Does Intercessory Prayer Bring Healing?
By Dónal P. O’Mathúna, PhD
Holistic nursing is distinguished by concern for patients’ spiritual as well as physical, emotional, and relational needs. Prayer consistently tops the list of spiritual practices patients value. Surveys find that more than 90% of Americans pray, and 95% claim their prayers are answered.1 One third of Americans pray for their health, three quarters believe God answers prayer for healing incurable illnesses, and 14% claim they have experienced such healing.1 Given that half of all patients want to pray with their physicians, nurses should expect at least as many want to pray with them.1
Growing interest in evidence-based practice, and the need to justify the use of all resources based on outcomes research, has revived interest in testing the effectiveness of prayer for healing. What outcomes should patients be told to expect from prayer? Can nurses justify spending time praying with or for patients based on research studies?
Defining Prayer
People differ in what they mean by prayer, based both on different beliefs about how prayer works and on different practices. Prayer can be grouped generally as intercessory or contemplative (reflective). The latter seeks to deepen one’s relationship to, union with, or consciousness of a divine or transcendent being or force. Practices are deeply personal, primarily impacting the one praying.2 Contemplative prayer and its health effects have been researched significantly, but intercessory prayer will be the focus here.
Intercessory prayer is a request to God, a spiritual being, or transcendent energy to bring about a desired end.3 The words and thoughts are determined by beliefs about how prayer works. Christian, Jewish, and Muslim prayer asks a loving, all-powerful God to personally intervene. Other religions appeal to their divinities. Others believe prayer involves directing nonphysical healing energy toward people. Prayer is "directed" if requests are specified (e.g., "remove this cancer"). Nondirected prayer is more general, typified by, "Lord, let Your will be done." Another nondirected practice is the LeShan method where healers enter an altered state of consciousness believed to stimulate the patient’s natural capacity for self-healing.4
Intercessory prayer is more amenable to scientific study because the person praying can differ from the one prayed for. Controlled studies of intercessory prayer for health and healing in humans will be reviewed here.
Research on Psychological Outcomes
The first controlled prayer study was published in 1957 involving 45 volunteers with various emotional disorders.5 Subjects were nonrandomly assigned to three groups. Group 1 received weekly standard psychotherapy, Group 2 (all Christians) prayed daily for their own problems to be overcome, and Group 3 had weekly two-hour group therapy sessions. The group therapy participants discussed their problems and prayed for one another, and prayed for themselves between sessions. After nine months, standard psychological tests showed an average 62% improvement in Group 1, no improvement in Group 2, and 72% improvement in Group 3. This study is of historical interest, but its design makes any conclusion tentative.
The next study included patients with either psychological or rheumatic problems.6 Forty-eight subjects were pair-matched and randomly assigned to prayer or control. Christian prayer groups in English churches arranged for everyone to receive nondirected prayer daily for six months. No significant differences were found between the two groups during standard clinical evaluations for their conditions.
The only intercessory prayer study found in the nursing literature examined patients with chronic undifferentiated schizophrenia.7 Twenty student nurses were assigned to one-on-one care of 20 Christian patients unresponsive to psychotherapy at a state mental institution. Half the students and patients volunteered for the prayer group while the others engaged in standard therapeutic relationships. The prayer students offered Christian prayer as a group for their patients immediately prior to weekly visits, and began and ended each visit with prayer and Scripture reading. A nursing psychological instrument (of unstated reliability and validity) was administered before the study and after 10 weeks. The control group revealed no changes, while prayer group patients more appropriately and articulately expressed frustration and anger, developed a desire to change, and complained of fewer somatic problems (no statistical analysis given).
LeShan prayer was studied with 40 patients hospitalized for major depression.4 Patients continued standard therapy and medication, were pair-matched and randomly divided. Nondirected prayer for improved patient well-being was offered daily for six weeks. Validated tools showed no significant differences in depression or well-being scores, length of hospitalization, or number of re-admissions.
