Spiritual Prescribing – In the Turf War Between Religion and Science, Who Gets to Help the Suffering?
- Fields of Study
- Discussion and Pastoral Implications
1. Introduction and Hypothesis
The experience of illness is ubiquitous to human beings who have, throughout time, sought to reduce the suffering emergent from the state of illness. There have been countless ways to reduce suffering, from the days of amulets and magic spells onwards, up until even today when the menu of ways to tackle ill health is vast. In order to get somewhere in the exploration of suffering we name two fields that seek to help: the fields of medicine and psychology which seek to help and provide relief in terms of physical and psychological suffering, and the field of theology and the practice of religion.
The roots of the ‘help’ for both sides have an origin in the same place – ancient Greek philosophical schools (Bailey 1996, 257). The roots of our modern medical profession lie in the ancient Greek civilisation, notably temples built to the god Asklepios, a mortal hero physician idealised by Homer’s Iliad, and the philosophical school led by Hippocrates of Cos (Risse 1999). The human desire to help those in pain and distress has grown, particularly in the experimental leaps forward in the scientific revolution of the 16th and 17th century and the professionalisation of the medical science.
Since the healing practices in cults and the ancient mystery schools, there has been an intersection between religion, faith practice, and health across all the world faiths, including in Islam (Rahman 1987) and Judaism (Epstein 1987, 56). The study of this intersection has seen accelerated research in the last 100 years (Levin 2018, 267), and in this article I choose to explore it from the perspective of the Christian faith and its theological structure (but this problem would be fascinating to extend into the richness of the other world faiths and the New Age traditions).
From its foundation, the Christian faith has had a particular focus on suffering because it is founded on the miracle of the bodily resurrection of God’s son following a period of profound suffering. What followed and continues to this day, is Christian theological engagement on the meaning of the suffering for the faithful, how it relates to salvation and how to help (whether personally or for others). This is more than the tug of war between immanence and transcendence – it has profound implications for the purposes of prayer (‘Does it work?’), soteriology (‘Is there a relationship between sin and suffering?’), and the mission of Christians (‘How are we answering Jesus’ command to heal today?’).
In this introduction, we need to add to these theological and philosophical questions the practical entanglement of the Christian faith with the medical health care system and what that means today.
Amanda Porterfield states that historically Christianity is a religion of healing (Porterfield 2005, iv); Christians have always sought to ease suffering as part of their work to imitate Christ, including offering the healing of God. In addition, the parable of the Good Samaritan (Luke 10:25-37) was taken as a model of Christian behaviour.
With the growth of pilgrimage and the development of monastic houses, the treatment of the poor, suffering, and dying became a core aspect of Christian ministry. Additionally, these early Christian communities held many of the ancient Greek texts about the human body. These texts were curated and studied in the early Middle Ages, for example Corpus Hippocraticum, the writings of Hippocrates, a text which included biomedical methodology and cures for ailments. Building on this, in the first council of Nicaea in 325CE, Emperor Constantine called for hospitals to be built in every cathedral city in Europe. The history of medical science and hospitals have their root in these communities, which can be seen today in hospitals around the country, for example St Thomas’ and St Bartholomew’s (Platt 2017).
Given the ubiquitous nature of suffering, the history of faith, and medicine in human history, it comes as somewhat of a surprise perhaps that faith and medicine is a newer area of engagement for the science and religion dialogue, which has largely focussed on questions of how to relate science and religion, cosmological and evolutionary enquiries of origin and thinking around the nature of matter, for example in the study of quantum mechanics and the role of human consciousness.
Indeed, it is not just surprising – it is disappointing and now becomes urgent. Medical science has made such huge advances in the alleviation of human suffering it is almost impossible to overstate them. Yet people are still suffering in body, mind and spirit. There is little evidence of a reduction in suffering mapping in a linear way onto the progress of medical science. Indeed, when one considers the impact of war, pandemic and the breakdown of certainties caused by the climate crisis, we might be tempted to say the opposite.
