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The Nurse’s Handbook
of Spiritual Care
The Nurse’s
Handbook of
Spiritual Care
Pamela Cone
Azusa Pacific University, California, US
Tove Giske
VID Specialized University, Norway
This edition first published 2022
© 2022 John Wiley & Sons Ltd
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical, photocopying,
recording or otherwise, except as permitted by law. Advice on how to obtain permission to
reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Pamela Cone and Tove Giske to be identified as the authors of this work has
been asserted in accordance with law.
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John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
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other damages.
Library of Congress Cataloging-in-Publication Data applied for

[PB ISBN: 9781119890775]
Cover Design: Wiley

Cover Image: © Sandipkumar Patel/Getty Images
Set in 10.5/13pt STIXTwoText by Straive, Pondicherry, India

The authors dedicate this handbook on spiritual care to our
parents, who taught us the way of living for Christ, and to our
husbands, Dave and Jarl, who provided unwavering support to us
for our research and writing. This book would not have been
possible without you and your encouragement and that of our
families. We thank God for you all!
Contents
Acknowledgementsxi
Prefacexii
About the Authors xvi
CHAPTER 1 Basics of Spirituality and Spiritual Care 1

What is Spiritual Care? 1
Spirit – Breath of Life 4
Spiritual Care 7
The Spiritual as Part of Whole
Person Care 12
Existential Questions 14
Religion, Rituals, and Faith Practices 16
Life-View 25
Why Spiritual Care is Important in
Nursing Care 26
Our Professional Responsibility
for Spiritual Care 30
Spiritual Care as a Difficult Topic 34
One Learning Spiral in Three Phases 36
References 38
CHAPTER 2 Preparing for Spiritual Care 45

Knowing Yourself and Your
Own History 46
Background and Context Matter 49
Knowing Yourself at a Deeper Level 51
vii
viii Contents
Exercises to get Better Acquainted

with Yourself 53
Drawing Your Life Tree 54
Working With Your Own View of
Life and Personal Story 55
Becoming Aware of Values in
Your Own Life 57
The Art of Asking Good Questions 60
Two Simple Questions 62
Question Guides for Spiritual Care 63
Preparing for the “I-Don’t-Know-
What-To-Do” Situations 69
What Signal Do You Send Out? 71
General and Special Competence in
Spiritual Care 74
References 78
CHAPTER 3 Connecting: Recognizing and Following

up Spiritual Encounters 83
The Importance of Rapport Building 84
Determining the Need for
Spiritual Care 86
Willing to go Outside Your Comfort Zone 87
Building Trusting Relationships 89
Tuning in to the Spiritual Domain 92
Unveiling Important Concerns 94
Facilitating the Healing Process 100
Documenting Spiritual Concerns 105
Different Conditions That Affect
Spirituality 107
From Connection to Reflection 110
References111
CHAPTER 4 Reflecting and Growing Personally

and Professionally 115
Dimensions and Levels of Reflection 116
Contents ix
Reflecting on What Went Well 118

Reflecting on What Did Not
Go Well 123
Developing Self-Understanding
Through Reflection 124
Activity for Internal Reflection and
Dialogue 125
From Storytelling to Critical Reflection 130
Ending Unfinished Stories 135
Reflecting on What You Know and
What You Need to Learn 138
Spiritual Care Skills and Competencies 138
Features and Qualifications of the Helper 143
Moving from Student to Nurse 146
References 147
CHAPTER 5 Lifelong Learning, Self-Care, and

Workplace Care 151
Lifelong Learning 152
Spiritual Care Educational Standard
for Nursing Competency in
Spiritual Care 153
Tips for Nursing Educators 156
Self-Care for Nurses 162
Self-Care Skills and Strategies 163
Avoid Burnout 169
Develop Coping Strategies 172
Learn Assertiveness 174
Mitigate Bullying 175
Workplace Care: Creating a Welcoming
and Healing Environment 178
Suggested Resources 181
Online Resources 183
Bullying in Nursing 183
Creating a Healing Environment 183
Self-Care in Nursing 183
x Contents
EPICC Spiritual Care Competency

Self-Assessment Tool 184
References 188
Further Readings 194

Index 196
Acknowledgements
The authors appreciate the support given by our home universities,

Azusa Pacific University in California and VID Specialized
University in Norway. Thank you for the encouragement from our
leaders for our research and writing on spiritual care in nursing.
xi
Preface
The Nurse’s Handbook of Spiritual Care was developed for nursing

students and nurses in all aspects of healthcare. The authors, an
American nurse and a Norwegian nurse with 15 years of collabo-
rative research, wrote a parallel book in Norwegian published in
2019 (Å ta vare på heile mennesket: Handbok i åndeleg omsorg) for
the Scandinavian nursing audience. We hope this version, which
presents a variety of European and American perspectives, will
reach English-speaking nurses around the world. With this hand-
book, we want to help nurses develop competence as part of
patient-centered, whole person care, and we want to show that
spiritual care is a self-evident part of all nursing care. We would
like to equip the reader with a professional perspective on this
aspect of nursing care.
The authors build on extensive research in spiritual care by us
as well as other nurse scholars interested in spirituality, and we
present a learning spiral for improving knowledge and skills,
which can lead to increased facility with spiritual care. By following
the steps described, you can learn to “tune in” to patients and
recognize and follow up on spiritual suffering and existential
pain. You can also learn to use the inner resources that patients
have for healing, and to reflect on/over the experience of what
you have done to facilitate patient health and well-being. The
purpose of this handbook is to motivate students and nurses and
to improve their practice of spiritual and existential care as part of
whole person healthcare.
All nursing education should teach spiritual care and ensure
that students have fundamental knowledge, skills, and clinical prac-
tice within the spiritual domain so that they see this as an integral
part of whole person or holistic nursing care. At the same time,
xii
Preface xiii
supervisors in healthcare settings should ensure that the working

environment is a welcoming one so that students and nurses can feel
free to further develop their competence in this domain. Developing
competencies for nurses can enable them to include data collection,
situational assessment, follow-up, and reporting of patients’ spiritual
and/or existential needs and resources in their routine patient care.
Many colleagues have contributed to this project with ideas,
tools, and stories. All of the examples used in this handbook are
based on real events in the USA, Norway, and globally as reported by
spiritual care researchers. Some come from our own practice and
research, or they are stories from other scholarly research retold
fully or in part, and edited to ensure the anonymity of patients,
nurses, and students. Where we have used published narratives, we
provide references. Together, these present a variety of resources
that the readers can use to be inspired and challenged, and for
reflection and learning. We use “patient” in this handbook knowing
that some of the readers are nurses who utilize “clients” or “users.”
The handbook covers the fundamentals of spiritual care so that
reader awareness can be raised and nurses can be equipped and
encouraged to open up and learn what the patients want to share
with them. It is also important to emphasize that this is a field
where no one is ever fully trained; there is always more to learn. All
patients and situations you encounter are unique, and spiritual
relationships can be expressed and met in a variety of ways. We will
emphasize from the beginning the importance of life-long learning
in this field. The handbook includes an introduction to the spiritual
domain, followed by three chapters on the steps of preparing,
connecting, and reflecting on the spiritual. Finally, we conclude
with a chapter on self-care nursing with strategies to empower
yourself and others in healthy ways. It also provides further discus-
sions and resources to increase life-long learning of spiritual care.
The learning spiral, a teaching-learning theory developed by
the authors in our early spiritual care research in Norway, is what
guides the three chapters that follow. These chapters each deal
with one of the three phases of the learning spiral. Chapters 2
through 4 are structured in the same way with an introduction to
topics illustrated by stories that are followed by questions for
reflection and suggestions for competencies that nurses can use.
xiv Preface
Chapter 1 – Basics of Spirituality and Spiritual Care is a discussion

of how spirituality and spiritual care are understood by the nursing
profession globally. We begin with the premise that whole person
care includes the physical, psychosocial, and spiritual. Spirituality
is about existential questions; it is about meaning and purpose and
hope as well as connectedness to self, others, and the transcendent.
It addresses what a view of life is from different perspectives. It also
includes religion and faith traditions with a variety of rituals and
practices. We know that quality care is an important part of
person-centered, whole person nursing care, and the ethical
standards that guide the curriculum for nursing education, theory,
practice, and research as well as the reporting and documentation
of care represent a view of nursing care that includes spiritual care
as an integral part of the nurse’s area of responsibility.
Chapter 2 – Preparing for Spiritual Care is the first phase of the

process. Initially, we go into different aspects of knowing yourself
on a deeper level. We encourage the reader to consider why this is
important in the exercise of spiritual care, and we invite the reader
into various activities that can help in the process of becoming
better acquainted with your own views, prejudices, attitudes, and
stereotypes, particularly related to the spiritual domain. We also
go through some assessment guides that can help nurses identify
what patients need that is of a spiritual nature. Preparation is
done through reading, reflecting, journaling, and dialoguing on
the topic. At the end of the chapter, we look more closely at gen-
eral and special competencies for spiritual care.
Chapter 3 – Connecting: Recognizing and Following up on the

Spiritual discusses how we can identify, assess, and follow up on
spiritual/existential and life-related situations and conditions
with patients. We also address how to identify and use the patient’s
resources in the same way that we consider and follow up the
physiological and psychosocial needs of patients for whom we are
responsible. When there is something of a spiritual nature that is
at stake in the patient’s life, we illustrate the iterative process until
he or she gets help. Scenarios and questions for reflection are
integrated throughout the chapter. We discuss how to report spiritual
Preface xv
needs and resources, and illustrate this with a story. The chapter
concludes with a review of various factors that affect the spiritual
care process.
Chapter 4 – Reflecting on Experiences in Spiritual Care is where we

look more closely at how important reflection is for events and
experiences to be transformed into growth and wisdom. We also
look at how we can work with reflection both individually and in
groups to deepen our understanding of what is spiritual in nature,
what is considered as best practice in various situations, and how we
can improve our patient-centered, whole person care. We go into
what competencies students will develop during their course of
study and how nurses can further develop competence in spiritual
care as they encounter the deep inner spirit needs of patients.
Chapter 5 –Life-long Learning and More is where we discuss how

nurses can grow and mature into healthy and robust professionals
who thrive in any healthcare setting. We promote self-care of the
nurse by focusing on how nurses can pay attention to our own
needs and care for ourselves, thus avoiding burnout. Assertiveness
training and development of a variety of coping strategies is
discussed. We face head-on the challenge of bullying in the
workplace and how caring for the spirit can counteract such
negative practices among nurses. In this way, we will avoid the
promotion of a hostile environment, and instead provide a warm
and welcoming environment for patients and their families as
well as for our fellow healthcare professionals. We conclude with
more resources to promote increased capacity in and facilitation
of spiritual care so that nurses can thrive in our challenging
healthcare environment.
About the Authors
PAMELA CONE, PhD, RN, APRN-CNS, PHN

Professor, Masters & Doctoral Nursing Programs, School
of Nursing, Azusa Pacific University, Azusa, CA USA
Dr. Pamela Cone was born and

raised in Haiti by missionary
parents and has been a nurse
since 1974 and a nurse educator
for 31 years. She has taught
courses in theory, research, inter-
national health, and writing with
bachelor, masters, and doctoral
students at Azusa Pacific Uni-
versity and has served as an
expert in Grounded Theory
research for doctoral students since 2006. Her 2006 PhD disserta-
tion was Reconnecting: A Grounded Theory Study among Formerly
Homeless Mothers. A Fulbright Scholar in Norway in 2008-2009,
Cone worked collaboratively with Norwegian Nurse Researcher,
Dr. Tove Giske, to develop several grounded theories from their
spirituality research. She was awarded the Beverly Hardcastle
Stanford research grant from APU in 2014 for a semester of
research in Norway. In collaboration with the EPICC scholars,
their Spiritual Care Education and Practice (SEP) research team
received a four-year Excellence in Research award from VID in
Norway for research in spiritual care education and practice for
xvi
About the Authors xvii
2020 through 2023, which is their current work. Together, Drs.

