The Four Arguments
We’ve seen the headlines: Spirituality and religion are good for you, most researchers agree. But why?
This article appeared in our February 2004 issue.
The past five or six years have seen an escalating number of studies offering evidence for the health benefits of religious practice and spirituality. This evidence in turn is leading to a growing awareness that medical science and religion now have a basis for a new and progressive partnership, in which medicine becomes more spiritual, and religion gains new utility and status in the scientific world. But researchers and theologians do not reach the same conclusions. To understand what is going on, we must look at four distinct arguments now emerging.
Argument 1: Going to church is good for your health
In the late 1960s, researchers began to find that social isolation contributed to heart disease. Some studies suggested that living in traditional close-knit communities protects people from heart disease. Others indicated that more isolated people tended to be sicker and die earlier than those more socially embedded. Not surprisingly, various studies suggested that church attendance was negatively correlated with any number of health problems, especially in old age. Some studies even suggested that going to church was correlated with extended lifespan.
Initially, researchers said that churches (and by extension synagogues and mosques) promote health because they provide really good community. But not everyone believed this was the whole story. In 1996, Israeli epidemiologist Jeremy Kark compared mortality rates in 11 secular and 11 matched religious kibbutzim between 1970 and 1985. He found that mortality in the secular kibbutzim was twice that of mortality in the religious kibbutzim. At the same time, he and his colleagues insisted that “there was no difference in social support or frequency of social contact between religious and secular kibbutzim.”
What else might explain such differences? The possible answer takes us to the next two arguments, both concerning intrinsic (roughly, one’s private sense of the divine based on experience, sometimes called spirituality) rather than extrinsic (public) religiousness.
Argument 2: Contemplative practice is good for your health
In the mid-1960s, when middle-class Americans began a romance with practices such as transcendental meditation (TM), they sought emotional and spiritual benefits rather than physical health. Meditation began to be re-conceptualized only in the 1970s, with the work of people such as cardiologist Herbert Benson at Harvard. Noting the evidence that stress contributed to many diseases, he de-emphasized the sectarian aspects of TM, renamed it the “relaxation response,” and redefined it as a natural physiological technique to counter stress.
Beginning in the 1980s, Benson found both a comrade and a rival in the meditation teacher Jon Kabat-Zinn, who in 1979 established what was then called the Stress Reduction Clinic at the University of Massachusetts Medical School in Worcester. He taught patients a meditative practice based on a Buddhist technique called mindfulness. In best-selling books such as Full Catastrophe Living, Kabat-Zinn argued that mindfulness meditation helped patients cope with the stress of chronic illness. In other publications, he offered evidence that the practice directly influences healing and resistance to disease.
While both Benson and Kabat-Zinn taught practices with origins in Asian (Hindu and Buddhist) contemplative traditions, both insisted that you need not be Hindu or Buddhist to meditate, and that you need not fear doctrinal conflict — in fact, you don’t have to be religious. In interviews, Benson has said that when he began to spread the word about meditation, or the relaxation response, he was “startled at the excitement among the religious pros” in the Christian community. He had reminded them of the power of similar practices in their own traditions. “This is why I came into church work in the first place,” said one, “and I’d lost it.”
Argument 3: Belief is a healing power
The claim that belief can heal is rooted in a late-nineteenth century American Protestant movement variously called mind cure, New Thought, Christian Science, Unity Science, and practical Christianity. The leaders of this movement were influenced by European investigations of mesmerism, hypnosis, and so-called faith healing (Lourdes was then a subject of scrutiny by some medical doctors).
If faith can heal, they reasoned, why not cultivate faith? To do so, they said, shows no lack of respect for God, but recognizes the practical presence of God in one’s own life. At the turn of the twentieth century, William James was impressed and bemused by this movement: “The blind have been made to see, the halt to walk; lifelong invalids have had their health restored.... One hears of the ‘Gospel of Relaxation,’ of the ‘Don’t Worry Movement,’ of people who repeat to themselves, ‘Youth, health, vigor!’”
Present-day empirical research investigates these popular understandings more rigorously. Some studies suggest that terminally ill patients with strong faith, a “fighting spirit,” and a “positive attitude” may live longer or face better odds of recovery than pessimistic or fatalistic patients. Researchers have studied how dummy pills — placebos — may also cause measurable changes in clinical conditions.
The new research carries an ecumenical and utilitarian message. Just as some claim that attending religious services promotes health, irrespective of the particular religion, and that meditation is good for your health, irrespective of the practice employed, it is also claimed that belief or faith is good for your health — irrespective of what you believe. All beliefs in a higher power are equal, because all (or so it is assumed) marshal the body’s endogenous healing abilities. In the words of Herbert Benson, “In my scientific observations, I have observed that no matter what name you give the Infinite Absolute you worship, no matter what theology you subscribe to, the results of believing in God are the same.”
