People are not their disease. The terminally-ill patient says I have cancer and not I am cancer; I have Lou Garrick’s disease, not I am that disease; I have alcoholism, not I am alcoholic. And people are not their mental illness. The patient suffering schizophrenia says I have schizophrenia, not I am schizophrenic; I have bi-polarity, not I am bi-polar. The conditions of disease and mental illness affect us deeply, perhaps leading to mental collapse or death, but they do not define the whole of us. These conditions call for curing in some cases while they always call for healing. Healing is the provenance of spirituality. In this case, the condition defines us. The distinction between being spiritual and directing that spirituality in a constructive way is fundamental to good health as we recover from all our losses. This is not always an easy task because how can we find meaning in the face of a terminal-illness or mental disease? The quick answer to that question in medicine lies in the dual role of curing and healing. The goal of medicine is not only to cure disease but also to present the opportunity for personal healing in the face of disorder. This is accomplished through the integration of mind and body with or without curing disease. The goal of religion, on the other hand, promotes a different kind of healing. The faithful heal mind and body by entering into communion with the divine through the development of culturally sensitive rituals and symbols. The role of 12-Step programs, on the other hand, promotes recovery and healing through the identification of and removal of obstacles to personal growth. The role of these programs is to identify and redirect misdirected spiritual energies. The arts play a positive role in all these healing outcomes as a conduit to the integration of mind and body. Unity is a sign of perfection. The greater the mind body unity, the better the application of spirituality to life experiences.

The nature of spirituality as such is illusive because we are that very spiritual being seeking to know itself. It seems possible to deconstruct the nature of spirituality after the fact, that is, in its operations to uncover it as a movement towards a search for meaningful values and the integration of mind and body. This fact is illustrated in the classroom through a mock death condemnation. Everyone is mortal but most of us are not sure when our personal death will occur. I settle that matter in the classroom as each academic year I sentence students in my spirituality and health class to death, not because I dislike students but because I believe that facing our very own death can function as a means to uncover the nature of spirituality. The realization of personal finitude makes the point that spirituality’s search for meaning is value laden. We begin the exercise with a reading of Leo Tolstoy’s novel The Death of Ivan Ilyich, followed by a discussion of Martin Heidegger’s work Being and Time and the chapter he devotes to the existential study of death. Human death, he says, is an integral component of our (Dasein’s) fundamental essence much in the same way as embodiment, concern for the environment and other persons, anxiety, and temporality characterize us. Heidegger explains in insightful though convoluted metaphysical language how the acceptance of personal death functions as a source of inspiration. The key to this insight lies in the distinction he establishes between death as a process of life and death as an event that happens to us someday. Heidegger makes the point that personal death is an integral component of our very being (Dasein) here and now rather than a threat lurking in the distant future. Once I accept death as an integral part of my nature, it functions as something positive, namely as a source of inspiration to make the best of the time allotted me. The nature of spirituality can be cast in a similar light as it functions as a source of inspiration to make the best of the time allotted me. Thus spiritual energies focus on making value laden choices rather than on finding meaning through the pursuit of trivia.

Raymond Moody’s research into the near-death experience also provides psychological evidence that the experience of death, more literal than hypothetical in this instance, functions as a source of inspiration to make the best of today. The thoughts of Tolstoy, Heidegger, and Moody crystallize an essential characteristic of spirituality and the search for the higher meaning of life. My students’ classroom death condemnation experience provides time for reflection as the sentence takes effect the following morning at 5:00 when blood sugar levels are low. I invite them to write their obituary, though I leave the manner of death to their imagination. I invite them to provide details on how to spend the final 12 hours of life. Some reactions are humorous because the thought of imminent death is too much to handle all at once. But the greatest source of insight comes from individuals that can and do accept the possibility of their very own death. In most instances, their spirituality clock runs ahead not to material concerns like giving possessions away or doing laundry but to human values and the deeper issues of life such as sharing an expression of love with a parent, sibling or friend, and on occasion making peace with God. The reminder that I am running out of spirituality (and death) is a powerful incentive to enter into relationship with the sacred.

Spirituality as an embedded part of human nature is factual rather than normative. The study of how this concept has been used since mid-1980s reveals its great flexibility. The most frequent use of spirituality is in its connection to religion. Religion and spirituality have many points of commonality and points of departure. The research of Hill, Pargament, Hood, MCCullough, Swyers, Larson, Zinnbauer [1] provides rich detail on this connection that set the agenda for future research in this area. The criterion they provide for spirituality is the first of the criteria proposed for religion, namely;

“The feelings, thoughts, experiences, and behaviors that arise from a search for the sacred. The term “search” refers to attempts to identify, articulate, maintain, or transform. The term “sacred” refers to a divine being, divine object, Ultimate Reality, or Ultimate Truth as perceived by the individual.”

The religious criteria, on the other hand, include “The means and methods (e.g. rituals or prescribed behaviors) of the search that receive validation and support from within an identifiable group of people”. Further, Hill et al. provide a criterion for spirituality that is of possible use in religion and in other applications such as health care; “A search for non-sacred goals (such as identity, belongingness, meaning, health, or wellness) in a context that has as its primary goal the facilitation of (spirituality as defined above)”. The present paper addresses these concerns in the sections that follow. I found it necessary, however, to add religion’s concern with the afterlife state to fully explain how spirituality and religion are not connected. Further, I added a criterion on a process required to remove an obstruction to spiritual growth in 12-Step recovery programs and in medicine to clarify in more detail how the spiritual has a life of its own outside religion. The spiritual character of the arts provides a test case for the points of commonality and points of departure between spirituality and religion, however.

A dozen or so years after the appearance of Hill’s foundational article, Hadzic [2] finds that the concept spiritual remains unclear. He suggests that future research could clarify matters by contextualizing the connection between spirituality and its application to religion. In my opinion, the connection between spirituality and authentic religion is clarified through the introduction of a fresh criterion for religion, as well as through the anthropomorphic lenses of systems such as culture, society, politics, economics, and ethics. Second, the connection between spirituality and religion can be clarified by examining the applications of spirituality in a non-religion setting. This provides an additional element to recast the connection between spirituality and religion with clearer light.

