How Can Spirituality Be Used in Clinical Practice?

Drew Ramsey, MD


December 27, 2018

Drew Ramsey, MD: Welcome back to the Brain Food blog. I'm Dr Drew Ramsey. In these trying times, spirituality is an issue that's increasingly coming up in our clinical practices as patients wonder what to make of all the news today.

[Today, I'm going to] speak with one of our experts, Dr Anna Yusim, a psychiatrist and author of a new book, Fulfilled. Anna, thank you so much for coming on. As a clinician, I want to hear how you began to integrate spirituality into your clinical work.

Anna Yusim, MD: Spirituality entered my clinical work when it entered my own life because I found a spiritual path to be quite transformative. I had my own dark night of the soul that led me to soul searching. That search took me to ashrams in India, learning meditation in Thailand, working with shamans in South Africa and South America, and eventually studying Kabbalah here in New York City.

Ramsey: You were that resident who said, "I had a spiritual crisis..."

Yusim: I was that resident.

Ramsey: I had a spiritual crisis in residency, but it sounds like you actually did something with yours.

Yusim: I certainly tried. That ended up defining my life in such a powerful way. As I integrated spirituality into my own life, I started working with patients to the degree that they were open to it in my practice.

Ramsey: What would you recommend to those of us who aren't doing a lot of this work clinically? What kind of questions should we ask to get started?

Yusim: [My definition of spirituality is] connection to something greater than oneself. For some people, that's God. For other people, it's the universe [or transcending global values] like hope and love.

What I would ask is, in terms of patients, do you consider yourself a spiritual person? In what way? What are practices that you do? What are rituals that you may follow? How were you raised, and how has that changed over time in what you do now?

Ramsey: It sounds like there's this real distinction that sometimes we don't make between a religious practice and a spiritual practice.

Yusim: Exactly. For some people, it's one and the same, and religion can be the gateway to a very spiritual practice. At the end of day, spirituality is what brings people more love and unity. If religion does that, beautiful. However, religion, with extremism, can bring disharmony at times.

Ramsey: Love and unity definitely would be a good end-treatment goal for most of our patients. What types of things do you see happen in your clinical practice as people begin to think more about their spiritual lives?

Yusim: In my practice, I feel that it's really important to meet people where they're at. Some people are going to be spiritual and very open to it, and others won't be. For those people, it could develop over time.

As people start to connect to that part of themselves, they rely less on external ways of starting to fill their inner voids. They start to look for fulfillment more internally—within their own hearts, really—through meditation practices, as opposed to through external accoutrements of success like achievement, money, power, status—the so-called psychological addictions.

It's not to say that those things are bad or negative in any way—not at all. They become more addictive when the more of them that you have, the emptier you feel. Those times that we start to fill our inner voids [are when] we have spiritual or existential crises.

Ramsey: We have a huge issue around physician burnout. I think, for those of us in mental health, this presents a bit of a conundrum because we want to help our colleagues and we aren't exactly sure what to do. Spirituality feels like it plays a big role in physicians feeling satisfied. I'm wondering what you recommend when people want to deepen their own spiritual practice. What are some quick first steps for people to think about?

Yusim: The first step that I would recommend is for people to start to reconnect with themselves. Often, what leads to burnout is that, on some level, we're disconnected from ourselves and what we really need. We find ourselves having to people-please.

I would recommend starting to ask oneself the question, "What do I most deeply want?" It's such a simple question, but how many of us really ask that question? How many of us forget because everybody else wants something from us?

I treat so many physicians who are so good at taking care of everybody else but not as good at taking care of themselves. It's just a very simple question. Ask yourself throughout the day, sometimes multiple times a day, "What do I most deeply want?"

Ramsey: It feels like that part of spirituality in medicine has been lost, where we almost can't ask that anymore. This has been wonderful.

Yusim: Thank you, Drew.

Ramsey: Everyone, please check out Dr Yusim's book, Fulfilled. It's in bookstores all over. Thank you so much for tuning in again to another episode of the Brain Food blog, where we've discussed spirituality and some of the ways to think about that as a mental health professional and physician, but also ways to think about that personally. Thanks.


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