Does Prayer Really Work?

targOn a brilliant February morning in San Francisco, I’m talking to Elisabeth Targ, a psychiatrist with impeccable research credentials who’s conducting studies that disturb some people and fascinate others: the ability of prayer to heal life-threatening disease.

Targ, who’s tall and regal with deep reserves of warmth, has been doing prayer studies for seven years. In her first project, she enrolled twenty patients with AIDS and randomly assigned them to two groups: one that received prayers from experienced healers and one that did not. The patients and healers never met, and neither the patients nor their doctors knew if or when they were being prayed for. To Targ’s surprise, 40% of the control group died and no one in the prayer group died during the six-month trial period. She repeated the study with 40 patients but by then, protease inhibitors were being used that kept people on AIDS alive. No one in either group died, but those in the control group suffered six times more complications and illnesses than those in the prayer group.

She’s currently doing two studies with 150 patients each, funded by the National Institutes of Health: one on AIDS and one on a different illness Targ selected because AIDS is no longer necessarily fatal. She picked glioblastoma multiforme, a rare, aggressive brain tumor which few survive. “I wanted a hard problem,” she says, so the effects of prayer, if there were effects, would be noticeable. She’s enrolled 40 patients for the glioblastoma study and healers have started praying for them, but Targ is about to take a month’s leave. At 40, she’s going to be married and have in vitro fertilization, and wants to withdraw from her nonstop schedule of teaching, research, and seeing patients to give herself the best chance to conceive a child. “I’m trying to do a prayer for a baby,” she says. “My prayer is staying home.”

What neither of us knows, as we sit in her tranquil office decorated in teal and mauve, is that tumors are growing in her brain. Before the month is up, she’ll be diagnosed with glioblastoma—and will become a subject in her own experiment.

* * *

Prayer, or distant healing, is one of the liveliest areas of research in alternative medicine. Respected scientists at major institutions such as Harvard, Duke and the Mayo Clinic are conducting studies and publishing their results in mainstream medical journals. While results are preliminary and inconclusive, if it’s ultimately proved that distant healing works—that one person praying in Chicago can affect the physical health of a stranger in Mexico—this will require a radical revision of the way we see reality. Distant healing goes against the known laws of physics and calls for us to tear down the wall between science and religion.

Most of us apparently believe in prayer. A national survey in 1996 found that 82% of Americans believe in the healing power of prayer and 75% of about 300 family practice doctors who were polled believe prayer can affect the outcome of illness. Yet distant healing research is criticized by both scientists and religious leaders. Some doctors who’ve studied the data call it “junk science” that’s flawed and proves nothing. A group of Anglican scholars say prayer is a means for connecting with the sacred, not for controlling events. “Prayer can’t be used like a drug,” says Raymond Lawrence, chaplain at New York Presbyterian Hospital. “It won’t work. Lots of luck to those people who say it does. They won’t prove it.”

* * *

Elisabeth Targ grew up in a secular family in California where the household god was science. Her mother was a biologist, her uncle was chess champion Bobby Fisher, and her father, Russell Targ, was a senior research physicist at Stanford who helped invent the laser and conducted hundreds of experiments on the paranormal. He taught his daughter it was possible to design rigorous scientific experiments on phenomenon like ESP that can’t be explained by any known theory. “He was not a religious person,” Targ says. “He was simply interested in how things worked.”

At age twelve, Targ talked her way into a job at the brain research lab at Stanford, sticking electrodes into monkey brains to study the left and right hemispheres. She believed the mind has extraordinary abilities and science can study them. She herself was gifted at ESP and used it in experiments with her father to predict how stocks would perform. Their success paid for most of her tuition at Stanford Medical School.

While still in high school, she went to a conference on parapsychology and met Marilyn Schlitz, a college student doing research on the mind. They were roommates because “we were the only gals there,” Schlitz says. “We could talk girl talk and at the same time, we were flying high with ideas. Elisabeth was so bright it was breath-taking and so creative in her designs for experiments. People three times her age were in awe.”

