Special Section: Spirituality/Medicine Interface Project Definition of Terms: Spirituality versus Religiousness

“If you wish to converse with me, first define your terms. ” —Voltaire, 1694–1778 Nowhere is the need to define and clarify terms more fundamental than when discussing spirituality and religion. Though often set in the stone of tradition, this topic is so nebulous, subjective, emotional, and, at times, even prejudicial, that clear definitions are needed to avoid further ambiguity and confusion. Such a concern is particularly apt when discussing possible associations between spirituality, religion and health. The fact that 79 and 64% of those polled in the USA describe themselves as “spiritual” and “religious,” respectively, testifies to the importance of this issue. In essence, while both often involve a process of searching, religiousness manifests itself in external rituals of devotion or worship while spirituality focuses upon an inner state of being. Defined with respect to an external authority or way, religiousness centers upon the social/communal, the institutional and the discernible and is evidenced in the extrinsic use and practice of rituals, the most typical of which is church attendance. The significance of rituals cannot be underestimated—indeed, Sigmund Freud theorized that all religion was merely elaborated ritual. It is important to note, however, that while religiousness is most clearly witnessed in the rituals of organizational religiousness, it is also evidenced in both nonorganizational expressions, such as prayer or Bible study, and self-perceived or subjective measures, including religious identity and specific religious beliefs. By contrast, spirituality places the emphasis upon the individual, the personal and the subjective. Such belief systems tend to adhere to an inner sense of conformity and existential meaning, emphasizing the universe’s inherent transcendence—that is, its all-pervading and foundational connectedness. Spiritual philosophies—by way of meditation, yoga and the like—also encourage withdrawal from secular distractions and connection with the sacred. The divide between spirituality and religiousness is not absolute. Indeed, most—although not necessarily all—religions endeavor to inculcate a sense of the spiritual in their believers: as Joseph Cardinal Ratzinger (now Pope Benedict XVI) once said, “a dogmatic faith unsupported by personal experience remains empty. ” Within this division there exists a multiplicity of terms and nuances—and, consequentially, much confusion. Terms such as organizational religiosity 6 and experiential religiousness emphasize the institutional, but neither includes nor excludes a spiritual dimension. Subjective religiosity, nonorganizational religiosity, and devotional religiousness, on the other hand, emphasize the introspective and imply a dimension apart from the social and institutional aspects which largely characterize religiousness. Alternatively, the terms extrinsic and intrinsic religiousness convey a sense of the underlying motivation behind religiosity. Extrinsic religiousness connotes a religiousness which serves a practical purpose or use in one’s life—for instance, church attendance as a source of solace or sociability. The motivations for intrinsic religiousness, on the other hand, are more aptly looked upon as the conforming—or living—of one’s life to one’s religiosity; for example, finding pleasure in prayer or reading about one’s faith. This divide between the religious and the spiritual is not just academic. While, for many, religion may act as a source of comfort, for others it may serve as a source of conflict. Although the mechanism is still unknown, two possible operators, positive psychological outlook and social support, have been frequently noted as significant health-promoting factors, both of which correlate well with spirituality and religiousness, respectively. In addition, increased optimism and subjective wellbeing are often positively encouraged by the more profound sense of purpose and meaning of life which spirituality nourishes. Religiousness, on the other hand, appears to operate on health by way of participation in institutionalized rituals and the fellowship of the faith-based community which shares the religion. Although there may be other factors involved, the social support associated with religious involvement is a major health promoter, providing both psychological (eg, perceived) and practical support. Moreover, the rituals themFrom East Tennessee State University, Johnson City, TN.