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the dses and inter-religious and religious-secular dialogue

Presentation at the George Mason School for Conflict Resolution and Analysis

April 2, 2013

The Daily Spiritual Experience Scale: Uses for Inter-religious and Religious-secular Dialogue



The kinds of things that help to give life meaning, purpose, and satisfaction are often grounded in concepts we term religious or spiritual, a sense of the “more than” in daily life. This can be the case for those who find roots in religion as well as those not comfortable with religious language. Spiritual and religious attitudes and values help to shape: how people view the world, what they consider important, what they do, how they act, how they feel, identity and affinity, and also why they may mistrust or hate other people.

The Daily Spiritual Experience Scale (DSES) is a set of 16 multiple-choice questions, psychometrically validated, which can be also be used in an open-ended way. It measures ordinary experiences of relationship with, and awareness of, the divine or transcendent. It measures experiences rather than beliefs, and the ordinary rather than the extraordinary. It has been used in over 150 published studies, linking it to many good outcomes for many kinds of people. Tens of thousands of people have taken the test, and it has been translated into over 30 languages. It has proven useful for most religions and in secular settings for those not comfortable with religion. The DSES is proving to be helpful for assessment, personal exploration, and communication in interpersonal, therapeutic, organizational settings.

This presentation and the subsequent extended discussion with faculty, students, and fellows, explored ways that the questions might be useful for communication between people of different beliefs, allowing them to share about things that are important in their daily lives. Exploring answers to the questions can allow people to connect with others about things that have value and meaning to them without coming up against the walls that discussion of beliefs can lead to. Common ground can be found in the depths of the discussion, even when beliefs differ. This can be helpful in the resolution of conflict, and building bridges in peacemaking process. DSES scores have also been linked to less burnout in practitioners of various kinds.

invited speaker united methodist association national conference

Presented “Spiritual Connection: A Resource for Professional Caregiving” as an invited plenary speaker at the 73rd National Conference of the United Methodist Association in Orlando, FL on March 5, 2013.

“philosophy talks” interview

I discussed  “Unconditional Love,” on “Philosophy Talks” Radio Program, Stanford University, December 9, 2012. Available as a podcast on itunes or at http://philosophytalk.org/

metaphor and the self

Metaphor and the Self: A Role for the Arts in Understanding Suffering and Treating the Person in Distress, Lynn Underwood, International Neuroethics Conference, Brain Matters 3: Values at the Crossroads of Neurology, Psychiatry, and Psychology, October 24-25, 2012


Research shows that the metaphors we use affect our behaviors and attitudes in significant ways. (Holding a cup of hot coffee rather than a cold drink can cause us to have a more friendly attitude towards those we meet; Boroditsky’s work showing how reading about a description of crime as a virus rather than a beast can influence our decisions on the best ways to control the same criminal behaviors.) These effects usually happen implicitly – we are not aware of them. The machine metaphor recurs in our descriptions of the brain and the overall functioning of the body and has become an automatic default. It can be useful in simplifying complex systems, and medical training encourages this. Even efforts to promote humanism in medicine slide in this direction, as communication, empathy and ethical decisions are formulated in mechanistic terms.

This kind of thinking can get in the way when we treat conditions for which no “physical” cause can be found. Self-reports made by the person and their experiences of suffering are essential to the identification of the roots of the problems and opportunities for treatment. However if one buys into the machine metaphor too much, the experience of the person is given less weight in the overall assessment, while objective features such as brain scans, blood chemistry and physiologically evident symptoms are given the final say. Measurements based solely on a machine model lead to interventions that presuppose a kind of person that is incongruous with the way we live our lives, and what is most important to us.

Visual art, film and literature can give insight into the nature of the human person that offers alternative metaphors for the human person, and opens opportunities for creative approaches to treatment and evaluation of outcomes. This presentation would elaborate on those, and give specific examples of how they can help yield more effective treatments and decisionmaking.

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ethical implications of dses research

Ethical Implications of the Daily Spiritual Experience Scale, Bioethics Grand Rounds, Cleveland Clinic, September 11, 2012.


Recent research has asserted the value of incorporating the spiritual orientation, concerns and needs of the patient into the healthcare relationship, and accreditation requires attention to this aspect of the patient. Doing so raises a number of ethical issues, however. Use of the 16 questions from the Daily Spiritual Experience Scale (DSES) can help the health professional avoid some of these ethical problems by 1) focusing on experiences rather than beliefs, 2) using questions validated cross-culturally, 3) opening avenues for communication and understanding, and 4) emphasizing the spiritual aspect of life as a part of the whole person, rather than reducing it to a tool for improving physical health. The DSES questions also assist the professional in better delivering competent care that addresses this complex component of the human person.

