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CAM, Religion, and Schrödinger’s One Mind
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Perhaps surprisingly, many social workers appear to use intercessory prayer in direct practice settings. To help inform practitioners' use of this intervention, this article evaluates the empirical literature on the topic using the following three methods: (a) an individual assessment of each study, (b) an evaluation of intercessory prayer as an empirically supported intervention using criteria developed by Division 12 of the American Psychological Association (APA), and (c) a meta-analysis. Based on the Division 12 criteria, intercessory prayer was classified as an experimental intervention. Meta-analysis indicated small, but significant, effect sizes for the use of intercessory prayer (g =–.171, p =.015). The implications are discussed in light of the APA's Presidential Task Force on Evidence-based Practice.
All research domains are based upon epistemological assumptions. Periodic reassessment of these assumptions is crucial because they influence how we interpret experimental outcomes. Perhaps nowhere is this reassessment needed more than in the study of prayer and intention experiments. For if positive results from this field of research are sustained, the reality of nonlocal consciousness must be confronted. This paper explores the current status of healing and intention research, citing a number of major studies and using the "Study of the Therapeutic Effects of Intercessory Prayer (STEP) in Cardiac Bypass Surgery Patients: A Multicenter Randomized Trial of Uncertainty and Certainty of Receiving Intercessory Prayer" as a case study of this line of research. The paper argues that the dose-dependent model typical of drug trials, and adopted for use in the STEP and other studies, is not the optimal model for intention-healing research, and critiques this approach in detail, citing apposite research from which we draw our recommendations and conclusions. The paper suggests that the usual assumptions concerning blindness and randomization that prevail in studies using the pharmacological model must be reappraised. Experimental data suggest that a nonlocal relationship exists among the various individuals participating in a study, one which needs to be understood and taken seriously. We argue that it is important to account for and understand the role of both local and nonlocal observer effects, since both can significantly affect outcome. Research is presented from an array of disciplines to support why the authors feel these issues of linkage, belief, and intention are so important to a successful, accurate, and meaningful study outcome. Finally, the paper offers suggestions for new lines of research and new protocol designs that address these observer-effect issues, particularly the nonlocal aspects. The paper finally suggests that if these effects occur in intention studies, they must necessarily exist in all studies, although in pharmacological studies they are often overshadowed by the power of chemical and biological agents.
To conduct a systematic review of the available data on the efficacy of any form of "distant healing" (prayer, mental healing, Therapeutic Touch, or spiritual healing) as treatment for any medical condition.
Studies were identified by an electronic search of the MEDLINE, PsychLIT, EMBASE, CISCOM, and Cochrane Library databases from their inception to the end of 1999 and by contact with researchers in the field.
Studies with the following features were included: random assignment, placebo or other adequate control, publication in peer-reviewed journals, clinical (rather than experimental) investigations, and use of human participants.
Two investigators independently extracted data on study design, sample size, type of intervention, type of control, direction of effect (supporting or refuting the hypothesis), and nature of the outcomes.
A total of 23 trials involving 2774 patients met the inclusion criteria and were analyzed. Heterogeneity of the studies precluded a formal meta-analysis. Of the trials, 5 examined prayer as the distant healing intervention, 11 assessed noncontact Therapeutic Touch, and 7 examined other forms of distant healing. Of the 23 studies, 13 (57%) yielded statistically significant treatment effects, 9 showed no effect over control interventions, and 1 showed a negative effect.
The methodologic limitations of several studies make it difficult to draw definitive conclusions about the efficacy of distant healing. However, given that approximately 57% of trials showed a positive treatment effect, the evidence thus far merits further study.
EXPERIMENTAL studies on the health effects of distant intercession (prayer) ignore important facets of construct validity, philosophy of science, and theology while focusing on issues like randomization and double-blinding. These tendencies reflect a desire on the part of researchers to remove nature as a causal factor when intercession seems efficacious. We argue that close attention to construct validity of cause-and-effect variables invalidates distant intercessory prayer as a scientific construct. Further, the application of statistical techniques to metaphysical causal phenomena is critiqued. We conclude that research on the effects of religion and spirituality on health should avoid attempting to validate God through scientific methods.
