Distance Healing

Mental healing movements in the United States

Nineteenth-century mental healing in the United States forms part of the background to later ideas of healing without touch, although the source reviewed does not discuss healing at a distance. A history from the Mary Baker Eddy Library describes Phineas Quimby (1802-1866), a non-medical healer in Bangor and Portland, Maine, who was interested in mesmerism and held that illness could be created and reversed by thought. Mary Baker Eddy was his patient from October 1862 for about three years; by 1872, the same account says, she had rejected his theories on religious grounds.

General statements about antiquity

Researchers who write about distant healing intention state that reports of people said to restore health through focused intention appear throughout history and in virtually all cultures, and one review chapter calls distant healing the oldest ancestral curative practice. These are broad statements. They are not dated, tied to a named tradition or supported in the passages reviewed by primary sources, and they do not show an unbroken line to present-day practice.

Controlled trials from the late twentieth century

Among the sources reviewed, the earliest controlled trial is Byrd's 1988 randomised study in a coronary care unit in San Francisco, in which Christians praying outside the hospital were assigned to 192 patients while 201 served as controls. Harris and colleagues described its positive findings in 1999 as not yet replicated and ran a further trial. Radin and colleagues report that, as of 2000, the United Kingdom had about 14,000 distant healers, more than any other complementary practice.

Overlapping labels

No single term is standard. Radin and colleagues use distant healing intention for a compassionate mental act directed at another person's health at a distance, and list intercessory prayer, spiritual healing, aura healing, energy healing, therapeutic touch, qigong and Reiki among related terms. A 2000 systematic review used distant healing to cover prayer, mental healing, Therapeutic Touch and spiritual healing, and another review team used noncontact healing.

A review chapter defines distant healing as acts of conscious intent, wish or focus dedicated to improving the health or well-being of a person far away, and says distant means the parties are shielded from ordinary physical and psychological influence. That is a research definition, and it may not match how individual healers or religious communities describe their own practice.

Intercessory prayer as a research term

The Cochrane reviews of intercessory prayer included trials of personal, focused, committed and organised prayer in which those praying held some belief that they were praying to God or a god. The 2009 version states that whether such trials bear on the existence of God is a philosophical question outside the scope of the review, which concerned effects on health.

Retroactive, noetic and non-whole-human studies

Some terms are specific to research. Retroactive prayer is said after the outcomes under study have already occurred. The MANTRA II investigators describe noetic therapies as healing practices not mediated by tangible elements. Roe and colleagues separate studies of whole human participants from studies of other biological systems such as plants or cell cultures, which they considered less open to expectancy effects.

What the sources describe

The sources reviewed describe distant healing mainly through research protocols, so session formats used by healers outside trials are not documented here. Radin and colleagues state that practices in this family share an assumption that distance between healer and recipient is not a limiting factor. They also describe a laboratory design in which a sender directs intention at an isolated recipient in 30-second periods alternating with rest; that is an experimental procedure and not a description of a healing session.

How prayer was delivered in trials

In the STEP trial, three mainstream religious sites provided daily prayer for 14 consecutive days beginning the night before bypass surgery. In Harris and colleagues' trial, the first names of patients were given to outside intercessors who prayed daily for four weeks. In MANTRA II, off-site prayer was offered by established congregations of various religions.

Awareness and consent in the studies

Trials differed in what recipients knew. Byrd's patients signed informed consent before randomisation, Harris's patients were unaware they were being prayed for, and STEP told two of its three groups that they might or might not receive prayer. Leibovici stated that his retroactive design made informed consent impossible.

Conditions and outcomes that were tested

The 2000 systematic review of distant healing considered treatment of any medical condition, and the Cochrane reviews considered prayer offered for anyone with a health problem. Trials in the sources reviewed tested prayer for complications after heart surgery, course of illness in coronary care, outcomes after coronary procedures and mortality, hospital stay and fever in bloodstream infection. An earlier Cochrane version also reported an IVF trial, whose integrity is disputed.

Proposed explanations

Radin and colleagues describe distant healing intention as claimed to transcend the usual constraints of distance through space or time and call this proposed nonlocal quality a source of methodological and theoretical challenges. Schwartz and Dossey argue that if positive results in this field were sustained, nonlocal consciousness would have to be confronted. These are proposals by the authors, not demonstrated mechanisms.

