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Is spirituality good for your health?. Intrinsic and Extrinsic Spirituality. Intrinsic commitment --refers to a deep commitment to a particular faith or/and way of life. Extrinsic commitment refers to a loose tie to a set of beliefs or a way of life. Structural/Behavioural understandings.

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intrinsic and extrinsic spirituality
Intrinsic and Extrinsic Spirituality
  • Intrinsic commitment--refers to a deep commitment to a particular faith or/and way of life.
  • Extrinsic commitment refers to a loose tie to a set of beliefs or a way of life.
demonstrated benefits of regular church attendance
Demonstrated Benefits of Regular Church Attendance
  • Greater Physical and Mental Health.
  • Lower Rates of Drug and Alcohol Abuse.
  • Increased Quality of Life.
  • Enhanced Recovery From Illness.
  • Increased Life Expectancy.
  • Marital Happiness and Fewer Divorces.
  • Happier and More Successful Children.
coping with illness gynecologic cancer
Coping With Illness:Gynecologic Cancer
  • 91% religion helped them sustain their hopes
  • 76% religion had a serious place in their lives
  • 49% of patients became more religious since
  • their diagnosis
  • 41% religion supported their sense of worth
  • None had become less religious since their
  • cancer diagnoses
  • Roberts, JA, et al. (1997). American Journal
  • of Obstetrics and Gynecology, 176(1):166-172.
coping with illness breast cancer
Coping With Illness:Breast Cancer
  • 88% considered religion to be important or very important
  • 85% felt religion helped them to cope with their illness
  • 95% very satisfied with clergy home and hospital visits
  • Johnson and Spilka (1991). Journal
  • of Religion and Health, 30:21-33.
illness prevention suicide
Illness Prevention: Suicide
  • Review Findings:
  • There is a strong protective relationship between greater religious commitment and less suicide.
  • Gartner et al (1991). Journal of Psychology and Theology, 19:6-25.
illness prevention suicide11
Illness Prevention: Suicide
  • Study Findings:
  • Frequent church attenders are four times less likely to commit suicide than non-church attenders.
  • Comstock and Partridge (1972).
  • Journal of Chronic Disease, 25:655-672.
illness prevention suicide12
Illness Prevention: Suicide
  • Study Findings:
  • Lack of church attendance is a stronger predictor of suicide than any other risk factor.
  • Stack (1983). Journal for the
  • Scientific Study of Religion, 22:239-252.
emotion focused coping

Emotion-Focused Coping

A person's religious belief system offers an interpretative framework within which they can re-appraise and re-define threatening or disturbing situations, and manage distressing affective emotions.

This would be especially important when an individual has little or no influence on or ability to modify the situation such as in times of bereavement, poverty, illness and so forth.

problem focused coping

Problem-Focused Coping

Belief systems can also provide a means of 'construing a threatening environment in such a way that the individual can take positive action to alter the source of stress.'

social support

Social Support

Religious beliefs are corporate beliefs, stemming from and binding a person to a particular community and social network. They are thus an important source of social support.

spiritual support

Spiritual Support

Religion offers spiritual support in times of adversity.

This support might manifest itself overtly through prayer, ritual and an accepting, healing community,

“hidden” social support networks

prayer meditation

Prayer/Meditation

Does prayer work?

prayer and coping bypass surgery
Prayer and Coping: Bypass Surgery
  • 96% of patients used prayer to deal with stress of cardiac surgery
  • 2% of patients had others praying for them
  • 97% reported prayer helpful in their coping
  • 70% found prayer extremely helpful in their coping
  • Saudia, et al. (1991). Heart and Lung, 20:60-65.
slide20

The Power of Prayer: Six Year Study

Suggest People Live Longer

Over the Six Years of the Study, Healthy

Senior Citizens Who Rarely or Never Pray

Have a 50% Greater Risk of Dying Than a

Matched Group Who Prayed or Meditated

More Than Once a Month. All Types of

Prayer and Meditation Can Offer

Health Benefits.

Harold Koenig, Duke University Medical Center,

(Journal Of Gerontology, July 2000)

healing power of prayer
Healing Power of Prayer

Prayer and Meditation Potentially Blocks the

Cascade of Stress Hormones (Adrenaline)

That Would Ordinarily Boost Blood Pressure

Dampen the Immune System and Damage

a Variety of Body Systems.

Herb Benson, Chief, Mind/Body Medical Institute, Berth

Israel Deaconess Medical Center, Boston.

positive emotions

‘Mechanism’ of Religion and Prayer

Is There a Biology of Hope?

