Diagnosis with an incurable health condition often prompts people to ask Why is this happening to me? During the early phase of tests and diagnoses, we often rely on understandings of illness inherited from the familial, social and cultural contexts of our childhood and youth. Over time, we’re better able to make sense of illness using core values, beliefs and meanings we’ve chosen as adults.

Making sense of illness engages our spirituality in the experience. If we can readily answer the Why? question, we maintain a coherent view of the world. If we can’t make sense of illness, the conflict between our lived experience and our assumptions about the world generates spiritual distress. Studies show that spiritual distress affects our ability to cope with pain, lessens resilience in the face of ongoing losses and uncertain prognoses, and diminishes overall well-being. How we answer the Why? question influences our choice of healthcare providers, commitment to treatment plans, and the effectiveness of these relationships and interventions.

I’ve identified four common models people use to answer the Why? question when diagnosed with a chronic health condition. These models are neither “good” nor “bad.” The way I understand illness may be life-affirming for me but life-limiting for you. People may draw on more than one model as they make meaning of illness. For clarity, I describe the models independently:

• Moral model: Illness is the result of sin, karma, God’s/Allah’s plan or will, fate, divine favor, spiritual lessons we need to learn, or an opportunity for personal growth. Worldwide, the moral model is the oldest and most prevalent model for making sense of illness.
• Biomedical model: Illness is the result of genetics, poor health habits, aging, germs, viruses, accidents, environmental toxins, or random acts of nature. This is a widely used model in the U.S. where science is revered.
• Social model: Illness is the result of systemic, communal, and cultural factors, also known as “social determinants of health” (e.g., gender, socioeconomic status, ethnicity). Individuals experience health limitations to varying degrees, depending on their social setting and access to resources. This model works especially well for conditions associated with disability.
• Energy body model: Illness is the result of imbalances, blockages, or disharmony in the layers of life force energy that flow through and around our being. In the U.S., this model has grown with the acceptance of positive psychology (the power of positive thinking) and Eastern approaches to health and healing (e.g., yoga, Ayurveda, Traditional Chinese Medicine).

To learn more about meaning making and meaning making, see my new book: Spirituality and Meaning Making in Chronic Illness: How Spiritual Caregivers Can Help People Navigate Long-term Health Conditions.

Link to Amazon page: https://www.amazon.com/Spirituality-Meaning-Making-Chronic-Illness/dp/1784509965