Mitch Krucoff was returning home from India in 1994 with almost every idea he’d held about the practice of medicine turned on its head. Krucoff, a cardiologist at Duke University Medical Center, and his nurse practitioner, Suzanne Crater, had been invited to inspect the Sri Sathya Sai Institute of Higher Medicine, a hospital in Puttaparthi, at the end of its first year of operation. The hospital was the pet project of the Indian guru Sri Sathya Sai Baba, who wanted to make available the services of a modern Western hospital to the poor and needy, entirely free of charge. Krucoff had been recruited as its cardiac specialist, to advise on the technology needed to build a state-of-the-art facility for high-tech cardiac catheterizations.
Krucoff and Crater were astonished by what they’d seen. The overwhelmingly spiritual dimension of the facility—even the special quality of the sound and light—had dwarfed its considerable technological achievements. Spirituality was present in the very design of the building—in the Hindu images lovingly chosen to grace the walls. Situated five miles from Sai Baba’s ashram, the building resembled an elongated Taj Mahal. The wings had been structured as a curvature, like a welcome embrace for all those approaching its doors, and the rotunda inside the entrance was meant to represent a heart whose apex was pointing to heaven.
During their rounds, Krucoff and Crater had been struck by the effect this had on the patients—many of them Indians from extremely remote areas who had never seen running water before. Despite the fact that they had been diagnosed with a life-threatening illness and were set to face an imposing twenty-first-century digital cath lab, not one of them seemed the slightest bit afraid. This utter absence of fear contrasted starkly with the terror and despair to which Krucoff had grown accustomed among the cardiac patients he regularly saw back home.
Krucoff longed to introduce some of these practices to hospitals in America, but if he was going to convince any of his colleagues in cardiology, he would have to prove the benefit of spirituality to the practice of heart surgery through hard data showing a measurable physiological effect. He would have to demonstrate that intangible aspects like intention, or spiritual beliefs, or even a spiritual, uplifting environment could really make a difference to a patient’s outcome.
During the eighteen-hour flight home, Krucoff and Crater began teasing out ideas for a study. The only way to do it, they eventually realized, was to put prayer to the test—with the biggest test of its kind.1
When Kruoff got home, he began researching the scientific literature for any evidence that prayer had improved medical outcomes. Fourteen well-conducted trials of prayer had shown a positive effect. In the most famous, published by Randolph Byrd in 1988, a group of born-again Christians outside a hospital had prayed for patients in a coronary care unit. Those who had been prayed for had significantly fewer symptoms, and needed fewer drugs and less medical intervention.2 A Mid-America Heart Institute study, published around the time Targ published her AIDS study and considered at the time to have bolstered Targ’s findings, showed that Christians of all denominations enlisted to pray for hospitalized cardiac patients reduced symptoms by 10 percent, with fewer medical setbacks.3
Prayer is viewed as a kind of super-intention, a joint endeavor: you do the intending, and God carries it out. In some quarters, intention is considered synonymous with prayer, and prayer synonymous with healing; when you send out an intention, God puts the intention into action. Indeed, many consciousness investigators consider these early prayer studies intention experiments. The small studies that had made use of groups of Christians to send intercessory prayers to heart patients are often construed as a group intention—an attempt by a collection of people to influence the same thing at the same time.
However promising the results of these early studies, Krucoff realized that a large-scale trial with tightened protocols was needed, and he mounted his own small pilot study. He enlisted 150 cardiac patients, recruited from nearby Durham Veterans Affairs Medical Center, who had been scheduled for angioplasty and stents. Besides prayer, Krucoff wanted to see whether “noetic” therapies, involving some form of remote or mind-body influence, could affect patient outcomes. He divided the patient population into five groups. In addition to standard medical treatment, four of the five were to receive one of the noetic treatments—stress relaxation, healing touch, guided imagery, or intercessory prayer. The fifth group would be given no additional intervention besides orthodox medical care. Every patient would undergo continuous monitoring of brain waves, heart rate, and blood pressure, to gauge the moment-by-moment effect of these intangible healing influences.
