First, though, we needed to define our terms. Wellness, according to The Merriam-Webster online dictionary, is "the quality or state of being in good health especially as an actively sought goal." Holistic implies "relating to or concerned with wholes or with complete systems rather than with the analysis of, treatment of, or dissection into parts (holistic medicine attempts to treat both the mind and the body)." Those who endorse holistic wellness programs believe that we are composed of interlaced parts and that our perceptions of body, emotions, mind, and spirit must be addressed holistically in any effective program of lifestyle behavior. Thus, the maintenance or optimization of health depends on harmony of this whole. In fact, this line of thinking was introduced by Koenig and is referred to as the biopsychosocial-spiritual model (Koenig, 1995).

The dictionary refers to spirit as "an animating or vital principle held to give life to physical organisms." After a review of the existing literature on spirituality and disability, it becomes clear that spirituality is defined differently by a variety of authors. There does seem to be a recurring theme, however: spirituality is awe-inspiring and gives life meaning. According to Kaye and Raghavan, "spirituality may be perceived as personal views and behaviors that express a sense of relatedness to a transcendent dimension or to something greater than the self that empowers, values, and integrates the self" (Kaye & Raghavan, 2002). Further, spirituality connects back to the spirit, which is the non-physical and non-intellectual dimension of a person that is the source of unity and meaning. Tate and Forchheimer comment that spirituality is related to religion and religiosity, but is not the same: "Religion is described as being affiliated with a specific community, doctrine and set of rituals... and while religions aim to foster and nourish spiritual life - and spirituality is often a salient aspect of religious participation - it is possible to adopt the outward forms of religious worship and doctrine without having a strong relationship to the transcendent (Tate & Forchheimer, 2002). Kuhn writes that spiritual elements are capacities in a person that enable one to transcend any experience at hand and seek meaning and purpose, to have faith, to love, to forgive, to pray, to meditate, to worship, and to see beyond the here and now (Kuhn, 1988). Muldoon and King (1991) go on to say that spirituality is the spirit that animates human life, the inner force that fuels how we think and behave. It is breath, wind, and spirit that give us life. Inspiration, then, is the act of breathing in or a "divine influence or action on a person believed to qualify him or her to receive and communicate sacred revelation" (Merriam-Webster online dictionary).

Finally, in holistic wellness programs there would be a difference between mind-body workshops and spirituality workshops. Mind-body medicine, according to Stephan Rechtschaffen, M.D., maintains that there is a direct connection between the central nervous system and the immune system (Rechtschaffen, 1996). Scientifically termed psychoneuroimmunology, it has become a growing area of medical research that explores the relationship and pathway that goes from the mind through the nervous system, the endocrine (hormonal) system, and finally to the immune system. On spirituality, in a personal e-mail, Sara Warber, M.D., Co-Director, Michigan Integrative Medicine and University of Michigan Complementary and Alternative Medicine Research Center, explains that "... a lot of people would try to separate mind-body from spiritual, so I think many would argue that modalities such as yoga and mindful meditation have really been separated from their origins within spiritual traditions in order to make them available to a wider audience. So this is tricky business, labeling modalities as spiritual. I am not sure that anyone has done that. Certainly prayer is spiritual, shamanic work is also often thought of as spiritual. You might check out the Society of Shamanic Practitioners website (http://www.shamansociety.org) for insight about that."