By Rev. Dr. Arnold Hoskins
In the aftermath of losing a limb, individuals routinely experience powerful emotions such as anger, depression, denial, grief, and despair.
These feelings are often accompanied by a sense of spiritual confusion, abandonment, or disaffection. As a hospital chaplain, I have had many amputees ask me why God (or the universe) is punishing them, because “I am a good person and I haven’t hurt anyone.”
Resolving such questions is a crucial part of the healing journey.
Just as doctors, prosthetists, physical therapists, and other clinicians evaluate an amputee’s needs in the physical realm, hospital chaplains will perform a spiritual assessment and develop a plan that supports the new amputee’s overall health. Spiritual care can help amputees from diverse backgrounds (both religious and nonreligious) to find comfort, inner strength, and peer support as part of their healing process. It also can help amputees actively promote their own healing by incorporating values, symbols, and rituals that have personal significance to them.
It should be noted that spirituality and religion are distinct but related domains. Religion is often associated with God and the beliefs of a particular faith tradition, such as Christianity, Buddhism, Islam, or Judaism. Spirituality is more often associated with personal values that are not necessarily aligned with a specific religion. When I perform a spiritual assessment as hospital chaplain, I am not attempting to determine the patient’s religion or to place a label on their system of belief. The goal is to invite individuals to identify and express their own spiritual values, and use them to discern meaning in their life.
Contrary to popular perception, most people are not affiliated with a particular religion. According to one Gallup poll, only 47 percent of Americans identify as religious, whereas 33 percent consider themselves spiritual. Studies have shown a 20-year decline in the number of Americans who declare a religious affiliation, and that trend is growing. But 82 percent of Americans endorse some type of religious or spiritual practice, which suggests it serves as a significant role in their lives.
In a spiritual assessment, a chaplain journeys freely with a patient, without the typical restraints often associated with religion. Rather, the patient is granted the liberty of self-expression without the guilt, shame, or judgment that is often associated with some religious practices. This approach respects the individual’s own values, grants them a sense of autonomy, and motivates them to actively pursue a path of healing with a high level of confidence.
When patients actively engage in their own healing process, better outcomes ensue. One study suggests that patients who are actively involved in their plan of care increase their knowledge, skills, and ability to care for themselves, which improves outcomes and reduces health care. Since many patients struggle to understand the complexities of healthcare, patient literacy plays a significant role in the efficacy of their own treatment plan, and shared decision making increases the patient’s viability of performing better in reaching healing outcomes.
Limb loss often triggers emotions such as bitterness, anger, acceptance, and grief. Spiritual guidance and mental health counseling can equip patients with coping skills and empower them to identify psychological obstacles that may impede their healing process. In one study of 100 patients with limb loss who were offered counseling, only 31 percent elected to accept. However, most of the participants who opted for counseling reported that it was useful or beneficial. Many cognitive behavior therapists believe that if negative thoughts, emotional pain, and self-defeating behaviors are not addressed, they can significantly contribute to prolonging or even preventing a loss of limb patient from reaching their potential in healing.
Finally, there is the aspect of meaning-making which is often associated with one’s religious or spiritual perspective. Author Laurence Lepherd opines that “the spirit is the core to a person’s being…and comprises multiple dimensions.” Religion and spirituality serve as a means of introspection that are personal and categorically influenced by one’s culture, ethnicity, and worldly views. The human search for meaning can be a complicated process, but there are many ways for amputees to define and discern meaning for themselves. Although there are no absolute answers, taking this step can support amputees on the road to healing and acceptance of limb loss.
Spiritual healing is not a one-size-fits-all endeavor. The transition to a new dimension of well-being is different for each individual. It is important to note, however, that spirituality is not a panacea for the loss of a limb. But it is a critical part of recovery that can complement and enhance mental and physical recovery.
Rev. Dr. Arnold Hoskins, MTh, DMgt, is Manager of Spiritual Care at Northwestern Medicine Marianjoy Rehabilitation Hospital.
