Choice in Unconventional Cancer Therapies
Spiritual Approaches to Cancer
Cancer means facing the certainty of illness, the probability of pain, and the possibility of death. For many people, these encounters evoke profound shifts in consciousness that may be called “spiritual.” For some, the use of prayer, meditation, contemplation, and a review of how they are acting in the world–and how they choose to act under these new circumstances–comes easily. For others, who may never have considered the possibility that they have a spiritual nature, the encounter with these deep shifts in consciousness brings them into unknown territory. They may have had no previous reason to sort out the differences between religion–which they may have had difficulties with–and personal spirituality. They may not have considered the relationship between spirituality and the opportunities for healing. They may not have considered how spirituality is often evoked–sometimes for the first time–by a deep wound such as cancer.1
My father, Max Lerner, had just such an experience with cancer. In his book, Wrestling with the Angel, he wrote:
In earlier years, while teaching seminars on selfhood and its components, I would move from soma to brain to mind to psyche, elaborating on what differentiated and connected them. During my healing phase, as I stood at the blackboard for another go at the same question, I found myself, after psyche, adding spirit and soul. I had not planned it, yet somehow, having written the added words, I knew that after the experience I have described I could do no other. In a different way each stage moves through what physiology, neurology, logic, and psychology study, to a realm that transcends them but remains an important component of the total person.2
On Definitions of Spirit, Spirituality, and Spiritual Healing
What is spirit? What is spirituality? What is spiritual healing? A superb symposium in Advances, the journal of mind-body health published by the Fetzer Institute, discussed the issue of spiritual healing in unusual depth. David Aldridge wrote:
The natural sciences base of modern medicine that, in turn, influences the way in which modern medicine is delivered, often ignores the spiritual factors associated with health. Health invariably is defined in anatomical or physiological, psychological or social terms. Rarely do we find diagnoses that include the spiritual concerns of patients.
The descriptions we invoke as clinicians or researchers to characterize disease have implications for the treatment strategies we suggest and the ways we believe people can be encouraged to become healthy or to maintain the state we regard as “health.” We need to recognize that patience, grace, prayer, meditation, hope, forgiveness and fellowship are as important to many of our health initiatives as medication, hospitalization, incarceration or surgery. The spiritual elements of experience help us to rise above the matters at hand such that in the face of suffering we can find purpose, meaning and hope.3
Aldridge quotes a definition of the spiritual in medicine by Hiatt, a psychiatrist: “Spirit refers to that noncorporeal and nonmental dimension of the person that is the source of unity and meaning, and spirituality refers to the concepts, attitudes and behaviors that derive from one’s experience of that dimension. Spirit can be addressed only indirectly and inferentially, while spirituality can be understood and worked with in psychologic terms.”4
It is a very critical point that spirit is that which some people experience as a source of unity and meaning, while spirituality refers to the experience of that dimension that we are able to talk about. The distinction is critical because while all human beings–perhaps all beings–may be said to be one in spirit, as soon as we begin to talk about spirituality we inevitably use concepts that have the potential to disrupt the unity to which we refer, and to divide us.
It is useful to think of spirit, spirituality, and religion as different points on a continuum. Spirit is the source dimension behind every personal or collective experience of spirituality. It is also the source dimension behind every religion. Spirituality can be considered closer to the source dimension than everyday religion that has moved far from the experience of spirit and primarily serves social and moral purposes. Spirituality can be found both within religious frameworks, by people who have stayed close to or recovered the source dimension of their religion, and outside of religious frameworks. But since any discussion of spirituality, in order to talk about spirit, necessarily uses concepts and proposes attitudes regarding that experience, it already has the makings of divisiveness, and indeed the potential structures of a religion, within it.
Spirit is said, then, to be a realm that unites us. When we talk about spirit, and therefore enter the realm of spirituality, we have seen how concepts and attitudes that divide us begin to enter the dialogue. This is particularly true when we begin to address the question of whether any kinds of spiritual energies or spiritual realities exist beyond what we see or what is scientifically demonstrable. For example, claims that prayer or laying on of hands can be physiologically healing begins to bring us into this realm.
Spiritual and Psychological Approaches to Cancer
Spiritual and psychological approaches to cancer are deeply interrelated, yet distinct. The mind, the subject of psychology, is one of the approaches to the spirit, but not the only one. The very word “spiritual” repulses many people, particularly people who were forced into religious systems in their childhood that thwarted or even denied the authentic voyage of inner self-discovery that spiritual life represents. In fact, only in the face of cancer do some patients discover that there can be a profound difference for some people between being religious and being spiritual. One can be spiritual without being religious, and one can be religious without being spiritual. For people who are fortunate enough to have had families or religious teachers who did not destroy their religious tradition for them, the great religions are often safe and known paths into the life of the spirit. For others, the distorted presentation of these traditions has turned them away from the spiritual quest for inner knowledge.
