To suffer the slings and arrows of outrageous fortune – researching resilience and spirituality

Today, we launch a new series on Spirituality and Palliative Care where we shall look at how people deal with crisis and suffering when confronted with life-threatening disease.

In this post, Lukas Radbruch and Cornelia Richter explain how a small group of academics at Bonn University, Germany, are researching the deeper meaning of resilience and how patients can be empowered to use it.

To suffer the slings and arrows of outrageous fortune (1)

Professor Cornelia Richter and Professor Lukas Radbruch.

There seems to be a real hype about spirituality in palliative care. No conference or workshop without a plenary on spirituality, and sometimes I (LR) have wondered whether this is an undue inflation of the term spirituality, which now encompasses everything that had been the realm of psychosocial discussions before. The European Association for Palliative Care (EAPC) social media team wants to take up this discussion on spirituality, providing some input on the range of issues related to spirituality in European countries and beyond, and hopefully triggering some discussion with the blog readers.

Resilience (similar to spirituality) has recently taken the spotlight in palliative care, but also in other areas of health care or society, but quite often without a clear understanding of what it means. So, it was really exciting when we came together some years ago in a small group of academics at Bonn University to discuss these issues of spirituality and resilience. This included some experts from the faculty of theology, together with expertise from philosophy, psychosomatic medicine, palliative care and spiritual care.

As usual in these interdisciplinary discussions between different scientific fields, we had to work on understanding each other and finding a common language first. As an example, the understanding of methods such as discourse analysis or grounded theory seems to be rather different in our different disciplines.

However, from the outset we had great fun in our research group and shared thrilling moments of sudden insight in exploring our common interest in how people deal with crisis and suffering, for example when confronted with life-threatening disease (even though this is a really serious topic). And we were really overjoyed when our research grant was approved by the German Research Foundation in April 2019.

Our joint project on ‘Resilience in Religion and Spirituality – enduring or constructing of Powerlessness, Anxiety and Distress’ (2) is starting now with eight work packages ( We cover a wide range of topics. This includes analysis of resilience in praying, looking at lamentation as an expression of anxiety and confidence in an evaluation of the psalms. Other work packages will interview patients and caregivers in different settings, trying to find out how they are trying to cope with (health-related or other) crisis. All this should lead to a better understanding of resilience, and how patients can be empowered to use it. The work plan also includes the development of an assessment instrument, as well as a description of incommensurabilities (what cannot be assessed).

‘Resilience in Religion and Spirituality’ group with Professor Aileen Fyfe.

Pictured above is the first official presentation of the ‘Resilience in Religion and Spirituality’ group with Professor Aileen Fyfe, Professor of Modern History and Director of Research at the University of St Andrews, UK. As part of the group’s discoussion about gender equality in research, she gave the lecture “Being part of the scholarly community: Women in Research”.

The palliative care work package will look at resilience and its relationship to other prominent concepts in palliative care, such as sense of coherence, meaning or quality in life, or dignity. We will evaluate the literature with discourse analysis, and try to find out how much these concepts overlap, and what is distinguishing them. We will interview patients, caregivers and healthcare professionals to confirm our hypothesis on these concepts, how they interact and what they find useful for themselves.

The research group will perform the project work in the next three years. This is an exciting journey for us, thinking outside our specific boxes, getting new perspectives and learning from each other. Wouldn’t it be interesting to see whether the symbolic language used for lamentation in the biblical psalms is still being used by modern day patients?

Stay tuned for more information from our research group, and for more blog posts on spirituality!


  1. The quote is from Shakespeare’s play Hamlet. In act 3, scene 1 Hamlet contemplates the pain and unfairness of life: “To be or not to be? Whether tis nobler in the mind to suffer the slings and arrows of outrageous fortune, Or to take arms against a sea of troubles, And by opposing end them…”
  2. Resilienz in Religion und Spiritualität – Aushalten von Ohnmacht, Angst und Sorge.

More about the authors…

Lukas Radbruch is Professor of Palliative Medicine at the University Hospital Bonn  and president of the German Association for Palliative Medicine.
Follow Lukas at @LukasRadbruch

Cornelia Richter is Professor for Systematic Theology at the University Bonn and chairs the Research Group on Resilience in Religion and Spirituality (DFG-FOR 2686). Follow Cornelia  @CRichter_Bonn

Follow our series on Spirituality and Palliative Care on the EAPC blog. Next week, we hear from Alain Ducq, a music and sound therapist from the Palliative Care Unit, Forcilles-Fondation Cognacq-Jay Hospital, France.



This entry was posted in RESEARCH, SPIRITUAL CARE. Bookmark the permalink.

3 Responses to To suffer the slings and arrows of outrageous fortune – researching resilience and spirituality

  1. Lubayna Fawcett says:

    Congratulations! Finally the realm of spirituality is under the stop light. My question:- how are various religions/faith perspectives represented is your team?

  2. pallcare says:

    right now the project covers christian faiths, but not other religions. This will be the focus of subsequent work. However, we do not restrict our work to religious perspectives, but want to cover spirituality more broadly, for example discussing meaning in life.

    • Dr. Lubayna Fawcett says:

      Thank you Lukas for your response.
      I am not sure of the disparities across culture/ethnicity/religions on access and utilization of palliative care (PC) in your region; speaking from the US and East Africa (I work in the US , originally from Zanzibar, Tanzania where I spend time every year)- there is a huge disparity problem across ethnicity and religion/faith in utilization and access on PC. My interest is how to best narrow the gap. Will be interesting to hear your views on disparities and whether it is a concern you wish to address.
      I hear you- spirituality can discussed with a broad bush- shaped by culture and social environment; however, religion/faith are intricately connected to spirituality and resilience.

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