What the sources do not cover

The sources reviewed do not document why members of the public seek distance healing, what healers commonly claim, or how often it is used outside trials. This section therefore records research targets and the explanations offered by researchers only.

Reviews of distant healing trials

A 2000 systematic review (searched to the end of 1999) analysed 23 trials with 2,774 patients: five of prayer, eleven of noncontact Therapeutic Touch and seven of other distant healing. Thirteen showed statistically significant effects, nine showed none and one showed a negative effect; heterogeneity precluded meta-analysis, and the authors judged methodological limits too serious for definitive conclusions. A 2003 update by Ernst alone, covering nine randomised and eight non-randomised trials, concluded that most rigorous trials did not support specific therapeutic effects. A 2007 meta-analysis of distant intercessory prayer found no discernible effects.

Cochrane review of intercessory prayer

The 2009 Cochrane review included ten trials with 7,646 patients, all comparing prayer plus standard care with standard care alone. Death showed no clear effect (six trials, random-effects risk ratio 0.77, 95% confidence interval 0.51 to 1.16, heterogeneity I-squared 83%), nor did general clinical state, readmission to coronary care or rehospitalisation. The authors called the findings equivocal, found no basis to recommend for or against prayer and doubted that further trials should be undertaken. The 2007 version had reported a small difference in deaths favouring prayer (risk ratio 0.88); its abstract does not explain why the later estimate changed.

Large trials in cardiac and infection settings

STEP randomised 1,802 coronary bypass patients at six US hospitals. Among patients told they might or might not receive prayer, complications within 30 days occurred in 52% with prayer and 51% without (relative risk 1.02, 95% CI 0.92 to 1.15); major events and mortality were similar. MANTRA II assigned 748 patients to double-blinded off-site prayer or none in a 2x2 design and found no significant difference in its primary composite endpoint for any comparison. Earlier single-centre trials were less consistent: Byrd (393 patients) and Harris (990 patients) each reported lower scores for hospital course with prayer, but Harris found no difference in length of stay.

Leibovici's randomised retroactive trial of 3,393 bloodstream-infection patients reported mortality of 28.1% versus 30.2% (P=0.4), with shorter hospital stay and fever in the prayer group; it appeared in a Christmas issue of the BMJ.

Disagreement over how to read the evidence

Roe and colleagues pooled studies of noncontact healing and reported significant effects in 49 studies of non-whole-human systems (weighted r 0.258) and 57 studies of whole humans (r 0.203), but outcomes were heterogeneous and tracked study quality: restricting to 22 higher-quality non-whole-human studies reduced the estimate to 0.115. Radin and colleagues state that about 47% of clinical trials were significant, that 48% of those were of poor methodological quality, and that the evidence does not yet give confidence in clinical efficacy. Their conclusions differ from those of Ernst and of Masters and Spielmans.

Schwartz and Dossey argue that the dose-response, blinded and randomised model used in drug trials is not the best model for intention research. This is an argument by authors who propose nonlocal effects, and it does not by itself show that such effects exist.

Ethical and scientific critiques

Jorgensen, Hrobjartsson and Gotzsche argued in 2009 that the Cochrane review mixed theological and scientific arguments, that two heavily weighted trials had undescribed problems, and that it advised intercessors to be cautious about telling surgical patients they were being prayed for. They also raised concerns about the integrity of the IVF trial. Leibovici acknowledged that his design prevented informed consent. Felding and colleagues found that this Christmas-issue trial was taken at face value in 12 of 36 citing articles and was included in three systematic reviews.

Adverse findings reported in trials

Distance healing involves no physical contact, but trials have reported unfavourable findings. In STEP, complications occurred in 59% of patients certain of receiving prayer against 52% of those uncertain (relative risk 1.14, 95% CI 1.02 to 1.28); the authors reported an association and did not establish a cause. The 2007 Cochrane abstract reported similar signals for patients aware of prayer, and Ernst's 2003 update noted that two studies suggested adverse effects. The sources reviewed give no incidence data beyond these trials.

Care boundaries and gaps in the sources

No verified source reviewed describes training, accreditation or regulation of distance healers in any jurisdiction, and none documents delayed or replaced care. In the trials reviewed, prayer was offered in addition to standard medical care. Distance healing is not a substitute for medical assessment or prescribed treatment, and urgent or worsening symptoms call for medical help.