There are still others who recoil from the word “spiritual” because it evokes for them ways of relating to life that they find inauthentic for reasons that may have nothing to do with early childhood experience. Many cancer patients have told me that they cannot relate to the concept of a spiritual reality, but that they can relate deeply to nature, mankind, friends and family, art and music, or science and reason. At the heart of all great spiritual traditions is a clear recognition that all forms of dedication to what is worthy in human experience are ultimately spiritual. In this sense, the spiritual quest is the search for the life path on which we explore the highest potential each of us was given in this life. The spiritual quest can be undertaken as completely by an atheist or agnostic, or a worshiper of nature, family, mankind, art, music, or science, as by a believer in an explicitly religious or spiritual tradition.
For the cancer patient engaged in an intense search for healing and recovery, these considerations are not abstract theological issues. Like a soldier in a trench under bombardment who suddenly discovers prayer, or a prisoner in a forgotten cell awaiting execution, the person with cancer often has urgent reason to reflect on ultimate questions: the meaning of his life; what has true value for him; what happens when he dies; how he should live from now on. If he immerses himself in books about alternative cancer therapies, he will read about many spiritual approaches to cancer. But he may feel blocked and frustrated because he does not consider himself a religious or spiritual person, or because the kinds of spiritual experiences that the books describe seem foreign to him. For such a person, the fundamental distinctions between spirit, spirituality, and religion may never have been made clear. Without these distinctions, he may not see–or give himself permission to explore–the path to the realm of spirit that for him, as a unique human being, would be authentic, life-enhancing, and perhaps lifesaving.
Spirituality and the Perennial Philosophy
Aldous Huxley, the great British writer and thinker, died of cancer. When his first wife died of cancer before him, he sat beside her as she died and whispered in her ear the sacred instructions from the Tibetan Book of the Dead, reminding her–as many great spiritual teachings do–to follow the light as her soul gradually separated from her body. Huxley also was one of the great early ethical experimenters with lysergic acid diethylamide (LSD). He wrote a book about his experience called The Gates of Perception. When his own death came near and he sensed its nearness, he wrote his second wife a note asking her to ask his physician to give him an intramuscular injection of LSD. His physician complied. After the injection, Huxley grew still and seemed to turn inward. “Interesting” was the last word he said before he died.
During World War II, Huxley wrote a beautiful book called The Perennial Philosophy. The book was an anthology of passages that Huxley had selected from the great religious and spiritual traditions of the world. His purpose was to demonstrate that there was a central unchanging teaching–a perennial philosophy–at the core of all the great spiritual traditions, and that all traditions represent different paths to that teaching. As the Rig Veda, one of the most ancient of spiritual texts, puts it:
Truth is one: sages call it by various names.
It is the one Sun who reflects in all the ponds;
It is the one water which slakes the thirst of all;
It is the one air which sustains all life;
It is the one fire which shines in all houses.
Colors of the cows may be different, but milk is white;
Flowers and bees may be different, but honey is the same;
Systems of faith may be different, but God is one.
· · ·
As the rain dropping from the sky wends its way toward the ocean,
So the prostrations offered in all faiths reach the One God, who is supreme.5
Because most ancient religions grew out of tribal traditions where the religion played the dual role of a spiritual guidance system and a social boundary system, many religions–including Christianity and Judaism–have teachings that seem to say that they are the only true way to God. While this was a natural stage in the evolution of spiritual consciousness, most great spiritual teachers in the ages since humans have emerged from tribal consciousness have recognized the teaching that religious and spiritual traditions represent, as Huxley believed, different approaches–suited to different peoples and different temperaments–to cultivating the life of the spirit.
This recognition of the huge variety of spiritual paths that ultimately lead toward the same essential self-realization is important to cancer patients because it further liberates them to find a spiritual path that has vitality for them. This is more than theory for the person with cancer. Hugh Prather and Gerald Jampolsky, M.D., reflect on the importance of this truth for those in crisis:
It has been assumed that although the perennial wisdom remains the same, it is really a mental plaything for the comfortably situated and is partially, if not wholly, impractical for those who struggle and suffer and even for those whose lives contain a common measure of hardship. .ê.ê. We have seen that, on the contrary, the more desperately these concepts are needed and the more wholeheartedly they are turned to, the more enormous is their potential for delivering a growing sense of peace and even glimpses of a higher reality.6
Achieving deeper levels of self-realization can unquestionably transform the experience of cancer, deeply lessening unnecessary stress and anguish. And the psychobiological correlates of achieving inner peace, of regaining inner tranquility and joy in life, may transform the biological environment in which the cancer developed. There are those, myself included, who believe that in some cases this inner quest may have an important effect on the course that the cancer takes.