The word spiritual is from the Latin spiritus meaning breath or life. Spirituality is the engine that drives human breath and existential restlessness. John Daniel Wild claims that this restlessness provides an argument for the existence of God. The explanation is that no finite good curbs the demands of existential restlessness as the insatiable search for meaning continues until we discover God as the source of infinite meaning. Viktor Frankl’s classic work Man’s Search for Meaning, identifies love as the highest good towards which we can strive. Frankl’s experiences in an Auschwitz concentration camp during World War 11 taught him a lesson in spiritual survival through the visualization of his wife and the love he felt for her. The search for higher meaning is the cornerstone of life, as is evident in some student reactions to the death condemnation, and as is plainly the case in Frankl’s concentration camp experience. Moments of intense pressure bring this search for meaning in clearer light although spiritual energies continuously prod us to find meaning in all our relationships the spiritual force is loudest in the face of illness, disease, broken relationships, and times of crisis. We turn to psychology, medicine, religion, and self-help gurus to find what is hidden within the depths of psyche. Spirituality is the engine that drives the search for healing and recovery from all our broken associations. The pursuit of meaning is generally directed towards what is best about the human condition. Healthy individuals strive to be more loving, compassionate, caring, forgiving, and tolerant in all their associations—qualities we usually associate with spirituality. But the same spiritual search for ultimate meaning can also be directed towards the worst destructive elements of human nature or quite simply the pursuit of disempowering relationships. The fact that our relationships never completely satisfy us provides insight into the meaning of spirituality. In the first place, many people find meaning in the pursuit of secular ambitions. My desire for a new chesterfield or curtains is not a spiritual ambition. However, my desire to enter into relationship with the sacred is spiritual. In that light, spirituality is connected more with religion than with a furniture store. But spirituality can also be applied to medicine, a recovery program, or the arts in as much as they serve as a conduit to the sacred. The sacred finds expression in love and compassion, as Frankl discovers through his experiences at Auschwitz. In light of this it seems possible to suggest a provisional definition of spirituality: Spirituality is an innate search for sacred meaning. That search is misdirected whenever spiritual energies move us to substitute the secular for the sacred. This is because the spiritual tendency is factual rather than normative as we frame the meaning of life in a way that reflects the best and worst of the human condition.

Since spirituality is always expressed through human relationships, applied spirituality connects with the types of relationships that characterize persons. It is not surprizing that Spilka’s [3] review of the literature lead him to conclude that spirituality is a multidimensional concept. Spirituality is multidimensional because a person is the output of multidimensional relationships. A person is the output of three main clusters of associations or relationship streams, active and passive. The best way to begin this study of what makes us persons is by stating what we are not. The relational nature of being human suggests that the tendency to refer to the self as I, ego, or subject of experience is a misleading abstraction. No self and therefore no spirituality exist outside of relationships. This view provides an operational framework for the search for spiritual meaning. It seems clear that when Descartes cuts himself off from relationships in his Meditations on First Philosophy, he left no foundation for a ‘cogito ergo sum’. Nothing exists outside relationships. We appear to be the output of three main streams of relationships. Spirituality exists in one or more of those clusters, or not at all.

Our most basic spiritual connection exists at the level of matter and energy or the carbon-self. The strings of relationships that take place at the level include our genetic structure and the whole of the environment [4]. Life begins as the output of relationships between sperm and ovum in a physical uterine environment. The mother’s environment is itself a product of carbon based relationships along with other determining and self-determined relationships. Persons are born out of relationship with the whole of nature. We form a dynamic unit with nature. The carbon-self includes the physical brain and associated processes though I situate the mind in another set of relationships called the psychological-self or internal-self. The carbon-self is basic to human life. Disease destroys the carbon based unity of a person. Disease affects the whole of a person, including all relationships with other persons as well as relationships taking place at the level of the psyche. The pollution of the environment provides an instance of a disempowering spiritual connection. We are an extension of the environment and therefore environmental degradation leads to a qualitative change in all the relationships that characterize us.

The second stream of relationship to individuate persons is the social-self. The social-self cluster of associations includes all person based associations, as well as associations with pets and all other living things. A person is the output of a social network consisting of parents, siblings, relatives, friends, neighbors, society-at-large, animals, and other living things such as trees, and plants. At birth, the existing social network of others is forced into the mix of relationships that characterize persons, but gradually as the psyche begins to emerge, persons proactively choose some of their interpersonal relationships. Thus, there is no ‘I’ or walled in internal-self peering out at the flood of incoming carbon connections and social connections. Persons are aware of being aware but self-reflection arises out of a third type of relationship. We are aware that we live side by side with others, inhale the same air, drink the same water, and walk, swim, fly or climb common ground. But the awareness of that awareness calls for a third layer of associations.

The third arm of the person-making process is the psychologicalself. This is the repository of all conscious and unconscious processes of mind. The conscious mind is aware of itself as it identifies and processes, restores, and replaces lost or broken sources of meaning. The psychological-self is the clearinghouse of meaning; the place where old sources of meaning are varied and new relationships formed, including spiritual welding or the attempt to heal broken relationships with the psychological self, the social self and the carbon self. The psychological self is the locus of intellect and will, the place where we freely decide to empower or disempower other persons and the environment through love, or acts of violence and war, the place where we decide to empower or pollute the environment, the place where we freely accept, modify or reject the existence of a Supreme Being. The existence of God is necessarily grounded and therefore evident in all our connections, or not at all. No God exists outside the carbon self, the environmental self, or the psychological self. This is an important point to note that some otherwise insightful authors such as Elizabeth Taylor [5] seem to overlook. We do not have relationships of the 4th kind with a God. We either experience the sacred in our carbon based relationships, our socially based relationships, our psychological relationships, or not at all! The nature of spirituality is framed by all person-making relationships. However, we differ by temperament or personality type as can be expected given our varied carbon based and other person based associations.

The person-making process and spirituality in action model provides a foundational perspective for the application of spirituality to various areas of human activity such as religion, medicine, the 12- Step movement, and the visual arts to name a few. The spiritual drive generates our existential thirst for meaning in those areas of human relationships while the specificity of religion, medicine, and the 12- Step recovery movements provide instances of spirituality at the operational level of discovering meaning. For instance, the process of religious healing, not unlike other forms of healing and becoming more truly personal enlists a process of filling the void left behind by lost or broken relationships, as healthy relationships are defined by a religious faith. The recovery movement, on the other hand, brings its own brand of healthy relationships as spiritual applications gone sour result in the production of negative emotions. That process enlists the use of suggested steps to replace negative associations by positive connections with the goal of establishing healthy emotions along the arms of affected relationships. Spirituality clusters on three streams of integrated person-making relationships;

(1) Environmental spirituality clusters on carbon-self (DNA) associations

(2) Interpersonal spirituality (includes animals) clusters on socialself (other persons) associations

(3) Internal-self (Psyche) is the locus of decision making about all spiritually based associations

Sub-categories of spiritual applications: (A) Religion, (B) 12-Step recovery, (C) Medicine and holistic health, and (D) Art as a medium for spiritual regeneration. A person’s spiritual history is detailed through systems analysis (culture, society, politics, economics, environment, and ethics).