This study, using functional magnetic resonance imaging (fMRI) technology, demonstrated that distant intentionality (DI), defined as sending thoughts at a distance, is correlated with an activation of certain brain functions in the recipients. Eleven healers who espoused some form for connecting or healing at a distance were recruited from the island of Hawaii. Each healer selected a person with whom they felt a special connection as a recipient for DI. The recipient was placed in the MRI scanner and isolated from all forms of sensory contact from the healer. The healers sent forms of DI that related to their own healing practices at random 2-minute intervals that were unknown to the recipient. Significant differences between experimental (send) and control (no send) procedures were found (p = 0.000127). Areas activated during the experimental procedures included the anterior and middle cingulate area, precuneus, and frontal area. It was concluded that instructions to a healer to make an intentional connection with a sensory isolated person can be correlated to changes in brain function of that individual.
Previous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) experiments have suggested that correlated neural signals may be detected in the brains of individuals who are physically and sensorily isolated from each other. Functional MRI and EEG methods were used in the present study in an attempt to replicate these findings. DESIGN/SETTINGS: Subjects were electrically and magnetically shielded because of the characteristic surroundings of the scanner room. During the experiment, the nonstimulated subject was placed in the scanner with sensory isolating goggles covering the subject's eyes. The stimulated subject was placed 30 feet away and sat in front of a video monitor that presented an alternating schedule of six stimulus-on/stimulus-off conditions. The stimulus- on condition consisted of a flickering checkerboard pattern whereas the stimulus-off condition consisted of a static checkerboard. Stimulus-on/-off conditions were presented in the sequence on/off/on/off/on/off. The duration of these intervals was randomly assigned but consistently provided a total of 150 seconds of flicker and 150 seconds of static. Sessions were repeated twice to assess possible replication of the phenomenon.
Changes in fMRI brain activation (relating to blood oxygenation) and EEG signals were measured in the nonstimulated subjects. Changes occurring during stimulus-on conditions were statistically compared to changes occurring during the stimulus-off conditions.
Statistically significant changes in fMRI brain activation and EEG signals were observed when comparing the stimulus-on condition to the stimulus-off condition in nonstimulated subjects (p < 0.001, corrected for multiple comparisons). For fMRI, these changes were observed in visual brain areas 18 and 19 (Brodmann areas). One of the subjects replicated the results.
These data replicate previous findings suggesting that correlated neural signals may be detected by fMRI and EEG in the brains of subjects who are physically and sensorily isolated from each other.
The idea that conscious intentions, in the form of prayer, can affect living organisms is an ancient and universal belief spanning ideology, religion, culture, and race. Anthropologist Stephan A. Schwartz states, "The shamanic cave art of Altamira, Tres Freres, and Lascaux presents compelling testimony that our genetic forebears had a complex view of spiritual and physical renewal, one that has survived to the present unchanged in at least one fundamental respect. The intent to heal, either oneself or another, whether expressed as God, a force, an energy, or one of many gods, has consistently been believed to be capable of producing a therapeutic result."1. In the past 2 decades, this ubiquitous belief has been increasingly subjected to scientific scrutiny. In 1988, cardiologist Randolph C. Byrd, of UC-San Francisco School of Medicine, published the first randomized controlled trial (RCT) involving distant intercessory prayer.2 Since then, investigators have continued to explore in controlled trials the possible effects of remote prayer and healing intentions in coronary heart disease,3-5 AIDS,6 infertility,7 and other clinical conditions.8, 9. Prayer research did not originate with Byrd's provocative study, however. Numerous controlled experiments exploring prayer and distant healing have been done in nonhuman subjects since the 1960s. Significant among them is a series of experiments by psychologist Bernard R. Grad, of McGill University. Grad explored the influence of healing intentions on the rate of healing of surgical wounds in animals, the growth rate of animal tumors, and the rate of growth of plants and microbes.10-16 Similar results were obtained by successive investigators building on his methods.17-20 Succeeding studies involved increasingly objectifiable end points, such as the rate of hemolysis of red blood cells21 and the kinetics of specific biochemical reactions.22, 23 Experiments in nonhuman subjects are important because they eliminate the placebo effect, one of the most common objections lodged against human studies. Of the eight major controlled clinical trials of prayer and distant healing in humans that have been published to date, four have yielded statistically significant results. Both the human and nonhuman studies in distant healing have been the subjects of recent reviews and systematic and metaanalyses.24-35 All but one31 of the systematic and metaanalyses of the human experiments in prayer and distant healing that have been published to date have been generally positive, and even this review concluded that the evidence, although inconclusive, was interesting enough to justify further study. A variety of objections to prayer experiments have understandably been raised. We will comment on the most common of them.