Krucoff decided to turn up the volume on prayer to full blast. To recruit prayer groups, his nurse assistant practitioner Suzanne Crater launched a worldwide campaign of solicitation. She wrote to Buddhist monasteries in Nepal and France, and to VirtualJerusalem.com, which arranged for prayers to be placed in the city’s Wailing Wall. She phoned Carmelite nuns in Baltimore to ask for prayers during vespers. By the time she finished her campaign, she had enlisted prayer groups from seven denominations, including Fundamentalists, Moravians, Jews, Buddhists, Catholics, Baptists, and members of the Unity Church.
Each prayer group was assigned a group of patients, who were identified only by name, age, and type of illness. Although Crater and Krucoff left the design of individual prayers to the groups themselves, they stipulated that the patients had to be prayed for by name and that the prayers on behalf of these patients had to concern their healing and recovery. The prayer portion of the study would be blinded, so that neither patients nor staff knew who was going to be prayed for. The other mind-body therapies would be administered an hour after the patients had undergone the angioplasty.
The results were impressive. Patients in all the noetic treatment groups enjoyed 30–50 percent improvements in health during their hospital stay, with fewer complications and a lower incidence of narrowing of the arteries compared with the controls. They also had a 25–30 percent reduction in adverse outcomes: death, heart attack, heart failure, a worsening of the state of their arteries, or a need for a repeat angioplasty. But of all the alternative therapies employed, prayer had the most profound effect.
The study was too small to yield any definitive conclusions; after all, only 30 patients had been in the prayer group. Nevertheless, Krucoff’s results seemed highly promising. Krucoff and Crater, who had christened their study MANTRA (Monitor and Actualization of Noetic TRAinings), published it and presented their findings before the American Heart Association.4 Even the most conservative of cardiologists were beginning to take home the message that remote healing might actually work after all, and that prayer in particular was good for the heart.5
Krucoff understood that for his results to be meaningful, the study needed to be replicated on a far larger scale. He rolled out his study and created MANTRA II by launching into an ambitious recruitment program, eventually enlisting 750 patients from Duke’s Medical Center and nine other hospitals across America, and solicited twelve prayer groups made up of an even larger, more ecumenical collection of the world’s major religions. Christians were recruited from Great Britain; Buddhists from Nepal; Muslims from America; Jews from Israel. Emboldened by his early success, Krucoff and Duke loudly trumpeted the project as the largest multicenter study of remote influence, the supreme test of prayer.
With MANTRA II, Krucoff divided the patients into four groups. One group would receive prayer; another, a specially designed program that included music, imagery, and touch (or MIT therapy); the third group, MIT plus prayer; and the final control group, standard medical care. Immediately prior to undergoing angioplasty, those assigned to receive MIT would be instructed in a method of relaxed breathing while visualizing a favorite place and listening to calming music of their choice. They would then receive healing touch for 15 minutes from a trained practitioner. These patients could also wear headphones during surgery.
The point of the new study was to examine whether prayer or the noetic interventions would prevent further cardiovascular events in the hospital, such as death, new heart attacks, a need for additional surgery, readmission to the hospital, and signs of a sharp rise in the enzyme creatine phosphokinase, an indication that the heart has suffered damage. This time, Krucoff also wished to investigate longer-term effects as “secondary endpoints”: whether the interventions could alleviate emotional distress, or prevent death or rehospitalization at any point six months after the patients had been discharged.
Krucoff’s study fell right in the midst of the terrorist attacks of 9/11 and their aftermath. For three months, enrollment fell so sharply that he had to amend its design. He developed a two-tier prayer strategy by recruiting twelve second-tier prayer groups. As soon as new patients were added to the study, the second-tier groups were to pray for the members of the first-tier prayer groups, who had been praying for the patients all along. Through this strategy Krucoff hoped that newly enrolled patients would receive a higher dosage of prayer to approximate the amount received by his patients enlisted earlier in the study.
