History of Research on Faith, Prayer, and Medical Healings

Kevin J Eames. Miracles: God, Science, and Psychology in the Paranormal. Editor: J Harold Ellens. Volume 2: Medical and Therapeutic Events. Westport, CT: Praeger, 2008.

During the early part of the twentieth century, three important scientific and cultural movements emerged that set the stage for their subsequent convergence: first, the emergence of psychological functionalism and an expanded interest in applied psychology, which translated into a growing interest in the psychology of religion; second, the recognition of the connection between the mind and the body; and third, the rapid growth of the Pentecostal movement, with its emphasis on religious experience, including the experience of divine healing. These movements represented very different and often conflicting intellectual traditions, yet they converged in the middle to late twentieth century, as we developed increasing empirical research on the relationship between faith, prayer, and nonmedical healing.

Functional psychology was primarily an American intellectual movement. It expanded scientific psychology, which observed psychological phenomena and asked what? and how? Functional psychology added the question, why? By asking why, the functionalist sought to identify human potentials, capabilities, and aptitudes behind observable psychological phenomena. This approach, in turn, enabled psychology to be applied to “success in living, with the adaptation of the organism to its environment, and with the organism’s adaptation of its environment to itself.” It set the stage to enable researchers to ask how divine healing might be explained as an adaptive mechanism—as an individual seeking to adapt to the environment or changing the environment to better suit the individual.

The emergence of functionalism as the dominant school in American psychology found compatibility with the second movement: the connection between the mind and the physical health of the body. The psychosomatic medicine movement sought to identify the relationship between emotions and disease, recognizing the mind’s power to influence physical health. The work of Walter Cannon and Hans Selye exemplified this movement, with an emphasis on the pathogenic effects of stress. Highlights of the psychosocial aspects of the pathogenesis of disease included the development of the Social Readjustment and Hassle scales, which sought to link both significant life events and daily frustrations with the onset of disease. Some personality traits, such as the type A behavior pattern first observed by two cardiologists in 1959, are believed to enhance the development of stress-related illness.

Although functionalism and psychosomatic medicine were intellectually compatible, they both approached the study of psychological phenomena with an essentially naturalistic framework. Extensions of American functionalism into radical behaviorism and evolutionary psychology underscored this naturalism, leaving little room for mystical model as an explanation for experienced phenomena. Hence the emergence of Pentecostalism, with its emphasis on signs and wonders such as divine healing, was antithetical to the skepticism of functional psychology. Both movements as intellectual and cultural forces grew in ascendancy in their separate and very different spheres. It was the mid-twentieth century before attempts at subjecting these miraculous outcomes to empirical scrutiny were undertaken. More significantly, inasmuch as divine healing seemed confined to a specific milieu that remained on the fringes of mainstream religiosity, researchers also explored what role religion itself had on health and illness.

In the March 2002 volume of the Journal of Religion and Health, Thomas St. James O’Connor published an article that asks the question, Is evidence-based spiritual care an oxymoron?4 The tension between the empirical and the spiritual is eloquently reflected in O’Connor’s question and recalls Hamlet’s caution to Horatio as they confronted the ghost of Hamlet’s father: “There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.”

Hamlet’s caution against an overly narrow metaphysic has not deterred researchers from attempting to explore the relationship between religion and psychological phenomena. Two seminal works that no respectable chapter on the psychology of religion would omit are Sigmund Freud’s The Future of an Illusion (1928) and William James’ The Varieties of Religious Experience (1902).

Freud’s book certifies science as the ultimate victor over religious dogma. He notes that the scientific spirit will encourage a process that replaces ignorance with rational enlightenment, with no room left for religion: “The more the fruits of knowledge become accessible to men, the more widespread is the decline of religious belief, at first only of the obsolete and objectionable expressions of the same, then of its fundamental assumptions also.” Freud also dismisses pragmatism as an argument for religion’s maintenance. He argues that while religion may have made beneficial contributions by engendering happiness and consolation and restraining antisocial behavior, it has not kept humankind from wanting to escape its influences as repressive of primal instincts. It is only through scientific rationalism, and more specifically, Psychoanalysis, that humanity will escape the confines of the religion that both comforted and enslaved their ancestors.

Freud’s dismissal of so-called medical miracles would no doubtdologyhis belief in the development of hysterical symptoms as a means of repressing unwanted impulses, a perspective he cultivated in his work with the hypnotist Charcot and his older colleague Breuer. In short, religion itself was, for Freud, a manifestation of pathology and incongruent with the notion of healing reflected in Freud’s system of Psychoanalysis. While Freud was unwavering in his rejection of the spiritual, however, many of his followers were unwilling to accept a purely naturalistic explanation for some phenomena. They attempted a rapprochement between Psychoanalysis and religion. In A History of the Cure of Souls, John T. McNeill notes that Otto Rank, Oskar Pfister, and Carl Jung made notable efforts to return some aspects of the soul to the curative potential of Psychoanalysis.