Decreased activation of sympathetic nervous system and hypothalamic-pituitary-adrenal axis

Psychological effects (less anxiety)

Physiological effects (lower BP, HR, oxygen consumption)

Better health

Positive emotions

questions
Questions
  • What is prayer?
  • Are the effects measurable?
  • Are the effects reproducible?
slide26
A solemn and humble request to God, or to an object of worship

A supplication, petition, or thanksgiving, usually expressed in words (and based on faith)

Prayer

intercessory prayer studies

Intercessory Prayer Studies

Randomised control trials testing the healing power of prayer

first experiments
First Experiments
  • Sir Francis Galton (1822-1911) compared average life spans
    • Kings vs. lords
    • Clergy children vs. other children
  • Frequency of disaster for ships carrying missionary’s
  • Result showed negative correlation based on his hypothesis
the byrd study

The Byrd Study

Positive therapeutic effects of intercessory prayer in a coronary care unit, R. C. Byrd, Southern Med. J. 1988, 81, 826-829.

parameters
Parameters
  • Double-blind
    • Patients were not informed at all about study
    • Medical staff were unaware of study
  • Intercessors received no feedback
  • Only chaplain’s nurse knew assignments
  • No attempt to estimate ‘background’ prayer.
prayer protocol
Prayer Protocol
  • Patients were assigned to a group based on the parity of the last digit of their medical record number.
  • Intercessory prayer team leaders were contacted with only the first name of the patient to be prayed for.
  • 15 teams of 5 prayed individually for 28 days for each patient.
  • Specifically requested “a speedy recovery with no complications” and anything else that seemed appropriate to them.
intercessory selection
Intercessory Selection
  • No particular denominational affiliation required.
  • All intercessors acknowledged:
    • “I believe in God. I believe that He is personal and is concerned with individual lives. I further believe that He is responsive to prayers for healing made on behalf of the sick.”
can prayer cure

Prayer Group (192)

Result

Control (201)

3

Required antibiotics

16

6

pulmonary oedema

18

0

endotracheal intubation

12

13

death

17

Can Prayer Cure?
  • 5 – 7 Intercessors prayed for each of 192 patients in the CCU of San Francisco General Hospital.

Positive therapeutic effects of intercessory prayer in a coronary care unit, R. C. Byrd, Southern Med. J. 1988, 81, 826-829.

a repeat experiment
A Repeat Experiment
  • Building on the study by Byrd, William S. Harris heads a study aiming to measure the efficacy of remote intercessory prayer on the outcome of nearly 1000 patients admitted to a coronary care unit.

A Randomized, Controlled Trial of the Effects of Remote, Intercessory Prayer on Outcomes of Patients Admitted to the Coronary Care Unit, W. S. Harris, et al. Arch. Intern. Med. 1999, 159, 2273-2278.

does prayer work
Does prayer work?
  • What would be the main issues and problems with this approach?
  • Does prayer function in this way?
  • What would be the implications for medical/spiritual co-operation if the results of such studies turned out to be the case?
the benson study 2006

The Benson Study 2006

Prayer doesn’t work!

Benson, H. American Heart Journal, April 2006; vol 151: pp 934-942.

background
Background
  • Intercessory prayer is widely believed to influence recovery from illness, but claims of benefits are not supported by well-controlled clinical trials. Prior studies have not addressed whether prayer itself or knowledge/certainty that prayer is being provided may influence outcome.
slide38
The study evaluated whether:
  • (1) receiving intercessory prayer or
  • (2) being certain of receiving intercessory prayer

was associated with uncomplicated recovery after coronary artery bypass graft (CABG) surgery.

methods
Methods:
  • Patients at 6 US hospitals were randomly assigned to 1 of 3 groups:
    • 604 received intercessory prayer after being informed that they may or may not receive prayer;
    • 597 did not receive intercessory prayer also after being informed that they may or may not receive prayer;
    • 601 received intercessory prayer after being informed they would receive prayer.
slide40
Intercessory prayer was provided for 14 days, starting the night before CABG. The primary outcome was presence of any complication within 30 days of CABG. Secondary outcomes were any major event and mortality.
results
Results:
  • In the 2 groups uncertain about receiving intercessory prayer, complications occurred in 52% (315/604) of patients who received intercessory prayer versus 51% (304/597) of those who did not (relative risk 1.02, 95% CI 0.92-1.15).
slide42
Complications occurred in 59% (352/601) of patients certain of receiving intercessory prayer compared with the 52% (315/604) of those uncertain of receiving intercessory prayer (relative risk 1.14, 95% CI 1.02-1.28).
  • Major events and 30-day mortality were similar across the 3 groups.
conclusions
Conclusions:
  • Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of receiving intercessory prayer was associated with a higher incidence of complications
problems
Problems
  • Numerous methodological problems
  • Studies suggest that God must respond positively to prayers based on what outcome is chosen; but prayer is more than receiving what is requested, and we aren’t sure how God answers our prayers
  • If distant prayer studies can make the results of prayer consistent, predictable, and replicable, then faith has become a science
problems45
Problems
  • Ethics committees
  • Sued for having a lack of faith!
  • Contradictory models of healing
  • Sometimes a successful outcome to prayer is a failure to heal
slide46

An attempt at scientific proof of the existence of God is an effort . . .“to create a situation in which God must show Himself and perform a miracle – something that God may do only rarely. Even more rarely does He perform on demand. If God feels the need to give us a sign – He tends to choose the time, place, and form; not us. Simply put, I am sure that such tests are hideously arrogant at best and certainly blasphemous.”