The mission of the Christian remains the same: to make disciples and to heal (see, for example, the work of The Guild of Health and St Raphael, www.gohealth.org.uk). It is undeniable that the world of health and healing looks very different from even 100 years ago, let alone the Middle Ages or the time of Jesus. But the church is still here, though much diminished in its strength of voice, and it still strives to help those who are suffering in a constellation of ways including physical and emotional healing through prayer, mental health healing through connection and community, and existential healing through theology (Maddocks 1995; Idler 2003).
For many people, there is, at best, a perception that there is a choice between the healing offered by science and the healing offered by faith. At worst, both perceive threat and danger in the other.
Medical science has the dominance and many millions have been saved through this progress. Indeed, the author is alive today because of the progress of medical science (Straine 2017). So, there is no sense in which I am saying that there is anything wrong with medical science. The problem that I want to address in this paper is the degree to which the dominance of medicine is disabling the healing power of faith from being accessed.
In this paper, I want to test the hypothesis that the dominance of medicine is a problem and causes human suffering. I suggest that deliberately prescribing spiritual practices within the medical system and linking to faith-based organisations will reduce human suffering. I will present a journey through a number of fields of study to suggest that the weight of evidence combined with the need demands an imperative to act and that medicine must make space in the public health agenda for spiritual healing, to increase human health in our communities today.
2. Fields of Study
2.1 Medicine and Religion: Why is This Crossover Difficult to Negotiate and Who is Suffering as a Result?
Let us first take a broad overview of the situation to note the obstacles ahead.
There is a lively and engaged field of research exploring the role of spirituality in health (Fetzer 1999). As already intonated, this is not a new field (Osler 1910, 1470; Brigham 1835), but since the 1980s onwards there has been an acceleration of the study of the links between health and disease, including symptoms, causation, morbidity and mortality, and religious practice across many diverse fields of medical science including clinical practice, epidemiology and biomedicine (Levin 1987; Larson 1998).
But the study of human health and healing from the faith perspective has not led to universal acceptance of the importance of spiritual health in overall health, despite the venerable history of these subjects being entangled. And even within this field of study itself there are hidden obstacles, agendas and assumptions. This is not just a diverse field; it is one that has created deeply siloed thinking and there have been very negative reactions to deliberately bringing the fields together. In this section we look at the factors which have caused this before moving beyond this divisive position.
Firstly, the words that we use to talk about this field can lead to an unhelpful fuzziness. When talking about medicine, what do we mean? To begin with health is studied through an enormous range of topics for example, the scientific specialisms (e.g. immunology, neurobiology, haematology) and the social sciences (e.g. psychology, sociology). But further, human health cannot be studied in a vacuum – the biopsychosocial model of human health reminds us of the interconnection between biology, psychology and socio-environmental factors that determine human health. Layered on top questions of health and healing are the various political agendas which influence health delivery at a local and national level. And when we bring them together the fuzziness continues to grow with the field self-identifying in a range of ways; for example, religion and health, spirituality and healing, theology and medicine (Levin 2009, 125). It has been described as ‘a dishevelled literature’ (Krause 2011, 20).
Aside from the words, medicine and faith look to different sources of evidence and interpret results in differing ways. More specifically, medicine might view the role and outcome of healing by faith as dangerous, unscientific, and/or dismissible. And so we come to another root of the dichotomy in the field of health and faith – power.
There are a number of papers and studies which show that faith (for example, expressed in prayer) has a positive impact on human health. For example, non-contact (i.e. without laying on hands) clinical trials of prayer (Roe 2015, 11), impact of faith on death rates (Levin 2018, 259), and impact of spirituality on mental and physical health (Koenig 2012).
But it is a notoriously difficult phenomenon to study and compared to the rest of medicine, the research that has been done is but a drop in the ocean – even the results that are published are not well translated into action to improve care. The weight of the academy is behind the idea that faith impacts positivity on health (Orr 2015, 409) but there is no universal acceptance nor significant change to how medicine is broadly practiced (though there are some notable exceptions).