Argument 4: Prayer works
Let us be very clear: Prayer works, not because it provides social connection, facilitates a meditative state, or deepens faith. No, prayer itself affects health independent of these factors. Those making this claim say that individual or group prayer for the health of a sick person — even when the sick person is not sure or even aware that he or she is being prayed for — has a measurable effect.
The origin of this research tradition dates to a late-nineteenth- century view of statistics as a new tool for resolving longstanding questions of social policy. In the 1870s, Charles Darwin’s cousin Francis Galton proposed to use statistics to test the efficacy of prayer. He reasoned that if prayer protects health and life, then those whose health was most frequently prayed for should on average live longer than those less frequently prayed for. Since the Church of England service includes prayers for the health of the British royal family, Galton decided to compare their longevity against others with “the advantage of affluence.” He found that, rather than living longer, the royal family were “literally the shortest-lived.”
For the naturalistically inclined intellectuals of the time, all this was a good joke. For many clergy, it was unseemly and wrongheaded. Prayer, one clergyman insisted, was a private matter, unquantifiable, its efficacy beyond the reach of statistics. Nevertheless, the idea that the efficacy of prayer should be an empirical question continues to tempt researchers. In our time, it has been tested using the gold standard of clinical medicine: the randomized, controlled double-blind trial.
The first such study was by Randolph Byrd in the 1980s. Byrd assigned 393 patients in a coronary care unit to one of two groups: those who were prayed for and a control group. He found that, on six out of 26 possible complications, the patients prayed for did significantly better than the control group. The control group did no better than the patients prayed for on any of the 26 measures.
Today, a range of replications and variations on the Byrd study have been completed or are in progress. In 1999, William Harris, a researcher in Kansas, claimed to have replicated Byrd’s findings with a larger sample, although his study did not use the same measures of improvement used by Byrd. This triggered a new spate of media attention, as well as critical scrutiny by skeptics. Currently, Herbert Benson’s lab at Harvard is attempting a definitive replication of the Byrd study.
Theologically, we are somewhere new. Proponents of the first three arguments for the health benefits of religious practice and spirituality are theologically neutral, insisting only that something called religion or spirituality stands above faith traditions, and that its health effects can be investigated. Proponents of these three arguments are careful to leave open the possibility of God’s existence, but their claims do not depend on whether God exists.
But the fourth argument is different. If prayer works — in ways that cannot be attributed to the placebo effect, social support, or stress reduction — then medical science has apparently obtained evidence for God’s existence. Small wonder that this fourth argument is the most contested, criticized, and publicized arm of the religion and health tradition. That almost all the publicized studies to date have tested the efficacy of explicitly Christian prayer has not been lost on at least some people. One Christian fundamentalist website has announced triumphantly that “no other religion has succeeded in scientifically demonstrating that prayer to their God has any efficacy in healing.”
The Religion - Health Link
What kind of medicine? What kind of religion?
In 1997, Dale Matthews, one of the medical researchers promoting the religion-health connection, gave a speech to graduating students at St. Louis Medical School in which he insisted that “The medicine of the future is going to be prayer and Prozac. If we can prove the medical benefits of intercessory prayer, it’s going to be page one news. You’re going to see a revolution. The world of medicine will be turned upside down.”
Since 1997, that revolution has still failed on any significant level to materialize, and Dale Matthews’ own widely anticipated study investigating the power of intercessory prayer proved disappointing. Nevertheless, the evidence, such as it is, continues to tantalize. As a result, conservative theologians and mainstream medical researchers, who might otherwise have dismissed the claims for a religion-health link as unworthy of their attention, now find themselves compelled to take a stand. A book written by two American theologians has recently attacked this whole research effort as a dangerous distortion of the traditional values and goals of Christianity. Editorials published in mainstream journals warn against a dark future in which doctors “prescribe” religion to their patients the way they prescribe a low-fat diet and exercise — thus undermining fundamental human rights to freedom of conscience. Meanwhile, the virulence with which advocates and skeptics currently debate the entire enterprise is worthy of an article all its own. The question as to whether there is a link between religious practice and improved health may be an empirical one, but it is clear that, as a claim, we have something too important, too potentially explosive, to be left to scientists alone.
All beliefs in a higher power are equal, because all (or so it is assumed) marshal the body's endogenous healing abilities.
Conservative theologians and mainstream medical researchers, who might otherwise have dismissed the claims for a religion-health link as unworthy of their attention, now find themselves compelled to take a stand.