In 1902, William James published a landmark study of religion titled The Varieties of Religious Experience.7 Consistent with his philosophy of pragmatism, James was not concerned with staking out a position about the veracity of a religious worldview; instead, he addressed the question as to whether religion is beneficial or harmful. He identified the positive aspects of religion in his discourse about healthy-mindedness and the mind-cure movements. James chronicled successful resolutions of mental anguish and also physical ailments, such as sprained ankles and influenza, through mind-cure, that is, psychospiritual healings. In contradistinction to Freud’s disdain for religion, James argued that the religion of healthy-mindedness is as successful as science in alleviating suffering. He asserted that healthy-mindedness “gives to some of us serenity, moral poise, and happiness, and prevents certain forms of disease as well as science does, or even better in a certain class of persons.” To support his observations of the effectiveness of psychospiritual cures, James appealed to an article written by H. H. Goddard of Clark University, who asserted that mind-cures are indeed cures, but “are in no respect different from those now officially recognized in medicine as cures by suggestion.”

Some 60 years later, Jerome Frank expanded on James’ notion of healthy-mindedness in his book Persuasion and Healing. Frank expanded on the curative power of suggestion through his exploration of the placebo effect. Amanda Porterfield noted that Frank’s book offered a “full-fledged theory about the relationship between the placebo effect and religious healing.” Frank’s book was an attempt to critique various forms of psychotherapy, with an eye toward identifying common themes and characteristics. He emphasized that illness is not necessarily divorced from the mind and that healing is as much a psychosocial phenomenon as it is a biological one.

In his chapter on nonmedical healing, Frank noted that those who practice it tend to view “illness as a disorder of the total person, involving not only his body, but his image of himself and his relations to his group; instead of emphasizing conquest of the disease, they focus on stimulating or strengthening the patient’s natural healing powers.” He summarized his chronicle of nonmedical healing in primitive cultures by noting the power of emotions on health. Converging with much of the current and past literature on the physiological damage of stress, Frank asserted “that anxiety and despair can be lethal; confidence and hope, life-giving.” Thomas Csordas lists Frank’s “persuasive hypothesis” as one of the compelling anthropological hypotheses for the efficacy of ritual healing, noting that if the supplicant is persuaded that his or her ailment will be relieved by the culturally sanctioned healer, then relief is likely to occur.

Frank also identified common characteristics of phenomena like Communist thought reform, religious revivalism, and nonmedical healing. They all include a sufferer and a persuader: the former is distressed, demoralized, and alienated from the support community; the latter represents the power of the overarching worldview that governs the commonly accepted views of illness and health, despair and hope. He summarized the empirical research on the placebo effect, wherein “the administration of inert medications by physicians demonstrate that the alleviation of anxiety and arousal of hope through this means commonly produces considerable symptomatic relief and may promote healing of some types of tissue damage.” Frank’s work on persuasion and the placebo effect provided a psychological explanation for the medical miracles that occurred during the Pentecostal revival movements in the mid-twentieth century.

The study of religion as psychological phenomena was occurring together with a reemerging emphasis on the miraculous in Christianity. Popular images of evangelists surrounded by clouds of suspicion have been fueled by cinema works like Elmer Gantry and the more recent Steve Martin film, Leap of Faith. Financial and sexual scandals involving televangelists have added credence to these negative impressions. David Harrell Jr. chronicles the history of the healing revival movement in his book All Things Are Possible: The Healing and Charismatic Revivals in Modern America. Harrell notes that prayer for the sick and healing miracles became part of the overall revivalism experience growing out of the nascent Pentecostalism of the early twentieth century, with its surge of divine healing revivals in the 1950s.

Pentecostalism was characterized by ecstatic religious experiences, the sign gifts of the Holy Spirit, and divine healing. The healing revival movement that blossomed into the charismatic movement solidified the Pentecostal doctrine of divine healing. Pentecostal revivalists preached that good health was a benefit of Christ’s atonement but that the supplicant must have the requisite level of faith for the healing to occur; in fact, the supplicant was held responsible whenever a miraculous healing did not occur.17 The evangelists claimed themselves to be conduits of divine healing, with varying degrees of proximity to the afflicted. Healing was not only conveyed through the laying on of hands, but also through anointed prayer cloths, praying from prayer cards, and through media like radio and television.

Of course, skeptics also arose to challenge the authenticity of medical healing. To support the validity of their healing ministries, many of the Pentecostal evangelists encouraged participants who had been healed to provide testimonials, particularly with medical evidence. Unfortunately, such evidence was often of poor quality, and evangelists were compelled to publish disclaimers to protect themselves against legal action.

