Page 115 - Cultural Competence in Health Education

A Spiritually Grounded and Culturally Responsive Approach 93

talking about their connection to what they see as sacred, the interconnectedness of
everything, and what they draw on in their journey toward wholeness (Wuthnow,
2001; Tisdell, 2003). Thus a first assumption is that to have health is to be whole,

which also relates to spirituality, given that so many people describe spirituality as a
journey toward wholeness. We were trying to capitalize on that sense of spirituality as
a journey toward wholeness at the immigrant women ’ s health conference.
A second and related assumption is that educating for health is about fi nding ways
to assist people in their move toward health. Because health is interconnectedness, the
movement toward it is dynamic, never ending, and cannot be described by a single or
unidirectional path. A third assumption is that many people serve as educators for
health (and at times, as “ mis - educators ” ) to each individual over the course of a life-
time. They include the individual ’ s parents and other members of her home cultural
community who pass on folk wisdom about ways of promoting healing, and also doc-
tors, nurses, curanderos, shamans, or other health care workers who may have been
part of the processes of healing at different points in her life. Religious or spiritual
communities may have also provided various rituals that relate to mental, spiritual,
and physical healing, and therefore they may have been important sources of health

education. Thus a final assumption, based on the earlier three, is that people can fi nd a
sense of wholeness, a sense of health, partly through embracing both their culture and
spirituality. Human beings always express themselves culturally — in the language
they speak, in the food they eat, in the clothes they wear, in the music they make, in the
art they create, and in their direct expression of what they see as sacred or as spiritual,
including many of their rituals around healing (Leininger & McFarland, 2002). As a
result, a culturally responsive education for health and wellness needs to honor both
the spiritual and cultural dimensions of each person in her move toward health and her
move toward wholeness. That ’ s what we were trying to achieve at the immigrant
women ’ s health conference.
These assumptions about spirituality stem from the results of Libby ’ s research on
spirituality (Tisdell, 2003, 2006). They are supported by the wider body of literature
and research on spirituality and health cited throughout this chapter. These fi ndings
may be summarized as follows: (1) Spirituality and religion are not the same; but for
people who were socialized in a religious tradition, there is usually some overlap
between the two. (2) Spirituality is always present though often unacknowledged in
education and health environments. (3) Spirituality is about (a) a connection to what
people experience as sacred or refer to as God, the Lifeforce, Great Mystery, or a simi-
lar term; (b) ultimate meaning making in a journey toward wholeness, healing, and the
interconnectedness of all things; (c) the ongoing development of identity (including
cultural identity), moving toward what many authors refer to as greater authenticity;
or (d) the way people construct knowledge through largely unconscious and symbolic

processes (as first suggested by Fowler, 1981), a process manifested in metaphor,
image, symbol, music, and other expressions of creativity, which are often cultural.
(4) Finally, spiritual experiences often happen by surprise. It is not always necessary

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