Both women are striking and stylish–contradicting the stereotype of the nerdy female scientist. When they walk into a room, people notice. Targ is tall with intense, dark Slavic looks and Schlitz has the wholesome blonde radiance of a Midwesterner. While Schlitz set out to do cutting edge research on topics that were considered on the fringe of science, Targ, at first, took a straighter road. She became a resident in psychiatry at UCLA, where she did research on group therapy and found it was as good as Prozac in treating depression.

In the mid 90s, Targ was settled in San Francisco, practicing psychiatry and teaching at U.C. San Francisco, when she was asked to study the effects of spiritual practice on breast cancer. Her first response was, I’m the wrong person. “I thought spirituality was for people who can’t face reality,” she recalls. She spent months visiting spiritual practice groups, and designed a study that would measure the effects of conventional group therapy versus a spiritual-based group therapy that included activities like meditation and yoga. She’s still analyzing the data, but feels that women in both groups “did extremely well.”

During the course of the study, she began to meditate herself and to posit that people are connected in deeper ways than we know, and that this connection has the power to heal. Marilyn Schlitz, who’d become director of the Institute of Noetic Sciences, a private research group in the Bay Area, wanted her to go further. She invited her on a sailboat ride and with the help of cognac and a partial eclipse of the moon, persuaded her to design a study of distant healing that the Institute was funding. Targ was skeptical. “I didn’t think prayer would work at all,” she says. “I thought it was this outrageous claim people were making, so why not test it? I wanted the challenge.”

* * *

When Targ entered the field, more than a hundred studies had been done on distant healing. But according to Mitchell Krucoff, a cardiologist at Duke who’s doing current prayer studies, “Most of the science was mediocre at best.”

The breakthrough study was done in 1988 by Randolph Byrd, a cardiologist, published in the Southern Medical Journal. Byrd studied 393 patients in the Cardiac Care Unit at San Francisco General Medical Center. He assigned patients randomly to an intercessory prayer group or a control group. The first group was prayed for every day by Christians who never met the subjects. They prayed at a distance to rule out any possibility that hope, positive thinking or the power of suggestion—the placebo effect—would be responsible for results. After ten months, people in the prayer group fared better than the control group. Their symptoms were less severe and they required less medication. Critics pointed out flaws in the data, but Byrd’s study made prayer research legitimate. He established that scientists could study prayer in controlled, double-blind experiments with the same rigor with which they study new drugs.

At least four other doctors after Byrd have done research on prayer with cardiac patients: William Harris at the Mid America Heart Institute, Stephen Kopecky at the Mayo Clinic, Herbert Benson at Harvard and Mitchell Krucoff at Duke. Cardiologists have dominated the field, possibly because they work with the heart–long identified as the seat of the soul, the source of love and the vessel for the divine spark.

* * *

On a computer screen in Targ’s office, there’s a complex grid of letters, numbers, and red, blue, purple and green rectangles that show who’s praying for whom at what time. Before Targ began her first study, she spent months designing the protocol, or methodology, to make her study more precise and bullet-proof than previous experiments. For the healers—people doing the praying–Targ did not want random volunteers but trained professionals from many traditions, including Christian, Jewish, Buddhist, Native American and energy healing. She recruited people who had an average of 17 years experience in distant healing, who’d dealt with AIDS patients before, and who believed their prayers would work. It was critical, she felt, to use professionals. “If you wanted to test how effective Western medicine is, you’d use doctors,” she says. “You wouldn’t call in a bunch of secretaries and say, `Would you please do Western medicine?'”

The next issue she addressed was the “dosage” or how much prayer was done. In previous studies, it had not been clear whether the healers simply lit a candle for a minute or prayed for hours. Targ asked the healers to sit for one hour every day for six days. She sent them the name of the subject, a photograph and list of symptoms, and asked them to “hold an intention for the health and well being of the subject.” How they held this intention was up to them, and it varied from Christians working with a rosary to energy healers doing visualizations to a shaman beating a drum and chanting in Lakota to the Creator. Through a complex system of rotation, the healers would pray for one subject six days, take a week off, then pray for a second subject. All subjects were prayed for by ten healers, so all received 60 hours of prayer.