Yoga and Meditation
One example of the distinction between spirituality and religion is the relationship between yoga and the religious tradition which gave birth to it as a spiritual path. Yoga is only one manifestation of the Perennial Philosophy, but one which is very accessible for people in the West and which can accommodate within its range people of all backgrounds, tastes and temperaments. Meditation, the stilling of mind, is at the heart of yoga. But yoga is only one of many paths to learning meditation. I have a personal prejudice in favor of yoga that the reader should be aware of. I believe that yoga probably saved my life and helped me in a transition from a highly stressful period to a much more fulfilling way of living.
What is yoga? The word means, among other things, “union,” which is taken to mean “union with the Higher Self” or whatever we designate as sacred or meaningful that is greater than our individual selves. Yoga originated as one of the religious schools of Hinduism. Hinduism is, as Arnold Toynbee described it, the oldest of the six principal surviving “higher religions.” The list includes Hinduism, Judaism, Zoroastrianism, Buddhism, Christianity, and Islam. The higher religions (many would argue whether or not “higher” is a correct description) differed from their predecessors, according to Toynbee, in that their principal purpose was “to enable human beings to enter into a direct personal relation with a trans-human presence in and behind the Universe, instead of being introduced to this ultimate spiritual reality only indirectly, through the medium of the civilization or the pre-civilized society that is the individual’s social setting.”7
Hinduism, Judaism, and Zoroastrianism, the oldest of the principal religions, retained a kind of double line of thinking that straddled the division between sectarian religious thought and universal religious thought: they conceived of God as universal but, according to Toynbee, “they went on thinking of him at the same time as being the peculiar local god of the society or community in which he had originally been worshipped as such .ê.ê. It has never been feasible to be converted to the Hindu, the Jewish or the Zoroastrian religion without at the same time having to become a member of the Hindu, Jewish, or Zoroastrian society.”8
In contrast says Toynbee:
Buddhism, Christianity and Islam have each been–or become–whole-heartedly universalistic. Each of these three religions has set out to convert the whole of Mankind .ê.ê. Each has succeeded in converting whole continents, embracing the regional domains of a number of different civilizations. .ê.ê. This missionary prowess has been the reward of Buddhism’s, Christianity’s and Islam’s relative success in disengaging themselves from the irrelevant legacy of their historical origins. .ê.ê. Unlike Christianity and Islam, Buddhism has usually coexisted amicably with other faiths. It is surely not just a coincidence that Buddhism has been the most successful of the three missionary religions.9
While it is unquestionably correct that Hinduism never extricated itself from its origins, it is also true that Hinduism made space within its bounds for a general tolerance and sometimes endorsement of a remarkable range of religious experiences. But the critical point here–my reason for this digression into the history of religions–is that while Hinduism did not disengage itself from its historical antecedents, yoga did. Yoga as an international psychophysiological discipline and spiritual path to a direct personal relationship with God, Nature, or whatever we choose to call the Greater Reality, detached itself from the historical circumstances of its birth, where its mother religion could not. Yoga went on to become, at least in the teachings of many of its adherents, a profoundly ecumenical approach to spiritual life, which values equally every religion and spiritual path. It does not seek, moreover, to replace the mother religions of its practitioners, but simply to serve as a kind of complementary “operations manual” for achieving higher states of consciousness, thereby enabling the practitioner to appreciate more deeply the teachings of his or her mother religion–and the teachings of the mother religions of all other peoples as well.
Yoga is best known as a set of physical practices that include gentle stretches, breathing practices, and progressive deep relaxation. These physical practices are intended to ready the body and mind for meditation as well as for a meditative perspective on life. These meditative practices also follow a sequence. First developed is the capacity to withdraw the senses from focus on the outer world, then, the capacity to concentrate on a meditative subject–a candle flame, a sacred or uplifting word or image, or the movement of the breath. Finally, and for most of us only occasionally, the concentration leads into a wordless and timeless experience of inner peace. The yoga masters describe various subtleties among these states of inner peace, but most of us, at best, achieve moments of this experience from time to time.
Yoga also includes, for those who wish to go beyond the physical and meditative practices, a set of ethical imperatives similar to the Ten Commandments and the moral precepts of the other great spiritual traditions, as well as a set of recommendations for clean and healthy living. Finally, yoga offers a set of spiritual scriptures including the Bhagavad Gita,10 perhaps the greatest of Hindu spiritual texts, and Patanjali’s Yoga Sutras, which are specifically devoted to the description of yoga. The Yoga Sutras begin with the statement that “Yoga is the stilling of the mind-stuff.” Patanjali then explains that when the mind-stuff is quiet, the busy images and concepts with which we identify our “selves” subside and we can recognize the true inner self, the place from which we watch (and mistakenly identify ourselves with) the busy activities of our daily lives.11
One of the greatest sutras (sutra means “string of thought”) introduces the third book of the Yoga Sutras. Patanjali writes: “The acceptance of pain as an aid to purification, the study of great scriptures, and complete surrender to the divine being constitute yoga in practice.”12 This idea, that pain is an aid in purification, is central, Aldous Huxley believed, to the perennial philosophy of all the great spiritual traditions. It is a difficult concept to embrace, but for anyone facing pain and illness, one well worth contemplating.