On the other side, there is a suspicion of medicine by those of faith who see the dominance of medicine as a problem which threatens faith and steps into the grounds that it sees naturally as its own domain. This is particularly in questions of medical ethics which is grounded in an understanding of the value of a human being.
At the heart of both of these places of tension, are questions over what a human being is and how to help when a person is suffering. If medicine has the dominant voice in society when things go wrong to a human being, how it views the human being will then also become dominant. Is it just a machine to be fixed, or a mind, body, spirit with self-understanding that extends beyond this world? (Levin 2018, 274). Interestingly, over the last few decades more practitioners within established medicine are recognising an understanding of the human being which values the spiritual dimension in health and healing (Engel 1977, 129). Now, I suggest, is the moment to act on this.
2.2 Medical Study of Prayer and Faith: What is the Evidence?
The efficacy of prayer is usually the first topic that springs to mind when people consider this area. Pausing to consider this might seem a slight sideways step given the section above. However, we take this pause as it gets us quickly into more fertile ground.
There have been multiple papers on the impact of prayer. For example, there has been a double-blind clinical trial researching distant prayer (Cadge 2021, 43) and a study into the phenomenon of medical cures at shrines (Francois 2014, 135). These papers are often criticised for poor methodology (Dossey 2005, 109), and many (from both ‘sides’) see it as an area of research which should be consigned to the past.
Many would argue, author included, that the impact of prayer for healing is simply beyond the scientific method. When a cure is explained via a divine intervention there is potential danger ahead for the faith when present unknowns become future knowns as science progresses.
While this is a field of study that inspires some to push the role of faith in health agenda, I would like to turn instead to something more concrete – the experience of illness.
The experience of ill health can be devasting. Illness changes lives and disrupts bodily patterns. It moves the ill to question foundational aspects of their life especially when a sense of control is lost. The reasons for this are not only the depths of physical suffering, but the social, mental, psychological and existential pain that often goes with serious illness or accident. Simone Weil identifies this type of multi layered suffering as affliction, and affliction, she writes, ‘leaves a trace upon one soul. It is this type of suffering that I suggest we examine moving forward because it is the type of suffering that, I will argue, the faith is best equipped to heal.
2.3 Theological Hermeneutics of Suffering
As we move towards making a case that faith in God can help with suffering, let me first make the case that in the experience of illness, knowledge of God can be discerned; that in studying this universal human experience we can uncover knowledge that helps heal the experience.
For a host of reasons, we don’t expect to get ill. It is almost always an unwelcome shock. As Carrel claims, ‘we have a tacit sense of bodily certainty that only comes to our attention when it is disrupted and replaced by bodily doubt’ (Carrel 2016, 5).
Whether not expecting suffering is a survival mechanism or not, the experience of losing health, losing control, and importantly, losing the ability to imagine with certainty a future is deeply shocking. For the person of faith, the experience of illness might clash heavily with a faith in a loving God, who ‘created you in your mother’s womb’ (Psalm 139 NRSV). So when illness hits what can we do? As illness is, by definition, an experience of the body it comes as no surprise that the study of the embodied experience can have a bearing on understanding the human experience at large.
What is the experience? On one hand, illness and suffering are experiences that are unique to the individual. On the other, it is possible to understand illness as an experience with some common feature: loss of wholeness, certainty, control, freedom to act and loss of a familiar world (Toombs 1987, 229).
Illness is also argued to be worthy of serious philosophical study: it challenges how we think, therefore it is an experience in which to seek wisdom; when you are ill, time and space are impacted (classical topics of philosophy); it impacts how we experience the world and therefore, for many, the meaning of life.
This invites in the intriguing idea that an interpretation of illness might lead to knowledge which transcends the individual. Further, phenomenologists would argue that it is in considering the importance of the body and soul as a unity in experiencing the world together that we understand the world known to our consciousness (Merleau-Ponty 2012, 147)
Building on phenomenology and existential theology, with its origins in the 20th century, and noting models of interdisciplinary hermeneutics of the experience of illness, some have offered into the academy the study of the science of ill health in uncovering theological interpretations which aid healing from the experience (Straine 2017; Toombs 1993). The meaning-making happens when the experience of ill health is taken into a conversation with our self-identity. Part of that identity for the faithful is a theological/spiritual identity of who we are, why we are here, and where we are going – all angles that offer meaning and healing from the liminal space of ill health.