The DSES is a 16-item, psychometrically validated scale, used in over 100 published studies and translated into over 20 languages. It measures reported frequency of such ordinary spiritual experiences as awe, compassionate love, mercy, divine closeness, sense of spiritual support, gratitude, and deep inner peace in daily life (www.dsescale.org). The research involved in its development used ethical principles such as respect for diversity to construct a scale that would reach many people substantively. It was based on extensive international qualitative research in multiple cultures, ages and socioeconomic status. It functions well for people from the various major religious traditions as well as for those who call themselves spiritual but not religious, and atheists. Higher scores have been linked with happiness, life satisfaction, less addictive behaviors, less depression and anxiety, better health behaviors, self-efficacy, less burnout, and improved relationships.

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using the dses to improve patient care

Using the Daily Spiritual Experience Scale to Improve Patient Care. Psychiatry Conference: Sympozion National al ARSP cu Participare Internationala. Lynn Underwood. Sponsored invitation to speak. Targu Mures, Romania. 31 May – 3 June, 2012.


Spiritual and religious issues and values can influence how people cope with disease, make decisions, and behave in ways that affect their health. Spiritual and religious attitudes help to shape how people view the world and what they consider important. They can provide resources for patients to draw on. These may be particularly salient for them in the midst of mental illness, chronic disease, addiction, times of medical crisis, and at end-of-life.  It is often challenging to communicate with patients about religious and spiritual values and issues without running headlong into beliefs that may polarize conversation and empathic understanding, and limit the caregiver’s capacity to attend to patient needs and desires.

The Daily Spiritual Experiences Scale (DSES) is a 16-item psychometrically validated scale that measures the frequency of ordinary experiences such as awe, compassionate love, mercy, divine closeness, sense of spiritual support, gratitude, and deep inner peace in daily life ( www.dsescale.org ).  The DSES was constructed based on extensive qualitative research in multiple cultures, religions and secular settings.  It has been used in over 100 published studies, answered by many thousands of people, put on longitudinal health studies, and translated into over 20 languages.  It is linked to outcomes such as less addictive behaviors, better mood, improved relationships, decreased hospital stays, positive health behaviors, and diminished burnout.  It has been used extensively in medicine, psychiatry, psychology and social work research.   It functions well for people from various major religious backgrounds as well as for those who call themselves spiritual but not religious.  It does not reduce the spiritual to vague positive features, rather it allows for the kinds of experiences that encompass religious and spiritual depth. It is not only a potential mediating variable but also a measure of a significant component of quality of life for many.

This presentation will discuss ways in which the scale can be used in health-care settings to enhance the caregivers’ capacity to communicate with the patient and to help those who are ill to mobilize their own spiritual and religious resources to better cope with illness.  Another use of the scale is as a self-exploration tool for caregivers themselves using a structured method to enhance self-understanding and their ability to communicate with others different from themselves.  Scores have predicted less burnout in a large hospital system in Hong Kong, as well as in a study of those in the US working in palliative care.

In addition to describing its use in research, and how spiritual experience interacts with biology, this presentation will describe how this psychometrically validated set of 16 questions can be used as a clinical tool to improve patient care.

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enhancing spiritual connection through poetry in a secular context

Enhancing Spiritual Connection through Poetry in a Secular Context. Lynn Underwood. University College London. Institute for Advanced Study, Senate House, June 29, 2012.


Poetry can open the mind to better grasp the complexity of the divine, the holy, and help make connections in down-to-earth ways, integrated into daily life.  The language of poetry and the use of metaphor and apparent paradox can expand our conceptual understanding.  The concreteness of poetry can also help ground this in the substance of our days.  This paper will give examples of specific poetry from Seamus Heaney, Billy Collins, Rainer Maria Rilke, R.S. Thomas, Jessica Powers and others, and point to specifically religious poetry from a variety of faith traditions, describing how they have been useful in the classroom for enriching capacity for sense of communication with the divine for those from specific faith traditions and those who call themselves “spiritual but not religious.”  Poetry provides words that can open doorways without reducing the spiritual to a meaningless common denominator – leading instead to the depths and richness of religious traditions.

Poetry can help those of faith and those not comfortable in a religious tradition to enhance sense of connection with God and become increasingly aware of that connection in daily life. It can bridge traditions and beliefs and has been used effectively by the author of this paper in a variety of secular college classroom settings and in small group work.  Approaching poetry in a contemplative rather than analytic way facilitates this engagement, and journaling encourages direct encounter with the poems themselves in written conversation.  Structured group discussion of personal responses to the poems can also provide mutual illumination of contexts and invitation.

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neuroethics, the arts, and the nature of the human person

Neuroethics, the Arts and the Nature of the Human Person. Lynn Underwood. Medical Humanities Conference, Western Michigan University, Kalamazoo, Michigan, September 29-30 2011.