Another aspect of yoga deeply related to healing is its recognition that every person has his own personal way to self-realization (or healing), but that there are some major highways of the spirit that have proved useful to accelerating these inner processes. Hatha yoga, for example, represents the physical poses, breathing, and related practices: some people need a major emphasis on these physical practices to heal. Karma yoga is the yoga of work: healing is achieved by working in the world–through art, through service, through education or an exciting or worthwhile business–with full commitment to the work but without any personal attachment to praise or blame for the outcome. Bhakti yoga is the yoga of achieving inner peace or healing by emotional devotion to God or a spiritual teacher: this is the path of passionate devotion and prayer. Jnana yoga is the yoga of achieving inner peace or healing through wisdom, through understanding scriptures and spiritual teachings: this is the way of the person who absorbs books, audiotapes or videotapes, and information, and who seeks to move from information to understanding to wisdom to the transcendence of mind by the power of mind. Raja yoga is the yoga that integrates these and other forms of yoga as a balanced whole: raja yoga means the “kingly yoga,” and the name is a recognition that the yoga that integrates, according to the individual’s needs, physical practices, work practices, prayer and devotion, and wisdom, is the greatest yoga–or path to union–of all. The recognition that different people are psychophysiologically and culturally suited to different paths to self-realization is one of the most fundamental precepts of yoga.13
The specific relevance of yoga and meditation to cancer patients is clear and profound. Inasmuch as the physical, mental, and spiritual practices of yoga that lead to inner transformation can help us heal at many levels, the cancer patient is advised by the most fundamental teachings of yoga that there is no single right way to do this. The Bible contains many similar scriptural admonitions: “In my Father’s house are many rooms .ê.ê.”14 Yoga is simply one of the clearest statements of the fundamental ecumenicism of this perennial truth. Meditation, common to virtually all religious and spiritual traditions, teaches us the profound benefits of sitting still.
Shamanism and the Perennial Philosophy of Healing
In societies all over the world, the ancient human art of guiding sick people through life-threatening illness, either back to recovery or through the dying process, has through the millennia of human history been conducted by medicine men and women known as shamans. Shamanism has more recently become something of a fad in holistic healing circles. Purists decry the abuses and romanticism of this modern neoshamanism; advocates celebrate its contribution to the understanding of healing. The abuses are real, but I will focus on the benefits of the neoshamanic metaphor.
Scholars of shamanism, such as Micrea Eliade and Michael Harner, have noted the striking similarities of shamanism in otherwise wholly dissimilar tribes and cultures. Harner came to the conclusion that the central healing traditions of shamanism were–like the incest taboo–among the very few human teachings that are culturally invariant. He suggested that shamanism was, perhaps, culturally invariant because, as a human response to illness, shamanism was somehow rooted in a bedrock of human experience. The shamans were not only healers of the sick. They were also spiritual leaders. So the fact that shamanism was to a surprising degree culturally invariant leads us back to the idea of a common core in all spiritual traditions.
What were some of the elements at the core of shamanism? One of the deepest teachings of shamanic healers was that the shaman, in order to be of the greatest possible assistance to the patient, should be less concerned with the maintenance of physical health and more concerned with safeguarding the patient’s soul. The shaman went into trance and ventured down into the underworld to see if he could find the secret to helping this soul that had become lost, or that had–as Rachel Naomi Remen has so beautifully put it–entered into the illusion of having become lost. The shaman was there to help bring the soul back into this life, if that was God’s will, or, if this life were passing, to conduct the soul safely into the next world.
How similar this shamanic teaching–to safeguard the soul above all–is to one of the central traditions of what Huxley called the perennial philosophy at the heart of all spiritual traditions. In Christianity, this teaching says: “Seek ye first the kingdom of God, and everything else will be added unto you.” And how fundamentally similar this shamanic teaching is to the most important insight of psychotherapists who work with cancer: that if, as Lawrence LeShan says, the patient looks for his own “unique song,” his own unique way of being in the world–if the patient is true to his deepest self, which is to say his soul–he may maximize his potential for physical survival.15
So shamanism, the perennial philosophy, and contemporary wisdom on healing seek to help the physician, patient, and family create the conditions under which whatever healing is possible–physical, emotional, mental or spiritual–may take place. And if physical recovery is no longer possible, the search for the spiritual heart of life may extend life or bring a peaceful and dignified death.