Clear and authoritative, this unique book explores the results and clinical implications of research in spiritual healing, energy medicine, and the effects of intentionality. Rigorously evaluating the science of healing intention, it also makes recommendations for future research and investigations on the impact of spiritual healing practices in the clinical setting.
Erwin Schrödinger was a brilliant and charming Austrian, a great scientist, and a man with a passionate interest in people and ideas. In this, the first comprehensive biography of Schrödinger, Walter Moore draws upon recollections of Schrödinger's friends, family and colleagues, and on contemporary records, letters and diaries. Schrödinger's life is portrayed against the backdrop of Europe at a time of change and unrest. His best known scientific work was the discovery of wave mechanics, for which he was awarded the Nobel prize in 1933. Schrödinger led a very intense life, both in his scientific research and in his personal life. Walter Moore has written a highly readable biography of this fascinating and complex man, which will appeal not only to scientists but to anyone interested in the history of our times, and in the life and thought of one of the great men of twentieth-century science.
To comprehend the results of a randomized, controlled trial (RCT), readers must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through complete transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by using a checklist and flow diagram. The revised CONSORT statement presented in this paper incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results, and Discussion. The revised checklist includes 22 items selected because empirical evidence indicates that not reporting the information is associated with biased estimates of treatment effect or because the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrollment, intervention allocation, follow-up, and analysis). The diagram explicitly includes the number of participants, for each intervention group, that are included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have performed an intention-to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.
This book, the first of its kind, reviews and discusses the full range of research on religion and a variety of mental and physical health outcomes. Based on this research, the authors build theoretical models illustrating the various behavioural, psychological, and physiological pathways by which religion might affect health. They also review research that has explored the impact of religious affiliation, belief, and practice one use of health services and compliance with medical treatment. Finally, they discuss the implications of these findings, examine a number of possible clinical applications, and make recommendations for future research in this area
Objectives. The objective of this study was to determine the attitudes and beliefs of pharmacy students that prompt them to take an elective course in complementary and alternative medicine (CAM) while in pharmacy school. Methods. A questionnaire was administered to 90 third-year pharmacy students, 55% of whom were taking the elective course. The questionnaire was designed to assess student attitudes towards CAM in 5 areas: future concerns for professional competence, personal interest, personal experience, beliefs, and philosophical congruence. Students taking the elective course were compared with students not taking the course for the 5 areas. Results. The 2 student groups differed in their personal interests and beliefs. Conclusions. Belief system and personal interest were found to be significant motivating factors for selecting an elective in CAM among the pharmacy students surveyed.
Context.—
Research both in the United States and abroad suggests that significant
numbers of people are involved with various forms of alternative medicine.