(A) Religion: The spiritual character of the major World Religions is contextualized in accordance with environment or geography, culture, society, politics, economics, ethics, and history.

1. First characteristic: Doing good things and the 1.1 Carbon-self, 1.2. Social-self and 1.3. Psyche.

2. Second characteristic: Relationship to the Supreme Being and the 2.1. Carbon-self, 2.2. Social-self and 2.3. Psyche. Spiritual application for some Christians includes a connection to the Blessed Trinity of Father, Son, and Holy Spirit.

3. Third characteristic: Belief in the afterlife state (contextspecifics include environment [reincarnation], other persons [spiritual body], and psyche [karma, heaven or hell, or return to the Unmanifest of creation]

(B) 12-Step movement: A spirituality of recovery from negative dependence

1. First characteristic/carbon-self: Ego deflation (powerlessness and unmanageability).

2. Second characteristic/social-self: Higher Power manifested through other persons in recovery.

3. Third characteristic/internal-self: Anonymous Promises’ (emotional maturity as spiritual progress).

(C) Medicine: Curing and healing patients.

1. First characteristic/carbon-self: Curing disease through science and technology.

2. Second characteristic/social-self: Healing through compassionate care.

3. Third characteristic/internal-self: Personal acceptance and peace.

(D) The Arts as Spiritual Conduit: Beauty as a spirituality of intuited consonance between natures.

1. First characteristic/carbon-self: the brain and spontaneous insight.

2. Second characteristic/social-self: View the world as an interconnected whole; relationships and patterns.

3. Third characteristic/internal-self: Intuition and creativity; relational connections rather than linear associations.

How does spirituality apply to religion? All persons are spiritual but not everyone is religious. Markham [6] found that fifteen years ago approximately 83% of all people belong to some form of organized religion. Hitchcock and Esposito (Geography of Religion, 61) have somewhat lower numbers (77%) for the worldwide practice of religion but the numbers confirm the close connection between spirituality and religion. The connection between spirituality and religion is clearest in the Abraham religions. Hitchcock and Esposito distill the main elements of religious connection as being (1) a belief in the value of acts of kindness, (2) a belief in the existence of a Higher Power, Supreme Being or God, and (3) a belief in the existence of an afterlife state. While the search for ultimate meaning is different for some Hindus and for Buddhists, the common element is the spiritual search for happiness. In Christian circles, Jesus the Christ opens greetings with “Peace” (Shalom) which means ‘whatever you need to be happy’.

The connection between spirituality and religion is expressed on the arms of the person-making process. Further, the nature of a given connection is determined by systems, namely the cultural, societal, political, economic, and ethical dimensions of a person entering into a religious connection as an expression of ultimate meaning. Each of these systems has a history. For instance, the search for meaning in Christian spirituality is enacted through relationship with Christ [7], which is to say a relationship expressed through the lenses of the Blessed Trinity because Christ as divine is the connection between God the Father and God the Holy Spirit. The spiritual dimension of the person-making process enables us to establish a connection in Christian theology between God the Father and the carbon-self, God the Son and the social-self, and God the Holy Spirit with the spiritual wisdom that emanates from the psychological self. The elements to furbish this spiritual detail are gleaned from the Old Testament as well as from the New Testament bible. On the other hand, the spiritual history of Judaism is told through a cultural, societal, political, economic, and ethical setting of the Old Testament as a religious paradigm. Thus the spiritual voice is articulated in this perspective through God the Father alone. In Hebrew scripture the Father is the Creator and therefore represented on the arms of the carbon-self set of relationships. The absence of reference for the social self and the internal self also helps to explain why not all Jews believe in God as personal or in the afterlife state of existence. The full details of this focus moves beyond the range of this paper but enough said to illustrate the connection between spiritual and religion is made through the filter of history and systems. The connection between spirituality and Buddhism, on the other hand, is enacted without reference to a transcendent deity. We could argue that Buddhism is not a religion because of that omission. Buddhism is clearly spiritual but not necessarily religious because the search for meaning is expressed as a state of enlightenment arising out of the absorption of the ego into the All of existence rather than in the encounter with a personal God through the transparency of a personmaking outcome. The point is to get away from personhood and the apparent suffering it carries in its wake. Spirituality in Hinduism is freedom from the illusions of the manifest and a return to the Unmanifest. Again Hinduism is not a religion though all Hindus have strong spiritual beliefs. Some Hindus are Christians. Thus, spirituality exists without religion, but authentic religion is necessarily spiritual. This is because the process of filtering the spiritual search for higher meaning through the lenses of systems (culture, society, politics, ethics, and history) allows for the expression of spirituality in a richer setting. This enables the adherents of a religious faith to root their search for higher meaning in a setting that incorporates their lived life experiences into the religious narrative.

The term religion is from the Latin verb ‘religare’ which means to reconnect or unite. Religion uses rituals and symbols as a bridge between individuals and the sacred to accomplish this reconnection. That connection promotes holistic healing because it also suggests a reconnection between the healing roots of the sacred and the arms of person-making. Thus religion promotes healing of body, social relations, and the inner self. Religion is a source of comfort for the faithful because it bridges the gap between the personal self and the supernatural. This connection begins with an intuited insight or faith claim. Religious doctrine descends from above (deductively) to feed persons but the descent has to land on willing thirsting ground that individuals can recognize as being spiritually based. Organized religion is the objective response to our spiritually based quest for meaning. In this imagery spiritual thirst ascends towards the unconditional love and forgiveness that only a deity can dispense. Organized religion is not for everyone because the religious leadership role is often abused and exploits the spiritual thirst of the faithful.

Religion can provide a legitimate conduit for the spiritual search for meaning when the connection between the relationships that individuate persons and the relationships that characterize religion blend into a harmonized unit. The particular way this blend works is determined by the systems, namely culture, society, economics, politics, ethics, and history as suggested above. The cultural perspective embodies the individual’s attitudes, values, and beliefs while the societal perspective embraces the significance of group interactions such as family, associations, and institutions. The economic system refers to the structure and processes used to meet basic survival needs. The polity or political system addresses a society’s structures and processes for conflict resolution at government level(s). These four systems are grounded in an ethical belief system and a history as they resolve themselves into homes or places where their effects land on the arms of the person-making process. Ethics provides a guide to the rules of moral conduct expressed by religious beliefs as we seek to determine the ways in which the particulars of systems and homes are in harmony with being human. History provides the sharp focus to make sense of why events happen.