It is interesting to contrast the shamanic tradition of healing with contemporary medical care. The shaman had no modern medical tools. But he understood that, in the face of illness, the inner healing force was at its strongest when the patient was attended by an experienced spiritual midwife–someone familiar with, and unafraid of, the frontier between life and death. The shaman was, as we have seen, almost always one who had been near death himself. His lack of fear, his hope for the possibility of recovery, his certainty that the journey through the portals of death could be taken safely, his capacity to communicate with powers that maximized the chances for recovery–all of these things made the patient feel safe and cared for, come what may.
The modern medical doctor, equipped with every instrument for technical care, usually has not been trained as a shaman. More often than not, he has not been near death himself. He is often afraid of death; it is something he may not have explored. Frequently, he feels obliged not to reinforce hopes for recovery so that the patient “doesn’t develop false hopes.” He feels ill-equipped to communicate with the deep inner powers. Recruited for his skills in mathematics and science, he is commonly unfamiliar with the world in which the patient with serious illness lives. And frequently, he feels that the death of a patient is a personal and professional failure on his part.
Shamanism and the Archetype of the Wounded Healer
A physical wound naturally evokes the physical healing response. But some physical wounds, as well as some emotional and spiritual wounds, are so deep that they evoke psychospiritual, as well as physical, healing responses. Cancer is often such a wound.
The ancient shamans were, almost without exception, people who became shamans as a result of life-threatening illnesses. In the course of coming to the frontier between life and death, they arrived at a state of awareness in which it became clear to them that, if they recovered, they would devote the rest of the life that they had been given to helping others traveling the same perilous passage. They lost all fear of death; they were unafraid in the presence of death; and it was, in part, this fearlessness that prepared them to help others to fight for life when the margins were thin.
The psychoanalytic pioneer C.G. Jung considered shamans to be representative of one of the greatest archetypes of human experience. He called this archetype the “wounded physician” of Greek myth. “It is his own hurt that gives the measure of his power to heal.”16 This archetype is now widely known as the “wounded healer.”
Rachel Naomi Remen suggests that many of us have within us the capacity to be wounded healers. The wound in us–and we are all at some level wounded–evokes the healer in those who care about us. The wound in those we care for evokes the healer in us. “My wound evokes your healer. Your wound evokes my healer. My wound enables me to find you with your wound where you have the illusion of having become lost,” she says.
It is certainly a common experience of cancer patients who attend the Commonweal Cancer Help Program that they have had their own versions of the shamanic awakening. Their experiences with cancer have often led them into deep places and encounters with the ultimate realities of life that they never experienced before. Some refer to these encounters as “the gift” of the cancer experience. Many come away from these encounters with a certainty that, if they recover, they want to devote at least a part of their time to helping others with cancer.
In reality, I believe it is an illusion to think that you have to recover from cancerêto offer others spiritual assistance. The healing that takes place among people with ongoing cancer is often beyond any words. It is not an accidentêthat some of the deepest healing work in the course of the week-long Cancer Help Programs is not initiated by the staff but takes place among theêparticipants. Many people come to the Cancer Help Program saying that their primary reason for being there is to be with others who are “in the same boat.” They instinctively recognize how healing it would be for them to be able to share their experience of cancer with others who are having a similar experience.
The Creative Force in Illness
Many have recognized the creative role of illness in helping us find our true selves–in moving us forward on our life paths. A little known biographical work called Creative Malady by George Pickering describes the essential role of illness in forming or consolidating the lifework of Charles Darwin, Florence Nightingale, Marcel Proust, and others. The wound in each evoked the special genius of the life force. “He was cracked,” Dame Edith Sitwell once said of William Blake, “but it was through the crack that the light came through.” A wound, Rachel Naomi Remen reminds us, is also an opening.
The role of illness and suffering in spiritual growth is one of the central teachings of the perennial philosophy. The diaries of early Christian saints record that they welcomed suffering for its known benefits for spiritual clarification. This dual nature of painful events–as both causes of suffering and also possible deliverers of great wisdom–is noted by Howard Brody, M.D., when he says that “suffering is produced, and alleviated, primarily by the meaning that one attaches to one’s experience.”17
In modern Western civilization, we often see only the obvious negative side of pain and suffering. We have forgotten the ancient teachings about their possible benefits. Most of the great spiritual traditions emphasize that you need not seek out pain and suffering. In fact, they counsel that “the wise learn by observation, the rest by experience.” So, if you have the wisdom and the discipline, you can avoid a great deal of needless pain. But even if you avoid needless pain, pain and suffering will still come. If the benefits of pain seem hypothetical or even ridiculous to you, ask yourself whether you have learned the most and grown the most during the easy times in your life, or whether the quantum leaps toward self-discovery have taken place in times of adversity. Most of us recognize that it is in adversity that we tend to grow most quickly.