However, the reasons for such use are, at present, poorly understood.Objective.—
To investigate possible predictors of alternative health care use.Methods.—
Three primary hypotheses were tested. People seek out these alternatives
because (1) they are dissatisfied in some way with conventional treatment;
(2) they see alternative treatments as offering more personal autonomy and
control over health care decisions; and (3) the alternatives are seen as more
compatible with the patients' values, worldview, or beliefs regarding the
nature and meaning of health and illness. Additional predictor variables explored
included demographics and health status.Design.—
A written survey examining use of alternative health care, health status,
values, and attitudes toward conventional medicine. Multiple logistic regression
analyses were used in an effort to identify predictors of alternative health
care use.Setting and Participants.—
A total of 1035 individuals randomly selected from a panel who had agreed
to participate in mail surveys and who live throughout the United States.Main Outcome Measure.—
Use of alternative medicine within the previous year.Results.—
The response rate was 69%.The following variables emerged as predictors
of alternative health care use: more education (odds ratio [OR], 1.2; 95%
confidence interval [CI], 1.1-1.3); poorer health status (OR, 1.3; 95% CI,
1.1-1.5); a holistic orientation to health (OR, 1.4; 95% CI, 1.1-1.9); having
had a transformational experience that changed the person's worldview (OR,
1.8; 95% CI, 1.3-2.5); any of the following health problems: anxiety (OR,
3.1; 95% CI, 1.6-6.0); back problems (OR, 2.3; 95% CI, 1.7-3.2); chronic pain
(OR, 2.0; 95% CI, 1.1-3.5); urinary tract problems (OR, 2.2; 95% CI, 1.3-3.5);
and classification in a cultural group identifiable by their commitment to
environmentalism, commitment to feminism, and interest in spirituality and
personal growth psychology (OR, 2.0; 95% CI, 1.4-2.7). Dissatisfaction with
conventional medicine did not predict use of alternative medicine. Only 4.4%
of those surveyed reported relying primarily on alternative therapies.Conclusion.—
Along with being more educated and reporting poorer health status, the
majority of alternative medicine users appear to be doing so not so much as
a result of being dissatisfied with conventional medicine but largely because
they find these health care alternatives to be more congruent with their own
values, beliefs, and philosophical orientations toward health and life.
IN 1993 Eisenberg and colleagues1 reported
that 34% of adults in the United States used at least 1 unconventional form
of health care (defined as those practices "neither taught widely in U.S.
medical schools nor generally available in U.S. hospitals") during the previous
year. The most frequently used alternatives to conventional medicine were
relaxation techniques, chiropractic, and massage. Although educated, middle-class
white persons between the ages of 25 and 49 years were the most likely ones
to use alternative medicine, use was not confined to any particular segment
of the population. These researchers estimated that Americans made 425 million
visits to alternative health care providers in 1990, a figure that exceeded
the number of visits to allopathic primary care physicians during the same
period.
Recent studies in the United States2
and abroad3- 4 support the prevalent
use of alternative health care. For example, a 1994 survey of physicians from
a wide array of medical specialties (in Washington State, New Mexico, and
Israel) revealed that more than 60% recommended alternative therapies to their
patients at least once in the preceding year, while 38% had done so in the
previous month.2 Forty-seven percent of these
physicians also reported using alternative therapies themselves, while 23%
incorporated them into their practices.
When faced with the apparent popularity of unconventional medical practices
and the fact that people seem quite willing to pay out-of-pocket for these
services,1 the question arises: What are the
sociocultural and personal factors (health status, beliefs, attitudes, motivations)
underlying a person's decision to use alternative therapies?
At present, there is no clear or comprehensive theoretical model to
account for the increasing use of alternative forms of health care. Accordingly,
the goal of the present study was to develop some tentative explanatory models
that might account for this phenomenon.