Cone and Giske have edited two books as well as authoring two,
published over a dozen articles in spirituality and spiritual care,
and have presented their work in spiritual care education and
practice at professional conferences and workshops in 25 coun-
tries to date around the world.
https://www.apu.edu/
https://discover.apu.edu/?s=School+of+Nursing+Faculty
TOVE GISKE, PhD, MPhil, RN

Professor, VID Specialized University Faculty of Health
Studies Bergen, Norway
Tove Giske is a Professor in

Nursing and works as a pro-
fessor and researcher at
VID Specialized University,
Faculty of Health Studies,
Bergen, where she also
serves as the Director of
Research and Development.
She has researched and
published widely interna-
tionally about spiritual care.
She has collaborated with
Professor Pamela Cone for
over 20 years, and they have
published a Handbook about Spiritual Care together in Norwegian
(2019), and a similar English book in 2022. Tove has been a part of
a European spiritual care network, which now has developed into
the EPICC network, including the Spiritual care Education and
Practice (SEP) Team that wrote the 4-year grant to develop
xviii About the Authors
materials in spiritual care for nurses and students globally. She

developed an interest in how to serve nurses internationally and
has been doing so since 1984. The last 4 years she has been the
President of Nurses Christian Fellowship International and she
seeks ways to teach and serve nurses around the world.
https://www.vid.no/en/employees/tove-giske/
https://app.cristin.no/persons/show.jsf?id=46926
https://www.researchgate.net/profile/Tove_Giske2
CHAPTER 1
Basics of Spirituality
and Spiritual Care
WHAT IS SPIRITUAL CARE?
The authors asked that question during our 2008 study in Norway
of how teachers understand and teach about care that is spiritual
in nature. One teacher said this:
I was working with students in the clinical setting at a

nursing home where many patients had dementia. During
our pre-conference time a student asked how the nurses
could give spiritual care when the patients could not answer
questions or talk about their beliefs and values. The nurse
thought a moment and said, “I make waffles.” The students
looked at each other in puzzlement. “ Waffles?” one said.
“Yes, I make waffles, and you know, the patients are so
happy to smell them and eat them, and they just love it!
I don’t know what they are thinking, but they are happy for
a long time afterwards. So, yes, I make waffles.”
The Nurse’s Handbook of Spiritual Care, First Edition. Pamela Cone and Tove Giske.
© 2022 John Wiley & Sons Ltd. Published 2022 by John Wiley & Sons Ltd.
1
2 Chapter 1 Basics of Spirituality and Spiritual Care
To contextualize this story, many Norwegians have a long

t radition of having family time on Saturdays, with families gath-
ering in the kitchen and making waffles with lots of delicious top-
pings. These are precious times for the family (families have
various ways of preparing waffles that are passed down from
mother to daughter), and this cultural practice is something that
every Norwegian understands is important to the family. So, what
made this waffle-making activity spiritual in nature? It certainly
is not related to religion or faith, but rather, it is about something
that touches what is deeply important to someone, what gives a
person a sense of love and belonging, regardless of any ability to
think or actually remember events.
In this chapter, we first present how spirituality and spiritual
care are understood by the nursing profession and in relation to
health globally. We discuss existential questions that often arise
in situations of uncertainty or serious illness before we raise
the issue of religion or faith tradition and what a view of life or
life-view is. That spiritual care is part of the nurse’s area of respon-
sibility is evident in the ethical guidelines for nurses (ANA 2015;
ICN, 2021) and in nursing theories like the Artinian Intersystem
Model (Artinian et al. 2011; McEwen and Wills 2017) and
Neuman’s Systems Model (Alligood 2018; Petiprin 2016) that
emphasize the central role of spirituality in every person.
The Artinian Intersystems Model (AIM) has a view of person
that is threefold (biological, psychosocial, and spiritual) with spir-
ituality at the core of the person (Artinian 1991). Nursing stu-
dents at Azusa Pacific University (APU), where Artinian taught
while developing her model, use this focus of person in their
nursing care plans, requiring the nurse to complete assessments
of all three aspects of the person. The focus of the AIM, with its
traffic light framework for identifying knowledge (comprehensi-
bility), values/beliefs/attitudes (meaningfulness), and behaviors/
actions (manageability), is to assess the patient and the nurse in
these areas and to develop a mutually negotiated plan of care
(Artinian et al. 2011; McEwen and Wills 2017). By requiring reg-
ular spiritual assessment alongside the other domains, the nursing
program heightens student awareness and understanding of the
spiritual area. Spirituality is a thread that runs through the APU

nursing curriculum from bachelors through doctoral studies.
The systems focus of Betty Neuman’s model emphasizes the
“wholistic” approach to nursing (Neuman 1996) and the open-
ness required to appropriately gather information. The Neuman
Systems Model (NSM) also identifies the spiritual as an integral
part of the whole person (physiological, psychological, sociocul-
tural, developmental, and spiritual), with all aspects of the core
structure focused on basic survival factors that allow the human
system to function (McEwen and Wills 2017). For Neuman, the
spiritual variable includes beliefs and influences that provide
lines of defense around the core of the person to help their spirit
survive and thrive. The interrelationship between the five aspects
of the person is crucial to appropriate functioning of the whole
person. Neuman is also known for promoting three aspects of
prevention (primary, secondary, and tertiary) that help the system
work at peak efficiency (Alligood 2018). The NSM supports the
importance of gathering information on spiritual resources of
patients as well as identifying the needs, both met and unmet, in
the spiritual realm that can help guide spiritual care.
The North American Nursing Diagnosis Association (NANDA
2016) addresses four elements of care that are spiritual in nature:
1. meaning and purpose, especially in light of health

challenges
2. love and belonging (or connectedness and relationships to
self, others, and the environment)
3. hope versus hopelessness or despair and
4. religious beliefs, values, and practices and/or faith tradi-
tions and a sense of the transcendent (Herdman and
Kamitsuru 2017).
A person experiences spiritual well-being when those needs

are met; but if any of those needs are not met, there can be spiritual
distress (Herdman and Kamitsuru 2017; Taylor et al. 2019b). This
is similar to the European understanding of nursing care that
includes three elements of spirituality: meaning, connections,

and transcendence (Kristofferson et al. 2016). Other theorists
organize these components in different ways (McSherry and
Ross 2010). Regardless of the definition of spirituality, spiritual
care is an integral part of nursing care and an area of ethical
responsibility of the nurse (ANA 2010).
Spirit – Breath of Life

In nursing literature, “the spirit” is understood in a broad sense as
being the element that holds the person together, and though we
have no common global definition of what it is all about, there is
a general understanding that it is central to the person (Artinian
et al. 2011; Stoll 1979; Taylor et al. 2019b). The spirit encompasses
the entire human being and is not material or tangible. It is the
intangible “breath of life” of every being. The spirit of a person
touches on the inner being and may be expressed alone or when
interacting with others. Spirituality includes the big questions in
life, as well as peace of mind or inner peace, and is what provides
the life spark of a human being. It is important for health and
for the experience of wholeness in which body, soul, and spirit
form the entire being (Rykkje 2016; Stoll 1979).
The authors of this handbook exemplify cultural diversity to
some extent since we are from very different backgrounds. The
first author is American (though born of missionary parents and
raised in Haiti), living in the Los Angeles, California area where
many cultures and people groups intersect, so a variety of views
on the spiritual are regularly encountered by nurses. In contrast,
the word for “spiritual” in the Norwegian context, where our sec-
ond author lives, has a religious overtone that causes people to
think immediately of faith, religion, and Christianity, which she
sees as too narrow for a multicultural global society. In areas
where spirituality is entwined with religious or faith-based mean-
ings, some nurses would rather use the word “existential,” which
has a broad non-religious meaning. Because the nature of spiritu-
ality is interpreted differently across countries and cultures
around the world, it can be difficult to grasp and hard to explain.
In light of this lack of consensus, we present various views,

descriptions, and definitions of the spiritual as understood by
nurses in a variety of settings. At times, we use the concepts
spiritual and existential together (spiritual/existential) to encourage
a broad understanding of spirituality.
The English nursing association, the Royal College of Nursing
(RCN), defines spirituality as being about hope and strength, trust,
goals and thinking, empathy, beliefs and values, love and relation-
ships, morality, creativity, and being able to express yourself and
communicate with others (RCN 2011). These are many keywords
that go back to what the spiritual is across nursing literature. The
RNC created a nurse pocket guide as a free download to help
address spiritual issues as part of nursing care (www.rcn.org.uk).
Another way of discussing spirituality is in the European
Association of Palliative Care (EAPC) literature, where scholars
provide a consensus definition for this concept. “Spirituality is the
dynamic dimension of human life that relates to the way people
(individual and community) experience, express and/or seek
meaning, purpose and transcendence, and the way they connect
to the moment, to self, to others, to nature, to the significant and/
or to the sacred” (Nolan et al. 2011, p. 88). Within their definition,
spirituality encompasses three primary dimensions:
1. existential questions (concerning, for example, identity,

meaning, suffering and death, guilt and shame, reconcilia-
tion and forgiveness, freedom and responsibility, hope and
despair, and love and joy)
2. value-based considerations and attitudes (that is, the
things most important to each person, such as relations to
oneself, family, friends, work, things, nature, art and
culture, ethics and morals, and life itself)
3. religious considerations and foundations (faith, beliefs
and practices, rituals, one’s relationship with God or the
ultimate) (Nolan et al. 2011, p. 88).
Additionally, an Irish research team analyzed 47 theoretical

and empirical articles from various areas to clarify the content of
the concept of spirituality (Weathers et al. 2016). The analysis

shows that the spirit has many dimensions, the individual person
has a unique history, and the spirit is expressed in different ways
among different people. The relationship aspect encompasses the
self and attachment to others, the environment and/or nature,
and/or a higher power or something that is beyond self, together
with a sense of meaning in life. Another aspect of the spirit is the
experience of transcendence beyond yourself, everyday life, and
the world in which you live. Transcendence is the ability to trans-
form or change perspective on a given situation or life in general
so that the experience of the situation changes and moves beyond
self. Weathers et al. (2016) found three defining attributes of
spirituality: acknowledgement of a higher power or someone/
something beyond self; connections or attachment/relationship
to self, others, and nature; and the need to find meaning and
purpose in life. Transcendence, relationship, and meaning are
thus found across nursing literature, and the importance of caring
for patients spiritually as part of whole person, patient-centered
care is in most foundational nursing textbooks (Kristofferson
et al. 2016; Taylor et al. 2019b).
We summarize the spiritual domain with a paraphrased nar-
rative from psychiatrist Victor Frankl, a holocaust survivor who
wrote Man’s Search for Meaning (Frankl 1946/1959).
A widower came to Frankl for treatment. After his wife’s

death, the man felt that life was no longer worth living. Over
time, this man and the psychiatrist talked about many dif-
ferent things, and during one conversation, Frankl asked
him, “What would it be like if you were the one who died
and your wife the one who lived as a widow?” “Oh,” said the
man, “that would not be good! If it were one of us who had
to die first, it was good that I’m the one who lived, because
I am better able to live alone than she would be.”
This extract from Frankl’s conversations with the widower

highlights the importance of having meaning in relationships and
finding what is meaningful for each of us. The man had felt that
Spiritual Care 7
his life no longer had meaning since he was alone. The question
about what it would have been like if he had been the one who
died, and thus, avoiding a life with such great sadness, made him
suddenly look at his situation with new awareness. Thus the
whole experience of the situation changed (transcendence), and
he had a new sense of purpose for his grief (meaning), namely,
that he had saved his wife from the experience of being widowed
and living alone.
Reflection 1.1
• After reading the different ways of describing “the spirit,”
what do you think about “the spirit” in your own life?
• How would you define or describe the spiritual domain?
• What element of the spiritual do you see most often when
caring for others?
• Do you recognize spiritual expressions, cues, or themes
when working with patients?
SPIRITUAL CARE
What then is spiritual care? Spiritual care can be summed up as

caring for the whole person through patient-centered care and
being completely present for the other, by listening for what is
important in the patient’s life, and often by facilitating practical
matters that are deeply important to the person (Carson 2011;
Kuven and Bjørvatn 2015; Rykkje 2016; Taylor et al. 2019b).
American nurse philosopher and theorist Jean Watson (1997) has
presented many spiritual aspects of care in her 10 Caritas Factors
(Watson 1999; Wei and Watson 2011) that are foundational to
caring practice in nursing.
1) humanistic and altruistic values; 2) faith/hope; 3) sensi-

tivity to self/others; 4) developing helping, trusting, caring
relationships; 5) accepting/expressing positive/negative
feelings/emotions; 6) creative/individualized/problem-
solving; 7) transpersonal teaching/learning; 8) supportive,
protective, or corrective mental/physical/societal/spiritual
environment; 9) human needs helping; and 10) phenome-
nological existential, or spiritual forces
(Alligood 2018, pp. 95–96).
Of these factors, more than half explicitly address the spiritual

(1–5, 8, and 10), while others (6, 7, and 9) have a more implicit
connection to the inner person/spirit. These remind us that com-
passionate care comes from the inner spirit of the nurse.
Danish nurse researcher Vibecke Østergaard Steenfeldt puts
it this way: “Spiritual care is to have the courage to go with
the patient into the space of the suffering and be there with the
patient” (Steenfeldt et al. 2018, p. 34). The purpose of spiritual
care it is “to help the patient with life development” (p. 30).
Spiritual care alleviates patient suffering and increases a sense of
well-being and of feeling supported (Best et al. 2015). When life is
difficult, the spiritual can be an important resource, which can
help the patient achieve a sense of inner peace and strength (Giske
and Cone 2015; Rykkje 2016; Taylor et al. 2019b; Weathers
et al. 2016). Spiritual health promotion is part of whole person
nursing care and includes relieving or alleviating pain and/or
suffering, or simply treating the patient with dignity and respect.
Jessie, a patient who was very anxious to go home the day after
having a stroke, haltingly told the nurse this story:
I had a stroke on my right side, and the night nurse put the
call button on that side even though my hand is weak. Dur-
ing the night, I had to use the toilet, but I couldn’t press the
button. I tried calling out, but nobody came. I tried to hold
my urine, but finally, I could not, so I wet the bed. I felt so
humiliated! I lay there for a long time in a wet bed until
morning when that nurse came to check on things near the
end of her shift. She said to me “You all right, honey? Oh,
you peed in the bed! Oh dear, I guess we’ll have to put a
diaper on you!” I said “Sorry!” but she did not answer. She
Spiritual Care 9
came back with another nurse and proceeded to change the

bed, just rolling me from side to side and talking over my
head to the other nurse, and then putting a big diaper on
me and settling me down again with the call light still by my
weak right hand! She never called me by name, just “honey”
and she never found out that I can hold my urine just fine
as long as I get a bedpan when I need it!
The day shift nurse, who had listened patiently while Jessie
struggled to communicate, apologized for the way her inner sense
of dignity was destroyed and her spirit was hurt by the night
nurses’ attitudes and actions. The nurse removed the diaper and
made Jessie comfortable again, and then placed the call light
beside her strong left hand.
Reflection 1.2
• What was spiritual about this nurse-patient encounter?
• What would have changed this encounter into a positive,
uplifting experience?
• How did the day nurse provide spiritual care?
• Can you think of a time when practical care had/has a spir-
itual dimension to it?
The RCN in the UK also made a list of what kind of care is not
spiritual. According to these guidelines, spiritual care is not simply
about religious beliefs and practices; such needs can be referred to
the appropriate spiritual leader. Nor is it right for students or
nurses to force their personal values on a captive audience,
threaten others with their own beliefs, or exploit situations to per-
suade patients to change their beliefs to match those of the nurse,
all of which are completely unethical (Fowler 2020). Spiritual care
is not just a responsibility for specialists or especially interested
nurses, and it is not simply the responsibility of the hospital
chaplain/priest or other religious leaders (ANA 2010; RCN 2011).
Spiritual care is about being interested in and paying attention