The first studies were aimed at answering the broad question: Does distant healing work? Targ did not expect a yes answer. “I’m not a true believer,” she says. “I follow the data. I’m open and excited to see whatever news comes in.” She smiles. “But when distant healing worked–that made it much more interesting.”

* * *

Targ and I are eating spicy chicken and shrimp at Zao, a Thai noodle shop on California Street. There’s a fire house nearby and trucks go screeching down the street, alarms clanging. Targ is wearing a black shirt and slacks, lace-up shoe boots, a green jacket and distinctive ethnic jewelry. I ask her how distant healing works. “We don’t know—science can’t answer that yet,” she says, adding that the healing agent could be God, consciousness, love, electrons or a combination.

I tell Targ that if distant prayer works, it seems to me there are two possibilities: either the mind has the power to affect another person’s body; or there’s a greater power or force that can be appealed to or harnessed to bring about healing.

“This will surprise you,” she says, “but I don’t worry about those questions. We’re not proving whether God exists. Our study is not about God, it’s about intention. I’m just interested to see if holding an intention for someone’s health has an effect.” Targ says that science is a mosaic—constructed from small bits of information—and she’s looking at one small piece at a time. In future studies, she wants to focus on questions like: Does praying for five minutes work as well as praying for an hour? Does the patient have to believe in prayer for it to work? What kind of prayer has the strongest effect?”

I tell her I’m more interested in the big questions.

“If you ask a big question, you’re gonna get a big answer,” she says.

“There is no answer to the big questions,” I say.

Targ laughs. “That’s why you should ask a small question. You might get an answer. And you’ll get to the big questions later.” She says the issues that intrigue her most are: Who are we, and what can we do?

As I speak with Targ and later with other leaders in the field—Larry Dossey,M.D., Mitchell Krucoff, M.D., Marilyn Schlitz, Ph.D.—I have the sense of what it might have felt like to be in classical Greece, engaging in discourse on the mysteries of life with people who have the most brilliant, playful minds. What’s exciting is that they’re operating in the free fire zone between science and faith, the zone where anyone can take a shot at anything. They’re using science to measure the ineffable, which by definition can’t be understood through the rational mind but is experienced subjectively by intuition, whispers, things seen at a glance when a door opens and a curtain flutters in the wind.

Targ may say she’s not proving whether God exists, but sooner or later, scientists who study prayer will bump against the questions: Is there a greater power? How are we connected? Does individual consciousness survive death? Larry Dossey, who wrote the definitive book on prayer, Healing Words, says, “I’ve met a few people who claim not to be interested in those questions.” Dossey smiles. “I don’t believe ‘em.”

Dossey is tall and elegant with a mane of silver hair and an irreverent wit. He grew up in Texas, wanted to be a Baptist preacher but put religion aside when he became a doctor, only to discover later the appeal of Eastern spirituality. “I prefer going for the big questions,” he says, when we meet at a conference on Alternative Therapies in San Diego. “I’m more interested in the implications of distant healing than whether it cures cancer or AIDS.”

What are the implications? I ask.

Dossey says that if part of our consciousness can transcend space and time to heal another person’s body, “we’ve discovered something that seriously resembles what we in the West have always called the soul. If part of our consciousness is infinite in time, that’s what we mean by immortality. Part of us survives bodily death, which is the big disease. It’s not cancer or AIDS, it’s death, and these studies point like an arrow toward survival of consciousness. That’s the holy grail for humans. That’s the huge question: Is there anything more after we die?”

I ask if he has an answer to that question?

He says he’s given it a resounding “yes.”

I tell him I’m not there yet. I’ve missed some steps, some links in the chain he’s laying out. Even if distant healing proves that consciousness is nonlocal, that it extends beyond one’s body and affects others, how do we know that the little piece we carry—individual consciousness—survives death?