This sets the stage for the integration of the relationships that religion brings to the table of human needs with the actual relationships that define us as persons. In other words, the spiritual search for meaning expressed on each of the three streams of relationships that characterize being human are fed by the religious roadmap for doing good things, entering into relationship with a Supreme Being or God, and the possibility of surviving personal death through existence in the afterlife. On the religious claim that we find spiritual meaning in doing good things.

The first and most basic connection between spirituality and religion is that we appear to be genetically programmed to do what is good. Babies are born with a tendency to be good [8]. Thomas Aquinas’s philosophical theology revolves around the belief that God creates us to be good [9] we naturally move towards the good and avoid what is evil. That principle governs ethical life. Natural law ethics claims that we self-perfect by acting in harmony with this principle. Utilitarianism and deontological ethics express a likeminded formula for seeking to be good, though different from the point of view of history and systems. The desire to act spiritually or move towards the attainment of the good appears to be universal; “I sincerely believe that all of us have an element inside us that allows us to recognize ethical acts, other people’s genius, inspiration and the finer qualities that people possess. I call that essence spirituality” [10]. This view refutes the claim that babies are born as morally blank slates. While cultural differences between East and West direct the tendency to seek the good in different directions, the one towards the individual, the other towards the collective or common good of society, no modern psychologist maintains the view that babies are born as blank ethically neutral slates. The tendency towards seeking the good is genetically based and corresponds primarily to the carbon-self’s search for meaning. All religions assume we have a capacity for the ethical life by performing acts of kindness and compassion. Satanism is the exception since it promotes the search for evil. Religions that promote acts of wrongdoing, such as Satanism and Devil worship, it seems to me, subvert a basic human tendency towards pursuing the good. In fact we can argue that Satanism seeks a distorted perception of the good in the claim that those who pursue evil will be rewarded with a position of authority in hell, thus an ultimate good. No authentic religion promotes acts of wrongdoing without plugging spiritual energies into destructive sockets, however. Humans are free to direct spiritual energies towards the object of choice. Acts of injustice, violence, and murder are aberrations of spirituality and religious faith. Most persons hope for a time when goodness will prevail over evil. Unfortunately we do not succeed in being good at all times. While we can explain this as human error or ‘being human’ the reality is that the tendency to be good is ongoing. The hope that the good will eventually prevail over the bad assures us that the human craving for meaning makes sense. While the tendency towards the good is universal, not everyone is religious.

On the religious claim that we find spiritual meaning by entering into relationship with a Supreme Being; The second characteristic of religious faith leads to a relationship with the divine as the source of ultimate good. Reason discovers that no series of finite goods completely satisfies us and therefore posits the existence of an ultimate good or Supreme Being to meet that internal hunger. The existence of God satisfies our spiritual addiction to the ultimate good. The fact that we do not have universal agreement on the existence or nature of a Supreme Being adds to the richness of the spiritual tendency. If not God then what satisfies our addiction to ultimate good? All religions express a systems based belief in the existence of a Supreme Being of some form. The arguments for the existence of God developed by Anselm of Canterbury, Thomas Aquinas, the French mystic and mathematician Blaise Pascal, René Descartes, Immanuel Kant, and Jacques Maritain and countless others resonate with some individuals because they correspond to that systems individuated pluralistic hunger for God, as Saint Augustine makes known in The Confessions; “Thou madest us for Thyself, and our heart is restless until it repose in Thee”. Cultural differences fine tune the nature of a Supreme Being to reflect an author’s cherished beliefs. Christian religions celebrate the existence of the loving God of the Blessed Trinity as being the ultimate good promised by the innate tendency towards good; Father, Son, and Holy Spirit. Most adherents of the Jewish faith believe in the existence of God the Father rather than in Christ, while Muslims proclaim the existence and absolute goodness of Allah. On the other hand, most Hindu religions express a belief in the impersonal existence of the divine as the Unmanifest; we know the manifestations of the Unmanifest but they are illusory. The point is to move beyond the manifest towards the Unmanifest as the ultimate source of all meaning. On the other hand, Buddhists focus on the problem of suffering. Their belief is that the cause of suffering arises out of the tendency to cling to the self. Thus, the enlightened Siddhartha (the Buddha) develops an eightfold path to purification to offset it. The path ultimately leads the faithful to absorption of the self into the All of existence. Once we become one with the All, suffering ceases because nothing is outside self and we therefore lack nothing. The movement towards the All, the Unmanifest, or the God of Abraham religions generates the promise of spiritual fulfillment, enlightenment or holistic happiness. This realization is expressed on the arms of the person-making process as holistic healing with the dynamic apogee of spirituality at work in each cluster of meaning. The focus towards the Supreme Being shifts from obedience to love, to justice, and to self-effacement depending on systems, but the spiritual quest for ultimate meaning is the common thread that brings everything together.

Non-believers such as Jean-Paul Sartre and Albert Camus speak in different systems based voices because of their personal experiences (WW 11, Auschwitz, the great depression, and sickness in the case of Camus) but they agree on the courage required to live in the face of the irrational nature of the universe (Camus) and the non- existence of God (Sartre). The spiritual quest to uncover meaning is ongoing, however, if only to abandon it. The key to a happy life according to Camus is to accept the absurdity of reasoning while resigning our self to the benign indifference of the universe. The key to a happy life without God and ethical values, it seems, is to accept the absurd without seeking to explain or settle it. Sartre, for his part, issues a call to action in which we retain some belief in the efficacy of reason to form groups that strike out against the world issues facing us such as the scarcity of resources and food. The challenge facing us, if the case for the psychological belief in the existence of God is granted, becomes if not God, then what? In some cases, the 12-Step discovery of a power ‘greater than self’ fills the void as an operational substitute for a deity. If God is dead, as Frederick Nietzsche claims, then, we need some other great belief to fill the vacuum left by the death of God. This feature of spirituality was not missed by Ludwig Feuerbach when he proclaimed belief in God as a human projection and redirected the energy towards humankind. The philosophical sceptic David Hume is not convinced that religion is rational, but he is struck by the order of nature. He remarks in Dialogues Concerning Natural Religions, “The most careless, the most stupid thinker, sees everywhere a purpose, and intention, a design; and no man can be so hardened in absurd systems as to reject that at all times.” The point is that the tendency towards the good must be redirected somewhere else if not towards God.