After the enormous advance publicity, Krucoff’s findings were an enormous letdown. When the results were finally in and tallied, there was no denying it: there were no differences in outcomes between any of the various groups during their hospital stay. The only apparent benefit was a slight reduction in distress among the MIT patients prior to their procedure. Otherwise, the large-scale MANTRA was a failure. Prayer did not seem to make anybody better.6
Among the long-term effects, there had been some therapeutic effects in alleviating emotional distress, need for further hospitalization, and even death rates after six months, but these were not considered statistically significant and they hadn’t been the main focus of the study.
Wresting a small victory from this enormous defeat, Krucoff managed to get his findings published in the prestigious British medical journal The Lancet. To the public, he maintained that he was “thrilled” with the findings and that they had been misinterpreted. Krucoff’s study appeared to vindicate the skeptics of prayer as a subject for scientific inquiry. The simple message appeared to be that getting someone to pray for you just does not work.
Meanwhile, in 1997, the Mayo Clinic had begun a two-year study of patients with cardiovascular disease who had been recently discharged from its coronary care unit. Nearly 800 patients were subdivided into two groups: high risk (those who had one or more risk factors, such as diabetes, a prior heart attack, or preexisting vascular disease), and low risk (those they had no risk factors other than their present symptoms). The two groups were again divided in two. In addition to ordinary medical treatment one group in each of the two categories was to receive the prayers of five people once a week for 26 weeks. The two other groups would simply continue with standard medical treatment.
At the end of the study, the investigators concluded that prayer made no difference in mortality, future heart attacks, or the need for further intervention or hospitalization. Although there were small differences between the treated and untreated groups, particularly among the low-risk patients, these results were not deemed to be significant.7
To settle the matter once and for all, Herbert Benson came forward with an ambitious plan. Benson had managed to straddle both mainstream and complementary camps in medicine and was well respected for it—a diplomat with the status of elder statesman between two suspicious factions. Besides his Harvard Medical School credentials, he had set up Mind/Body Medical Institute, which was devoted to the study and practice of mind/body healing techniques. He’d even coined a term, “the relaxation response,” to describe their effects.8 Lending his name to a study of prayer would legitimatize it among the conservative camps. For this study, Benson recruited five other powerhouses of medicine in the United States, including the Mayo Clinic. His plan was that this study of prayer, which he had dubbed STEP (Study of Therapeutic Effects of Intercessory Prayer), would be the largest, most scientifically rigorous of all time.
The study recruited 1,800 patients undergoing coronary artery bypass surgery and divided them into three groups: the first two groups were uncertain whether they were going to receive prayer or not; the first group received prayer and the second did not. The third group, which would definitely receive prayer, was also told of the fact. Benson settled on this particular design so that he could isolate two potential effects: whether being prayed for in itself worked, and whether knowing you were going to be prayed for had any additional benefit. In this way he could control for the effect of belief.9
For his prayer groups, Benson enlisted a group of Roman Catholic monks and members of three other Christian denominations: St. Paul’s Monastery in St. Paul, Missouri; the community of Teresian Carmelites in Worcester, Massachusetts; and Silent Unity, a Missouri Unity prayer ministry outside Kansas City. He maintained that his prayer groups included no members of Islam or Judaism because he could not find non-Christian groups happy to work within the demands of the study schedule. The prayer groups were given the patients’ first names and last name initials. Although the design of their prayers could be individual, they had to include the phrase “for a successful surgery with a quick, healthy recovery and no complications.” The groups were then followed for thirty days, and any postoperative complications, major events, or deaths were tracked among all groups.
