Could it be possible? Could the prayers of a handful of people help someone -- even someone on the other side of the world -- facing heart surgery?
A few years back, Roy L. was heading into his third heart procedure -- an angioplasty and stent placement. Doctors were going to thread a catheter up a clogged artery, open it up, and insert a little device, the stent, to prop it open. It's a risky procedure under the best of circumstances. "The risks are the big ones -- death, stroke, heart attack," says his doctor, Mitchell Krucoff, MD, a cardiovascular specialist at Duke University School of Medicine in Durham, N.C.
"You're mighty thankful you came out of it," Roy tells WebMD
Though he didn't know it, Roy may have had some help getting through the procedure, some nonmedical help. Later, he learned he was on the receiving end of prayers before, during, and after the procedure -- prayers sent from nuns, monks, priests, and rabbis all over the world, with his name attached to them.
"I'm not a church-going man, but I believe in the Lord," he tells WebMD. "If somebody prays for me, I sure appreciate it." And he's doing well now, with his heart problems anyway. The only thing plaguing him presently is the onset of diabetes.
Roy was part of a pilot study looking at the effects of "distant prayer" on the outcome of patients undergoing high-risk procedures.
But did prayers help Roy survive the angioplasty? Did they help ameliorate some of the stress that might have complicated things? Or do a person's own religious beliefs -- our personal prayers -- have an effect on well-being? Is there truly a link between mere mortals and the almighty, as some recent neurological studies have seemed to show?
Those are questions that Krucoff and others are attempting to answer in a growing number of studies.
God Grabs Headlines
Research focusing on the power of prayer in healing has nearly doubled in the past 10 years, says David Larson, MD, MSPH, president of the National Institute for Healthcare Research, a private nonprofit agency.
Even the NIH -- which "refused to even review a study with the word prayer in it four years ago" -- is now funding one prayer study through its Frontier Medicine Initiative. Although it's not his study, Krucoff says it's nevertheless evidence that "things are changing."
Krucoff has been studying prayer and spirituality since 1996 -- and practicing it much longer in his patient care. Earlier studies of the subject were small and often flawed, he says. Some were in the form of anecdotal reports: "descriptions of miracles ... in patients with cancer, pain syndromes, heart disease," he says.
"[Today,] we're seeing systematic investigations -- clinical research -- as well as position statements from professional societies supporting this research, federal subsidies from the NIH, funding from Congress," he tells WebMD. "All of these studies, all the reports, are remarkably consistent in suggesting the potential measurable health benefit associated with prayer or spiritual interventions."
Wired for Spirituality?
For the past 30 years, Harvard scientist Herbert Benson, MD, has conducted his own studies on prayer. He focuses specifically on meditation, the Buddhist form of prayer, to understand how mind affects body. All forms of prayer, he says, evoke a relaxation response that quells stress, quiets the body, and promotes healing.
Prayer involves repetition -- of sounds, words -- and therein lies its healing effects, says Benson. "For Buddhists, prayer is meditation. For Catholics, it's the rosary. For Jews, it's called dovening. For Protestants, it's centering prayer. Every single religion has its own way of doing it."
Benson has documented on MRI brain scans the physical changes that take place in the body when someone meditates. When combined with recent research from the University of Pennsylvania, what emerges is a picture of complex brain activity:
As an individual goes deeper and deeper into concentration, intense activity begins taking place in the brain's parietal lobe circuits -- those that control a person's orientation in space and establish distinctions between self and the world. Benson has documented a "quietude" that then envelops the entire brain.
At the same time, frontal and temporal lobe circuits -- which track time and create self-awareness -- become disengaged. The mind-body connection dissolves, Benson says.
And the limbic system, which is responsible for putting "emotional tags" on that which we consider special, also becomes activated. The limbic system also regulates relaxation, ultimately controlling the autonomic nervous system, heart rate, blood pressure, metabolism, etc., says Benson.
The result: Everything registers as emotionally significant, perhaps responsible for the sense of awe and quiet that many feel. The body becomes more relaxed and physiological activity becomes more evenly regulated.
Does all this mean that we are communicating with a higher being -- that we are, in fact, "hard-wired" at the factory to do just that? That interpretation is purely subjective, Benson tells WebMD. "If you're religious, this is God-given. If you're not religious, then it comes from the brain."
The Impact of Religion on Health
But prayer is more than just repetition and physiological responses, says Harold Koenig, MD, associate professor of medicine and psychiatry at Duke and a colleague of Krucoff's.
Traditional religious beliefs have a variety of effects on personal health, says Koenig, senior author of the Handbook of Religion and Health, a new release that documents nearly 1,200 studies done on the effects of prayer on health.