Finally, and most importantly, what does a phenomenological study of the experience of ill health lead us to? What does the healing look like from philosophical engagement with the experience? Firstly, control might be regained by the ill who are subject to a medical system when the body is not just understood to be a machine to be fixed, but a key part of our self-identity and how we experience the world. Science, theologically considered, deepens self-understanding.
When time is taken to reflect on the meaning of the experience, which will be personal, what happens is that control of the story is taken back from the medical establishment and given to the ill person. Indeed, Sontag wrote that an experience of suffering and limitation gains meaning if put in a social and cultural context (Sontag 1978). The field of narrative medicine supports the idea that when the ill are allowed to tell their story of ill health, meaning and healing is found in the telling (Frank 1997). There is something so healing about storytelling in illness – we know it personally perhaps – when someone listens, we feel better. The storytelling helps to find the meaning, the purpose now. Furthermore, trauma recovery suggests that when the spiritual meaning of an embodied experience of trauma is sought, then not only is healing possible, but growth in happiness and satisfaction can be seen (Post Traumatic Growth) (Tedeschi 2004).
2.4 Spiritual Healing
The penultimate voice that I bring into play is one that makes the point that engaging in a church community and worship is not only good for your soul, but also measurably good for your physical, spiritual, and mental health. There are a multitude of papers exploring this area, which, as outlined above, is not without nuance but two recent key books on spiritual healing are by Sarah Coakley (Coakley 2020) and Fraser Watts (Watts 2011) both exploring the depths and complexity of the role of the spiritual in healing. These are built on a wealth of research exploring healing in terms of the social-scientific research (Lademan and Roseman 1996), the theology of healing (Kydd 2001; Pattison 1989), and the scientific study of spiritual healing (Koenig 2012).
Watts helpfully brings clarity to the discussion, firstly by defining three different ways to understand spiritual healing. The first is healing in which spiritual practices play a role, for example in the psychosomatic processes in meditation, or the laying on of hands in healing ministry and in prayer (Dourley 1997, 211). The second is healing in which spiritual aspects of the person are involved in the healing. This area of healing largely takes place through an understanding of the human person as having a spirit interconnected with mind and body. The healing through religious practices therefore offers healing to the whole person (Watts 2001). Further, the emerging field of psychoneuroimmunology offers more evidence of the health benefits of religious practice (Koenig 2000, 37). The third category is perhaps the most challenging for the present discussion – healing which happens through interaction with a high power, bringing into the debate questions around divine action in the world.
These are just a few voices from a vast field of expert discussion of the diverse ways that healing can happen within a faith context. The most challenging final point offers us a moment to pause at the causal joint and I would side with Watts who argues for an augmentation about what science studies. He suggests that science needs to be open to more areas of thought and look at the queue of practices, such as acupuncture and prayer from a distance, that produce healing results beyond the comfort zone of many scientists: ‘It is better to see healing in terms of a subtle interpenetration of the natural and the spiritual, rather than in terms of a sharp disjunction between them (Watts2011, 8).
2.5 Public Health Studies
The final voice that I want to offer into this debate is from public health in the UK. Over a number of years, there has been a growing body of literature exploring the role of faith and worshipping communities in the provision of community health-based projects, most of which are based on a biopsychosocial model of human health (Idler 2003).
The pandemic has moved these studies from the interesting to the urgent. The Keeping the Faith report published by the Faith and Society All Party Parliamentary group explored the relationship between faith groups and local authorities during and beyond the pandemic. It found an increase in the number and depths of the relationships. Faith groups were broadly noted for their contribution in the pandemic around resilience, mental health provision and outreach. They were recognised as agile, flexible, and having key community networks which allowed the health provision work to be significant. Within local government, the report stated that significant momentum around partnership had been built with 76% of local authorities expected that the new partnerships undertaken in the pandemic will continue. The reported concluded that the pandemic had both significantly increased local authority partnerships with faith groups and opened up a ‘new normal’ in relationships with them. There is opportunity and urgency here.