The results shocked the world and bewildered the researchers, most of all Benson, who had spent much of his career promoting the beneficial effects of the mind on the body. The researchers had predicted the greatest benefit in the prayed-for-and-knew-it group, the second greatest effect in the prayed-for-
but-didn’t-know-it group, and the least effect among the didn’t-get-prayed-for-and-didn’t-know-it group. But their results indicated that no amount of prayer under any condition, whether the patients knew it or not, made any difference to the outcome of their operations. Indeed, the results were the very opposite of the researchers’ expectations. Those patients who were prayed for and knew they were being prayed for were worse off, by a statistically significant degree: 59 percent of the prayed-for-and-knew-it group suffered postoperative complications, compared with 52 percent among the nonprayed-fors. Even the prayed-for-but-didn’t-know-it group suffered slightly more heart attacks and strokes than those who had not been given prayer. Among the uninformed patients who had received prayers, 10 percent suffered major complications of the surgery, compared with 13 percent of those who did not receive prayer.10
Benson and his coauthors didn’t know what to make of these results. They even wondered if the patients had suffered from a type of “performance anxiety” as a result of the undue pressure and expectations created by the prayers.
Many commentators concluded that this study proved that prayer not only does not work but is bad for you—or at least it cannot be scientifically tested. Krucoff, who was asked to write a commentary about the study, emphasized that prayer indeed had an effect—a negative one. People needed to discard the universally held view that being prayed for is “a priori” good for you, as these results impelled one to consider that not simply “voodoo and spells” but “well-intentioned, loving, heartfelt healing prayer might inadvertently harm or kill vulnerable patients in certain circumstances.”11
The American Heart Journal released the study online, and its authors held press conferences. Benson cautioned the media that STEP was not the last word on prayer, although it did raise questions about whether patients should be told about prayers being offered for them. A patient’s awareness of being prayed for was considered the most important subject about prayer for future study. But others were not sure whether prayer should or could be studied any more. The John Templeton Foundation had spent $2.4 million on the study, and with negative results like these it was likely that theirs would be the last funds available.
The STEP findings seemed to undercut my own plans for a large intention experiment. Then as I mulled over the negative findings, I came to think that the very designs of the studies might have been responsible. Although the studies attempted to be rigorous, in many instances they violated the most basic rules of scientific research.
For instance, all of the failed studies did not clearly formulate the content of the healing intention, and left the content of the prayers up to the individual supplicant. Although Benson asked that the single phrase “for a successful surgery with a quick, healthy recovery and no complications” be included, he had not asked the supplicants to be specific. The most successful intention experiments incorporate a highly specific target into the intention. In Targ’s study, the healers were given the immune system T-cell counts of the AIDS patients and they sent healing specifically to improve the counts. The prayer groups should have been instructed to ask for a specific outcome in cardiac symptoms or fewer cardiac stents placed during the study time or any other highly specific request, rather than a nebulous, highly generalized statement about the patient improving.
None of the studies tightly controlled for the number of people involved in the prayer groups or for either the frequency or length of time they were to pray; this again might have confused the mass intention. Perhaps, since they were using highly diverse prayer groups, their prayers were not equivalent. In Benson’s study, the prayer groups were allowed to pray anywhere from 30 seconds to several hours four times a week. His researchers never recorded how long the individuals prayed. In Targ’s study, although diverse healers were used, they rotated patients, so that each patient received only a single healing message at any one time.
As Bob Barth, director of the Office of Prayer Research, put it: “How do you determine a dose of something as intrinsic as prayer? For example, is one five-minute prayer by a Buddhist different from ten Catholic nuns in prayer for an hour or more? Is prayer more effective once or twenty times a day?”
In commenting on Krucoff’s findings, The Lancet also aired its reservations about his study design. “Could a more restricted denominational approach have influenced the outcome?”12
Benson’s attempt to standardize the prayer methods used in his study inadvertently interfered with the methods by which the prayer groups usually carry out intercessory prayer. In ordinary circumstances, when prayer groups are asked to pray for someone, they request specific details about the patient, including full name, age, medical condition, and periodic reports of the patient’s progress. Often they meet with the patient and his or her family. By gathering this personal information, they are able to personalize the prayers.
