News stories, midmorning talk shows, and celebrity figures such as Deepak Chopra claim that prayer can improve health. Biologists, pundits, and others scoff at the same assertion. As is typical of so many debates regarding faith, people often see what they want to see: believers seeing proof of prayer and skeptics seeing disproof. This raises the question: What does the research show?

According to Dr. Harold Koenig, an associate professor of medicine at Duke University and the country's leading authority on faith-and-medicine studies, academic research does show that prayer has beneficial health effects, although mainly for the person who does the praying. Studies of "intercessory" prayer--Person A prays for the health of Person B--find scant if any effect. But studies of "petitionary" prayer, in which a person prays for his or her own health or peace of mind, show tangible statistical results. When you pray for your own health--especially your own mental health, in cases of clinical depression--science suggests you may be on solid ground.

EARLY PRAYER STUDIES
Objective attempts to determine whether prayer has demonstrable effect on health trace to the 1860s, when Francis Galton, a cousin of Charles Darwin, studied the subject. Galton examined English mortality records to determine if ministers, whom he presumed would pray more than the public at large, had longer life expectancies than those in other professions. He found that, at that time in England, the typical cleric lived 69 years, versus 68 years for lawyers and 67 years for physicians. Galton thought this was too small a difference on which to base any claim of prayer benefits.

Galton also studied death records for English aristocracy, whom he assumed would live longest of all if prayers were answered--because standard Anglican liturgy of the period asked parishioners to offer prays for "the nobility" of the nation. But rather than enjoying prayer-conferred longevity, Galton found, English nobles of the 1860s died on average after 66 years. From such numbers, Galton concluded that prayer has no effect.
Although Galton's work was rigorous by the standards of a century and a half ago, it had what today would be considered "control" problems. Galton made no attempt to determine whether ministers actually did receive more prayers than others; he just assumed it. Similarly, he assumed that since the Anglican liturgy asked parishioners to pray for the health of nobility, people must be doing so. But we know from sociology that millions of 19th-century Britons despised the titled class: Maybe churchgoers were silently praying that the local lords and ladies would come to woe.

Today, many skeptics who reject prayer-and-health studies cite Galton, without mentioning the flaws in his work. They also don't mention Galton's bias--he was an ardent foe of religion.

LONG-DISTANCE PRAYER
Flash forward to the present and the two most oft-cited, "controlled" scientific attempts to determine if "intercessory" prayer improves health. The first was conducted by a California physician named Randolph Byrd, who in 1983 studied patients entering the coronary care unit of San Francisco General Medical Center. Byrd broke the patients into two groups, a control group for whom no praying was done (at least, so far as Dr. Byrd was aware) and a test group whose names were given to volunteers who had offered to pray for the patients. The test was "blind," meaning the patients did not know which group they were in so there could be no placebo effect of feeling better simply because you believed others were praying for your recovery.

One researcher found that patients in the prayed-for group were 11% more likely to do well than patients in the not-prayed-for group.

Byrd found that 85% of those in the prayed-for group had a "good" medical outcome, versus 73% in the non-prayed-for group, while only 14% in the prayed-for group had "bad" outcomes, versus 22% in the no-prayer category. These differences were statistically significant for the size of the group studied and thus seemed to confirm that prayer had helped.

A second, similar study, widely noted in news reports in the fall of 1999, also concerned coronary care patients, this time in a hospital in Florida. William Harris, a medical researcher, again broke patients into prayed-for and non-prayed-for groups. Again, the test was blind, patients not knowing which category they were in. Harris found that patients in the prayed-for group were 11% more likely to do well on a standard scale of coronary health indicators than patients in the not-prayed-for group.

The Byrd and Harris studies form the basis of hard-science assertions that the value of intercessory prayer has been scientifically confirmed. A third study, by Elizabeth Targ of the University of California at San Francisco, where a number of researchers form an important Spirituality and Health Group, claims further proof.

Targ staged a randomized, double-blind study of what she calls "distant healing," in which volunteers prayed for AIDS patients. Targ and her colleagues found that the prayed-for group had fewer hospital and physician visits than a control group and showed other indicators of improved health.

But do intercessory-prayer studies make the grade? Targ's findings are contested as "soft" because she used some highly subjective measures, such as attempts to rate the psychological well-being of prayed-for AIDS patients; and her studies did not find any improvements in prayed-for AIDS patients' "CD4 levels," a basic measure of the immune system's ability to combat the disease.

Irvin Tessman, a Purdue University professor of biology, has examined the Byrd and Harris studies and considers both flawed. In the San Francisco study, Tessman notes, Byrd made subjective judgments regarding whether each patient's outcome should be ranked as good. This meant, Tessman thinks, that Byrd himself was not "blinded" regarding the outcome--that the researcher's own hope to prove the efficacy of prayer may have subtly biased his rankings. The Harris study attempted to correct for this by using a textbook group of coronary indicators based strictly on statistics and hospital-chart entries, not subjective judgments. But the 11% improvement Harris found is, Tessman thinks, only a tiny bit more than the standard statistical allowance for random outcomes--if it's the result of prayer, then it is a weak result.