On the religious claim that we find spiritual meaning by believing in the existence of an afterlife state;

The third connection organized religion brings to the table of spiritual needs is the desire for life after death. Most individuals seek to avoid personal extinction. Religion meets that need through the promise that God’s love for us maintains us in existence after personal death. Religion develops culturally, societally, politically, economically, and ethically sensitive symbols and rituals to express God’s love and to accompany the dead into the next life. The differences among the major world religions are traced to the differences that exist in these varied perspectives. Neville A. Kirkwood’s A Hospital Handbook on Multiculturalism and Religion provides a useful guide to contextualize those settings as Chaplains and pastoral counselors set out to find an appropriate fit between spirituality and religious beliefs of hospital patients.

While the fulfillment of the desire for continued existence after death is a cornerstone of religious belief, the major world religions express different views about the nature of that state. This difference follows in part from the functional role assigned to the Supreme Being. Western religions subscribe to a personal relationship with God while Eastern beliefs tend to view the relationship with the sacred as being impersonal because clinging to the ego is thought to be the primary source of suffering. These differences put the nature of the afterlife in context but satisfy the spiritual search for meaning given the heterogeneous role of systems worldwide. The connection between spirituality and religious beliefs worldwide is expressed through different rituals, symbols, sacrifices, incantations, prayer, and ceremonial dances because of differences in systems (culture, society, politics, economics, ethics, and history). All religions have sacred rituals designed to accompany the dead into their afterlife state. These practices are designed to beseech the Gods to grant the dead safe passage into the next life (reincarnation, or eternal life).

Holy places like Church, Temple, Mosque, Mecca, and the Ganges River provide a sacred space where like-minded faithful gather to continue the search for meaning together. They experience the psychological benefits that arise out of the societal constructs of the social-self in the expectation that the relationships that individuate us in this life will accompany us into the next life. The study of these sacred spaces provides a concrete positioning system to observe how the marriage between spirituality and religion works in any given religion. The process of sharing in religious celebrations generates a feeling of peace as the faithful find ground to believe in the ongoing existence of the dead. Each connection between the associations of personhood and religion generates beneficial health outcomes. The religious view of the self as moving towards the good, the Supreme Being, and the afterlife-state of existence answers a profound spiritual thirst for ultimate meaning. If religion did not exist, spirituality would need to invent something in that likeness.

The way in which spirituality connects with a 12-Step program is different from the connection between spirituality and religion because in this instance spirituality connects with the needs of an individual in recovery from a substance or behavioral dependency (addiction). In this essay the focus is on recovery from alcohol dependency. While this application extends to other dependencies whether behavioral such as sex or gambling dependencies, or substance based as in dependency on narcotics, the focus on alcohol is historically first in line as it was first introduced by Bill Wilson and Dr. Bob Smith in 1935. We continue the use of a methodology that looks to the arms of the person-making process to identify spirituality in action. Thus, the spiritual character of the Anonymous program contains elements that could connect with the carbon-self, the social-self, and the psychological-self. The view of spirituality as kinetic energy explains why it naturally tends to run into the one or more of the associations that characterize persons. The Anonymous literature is explicit on the spiritual character of Anonymous.

From the point of view of the psychological self, 12-Step programs have no explicit connection to organized religion, although an implicit similarity exists between the nature of spirituality in religion (observing God’s commandments) and Anonymous (turning control of life over to the God of individual understanding). Nevertheless this focus provides a clear vision of how spirituality functions without religion while clearing a pathway towards the nature and breadth of religious expression. The essential character of 12-Step spirituality is related to its role in recovery from addiction or substance dependence. To be clear about this aspect of spirituality, let me emphasize that all persons are spiritual, that is, we appear to be driven by an innate search for ultimate meaning. The act of redirecting spiritual energies towards a false sense of meaning can lead to dependency. The addict learns to use that substance or behavior as a way of dealing with negative emotions. Thus, 12-Step spirituality opens as an attempt to reverse false spiritual starts or non-life giving spiritual connections. Such wrongheaded connections are not found only in the realm of substance dependence. Clearly the belief and dependence on God can also become an addiction. Leo Booth claims that “Religious addiction does exist; it is a disease like any other addiction; and it can and should be treated by the same methods used to treat other addictions.” No need to go from the frying pan to the fire. While religious spirituality plays a role in freeing the faithful from sin and guilt, it does use God as a strategy for recovery, as do substance dependents. The first introduction of a 12-Step program intended for personal recovery from substance and/ or behavioral dependency is found in the Twelve Steps of Alcoholics Anonymous. While the Oxford Group’s focus on spirituality and recovery predates Anonymous, and influences its development, the Oxford Group’s intent is primarily that of a religious experience rather than a spiritual recovery. This fact points to an important distinction between spirituality and religion. Furthermore, A.A’s spirituality arises out of deflation at depth rather than in the practice of the Oxford Group’s precepts; absolute purity, honesty, unselfishness, and love. Dr. Silkworth, one of Bill’s early mentors gave him solid advice [11] when he told him not to focus on purity and honesty when working with alcoholics because their spirituality was of a different sort. Rather he ought to focus on deflation of the alcoholic’s ego; “deflation at depth is the foundation of most spiritual experiences.” Without that bit of advice A.A. might never have been born. Carl Jung recognizes the value of Anonymous when he directs one of his patients, Roland H., to seek help from this group [12]. Spirituality can go sour as was apparently the case with Jung’s patient Roland H. Alcohol in Latin is ‘spiritus’ and you can use the same word for the highest religious experience as well as for the most depraving poison.” The spirituality that animates recovery appears to emanate out of hitting a personal bottom, a spirituality gone sour, as others such as Søren Kierkegaard and William James experienced in their personal struggles with melancholia, as is the case with many other gifted individuals.

The clearest expression of the central role of spirituality in recovery is expressed in Anonymous’ 12th Step; “Having had a spiritual awakening as a result of these steps …” Thus, a ‘spiritual awakening’ implies that the alcoholic had otherwise misdirected spirituality until that point. This is to say that the individual in recovery becomes aware of the need to redirect spiritual energies after the fact of the previous eleven Steps. Adherence to the Twelve Steps is prescribed as a necessary and sufficient condition of recovery from dependency. Further, the 11th step’s suggestion that the need to ‘improve conscious contact with God…’ is integral to righting spirituality signals the pivotal role of God or a Higher Power in personal recovery. However, ‘recovering’ might be a more appropriate characteristic of the spiritual awakening than ‘recovered’; the A.A. program promises ‘spiritual progress’ rather than ‘spiritual perfection’. Thus, ‘spiritual awareness’ is an ongoing process of recovering from alcohol dependency.