Dossey says, “That knowledge is something you live into. It’s almost as if it grabs you and declares itself to you. Anyway, I’ve been grabbed!” He laughs at this muscular image. “It contributes greatly to my mental peace. And if it turns out there truly is nothing after you die…” He shrugs. “Presumably there won’t be a problem.”

Even the skeptics of distant healing are exhilarating to speak with, because their arguments are passionate and devolve fairly quickly to discussions of the nature of God. What kind of a God, they ask, would heal half the people in the CCU and ignore the other half just to prove an experimenter’s point? Dr. Arnold Relman, the former editor of the New England Journal of Medicine and a vigorous critic of alternative healing, says, “What kind of merciful and all-knowing god would allow him or herself to be manipulated like that? It makes God into a toy.”

I point out that many researchers don’t conceive of a personal god but some greater force that could be harnessed for healing.

“What kind of a force would allow itself to be harnessed!” he says. This makes me laugh, but when I repeat his question to Rosalyn Bruyere, who’s been an energy healer for thirty years—”What kind of a force would allow itself to be harnessed?” She gives a puckish smile. “Water.”

* * *

What do prayer studies prove? It depends on who’s reading them.

Dr. John Astin, who does research on mind-body therapies at the University of Maryland Medical School, did a review of 23 trials of distant healing and found that 57% showed that prayer had a positive effect. He concluded that distant healing works sometimes, and merits further study. Dr. Daniel J. Benor, a psychiatrist whose book, Spiritual Healing, is an encyclopedic review of healing research, says that, based on existing evidence, “if prayer were a drug, it would be approved for use.”

Nonsense, say the critics. Dr. Richard Sloane, a psychologist in the department of Psychiatry and Biostatistics at Columbia University medical school, has reviewed the literature with his colleagues and says the experiments are “awful. Just terrible. The findings are very weak and if they exist at all, disappear under scrutiny.” He says the Byrd study looked at 26 variables to measure outcomes in the prayer and control groups, but found only 6 variables that were different between the two groups. Sloane refers to this as “the sharp shooter’s fallacy. You empty a six-gun into the side of a barn and then draw a bull’s eye around the hits.” If you look at enough variables, Sloane says, something will turn up that appears significant, but it’s a chance finding.

Sloane says Targ’s study appears to be well conducted but uses a small sample and doesn’t warrant sweeping conclusions. “To accept that prayer works at a distance, we have to abandon our conventional understanding of the universe,” he says. “Forces act proximally, not at a distance. Gravity acts proximally. Heat and light are strongest when you’re close to them and grow weaker over distance.” He says that in the past, we’ve abandoned our conventional understanding when breakthroughs occurred. “It happened when the Ptolemaic view of the solar system was replaced by the Copernican. It happened when Newtonian mechanics were supplanted by quantum mechanics. But we’re talking about great scientists—Newton, Einstein, Copernicus—and major scientific revolutions where the evidence was unassailable. We have nothing like that in this literature.”

Krucoff says that’s because it’s a young literature. “It’s only in the past ten years that we’ve been studying this with rigor, trying to build a bridge to the kind of science that mainstream doctors would recognize.”

He says that science can never prove absolutely that prayer works because it’s impossible to create a pure control group. “There’s prayer going on all the time, all over the world. There’s no way to turn it off. Everyone is receiving some prayers.”

I ask, couldn’t you form a control group of atheists who don’t associate with people who pray? Krucoff replies, “There are thousands of monks praying for the wellness of the earth and all who dwell on it. Is an atheist immune to that prayer?” He says that what science can prove is whether more prayer works.

Even before conclusive data emerges, consumers are eager to add prayer to their health care because it’s cheap and seems to have no side effects. One nurse said jokingly, “The only side effect is disappointment when it doesn’t work.” And it doesn’t always work. The traditional religious explanation is that God has a higher plan which humans can’t apprehend, and that answered prayers are not always in the person’s best interest. Targ says people should make sure the experience of praying is positive and inspiring, so if someone dies, “you don’t feel you’ve wasted your time.” She says the fact that prayer works at all is “important information. Maybe we can learn how to make it work better.”