The largest psychological study used 406 healthy volunteers randomly assigned to receive no prayer, directed prayer, or nondirected prayer.3 Prayer was offered to God, with two thirds of those praying being Catholic. Each subject received prayer from three people for 15 minutes daily for 12 weeks. No significant differences were found between any of the groups on 11 measures of self-esteem, anxiety, depression, and mood.
The latest psychological study examined 40 people admitted to an alcohol abuse center.1 Subjects were randomized after match pairing. Volunteers used nondirected prayer for three patients each for six months. Numerous religious beliefs were initially represented, but only Protestant, Catholic, and Jewish volunteers completed the study. The groups had no significant differences in alcohol consumption.
Research on Miscellaneous Physiological Outcomes
A study finding prayer had no significant difference on rheumatic conditions was already examined.6 Another study randomly assigned 18 children with leukemia to prayer or control.8 Each child was prayed for daily by a Protestant family while standard chemotherapy continued. After 15 months, seven of 10 receiving prayer were alive, compared to two of eight in the control (P = 0.1).
Science of Mind healers believe their thoughts influence universal energies to bring healing.9 A double-blind study randomly assigned 96 hypertension patients, who continued standard medication, to either prayer or control. Eight healers used nondirected prayer, but only results of the four most effective healers were used. No differences were found in a general health status index, diastolic blood pressure, heart rate, or weight change, but systolic blood pressure dropped significantly (P = 0.0144).
Wirth has published two double-blind studies, the first using LeShan prayer and Reiki for pain following extraction of impacted molars.10 Twenty-one volunteers were randomly assigned to one group for extraction of the first tooth, and then the other group for their second extraction two weeks later. In addition to standard analgesia, Reiki and LeShan commenced three hours postoperatively, alternating hourly for six hours. Pain intensity was significantly lower and pain relief significantly higher in the treatment group at each hour (P < 0.05 or P < 0.01).
Wirth’s second study was an "exploratory pilot study" with 16 type 1 diabetes patients.11 A double-blind, within-subject crossover design again was used. Alternating daily for two weeks, the treatment group received either Christian prayer or an adaptation of therapeutic touch practiced through a one-way mirror (for blinding). Insulin use did not differ significantly between treatment and control intervention.
An unpublished study randomly divided 53 post-hernia male patients between three groups.12 One group used audiotapes suggesting accelerated recovery; the second group received distant or psychic healing during surgery (no details reported); and the third was a control group. Those receiving distant healing had significantly better outcomes in nine of 24 variables measured (P < 0.05), including wound appearance, fever during hospitalization, and amount of pain.
Forty pair-matched AIDS patients were randomized in a double-blind study.13 Healers used Christian, Jewish, Buddhist, American Indian, shamanic, bioenergetic, or meditative distant healing practices. Patients received one hour of nondirected prayer daily from a different healer every week. After six months, the treatment group had significantly better medical outcomes in six of the 11 variables measured, including fewer new AIDS-defining illnesses, fewer doctor visits, and improved mood (P < 0.04). Outcomes showing no significant differences included recovery from AIDS-defining illnesses, CD4+ count, and quality of life.
Research on Coronary Care Outcomes
In probably the best-known prayer study, Byrd randomized 393 coronary care unit patients to either control or daily prayer from "born-again" Christians.14 Between three and seven people prayed for each patient for a rapid recovery and prevention of both complications and death. No significant differences between the two groups were found on those outcomes. Twenty-six other medical outcomes were measured, with the prayer group showing significantly better results in six. A tool for ranking patients’ overall outcome was developed (but not validated), and showed the prayed-for patients did significantly better (P < 0.01).
Harris replicated Byrd’s study with 990 coronary care unit patients.15 This randomized, double-blind study used Christian prayer for 28 days. Thirty-five medical outcomes were examined, with no significant differences on any individual measure. Using Byrd’s tool no significant differences in overall outcome were found, but a tool developed (but not validated) by Harris found significant improvements (P = 0.04). The prayer group scored 11% better than the control, but the researchers questioned the clinical significance of this.
