Prayer

Prayer as a cross-cultural practice

The sources reviewed for this page do not trace a single origin for prayer. The Cochrane review of intercessory prayer opens by calling prayer among the oldest and most widespread interventions used with the intention of alleviating illness. That statement is a general framing by the reviewers, and the review does not date it or document the history behind it.

The Encyclopaedia Judaica entry reproduced online describes prayer as the offering of petition, confession, adoration or thanksgiving to God. It adds that prayer was originally spontaneous and personal, and that the need to organize religion later produced liturgical patterns. The entry concentrates on biblical material, so it does not cover later rabbinic prayer or prayer for the sick.

Tradition-specific developments

Scholarship on Hindu japa illustrates how one form of prayer changed over time. In a 2011 lecture, John Brockington distinguished the murmuring of Vedic mantras as an accompaniment to sacrificial ritual from the meditative repetition of a divine name in bhakti traditions, using a passage of the Mahabharata to trace the shift. The page summary does not give dates for the shift.

Du'a and salat are distinguished in Islamic usage. A Leiden University genre page quoting Annemarie Schimmel describes salat as formal ritual prayer and notes that after it a believer may offer personal and petitionary prayers, called du'a or munajat. The sources reviewed give no dates for the development of either form.

Prayer, petition and intercession

Philosopher Scott Davison defines petitionary prayer as prayer in which a petitioner requests something, and notes that people also pray to give thanks, to offer praise and adoration, or to apologize and seek forgiveness. He separates requests made for oneself from requests made for others. Prayer on behalf of others is usually called intercessory prayer, and prayer offered at a distance from the person concerned is often called distant prayer.

The Cochrane review used a narrow research definition: personal, focused, committed and organized intercessory prayer, offered by people who hold some belief that they are praying to God or a god. That definition excludes a person's own prayer, which most other research on prayer addresses.

Terms used within traditions

Tradition-specific words are not interchangeable with the English term. Tefillah is the most common Hebrew word for prayer. Salat denotes the Islamic ritual prayer, while du'a and munajat denote personal, petitionary prayer. Japa is the repetition of a mantra or divine name in Hindu traditions. A dedication prayer in Tibetan Buddhist usage, called bsngo-ba in Tibetan, directs the merit of a constructive action toward a spiritual goal.

This page treats prayer as the wider category. Faith Healing and Distance Healing have their own Machipedia pages, which cover healing rituals and practices that do not necessarily involve prayer to a deity.

Personal prayer and tradition-specific forms

A 2007 behavioral-science review separated prayer research into frequency of prayer, content of prayer, prayer as a coping strategy and distant intercessory prayer. A 2004 US survey found that prayer for one's own health was the most commonly reported complementary approach, reported by 43.0 percent of adults, and that 9.6 percent had taken part in a prayer group for their own health.

Islamic salat is described in a narrative review as performed five times a day, with recitation of Quranic verses and set postures, so it combines words, movement and a daily schedule. Du'a, by contrast, is described as personal prayer that may follow it. Hindu devotional prayer, as one scholar describes japa, includes the murmuring of mantras in Vedic ritual and the meditative repetition of a divine name in bhakti traditions.

Intercessory prayer in research settings

In trials, intercessors typically prayed for named patients they did not meet, often daily, from outside the hospital. The Cochrane review reports trials that used Christian prayer groups, a group of intercessors with several years of prayer experience, and prayers placed at the Western Wall in Jerusalem. The STEP trial asked three Christian groups to pray for 14 days, starting the night before surgery, using a standard phrase wishing for a successful surgery with quick, healthy recovery and no complications.

Reasons people report for praying

In the 2002 US survey, adults who used complementary approaches commonly said they did so because they believed combining them with conventional treatment would help. Prayer for health reasons was counted in the survey as a complementary practice. When it was included in the definition, 62 percent of adults reported some use; without it, 36 percent did. Prayer by others on the respondent's behalf was reported by 24.4 percent.