The arts and humanities are essential to effectively grapple with the questions that arise from advances in neuroscientific technologies and treatments. They are essential for medical practitioners as they make treatment and policy decisions. But even those not professionally involved with health care need the arts and humanities as we make decisions about what kinds of pharmaceutical and neurosurgical interventions are appropriate for ourselves and those we care for, policy decisions regarding issues such as human responsibility within health care and criminal justice, and decisions about how to regulate and respond to marketing of neurotechnologies of various kinds.

Also, neuroscientists and interpreters of neuroscience make claims about how ethics operates and the nature of the human person. The humanities can provide us with tools for doing the kinds of reflection necessary to effectively accept or discard these claims. The arts can help to reveal qualities and issues in novel and useful ways.

This presentation will lay out the scope of the problems, and highlight some particularly thorny issues.  Also, it will outline some of the ways to engage students, those in the health sciences and others, with these topics using the humanities and arts to better equip them for the particular challenges neuroscientific knowledge and technologies have brought to the fore. In this context the presenter will draw on four years of classroom experience teaching both Neuroethics and general medical humanities using these methods.

Examination of how we envision the nature of the human person is essential to adequately address many of the issues that increasing knowledge and technology in neuroscience has raised. Film, memoir and poetry, as well as insights from philosophy and religious studies, can usefully inform our decision-making and attitudes.  The visual arts, particularly portraiture and self-portraiture can give us special insight into the nature of the human person. The emergence of popular and scientific appreciation for the complexities of decision-making enable us to see why approaching a complex topic through the arts can give insight that can complement and enhance other kinds of analysis. The arts can enable us to enter into situations in ways beyond merely speculating on how we think we would feel in a given situation. Empathic engagement as well as enhanced sensibilities can result from the inclusion of the arts and humanities in these discussions.

The presentation will outline some of the issues and give specific examples of humanities and art resources that have been effectively used in teaching situations.

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the human person: possibilities for flourishing in dire circumstances

The Human Person: Possibilities for Flourishing in Dire Circumstances. Lynn Underwood. Hellenic Research Foundation, European Research Network. Athens, Greece, September 21, 2007.


Even in the midst of suffering there can be opportunities for the human person to flourish. Of course we do not seek suffering and continually seek to relieve the suffering of self and others. One positive aspect of dire circumstances is that various false illusions and assumptions do not hold up once exposed to situations such as disability, chronic disease, extreme suffering or experiences at end of life. These include various assumptions about apparent self-sufficiency, functionalism (seeing ourselves as “human doings” rather than “human beings”), the place of suffering, our delusions of control, and the fact of mortality. The exposure provided by dire circumstances illuminates the actual situation in such a way that the core or “heart” of the person can be more fully revealed. Science, the arts, theology, philosophy, personal experiences and relationships with others can also provide insights into the nature of the human person when in extremis that can not only help to bear the burdens found in these situations, but actually help to enable human flourishing. There emerge implications for actions that we might take to improve the lives of those in dire circumstances, help us to learn from these situations, and also better handle dire circumstances when we encounter them ourselves.

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human being as revealed in disability

The Human Being as revealed more fully in Disability and In Extremis. Lynn Underwood. European Research Network meeting: The human person in the 21st Century. Thessaloniki, Greece, April 22-25, 2007.


Interaction with people with severe disabilities and chronic disease, people at end of life, and people in other dire circumstances can inform our understanding of the human person.  This can happen through personal and professional interactions and in the context of scientific research. Direct experience of dire circumstances in our own lives can also contribute to insight. When combined with theological, philosophical and artistic explorations these interactions and experiences can lead to further reflection on the core, or “heart,” of the human being, revealing the nature of the human being more fully. This exploration could also provide us with some questions to pursue in greater depth using the tools of the sciences and the humanities.

Various illusions and assumptions do not hold up as people are exposed to situations such as disability, extreme suffering or experiences at end of life. These include assumptions concerning self-sufficiency, functionalism, the place of suffering, the ability to control and mortality. People with disabilities have learned that receiving help does not diminish who they are and that it can actually enhance the human person. Likewise, the disabled person is at a disadvantage in the world constrained by functional evaluations. This realization can expose the fundamental value of a human being as not necessarily identical with their functional status or their physical selves. Suffering can encourage people to draw on the religious sphere, and open sufferers and others to the reality of the spiritual and its intrinsic importance in life.  In the process of suffering one can see more clearly that there is more to a full life than superficial happiness and the pursuit of that happiness. When disabled,  suffering serious chronic disease or in other dire circumstances, it becomes obvious that we are not in control and we are forced to see that sense of control is a delusion.  The realization that death is inevitable affects how someone views life itself, and the fundamental nature of the human person.  Being faced with these situations in extremis can more fully reveal the full nature of the human person.

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