to the patient’s deep inner concerns and/or existential questions
(Cone 2020). By encouraging the patient to express himself or her-
self and listening in an open and non-judgmental way to the
patient sharing his/her own beliefs and traditions, the nurse is
providing supportive spiritual care. Moreover, spiritual care is
about how one carries out practical and concrete nursing care, that
is a combination of what we do (the science of nursing) and the
way we do it (the art of nursing), both of which are very important
(Cone 2020; Taylor et al. 2019a). Spiritual competencies include
knowledge, skills, and attitudes as we provide care (Van Leeuwen
and Cusveller 2004). It can be about how we wash and feed a
patient, change dressings on wounds, or change the diaper on a
patient who is incontinent. The way these things are performed
can alleviate suffering, build good relationships, and strengthen
hope in a patient, or it can increase suffering and lessen hope and
life courage, which is the courage to be (Clark 2013).
With patients and their families in clinical practice, we seek
to understand the patient’s situation in a whole person way rather
than dividing things up to consider physical, mental, emotional,
social, and spiritual elements separately; all of these are inter-
woven in a human being’s life (McSherry and Ross 2010). During
the learning process, it may still be necessary to clarify that
spiritual care has its own characteristics that you can consciously
look for, read about, discuss within the nursing profession, and
report on or document. However, as you grow in your under-
standing, whole person care will begin to weave these elements all
back together (Cone 2020). In the work to develop quality of life
goals for spirituality, religiousness, and personal beliefs, the World
Health Organization conducted a large, 18-country international
study in 2002 and developed eight characteristics that distinguish
spiritual care from psychosocial care (WHO-QOL SRPB
Group 2006). They found that quality of life that measures
spirituality, religion, and personal faith is about:
1. what relationship one has to a spiritual being or power and

how it helps one through difficult times and stress
Spiritual Care 11
2. the meaning of life, which is related to the experience of

meaning, if one feels that one has a goal or purpose in life,
and whether one feels that one has a reason to live
3. to what extent one experiences awe in relation to nature,
music, art, or beauty and whether one experiences
being grateful
4. wholeness and integration, which is about the experience
of the relationship between mind, body, and soul and con-
sistency between thoughts and feelings
5. spiritual strength, which relates to the extent to which the
inner spirit helps one to bear it when life is difficult as well
as helping one to be happy in life
6. inner peace/calm/harmony, which is about to what degree
one has inner peace and feels an inner harmony with oneself
7. hope and optimism, seeking hope or being hopeful and
optimistic in life and
8. to what extent faith contributes to well-being, strength,
and joy in life (WHO-QOL SRPB Group 2006).
Spiritual care is not just about addressing spiritual needs; it

also includes helping the patient access spiritual resources that
bring joy and strength, thus helping them not only to survive but
also to thrive (Cone 2020). The National Health Service (NHS)
Education in Scotland, which has worked extensively with what
kind of care is spiritual in nature and what space it should have in
healthcare, describes spiritual care as care that:
. . .recognizes and responds to the need of man’s spirit. . .

Spiritual care can include the need for self-worth, for
expressing, for support, perhaps for ritual or prayer or sac-
rament, or just for a sensitive listener. Spiritual care begins
with encouraging human contact in a compassionate rela-
tionship and moves in the direction needed.
(NHS 2009, p. 6)
The last part of the quote, moves in the direction needed, means
that the patient is the one who decides what is important
(Giske and Cone 2015). It is not the nurse controlling the process;
the nurse should follow the patient on the path they or their
family need. We must be willing to go where the patient is and at
the pace the patient sets (Giske and Cone 2015; Minton et al. 2018).
Journeying with (Cone and Giske 2013b) can mean following
along with or being a fellow human being together on a learning
journey or on a mutual journey through crisis and suffering (Cone
and Giske 2013a, 2013b; Edwards et al. 2016; Krauss et al. 2016).
Reflection 1.3
• After reading all this, what is your understanding of
spiritual care?
• How are the spiritual and psychological similar when
giving care?
• In what ways are the spiritual, psychological, and/or social
different?
• What do you think is important about distinguishing
between spiritual and psychosocial care?
THE SPIRITUAL AS PART OF WHOLE

PERSON CARE
The spiritual is an integral part of whole person nursing care

(Taylor et al. 2019a). Humanity is body, soul, and spirit at the
same time, so while we meet as physical human beings with per-
sonalities, cultures, attitudes, and experiences, there is also a
spiritual encounter. The Norwegian nursing education plan for
mental health (Norwegian Ministry of Health and Care
[NMHC] 2009) emphasizes that existential questions and spiritual
expressions must be seen as an integral part of health services:
A person with mental problems must not only be seen as a

patient, but as a whole person with body, soul and spirit.
The Spiritual as Part of Whole Person Care 13
Necessary considerations must be taken of human spiritual

and cultural needs, not just the biological and the social.
Mental disorders affect basic existential issues and this must
characterize the construction, practice and management of
all health services.
(NMHC 2009, State Proposition 63, p. 6)
The spiritual is not always clear, since humans are integrated

creatures who cannot be limited to a particular aspect or area; spir-
ituality can only be understood together with everything else in a
human being’s life. One patient who was asked if he experienced
spiritual care while he was hospitalized replied: “Yes, I did, but I
do not believe that the one giving it was aware of it.” This may also
be true in the following story of another nurse-patient encounter.
A nursing student in clinical practice at a stroke unit

worked with Anna, who had right-side paralysis in the right
hand and foot as well as in the throat so she could not eat or
drink and had lost the ability to talk. Anna was clear and
oriented and could write left-handed on a tablet what she
wanted or needed. It came out clearly, both in body lan-
guage and in the words written on the tablet, that she was
feeling down. Anna felt bothered because she needed a lot of
help. The student, who cared for Anna together with many
different nurses, saw that the nurses treated Anna with care
and respect. This showed in the way they cared for, talked
with, and worked with her on her treatments. One of the
nurses said that it was important for Anna to have a good
time and that she had chosen to work at a stroke unit
because she liked this work. Both Anna and the student
knew that these words went from heart to heart. That nurse
gave Anna a hug and Anna cried – and she was allowed to
cry. When the student reflected on what she had learned in
this clinical placement, the student said: “Real care builds
up human dignity!”
Reflection 1.4
• What do you think of the claim that a person is “spirit, and
when you meet a fellow human being, there is a spiritual
encounter”?
• What do you think about spiritual care in the story of Anna?
• Can you think of a time when you may have provided spiritual
care without realizing it?
EXISTENTIAL QUESTIONS
In the literature on spiritual care, existential and religious needs

and resources are usually addressed separately. Existential long-
ing and existential questions are general, and we find them
expressed in philosophy and in religions related to questions such
as “What gives life meaning?”, “Why am I suffering?”, “What can
I do with my guilt?”, and “What happens after death?” In the face
of illness, crisis, loss, and/or impending death, these questions
surface more readily than when life goes on in a normal fashion.
When the existential quest and longing, or even pain, awakens
within, it touches the innermost part of a person. What we have to
help us is our philosophy of life, our successes in life, our own life
story of good and bad experiences, as well as the people around
us – family, friends, and professional helpers. Knowledge of
mental and physical health, different forms of treatment, and
social networking is not contrary to knowledge of existential long-
ing, but it helps us to see the context and thus gives a complemen-
tary picture of the patient’s situation. Existential wonder,
questions, or pain is a general spiritual phenomenon that touches
us all whether we are nurses or patients.
Reflection 1.5
• What gives you a sense of meaning in life? How do you create
meaning in your life?
Existential Questions 15
• What makes you feel a sense of security or of freedom?

• What do you do with the experience of emotional and/or
existential doubt?
• What do you think will happen when you die? What is
beyond this life?
• Have you encountered existential questions in others?
• If you have met this in others, what did you learn that you
can take with you in life for your professional experience?
In one research interview, a nursing student we will call

Marta reflected on how breaking both bones in her right forearm
as a 12-year-old changed her future:
When I was 12 years old, my great passion was playing

handball. I talked about playing on the national team;
Norway had the world’s best women’s handball team! Then
I was unlucky and broke both bones in my right forearm in
a bad fall. Nurses and doctors at the hospital talked to my
parents about the injury and treatment and explained that
healing would come with time. The nurses were pleasant,
but no one talked to me about the injury and the healing
process. At night, I thought that I would never be able to
play handball again and was very sad because I had to give
up the big dream of my life. None of the nurses asked me
why I was sad; they just feared that I was in pain and they
thought I was a quiet and withdrawn child because I did
not talk about my arm. I worked through this loss and grief
all alone and cried my tears quietly in the pillow so no one
could see it, and I never played handball again.
Several years later, when I thought about what I was going
to be and how I should educate myself, I thought of the
nurses I met as a 12-year-old in the hospital. Although they
had not spoken to me, they had treated me with kindness
and care, and I decided to become a nurse. During my early
nursing education, I realized that with physiotherapy

I could have trained my poor right arm to regain its full
function and still become a professional handball player.
Maybe I could have reached my dreams, if I had gotten
better follow-up when I was a child! I wonder?
Reflection 1.6
• What existential themes do you recognize in Marta’s story?
• How could the nurses have discovered what Marta was
struggling with and sad about?
• What would you have done in this situation to help the
child Marta?
RELIGION, RITUALS, AND FAITH PRACTICES
Religion comes from the Latin religare, which suggests to be

bound to someone (Aadnanes 2012). To have a religious belief is
to believe that there are other forms of existence or powers than
what we can grasp with reason, see, or sense around us. Religions
can be mainstream faith traditions or unique sets of beliefs held
by people groups; they can also be defined in relation to categories
of mythos, culture, and ethos (Aadnanes 2012; Bråten and
Everington 2018). Mythos is the educational side of religion and
communicates how one should understand God and humanity’s
place, tasks, and responsibilities in our existence. Culture relates
to the social part of religious practice and can be understood
through symbols and rituals when they bring together the divine
and fellowship with others. Ethos is about values, moral norms,
and practical ways of life that provide guidance for how to live
(Aadnanes 2012).
Being religious is one way of being spiritual where the reli-
gion provides an interpretive framework in the face of big ques-
tions about life and death (Chan et al. 2006). American psychologist
Kenneth Pargament raises another aspect of religion, namely the
sacred (Pargament 2007). What is sacred to a person is not just

about God. It is about every aspect of life that becomes extraordi-
nary because of an affiliation with what is beyond self or repre-
sents transcendence for the person. It includes what is deeply
personal and important to the patient that is sometimes hard to
put into words. Understanding who/what is sacred to someone
can help us to avoid violating patients; it can help us show respect
even when we disagree.
Religions also have some type of organized structure in
common. Because of a thousand-year history of Christianity in
Norway (Catholic in the 1000s changing to Lutheran in the 1500s),
there are values that have influenced societal views, and there is
one large church organization along with many smaller religious
groups. The Lutheran Church, which at one time was the State
Church, makes up about 69% of the population, while other
Christian groups together make up about 8% and other religions
add up to about 5% of Norwegians, making 82% who have some
type of religious beliefs, rituals, and/or practices (Statistics
Norway 2019). Because many Norwegians were christened and
confirmed or grew up in a church, people often know special
music or hymns from a faith tradition when they, to a greater or
lesser extent, interpret life in light of the doctrine of their
childhood religion. They may actively participate in rituals and
social activities and live in alignment with the values and norms
of that religion, or they may simply have an underlying belief
system with very limited actual practice of traditional rituals.
While there is no primary church in the United States, Chris-
tianity is also the largest religion in America, where 63% belong to
some type of Christian church (both Catholic and Protestant
Christian) organization, while 14% have some other faith or belief
in God. This has declined about 8% in the last 7 years and varies
about 10 percentage points among states, with Alabama being the
most oriented to Christianity and Florida being the least, but
overall, at least 77% of Americans have a religious belief of some
kind (Pew Research Center [PRC] 2021). Percentages vary else-
where in the world, but religion is a strong force globally. Because
of this, nurses need to be able to determine if patients have a
spiritual issue that has its roots in religion, and to either allow
patients to express their concerns while simply listening attentively
or to call in an appropriate spiritual leader to help them.
As nurses, we meet many patients who have a religious belief,
and we have to defer our own beliefs while being open to support-
ing patients with different religious understandings from us. It is
important to have good basic knowledge about different religions
and health beliefs and about religious matters that are important
in the face of illness and death (Fowler et al. 2011; Horsfjord 2017;
Taylor 2012). We emphasize that what feels like a threat to an
individual is not necessarily so when compared to our own views
or to the mythos, culture, or ethos of a particular religion.
It is important that we, in addition to listening to what the
patient says and identifying any existential issues that are emerg-
ing, also ask for the beliefs and values the patient holds. Without
knowing how patients who have a religious belief seek to under-
stand their life and can gain hope and strength through prayer,
holy texts, fellowship, or other religious elements, it is difficult to
facilitate and support the sacred in their care. The three following
examples show how varying challenges that patients face can be
woven into their life and can have decisive significance for nursing
care. The first scenario is about a Muslim family.
This man, let’s call him Hassan, had come from Afghani-
stan some years ago, and both he and his wife spoke
Norwegian well and had many friends locally. This was a
family with three young children when he got sick with can-
cer. Hassan was a devoutly practicing Muslim, and he and
his wife often prayed for him to recover. He said that Allah’s
plan for life has no direct control over man, so the family
tried to live day to day as best they could. Hassan went
through a lot of treatment. He was optimistic with a cheer-
ful and calm temperament and was sure he would get well.
But the cancer spread throughout Hassan’s body and even
metastasized to the brain, and the situation was difficult for
everyone. His wife was tired, and Hassan was very scared
and would have preferred to be home. Hassan was hospital-

