude that:

"The pastoral counselor often with considerable training in both psychological and religious methods, may play a vital role in fulfilling the expanding need for mental health care... a moderately strong association between religion and morale in a sample of community-dwelling elderly has been demonstrated in this present study, and suggested that religious behaviors and attitudes are involved in the complex interacting of health and sociodemographic factors affecting well being." (Page 27)

The conjunction of "science" and "religion" appears at hand. McSherry, et al has found instances where mental health services to needy clients may approach either group unilaterally. In this era of major changes in interpretive paradigms, more and more the claims of religion going back into the earliest mystical times have affirmed and proclaimed that humankind's essential nature is spiritual. No matter what the characteristics of a sacrament, or protocol that has been developed by the various faith groups, then even at the most physical level there is a strong correlation between human contact of all kinds and its direct impact on health status. These translate into economic savings when the elderly requires less intense or prolonged healthy care as a result of a heightened spirituality that prayer can nourish (McSherry, 1991.) There is yet another arena in which there is a relentless accumulating of credible evidence that we are not alone, and that everything that the sacred scriptures and cultural mythologies have been saying since the dawn of human consciousness is true. There is a spiritual realm from which we come and to which we return, and for which are being here has some kind of purpose. This is the area of the NDE (Near Death Experience). I will return to this topic later in the book.

A. Effects of religiosity and spirituality related to health: The following literature provides a context for the relationship of religiosity and related surrogates for human "Consciousness" as contributory to health. Larson and Larson (1992) in manual intended for use in the education of clinical providers have presented extensive conclusions based on a systematic review of literature with those findings applicable to religion and spirituality as independent constructs affecting health. They have concluded that religion and spirituality are profoundly important forces in wellness and recovery, but have suffered from inappropriate adverse neglect and prejudice. Larson et al (1986.) stated that only one percent of 2,348 studies included one or more religious variables, and only one study included a multidimensional religious commitment questionnaire that had been tested for its statistical accuracy. They carefully document the variety of ways that competent research has shown the efficacy of spiritual forces as factors in wellness and recovery.

The following studies are reported by the Larson and Larson (1992) reference: Mental Health: The authors cite a number of studies that document a consistent negative, discounting and even hostile attitudes among segments of the scientific community. They note that a "Gallup poll (1985) demonstrated that about 72% of the US population state that their "whole approach to life is based upon religion." However only 33% of psychologists, 39 % of psychiatrists, 46 % of social workers and 62 % of family therapists were religious according to Bergin and Jensen (1990). This discrepancy between the general population can be expected to appear within the VAMC community and affect the capacities of treatment teams that include mostly psychologists, psychiatrists, and social workers.

Even support for the role of pastoral counseling from psychiatry (Waldfogel & Wolpe, 1993) does not acknowledge or affirm chaplains or pastoral counselors as devoted and effective agents of spiritual intercession. Pastoral counselors are useful in treatment teams not as literal agents of healing but as "culture brokers" to mediate (as though they were separate) medical treatment with the religious structure and experience of the patient. Depression: Among elderly female patients subject to the severe trauma of hip replacement surgery, recovery as measured by effort and success at walking was positively correlated with religious beliefs (Pressman, Lyons, Larson & Strain, 1990). Four other studies are documented whose results are consistent with these effects. Re-Stress and Well-Being: Williams et al, (1991) found that both direct and symptomatic expressions of stress measures correlated with religion with the effect that stronger religious involvement produced better coping and less systems in the presence of induced stress. Similar results were obtained in epidemiological studies by Lindenthall, et. al. (1970) and Stark (1971.) Physical Health (Longevity, Blood Pressure, Cardiac Disease): Zukerman, Kasl and Ostfeld (1984) reported in an epidemiological study in the New Haven area that mortality levels after hospitalization were less when patients were involved with religion, and that the discrepancy doubled after two years. The effect was sustained when race, gender, age, health measures and prior hospitalizations were controlled. Likewise, after controlling for other variables House, Robbins and Metzner (1984) found that in an 8 to 10 year follow up of 2,700 persons, of women only, increased church attendance was found to be protective of mortality. In another 1988 study, Koenig, Kvale and Ferrel found that religious attitudes, activities and commitment tended to affect measures of health, while sociodemographic factors such as church attendance, group support and financial aspects, tended to more directly affect coping, morale and well being. The authors conclude in support of the role of pastoral counseling, that:

"The pastoral counselor often with considerable training in both psychological and religious methods, may play a vital role in fulfilling the expanding need for mental health care... a moderately strong association between religion and morale in a sample of community-dwelling elderly has been demonstrated in this present study, and suggested that religious behaviors and attitudes are involved in the complex interacting of health and sociodemographic factors affecting well being." (Page 27)

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