The study of these steps reveals that recovery is contingent on the discovery of a Higher Power (Step 2) and the willingness to turn ‘will and life’ over to the care of this Power (Step 3). The nature of the Higher Power is unspecified, as expected from a non-religious movement. Each will take from this concept what is needed to recover from dependency. The only requirement for membership in Anonymous is a ‘desire to stop drinking’ [13]. The 12-Steps are suggested as a condition of recovery. While the nature and function of the Higher Power is unspecified, the individual is invited to enter into relationship with it so that ‘God’ could do for the individual what could not be done otherwise. The action of Steps 2 and 3 is presented as a necessary condition of recovery. This is the first indication that spirituality could have a transcendental character, though the nature of the Higher Power is unspecified. The Anonymous program is designed for atheists as well as theists. It arises out of the individual’s relationship with whatever Power the individual identifies as being ‘greater than self.’ No reference to religion is made or intended. The ongoing process of spiritual awakening (steps 4 through 11) then appears to be contingent on an ongoing effort to remove whatever obstacles stand in the way of that relationship with the Higher Power as identified.

Five blockages to ongoing recovery and spiritual awakening (personal deficiencies, defects of character and shortcomings) are addressed from Steps 4 through 5-6-7, and 10, while two other impediments to spiritual growth are found in blocked relationships with other persons (steps 8 and 9). The 11th Step provides an opportunity to deepen the relationship with a Higher Power.

The resultant ‘spiritual awakening’ is concretized through the realization of a number of promises. While the promises contained in Anonymous are expressed throughout its pages, the greatest concentration of promises is found on two pages of that volume. The promises arise as the beneficial outcome of cultivating the spirituality found in the teachings of this program. The emotional benefits of 12-Step spirituality include the discovery of a new sense of freedom, happiness, and serenity; “…that feeling of uselessness and self-pity will disappear (…). Our whole attitude and outlook upon life will change. Fear of people and of economic insecurity will leave us (…). We will intuitively know how to handle situations which used to baffle us.” (Anonymous)

These emotional changes happen because of the connection between spirituality, the Higher Power, and mental states. Anonymous promises recovering addicts that the negative emotions of the past such as the fears, insecurity, and guilt that arise out of mishandling spirituality and past emotional challenges will give way to a new sense of belonging. The belief in the existence of a Higher Power and the individual’s willingness to change provide a promised map to recovery. The act of entering into personal relationship with a Higher Power— usually expressed through other persons in recovery—puts life’s issues into clearer perspective. Anonymous continues; “Are these extravagant promises? We think not. They are being fulfilled among us—sometimes quickly, sometimes slowly. They will always materialize if we work for them”.

It seems possible to conclude that spirituality is a force for meaning but also a force to unmask what stands in the way of meaning; “We recovered alcoholics are not so much brothers in virtue as we are brothers in our defects, and in our common striving to overcome them” [14]. The spirituality of Anonymous is characterized by a process that begins with the recognition and admission of failure. This is an instance of a blockage in personal growth. The experience of ego deflation and failure prompts some addicts to seek out a source of power outside the self. This higher power is God as the alcoholic understand the term. The process of recovery takes place through Steps leading to a spiritual awakening. This sets the stage for an alternate substance free search for meaning. Spirituality in this instance is the awareness that the promise of a meaningful life is at hand without the use of alcohol (or any other minds altering substance). The spiritual awakening and the ensuing physical sobriety ushers in a new era of personal growth otherwise beyond the reach of the individual. The process paves the way for a spirituality now unblocked from dependency to step into the light of recovery to the discovery of a new sense of meaning, possibly through personal counseling. In the words of Bill W; “…sobriety is only a bare beginning; it is only the first gift of the first awakening.”

The dual role of spirituality as a search for ultimate meaning and as a force to overcome whatever stands in the way of a meaningful life is nowhere less apparent in the triumphs of modern medicine to heal a patient when a cure is not possible. Spirituality appears to auto correct in time of crisis and with the help of compassionate care a patient moves on with life even in the face of a terminal illness.

The distinction between curing and healing highlights the dual role of medicine. While the primary goal of medicine is to vanquish disease, healing is essential to the medical objective because the whole person is affected by disease. No one doubts the power of mind over matter. Studies in psycho-cybernetics support this claim because the central nervous system does not distinguish between a real experience and an imaginary one. In this role, as we see in the concluding section of the paper, the use of the arts—visual, musical, literary—to enlist the external senses in the healing process is proving to be successful. The Hippocratic Oath and the current AMA code of ethics express a promise to always act in the best interest of the whole patient. This includes a focus on patient rights such as informed consent, personal autonomy, beneficence and non-maleficence, which are part of our spiritual makeup. For that reason the medical treatment of alcoholism as disease includes a holistic mandate to treat the whole person and to move beyond the disease concept [15]. This focus is relatively recent, since it began to appear in the literature around 1985.

The explanation for the slow development in holistic care in medicine is due in part to the success of medical technology. With each technological breakthrough medicine became more successful in eliminating disease but it also became more impersonal. Couple this fact with the threat of malpractice lawsuits, and what Neil Postman claims is a love affair with medical technology, and the patient comes to be identified with his or her disease. As a backlash against this tendency, courses in spirituality began to find their way into the nursing and medical school curriculums in the mid-1980s. Elizabeth Taylor’s Spiritual Care contains an excellent summary of the literature on spirituality over that thirty year span, plus her own assessment of spirituality as a search for meaning. Taylor defines spirituality as being “(an) innate, universal aspect of being human. Everyone has a spiritual dimension. This dimension integrates, motivates, energizes, and influences every aspect of a person’s life”. Taylor and others such as Burkhardt & Nagi-Jacobson express a like-minded belief that spirituality takes place through relationships and “connectedness with God or Sacred Source, Self, Others, and Nature” [16]. However, the nursing care connection between spirituality and God is not religious. It takes place through a ‘vertical dimension’ [17]. This creates the impression that the connection with God takes place through a relationship of the ‘4th kind’. While Stoll argues that the horizontal dimension of the person-making process serves as the basis for a personal reflection on the connection to God, the point is that the person-making process (my term) is not the actual source of the encounter between persons and God. Further, nursing spirituality’s use of the term Supreme Being or Higher Power invariably substitutes for the religious view of God. This shift seems necessary in light of the inclusivity of nursing care. Not all patients are religious or believe in the existence of God, though most would agree about the existence of a power greater than they are. All persons are spiritual by nature but the search for ultimate meaning generates non theistic alternative outlets for atheist and agnostics. Thus, the nature of spirituality in medicine is closer to the spirituality of Anonymous than to the spirituality of religion. This is not surprizing, given that alcoholism is a disease. Religious patients have access to a hospital Chaplain, however.

