The Quest for Spirituality and Health: Well-Being or Transcendence?

Posted by Joel Bennett on

To be a warrior of spiritual health, thee must forge the swamp of silly definitions, fight the dragon of hypocrisy in health systems, scale the castle of spiritual transcendence and, once you find thyself in the tower of wholeness, wander through the shadows until thee finds the Holy Grail

Many people believe the ultimate goal of our life’s journey lies in the meaningful fulfillment of some cherished value, accomplishment, realization, or legacy – whether in family, service, career, or one’s own private aspiration. Others think that these activities and aspirations are fleeting: what matters most is access to higher states of being, insight into the flourishing and eternal cosmos, touching or merging with the divine, surrendering oneself. These two “world” views are not mutually exclusive, do not depend on religious belief, and actually nourish each other.



The psychologist Abraham Maslow viewed these ideas in terms of two distinct ways of being: self-actualization (fulfillment of personal potential) and self-transcendence (expanding beyond the boundaries of one self).  These two ways of being both influence and even define our health. Indeed, the word for health has the same origin as the words for whole and holy. Each of us is not really healthy without some integration of our whole and spiritual nature. But, even beyond that, we may learn that all of humanity – especially the complex design of our DNA, brains, and nervous systems – is a simple manifestation of cosmic consciousness residing in the universe.

The past 20 years has seen significant growth in the scientific study of self-transcendence and its relationship to health and well-being. Within the field of psychology alone, the topic is treated in one of three peer-reviewed journals: The Journal of Humanistic Psychology (founded in 1961; see Victor Frankl’s 1996 paper), The Journal of Transpersonal Psychology (founded in 1969; see Frances Vaughan Clark’s 1973 article), and The Journal of Positive Psychology (founded in 2006; see Schnell, 2009 who distinguishes vertical and horizontal transcendence). Studies of self-transcendence are growing in the fields of holistic nursing, hospice studies, aging (gerontology) and psycho-oncology.


The study of human growth and consciousness contains many broad, superordinate, and open-ended constructs, such as resilience, intimacy, and love. Most current science – stuck in a reductionist and operational paradigm – will naturally struggle to agree on a common definition of these ideas. The same goes for spiritual health. When it comes to any aspect of spirituality, it may be near-sighted and self-limiting to use only one definition. Or, even worse, to act like we know what we are talking about when it comes to transcendent matters.



Instead, and for this brief orientation, do your own personal quest.

Let’s look at some of the self-report questionnaires – what scientists are actually studying when they measure self-transcendence and spiritual health. Here is a random selection of items that people would endorse if they were moving in the direction or evolving toward and beyond spiritual health.

I encourage you to review these items with the intent of self-assessment. How much do you agree with them?


  1. I am able to reach deep down into myself for comfort

  2. A higher spiritual power or being is a source of help and direction in my life

  3. I spend a portion of every day in prayer, mediation, and/or personal reflection

  4. It seems that my life has always had purpose.

  5. I have had moments of great joy in which I suddenly had a clear, deep feeling of oneness with all that exists

  6. Often when I look at an ordinary thing, something wonderful happens – I get the feeling that I am seeing it fresh for the first time

  7. I feel that my individual life is a part of a greater whole

  8. I am able to move beyond things that once seemed important

  9. I believe that death is a doorway to another plane of existence

  10. I believe that no matter where I am or what I’m doing, I am never separate from others

  11. At the most basic level of reality, everything is one


So… what did you notice? Do you agree with all, some, a subset? Do the items relate to each other? Are you inspired?

These items come from existing research surveys (references for each are below). Did you notice a difference between the first four (1 through 4) and the latter items (5 through 11)? The first set comes from measures of spiritual health or well-being. In contrast, the latter come from measures that purport to measure self-transcendence or access to experiences that go beyond the self.

Both of these types of measures are used in treating patients, hospice work, and in death and dying research.  However, there may be a tendency for wellness practitioners to only focus on spiritual health and not transcendence. Given that the two nourish each other – especially as we get older – I believe it is essential that health professionals always use both approaches (personally and in career).



This brief article began with the distinction between self-actualization and self-transcendence. For those on a path of spiritual health, things happen that move us from a focus on health, to a focus on wholeness, and ultimately to an expanded opening to the transcendent realities that death represents. Our personal quest likely depends on knowing the possibilities on this path.  Accordingly, fellow warriors, may this article further your journey.



Items and corresponding references

Item 1 - Spiritual Well-Being Scale (FACIT-Sp) – for example, see Canada, A. L., Murphy, P. E., Fitchett, G., Peterman, A. H., & Schover, L. R. (2008). A 3‐factor model for the FACIT‐Sp. PsychoOncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer17(9), 908-916.

Item 2 - Advocate HealthCare’s Health Risk Assessment – Page 10 (Spiritual Health) -

Item 3 - TestWell® - National Wellness Institute

Item 4 - from Adams, T., Bezner, J., & Steinhardt, M. (1997). The conceptualization and measurement of perceived wellness: Integrating balance across and within dimensions. American Journal of health promotion11(3), 208-218.

Items 5 And 6 – Kirk, K., Eaves, L., & Martin, N. (1999). Self-transcendence as a measure of spirituality in a sample of older Australian twins. Twin Research, 2(2), 81-87. doi:10.1375/twin.2.2.81

Item 7 - Levenson, M. R., Jennings, P. A., Aldwin, C. M., & Shiraishi, R. W. (2005). Self-transcendence: Conceptualization and measurement. The International Journal of Aging and Human Development60(2), 127-143.

Item 8 – from Self-Transcendence Scale, by Reed, P. G. (1986a). Developmental resources and depression in the elderly. Nursing Research, 35(6), 368-374.

Item 9 – from Self -Transcendence Scale, by Piedmont, R. L. (1999). Does spirituality represent the sixth factor of personality? Spiritual transcendence and the five- factor model. Journal of Personality, 67, 985–1013.

Item 10 -  DeCicco, T. L., & Stroink, M. L. (2007). A third model of self- construal: The metapersonal self. International Journal of Transpersonal Studies, 2, 82–104.

 Item 11 - Kate J. Diebels & Mark R. Leary (2018): The psychological implications of believing that everything is one, The Journal of Positive Psychology, DOI:10.1080/17439760.2018.1484939


See also

Ano, G. G., & Vasconcelles, E. B. (2005). Religious coping and psychological adjustment to stress: A meta‐analysis. Journal of clinical psychology61(4), 461-480.

de Jager Meezenbroek, E., Garssen, B., van den Berg, M., Van Dierendonck, D., Visser, A., & Schaufeli, W. B. (2012). Measuring spirituality as a universal human experience: A review of spirituality questionnaires. Journal of religion and health51(2), 336-354.

Koltko-Rivera, M. E. (2006). Rediscovering the later version of Maslow's hierarchy of needs: Self-transcendence and opportunities for theory, research, and unification. Review of general psychology10(4), 302-317.

Haugan, G. (2014). Nurse–patient interaction is a resource for hope, meaning in life and self‐transcendence in nursing home patients. Scandinavian Journal of Caring Sciences28(1), 74-88.

Sawatzky, R., Ratner, P. A., & Chiu, L. (2005). A meta-analysis of the relationship between spirituality and quality of life. Social indicators research72(2), 153-188.

Schnell, T. (2009). The Sources of Meaning and Meaning in Life Questionnaire (SoMe): Relations to demographics and well-being. The Journal of Positive Psychology4(6), 483-499.


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