ized and wished his wife would be there all the time to help
with his care, something that was difficult with three young
children at home. When the family couldn’t be there, the
nurses did their best to make sure Hassan got kind and
humane care.
Many practicing Muslims were interacting more often when
he was doing poorly and as death was approaching.
Adherents visited and recited prayers and verses from the
Quoran or Koran to him. Hassan also got a visit from an
Imam, who prayed for him. Nurses placed the bed so that it
stood in a way that made him face toward Mecca so he
could pray whenever he wanted. Hassan had lots of visits,
something that was important to him and his wife. Nurses
did their best to facilitate important cultural values to Has-
san and his family.
His wife was with Hassan when he was dying, and all the
relatives they wanted were allowed to stay there in the room
after his death. Hassan’s wife took responsibility for the reli-
gious rituals that were important to them and gave comfort
to the family, and the staff made sure that they were able to
do all that they wanted to do.
Here we can recognize the three defining attributes of spiritu-

ality that were shown earlier: transcendence, relationships, and
search for meaning (Weathers et al. 2016). We also see that facili-
tating rituals in relation to prayer was of great importance to this
patient. For the wife and extended family and friends he would
leave behind, ritual around the death was very important.
The second example illustrates that, even for patients who
have dementia, beliefs can have great significance. In this story,
the right to find peace in relation to what will happen to you after
death is at stake. When the ability to put their thoughts and feel-
ings into words is reduced, it adds an extra challenge for the nurse
to interpret the patient’s situation and find ways to help. One nurse
shared the following experience with a Christian patient.
I had the evening shift in a nursing home and one of my

patients was an elderly man we will call Ben who had
dementia. I found Ben in a day care room, partly undressed
and very agitated. Ben looked at me and asked, “Is there
room for me?” Room for me, I thought, and there was
something in the situation that made me wonder what was
in this question. My thoughts went to Jesus’ story in John’s
Gospel where He says to His disciples that they should not
be afraid and that there are many rooms in His Father’s
house. Was this what Ben was wondering about more than
what rooms he had here in the nursing home? “Is it heaven
you are thinking of?” I asked to find out how I was going to
move on in the conversation to help him. “YES!” Ben said,
looking at me. “Do you know Jesus?” I asked. “YES!” he
said again. I said, “The Bible says that all who receive Jesus
have a place in heaven.” Ben listened and became calm.
“There is room for you,” I confirmed. I followed Ben back to
his room, and he found rest in bed.
The last example is a longer narrative of a foreign student

who was studying nursing in a different country. He talked about
meeting a patient in a nursing home who was seen by staff as very
demanding. In addition, the student felt that it was difficult to
relate to the patient’s documented view of life since it was quite
different from his own.
This elderly patient we will call Jacob had struggled with

chronic pain and was bedridden. Jacob had poor vision
and was very hard of hearing, something that made com-
munication difficult. The staff had told me that Jacob was
very Christian, often crying out loud to God when he was
upset, angry, or in pain. They suggested I overlook this
behavior because Jacob was deeply concerned with religious
things. Jacob also had some routines that were very impor-
tant to him, such as the Bible and hymn book should be in
a special place on the nightstand. During the summer, I had
enough experience with Jacob to share the staff’s frustration
with him, and it annoyed me that placing both the Bible

and the hymn book in exactly the right spot could take up to
20 minutes. And I was used to him calling for God, salva-
tion, Jesus, and Mary.
One day Jacob had been calling for a long time. I looked in
on him through the open door and didn’t want to go inside.
All the others were busy, and Jacob was waving to me.
I reluctantly entered. I bent down to Jacob who nodded and
waved at the books on the nightstand. “No, please, no!”
A voice inside me said, “Not the books!” I pointed at the
black-bound Bible with gilded edges. Jacob shook his head.
I pointed at the dark brown book beside it. Jacob nodded
vigorously. He grabbed the book from me and tried to scroll
through it. I was a little surprised because I had expected a
long session to place the books in relation to the edge of the
bedside table. The brown book was old and well-used. What
I thought was a hymn book was full of biblical texts, one for
each day of the week. “So practical,” I thought. I browsed
until Tuesday and read the text of the day.
Jacob grabbed my hand hard and nodded gratefully. He

did not protest when I put the book back on the bedside
table. He didn’t see me going after it was closed. I went out,
almost a little disappointed that the whole thing was over so
fast. I looked around in the hallway. Was there anyone who
had seen or heard me? I looked at the clock; it had taken
just five minutes. And I had been both annoyed and a little
scared of the brown book. Small, precious words in an ordi-
nary evening. Special words that I had not planned for my
lips to shape or for my voice to say. It was just such a shame,
I thought, that Jacob could not read it for himself.
Several months later, I was on this same ward. I stopped in

the patient’s doorway even though Jacob had not called.
Everyone knew he didn’t have a long time left. I went in
and over to the bed. Jacob lay there quietly, and then he
reached out to grab my hand. His hands folded around
mine, and he pleaded “please, please.” I had heard in the

report that Jacob had asked more of the staff to help him to
let go. It was nagging at me. Was this what he asked me to
do, did he plead for help to die? I understood, but I didn’t
want to think about what Jacob had, the pain that he had
to endure.
Jacob pointed at the two books. He raised two folding hands.
Then it hit me. Maybe he was asking for prayer! I browsed
in the brown book I had read before, but found no prayers
there. I was stressed and embarrassed by my own inability
to help him. A dying patient is entitled to something more
than this, I thought. Anything better than a foreign student!
I thought of my godly childhood. I think pretty much Psalms
and prayers in my own native language came to mind.
The Lord’s Prayer! The inspiration was like a light went off.
I leaned over Jacob and shouted in his deaf ear: “Our
Father who art in heaven, hallowed be Thy name. . .”
His hair got into my nostrils. It was very unpleasant. I didn’t
feel anything about what I said. I screamed in discomfort at
a god I do not know, but in a pattern the patient recognized.
Then I realized Jacob was expressing his feelings. He lay
there with pain, in darkness and isolation. I had cried out
to God on his behalf.
“Amen.” The word was spit out in a sigh of relief. Jacob
released his grip on my arm and lay quietly. This time, I did
not look around when I walked out of the room. I didn’t
care if anyone had heard. I had just called out a poor
prayer, in a foreign language, for blind eyes and deaf ears.
Afterwards, I wish Jacob could have told me why the prayer
helped, though he had become calm. What is the secret of
the sacred? Perhaps the answer is that no prayer is poor.
There is no language that is foreign to God. And a prayer’s
effect is not dependent on whether it is believed by the nurse
or heard by a deity; we just know it is said. For Jacob,
shouting, and spitting God’s name was a relief. As health
workers, we must learn to look beyond our own reactions to

such expressions and work our way through our patients’
different beliefs. Then we can actually help the patient
express the need, regardless of how it feels to us.
This example challenges us to think about how workplace

cultures can evolve differently so that you might overlook or
ignore patients’ expressions of spiritual pain rather than address-
ing them. The story encourages us to reflect on whether exercising
spiritual care saves time and/or if there are any times when not
addressing patient spiritually can be acceptable. It also reminds
us that there are spiritual resources a patient can use if we are
willing to help the patient access them.
Reflection 1.7
• How can the nurse/student find out what the patient needs
in these three situations?
• In what way is Jacob’s situation different from the other
scenarios?
• Think about what the nurse/student says in each scenario.
How can what we learn from them have an influence on
spiritual care that we facilitate?
• How would you meet these three patients?
Many of those who have a religious belief are not interested

in being part of an organized faith community. They live out
their faith in their own way. This form of private religion seems
to be increasing in many areas. Often, people who are members
of some major religion are not active participants and have little
contact with church or temple outside of baptism, confirma-
tion, marriage, and burial, and perhaps they go to church at
Christmas, Easter, or some other religious holiday. Such a priva-
tized faith often has little obvious acknowledgment and
represents a voice that is almost silent in the public space.

Personal belief is shaped by upbringing, background, and
culture (Torskenæs et al. 2015). During crisis and illness, it may
be important to understand this belief because it is what the
patient uses to work through whatever is difficult in life. It is
this, more than official doctrines of a particular religion, that is
important for the nurse to understand.
In our spiritual care research, many patients we interview say
something like, “I do not go to church and do not read in the Bible
[or other sacred texts].” However, the family may have had some
faith tradition in their childhood that has influenced them in
some way. Others follow specific rituals related to their religion,
such as prayer and dietary restrictions, but do not actually attend
the church or temple, while still others gain spiritual strength
from nature or a vague sense of the transcendent. Depending on
what kind of beliefs people have, many turn to God with prayers
when they face challenging life situations even if they never think
about God in everyday life (Giske 2010). Rykkje et al. (2013) found
in their study of the elderly that when death approaches, many
people experience an increased need for religious support, and
that childhood beliefs drilled into them throughout their early
years once again became important to them. Nonjudgmentally
helping patients to express their deeply held beliefs can be
very healing.
Reflection 1.8
• Do you belong to any organized faith community?
• If so, to what extent do you share mythos, culture, and ethos
that this community stands for?
• To what extent do you fit under the term “private beliefs”?
• What life experiences and understandings in relation to
truth or faith are important to you?
• What can your experience mean for your understanding of
and care for patients?
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subiectam grammaticen musicae putaverunt. Sie rechneten die
Grammatik zur μουσιϰή.
Die ungeheure Entdeckung des Pythagoras, daß die
musikalische Tonhöhe von der Länge der tönenden Saite abhänge,
hat die Mitlebenden geradezu berauscht und wie kaum jemals ein
anderer naturwissenschaftlicher Fund das Denken Späterer
bestimmt. Die Töne hatten sich als verkörperte Zahlen
herausgestellt, die qualitativen Unterschiede waren auf quantitative
zurückgeführt. Der tiefe Sinn der Musik war der, daß sie Klang
gewordene Zahl ist. In der Zahl hatte man jetzt einen Schlüssel, der
alle Tore zu öffnen verhieß. Sie war das Wesentlichste am Kosmos,
vielleicht das Wirklichste überhaupt, das Symbol der Vernunft. Die
schönsten Sätze darüber stehen bei Philolaos (fr. 11 Diels):
Kenntnisspendend ist die Natur der Zahl und führend und lehrend für
jeglichen in jeglichem, das ihm problematisch und unverständlich ist.
Denn gar nichts von den Gebilden wäre irgend einem klar, weder ihr
Zusich noch des einen zum andrem, wenn nicht die Zahl und deren
Wesen wäre. Nun aber wirkt diese durch die Seele hin in die
Empfindung gestaltend alles erkennbar aus und gesellig, nach des
Gnomons Natur, gibt ihnen Leib und scheidet voneinander alle die
Glieder der Gebilde als unendlicher wie als begrenzender. ... Sehen
kann man nicht nur in den dämonischen und göttlichen Gebilden die
Natur der Zahl und ihre haltende Macht, sondern auch in allen
menschlichen Werken und Worten allenthalben und hin durch alle
Schöpfungen des Bildens und hin durch die Musik.[44] —
Fällt also die Grammatik unter die Rubrik Musik, so mußten in
der Tat die Schriftzeichen die Aufmerksamkeit der Pythagoreer
besonders auf sich ziehen. Denn sie waren zugleich die Zeichen für
die Zahlen und die Musiknoten. In ihnen, in ihrer Form, ihrer Anzahl
und ihren Verschiedenheiten mußte wohl manches von kosmischer
Bedeutung zu finden sein. Aristoteles erwähnt darüber Folgendes
(Metaphys. N 6, 1093 a 20): ἐπεί ϰαὶ τὸ Ξ Ψ Ζ συμφωνίας φασὶν
εἶναι ϰαὶ, ὅτι ἐϰεῖναι τρεῖς, ϰαὶ ταῦτα τρία (nämlich διατεσσάρων,
διαπέντε und διαπασῶν). ὅτι δὲ μύρια ἂν εἲη τοιαῦτα, οὐϑὲν μέλει· τῷ
γὰρ Γ ϰαὶ Ρ εἴη ἂν ἒν σημεῖον (d.h. man könnte ja ebenso gut auch
den Laut γρ durch ein einziges Zeichen ausdrücken). εὶ δ΄ ὅτι
διπλάσιον τῶν ἅλλων ἕϰαστον ἅλλο δ΄ οὔ, αἴτιον δ΄ ὅτι τριῶν ὄντων
τόπων ἒν ὲφ΄ ἑϰάστου ἐπιφέρεται τὀ σῖγμα, διὰ τοῦτο τρία μόνον
ἐστίν, ἀλλ' οὐχ ὅτι αί συμφωνίαι τρεῖς, ἐπεὶ πλείους γε αί συμφωνίαι·
ἐνταῦϑα δ΄ οὐϰέτι δύναται. Ebenso wie sie die Dreiheit der
Doppelkonsonanten musikalisch, d. h. metaphysisch, begründet
dachten, so auch die Tatsache, daß es gerade 24 Buchstaben gibt
(ebenda 1093 b 1): ϰαὶ ὅτι ίσον τὀ διάστημα ἒν τε τοῖς γράμμασιν
ἁπὸ τοῦ Α πρὸς τὀ Ω, ϰαὶ ἁπὸ τοῦ βόμβυϰος ἐπὶ τὴν ὀξυτάτην
νεάτην ἒν αὐλοῖς, ἧς ὁ ἁριϑμὸς ίσος τῇ οὐλομελείᾳ τοῦ οὐρανοῦ. So
stellten sie die Elementargrammatik in die denkbar kosmischsten
Zusammenhänge ϰαὶ ὅσα εἶχον ὁμολογούμενα δειϰνύναι ἒν τε τοῖς
ἀριϑμοῖς ϰαὶ ταῖς ἁρμονίαις πρὸς τὰ τοῦ οὐρανοῦ πάϑη ϰαὶ μέρη ϰαὶ
πρὸς τὴν ὅλην διαϰόσμησιν, ταῦτα συνάγοντες ἐφήρμοττον. Dieser
Satz aus Aristoteles Metaphysik (A 5, 986 a) paßt nicht bloß auf die
alten Pythagoreer: er erschöpft den Inhalt eines beträchtlichen Teils
der europäischen Literatur bis in die Renaissance hinein.
An den Vokalen mußte den Pythagoreern ihre Siebenzahl[45]
wichtig erscheinen. „Sowohl die Altpythagoreer als auch der
Verfasser der altionischen (nach andern [vgl. Boll, Neue Jhb. 31
(1913) S. 137 ff.] erst dem 5. Jahrhundert angehörigen)
pseudohippokrateischen Schrift περὶ ἑβδομάδων erblickten in den
sieben ionischen Vokalen (φωνήεντα, φωναί) oder Urbuchstaben
eine der ältesten und wichtigsten Manifestationen der heiligen
Siebenzahl.“ W. H. Roscher, Hebdomadenlehren S. 145. Dieser
Hinweis auf die Bedeutsamkeit der Vokale ist, wie wir unten sehen
werden, nicht ungehört verhallt.
[43] Aristot. metaph. XIV 6; Hippokr. περὶ ἐβδ. 541 Erm., π.
διαίτης I p. 645 f. Kühn; Varro bei Gell. III 10, 2 und 16; alles bei
Roscher, Hebdomadenlehren 27.
[44] Deutsch nach Herman Schmalenbach, Das Seiende als
Objekt der Metaphysik I: die erste Konzeption der Metaphysik im
abendländischen Denken. Dissertation Jena 1909 S. 36 ff. [Viel
Material dazu zuletzt bei Weinreich, Triskaidekad. Studien RGVV
XVI 1 (1916) S. 96 f.]
[45] Über die Siebenzahl Boll in PW s. v. Hebdomas Bd. VI
Sp. 2552, wo gezeigt wird, daß die Heiligkeit einer Zahl sich dann
herausbildet, wenn diese Zahl in der Natur wiederholt gegeben
ist, so daß der Mensch immer wieder auf sie hingewiesen wird.
§ 3. ELEMENTUM
Recht folgenreich für die antike Wertung der Buchstaben war
es, daß man sie mit dem Wort στοιχεῖον bezeichnet hat. Durch
dieses Wort wurden die Buchstaben der Schrift für den Griechen,
der vom Namen einer Sache aus unwillkürlich weitergehende
Folgerungen zog als wir, — die „Kritik der Sprache“ fing erst an —, in
die Sphäre philosophischer und religiöser Begriffe gehoben.[46]
Die Wortgeschichte von στοιχεῖον stellt sich nach den
Untersuchungen von Diels und Lagercrantz folgendermaßen dar:
Die Ableitung des Wortes στοιχεῖον von στοῖχος bei Dionys. Thrax,
worauf Diels seine Übersetzung „Reihenglied“ gründet, ist wertlos
und verbindet zu nichts.[47] Es ist vielmehr von στείχειν = „gehen,
marschieren“ auszugehen (S. 88). Στοιχέω ist nach Lagercrantz’
Nachweisen in der Bedeutung gehen, marschieren ganz geläufig (S.
103). Davon ist mit objektivisch-transitiver Verwendung der Endung
-εῖον (S. 106) στοιχεῖον in der attischen Sprache gebildet und
bedeutet:
I. das begangene Stück, der Gang, die Strecke (so die früheste
Verwendung bei Aristophanes Eccles. 651):
II. Grund: a) Erdfläche; b) Grundlage, so bei Xenophon memor.
2, 1, 1; c) Stütze, so in der Astrologie (S. 62) und im Neuen
Testament (S. 42). Die vollkommenste Analogie bietet die
Bedeutungsentwicklung des von βαίνω abgeleiteten Wortes βάσις.
Das Wort dringt sodann in die wissenschaftliche Fachsprache
und tritt auf: 1. in der philosophischen Sprache als Übersetzung von
ῥιζώματα τοῦ παντός (der Elemente) bei Empedokles ins Attische,
für uns zuerst bei Platon Soph. 252 b, Tim. 48 b (S. 16); 2. in der
grammatischen als attischer Ersatz für πυϑμήν, ein Wort, das in
grammatischen Ausführungen des Protagoras (Diels Vorsokr. S.
512, 26) in der Bedeutung „Grundform“ vorkam (S. 21). In Platons
Theait. p. 202 e heißt στοιχεῖα τῶν γραμμάτων „Urbestandteile der
Schrift“ (S. 19). Sicherlich waren aber schon vor Platon die
Buchstaben στοιχεῖα genannt worden, sonst könnte Phileb. 19 c
nicht so lauten, wie es überliefert ist. Da im Lauf der Kaiserzeit der
persische Elementenkult, der besonders im Mithrasdienst
ausgeprägt worden ist, in die griechische Welt eindrang (Diels S. 45)
[48], so hat das Wort στοιχεῖον von diesen Kreisen her für viele einen
starken religiösen Akzent erhalten.[49]