Three theories that have been proposed to explain the use of alternative
medicine were tested:
Dissatisfaction: Patients are dissatisfied with
conventional treatment because it has been ineffective,5- 6
has produced adverse effects,6- 7
or is seen as impersonal, too technologically oriented, and/or too costly.6- 15Need for personal control: Patients seek alternative
therapies because they see them as less authoritarian16
and more empowering and as offering them more personal autonomy and control
over their health care decisions.14,16- 19Philosophical congruence: Alternative therapies
are attractive because they are seen as more compatible with patients' values,
worldview, spiritual/religious philosophy, or beliefs regarding the nature
and meaning of health and illness.19- 24
In addition to testing the validity of these 3 theoretical perspectives,
this study also sought to determine on an exploratory basis how the decision
to seek alternative therapies is affected by patients' health status and demographic
factors.
Since the 1950s, researchers have attempted to understand reports of distant or "psychic" healing, developing experimental protocols that test the distant healing hypothesis by measuring biological changes in a target system while ruling out suggestion or self-regulation as counterexplanations. This article provides a brief overview of these "healing analog" experiments. It also provides a summary and meta-analysis of 30 formal experiments in which self-reported healers, "psychics," and other self-selected volunteers attempted to influence autonomic nervous system activity in a distant person. Results across the experiments showed a significant and characteristic variation during distant intentionality periods, compared with randomly interspersed control periods. Possible alternative explanations for the reported effects are considered. Finally the implications of distant intentionality are discussed for an understanding of the possible mechanisms of distant healing, the nature of the mind-body relationship, and the role of consciousness in the physical world.
To assess, from published clinical trials, the evidence for the use of healing as a complementary medical intervention in human disease.
Limited to studies involving random assignment to a treatment group consisting of "healing," broadly defined, or to a concurrent control group. All randomized trials published up to the year 2000, were identified from MEDLINE, CINAHL, BIDS-EMBASE, the CISCOM complementary medicine databases and from bibliographic references of published articles. Copies of all published studies were obtained, data were extracted, and methodological quality (Jadad) scores were derived where possible.
Fifty-nine randomized clinical trials (RCTs) were found comparing healing with a control intervention on human participants. In 37 of these, healing was used for existing diseases or symptoms (22 existed as fully accessible published reports, 10 as dissertation abstracts only, and 5 as "preliminary" investigations with limited evidential value). The 22 full trials (10 reporting a "significant" effect of healing compared with control) constitute an extremely heterogeneous group, varying greatly in the method and duration of healing; the medical condition treated; the outcome measure employed; and the control intervention used. Many trials had a number of methodological shortcomings, including small sample sizes, and were inadequately reported. Only 8 studies (5 with a significant outcome for healing) had a maximum methodological quality score of 5, and in 10 studies this score was 3 or less. Two trials-both large scale and methodologically sound-were replicates, and each found a significant beneficial effect of intercessory prayer on the clinical progress of cardiac patients. Eleven of the 15 dissertation abstracts and pilot studies reported nonsignificant results for healing compared with control, a finding that probably reflects the relatively small sample sizes and the likelihood of type II errors. The significant heterogeneity found in this group of trials makes categorization problematic and inhibits the pooling of results by meta-analysis or similar techniques to obtain a global estimate of the "treatment effect" of healing.
No firm conclusions about the efficacy or inefficacy of healing can be drawn from this diverse group of RCTs. Given the current emphasis on evidence-based medicine, future investigations should be adequately powered, appropriately controlled, and properly described. These future investigations would most usefully consist of: (1) pragmatic trials of healing for undifferentiated conditions on patients based in general practice and (2) larger RCTs of distant healing on large numbers of patients with well-defined measurable illness.
To determine whether remote, retroactive intercessory prayer, said for a group of patients with a bloodstream infection, has an effect on outcomes.
Double blind, parallel group, randomised controlled trial of a retroactive intervention.
University hospital.
All 3393 adult patients whose bloodstream infection was detected at the hospital in 1990-6.
In July 2000 patients were randomised to a control group and an intervention group. A remote, retroactive intercessory prayer was said for the well being and full recovery of the intervention group.
Mortality in hospital, length of stay in hospital, and duration of fever.
Mortality was 28.1% (475/1691) in the intervention group and 30.2% (514/1702) in the control group (P for difference=0.4). Length of stay in hospital and duration of fever were significantly shorter in the intervention group than in the control group (P=0.01 and P=0.04, respectively).