Five years ago, doctors conducting prayer research were afraid of losing credibility. Today, the work gets more respect. When I visited Targ in San Francisco, she said she’s presented her findings at mainstream medical conferences and always received a positive response. “This is my major work, and it might do some good in the world, so I don’t care if people like it. This is the research I want to do.” She gathered her papers, preparing to leave her office for the month. “I’m having a blast.”

* * *

Three weeks later, after her IVF procedure, Targ began to have trouble walking and part of her face became paralyzed. Her doctors thought it might be a reaction to the procedure. When she didn’t improve, they did an M.R.I. and found tumors in her brain, one in a site that was not operable. The diagnosis: glioblastoma.

Shock and disbelief hit her circle of family and friends. It was impossible. Unbelievable! What were the odds of Targ contracting the rare disease she’d picked to study? And if the psyche affects the immune system, how could Targ, who’s calm and self-assured, who thrives on her work, takes excellent care of her body, meditates, has examined her mind and soul, who’s connected to a large community and about to be married and looking forward to starting a family develop this lethal cancer? Was it bad luck, some unconscious foreknowledge, or a Job-like testing?

On a website created after she fell ill, a report said that Elisabeth “understands what a powerful test of her research findings this is.” On April 5, surgeons removed as much of the cancer as possible and when Targ regained consciousness, she said several times: “The next phase of the experiment begins.” She told friends she wants to mobilize all the prayer and loving intentions being directed toward her to demonstrate the power of distant healing.

Marilyn Schlitz, who was shattered by the news, says, “We’re in the business of believing in miracles.” She notes that Targ has always had a positive attitude. When she was trying to get into Stanford Medical School, she wrote herself a letter of acceptance and put it in the mail. “She wrote it by hand with the idea that it would come back typed,” Schlitz says. “And it did!”

The challenge of glioblastoma seems incomparably more daunting. Only five per cent of patients are alive after five years and the long-term survival rate is 1.8%. Targ has access to the finest doctors in Western medicine as well as to accomplished healers. Many who prayed in her studies are now praying for her using the protocol she designed: six days on, one week off and six days on again.

On May 5, Targ was married to her partner of seven years, Mark Comings, a physicist. They’d set the date long before and carried out their plan. On a brilliant Sunday, 150 guests gathered in Tiburon, just across the Golden Gate Bridge, at a Victorian house overlooking the Pacific. The water sparkled, bells rang and flutes played. Targ looked radiant, wearing the dress Schlitz had worn at her own wedding. Targ’s father walked her down the aisle and she and Mark sat on stools to recite their vows. Her bridesmaids took turns holding her up.

Targ’s research continues, with colleagues stepping in to take on her duties. Dr. Andrew Freinkel will lead the glioblastoma study. If the prayers for Targ fail to help her recover, I asked, will it be difficult to go on studying distant healing? He paused, and said that Targ’s illness is a tragedy but not reason to abandon scientific inquiry. “It’s happenstance, it’s being struck by lightning. There’s tragedy and there’s science, and science proceeds by the scientific method. We know so little about the role of distant healing in disease—that’s why we’re doing this work.”

Targ had told me, when we met in San Francisco, that if one prays for a person’s highest good, “that might not make cancer go away but it could help the person lead a meaningful and celebratory life instead of a depressed, frightened one.”

I remember asking her: What’s the best way to pray?

Targ smiled. “The good news is, there are lots of ways to do it and people will find the way that’s best for them.” She said what’s important is to give yourself time to sit, to quiet the mind and then to be with the person in your thoughts and heart. “You could draw a picture of them, make an offering. The main thing is to stop talking about prayer and start doing it.”

(Just at press time, on July 18, 2002, Elisabeth Targ died peacefully, surrounded by friends, in her family home. Marilyn Schlitz said, “Her goal in conducting rigorous science was not to provide definitive answers but to ask the deepest questions, bringing new horizons into view.” Schlitz said that whether distant healing works is still a question. “It worked in her AIDS experiments; it didn’t work with her, but she picked one of the most intractable diseases to have or study.”