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Spiritual healing research: rigor but no stiff neck.

451 Spiritual healing is an ancient, widespread, and heterogeneous group of practices in which one individual or group attempts to influence the health of another without overt physical contact (Benor, 2001; Dossey 2003). Taken in its wider description of “mental” healing or ritual healing, it has been and continues to be a universal behavior of humankind. Many forces are postulated or implied in spiritual healing. These include God, spirits, mental and psychic influences, subtle energies, behaviors such as reduced goal seeking, cognitive influences such as expectation and belief, physiologic responses such as relaxation and social influences, and context effects including the equally ephemeral “placebo” effect. Traditionally, spiritual healing has been the realm of religion and metaphysics or, occasionally philosophy and usually remains outside the bounds of science. Recently, there has been a flurry of interest in scientific studies of spiritual and related healing as found in published data from clinical trials of prayer, energy medicine, and the effects of spiritual healers of various types (Jonas et al., 2003). The study by Gerard et al. in this issue of the Journal (pp. 467–477) is an example of the latter. In this study, the effect of a single spiritual healer, who is also the first author, was studied on 68 patients who were self-referred for perceived restricted neck movement. Using a pragmatic study design (Walach, 2002), patients were randomized to a spiritual healing intervention 3 times per week or assigned to a wait list control with no therapy. The healing sessions involved prayer and meditation, music, laying-on-of-hands without actual touching, undefined verbal interaction, and undefined visualization. No theories along the lines of those listed above were offered to the patients or to readers of the paper. Patients who received the treatment had significant improvements in neck mobility compared to waitlisted patients who had no change in their neck movement over 4 weeks. The treated group also had improved physical function, energy, and vitality as measured by the Short Form 36 (SF 36) Health Survey but experienced no other changes from those in the wait list. What does this study tell us? That patients from this area, self-referred to this healer, had less neck stiffness after healing sessions than those not seen by this healer. To their credit, the authors explicitly state this conclusion and do not generalize beyond the data. The authors call for more research. But what kind of research can be done further if, as they state in their discussion, it is “impossible to exclude a genuine healing effect” in spiritual healing given the “theory that governs [it]”? (p. 475) Thus, the question can be: Does this study provide useful information? Should patients now go to this healer for stiff necks rather than seeing a physical therapist or a psychotherapist; go to a church or a concert hall with couches; or simply buy some visualization tapes and lay down 3 more times per week than usual? There are no answers that emanate from this study.