Modified from its original form in

Targ and Thompson. Alt Ther Health Med 1997;3:92-105

nearly half of uk adults pray 20 million people
Nearly half of UK adults pray –20 million people
  • Twenty million adults (42%) say they pray (outside of church/religious services).
    • One in six adults (9 million people or 18%) prays every day.
    • One in four of us (12 million adults or 26%) prays at least once a week.
    • 13 million adults (27%) pray at least once a month.
    • London is the prayer capital of the UK with the highest proportion of people who pray (73%).
    • Even among those with no religion, around one in eight (12%) pray sometimes.
    • Across Europe 60% of people pray, while in the US the proportion is even higher.
1 in 3 says god watches over me
1 in 3 says ‘God watches over me’

One in three adults in the UK (16 million) agrees with the statement ‘there is a God who watches over me and answers my prayer’. The same number of people agrees that ‘praying makes me feel better’.

After praying, people most often feel: – Peaceful and content (38%) – Strengthened (30%) – Close to God (22%) – Reassured/safe (21%) – Happy/joyful (19%).

what we pray about
What we pray about
  • When asked what they pray about, the 20 million UK adults who pray cited family and friends as their foremost topic, followed by gratitude to God.
  • Worldwide problems such as poverty, wars and disasters were the fifth most popular topic for prayer. The top prayer topics among the 42% of UK adults who pray are: – Family and friends (68% of them) – Thanking God (41%) – Guidance (32%) – Healing (26%) – Worldwide problems e.g. poverty, wars and disasters (25%).
  • Among regular churchgoers, eight out of 10 pray for people living in poverty in developing countries, equivalent to 5.2 million people.
1 in 5 believes prayer changes the world
1 in 5 believes prayer changes the world
  • Across the UK millions of people believe that prayer brings about positive change in the world.
    • One in four people (12 million adults) believe that prayer changes ‘what happens in my life’ and ‘what happens to other people I know’.
    • 6.5 million people (32% of those who pray) have seen the effects of prayer in their own lives
    • 9.5 million people (47% of those who pray) believe that ‘prayer changes what happens to the lives of people living in poverty in developing countries’
    • 10 million people (50% of those who pray) believe prayer ‘changes the world’; equivalent to one in five of all UK adults.
spiritual history
Spiritual History
  • F = Faith and belief – “Do you consider yourself spiritual?” “What gives your life meaning?”
  • I = Importance – “What importance does your faith or belief have in your life?” “What role do you beliefs play in your health?”
  • C = Community – “Are you part of a spiritual or religious community, and how are they of support to you?”
  • A = Address in Care – “How would you like me to address these issues in your health care?”

-developed by Dr. Christina Puchalski at GWISH

spiritual history54
Spiritual History

Goal – to LISTEN empathetically: listen to their fears, hopes, beliefs.

- Can open up communication about how a person wants to die.

- Helps bring compassion back to medicine, taking care of the whole individual.

- Helps to bring dignity to medical care, improving patient trust.

- Can help to relieve suffering.

- Certain religious believes may impact medical decisions.

spiritual history scenarios
Spiritual History- scenarios

Mr. T is a 65 year old gentleman with lung cancer, failing chemotherapies. He is in the hospital with dyspnea. You want to discuss DNR (do not resuscitate) issues with him. After describing what resuscitation is, you state that in his condition, it is extremely unlikely to succeed. You ask him what he thinks about all this.

He replies: “Well, I want you to do what you can. I trust that God will decide when it’s my time.”

What is your response?

spiritual history scenarios56
Spiritual History- scenarios

Ms. B is a 46 yr. old woman with renal failure, partial blindness, and admitted for a foot infection from diabetes. She now is needing dialysis. On discussing this with her, you ask how she is doing?

She replies: “I don’t know. I keep wondering why all of this is happening to me.”

What is your reply?

avoid pitfalls
Avoid pitfalls
  • Don’t try to solve the questions
  • Know your boundaries
  • Don’t try to provide premature reassurance
spiritual history scenario
Spiritual History - scenario

Mr. C. is a 76 yr old man admitted with a severe Gastro-intestinal bleed. He passed out on the way to the ER and remains unconscious, possibly also having a stroke. Initial work-up reveal a low blood pressure and a haemoglobin of 6. You prepare to transfuse him. His wife sees this and steps in saying: “No way are you giving him a blood transfusion. Jehovah’s witnesses cannot get someone else’s blood.”

What questions do you ask?