“Illness,” someone said, “is the meditation of Western man.” Another way to put it is that, in a society that has forgotten how to meditate while healthy, many people are guided to deep contemplation of the meaning of life only by illness.
Healing and the Sense of Connection
Many of the elements of spirituality as it relates to healing–the search for “union” in yoga, the wisdom of the shaman, and the bedrock of truth of the perennial philosophy–are summed up by Joan Borysenko, Ph.D., a cell biologist and author of Minding the Body, Mending the Mind.18 Borysenko is in the forefront of biologists and psychologists whose work is converging with that of healers from the spiritual traditions. She maintains that healing is fundamentally about connectedness–connectedness with our deepest nature, with other humans in community, or with the transpersonal realities. Such moments of connectedness–whether attained through meditation, inspiration, or human intimacy–are what Abraham Maslow calls “peak experiences.” These are, according to Borysenko, moments of profound peace and healing, both emotionally and physically.
Borysenko maintains that we fall away from the sense of deeper connection in our day-to-day lives by identifying with a “false self,” resulting in feelings of isolation, loneliness, and unworthiness. After being born into this world as “balls of radiance,” we gradually abandon parts of ourselves to the “shadow self” that Jung describes, in the belief that we need to do so in order to gain the love and acceptance that, as children, we needed above all else. We come to identify with the false self which we feel will be more acceptable to those we depend upon for love and care. The false self isolates us not only from other people, but from our own authentic natures as well. In doing so, it stands in the way of our true healing.
So the healing process, according to Borysenko, is in large part the rediscovery of our connection with self, with community, and with the transpersonal. At same time, healing involves disidentification with the false self. Times of adversity and serious illness can also be times of great personal growth because the false self and its way of being in the world serve us so poorly in times of difficulty. With little energy to spare, we realize the true difficulty of maintaining the artificial facade. In turn, the necessity to accept who we really are can open us to the healing power of connectedness.19
Results obtained in studies of more routine levels of social contact and measures of physical well-being provide a glimpse of the significance of profound connection. In a series of studies with rabbits in 1977 and 1978, Robert Nerem and colleagues at the University of Houston demonstrated that the social environment of the animals had a dramatic effect on diet-induced aortic atherosclerosis. Animals that were regularly handled, stroked, talked to, and played with had significantly lower levels of arterial disease than controls. Though the authors did not speculate about the possible mechanisms responsible for this effect, they did point out that the magnitude of the result was large enough that careful consideration must be given to social factors in the design of future studies of atherosclerosis interventions.20
Conversely, human studies show that feelings of isolation and loneliness have a detrimental effect on physical well-being, as measured by immune function. Ronald Glaser at the Ohio State University College of Medicine found in a study with medical students that those who scored high on the UCLA Loneliness Scale displayed significantly higher levels of immunosuppression as measured by changes in antibody levels in response to herpesvirus compared with students who scored low in the scale.21 Similarly, Janice K. Kiecolt-Glaser at the Department of Psychiatry at Ohio State University found that among students who scored high on the UCLA Loneliness Scale, significantly higher levels of Epstein-Barr viruses were required to transform B lymphocytes into plasma cells, which in turn make and secrete antibodies.22
One can think about the data reported in the preceding section in either psychological or spiritual terms. There are no assumptions of any special “spiritual” energy or force in those studies. But at the start of this chapter we identified the question of whether spiritual energies exist as one of the divisive issues that this field raises.
In chapter 18, we review the extraordinary literature on Therapeutic Touch and report that researchers have found that a practitioner trained in this technique can raise hemoglobin levels without touching the patient. Even more remarkable, working under randomized blind conditions, a researcher showed that Therapeutic Touch could make experimental wounds heal faster than controls. This and a series of other studies of the capacity of healers to affect growth of plants, healing in animals, and enzyme activities in laboratory solutions, point to the existence of energies we do not yet know how to measure. As Aldridge sums up the situation: “Most of the studies have fallen by the wayside because of poor research design. Nonetheless, there appears to be material evidence for an intentional healing effect. At the same time it must be said that the energetic correlates of that effect remain elusive to measurement in both the laboratory and the clinic.”23
Can prayer by others reverse or mitigate physical illness? The most frequently cited research study on this subject was carried out by Randolph Byrd, M.D., at San Francisco General Medical Center in 1982-83. Byrd wanted to determine whether intercessionary prayer–prayer for a patient by others–made any measurable difference in outcomes in the coronary care unit where he worked. The results of the study, entitled “Positive Therapeutic Effects of Intercessionary Prayer [IP] in a Coronary Care Unit Population,” was published in the Southern Medical Journal in July 1988.