Benson’s study design allowed for the prayer groups to be given only the name and a last initial of the person to be prayed for. The limited information made it impossible for the prayer groups to establish a meaningful connection with or indeed even to zero in on the people they were praying for—one of the conditions that Schlitz and Radin consider important for effective remote influence. Several groups in Benson’s study objected to the design of the study. As one commentator wrote, “This would be similar to the concept of attempting to make a cell phone call to a friend and expecting her to answer when you have only dialed the first three digits of the phone number.”13
Like STEP, Krucoff’s studies also did not reveal anything about the patients in order to create a connection. In Targ’s research, the healers had been given a photo and a name as well as information about the patient’s condition. None of the groups tested the difference between praying for a patient whose full details were disclosed and simply praying for someone with a first name and last initial.
The selection of the prayer groups was equally unscientific. None of the major prayer studies used any criteria to select participants in the prayer groups or kept track of their size or experience in prayer. Targ had selected only those healers who were highly experienced and committed with a long track record of successfully healing. Although Schlitz’s Love Study employed amateurs sending healing intention, training was provided to ensure a homogeneous approach.
Another problem was the lack of a genuine control group in any of the studies. To be truly scientific, a study must be “randomized” and randomly select participants in one group that is given the treatment and compare its outcome with a group not exposed to the treatment. However, in any health crisis, family members routinely turn to prayer. The odds were overwhelming in all the major prayer studies that the not-prayed-for people were being prayed for by their own loved ones. In MANTRA II, 89 percent of the patients from both treatment and control groups admitted that someone in their family was praying for them. These patients lived in the religiously active American Bible Belt.
The lack of a pure control group ultimately muddies the results of a study. This problem occurred with the early studies investigating the potential of hormone replacement therapy (HRT) to cause cancer. Many such studies were tainted because it is virtually impossible to enlist women for study who have not taken some form of exogenous hormones—the birth-control pill, the morning-after pill, or HRT—at some point in their lives. Consequently, none of the studies has a clean control group of true “nontakers,” with which to compare results. Women who take hormones now are compared with women who have taken hormones in the past. Both situations carry a cancer risk. The same “tainting” would apply to these prayer studies. People in the “treatment” groups getting prayed for are being compared with patients whose relatives are praying for them.
The large prayer studies had other basic flaws. In both the Benson and the Krucoff studies, the people praying did not know the patients and so would not have had a strong motivation to heal, as the “senders” had in the Love Study. In Benson’s study, as Krucoff pointed out in his commentary about STEP, there should have been a true placebo group, which would have no expectation of the possibility of prayer, and also there should have been a comparison between such a group and a super-group, whose members included all those exposed to prayer. No analysis compared the effect of being prayed for with the particular belief a patient held about the group he or she had been assigned to, which would have shed light on the possible role of a placebo effect. The researchers also had not taken into account any possible stress on the patient from having to hide his or her assignment in the study from the hospital staff.14
Krucoff’s study violated the basic rules of scientific design, largely because of events beyond his control. When he reconstituted his study in the wake of 9/11, some of the patients received straightforward prayer from diverse prayer groups, and the others, who had been enrolled after the World Trade Center tragedy, received the two-tier type of prayer, in which those doing the praying were themselves prayed for. Unlike the most basic of scientific trials, his study did not offer the participants the identical treatment.
Even Targ had complained about problems in study design of the very first major prayer study by Randolph Byrd, in which ordinary Christians had been asked to pray for cardiac patients. There was no information about who was taking blood pressure medication, so it was unclear whether prayer or medicine had done the healing. There were no controls for mental attitude during the study. A high number of patients with a positive outlook may have landed in the treatment group. Sometimes a placebo effect, an expectation of healing, can be a large factor in positive results. In one healing study of patients suffering from clinical depression, all the patients improved, even the control group, which did not receive healing, largely from the psychological boost created by the possibility of healing.15
In Benson’s study the prospect of prayer might have had the opposite effect. According to Larry Dossey, the elegant southern internist and author of many books on prayer,16 the STEP study offered prayer as a “tease,” dangled in front of seriously ill patients as something they might or might not be lucky enough to get.
