How Should Prayer Be Studied?

A LOT of studies on intercessory prayer have been published in recent years. This research has returned mixed results. Some studies conclude that prayer improves health, while others show no effect—or suggest that prayer may lead to worsening health.

Does any single study prove or disprove the efficacy of prayer? No, this is not how scientific research works. It's always possible that apparent results are the product of chance or a problem with how the experiment was designed or carried out. Replications can increase confidence in a finding, but sometimes even a large number of studies or systematic reviews of research may yield misleading results because of design flaws or unrecognized confounds. It matters not only that studies are done, but also how.

One of the first widely publicized prayer studies was conducted by cardiologist Dr. Randolph Byrd and published in the Southern Medical Journal in 1988. It was a prospective, randomized, double-blinded, controlled study-the gold standard of rigorous scientific research-that enrolled 400 subjects and found positive effects from distant intercessory prayer "to the Judeo-Christian God." Protestant and Catholic "born-again" Christians were given the patient's first name, condition, and diagnosis. Intercessors were instructed to pray "for a rapid recovery and for prevention of complications and death." Patients in the prayer group had less congestive heart failure, fewer cardiac arrests, fewer episodes of pneumonia, were less often intubated and ventilated, and needed less diuretic and antibiotic therapy.

In 1999, the prestigious Archives of Internal Medicine published a replication study by Dr. William Harris. He too did a prospective, randomized, double-blind, parallel group controlled trial of the effects of intercessory prayer on 990 coronary patients. The group that received prayer from intercessors who believed in a "personal God who hears and answers prayers made on behalf of the sick" had better outcomes than the control group.

But the intercessory prayer study that most people think of first is that published by Dr. Herbert Benson in the American Heart Journal in 2006. Similar to Byrd and Harris, Benson led a prospective, randomized controlled trial that enrolled 1,800 coronary patients. Intercessors were given the first name and first initial of the last name of each subject and told to pray "for a successful surgery with a quick, healthy recovery and no complications."

The New York Times picked up on Benson's conclusion: patients who received intercessory prayer fared no better than those who did not. And those who knew they were the recipients of prayer actually did worse—presumably because of anxiety that their condition seemed bad enough to warrant prayer.

What the New York Times did not advertise is that many of the intercessors enrolled by Benson may not have qualified for inclusion in either Byrd's or Harris's study. This is because the only Protestant intercessors enrolled belonged to Silent Unity of Lee's Summit, Missouri. Unity is a New Thought group, a New Religious Movement that traces its origins to the late nineteenth century. Unity leaders have long denied that prayer works "miracles," and have even called petitionary prayer "useless." Rather than understanding prayer as supplication to a personal deity outside the self, many Unity practitioners envision prayer as affirmative thoughts and words. This is a very different idea of prayer than that held by many other Christians—such as the Pentecostal and Charismatic groups that are experiencing wildfire global growth because of their expectant prayers for healing and dramatic claims of answered prayers. Consequently, Benson's results do not say anything about whether or not the prayer methods used by Protestant "born-again" or pentecostal Christians are effective.

Systematic reviews of prayer studies usually lump together prayer interventions that are so different from each other that it's a case of comparing apples and oranges. For instance, reviewers have put into one category pentecostal, Buddhist, and Jewish prayer, Therapeutic Touch, and external qigong. Reviewers ask of this mixed bag: do spiritual interventions work or not? But perhaps one type of intervention produces positive results, while another is ineffective or causes harm. By treating the interventions together, the results get muddied.

There is an additional problem with how prayer is usually studied. Most researchers—like Byrd, Harris, and Benson—focus on distant intercessory prayer. Intercessors are given the first name and condition of someone they do not know and told to pray for a complication-free recovery. Researchers base conclusions on the efficacy of prayer solely on whether subjects in the experimental group exhibit better health than those in the control group.

But when people actually pray for healing, they often get up close to someone they know, touch the person, and empathize with their sufferings—what I call proximal intercessory prayer, or PIP. Double-blinded, controlled trials are not the only—or even the best—way to gauge the effects of this kind of prayer practice. In future posts, I'll say more about why and how we might change our emphasis from distant to proximal intercessory prayer studies.