Die Verwendung des Ausdrucks in der Astrologie hat nichts mit
der in der Philosophie als „Element“ zu tun, sondern ist eine
unmittelbare Übertragung aus der Volkssprache, wo στοιχεῖον
„Stütze“ bedeutet. στοιχεῖον heißt da 1. die Tierkreisfigur, insofern sie
den wandernden Planeten zur Stütze gereicht[50], 2. Gestirn,
insofern es für dessen δαίμων die materielle Stütze abgibt (S. 65 ff.).
Ferner hat Lagercrantz S. 74 ff. nachgewiesen, daß στοιχειοῦν
durchaus nicht „verzaubern“ heißt, wie Diels S. 55 meint, der dort die
Wortgeschichte auf einer sehr schmalen Linie weiterführt. Es heißt
vielmehr gründen in der Bedeutung „festmachen“, real[51] und
symbolisch. Als einer, der das symbolische „eingründen“, das ein
magisches Binden und Festbannen an einen Ort bedeutet,
besonders gut verstand, wird Apollonius von Tyana ein
στοιχειωματιϰός genannt bei Cedrenus I 346, 18. Derselbe Ausdruck
οί στοιχειωματιϰοί steht schon im Καρπός (Ps.-Claudius Ptolemäus)
[52], ohne daß der Zusammenhang mehr lehrte als daß es sich um
Leute handelt, die sich mit Astrologie abgeben. Wir müssen daraus
schließen, daß es eine Anzahl von Magiern, Astrologen usw.
gegeben hat, die diese Art von „Eingründung“ betrieb.
Im Neugriechischen heißt στοιχειό Geist, Gespenst. Lagercrantz
entwickelt S. 80 ff. einleuchtend, wie dies aus Glauben und Brauch
beim ϑεμελιοῦν von Häusern entstanden ist.
Das alles hat nicht unmittelbar damit, daß στοιχεῖον auch
Buchstabe heißen kann, etwas zu tun, wie Albrecht Dieterich, Rhein.
Museum 56 (1901) S. 102 f. = Kl. Schr. S. 225 f. will. Aber man
begreift ohne Schwierigkeit, wie „die Tatsache, daß Buchstabe und
Gestirn durch dasselbe Wort ausgedrückt werden, mystisch
veranlagte Gemüter bewegen konnte, nach realen Entsprechungen
zwischen ihnen zu suchen“. Lagercrantz S. 57.
[46] Die Dielssche Bedeutungsgeschichte von στοιχεῖον
(„Elementum“, Leipzig 1899) wird in entscheidenden Punkten
berichtigt durch Lagercrantz, Elementum, eine lexikologische
Studie. Skrifter utgifna af K. Humanistiska Vetenskaps-
Samfundeti Uppsala XI 1, Leipzig, Harrassowitz 1911.
[47] Gegen eine verwandte Ableitung hatte auch schon
Bedenken Pa.-Sabas, „Über die Mysterien der griechischen
Buchstaben“, ed. Hebbelynck, Muséon N. S. I (1900) p. 21 f.:
„Man gibt den Buchstaben den Namen Elemente (στίχος!) nicht
deshalb, weil sie selbst nicht mehr in Elemente zerlegbar sind (d.
h. die kleinste Schrifteinheit sind), wie die Weisen der Griechen in
ihrer Hohlheit gedacht haben, sondern weil in ihren Zügen sich
die Form der Elemente der erschaffenen Welt findet.“
[48] Cumont, Textes et Monuments I 6; Dieterich,
Mithrasliturgie 2. Aufl. S. 64; Diels Elementum 45; Cumont-
Gehrich, Die Mysterien des Mithra² 1911 S. 104 f.
[49] Zuerst bei Hippobotos, einem Schriftsteller des ersten
Jahrh. v. Chr., der nach Diog. Laert. VI 102 von dem Hute des
Menedemos, des Stifters der Philosophenschule von Eretria,
sagte, auf ihm seien die zwölf στοιχεῖα abgebildet gewesen (Diels
S. 45, Lagercrantz S. 62). Diesen Sprachgebrauch deutet
Lagercrantz auf Grund von Tatian, orat. ad Graec. 9 στοιχείωσις
δὲ αὐτοῖς ἡ ζώωσις ἦν zu übersetzen: zur Stützung diente ihnen
(den Planeten) das Bevölkern des Himmels mit Tieren (S. 60 und
73).
[50] Nach Diels ist dieser Wandel der Wortbedeutung auf
dem Umweg über den grammatischen Gebrauch von στοιχεῖον
als Bezeichnung von „Buchstabe“ erfolgt. Den aus Nikomachos
von Gerasa belegten Satz von Diels S. 44: „So hat an ältere
Schrullen der Pythagoreer anknüpfend die neupythagoreische
Schule das Alphabet an den Himmel versetzt“, hätte Lagercrantz
noch mit folgendem chronologischen Argument widerlegen
können: In einem Auszug aus Vettius Valens, dem Astrologen aus
dem 2. Jahrh. n. Chr., steht zu lesen, daß im Gegensatz zu einem
verwickelten Verfahren des Vettius die ἁρχαῖοι die Tierkreisbilder
mit je zwei Buchstaben bezeichneten in der Anordnung Α Ν, Β Σ
usw. bis Μ Ω. Mit den ἁρχαῖοι sind in der astrologischen Literatur
meist „Nechepso und Petosiris“ gemeint. Also wahrscheinlich
schon diese Begründer der griechischen Astrologie im 2. Jahrh. v.
Chr. und durch die Tatsache, daß στοιχεῖον „Buchstabe“ und
„Tierkreiszeichen“ bedeuten konnte, dazu bewogen worden, diese
miteinander in Beziehung zu bringen (s. darüber unten in dem
Abschnitt über Astrologie).
[51] Schlagend spricht für Lagercrantz die Stelle in Anonymi
Byz. Παραστάσεις ed. Preger (Progr. d. Kgl. Max-Gymnas.
München 1898) p. 33, 12 § 72 ὁ λεγόμενος Νεώριος ὁ ϰαὶ
Ἀρϰάδιος, ὃν Κόνων ἐστοιχειώσατο, wo auch Diels das letzte
Wort durch „bauen“ übersetzte.
[52] 16⁰-Ausgabe von 1552 S. 214.
§ 4. KINDHEITSMYSTIK
Noch eine letzte mögliche Wurzel der Buchstabenmystik möchte
ich andeuten. In viel stärkerem Maße als es heute m. W. geschieht,
wurde im Altertum und bis ins 18. Jahrhundert auf das Erlernen des
Alphabetes bis zur virtuosen Beherrschung Wert gelegt.[53] Während
für uns die Alphabetreihe nur für Verzeichnisse und Lexika wichtig
ist, war sie für den antiken Menschen auch die Folge der Zahlen[54],
und das hatte, wie wir sahen, infolge der pythagoreischen Lehren in
Altertum und Mittelalter keine bloß praktische Bedeutung. Wir hören,
daß man das Alphabet an der Schule vor- und rückwärts einübte und
in der Reihenfolge Α Ω Β Ψ Γ Χ usw.[55] Die Beschäftigung mit den
Buchstaben war also etwas, das ein Wesentliches der Kindheit
bezeichnet, und daß Kindheitserinnerungen auf assoziativem Weg
zu Faktoren im religiösen Leben der Erwachsenen werden können,
ist bekannt.
Albrecht Dieterich hat in seiner „Mithrasliturgie“ über das
„liturgische Bild“ der Gotteskindschaft schöne Sammlungen
vorgelegt. Dabei handelt es sich hauptsächlich um Zeugung durch
die Gottheit und Geburt aus ihr. In der spätantiken, besonders der
christlichen Mystik haben auch Dinge, die mit dem Kindesalter
zusammenhängen, einen religiösen Gefühlston. Christus selbst hatte
gesagt: ἐὰν μὴ στραφῆτε ϰαὶ γένησϑε ὡς τὰ παιδία, οὐ μὴ εἰσέλϑητε
εἰς τὴν βασιλείαν τῶν οὐρανῶν Mt. 18, 3 Lc. 18, 17. Dies Wort hat
man nicht immer in seiner einfachen Tiefe verstanden. Christus
fungiert bei Clemens von Alexandria als Paidagogos, als
Kindererzieher. Seine Gestalt war schon zu fest umrissen, ebenso
wie seine Stellung im dogmatischen System, als daß es bei einem
rechtgläubigen Schriftsteller in der Zeichnung dieser Figur zu
realistischen Einzelheiten hätte kommen können. Desto mehr sollen
sich die Zöglinge hier als kleine Kinder fühlen. Am befremdlichsten
zeigt sich das in dem langen Kapitel über die Milch im Paidagogos I
6 p. 112 P, das betitelt ist πρὸς τοὺς ὑπολαμβάνοντας τὴν τῶν
παιδίων ϰαὶ νηπίων προσηγορίαν τὴν τῶν πρώτων μαϑημάτων
αἰνίττεσϑαι διδαχήν.[56] Dazu haben wir jüngst in der 19. Ode
Salomos eine Parallele bekommen, die uns zeigt, daß es sich hier
nicht um Seltsamkeiten Einzelner handelt, für die es erst etwa in
bekannten deutschen Kirchenliedern des 17. Jahrhunderts oder in
Zinzendorfs Ausdrucksweise Entsprechungen gibt, sondern um
verbreitete Stimmungen:
Ein Becher Milch ist mir dargebracht worden, und ich habe
ihn getrunken in der Süße der Freundlichkeit des
Herrn.
Der Sohn ist der Becher, und der, der gemolken ward, der
Vater.
Und es melkte ihn der heilige Geist, weil seine Brüste voll
waren usw.
Man ist sich bewußt, Frommes zu tun, wenn man der Gottheit
gegenüber und zu ihren Ehren Kindliches tut.
Der große Gnostiker Valentinos behauptete, der Logos sei ihm
in der Gestalt eines kleinen Kindes erschienen und habe ihm so
seine Offenbarungen mitgeteilt (Hippolytos philosoph. VI 5, 43 p. 309
Cruice). Sein Schüler Markos deutete den Vers 2 des 8. Psalmes:
„Durch den Mund von Kindern und Säuglingen hast du ein Bollwerk
gegründet um deiner Widersacher willen, damit du Feinde und
Rachgierige zum Schweigen bringest“[57] so, daß er das Geschrei
der Säuglinge als Vokale auffaßte. So loben die Kinder Gott ebenso,
wie es in Psalm 19, 1 heißt: „die Himmel erzählen die Ehre Gottes.“
Diesen letzteren Vers deutete er natürlich auf die unten zu
behandelnde Beziehung zwischen Vokalen und Planeten (vgl. Iren.
adv. haer. I 14, 8 Manucci; Epiphan. I 3, 7 haeres. 34) und hielt das
Geschrei der Säuglinge für eine Bestätigung dieser Entsprechung.
Die Buchstabenspielerei in den später zu besprechenden
Branchosversen gegen die Pest hält Klemens von Alexandria für
einen frommen Hinweis auf die Kindheit (Stromata V 8, 48 p. 675 P.):
αἰνίσσεται, οἶμαι, τὴν ἐϰ τῶν τεσσάρων ϰαὶ εἵϰοσι στοιχείων ψυχῆς
γαλαϰτώδη τροφήν, μεϑ' ἣν ἤδη πεπηγὸς γάλα βρῶμα, τελευταῖον δὲ
αἷμα ἀμπέλου τοῦ λόγου τὸν „αἴϑοπα οἶνον“ τὴν τελειοῦσαν τῆς
ἀγωγῆς εὐφροσύνην διδάσϰει.
Dasselbe meinte Remigius von Auxerre ( † ca. 908) in seinem
tractatus de dedicandis ecclesiis von dem Aschenkreuz auf dem
Boden der neu zu weihenden Kirchen, auf welche das Alphabet
geschrieben wird.[58] Auch der Kaiser Didius Julianus ließ 193 n.
Chr. durch junge Knaben, die mit verbundenen Augen in einen
Spiegel schauen mußten, die Zukunft erforschen.[59] Ein Knabe
fungiert als Pythia bei Hippol. philos. IV 4, 1 p. 93 ff. Cruice.
So mag mancher, der schon vielleicht aus den erwähnten
Gründen in den Buchstaben etwas Heiliges sah, in dieser
Vorstellung dadurch bestärkt worden sein, daß sie ihm ein heiliges
Stück Kindlichkeit waren. Und gerade die eifrige Erlernung des
Alphabets mochte in dieser Richtung mitwirken; später wird sich
zeigen, wie eine Anordnung der Alphabetreihe als mystisch
bedeutungsvoll verwendet worden ist, die im Anfangsunterricht der
Kinder ihre Stelle hatte. Ja, man hat auf dieser Unterrichtsstufe mit
Zauberei nachgeholfen, wobei die Alphabetreihe im Sinn der hohen
Anschauungen über den Ursprung der Schreibkunst als Symbol
alles Wissens erscheint. Um ein Kind lernbegierig und leichtfassend
zu machen, rät ein neugriechisches Zauberrezept, das ABC auf eine
Schüssel zu schreiben, die für die heiligen Brote gebraucht wird, sie
segnen zu lassen und die Schrift mit reinem Wein aufzulösen; das
soll das Kind trinken.[60]
[53] Man gab den Kindern Kuchen (Horaz sat. I 1, 25),
elfenbeinerne Typen (Quintilian inst. I 1, 26) und Würfel, worauf