“Nowhere on earth is prayer delivered in this fashion,” says Dossey “When prayer occurs in real life, we don’t taunt our loved ones with it. They are extended compassionate prayer unconditionally and without equivocation. Who can say what emotions—resentment? hostility?—were generated in these three groups of patients as a result of how prayer was offered?”17
The fact that the people who knew they were being prayed for not only had no placebo response but also evidenced more postsurgical complications than any other group, he says, “suggests that very strange internal dynamics were operating within the Harvard prayer study.”18
The Mid-America Heart Institute study—the study in which prayer by Christians of diverse denominations had reduced symptoms in heart patients by 10 percent—was also criticized for offering so many end points that it was bound to show a positive result.19
The negative results of these large prayer studies could be because praying for others does not work, because prayer simply cannot be subjected to scientific study, or simply because these new studies themselves were asking the wrong questions. After all, according to Bob Barth of the Office of Prayer Research, created by the Unity Church to study the scientific evidence on prayer, these studies represent only a small proportion of prayer research.20 Of the more than 227 studies investigated by the office, 75 percent show a positive impact.
Nevertheless, to study the effect of remote intention, it may be best to move away from prayer, which contains a good deal of emotional baggage. Targ tried to isolate the effect of simple healing intention, which is different from prayer. With intention, the agent of change is human; with prayer it is God. Simple healing intention can be more easily controlled for in a scientific study by ensuring that every member of the group sending the intention is sending the exact same message. For the purposes of my intention experiments, a simple intention to heal or improve something might avoid all the problems associated with studying prayer. Unlike prayer, healing has been persuasively proved; a large body of evidence exists about the positive effects of distant healing—perhaps 150 studies in all.21 These scientific studies have been subjected to overall reviews that rate both the significance of the effects and the outcome. In the most cautious such analysis, Professor Edzard Ernst, the exacting and skeptical chair of complementary medicine at Exeter University in Britain, concluded that of twenty-three studies, 57 percent had shown a positive effect.22 Among the most rigorously scientific (those with double-blind trials), the average effect size, or size of change among those treated, was 0.40—about 10 times better than the effect size of aspirin or propanolol, two drugs considered highly successful in preventing heart attacks.
Hidden in the failure of the large prayer studies lies vital instruction not only about the design of such mass experiments, but also about those elements that maximize the power of intention. To be successful, an intention may require other parameters besides trained attention, getting out of the way, and formulating a simple request to the universe. As Gary Schwartz learned during his own research on healing, the attitude of the healers as well as the patients may matter a good deal.
Schwartz’s research began as a simple study of healing intention by Reiki practitioners. Schwartz had enlisted his colleague, Beverly Rubik, founding director of the Center for Frontier Sciences at Temple University, Philadelphia, a biophysicist interested in subtle energies. As Rubik was well versed in studies using bacteria, they decided to use as their subject E. coli bacteria that had been severely stressed. One way to stress bacteria is to shock them with a sudden blast of heat. Schwartz, Rubik, and their colleague Audrey Brooks carefully managed the amount of heat so that it was enough to stress the bacteria without killing off the entire sample. They then asked 14 practitioners of Reiki to heal the bacteria that survived by transmitting a standard Reiki treatment for 15 minutes. Each practitioner was to heal three different samples over three days. Equipment with an automated colony counter kept track of the number of bacteria that survived.
Initially, Schwartz, Rubik, and Brooks were surprised to find that the Reiki practitioners made no difference to the overall survival of the viable bacteria. On closer look, however, they discovered that the Reiki practitioners seemed to be successful on certain days, but not on others. This spotty batting average puzzled them. Perhaps, Schwartz thought, a healer’s success depended on some sort of connection with the subject. It was difficult, after all, to feel any warm and fuzzy connection with E. coli bacteria, which ordinarily reside peacefully in the gut but can wreak havoc when they migrate out of the digestive tract. But what if he managed to get his practitioners in healing mode?