The Pentecostal movement was not the only Christian movement to appropriate the healing power of God. Anthropologist Jeannette Henney conducted field observations of Fundamentalist Shaker sects and a Dutch healing cult called “Streams of Power” in the Caribbean island nation of St. Vincent. Henney reports witnessing a healing session after a Streams of Power service, in which the afflicted awaited the laying on of hands by the evangelist. Unlike the highly charged emotional level of some Pentecostal healing services, Henney reports that there was no “trembling or excitement evident on the part of either the evangelist or the patient.” Similarly to Pentecostal practice, healing could occur at remote distances, with a handkerchief blessed by the evangelist functioning as the vehicle through which God’s healing power was conveyed.

Sociologist Meredith McGuire reports on alternative healing practices among suburban New Jersey residents in America in her book Ritual Healing in Suburban America. McGuire not only reports alternative healing practices among Christian groups, but also New Age and secular healing therapies as well. McGuire notes that among the Christian groups she observed, the healing power of God was appropriated through laying on of hands, prayers of faith in tongues (glossolalia), prayer with fasting, visualization, and claiming of healing. McGuire also witnessed the phenomenon known as slaying in the Spirit among traditional Pentecostals. The supplicant responds to the healing touch of the minister by falling to the floor. Reflecting the demand characteristic of this particular healing phenomenon among Pentecostals, McGuire notes that the “process is sufficiently common and ritualized in some prayer groups that persons who request healing stand in line and, as they are touched, fall into the waiting arms of an usher, who lays them on the floor gently while another usher covers their legs for modesty. In such a context, the ‘slaying in the Spirit’ is expected; not to fall is deviant and disturbing to the rest of the group.” McGuire reports that the Christian healing groups she studied shared similarities with other non-Christian healing groups regarding the role of the healer, the role of the supplicant, and the use of rituals. Differences centered on the centrality of the healing power emanating from God, the role of Satan in sickness and suffering, and the necessity of the supplicant’s faith in God.

Deborah Glik also conducted research with participants in healing rituals in Baltimore in the mid-1980s. Glik surveyed participants in Christian charismatic healing groups, metaphysical or New Age healing groups, and a comparison group of medical patients on variables related to religiosity and psychosocial distress. In her analysis of the results, Glik notes that the relationship between religiosity and distress may be accounted for by social selection and social causation. For the former, individuals who are less emotionally stable are attracted to charismatic healing groups that stress orchestrated rituals and scripted experiences; for the latter, the intensity of the small-group experience may induce a dissociative state in supplicants seeking alleviation of symptoms.

In a separate study, Glik analyzed survey data from 160 Baltimore participants in spiritual healing groups. She found that a majority of participants engaged in a “health problem redefinition” that was more congruent with the expectations of spiritual healing than their original problem formulations. Furthermore, those participants who did redefine their health problems were also more likely to claim that they had been healed. In essence, Glik hypothesized that the healing was a product of the interaction between the social context and cognitive receptivity.

Much of the empirical research on prayer and healing seeks to quantify the relationship between faith and health. The earliest empirical research was an 1872 study by Francis Galton on whether there was a statistical relationship between prayer and longevity—both for the ones who pray and for the subjects of prayer. Galton’s review of actuarial tables published at the time led him to conclude that no such relationship existed. Although Galton’s conclusions were based on flawed design methodology, his research was seminal in its supposition that prayer can be studied empirically.25 Carl Thoresen, Alex Harris, and Doug Oman note that initial modern empirical studies on the relationship between religious variables and health did not get started until the late 1960s and initially focused on specific denominations. These studies investigated the relationship between religious affiliation, denominational membership, regularity of church attendance, and health variables like coronary disease and cancer. The results suggested that “there is something about being involved in a religious organization, activity, or group that relates to better health status, including reduced risk of mortality.”

Margaret Poloma and Brian Pendleton focused more specifically on the religious activity of prayer and its relationship to quality of life. After conducting a factor analysis on 15 survey items related to prayer activities, Poloma and Pendleton found four discrete types of prayer: (1) meditative, (2) ritualist, (3) petitionary, and (4) colloquial. Their hypothesis that prayer would associate with measures of quality of life was supported; meditative prayer was moderately predictive of existential well-being and religious satisfaction, and colloquial prayer was predictive of happiness. Conversely, individuals who engage exclusively in ritualistic prayer are more likely to be depressed and tense.