das Alphabet stand (Hieronymus, epist. ad Laetam 107, 4). Über
altirische Alphabetkuchen Gaidoz, Les gâteaux alphabétiques,
Mélanges Renier, Bibliothèque des hautes études Paris 1887.
Woher die russischen Buchstaben stammen, die man noch heute
als — übrigens recht schmackhaftes — Gebäck zu essen
bekommt, weiß ich nicht. Jedenfalls stammt der Brauch, ebenso
wie die Suppennudeln in Buchstabenform, aus alter Zeit. Ähnliche
Verfahren des Elementarunterrichtes beschreiben noch Rabelais,
Gargantua I 14. Goldsmith, vicar of Wakefield cap. 12. Smollet,
Humphrey Clinker ed. Tauchnitz p. 122; über Basedows
Buchstabenbäckerei s. Grasberger, Erziehung und Unterricht im
klassischen Altertum I 2, 267, Würzburg 1864, vgl. Leclerq bei
Cabrol, Dictionnaire d’archéologie chrétienne et de liturgie I, Paris
1907, s. v. Abécédaire p. 60 f. Beudel, Qua ratione Graeci liberos
docuerint, Dissertation Münster 1911. S. auch die kuriose
Geschichte von dem begriffsstutzigen Sohn des Herodes Atticus,
des bekannten Redners zur Zeit der Antonine, bei Philostratos,
vit. sophist. II 10 p. 66 Kayser: das Alphabet hat er wenigstens
durch 24 mit den Buchstaben bezeichnete Spielkameraden
gelernt.
[54] Über das Alter des milesischen Zahlenalphabets (8.
Jahrh.) s. Larfeld, Griechische Epigraphik³ (1914) S. 294 ff. Man
hat aber auch mit den Buchstaben α–ω als 1–24 numeriert,
ebenso wie wir es mit unsern Buchstaben tun. Beispiele sind die
in Olympia zur Auslosung der Kämpfer gebrauchten Täfelchen
(Lukian Hermotimos 39), Theatermarken (J. Friedländer, Hermes
9 (1875) 251 ff. Svoronos, Περὶ τῶν εἰσιτηρίων τῶν Ἀρχαίων,
Journal International d’Archéologie numismatique I (1898) 45-
120; III (1900) 197–235; 319–349), Numerierung von
Gesimsblöcken an Bauten (Karapanos, Dodone et ses ruines 68
f. pl. 34–40; thessalische Inschriften bei Lolling, Athen. Mitt. VII
(1882) 69. Gesimsblöcke des Altars zu Pergamon, Robert,
Hermes 18 (1883) 466 ff. Eisler, Weltenmantel und Himmelszelt,
Nachtrag), der Sektionen des Heliastengerichtshofes in Athen
(Lipsius, Das attische Recht und Rechtsverfahren I [1905] S. 140
f.), von Äckern („casae literarum“, Inschrift von Halesa, IG XIV
352. Gromatici ed. Lachmann I 309; II 235, 268, 409), die
Bezeichnung der Stadtquartiere von Alexandreia (Ausfeld, RM 55
[1900] 379, Der griechische Alexanderroman, Leipzig 1907 S.
139), der Gesänge der homerischen Gedichte (Woisin, De
Graecorum notis numeralibus, Diss. Kiel 1886, S. 30), der
Wochentage (Boll s. v. Hebdomas, PW Sp. 2573). Über unsre
Benennung der sieben Töne der Oktave von C bis H unten mehr.
Auch der Alchimist Zosimos hat die 28 Bücher seines Werkes mit
Buchstaben bezeichnet, ebenso Mani und Aphraat die ihrigen mit
den 22 Buchstaben des syrischen Alphabets. Pachomius
numerierte seine Mönchsklassen mit Buchstaben, s. unten den
Abschnitt über die Spekulationen über die ganze Alphabetreihe.
[55] Quintilian, inst. or, I 1, 25: Quae causa est
praecipientibus, ut etiam, com satis affixisse eas pueris recto illo
quo primum scribi solent contextu videntur, retroagant cursus et
varia permutatione turbent, donec litteras qui instituuntur facie
norint, non ordine. Hieronymus in Jerem. 25, 26, Migne PL 24,
838 = p. 311 Reiter 1913. Ferner in Brief 107 an Laeta über die
Erziehung ihrer Tochter II p. 294 Hilberg: Et non solum ordinem
teneat literarum et memoria nominum in canticum transeat; sed
ipse inter se crebro ordo turbetur, et mediis ultima, primis media
misceantur, ut eas non sono tantum, sed et visu noverit.
Dieterich, Rhein. Mus. 56 (1901) S. 99. Solche Schulübungen
stehen auf einem Ostrakon im Brit. Museum, einem Säulenstück
aus Sparta, Papyrus aus Hermupolis, vgl. Milne, Journ. hell. stud.
28 (1908) p. 121 nr. 1; Annual of the brit. school of Athens XII
476; Wessely, Studien zur Paläogr. und Papyruskunde II (1902) p.
XLV nr. 2; Ziebarth, Aus der antiken Schule², Kleine Texte Nr. 65,
Bonn 1913 S. 1 ff.
[56] Über Anklänge an gewisse Bräuche beim
Verwandtschaftsschließen in diesem Kapitel Adolf Jacoby, Archiv
für Religionswissenschaft 13 (1910) S. 549 ff.
[57] Der sich m. E. am besten erklärt, wenn man ihn mit dem
Kommentar von Hitzig darauf bezieht, daß in einem Krieg ein
siegreicher Feind durch das Geschrei von Säuglingen sich zur
Milde hatte stimmen lassen, vgl. etwa 1 Sam. 30, 2.
[58] Migne PL 131, 851: Quid autem per alphabetum nisi
initia et rudimenta doctrinae sacrae intelligi convenit? offenbar in
Anlehnung an den Hebräerbrief 5, 12: τὰ στοιχεῖα τῆς ἀρχῆς τῶν
λογίων τοῦ ϑεοῦ. Diese Erklärung ist übernommen von de Rossi,
Bullettino di archeologia cristiana 1881 p. 135 und von Leclerq bei
Cabrol, Dictionnaire d’archéologie chrétienne et de liturgie, Paris
1907 s. v. Abécédaire Sp. 56.
[59] Aelius Spartian, vita Didii Iuliani VII 10. Über
ϰατοπτρομαντία Bouché-Leclercq, Histoire de la divination, Paris
1879, I 185. Wünsch, Hess. Blätter für Volkskunde 3 (1904) 154
ff. Reitzenstein, Historia monachorum, Göttingen 1916, S. 244 ff.
[60] Abbott, Macedonian Folklore, Cambridge 1903 S. 362.
Pradel, Griechische Gebete usw. Religionsgesch. Versuche u.
Vorarbeiten III, Gießen 1907 S. 381; Jacoby, Archiv für
Religionswissenschaft 13 (1910) 529.
II. DIE VERSCHIEDENEN GEBIETE
DER BUCHSTABENMYSTIK
§ 1. SPEKULATIONEN ÜBER EINZELNE
BUCHSTABEN
Wir sahen, daß die alten Pythagoreer kraft der ganzen Haltung
ihres Denkens dazu neigten, in den Buchstaben Übergrammatisches
zu sehen. In welcher Richtung, das zeigt eine seltsame Notiz in den
Scholien zu Dionysius Thrax (p. 183, 30): Ἀπολλώνιος ὁ Μεσσήνιος
ἐν τῷ περὶ τῶν ἀρχαίων γραμμάτων φησί τινας λέγειν, ὅτι
Πυϑαγόρας αὐτῶν τοῦ ϰάλλους ἐπεμελήϑη, ἐϰ τῆς ϰατὰ γεωμετρίαν
γραμμῆς ῥυϑμίσας αὐτὰ γωνίαις ϰαὶ περιφερείαις ϰαὶ εὐϑείαις. Man
hat also in pythagoreischen Kreisen — auf Pythagoras’ Person wird
niemand trotz der bestimmten Bezeugung bestehen wollen — in der
Form der einzelnen Buchstaben Symbolisches gesucht und
gefunden. Dafür gibt es noch manchen Beleg im Einzelnen.
Delta bedeutet noch heute in der Medizin τὸ γυναιϰεῖον αἰδοῖον.
Das ist eine uralte Bezeichnung, s. Aristophanes Lysistr. 151: γυμναὶ
παρίοιμεν, δέλτα παρατετιλμέναι. Der Pythagoreer sah im Delta das
Dreieck. So wird das Dreieck nach pythagoreischer Lehre zur ἀρχὴ
γενέσεως ϰαὶ τῆς τῶν γενητῶν εἰδοποιίας (Procl. in Euclid. 166, 14
Friedlein), vgl. die Porphyrios-Stelle bei Euseb. praep. ev. III 7, 4 p.
98: ϰῶνον μὲν ἡλίῳ γῇ δὲ ϰύλινδρον, σπορᾷ τε ϰαὶ γενέσει φάλητα
ϰαὶ τὸ τρίγωνον σχῆμα διὰ τὸ μόριον τῆς ϑηλείας.[61] Eine
Auseinandersetzung von 14 Seiten über das Δ steht in dem koptisch
erhaltenen Buch „Über die Mysterien der griechischen Buchstaben“,
das dem großen palästinensischen Klostergründer Sabas aus Talas
( † 532) zugeschrieben wird, S. 112–129 der Publikation von
Hebbelynck, Muséon N. S. I [1900]. Δ bedeutet die Schöpfung, es ist
das στοιχεῖον ὁλόϰληρον, die ὁμάς[62] des Kosmos; es weist mit
seinen drei Ecken auf die Dreieinigkeit und die sechs
Schöpfungstage, und ist als der vierte Buchstabe ein Symbol der
vier Elemente und anderer Tetraden.[63]
Über das Ε als Abbildung der Wage steht folgendes in den
Theologumena arithmetica p. 30 Ast (vgl. Lobeck, Aglaophamus S.
1341, 1345) — unter anderen Spekulationen darüber, daß 5 die
Mitte von 9 ist —: ϰαὶ τῷ σχήματι δὲ οἱ τοὺς τῶν γραμμάτων
χαραϰτῆρας προτυπώσαντες. ἐπεὶ τὸ Θ τοῦ ἐννέα σημαντιϰὸν
ὑπάρχει, μεσότης δὲ αὐτοῦ ὡς τετραγώνου τὸ Ε, τὸ δὲ μέσον ἐν
ἑϰάστῳ σχεδὸν ϰατὰ τὸ ἥμισυ ὁρᾶται, ἥμισυ τοῦ Θ γράμματος
τυποῦσϑαι τὸ Ε ἐπενόησαν, ὡς διχοτόμημα τοῦ Θ, ϰαϑὰ ϰαὶ τὸ τοῦ
Ο. Τούτῳ δὴ τῷ τρόπῳ τῆς διϰαιοσύνης τῷ Ε ἀριϑμῷ διϰαιότατα
ἐνοφϑείσης ϰαὶ τῆς τοῦ στίχου ἀριϑμητιϰῆς εἰϰόνος ζυγῷ τινι οὐϰ
ἀπιϑάνως εἰϰασϑείσης, τὸ παράγγελμα τοῖς γνωρίμοις ὲν συμβόλου
σχήματι ὁ Πυϑαγόρας ἐνεποιήσατο ‘ζυγὸν μὴ παραβαίνειν’ τουτέστι
διϰαιοσύνην. Anderes über das Ε aus Theodoros v. Asine bei
Proklos in Tim. 225 b II 274 Diehl, über das Ζ ebenda p. 275 unten.
— Das berühmte Ε in Delphi, über das Plutarch einen Dialog
geschrieben hat, kommt hier nicht weiter in Betracht, da es
ursprünglich wahrscheinlich kein Buchstabe gewesen ist, sondern
ein „andersartiges ἀνάϑημα, vermutlich eine ϰλεὶς ϰρυπτή, die
zunächst als eine Erfindung geweiht, dann symbolisch gefaßt und
endlich als Ε gedeutet wurde. Denn der Balanosschlüssel sieht
einem archaischen Ε sehr ähnlich“. Diels, Vorsokr. II² 520 Anm. 5;
Parmenides, Berlin 1897, S. 143; Norden, Agnostos Theos, Leipzig
1913 S. 231 f. Es ist übrigens recht merkwürdig, daß in dem
plutarchischen Dialog nichts von Buchstabenmystik vorkommt.
Das Θ (= 9) war zunächst einmal ein Symbol der großen
ägyptischen Enneas. Ferner schien seine kreisförmige Gestalt die
Welt abzubilden. Bei Philon von Byblos fr. 9 FHG III p. 572 aus
Euseb. praep. ev. I 10 = Johannes Lydus de mensibus IV 161 p. 177
Wünsch steht: ἔτι μὲν οἱ Αἰγύπτιοι τῆς αὐτῆς ἐννοίας τὸν ϰόσμον
γράφοντες περιφερῆ ϰύϰλον ἀεροειδῆ ϰαὶ πυρωτόν χαράσσουσι ϰαὶ
μέσον τεταμένον ὄφιν ἱεραϰόμορφον [οἱονεὶ συνεϰτιϰὸν ἀγαϑὸν
δαίμονα] (ϰαὶ ἐστι τὸ πᾶν σχῆμα ὡς τὸ παρ’ ἡμῖν Θ) τὸν μὲν ϰύϰλον
ϰόσμον μηνύοντες, τὸν δὲ μέσον ὄφιν συνεϰτιϰὸν τούτου ἀγαϑὸν
δαίμονα σημαίνοντες. — Das ist rein astronomisch gewendet im
schol. in Dionys. Thrac. p. 321, 37 und 488 Hilgard: Θῆτα ὅτι τοῦ
παντὸς ϑέσιν μιμεῖται· ἡ δὲ τοῦ παντὸς ϑέσις ἐστίν ὁ οὐρανός, ὃς τό
τε ϰυϰλοτερὲς ἔχει ϰαὶ τὸν διὰ μέσου ἄξονα τῇ ϰατὰ μέσον
χαραϰτηρισϑέντα μαϰρᾷ· und übernommen im Etymologicum
Magnum p. 441.[64] Weil man bei alleinstehendem Θ leicht daran
dachte, daß das Wort ϑάνατος damit anfängt, so wird dieses
Unglück bedeutende nigrum theta (Persius 4, 13) ängstlich
gemieden, z. B. in den Jahreszahlen der Alexandriner und den
Münzbuchstaben des Gallienus.[65]
Das Ι war wohl geborgen durch das Wort Iesu, Mt. 5, 18: οὺ μῂ
παρέλϑῃ ἰῶτα ἐν. Auch der Name des Heilands beginnt damit. So
spielt es im Mittelalter eine ziemliche Rolle auf Münzen; und Ps.-
Joachim von Floris, De seminibus scripturarum (13. Jahrhundert)
schreibt darüber Littera minima in forma sed maxima in sacramento.
[66]
Das Τ glich dem Kreuz (σταυρός), wie auch Heiden bemerkten,