How does the history of spirituality fit into healthcare? According to a recent survey conducted by Christina Puchalski et al. [18], courses in spirituality are currently in the curricula of over 75% of U. S. medical schools. I have no doubt that in the near future these courses will be required in all medical school programs throughout North America. In Eastern countries courses in holistic healing have always been an integral part of the medical curriculum. The focus on spirituality is based on the belief expressed in the Puchalski report; “(that) physicians should provide competent care based on respect and compassion— values many would consider core to spirituality.” In 1998, Puchalski’s et al. [18] researched the role of spirituality in the medical curriculum. The committee published its findings in the Medical School Objectives Project Report [19]. Fifteen years later the committee’s report advanced the following definition of spirituality; “…an individual’s search for ultimate meaning through participation in religion and/or belief in God, family, naturalism, rationalism, humanism, and the arts” (italics added). The intent was to integrate clinical and pastoral care into a seamless delivery model. The model is designed to meet the perceived needs of a patient at the point of treatment entry. This constructivist perspective focuses on all the relationships that individuate patients; the need to overcome disease and the need to treat the patient as a unit of mind and body.

Holistic medicine is clearly in a patient’s best interest. Research has shown that religious involvement has a beneficial effect on the faithful; self-esteem and lower depression scores [20]; worship attendance and prayer have significant health and survival implications [21], (although religious involvement can also have a negative effect when unscrupulous leaders manipulate people into giving up their personal autonomy). Explorations in neurobiology have shown that spiritual states of mind “can be powerful generators of creativity and can catalyze the resolution of conflicts” [22]. The systems play a main role in the value patients assign to religion; some Christians draw comfort from the selfless suffering of Christ while the primary focus in Hindus and Buddhist spirituality is to maintain good karma in the face of personal death.

It seems possible to suggest that while medicine’s success is based on the triumph of science and technology over disease, a patient’s need to find meaning in a hospital experience does not exclude a Chaplain’s focus on God or the introduction of other ways of complementing spirituality such as input from family members and support groups, if any. The spiritual character of medicine arises in context of holistic healing and is delivered through compassionate care along with the use of efficient technology. This fact provides the opportunity for healing, with or without successful treatment of disease. A patient’s acceptance of disease and trust in the healthcare team along with their compassionate care provides an opportunity for the patient to find meaning and spiritual comfort in the face of adversity.

The spiritual character of medicine suggests that the patient needs to find personal meaning in the suffering, discomfort, costs, and all the negativities usually associated with a serious disease. While the patient centered healing process can only be attempted by the patient, the staff’s compassionate care provides the appropriate framework to begin inner-work. This is to suggest that the patient is not viewed as a disease only, but as a whole person. The hospital environment retains its sterile scientific and technological dimension but allows for personal care by addressing all the relationships that individuate a particular patient. This includes the attempt to personalize the patient’s hospital room by inviting some aspect of a home environment into the hospital room. Thus, the patient’s ability to find meaning in a new setting is enhanced. Particular attention is given to the patient’s social-self dimension by ensuring that no patient is left alone or that no major decision affecting the best interest of a patient is taken in the absence of consultation with the patient’s family. The psychological level of spiritual development is an equally important area of focus. This is the place where all spiritual relationships are processed and new ones made. The psyche can be a hotbed of negative emotions at time of disease when all can seem to be lost. How can the healthcare team help a patient find meaning in personal suffering? To borrow from the 12-Step model, holistic recovery begins with resonance and identification with the suffering of the other. For instance we can enlist the help of patients in remission from cancer to meet with patients that have cancer. In the medical setting, spiritual development takes place as likeminded friends share their personal stories of tragedy and triumph. Perhaps a compassionate nurse will risk something of h/herself by using her own personal story of suffering as a gateway to the pain of the other. Nurses must first be aware of their own need for healing. Part of that learning process takes place in spirituality and health courses. This identification with the suffering of the other is the true test of compassionate caring. The patient resonates and identifies with the pain of the other to find spiritual meaning in h/her personal suffering. In Christian faith, for instance, the faithful identify with the suffering of Christ, left to dry and die on a wooden cross.

How do the arts serve as a conduit for spirituality? In the same way that beauty attracts attention. Thomas Aquinas’s definition of beauty is “that which gives pleasure when seen”. An artist has the ability to arouse the sense of awe in the human condition by drawing attention to the mystery of life, love, compassion, suffering, and joy through art. The possibility of entering into spiritual communion with art exists because the work of art rises above the limitations of matter. Aquinas says that immateriality is at the root of all knowledge, practical as well as speculative. The knower is able to enter into union with the form of the other because of this freedom from the limiting conditions of matter (De Trinitate). But the appreciation of beauty through the union of forms is contemplative rather than discursive. In this sense it can be argued that beauty is a transcendental property of being, that is it applies to everything that exists, though not everyone would agree with the claim. The reason is that not everyone is able to perceive the beauty that is in all things. How, for instance, can someone appreciate the beauty of cancer? While the beauty of cancer is not evident in its relation to the individual with cancer, it must be recognized that it has beauty in itself. The view that beauty is a transcendental property of being is shared by Henry Koren [23] as he cites with approval a text of Aquinas on Dyonisius “There is nothing that does not participate of the beautiful and the good; for everything is beautiful and good according to its own form” (Dionysium de divinis nominibus, c.4, lect. 5). The whole of existence has beauty. Jacques Maritain also shares the view that beauty is a transcendental property of being although the interpretation of beauty is subjective and therefore admits of degrees. Not all things are of equal beauty. Other transcendental properties of being include unity, truth and goodness. All things express unity in that they resist destruction. Reality clings to existence and therefore the parts of a being cling to themselves by acting primarily for the good of the whole. The transcendental truth is also interchangeable with being because the whole of reality exists in conformity with the divine mind, that is, in harmony with the divine plan for creation. And the whole of reality is good because being is pleasing to our appetite for goodness, as we saw in the discussion of spirituality and religion. The whole of reality acts towards the attainment of the good. In a sense beauty expresses all the transcendental properties of being; inasmuch as being has unity, truth, and goodness, it has beauty. While Aquinas did not develop a system of aesthetics, he leaves no doubt that beauty is perceived through an intellectual intuition.

