Running on faith

Spiritual healing can appear to have a positive effect, but when placebo reigns over rationality, I'm wary

The Guardian (UK)/February 15, 2005
By Edzard Ernst

Around 15,000 spiritual healers practise in Britain, so it is important to examine whether their techniques do more good than harm. The term covers a great many approaches: reiki, johrei, therapeutic touch, intercessory prayer, faith healing and distant healing all fall under the umbrella of spiritual healing. The common denominator is that healers of all types claim to somehow channel "healing energy" into the patient's body with the intention of improving health. The concept is as simple as it is unproven - nobody, for instance, has so far been able to measure the "energy" that these healers are talking about.

Yet healers have no doubts about their methods, and there is no shortage of satisfied customers - including celebrities willing to pay handsome hourly rates for energy-channelling consultations.

So what reliable evidence is there? Dozens of clinical trials have been published, but those that appear methodogically sound don't usually show much. Take, for example, the recent trial with 799 patients of a US coronary care unit. Half of them received "intercessory prayer" for 26 weeks; basically that means a group of healers regularly prayed for these patients at remote locations. The other half received no such interventions in addition to their usual care.

At the end of this period, the number of deaths, heart attacks and other serious complications were similar in both groups.

Now take a headline-making study published in the US-based Journal of Reproductive Medicine which apparently showed that distant healing dramatically increased the success of in-vitro fertilisation. The expert named as "lead author" later distanced himself from the study, stating that he edited the manuscript but was not involved in the trial. The primary organiser, Daniel Wirth, who has published numerous other healing studies, has subsequently been jailed on several counts of fraud, unrelated to this study.

My research team conducted a trial of about 110 chronic pain patients. We were keen to accommodate the ideas of all five participating healers and wanted to find out whether spiritual healing is more than a placebo effect. Patients therefore received eight healing sessions either by five healers - or by five actors. The actors had been coached by the healers in how to pretend to be healers. In a separate experiment, healers were hidden behind a one-way mirror while, in the control group, there was no one behind the mirror.

The results were staggering. Improvements were so remarkable that several patients practically abandoned their wheelchairs during the study. But there were no differences between the groups. If anything, the control patients fared slightly better than those receiving "real" healing. Even the often-quoted tingling sensation and feeling of warmth during healing sessions were also experienced by patients who received no healing at all. Results such as these strongly suggest that spiritual healing is a powerful placebo, but not much more. This is also the conclusion drawn from combining the findings of rigorous trials conducted in this area.

Many people believe, however, that it is irrelevant whether the effects are "real" or due to the placebo effect. Professor Jonathan Waxman, an oncologist at Imperial College London, was recently quoted as sharing this view on healing: "I've seen my patients look and feel better as a result. Who cares how it works, as long as it does?" I don't subscribe to this line of thinking, for several reasons.

The placebo effect on which healing relies is one which most other medical treatments generate as well - so we don't need an ineffective therapy in order to profit from this effect. Placebo effects rely on factors such as empathy, time, understanding and the warmth of a therapeutic relationship. It would be a serious mistake if doctors delegated these core qualities of medicine to healers. Why pay ?100 a session for placebo if it comes as a free bonus with most effective therapies?

There is some evidence that healing can harm certain patients; some mental conditions, for instance, can get worse. There is also the possibility that if patients feel encouraged to place credence in healers, some may give up vital treatments in favour of healing.

If we allow mystical conjecture to infiltrate our thinking, we are in danger of abandoning rationality in favour of superstition. It is easy to see how this could rebound on us.

I think the claims of healers should be taken with a pinch of salt. In the absence of convincing evidence, you might as well spend your money on something that demonstrably works.