In the next batch of studies, Schwartz and his colleagues asked the Reiki practitioners to work for 30 minutes on a human patient suffering with pain, and then set them back to work on their bacteria samples. This time, the healing was successful; the scientists discovered significantly more bacteria in the healed samples than in the controls. The healers appeared to enjoy a higher success rate once their healing “pumps” had been primed.23
Nevertheless, Schwartz and the other researchers continued to discover instances in which the healers had a deleterious effect on the bacteria. It occurred to them that a healer’s own well-being might affect results. They needed a simple test to assess true well-being, to gauge more than physical condition. They decided to use the Arizona Integrative Outcomes Scale (AIOS), an ingeniously simple visual means of assessing spiritual, social, mental, emotional, and physical well-being during the past 24 hours.24 Developed by physician and psychologist Iris Bell, one of Schwartz’s colleagues at the University of Arizona, AIOS allows patients to assess more than physical symptoms. The subjects are told to reflect on their general sense of well-being, “taking into account your physical, mental, emotional, social, and spiritual condition over the past 24 hours,” then mark a point on a horizontal line between “worst you have ever been” on the left and “best you have ever been” on the right that, in their view, represents their overall sense of well-being in the same time period. A number of studies demonstrated that AIOS is a useful, accurate tool for pinpointing emotional wellness and a healthy state of mind.25
In their next series of studies, Schwartz, Rubik, and Brooks asked the Reiki healers to assess themselves on the AIOS scale before and after they had carried out the Reiki. With these data, the scientists discovered an important trend. On days when the healers felt really well in themselves, they had a beneficial effect on the bacteria; the counts were higher in the bacteria given the therapy than in the heat-shocked controls. On days when they did not feel so well and they scored lower on the test, they actually had a deleterious effect. Those practitioners who began the healing with diminished well-being actually killed off more bacteria than naturally died in the controls. Evidently, a practitioner’s own overall health was an essential factor in his ability to heal.
Schwartz and his colleagues then tried a study using AIOS with a different type of healing, called Johrei. They recruited 236 practitioners and volunteers, and asked them to fill out the AIOS scale plus a questionnaire he had created assessing emotional state of mind before and after they administered healing. When Schwartz and Brooks compared the AIOS tests of both the healers and the patients before and after the healing, they discovered another interesting effect. Although the patients felt better after they had received the healing, so did the healers after they had performed the healing.
Giving was as good as getting for these senders. Other research showed a similar result.26 The act of healing and perhaps the healing context were themselves healing. Healing someone else also healed the healer. 27
Schwartz and his fellow researchers then carried out another study of distant Johrei healing on cardiac patients—a double-blind study so that no one but the statistician knew who was receiving healing.28 The primary outcomes measured were clinical reports of pain, anxiety, depression, and overall well-being. After three days, the patients were asked if they had had a sense, feeling, or belief that they had received Johrei healing. In both the treatment and the control groups, certain patients strongly believed that they had received the treatment and others had a strong feeling they had been excluded.
When Schwartz and Brooks tabulated the results, a fascinating picture emerged. The best outcomes were among those who had received Johrei and believed they had received it. The worse outcomes were among those who had not received Johrei and were convinced they had not had it. The other two groups—those who had received it but did not believe it and those who had not received it but believed they had—fell somewhere in the middle.
This result tended to contradict the idea that a positive outcome comes entirely down to a placebo response; those who wrongly believed they received the healing did not do as well as those who rightly believed they had received it.
Schwartz’s studies uncovered something fundamental about healing: both the energy and intention of the healing itself and the patient’s belief that he or she had received healing promoted the actual healing. Belief in the efficacy of the particular healing treatment was undoubtedly another factor. In the Love Study, Schlitz and Stone had stressed the importance of a shared belief system in the success of remote influence, and Schwartz’s results bear this out.
In the large prayer studies, the senders and receivers of prayer did not share the same belief system about God. Most of the patients had been prayed for by a number of groups from different religions and disparate belief systems. Even Benson’s Christian study employed different Christian sects, which do not share identical beliefs. It may be uncomfortable for some groups to be prayed for by people who do not share their views about the divine.
