Every Jewish Sabbath service includes reciting of the MiSheBerach, asking God to assist congregation members who are sick. Christians invoke God’s healing through prayer and fasting. Followers of Hinduism use meditation to heal time sickness, a state of discontent produced by rushing through life. Virtually every world religion has spiritual remedies to restore mental and physical wellness. Carl Jung, a younger colleague of Sigmund Freud, conceptualized religion as a primordial need of man. Now science is confirming that religion and spirituality can have demonstrable health benefits.
Spirituality encompasses the ways people find meaning, hope, purpose, a sense of internal peace and a connection to things greater than themselves. Many people find spirituality through the beliefs and traditions of organized religion, but others find it through music, art, meditation or a connection with nature. Some find it through working for greater causes that reflect their values and principles.
Research shows that the comfort and strength gained from religious prayer and spirituality can contribute to healing and a sense of well-being, and can help people cope when confronted with illness or death. Reviews of the medical, psychological and social science literature have shown that people who are motivated by spiritual factors have lower rates of cardiovascular disease, hypertension, obesity, depression, anxiety and gastrointestinal distress. Studies specifically evaluating the impact of religion (rather than broader spirituality) show that in general people who are more religious have less psychological distress, depression, suicide, illicit drug use, alcohol abuse, delinquency and divorce.
Additionally, most organized religions offer affiliation with a supportive religious community. In a long-term Yale University study of almost 3,000 older adults, attendance at community religious services and events predicted better physical functioning and less disability over the ensuing 8 to 12 years. This type of social connected ness has been identified as one of the strongest predictors of longevity and physical and mental functioning.
Many religions teach that even painful and difficult events can have a transcendental purpose. This philosophy can be helpful to people seeking sense in the midst of illness. The Korean psychiatrist Bou-Yong Rhi contrasts this spectrum of meaning to modern medicine’s dichotomy of good and bad that views illness only from a negative standpoint.
Unfortunately, religion and spirituality have only recently been considered important topics for medical research, and many studies are not methodologically sophisticated. Often they do not take into account differences in other health behaviors; for example, because people who are religious have lower rates of smoking, their reduction in cardiac disease could be related either to spirituality or to a reduced exposure to tobacco’s toxins.
Nevertheless, some studies are beginning to separate the specific factors in religious practice that appear to be health-related. One extensive survey of households in Ohio found that frequency of prayer was less important than individuals’ subjective experiences of feeling an interaction with God, having prayers answered or reaching a sense of peace. In general, people who seek connectedness with God while remaining open to the will of the divine derive greater benefit than for those who pray to change reality. Several studies have noted that people who prayed in their own words (used colloquial prayer) reported greater well-being than those who recited prayers by rote or read prescribed ritualistic prayers.
The varying effects of different types of prayer in these studies indicate that the commonly-used measures of religion (i.e., church attendance, orthodoxy, church membership and frequency of prayer) likely do not adequately capture the potential effects of religion and spirituality.
The most controversial studies of religion in the medical literature are those that have attempted to evaluate whether intercessory prayer (prayer for other people without their knowledge) has a measurable effect on medical outcomes. Several studies have looked at medical outcomes for seriously ill patients chosen at random to be prayed for by others without their knowledge. The studies compared health measures for these patients to health measures for other patients on the same hospital floors. In all of the studies, the vast majority of outcome measures were identical for the two groups. Some studies found a few measures, however, where the prayer group had a small but statistically significant advantage. Nevertheless, because of problems in study design, the results are difficult to interpret; more conclusive answers may come in the future with more methodologically sophisticated studies.
Western medical practices have generally eschewed discussion of religious or spiritual issues in the context of a medical visit. Nevertheless, numerous surveys indicate Americans consider religion a very important component of well-being. Gallup polls consistently show that about 90 percent of Americans say they pray, and about 75 percent say they pray daily. In studies during the past decade, nearly half of respondents claimed to have experienced healing through prayer at some point in their lives, 25 percent said they had turned to prayer for assistance with illness in the previous year, and more than half said they would like the opportunity to enlist their physicians’ help in religious or spiritual matters. Physicians, however, have been reticent. One study in the Journal of Family Practice found that although more than 90 percent of physicians surveyed believed it was important to consider the religious needs of their patients, more than 80 percent reported they had dis cussed religion with their patients rarely or only occasionally.
With the current cultural movement toward a more holistic view of health, America’s medical societies have begun to acknowledge the importance of addressing religious and spiritual needs. The American Academy of Family Practitioners makes the following recommendations for improving spiritual health: 1) Identify the things in your life that give you a sense of inner peace, comfort, strength, love and connection. 2) Set aside time every day to do the things that help you spiritually. These may include doing community service or volunteer work, praying, meditating, singing devotional songs, reading inspirational books, taking nature walks, having quiet time for thinking, doing yoga, playing a sport or attending religious services.
Religion and spirituality are complex concepts, with many unquantifiable facets (such as sincerity of belief, level of faith, and degree of connectedness to a greater cause or divine power). Consequently, research may never provide concrete evidence about the relationship of religion and spirituality to health. Nevertheless, it is difficult to contest their importance when millions of people around the world continue to seek solace and healing through prayer, meditation and other spiritual endeavors.
by Gillian Friedman, MD