The individual at peace sees the beauty of dying. No one wants to die, but the clarity (truth), integrity (unity), and harmony (goodness) that can come from dying is indisputable. Art, poetry, music, and the beauty of nature play an important role in helping a patient find peace in the face of a terminal illness. Art and music play an important role in Church history as primers for a relationship with God. In particular, the role of Chaplains and pastoral counsellors is to help patients blend their experiences of religious connections into the arms of the personmaking process. The existential feeling of hopelessness in the face of death provides evidence of a frustrated spiritual drive. The role of Chaplain is to assist the patient’s desire to find fresh meaning in light of those broken religious streams. All aspects of being human are affected by a life threatening illness. Anger and depression are not unexpected outcomes of dying. The spiritual rewards of the religious connection are found in the psychological benefits that arise out of being with likeminded friends in time of need.

Major poets often draw on the inspirational character of their works to provoke action [24]. For instance, Elliot’s The Wasteland reads like a religious poem that takes Western European civilization to task for its spiritual bankruptcy, while Musorgsky knew that he had been touched by the sacred when he wrote his poem Night on Bald Mountain. Albert Camus also claims to have a sense of God, though he does not believe in personal immortality; “Yes. I have a sense of the sacred and I don’t believe in a future life, that’s all”.

The arts provide a profound medium to express spiritual insight [25]. Jacques Maritain discusses the connection between art and poetry in the Mellon lectures he gave at the National Gallery of Art, Washington, D. C. in the summer of 1952, published as Creative Intuition in Art and Poetry. This volume of six lectures provides a basic introduction to the beauty and power of art and poetry. The spontaneous, intuited, consonance that arises between the artist and the object of beauty generates a spiritual awakening that is filtered through the medium of reason and emotion. The product of art arises as the expression of that encounter as the artist seeks to express the wonders and inexhaustible richness of spiritual insight. No single work of art ever completely succeeds in expressing the rich totality of a poetic experience. The awakening of artistic spirituality opens unto a lifelong project to deliver through canvas, poetry, music … the intuited insight that the soul knows spontaneously and that our sensibilities can only approach awkwardly through the geometrical medium of logic. No series of paintings or poem can completely catch the rumblings of an artist filled with the beauty of a landscape, seascape or presence of the beloved. No human tear can hope to catch the turmoil of a patient dying from cancer, but the beauty is in the expression of pain and anguish, not in the victory dance in the absence of a cure. Each act of painting, each stroke of the brush only prepares the way for a more urgent and impatient expressions of spirituality on fire. The artist becomes the landscape-seascape that reason seeks to replicate through art. Each success is also a payment of rent on the triumph and futility of trying to capture the whole of the intuited objective correlate of beauty. Each note I write is a payment of rent in making peace with the world I leave behind. To catch it all would be to extinguish it; to recognize that reason has impoverished it, lost it, by reducing it to the mathematical and sterile expressions of detoxified ideas. Thus, the spiritual is intuited rather than constructed, an awakening rather than the fruits of discursive reasoning, an act of faith rather than an act of reason, an awareness of the good and evil that exists in the human condition, a cry and a sob, a laughter and a tear, a moment of denial and acceptance, a moment of life and healing in the face of dying.

Religion is the output of three (objective) streams of associations:

(1) The desire to do good things (David Suzuki provides empirical evidence that babies are born to be good)

(2) Belief in the existence of God, and

(3) Belief in the existence of an afterlife state (most humans resist personal extinction).

Thus, religion and spirituality merge if religion’s focus successfully downloads into the arms of the person-making process to meet the search for ultimate meaning. Acts of love and compassion can be given a religious meaning or a recuperative meaning in recovery and medicine. A disconnect between these agencies and the personal search for meaning takes place when religion, 12-Step programs, medicine and/or counseling fail to meet the individual’s search for meaning and the attempt to resist personal destruction.

Religion is important to patients whose spiritual search for meaning coincides with the three goals of religion, namely (1) acting ethically, (2) deepening a personal relationship with God (or an impersonal relationship with the All, the Unmanifest, or freedom from self), and (3) as preparation for personal death and the afterlife state. Not all persons are religious, though everyone is spiritual by nature.

The spiritual character of recovery programs takes place as a means for removing whatever stands in the way of finding personal meaning. The process focuses primarily on the negativities of dependency as preparation for personal growth through religion and medicine. The preliminary experience of recovery in 12-Step programs is subjective rather than objective, that is, the objective assessment of dependency is contingent on the personal admission of dependency. Subjective truth arises as a process of entering into relationship with and accepting a condition of dependency rather than abuse.

The spiritual character of medicine takes place through a process of identifying broken spiritual associations on the arms of the personmaking process. Disease interrupts the patient’s search for meaning because the associations that cluster on the arms of the person-making process are broken. The spiritual application takes place on all the relationships that make human beings persons. Disease affects the whole person primarily and only the carbon-self secondarily. The carbon-self encompasses all the actions and reactions of persons as extension and energy. The most primitive drive of spirituality at the level of the carbon-self is to resist cellular destruction because it places a person’s social-self relationships and internal-self associations at-risk. The tension caused by disease is reversible with or without finding a cure for that disease.

Art serves as a conduit for spiritual wellbeing. An aesthetic experience generates a sense of meaning without causal explanation that elevates persons to a place of beauty and meaning undamaged by the realities of suffering and death. Art aligns us with what is best about the human condition, love, compassion, acceptance, forgiveness, and gratitude. Art empowers us to see the world as an interconnected whole rather than as bits and bytes of discontinuous data. The intuition of beauty allows us to become the object of beauty through the spontaneous consonance that takes place between the subjective and objective correlates of the encounter. The artist invites us into a world of beauty and harmony. A suggested systems analysis to delineate how culture, society, economics, politics, and ethics funnel spirituality into a source of meaning for the individual is discussed in my Guidelines for Conducting a Spiritual Assessment.

The varieties of spiritual experience find meaning in beauty as well as in suffering. While spirituality fuses with religion to discover the ultimate meaning of life, the 12-Step movement, holistic medicine, and the arts are primarily therapeutic interventions as they seek to remove the obstacles that stand in the way of personal happiness. This suggests that spirituality can serve as a force for good as well as a force for destruction. The associations that the spiritual search for meaning generates can be found as clusters on the arms of a person-making process. While authentic religion feeds the needs of the faithful as they seek to enter into relationship with the divine, medicine concentrates on the here and now of disease and wellbeing. The compassionate care of medicine finds its way into 12-Step spirituality as individuals share personal stories of tragedy and recovery from substance dependence. The variety of spiritual experience is expressed through the medium of art, music, literature, and horticulture as a conduit for healing in religion, medicine, and 12-Step recovery.