Byrd enrolled a total of 393 patients in his study–192 in the intervention group and 201 in the control group. The patients were watched over a 10-month period from August 1982 to May 1983. Byrd had asked all 450 patients who came through the coronary care unit over the 10-month period to participate. Fifty-seven (14.5%) patients declined. The patients who enrolled were told the purpose of the study and signed informed consent forms. They were then randomly assigned to the study group or the control group. Byrd then chose “intercessors” who were “born again Christians (according to the Gospel of John 3:3) with an active Christian life.” These Christians, who were to pray for the participants in the study group, were randomly assigned a patient for whom they prayed daily.
Byrd found that six conditions improved significantly more for the study group than for the control group. They were (1) the need for intubation or ventilation, (2) the need for antibiotics, (3) the incidence of cardiopulmonary arrest, (4) the incidence of congestive heart failure, (5) the incidence of pneumonia, and (6) the need for diuretics. There was a general tendency for the study group–those who were prayed for–to have better physical outcomes than those who were not prayed for.24
The study was summarized as follows in the Journal of the American Medical Association:
The therapeutic effects of intercessionary prayer (IP) to the Judeo-Christian God, one of the oldest forms of therapy, has had little attention in the medical literature. To evaluate the effects of IP in a coronary care unit population, a prospective, randomized, double-blind protocol was followed. .ê.ê. While hospitalized, the [study] group received IP by participating Christians praying outside the hospital; the control group did not. An .ê.ê. analysis revealed no statistical difference between the groups. After entry, all patients had follow-up for the remainder of admission. The IP group subsequently had a significantly lower severity score (P < .01). Multivariate analysis separated the groups on the basis of outcome variables (P < .0001). The control patients required ventilatory assistance, antibiotics, and diuretics more frequently than patients in the IP group. These data suggest that IP to the Judeo-Christian God has a beneficial therapeutic effect in patients admitted to a coronary care unit.25
This study appears to me to be one of the most important–if not the most important–empirical study of prayer ever to be undertaken. I do not regard the study as conclusive. The question is far too important to be assessed with a single study. Byrd’s study should be replicated and prayer studied in many different ways.
It would have been far less surprising if a study had shown that patients who pray for themselves had better outcomes. Although this would be an important and powerful finding–and such studies should be done–it could be explained as a simple placebo effect. However, Byrd’s finding that patients with a life-threatening illness who were prayed for by others did significantly better under randomized, controlled, double-blind conditions is a far more provocative finding in terms of our basic belief systems. There are only four or five possible explanations: (a) the data were not correctly reported, (b) the data were correctly reported but not correctly analyzed, (c) the data were correctly analyzed but represented a fluke (against high odds!) and the findings would not be replicated by other studies, (d) the study demonstrates that transpersonal healing effects can be obtained by “intercessors” with a strong Judeo-Christian healing belief system, but “God” has nothing to do with it, or (e) the study demonstrates that transpersonal healing effects can be obtained by “intercessors” with a strong Judeo-Christian belief system and points to the transpersonal reality called “God.” Explanations (d) and (e) may be essentially equivalent.
Aldridge comments as follows on the Byrd study and the frequency with which it is cited in the Advances symposium on spiritual healing:
We see a touching faith in science in the way in which several commentators have echoed my example of the Byrd study (1988). While the study is well constructed, and a fine example of medical research that highlights a healing phenomenon itself defying modern science, it is based on statistical inferences that are essentially flawed, or at least, open to interpretation. Belief in mathematic abstraction is an act of faith.26
If Byrd’s findings are correct and replicable under different conditions, they represent in my judgment an advance in medicine of the greatest importance; and in terms of empirically demonstrable outcomes, the convergence of the technologies of biomedicine and the technologies of the sacred. I assume, for example, that prayers to God in His or Her many other forms would be equally efficacious. But if Byrd’s findings cannot be replicated, that does not disprove the significance of intercessionary prayer. Rather, it could indicate that the results achieved by intercessionary prayer cannot be counted by anyêempirical calculus: that what we achieve by intercessionary prayer is tooêuniquely individual in terms of improved outcomes to be researched in this way.
Aesthetically and intuitively, it is not obvious to me that the efficacy of prayer should in principle be scientifically demonstrable. Or, if its efficacy is partially demonstrable, we should bear in mind what a tiny proportion of the benefits of prayer may be demonstrated. For prayer, like love, like creativity, like dedication to a life of service, is one of the great paths into the life of the spirit. If, 10 years from now, a review article finds that intercessionary prayer made an average contribution of approximately 15% to 25% in improvements in selected measurable outcomes for a wide range of health conditions, we would have to consider the possibility that the result might be the smallest glimpse of the true significance of prayer.