These studies show that religious people tend to live healthier lives. "They're less likely to smoke, to drink, to drink and drive," he says. In fact, people who pray tend to get sick less often, as separate studies conducted at Duke, Dartmouth, and Yale universities show. Some statistics from these studies:
Hospitalized people who never attended church have an average stay of three times longer than people who attended regularly.
Heart patients were 14 times more likely to die following surgery if they did not participate in a religion.
Elderly people who never or rarely attended church had a stroke rate double that of people who attended regularly.
In Israel, religious people had a 40% lower death rate from cardiovascular disease and cancer.
Also, says Koenig, "people who are more religious tend to become depressed less often. And when they do become depressed, they recover more quickly from depression. That has consequences for their physical health and the quality of their lives."
Koenig's current study -- conducted with Johns Hopkins University School of Medicine and the first to be funded by the NIH -- involves 80 black women with early-stage breast cancer. Half the women will be randomly assigned to participate in a prayer group, and will choose eight women in their church to form the group.
In the prayer group, he says, "[the support team] will pray for her; she will pray for them," Koenig says. "They will offer each other psychological support, talk about things that are bothering them." During the six-month trial period, each patient will be monitored for changes in immune function.
Religion provides what Koenig calls "a world view," a perspective on problems that helps people better cope with life's ups and downs.
"Having that world view helps people integrate difficult life changes and relieves the stress that goes along with them," Koenig says. "A world view also gives people a more optimistic attitude -- gives them more hope, a sense of the future, of purpose, of meaning in their lives. All those things get threatened when we go through difficult periods. Unless one has a religious belief system, it's hard to find purpose and meaning in getting sick and having chronic pain and losing loved ones."
"Nobody's prescribing religion as a treatment," Koenig tells WebMD. "That's unethical. You can't tell patients to go to church twice week. We're advocating that the doctor should learn what the spiritual needs of the patient are and get the pastor to come in to give spiritually encouraging reading materials. It's very sensible."
When We Pray for Others
But what of so-called "distant prayer" -- often referred to as "intercessory prayer," as in Krucoff's studies?
"Intercessory prayer is prayer geared toward doing something -- interrupting a heart attack or accomplishing healing," says Krucoff, who wears numerous hats at Duke and at the local Veterans Affairs Medical Center. An associate professor of medicine in cardiology, Krucoff also directs the Ischemia Monitoring Core Laboratory and co-directs the MANTRA (Monitoring and Actualization of Noetic Teachings) prayer study project at Duke. Long-time nurse practitioner Suzanne Crater co-directs that study.
Noetic trainings? "Those are complementary therapies that do not involve tangible elements," says Krucoff. "There are no herbs, no massages, no acupressure."
The goal of prayer therapy is to accomplish healing, yet "there are a lot of questions about what healing means," Krucoff tells WebMD. "At this level of this work, there are many philosophical debates that can emerge. The basic concept is this -- if you add prayer to standard, high-tech treatment -- if you motivate a spiritual force or energy, does it actually make people better, heal faster, get out of the hospital faster, make them need fewer pills, suffer less?"
Roy L. and 150 other patients took part in MANTRA's pilot study. All suffer from acute heart disease, and all needed emergency angioplasty.
The stress of the procedure -- because it is done on patients who are awake -- has its own negative effects on the body, Krucoff tells WebMD. "The heart beats faster, beats harder, blood vessels are constricted, blood is thicker and clots more easily. All that's bad." But if an intervention could mediate that stress, it would potentially be a pretty useful adjunct for people coming in for angioplasty, he says.
In the pilot study, the patients were assigned to a control group or to touch therapy, stress relaxation, imagery, or distant prayer. A therapist came to the bedsides of patients in the touch, stress-relaxation, and imagery groups, but not to the bedsides in the control or distant-prayer groups. Like Roy, people in those two groups didn't know whether prayers were being sent their way or not.
Those early results "were very suggestive that there may be a benefit to these therapies," Krucoff tells WebMD.
Krucoff and Crater are now involved in the MANTRA trial's second phase, which will ultimately enroll 1,500 patients undergoing angioplasty at nine clinical centers around the country.
Patients will be randomly assigned to one of four study groups: (1) they might be "prayed for" by the religious groups; (2) they might receive a bedside form of spiritual therapy involving relaxation techniques; (3) they might be prayed for and receive bedside spiritual therapy -- the "turbo-charged group," as Krucoff calls it; or they might get none of the extra spiritual therapies.
"We're not looking at prayer as an alternative to angioplasty," he adds. "We're very high-tech people here. We're looking at whether in all of the energy and interest we have put into systematic investigation of high-tech medicine, if we have actually missed the boat. Have we ignored the rest of the human being -- the need for something more -- that could make all the high-tech stuff work better?"