As Marilyn Schlitz pointed out, none of the clinical trials made use of what scientists call “ecological validity.” This means that the trials were not designed to model what happens in real life. In the Harvard study, for example, the prayer groups were instructed to pray differently from normal. None of the big prayer studies tested the effect of the kind of prayer that prayer groups believe is most likely to work.29 In these studies, says Dossey, “what is being tested is not genuine prayer but a watered-down faux version of it.”30 The contents and context of prayer were treated casually, as if prayer were no different than some new medication. The Benson study also framed its intention as a “negative”—asking that the patients heal with “no complications”—which counters the most basic folklore about prayer and affirmations, which stipulates that they should always be framed as a positive statement.
Ordinarily, says Schlitz, people have a meaningful relationship with the person they are praying for. Psychologist and mind-body researcher Jeanne Achterberg of the Institute for Transpersonal Psychology in California carried out a study at a Hawaiian hospital, using highly experienced distance healers, who selected as their “patient” a person with whom they had a special connection. Each healer was isolated from his patient, who was then placed in an MRI scanner. At random two-minute intervals, the healers sent healing intentions to their patients, using their own traditional healing practices. Achterberg discovered significant brain activation in the same portions of the brains—mainly in the frontal lobes—of all the patients during times healing energy was being “sent.” When the same regime was tried out on people the healers did not know, they had no effect on the patients’ brain activity. Some sort of emotional bond or empathetic connection may be crucial to the success of both prayer and healing intention.31
The large prayer studies may have failed because the researchers were looking in the wrong places for demonstration of an effect. A study of AIDS about to be published at the time of writing has also failed to find an effect. Nevertheless, a highly significant number of people in the treatment group correctly guessed which group they were in, while the control group did not. As Schlitz concluded, “The treatment group seemed to feel something; it just did not correlate with the clinical outcomes that were measured.”32 The study may just have been asking the wrong questions.
Another important variable may be the kinds of thoughts experienced by the recipient during healing. Researchers have discovered that negative thoughts and visualization can have a powerfully negative effect on the body, as if the negativity is somehow infectious and these thoughts take physical form. For instance, researchers from the Center for Advanced Wound Care in Reading, Pennsylvania, have discovered that patients with slow-healing wounds often have negative thought patterns and behavioral or emotional wounds, such as guilt, anger, and lack of self-worth.33
The same effect can occur with negative relationships. A recent study of couples showed that the stress of reliving an argument delays wound healing by at least a day. In an ingenious study by Ohio State University College of Medicine, the researchers gathered together 42 married couples and inflicted small wounds with a tiny puncture device on one partner of each pair. During the first sessions, the partners held a conflict-free, constructive discussion, and the wound healing was carefully timed. Several months later, the researchers repeated the injury, but this time allowed the partners to raise an ongoing contentious issue, such as money or in-laws. This time, the wounds took a day longer to heal. What is more, among the more hostile couples, the wounds healed at only 60 percent the rate of the more compatible pairs. Examination of the fluids in the wounds found different levels of a chemical called interleukin-6 (IL-6), a cytokine and key chemical in the immune system. Among the hostile couples, the levels of interleukin-6 were too low initially and then too high immediately after an argument, suggesting that their immune systems had been overwhelmed.34
The person sending out an intention might also need to be sent good intentions. Krucoff’s results as universally interpreted had overlooked one vital finding: the patients with the double-tier prayer groups who had been prayed for had fared far better in the secondary end points; their death and rehospitalization rates over the six months after discharge were 30 percent lower than those of the others. Mortality was lowest of all among patients given MIT with prayer. These results had been characterized only as a “suggestive trend,” but may have been the entire point of the story. Praying worked if the person doing the praying—or his prayers—also had been prayed for. 35
Healing and positive intention are simply an aspect of the constant two-way flow of communication between living things. In the person being sent intention, a shared belief in the power of the healing modality and a positive state of mind may enhance results. Fritz Popp’s research demonstrates that the degree of coherence of an organism’s light emissions is linked to its overall state of health. When healers are healthy, are in a positive state of mind, and have engaged in a healing “warm-up,” their light is more likely to shine brighter. The most effective healer of all may be the one who has been healed himself.