In the last several decades, especially among clinical psychologists, a preference for the terms "spirituality" and "spiritual" has emerged, along with efforts to distinguish them from "religion" and "religious." Especially in the United States, "religion" has for many become associated with sectarian institutions and their obligatory creeds and rituals, thus giving the word a negative cast; "spirituality," in contrast, is positively constructed as deeply individual and subjective, as a universal capacity to apprehend and accord one's life with higher realities. In fact, "spirituality" has likewise undergone an evolution in the West, from a time when it was essentially a synonym for religion in its original, subjective meaning.