The search for meaning has always plagued mankind, but until recently, that search has not been recognized by health care providers as an integral part of how people heal. A pioneer in the field of spirituality and health, Christina Puchalski, MD ’94, RESD ’97, founder and director of the George Washington University’s Institute for Spirituality and Health (GWish), has dedicated the better part of her career to creating awareness about the impact of spirituality on an individual’s journey through the health care system.
It all started with a question. Back in the early 90’s, Dr. Puchalski, then a medical student, began to ask herself: “As clinicians, we talk about treating the whole person. If that’s the case, why aren’t we teaching something about spirituality and health?” By 1992, she had instituted the first elective at GW on the subject, and within five years, the expanded course had become part of the required curricula in GW’s medical school.
The next logical step for Dr. Puchalski was to create an organization that “works toward a more compassionate system of health care by restoring the heart and humanity of medicine through research, education, and policy work focused on bringing increased attention to the spiritual needs of patients, families, and health care professionals.”
In 2001, with the support of the university and collaboration among like-minded colleagues, GWish was born.
“Our mission is to bring attention to the spiritual and give people tools to help integrate spiritual care into health care,” says Dr. Puchalski. To that end, the institute has a longstanding grant program to assist other medical schools with developing their own curricula on spirituality and health. Additionally, in collaboration with colleagues around the world, GWish has drafted clinical standards to better disseminate best practices and integrate a patient’s spiritual values into patient care. One particularly effective tool is the FICA Spiritual History Tool, developed by Dr. Puchalski and a group of primary care physicians for the purpose of acquainting medical staff with a patient’s spiritual preferences.
Dr. Puchalski is quick to point out that spirituality does not necessarily equate with religion. For some, spirituality might be experienced through nature, or a belief in the inherent goodness of humankind. She describes one patient who did not relate to the term ‘spiritual’ at all, but who did report she was feeling disconnected. Over time, the patient was able to identify that for her, spirituality was about spending more time in the woods. “What ensued was a sense of being grounded and connected to something outside of herself,” says Dr. Puchalski.
But Dr. Puchalski cautions that the exploration of spirituality and health care should not be limited to patients. “Unless a clinician is aware of his or her own spirituality, dealing with other peoples’ suffering is too hard,” she says. Medical providers are burdened with responsibilities that can be overwhelming at times: data entry, research, tests, insurance, educating patients—the list goes on. Under these types of constraints, it’s easy to let one’s own self-care slide, so that many providers experience disillusionment and are no longer able to work within a system that does not honor their calling. To address this issue, GWish offers support, education, and retreats for practitioners to explore their own spiritual development and tune in to their deepest purpose.
Dr. Puchalski’s 15 year tenure at GWish has yielded phenomenal results. Of note, the institute has just concluded a national 12-year program that grew the number of medical schools teaching spirituality and health from 3 percent to 80 percent. The institute’s work in hospitals has led to a national campaign that created competencies for the delivery of spiritual care. Demand for GWish programs is steadily growing, which has resulted in work at the policy level with organizations such as the World Health Organization and other initiatives that are cropping up in countries all over the world.
As a result of this international collaboration, in 2013, the Global Network for Spirituality & Health (GNSAH) was formed. Launched in September of that year, GNSAH was developed to facilitate information sharing among members and to provide a platform for advocacy.
In other words, what began with one question, one elective, and one individual has grown into an organization with significant reach, to include health care systems across the globe.