A large study of prayer and healing being conducted by Herbert Benson at the Mind/Body Medical Institute, a Harvard affiliate, may eventually become the 500-pound gorilla of this subject, but so far the study's conclusions are not known.

Others have also criticized the studies. Hector Avalos, an assistant professor at Iowa State University, asserts that these and all projects attempting to prove intercessory prayer are of no value, because when it comes to speaking to the divine, "there can be no such thing as a controlled experiment." His point is that it is impossible to know if someone outside the experiment is praying for those inside. Suppose family or friends were praying for those in the non-prayed-for groups--that could skew the results.
The Avalos point is itself subject to objection--after all, distortion of a prayer experiment by persons praying without the experimenter's knowledge could only happen if prayer actually works. (If prayer is pointless, it wouldn't matter even if millions of unknown persons were praying for the control group.) So objections to the intercessory prayer studies can cut two ways. But overall, even most science-and-faith researchers consider the effects of intercessory prayer to be weak, at best.

This may be challenged by an upcoming study to be published in Southern Medical Journal that will show demonstrable statistical value for direct intercessory prayer of the "laying on of hands" type: Patients suffering moderate to severe rheumatoid arthritis experienced reduced pain when touched by those praying for them. This effect could be psychological in origin--having someone take the time to touch you and pray on your behalf makes you feel better about life, thus lessening pain. But psychological effects can be just as real as physical effects, and in this case prayer appears to lead to tangible benefits.

DEPRESSION LIFTER
But if the benefits of intercessory prayer are debatable, petitionary prayer--praying for yourself--is another kettle of fish. Studies show that it clearly generates a benefit, though not for everyone. In one study overseen by Duke University researchers, subjects who both attended worship services and regularly prayed had lower blood pressure than a control group. In another study, women in a risk group for various complications of pregnancy were less likely to suffer problems, such as low-birth-weight babies, if they prayed.

The benefit-for-self effect of prayer is most statistically demonstrable when it comes to depression--both the lingering depression that can form in everyday life and the specific depressions associated with illness. Many who are seriously ill, especially the elderly, become depressed as a complication.

For instance, one study of 1,000 seriously ill men in Veterans Administration hospitals found that "religious coping," including prayer, decreased depression, though it did not prolong life span. A study of self-described Christian patients found that prayer accelerated recovery from depression caused by illness; a study of self-described Muslims found that prayer accelerated recovery from "anxiety disorder," a mild form of clinical depression suffered by many people. Other academic, peer-reviewed studies have also found that prayer reduces depression.
That prayer can have health benefits now appears sufficiently well supported by research data that the American Cancer Society recently declared, "Sometimes answers come from prayer when medical science has none." Some physicians and academics protested when the American Cancer Society made that statement. On one level, of course, the statement is inarguable. Reverence for a higher purpose might comfort the victim of illness in ways that no drug or technology ever could, regardless of whether a higher purpose exists--a self-placebo effect. But the Cancer Society's statement was influenced by the increasing body of research that suggests that when you pray for yourself, you are doing something medically wise.

Why could prayer help you when you pray for yourself but not help others when you pray for them? Intercessory prayer could only function via mystical power, but prayer for the self might have an effect similar to meditation, endorsed in both secular and spiritual theories of healing. The "answers" that come from prayer might be divinely provided, or reflect a person's own contemplative understanding of his or her condition. The nonsectarian form of prayer, which is akin to meditation and used for stress reduction, has long been recognized by clinicians to improve one's sense of well-being.

Martin Seligman, a former president of the American Psychological Association, has supposed that prayer helps recovery from illness and depression by focusing the mind on things to be grateful for in life. Studies by Dr. Herbert Benson of Harvard University have shown that inducing a relaxed state of mind is good both for health and immune-system response. Prayer might work partly in this way. Says Koenig, "I view the benefits of prayer mainly as psychological or social, not as a supernatural effect, though of course the research can't rule that out. All the research can show is that prayer sometimes really does confer benefits."

Put another way: Lack of strong evidence for intercessory prayer seems to argue against standard ideas about the supernatural as a commanding force that intervenes to cure. Yet the presence of evidence for effects of prayer on the self seems to argue that we would be foolish to assume away faith.

SMART PEOPLE PRAY
Clearly, Americans as a group think prayer is beneficial for health. A 1999 CBS News poll found that 80% of Americans believe prayer improves recovery from disease, and 63% believe doctors should pray with patients if asked--though only 34% think prayer should be "a standard part of the practice of medicine."

The kicker is that a surprising number of scientists agree. Francis Collins, a Darwinian biologist and head of the federal government's genome-sequencing initiative, says he prays daily. John Houghton, one of the world's foremost atmospheric physicists and a leading proponent of global-warming theory, has written articles on the value of prayer. The Nobel Prize-winning physicist Charles Townes, principal inventor of the laser beam, says he prays each day. Pundits might snicker, but if regular prayer composes the mind and confers health benefits, the person who prays is following the intelligent course, regardless of the verity of any religion.


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