Coping and well-being

Researchers in religion and health describe prayer and other religious practices as ways of coping with illness and stress. A 2005 meta-analysis of 49 studies on religious coping found that positive forms were associated with better psychological adjustment and negative forms with worse adjustment. A 2016 meta-analysis of 14 studies in young people with chronic illness reported similar patterns for spiritual coping.

Harold Koenig's 2012 review proposes psychological, social and behavioral pathways from religion to health, including coping, social support and healthier behavior. He states that he does not claim supernatural mechanisms are responsible. A narrative review of salat likewise proposes psychological, neurological, cardiovascular and musculoskeletal effects, though it reports these as its authors' reading of the literature.

Trials of intercessory prayer

The 2009 Cochrane review included ten randomized trials with 7,646 participants. For intercessory prayer added to standard care, there was no clear effect on death (six trials, 6,784 participants, relative risk 0.77, 95 percent confidence interval 0.51 to 1.16, heterogeneous), on clinical state, on readmission to coronary care, or on rehospitalization. The reviewers called the findings equivocal and said they were not convinced further trials should be undertaken.

The STEP trial randomized 1,802 coronary artery bypass patients at six US hospitals. Complications within 30 days occurred in 52 percent of those who were uncertain whether they were being prayed for and did receive prayer, against 51 percent of those who did not. Complications occurred in 59 percent of patients who were told they would receive prayer. The authors concluded that prayer itself had no effect and that certainty of receiving prayer was associated with more complications.

A 2007 meta-analysis of distant intercessory prayer by Masters and Spielmans concluded that no discernible effects could be found, and described the wider scientific evidence on prayer and health as limited.

Religious involvement and health

Koenig's review of studies published through 2010 reports that most studies of religiousness and spirituality found associations with better mental health. For depression, 272 of 444 studies reported an inverse association. He also notes that cause and effect are hard to sort out because few studies followed people over time, and that confounding may affect some findings. These studies concern religious involvement in general, not prayer alone.

Richard Sloan and Emilia Bagiella reached a more skeptical view. They found that only 17 percent of the Medline articles on religion they reviewed for the year 2000 were relevant to claims of health benefit, and that many of the relevant cardiovascular studies had methodological flaws. They concluded that there was little empirical basis for assertions that religious involvement is associated with better health outcomes.

The debate about the trials

Commentators disagree about what the trials can show. Davison critiques the designs on practical and theological grounds, and raises philosophical puzzles about requests to a God who is understood to be unchanging and all-knowing. Stephan Schwartz and Larry Dossey argue that the drug-trial model of blinding and randomization is not the best fit for studying prayer and intention, and propose nonlocal observer effects. That proposal is the authors' own position and is not an accepted explanation. The Cochrane reviewers state that trials cannot prove or disprove divine action.

Delayed or declined medical care

Prayer alongside medical care is not described as harmful in the sources reviewed. The documented concern is reliance on religious rituals in place of medical care. A 1998 case series in Pediatrics reviewed 172 children who died between 1975 and 1995 in families that withheld medical care because of reliance on religious rituals. The authors judged that 140 of the deaths were from conditions with expected survival above 90 percent with medical care.

Koenig's review likewise lists, among possible negative effects of religion, that it may delay diagnosis and effective mental health care. These sources do not measure how often such delay occurs among people who pray.

Other documented concerns

In the STEP trial, patients certain they would receive prayer had more complications than those uncertain, and the authors did not establish why. Studies of coping report that negative spiritual coping is associated with worse psychological adjustment and, in young people with chronic illness, with lower quality of life. These are associations, not demonstrated causes.

No statutory regulation or training standard for prayer as such was found in the sources reviewed. As a conventional care-boundary statement, prayer is not presented here as a replacement for medical evaluation or treatment, and the sources reviewed do not support delaying necessary medical care in favor of prayer alone.