Remote, retroactive intercessory prayer said for a group is associated with a shorter stay in hospital and shorter duration of fever in patients with a bloodstream infection and should be considered for use in clinical practice.
To comprehend the results of a randomised controlled trial (RCT), readers must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through total transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by use of a checklist and flow diagram. The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results, and Discussion. The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect, or because the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrollment, intervention allocation, follow- up, and analysis). The diagram explicitly shows the number of participants, for each intervention group, included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.
Findings in parapsychology suggest an effect of distant intentionality. Two laboratory set-ups explored this topic by measuring the effect of a distant intention on psychophysiological variables. The 'Direct Mental Interaction in Living Systems' experiment investigates the effect of various intentions on the electrodermal activity of a remote subject. The 'Remote Staring' experiment examines whether gazing by an observer covaries with the electrodermal activity of the person being observed. Two meta-analyses were conducted. A small significant effect size (d =.11, p =.001) was found in 36 studies on 'direct mental interaction', while a best-evidence-synthesis of 7 studies yielded d =.05 (p =.50). In 15 remote staring studies a mean effect size of d = 0.13 (p =.01) was obtained. It is concluded that there are hints of an effect, but also a shortage of independent replications and theoretical concepts.
Six channels electroencephalogram (EEG) were recorded simultaneously from pairs of separated human subjects in two acoustically and electromagnetically shielded rooms. While brain electric responses to visual pattern-reversal stimuli were elicited in one subject, the other subject relaxed without stimulation. EEGs of both subjects were averaged at times of stimulus onset, effective voltage of the averaged signals was computed within a running window, and expressed as ratio (Q) to the effective voltage of averaged EEG signal from non-stimulation periods. These ratios in non-stimulated subjects at the latency of the maximum response in stimulated subjects were analysed. Significant departures of Q ratios from reference distributions, based on baseline EEG in non-stimulation periods, were found in most non-stimulated subjects. The results indicate that correlations between brain activities of two separated subjects may occur, although no biophysical mechanism is known.
Our objective was to assess the effect of Therapeutic Touch (TT) on the proliferation of normal human cells in culture compared to sham and no treatment. Several proliferation techniques were used to confirm the results, and the effect of multiple 10-minute TT treatments was studied.
Fibroblasts, tendon cells (tenocytes), and bone cells (osteoblasts) were treated with TT, sham, or untreated for 2 weeks, and then assessed for [(3)H]-thymidine incorporation into the DNA, and immunocytochemical staining for proliferating cell nuclear antigen (PCNA). The number of PCNA-stained cells was also quantified. For 1 and 2 weeks, varying numbers of 10-minute TT treatments were administered to each cell type to determine whether there was a dose-dependent effect.
TT administered twice a week for 2 weeks significantly stimulated proliferation of fibroblasts, tenocytes, and osteoblasts in culture (p = 0.04, 0.01, and 0.01, respectively) compared to untreated control. These data were confirmed by PCNA immunocytochemistry. In the same experiments, sham healer treatment was not significantly different from the untreated cultures in any group, and was significantly less than TT treatment in fibroblast and tenocyte cultures. In 1-week studies involving the administration of multiple 10-minute TT treatments, four and five applications significantly increased [(3)H]-thymidine incorporation in fibroblasts and tenocytes, respectively, but not in osteoblasts. With different doses of TT for 2 weeks, two 10-minute TT treatments per week significantly stimulated proliferation in all cell types. Osteoblasts also responded to four treatments per week with a significant increase in proliferation. Additional TT treatments (five per week for 2 weeks) were not effective in eliciting increased proliferation compared to control in any cell type.
A specific pattern of TT treatment produced a significant increase in proliferation of fibro-blasts, osteoblasts, and tenocytes in culture. Therefore, TT may affect normal cells by stimulating cell proliferation.
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