Pathologies of the Spirit & Soul

Just as there are physical and mental illnesses, or pathologies, there are spiritual ones. Eric mentioned he has “other wounds that no one can see that hurt the most.” Many people have those wounds. Spiritual pathologies are linked to poorer health outcomes (mental and physical), and addressing them is an important aspect of integrative care.²

Common spiritual problems, and examples of what a person who experiencing them might say, include the following:

• Spiritual alienation. “I feel abandoned by my Higher Power. I feel disconnected from myself, from others.”
• Spiritual anxiety. “I feel unforgivable. There is so much that I don’t know.”
• Spiritual guilt. “I deserve to be punished. I must have done something wrong, to feel this way. I am full of regret.”
• Spiritual anger. “I am angry with God. I hate the Universe. I feel betrayed.”
• Spiritual loss. “I feel empty. I do not care anymore. I am not sure what matters anymore. My sorrow is overwhelming.”
• Spiritual despair. “There is no way a Higher Power could ever care about me. I have lost my hope. Things feel meaningless.”

These pathologies can arise when a person experiences moral injury. Moral injury, which is often described in terms of experiences people have related to combat situations, occurs when a person commits an act, or is unable to prevent an act, that goes against his or her deeply held moral beliefs.³ As one expert describes it, “This construct attempts to capture the constellation of inappropriate guilt, shame, anger, self-handicapping behaviors, relational and spiritual/existential problems, and social alienation that emerges after witnessing and/or participating in warzone events that challenge one’s basic sense of humanity.”⁴ Examples might include incidents relating to death or harm to a civilian, being under friendly fire, being unable to prevent a comrade’s death or suffering, or violating rules of engagement to save a comrade.⁵