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Understand what we thirst for

Whether for water or meaning, it’s a primal force.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A child wearing a wool hat holds a glass and drink water from it.
Johnny McClung on Unsplash

Quenching thirst is a global problem. It can also be profoundly personal, impaired by illness. For nurses, it can be ethically and emotionally difficult, when treating dying patients. But is there ultimate relief? 

Thirst is the subjective sensation of a desire to drink something that cannot be ignored. The world is thirsty; globally, 703 million people lack access to clean water. That’s 1 in 10 people on the planet. 

Thirst is a life-saving warning system that tells your body to seek satisfaction through swallowing fluid. It works in partnership with other body processes - such as changes in blood pressure, heart rate and kidney function - to restore fluid, and salt, levels back to where they belong. Failure of any part of this beautifully balanced system leads to dehydration (or water intoxication), and perhaps to seizures, swelling of the brain, kidney failure, shock, coma and even death. 

Sometimes it’s difficult to quench thirst, because of problems with supply. According to the World Health Organization, at least 1.7 billion people used a drinking water source contaminated with faeces in 2022. Sometimes in war, water is weaponised, with systematic destruction of water sources and pipes. Water laced with rat fur, arsenic and copper has meanwhile been reported in prisons across the USA.  

At other times, there may be “water everywhere, but not a drop to drink” because of individual problems with swallowing. As a nurse, some of my most heartbreaking moments have been when I have been unable to fulfil a need as basic as a patient’s thirst; when even thickened fluids have led to intense coughing and distress, and a realisation that I can only moisten mouths and give so-called “taste for pleasure”: very small amounts of a favourite liquid or taste using a soft toothbrush, or a circular brush gently sweeping around the mouth and lips to release some of the liquid - even, and especially, at the end of life when the patient is unconscious. 

Difficulties in drinking are common in dementia when fluid can seem foreign and swallowing a surprise to the system. It’s thought that over 50 per cent of people in care homes have an impaired ability to eat or drink safely; 30 to 60 per cent  of people who have had a stroke and 50 per cent of those living with Parkinson’s may struggle to swallow. 

Other conditions that may affect swallowing include multiple sclerosis, cerebral palsy, and head and neck cancers. Diabetes is characterised by a raging thirst owing to problems with insulin (diabetes mellitus) or an imbalance in antidiuretic hormone levels (diabetes insipidus). In intensive care, patients are predisposed to thirst through mechanical ventilation, receiving nothing by mouth, and as a side effect of some medications. But thirst is a “neglected area” in healthcare, writes palliative care researcher Dr Maria Friedrichsen.  

“Knowledge of thirst and thirst relief are not expressed, seldom discussed, there are no policy documents nor is thirst documented in the patient’s record. There is a need for nurses to take the lead in changing nursing practice regarding thirst.” 

Is there another thirst that is also being missed in nursing, and in life in general – a spiritual thirst, beyond the physical desire to drink? In his book, Living in Wonder, writer Rod Dreher argues that humans are made to be spiritual, and that a critical sixth sense has been lost in a “society so hooked on science and reason”. We humans crave love in our deepest selves; we have an insatiable thirst for everything which lies within – and beyond – ourselves. Auschwitz survivor Viktor Frankl, who was later appointed professor of psychiatry at the University of Vienna, became convinced that human beings have a basic “will for meaning.” “The striving to find a meaning in one’s life,” he wrote, “is the primary motivational force in man.”  

In the harsh sun of a Middle East day, an ancient story of a man and a woman encountering each other at a water well illustrates this dual thirst for water and meaning. The man, Jesus, thankful for a drink of water given to him at the well by an outcast Samaritan woman, said that “Everyone who drinks this water will be thirsty again, but whoever drinks the water I give them will never thirst. Indeed, the water I give them will become in them a spring of water welling up to eternal life.” In that midday sun, such imagery made a powerful statement.  

Being mindful of spiritual thirst when drinking water is something also captured in a Ghanaian proverb and pictured perfectly in the many birds that drink by gravity, so tipping their heads back when they swallow.  

“Even the chicken, when it drinks, 

Lifts its head to heaven to thank God for the water”. 

Unsatisfied thirst is part of the human condition, we long for something more; it’s living proof of our immortality, says French poet Charles Baudelaire. Despite his Olympic success, athlete Adam Peaty said that society didn’t have the answers he was seeking, and that a gold medal was the coldest thing to wear. He “discovered something that was missing” when attending church for the first time, and now has a cross with the words “Into the Light” tattooed across his abdomen, symbolizing his spiritual awakening. We are more than mechanical machines with physical needs. We are rather gardens to tend in a dry and thirsty land, with souls in need of intensive care.   