The MANTRA project’s pilot study randomized 150 patients scheduled for cardiac catheterization to receive either prayer, touch, imagery, stress relaxation, or standard therapy.16 Everyone in the prayer group received Christian, Jewish, Buddhist, and Unity Church prayer. The principal investigator concluded that a feasibility study cannot give "statistically definitive results," but the prayer group did better than all others on every measure of adverse events. The project is now enrolling 1,500 patients at several sites.
Conclusion
Early prayer studies had methodological weaknesses. Overall, the results reveal a pattern of inconsistencies. The Harris study exemplifies the current difficulty in reaching conclusions. The prayer group showed no significant improvement in any individual outcome, but did in a combined measurement. This approach is statistically questionable since individual outcomes are often interrelated (e.g., sepsis and antibiotic use). Additionally, the Harris data showed significant and nonsignificant improvements depending on which assessment tool was used. For those who believe intercessory prayer works, and those who don’t, the evidence from clinical studies will not convince them otherwise.
Studies show prayer sometimes brings improvements in some variables and not in others. This raises questions about prayer’s nature, a topic avoided in recent research. If prayer involves impersonal energy or an innate human ability, improved research should bring consistent results. But if prayer involves a personal God who chooses how to answer, controlled studies will never be conclusive. Randomized, double-blind studies can control for the placebo effect, but not for divine choice.
Decisions about prayer are based on people’s beliefs, and will remain that way. Clinical evidence does not support or refute those beliefs, rooted in the other evidence people use to form their worldviews. Those beliefs should be respected by knowing enough about one’s patients to know who would appreciate prayer.
References
1. Walker SR, et al. Intercessory prayer in the treatment of alcohol abuse and dependence: A pilot investigation. Altern Ther Health Med 1997;3:79-86.
2. Lewis PJ. A review of prayer within the role of the holistic nurse. J Holist Nurs 1996;14:308-315.
3. O’Laoire S. An experimental study of the effects of distant, intercessory prayer on self-esteem, anxiety, and depression. Altern Ther Health Med 1997;3:38-53.
4. Greyson B. Distance healing of patients with major depression. J Sci Exploration 1996;10:447-465.
5. Parker WR, St. John E. Prayer Can Change Your Life. New York: Prentice Hall; 1957.
6. Joyce CRB, Welldon RMC. The objective efficacy of prayer. J Chronic Dis 1965;18:367-377.
7. Carson V, Huss K. Prayer—an effective therapeutic and teaching tool. Psychiatric Nurs 1979;17:34-37.
8. Collipp PJ. The efficacy of prayer: A triple-blind study. Med Times 1969;97:201-204.
9. Miller RN. Study on the effectiveness of remote healing. Med Hypotheses 1982;8:481-490.
10. Wirth DP, et al. The effect of complementary healing therapy on postoperative pain after surgical removal of impacted third molar teeth. Complement Ther Med 1993;1:133-138.
11. Wirth DP, Mitchell BJ. Complementary healing therapy for patients with type 1 diabetes mellitus. J Sci Exploration 1994;8:367-377.
12. Bentwich Z, Kreitler S. Psychological determinants of recovery from hernia operations. Paper presented at: The Dead Sea Conference; June 1994; Tiberias, Israel. Cited in: Targ E. Evaluating distant healing: A research review. Altern Ther Health Med 1997;3:74-78.
13. Sicher F, et al. A randomized double-blind study of the effect of distant healing in a population with advanced AIDS: Report of a small scale study. Western J Med 1998;169:356-363.
14. Byrd RC. Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Med J 1988;81:826-829.
15. Harris WS, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. Arch Intern Med 1999;159:2273-2278.
16. Horrigan B, et al. The MANTRA study project. Altern Ther Health Med 1997;5:75-82.
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