Michael McCullough conducted a comprehensive review of the empirical research literature on prayer and health. He divided the research into four categories: (1) prayer and subjective well-being, (2) prayer as a form of coping, (3) prayer and psychiatric symptoms, and (4) intercessory prayer. The research on intercessory prayer is of particular interest to the relationship between prayer and healing. McCullough cites Byrd’s double-blind study of intercessory prayer for cardiac patients as a well-designed empirical study. One group of cardiac patients was the subject of intercessory prayer, while the other group was not. Those patients who were the subject of intercession had fewer cardiac events, required less medication, and reported a lower overall severity of symptoms than those patients in the control group. Thoresen, Harris, and Oman note that W. S. Harris and his colleagues replicated Byrd’s research. They, too, found that cardiac patients that were the subjects of intercessory prayer did better on objective outcome measures of cardiac health than patients who were not the subject of prayer.

The January 2003 volume of the American Psychologist set aside a section for studies on spirituality, religion, and health. William Miller and Carl Thoresen began the section by providing an overview of the state of the research and addressed three methodological issues related to the empirical study of religion and health: operational definitions, methods of statistical control, and criteria for judgment of evidence in support of specific research hypotheses. Lynda Powell, Leila Shahabi, and Carl Thoresen reviewed nine hypotheses related to the links between religion and physical health. The authors reviewed relevant research articles specific to the individual hypotheses, including or excluding research on the basis of a levels-of-evidence approach encouraged by Miller and Thoresen in the same volume. Their analysis of the research found persuasive evidence for the hypothesis that church attendance protects against death. Some evidence was found to support the hypotheses that religion protects against cardiovascular illness and that being prayed for improves recovery from acute illness. Some evidence was also found to support the hypothesis that religious belief actually impedes recovery from acute illness. Hypotheses that were unsupported by the research included protection against cancer mortality, cancer progression, disability, and longevity.

In the same volume of the American Psychologist, Teresa Seeman, Linda Fagin Dublin, and Melvin Seeman reviewed research literature on the possibility of biological pathways linking religiosity and health. The authors found some support for the hypothesis that Judeo-Christian religious practices are related to lower blood pressure levels, though the research designs employed in these studies were reason for caution in generalizing the research. Similarly, the authors found modest support for the hypothesis that Judeo-Christian religious practices are related to better immune functioning. Research associating cholesterol levels with religiosity was not supported; comparison studies among groups did not control for the affect of diet and genetic heritage on the participants. In a review of the research associated with the practice of yoga or meditation, empirical research appeared to support a relationship between these practices and lower blood pressure, lower cholesterol, lower stress hormone levels, variations in patterns of brain activity, and better health outcomes for clinical patients.

The final article in this section of the American Psychologist reviewed advances in the measurement of religion and spirituality and its implications for health-related research. Peter Hill and Kenneth Pargament noted the problems with common measures of religiosity such as the tendency to bifurcate spirituality and religiosity or assess global variables like church attendance. Such difficulties allow for inclusion of valid alternative hypotheses and make the linkage between spirituality/religiosity and health tenuous. The authors recommended several constructs that should be considered in the more precise assessment of religion and spirituality, including measures with greater sensitivity to cultural context that assess spiritual well-being and growth. They emphasized the importance of the use of alternatives to self-report measures.

These authors’ concerns dology earlier concerns expressed by Thoresen, Harris, and Oman regarding greater specificity in identifying and exploring religious variables. They cite three exemplary studies that dology greater precision in the relationship between religion and health: a study linking certain religious coping styles with mental health outcomes, a study examining the relationship of religious coping to adjustment after kidney transplant surgery, and a study examining religious and spiritual factors related to mood management and pain management among arthritis patients. The authors also recommend the wider employment of additional research designs and methods, including case studies, interviews, and daily monitoring methods.

It may appear that the empirical examination of faith is indeed an oxymoron. However, the link between the abstraction of faith and the very real outcome of physical healing does lend itself to a careful examination of the relationship between the two. Moreover, the apparent oxymoron is likely due to an artificial dichotomy between faith and the natural world that is a vestige of a Kantian dualism between the knowable and unknowable. An approach to the empirical examination of the relationship between faith and health must begin with an identification of the epistemological framework on which the research is based. If the researcher assumes an epistemological framework based on naturalism, the treatment of faith and health will be necessarily confined to naturalistic explanations for observed outcomes. Conversely, if the researcher assumes an epistemological framework that provides for the existence of a God who acts in the affairs of human beings, explanations may include divine intervention as bona fide.

It is, in any case, incumbent on the researcher to exercise adequate controls and employ responsible research designs in the investigation of health-related phenomena. In fact, it may be argued that the researcher whose epistemological framework provides for divine intervention must exercise greater stringency and accept a higher level of probability for outcomes indicating the positive role of faith on health. More important, it is the responsibility of all researchers, regardless of their epistemological framework, to acknowledge the potential for error and the limits of human knowledge, allowing us then to embark on our exploration with a requisite degree of humility.