Understanding Spirituality : 4 Dimensions of Health and Well-being

Understanding spirituality

Five types of spirituality are believed to exist, namely “humanistic spirituality” with focus on human spirit with no claim to a higher power; “unmoored spirituality” focusing on energy, connection, and nature; and three types of “moored spirituality” based on Eastern religions; or Western religions with evangelical, or conservative, bases. These five types of spirituality could just as easily be grouped into the three categories described as “God-oriented, worldly-oriented with an idolatrous stress on ecology or nature, or humanistic, stressing human potential or achievement. 

An attempted integration of the divergent views described spirituality as the ancient and abiding human quest for connection with something larger and more trustworthy than our egos—with our own souls, with one another, with the worlds of history and nature, with the invisible winds of the spirit, with the mystery of being alive.  This definition has many similarities to this author’s functional definition: Spirituality is concerned with a person’s awareness of the existence and experience of inner feelings and beliefs, which give purpose, meaning and value to life.

Dimensions of Health

The nature of health needs to be addressed, before investigating the relationship between spirituality and health. Even in Greek times, educators considered the total health of each individual as having a sound spiritual base. Thus, for Hippocrates, “it is nature which heals, that is to say the vital force—pneuma (or spirit)—which God gives to man”; whilst healing may be defined as “a sense of well-being that is derived from an intensified awareness of wholeness and integration among all dimensions of one’s being, which includes the spiritual elements of life.

It has been suggested that there are six separate, but interrelated, dimensions that comprise human health. Health involves much more than physical fitness and absence of disease; it includes the mental and emotional aspects of knowing and feeling; the social dimension that comes through human interaction; the vocational domain; and, at the heart, or, very essence of being, the spiritual dimension. It is the spiritual dimension which seems to have greatest impact on overall personal health.

Spiritual Health and Well-Being-

Ellison suggested that spiritual well-being “arises from an underlying state of spiritual health and is an expression of it, much like the color of one’s complexion and pulse rate are expressions of good [physical] health”. Miller and Shaw supported this view by adding, “spiritual well-being is an indication of individuals‟ quality of life in the spiritual dimension or simply an indication of their “spiritual health”.

These relationships can be developed into four corresponding domains of human existence, for the enhancement of spiritual health: relation with self, in the Personal domain relation with others, in the Communal domain relation with the environment, in the Environmental domain, and relation with transcendent Other, in the Transcendental domain. 

As one definition goes, spiritual health is described as:  A, if not the, fundamental dimension of people’s overall health and well-being, permeating and integrating all the other dimensions of health (i.e., physical, mental, emotional, social and vocational). Spiritual health is a dynamic state of being, shown by the extent to which people live in harmony within relationships in the following domains of spiritual well-being:

#1. Personal domain—wherein one intra-relates with oneself with regards to meaning, purpose and values in life. Self-awareness is the driving force or transcendent aspect of the human spirit in its search for identity and self-worth.

#2. Communal domain—as shown in the quality and depth of interpersonal relationships, between self and others, relating to morality, culture and religion. These are expressed in love, forgiveness, trust, hope and faith in humanity.

#3. Environmental domain—beyond care and nurture for the physical and biological, to a sense of awe and wonder; for some, the notion of unity with the environment.

#4. Transcendental domain—relationship of self with some-thing or some-One beyond the human level (i.e., ultimate concern, cosmic force, transcendent reality or God). This involves faith towards, adoration and worship of, the source of Mystery of the universe .

 This definition outlines the inter-connective and dynamic nature of spiritual health, in which internal harmony depends on intentional self-development, coming from congruence between expressed and experienced meaning, purpose and values in life at the Personal level.

This intentional self-development often eventuates from personal challenges, which go beyond contemplative meditation, leading to a state of bliss, perceived by some as internal harmony. Morality, culture and religion are included in the Communal domain of spiritual health, in accord with Tillich’s view that the three interpenetrate, constituting a unity of the spirit, but “while each element is distinguishable, they are not separable”. In this review, religion is construed as essentially a human, social activity with a focus on ideology and rules (of faith and belief systems), as distinct from a relationship with a Transcendent Other such as that envisioned in the Transcendental domain of spiritual health. It is acknowledged that the ideals of most religions would embrace relationships with both the horizontal (Communal) and vertical (Transcendental) aspects, but the two have been separated, for emphasis, in the following model.

A Model of Spiritual Health

Here, each DOMAIN of spiritual health is comprised of two aspects— knowledge and inspiration. Here we see the metaphorical “head‟ and “heart‟ working together, striving for harmony. Once achieved, this harmony is reflected in expressions of well-being.  In this model, people’s worldviews are seen to filter the knowledge aspects of spiritual health, while their beliefs filter the inspirational aspects. A key feature of this model is the partially distinct nature of, yet interrelation between, the “knowledge‟ and “inspirational‟ aspects of each of the four domains of spiritual well-being. 

The quality, or rightness, of the relationship that a person has with themselves, with others, with nature and/or with God constitutes a person’s spiritual well-being in those four domains. An individual’s spiritual health is indicated by the combined effect of spiritual well-being in each of the domains that are embraced by the individual. Spiritual health is thus enhanced by developing positive relationships in each domain, and can be increased by embracing more domains.


The notion of progressive synergism is proposed here to help explain the interrelationship between the four domains of spiritual well-being. As the levels of spiritual well-being in the domains are combined, the result is more than the sum of the quality of relationships in the individual domains. Progressive synergism implies that the more embracing domains of spiritual well-being not only build on, but also build up, the ones they include. 

When relationships are not right, or are absent, we lack wholeness, or health; spiritual disease can grip our hearts. The quality of relationships in each of the domains will vary over time, or even be non-existent, depending on circumstances, effort and the personal worldview and beliefs of the person. Not many people hold the view that they are sole contributors to their own spiritual health (relationship in the Personal domain only); most at least include relationships with others in their world-view of spiritual well-being.

The notion of progressive synergism implies that development of the Personal relationships (related to meaning, purpose and values for life) is precursor to, but also enhanced by, the development of the Communal relationships (of morality, culture and religion). Ideally, a person’s unity with the environment builds on, and builds up, their Personal and Communal relationships.          

Coherence in Domains

An individual’s spiritual health is indicated by the combined effect of spiritual well-being in each of the domains that are embraced by the individual. Spiritual health is thus enhanced by developing positive relationships in each domain, and can be increased by embracing more domains.


The relationship of a person with a Transcendent embraces relationships in the other three domains. For example, from a theistic point of view, a strong faith in God should enhance all the other relationships, reflecting Macquarrie’s assertion, “As persons go out from or beyond themselves, the spiritual dimension of their lives is deepened, they become more truly themselves and they grow in likeness to God” People known as Rationalists would be willing to embrace the knowledge aspects of “spiritual‟ well-being, but not the inspirational aspects. These people would hold atheistic or agnostic worldviews.

Just as spiritual health is a dynamic entity, it is similarly through the challenges of life that the veracity and viability of a person’s worldview and beliefs will be tested, together with the quality of their relationships in the domains considered to be important. When we have ways of assessing the current state of a person’s spiritual health, as clinician, friend, counselor, parent, or teacher, we have a basis from which to help nurture relationships appropriately, to enhance our own, and others’, spiritual well-being.


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