Dance of Disability and Spirituality

During the past decade, the scope of literature concerning spirituality has expanded into a wide range of health care contexts (Koenig. 2001; Meraviglia, 2004; Post. Puchalski. & Larson. 2000; Smith & McSherry, 2004). Spirituality issues have been included in areas of research such as oncology (Flannelly. Flannelly, & Weaver, 2002; Meraviglia, 2004). medical psychology (McEwen. 1998; Hill & Pargament. 2003). and cardiac care (Harris et al.. 1999). In the field of rehabilitation, the role of spirituality in the lives of individuals with disabilities has become a major topic of study related to coping with severe, chronic suffering and losses (McColl et al.. 2000a; McColl et al.. 2000b). Although deemed an important topic by people with disabilities (Chally & Carlson, 2004). there continues to be inadequate information and contrasting perspectives related to people with disabilities in the growing body of spirituality literature. Treloar (2002) reported that spiritual beliefs enabled people with disabilities and family members to establish meaning for disability and to cope with the challenges of losses associated with disability. These results may appear to be encouraging in regard to the potential benefits of spiritual beliefs for individuals with disabilities. but the study included participants affiliated only with evangelical Christian churches. Participants with disabilities from diverse faiths who do not hold similar religious and/or spiritual beliefs may respond quite differently when asked to address the role of spirituality in their lives. Numerous authors have characterized the experience of disability as a succession of losses, and as such, may create a context for spiritual changes (McColl et al., 2000a; Selway & Ashman, 1998). Disability -associated challenges may prompt one to question traditional concepts about a higher being, as well as to question the purpose of his/her own life, and in deed, the purpose of life in general. Although reflection on these questions may provide the impetus for personal and spiritual development, authors such as Ross (1995) have noted that the increased isolation that often accompanies the experience of disability may make a spiritual quest more difficult. Whether or not the experience of disability encourages or limits spiritual growth is not fully understood. These notions and the concern that spirituality is " an underused resource in the rehabilitation process" (Underwood-Gordon, Peters, Bijur, & Fuhrer, 1997, p.225) underscore the need to focus on understanding how spirituality may benefit individuals in long term rehabilitation. Many authors have recommended clarifying the meaning of the terms, spirituality and religiousness (Anandarajah, 2001; Koenig, George, Titus, & Meador, 2004). Although related, these terms are not used synonymously. Religiousness is associated with specific rituals and a doctrine that is shared with a group (Koenig et aI., 2004), while spirituality is viewed as one's inner beliefs or world view about the meaning and purpose of life and/or the quest for understanding these concepts (Thomas, 2000). In this sense, even without religious affiliation, individuals may consider themselves to be strongly spiritual. Despite clarification of the difference in meaning between spirituality and religion, there continues to be a lack of consensus concerning the definition of spirituality (Bash, 2004; Henery, 2003; MacLaren, 2003; Narayanasamy, 2002; Smith & McSherry, 2004). Howard and Howard (1996) stressed that spirituality refers to a person's, "subjective perception and experience of something or someone greater than him/herself"' (p. 18). In this view, spirituality is defined as an individual's personal beliefs about the forces that influence his or her life and the transcendent aspects of life. Other authors such as Taylor (2001) have emphasized that spirituality is a cultural phenomenon that should be considered within a cultural context and therefore subjective to a society, with no universal definition. …