I want to mention one project specifically in this final section – looking forward, one of the key ways that faith groups will contribute to the health provision in England, Scotland and Wales is through social prescribing. Social prescribing, also sometimes known as community reference, is a way of giving health professionals a range of non-medical services to prescribe to help patients find healing. Firmly underpinned by a holistic view of the human being, social prescribing recognises the range of non-medical ways that people find healing (largely through social connection). The project is aimed at people with a wide range of social, emotional or practical needs, often there is a focus on mental health and loneliness. Schemes can involve activities such as volunteering, gardening, befriending, cookery and sports – many schemes which are often run by faith groups. Indeed, faith groups are a recognised partner for social prescribing services due to their networks, volunteers and social outreach work.
3. Discussion and Pastoral Implications
There is no doubt that there is a clash between science and religion when the discussion is focussed on medicine, human health and healing. The origin of the clash is what counts as evidence, ethical questions which arise, and power. In this paper I have made a case that there is a fruitful area of engagement in the healing role that faith can bring when the experience of suffering is the object that can be healed by faith. Further, that there is enough evidence for the power of spiritual healing to say that what is offered is at the very least not going to make things worse, and at best will promote spiritual growth and holistic healing. It is not so much about prayers that make you better – spiritual healing offers a whole person approach to human health that is beyond the power of medicine to provide.
Put simply, if you get cancer medical science can offer a wonderful and powerful array of treatments to give you the best chance of physical survival. Faith can do the more important work – offering support to theologically and spiritually examine the impact of the illness upon the life, and help the one who had the disease to find meaning and purpose, beyond the physical. This is healing.
The impact of the pandemic, and the suffering of social trauma now makes the importance of the healing offered by the faith elevated. Recent evidence from the response of faith groups in the pandemics, coupled with a large corpus of work exploring the benefits of taking seriously the biopsychosocial model of human health (which includes spiritual health) suggests that there is a public health imperative to act.
We need to offer the compliment to social prescribing: spiritual prescribing. Where the faith can offer the healing they need through spiritual practices such as prayer, meditation, worship, in order to do the deep healing work of recovering identity when something has left a trace upon your soul.
Faith must regain ground and hold it confidently, reach out to the suffering in a way that is beyond the medical establishment. The theology, history and whole person approach to health, backed up by fields such as psychoneuroimmunology, can equip people to heal from the impacts of living in a complex and difficult world. Spiritual healing in partnership with medical science, in confident practice of its faith communities, can bring healing, meaning and purpose to those who seek it, and what they will find is not simply a way to ‘feel better’, but an opportunity to flourish.
In this paper, I have presented a journey through several voices to make the case that prescribing spiritual practices within the medical system will reduce human suffering. There are several threads to this argument – the efficacy of prayer, exposure of the unequal power dynamics between medicine and faith, the biopsychosocial understanding of human health, and the value of an examined experience of ill health. To these we add that when the role of spiritual healing is elevated within the suite of ways that medicine and the faith respond to human suffering we can offer healing that can meet the true demand of suffering. This I am sure is all arguable, and especially in the space created in the personal interpretation of what spiritual healing means. But that is the fertile space – in that space we can have a conversation with those of all different faiths, and those of no faiths. Take, for example, the role of the higher power in the healing work of the twelve step program of Alcoholics Anonymous that deliberately takes an agnostic position of what that power might be. Spiritual prescribing could be for all faiths and none, because beyond doctrinal statements and dogmas, human beings are always more than just bodies to be healed.
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Cite this article
Straine, Gillian. 2022. “Spiritual Prescribing – in the turf War Between Religion and Science, Who Gets to Help the Suffering?” Theological Puzzles (Issue 10). https://www.theo-puzzles.ac.uk/2022/07/01/straine/.