vgl. Lukian, Δίϰη φωνηέντων 61. Die Methoden, die die Christen
fanden, um das Τ in noch engere Beziehung zu Jesus zu bringen,
sollen unten in dem Abschnitt über den Gnostiker Markos behandelt
werden.
Das Υ ist das γράμμα φιλόσοφον schlechthin (Proklos in Plat.
Tim. III 225). Es wird an zahlreichen Stellen als Illustration des
Gleichnisses von den beiden Wegen der Tugend und des Lasters
aufgefaßt, das seit Hesiod in griechischer und jüdischer Moralistik
sehr beliebt gewesen ist.[67] Pythagoras selbst soll diesen Sinn des
Υ aufgezeigt haben.[68] Neuerdings hat Brinkmann auch „ein
Denkmal des Neupythagoreismus“ (Rhein. Museum 66 [1911] S. 616
ff.) richtig gedeutet, auf welchem ein großes Υ den Mittelpunkt einer
bildlichen Darstellung des Kebesschen Πίναξ bildet.
Α und Ω war in christlichen Kreisen durch das ΑΩ der
Offenbarung des Johannes geheiligt (darüber s. unten einen
besonderen Abschnitt). Aber ganz pythagoreisch schreibt
Theodosius von Alexandria, περὶ γραμματιϰῆς p. 4 Groettling, Zeile
12, Α bestehe aus drei Strichen, stelle also die ἀρχὴ πλήϑους
dar[69], ebenso Paulinus von Nola, carmen 29, 645 ff.:
645 Alpha crucem circumstat et Ѡ, tribus utraque virgis