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Mental Health
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Social prescribing for whole person care

Responding to an anxiety epidemic, there’s a growth in social prescribing with a spiritual wellbeing element. Esther Platt explores how it's working out locally.

Esther Platt

Esther works as a Senior Consultant for the Good Faith Partnership. She sits in the secretariat for the ChurchWorks Commission.

Two people sit at a table with their hands resting on top of it. One speaks to the other
Photo by Christina @ wocintechchat.com on Unsplash

Since 2001, Mental Health Awareness Week has been marked once a year in May. This year, the theme was anxiety - an increasingly relevant topic in a country that has endured three years of world-changing crises and the soaring cost of living. Research from the Mental Health Foundation has found that 1 in 10 UK adults feel hopeless about financial circumstances and more than one-third feel anxious. 

For centuries, it has been recognised that spiritual well-being is closely tied to mental well-being. By spiritual wellbeing, I don’t mean organised religion. I mean our sense of relationship to a higher-power or reality beyond our own, and our sense of purpose and meaning in life, as Craig Ellison outlines it as in his paper Spiritual Well-Being: Conceptualization and Measurement. 

In Man’s Search for Meaning holocaust survivor Victor Frankl compellingly makes the case that in a world of suffering, our survival depends on our sense of purpose, meaning and hope. Frankl coined the term ‘the self-transcendence of human existence’ by which he explained that human beings look for meaning beyond themselves, either in a cause, a person to love, or a higher power.

With an increased understanding of the holistic nature of wellbeing, and the value of spirituality, a new way of looking at health is emerging. 

While modern psychologists are still building a clinical-grade evidence base on the value of spirituality, there is clear agreement that spiritual wellbeing is crucial for a good quality of life, especially for those who are facing adverse life events, as you can read on the US National Library of Medicine web site. Traditionally, health provision in the UK has focused exclusively on the physical, and more recently the mental. However, with an increased understanding of the holistic nature of wellbeing, and the value of spirituality, a new way of looking at health is emerging.  

Social prescribing is one way in which this is being done, and across the country. 

In social prescribing, local agencies such as charities, social care and health services refer people to a social prescribing link worker. Social prescribing link workers give people time, focusing on ‘what matters to me?’ to coproduce a simple personalised care and support plan. This involves ‘prescribing’ individuals to local community groups such as walking clubs, art classes, gardening groups and many other activities. 

Churches are playing a crucial role making social prescribing happen. St Mary’s Church in Andover, offer a wellbeing course to members of the community who have been directed to them through the local GP surgery.  

Members of Revival Fires Church in Dudley have been trained to offer Listening and Guidance support to those who are referred by a GP.  

Beyond social prescribing, St John’s Hoxton in London offer the Sanctuary Mental Health course to their community which gives people an opportunity to share their experiences and find solidarity in their struggles.  

Church provides a space where the breadth of our wellbeing, our desire for purpose, community and hope can be supported in a way that the NHS does not have capacity or experience to deliver. As the Archbishop of Canterbury, Justin Welby, writes  

"The issue of mental health is one that requires a holistic approach on an individual basis, incorporating as appropriate psychiatric, medical and religious support’.  

Olivia Amartey, Executive Director for Elim, an international movement of Pentecostal churches adds,  

‘I am convinced that there is no other organisation on earth that cares for the whole person, as well as the church. Its engagement with the statutory authorities, focussed on individuals’ well-being, provides an invaluable opportunity for a synchronised partnership to the benefit of all our communities.’ 

Jesus told his followers, ‘I have come so that you can have life and have it to the full’. This is the hope that animates churches. Christians find meaning and purpose in the hope of life, peace and justice that Jesus gives. Church can be a space where the complexity of hurt and suffering is acknowledged, and where we can find solidarity and support in the presence of those who can help us find purpose and meaning.  

At ChurchWorks, a commission of leaders from the 15 biggest church denominations in the UK, we are excited by the prospect of more churches providing this space. On 18th May we held ChurchWorks for Wellbeing, in which we gathered over 300 church leaders to explore how the church can bring hope to our communities in this time. We shared stories of small and simple conversations, where offering a listening service, an art class or a food pantry enabled churches to give people in their community space to be, to grieve, to process and to grow. From the conference, it is our hope that we will see hundreds more churches start to engage in social prescribing and welcome their communities to access holistic wellbeing support.  

At a time when anxiety is rife, and it is so easy to feel despair and hopelessness, the church offers a vital resource to us: a place where our spiritual wellbeing can be nurtured, where we can find purpose, where we can find community, where we can find hope. 

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