littera diversam trina ratione figuram
perficiens, quia perfectum est mens una, triplex vis.
Ebenso deutet noch Clemens Brentano, Romanzen vom

Rosenkranz X 80 f. die Dreieinigkeit in das Α hinein:
„Ich will dich nun belehren,

Wie das Aleph ist geformet.
Aus drei Strichen es bestehet,
Wie auch steht die Einheit Gottes,
Dieses Aleph alles Lebens,
In drei göttlichen Personen.“
Und über das Ω schrieb der Alchimist Zosimus (Berthelot,

Collection des alchymistes grecs II 228): τὸ Ω στοιχεῖον <τὸ>
στρογγύλον, τὸ διμερές, τὸ ἀνῆϰον τῇ ἑβδόμῃ Κρόνου ζώνῃ ϰατὰ τὴν
ἔνσωμον φράσιν—ϰατὰ γὰρ τὴν ἀσώματον ἄλλο τί ἐστιν
ἀνερμηνεύτητον, ὂ μόνος Νιϰόϑεος <ὁ> ϰεϰρύμμενος οἶδεν, ϰατὰ δὲ
τὴν ἔνσωμον, τὸ λεγόμενον ‘ὠϰεανος ϑεῶν’, φησίν ‘πάντων γένεσις
ϰαὶ σπορά’, vgl. Reitzenstein, Poimandres S. 267. Historia
monachorum, Göttingen 1916 p. 150. Ähnliches über Ω steht im
Etymologicum Magnum p. 294, 29. Die rätselhafte Bemerkung
Isidors von Sevilla, Etymologiae I 3, fünf Buchstaben seien mystisch,
nämlich Α Θ Τ Υ Ω ist jetzt klar.
Die byzantinischen Lexikographen haben diese Dinge gerne
aufgenommen (vgl. Fuhr, Berl. phil. Wochenschr. 31 [1911] S.
1176[70], ebenso wie die griechisch-byzantinischen Gesprächbücher.
[71] Grübeleien über einzelne Buchstaben müssen also im
oströmischen Schulunterricht einen gewissen Raum eingenommen
haben. Ein Beispiel: Γ παρὰ τὸ ἀμᾶν, τὸ ϑερίζειν· δρεπανώδης γὰρ ό
τύπος αὐτοῦ. Die Verwendung der alphabetischen Akrostichis bei
allerhand Lernsprüchen leistete dem wohl noch Vorschub, s. unten
den Abschnitt über Akrostichis.
Zu solchen Spekulationen fand sich in Ostrom noch ein weiterer
Anlaß. In byzantinischer Zeit hat sich bei der Feier der Brumalia, die
damals vom 24. November bis zum 17. oder 18. Dezember
dauerten, die Sitte herausgebildet, diese 24 oder 23 Tage mit den
Buchstaben des griechischen Alphabets zu benennen. Jedes
Mitglied der guten Gesellschaft gab dann an dem Tag ein Fest, der
mit dem Anfangsbuchstaben seines Namens bezeichnet wurde, τὰ
ὑπὲρ τῶν ὀνομάτων συμπόσια (Agathias hist. V 3 p. 140 Bonn). Bei
diesen Festen durfte natürlich der Festredner nicht fehlen. Wir haben
noch einen Panegyrikos des Sophisten Chorikios aus Gaza εἰς τὰ
τοῦ βασιλέως Ὶουστινιανοῦ Βρουμάλια[72], in dem die Initiale Ι des
Kaisers zu grotesken Sehmeicheleien Veranlassung gibt: Die gerade
Form des Ι versinnbildlicht die Gerechtigkeit und Wahrheit Seiner
Majestät. Ι zu schreiben kommen in gleicher Weise Greise, Kinder
und Jünglinge in die Lage: Beweis, daß der Herrscher kein
Lebensalter ungerecht bevorzugt u. dgl.
Der Vater des Klosterwesens, der Kopte Pachomius, numerierte
die von ihm gebildeten Mönchsklassen mit griechischen Buchstaben;
im einzelnen gibt er darüber folgende Vorschriften, Palladios, hist.
Lausiaca 38 bei Migne, PG 34 p. 1100 = cap. 32 p. 90 Butler:
ἐϰέλευσεν εἰϰοσιτέσσαρα τάγματα εἶναι τῶν ἀδελφῶν, ϰατὰ τὸν
ἀριϑμὸν τῶν εἰϰοσιτεσσάρων γραμμάτων. Καὶ προσέταξεν ἑϰάστῳ
τάγματι τὸ ὄνομα τεϑῆναι στοιχεῖον Ἑλληνιϰόν, ἀπὸ τοῦ ἄλφα ϰαὶ
βῆτα ϰαὶ τῶν ϰαϑεξῆς ἕως τοῦ ω μεγάλου· ἴνα ἐν τῷ ἐρωτᾶν ϰαὶ
φιλοπραγμονεῖν τὸν ἀρχιμανδρίτην περί τινος εἰς τοσοῦτον πλῆϑος,
ἐρωτᾷ τὸν δεύτερον ἑαυτοῦ, πῶς ἔχει τοῦ ἄλφα τὸ τάγμα, ἢ πῶς ἔχει
τὸ βῆτα· πάλιν ἀσπάσαι τὸ ῥῶ· ἰδίῳ τινὶ σημείῳ ὀνόματος
γραμμάτων ἀϰολουϑοῦντος. Καὶ τοῖς μὲν ἁπλουστέροις ϰαὶ
ἀϰεραιοτέροις ἐπιϑήσεις τὸ ἰῶτα· τοῖς δὲ δυσχερεστέροις ϰαὶ
σϰολιωτέροις προστάξεις τὸ ξ. Καὶ οὕτως ϰατ’ ἀναλογίαν τῆς
ϰαταστάσεως τῶν προαιρέσεων ϰαὶ τῶν τρόπων ϰαὶ τῶν βίων
ἑϰάστῳ τάγματι τὸ στοιχεῖν τοῦ γράμματος ἐφαρμόσεις, μόνων τῶν
πνευματιϰῶν εἰδότων τὰ σημαινόμενα. Dasselbe steht bei
Sozomenos III 14 Migne PG 67, 1072. Der letzte Teil dieser Stelle,
der in 2. Person geschrieben ist, stammt anscheinend aus einem
Brief des Pachomius, s. unten in dem Abschnitt über Abc-
Denkmäler.
Die bisher erwähnten pythagoreisch gehaltenen Erklärungen
betonen vor allem die Bedeutsamkeit, die der F o r m der einzelnen
Buchstaben innewohnt. Demgegenüber weist man auf christlich-
jüdischer Seite darauf hin, daß die N a m e n der Buchstaben nicht
gleichgültig sind. Diese Namen waren ja uralt, älter, also richtiger, als
alle griechische Weisheit.[73] Mit Befriedigung führt der große
Kirchenhistoriker Eusebios von Caesarea in seiner Praeparatio
evangelica X 5[74] den Nachweis, daß die Griechen ihre
Bezeichnungen von den Hebräern übernommen haben. Denn jedes
hebräische Schulkind könne über die Bedeutung der
Buchstabennamen Auskunft geben, während unter den Griechen
selbst Platon nicht dazu imstande wäre, gesetzt den Fall, daß er
Ἄλφα, Βῆτα usw. für griechische Wörter hielte. Bei den
Kirchenvätern und später finden sich dann mehrmals etymologisch-
erbauliche Deutungen der Buchstabennamen im Anschluß an die
unten gesondert zu besprechenden alphabetisch akrostichischen
Stücke in den Psalmen und Klageliedern Jeremias. Schon Origenes
von Alexandria in einem Kommentar zu Psalm 126 und in einem „Fe
literae tractatus“ hatte Derartiges besprochen (Hieronymus, epistola
XXXIV ad Marcellam de aliquot locis Psalmi CXXVI p. 260 Hilberg).
Der älteste erhaltene Kommentar dieser Art ist die expositio in
Psalmum CXVIII des Ambrosius vom Jahr 387[75] (vol. V ed.
Petschenig 1913, Migne PL XV col. 1198–1526). Es folgt
Hieronymus mit Brief 30 (p. 246 Hilberg), de nominibus hebraicis 71
(Migne PL 23, 827; Lagarde, Onomastica sacra, ²Göttingen 1887 S.
79) und dem Kommentar zu den Threnoi des Jeremia (Migne PL 25,
787–791). Den hier gesammelten Stoff übernahmen dann im 9.
Jahrhundert der Abt Paschasius Radbertus von Corbie in seiner
expositio in lamentationes Ieremiae (Migne PL 120, 1059–1256),
Hrabanus Maurus, expositio super Ieremiam XVIII 1 (Migne PL 111,
1183 ff.), Remigius von Auxerre, enarrationes in psalmos (Migne PL
131 col. 145 und 732 ff.), Joseppus, memorialis liber 26 (Migne PG
106 p. 32 f). Eine kleine altenglische Abhandlung ähnlicher Art
veröffentlichte Bonnard, Revue des études juives 4 (1882) p. 255 ff.,
ein hebräischer Alphabet-Midrasch, die „Othijoth des Rabbi Akiba“
ist übersetzt „Aus Israels Lehrhallen“ von A. Wünsche 1909, IV S.
199–269.
Als Beispiel diene das Α. Bei Suidas s. v. Ἀβραάμ steht,
Abraham habe die Buchstaben erfunden. Καὶ τούτου μαρτύριον ἡ
τοῦ Ἄλφα φονὴ τοῦ πρώτον στοιχείου ϰαὶ ἄρχοντος, ἀπὸ τοῦ Ἄλεφ
Ἑβραιϰοῦ λαβόντος τὴν ἐπίϰλησιν τοῦ μαϰαρίου ϰαὶ πρώτον ϰαὶ
ἀϑανάτου ὀνόματος. Dieser herrliche Name ist „die Erkenntnis“.
Denn Aleph wird nicht immer gedeutet als Ochsenschädel, sondern
oft als alliph = μαϑέ, vgl. Euseb. praep. ev. V 5 p. 474 b und XI 6 p.
519 c, Theodosios von Alexandria, περὶ γραμματιϰῆς p. 1 Goettling.
An der letzteren Stelle heißt es weiter: Gott öffnete dem Menschen
den Mund zur Sprache mit dem Laut, der das weiteste Öffnen
erheischt. Auch das ΑΩ der Johannesapokalypse wird mitwirken.
Ferner war sicher jeder, der aus irgendeinem Grund in den
Buchstaben etwas Transzendentes sah, versucht, beim Α
anzufangen. So der apokryphe Jesusknabe der Markosier, der, als
er in der Schule die Buchstaben lernen soll, seinen Lehrer darüber
zur Rede stellt, ob er wisse, was das Α sei.[76] Ebenso macht sich
Johannes Chrysost homil. IX in epist. ad Hebr. Migne PG 63 col. 77
seine Gedanken zunächst über das Α: ὥσπερ γὰρ ἐπὶ τῶν στοιχείων
τὸ πᾶν ἄλφα συνέχει, ϰαὶ ὁ ϑεμέλιος τὴν πᾶσαν οἰϰοδομήν, οὕτω ϰαὶ
τοῦ βίου τὴν ϰαϑαρότητα ἡ περὶ τὴν πίστιν πληροφορία. Ταύτης δὲ
ἄνευ οὐϰ ἔστιν εἶναι Χριστιανόν· ὥσπερ οὐδὲ ϑεμελίων ἄνευ
οἰϰοδομήν, οὐδὲ στοιχείων χωρὶς ἔμπειρον γραμμάτων εἶναι.
Von der antiken Schule her kommen Gedichte wie Ausonius, De
litteris monosyllabis Graecis et Latinis S. 166 Peiper. Scotus, versus
de alphabeto bei PLM ed. Baehrens V p. 375 mit dem Kommentar
Expositio prescripti alphabeti ed. Omont, Bibl. des hautes études,
Paris 1881, p. 429. Cabrol Dictionnaire p. 61. Besonders wichtig
scheint eine Schrift des 13. Jahrhunderts, De semine — oder
seminibus — scripturarum, zu sein, die mit Unrecht dem berühmten
Apokalyptiker Abt Joachim von Floris in Calabrien ( † 1202)
zugeschrieben wird. Friedensburg, Symbolik der Mittelaltermünzen
S. 90 ff. druckt ein bezeichnendes Stück daraus ab.
In einem Dit de l’ABC (440 Verse) von Hue de Cambrai (um
1250) „werden die Buchstaben des Alphabets mit geläufigen
Wörtern in Verbindung gebracht, die mit ihnen anheben (z. B. crois,
con bei C, dieu bei D, Eve bei E, lettres, langue bei L, Marie bei M
usw.) oder es wird ihnen nach ihrer Form ein gewollter Sinn (wie bei
PQ) untergelegt, nicht ohne daß bei Gelegenheit satirische Hiebe
auf die verderbte Zeit fallen“ (Groeber, Grundriß der romanischen
Philologie II 837).
An der oben erwähnten Stelle Hieronymus de nominibus
Hebraicis 71 stehen nur kurze, rein etymologisch-grammatische
Angaben über die Bedeutung der Buchstabennamen im
Hebräischen. Irgendwelche mystische oder erbauliche Ausdeutung
wird nicht daran geknüpft. Laut Angabe des ersten Satzes Migne PL
23 col. 771 ist dieses Onomastikon die Bearbeitung einer Schrift des
Philon von Alexandria. Für Philon ist also irgendwelche
Buchstabenmystik dadurch nicht bezeugt. Sie ist es auch sonst
nicht. Trotzdem hat D. H. Müller in den Sitzungsberichten d. k.
Akademie Wien, philos.-histor. Kl. 167. Bd. 2. Abh., Wien 1911 auf
Grund dieses Tatbestandes und gestützt auf Vergleichung der
Deutungen des Ambrosius und Hieronymus einerseits und
spätjüdischer Midraschim andrerseits gemeint, die „verlorene Schrift
Philos über die Etymologie und Symbolik der Buchstaben“[77]
teilweise rekonstruieren zu können. Es liegt auf der Hand, wie
willkürlich es ist, auf diesem Wege Spekulationen des 4.
Jahrhunderts in das 1. zurückzudatieren.
Anhangsweise möchte ich für Leser, die hier derartiges wohl
suchen werden, einiges zusammenstellen über Buchstabensymbolik
nicht magischer und religiöser Art, Buchstabenspielereien u. dgl.
Wie im Altertum nicht anders zu erwarten, fehlt das obszöne
Element nicht. Es handelt sich aber in den Fällen, die uns hier
angehen, nicht um das primitive Jenseits von aller Scham, was eng
mit der Religiosität des Naturvolkes zusammenhängt, sondern um
einfache Cochonerien. Für den primitiven Menschen ist das
Obszöne, das heilige Geheimnis der Zeugung, Tabu, es wird als
solches gesucht und gescheut, verehrt und als verblüffendes
Schutzmittel gegen die Dämonen in Dienst genommen. Aber auch
schon da muß man, wie Albrecht Dieterich oft sagte, nicht so tun
wollen, als hätte das den Leuten nebenbei keinen Spaß gemacht.
Bei den Buchstabenzoten fällt alles Sakrale durchaus weg, es sind
παίγνια, Belege für das nichts verschonende Argot der Griechen und
Römer oder unpassende Schulwitze.
Das Älteste in dieser Art wird Aristoph. Eccl. 920 sein: δοϰεῖς δέ
μοι ϰαὶ λάβδα ϰατὰ τοὺς Λεσβίους.[78] Dann steht als Priapeum 54
ein Rätsel:
CD si scribas temonemque insuper addas,
qui medium te vult scindere, pictus erit
Lösung: testiculae + mentula φ. Das Stärkste ist das Epigramm
87 von Ausonius S. 344 Peiper: „Ad Eunum ligurritorem
paedagogum.“[79] Das Rätsel vom διπλοῦν γράμμα Συρηϰοσίων
gehört jedoch nicht hierher: Anthol. Pal. V 191 Μελεάγρου· εἰς
Καλλίστιον.
Γυμνὴν ἢν ἐσίδῃς Καλλίστιον, ὦ ξένε, φήσεις·
‘Ἤλλαϰται διπλοῦν γράμμα Συρηϰοσίων.’
Die Lösung ist harmlos. Doppelt kommt in dem Wort Συρηϰόσιοι
der Laut συ : σι vor. Umgestellt ergibt das ὗς.[80] Derartige
Anagramme müssen hier außer Betracht bleiben, sonst müßte ein
gutes Teil aller antiken Rätsel und, wenn die neuere Zeit
mitberücksichtigt werden sollte, die Unterhaltungsecke sämtlicher
Zeitungen und Zeitschriften aufgearbeitet werden. Das antike
Material ist gesammelt bei Ohlert, Rätsel und Rätselspiele der alten
Griechen² (1912) S. 211–241. Wolfgang Schultz, PW s. v. Rätsel Sp.
109 f.
Buchstaben dienen ferner als Namen oder Beinamen von
Personen. Recht lustig ist der Name, den der Korinthier Amphion
seiner lahmen Tochter gab, die später Mutter des Tyrannen Kypselos
wurde. Er nannte sie Labda[81]; natürlich ist das archaische
gemeint, das die ungleiche Beinlänge gut wiedergibt. Sonst gibt es
noch allerhand Schulwitze. Den großen Gelehrten Eratosthenes
nannten sie Βῆτα[82], den Aristarcheer Satyros Ζῆτα, den
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CHAPTER 1 Basics of Spirituality and Spiritual Care 1

CHAPTER 2 Preparing for Spiritual Care 45

Exercises to get Better Acquainted

CHAPTER 3 Connecting: Recognizing and Following

CHAPTER 4 Reflecting and Growing Personally

Reflecting on What Went Well 118

CHAPTER 5 Lifelong Learning, Self-Care, and

EPICC Spiritual Care Competency

Further Readings 194

The authors appreciate the support given by our home ­universities,

The Nurse’s Handbook of Spiritual Care was developed for nursing

supervisors in healthcare settings should ensure that the working

Chapter 1 – Basics of Spirituality and Spiritual Care is a discussion

Chapter 2 – Preparing for Spiritual Care is the first phase of the

Chapter 3 – Connecting: Recognizing and Following up on the

Chapter 4 – Reflecting on Experiences in Spiritual Care is where we

Chapter 5 –Life-­long Learning and More is where we discuss how

PAMELA CONE, PhD, RN, APRN-CNS, PHN

Dr. Pamela Cone was born and

2020 through 2023, which is their current work. Together, Drs.

TOVE GISKE, PhD, MPhil, RN

Tove Giske is a Professor in

materials in spiritual care for nurses and students globally. She

WHAT IS SPIRITUAL CARE?

I was working with students in the clinical setting at a

To contextualize this story, many Norwegians have a long

spiritual area. Spirituality is a thread that runs through the APU

1. meaning and purpose, especially in light of health

A person experiences spiritual well-­being when those needs

includes three elements of spirituality: meaning, connections,

Spirit – Breath of Life

In light of this lack of consensus, we present various views,

1. existential questions (concerning, for example, identity,

Additionally, an Irish research team analyzed 47 theoretical

the concept of spirituality (Weathers et al. 2016). The analysis

A widower came to Frankl for treatment. After his wife’s

This extract from Frankl’s conversations with the widower

What then is spiritual care? Spiritual care can be summed up as

1) humanistic and altruistic values; 2) faith/hope; 3) sensi-

Of these factors, more than half explicitly address the spiritual

came back with another nurse and proceeded to change the

Spiritual care is about being interested in and paying attention

1. what relationship one has to a spiritual being or power and

Library of Congress Cataloging-in-Publication Data applied for

CHAPTER 1 Basics of Spirituality and Spiritual Care 1

CHAPTER 2 Preparing for Spiritual Care 45

Reflecting on What Went Well 118

Further Readings 194

The authors appreciate the support given by our home universities,

Chapter 5 –Life-long Learning and More is where we discuss how

A person experiences spiritual well-being when those needs