It should be noted, however, that an agnostic could accept the possible reality of healing phenomena such as those associated with intercessionary prayer or Therapeutic Touch, and the possible explanation that undiscovered energies of some kind account for these phenomena, without accepting any of the metaphysical explanations that the spiritually or religiously inclined use for these phenomena. The same would even be true if the existence of energetic bodies, as described in many religious and spiritual traditions from around the world, were identified surrounding the human body. Scientists could go a long way down the road of demonstrating the reality of various psychic and energetic phenomena that appear in religious and spiritual accounts without changing the fundamental terms of the debate over whether there is meaning and purpose in the universe or not.
Different Approaches to Prayer
“More things are wrought by prayer than this world dreams of,” wrote Alfred Lord Tennyson. Reasonable people differ on whether or not this is true. But for those who have cancer and are exploring prayer for the first time, I offer some examples of the rich variety of prayers related to healing.
The simplest and most obvious prayer is a request to God that the adversity end and that one be restored to health. Such prayers often involve “affirmations.” There is a considerable psychological literature on the healing power of affirmations, and many cancer patients use them. Here is a beautiful Navajo prayer that uses affirmation:
O you who dwell
In the house made of the dawn,
In the house made of the evening twilight …
Where the dark mist curtains the doorway,
The path to which is on the rainbow ….
I have made your sacrifice.
I have prepared a smoke for you.
My feet restore for me.
My limbs restore for me.
My body restore for me.
My mind restore for me.
My voice restore for me.
Today, take away your spell from me.
Away from me you have taken it.
Far off from me you have taken it.
Happily I recover.
Happily my interior becomes cool.
Happily my eyes regain their power.
Happily my head becomes cool.
Happily my limbs regain their power.
Happily I hear again.
Happily for me the spell is taken off.
Happily I walk.
Impervious to pain, I walk.
Feeling light within, I walk ….
In beauty I walk.
With beauty before me, I walk.
With beauty behind me, I walk.
With beauty below me, I walk.
With beauty all around me, I walk.
It is finished in beauty.
It is finished in beauty.
It is finished in beauty.27
A prayer by an American Confederate soldier seriously disabled in the Civil War is a beautiful example of the depths of discovery of the gifts of suffering that a wound can bring:
I asked God for strength, that I might achieve,
I was made weak, that I might learn humbly to obey.
I asked for health, that I might do great things,
I was given infirmity, that I might do better things.
I asked for riches, that I might be happy,
I was given poverty, that I might be wise.
I asked for power, that I might have the praise of men,
I was given weakness, that I might feel the need of God.
I asked for all things, that I might enjoy life,
I was given life, that I might enjoy all things.
I got nothing that I asked for–but everything I had hoped for.
Almost despite myself, my unspoken prayers were answered.
I am, among all men, most richly blessed.28
One of the most powerful and most universal of all forms of prayer is a prayer seeking to be awakened to the inner light. Lao-tzu wrote:
See the small and develop clear vision.
Practice yielding and develop strength.
Use the outer light to return to the inner light,
And save yourself from harm.29
An Inuit Indian who had known adversity wrote this:
I think over again my small adventures,
Those small ones that seemed so big,
For all the vital things
I had to get and reach.
And yet there is only one great thing,
The only thing,
To live to see the great day that dawns
And the light that fills the world.30
“The Lord is my light and my salvation; whom shall I fear?” begins a psalm of David. Many prayers and visualizations of healing involve surrounding yourself, or the person you pray for, with light. Reading prayers from around the world develops our knowledge of how fundamental prayer has been to human experience.
Spirit and spirituality are meaningful categories of experience for me. But I have family members and friends for whom the categories are without meaning, and they seem to me every bit as “spiritual” as those for whom these categories have meaning.
We live in a time in which concepts of spirituality are becoming more and more popular in many parts of American culture. While this increasing popularity of spirituality may bring benefits for some, religious and spiritual revivals have historically been a sharp and double-edged sword. For spiritual and religious revivals have great collective psychic power that invites corruption and abuse, and may attenuate the collective commitments to reason, tolerance, and law that Western civilization developed at such great cost as an antidote to the religious and spiritual passions of the past.
So my friends for whom spirit and spiritual are not useful categories have a strong case that they can make with respect to the dangers of the spiritual perspective, just as I, acknowledging the dangers, also see its value. If spirit is what unites us, then true spirit must embrace equally these two ancient antipodes of human experience. Thus any spirituality that divides us is too far along the track toward religious sectarianism for my personal taste.
We have seen that the experience of cancer opens many people up to spiritual experience in ways that were often completely unexpected. But there are others for whom cancer brings no such opening to spiritual experience. They must be equally–not grudgingly–honored. Are they missing something?
If a person for whom spirit has no meaning experiences himself as missing something–if he feels that he would like to open himself to spiritual experience but cannot–that is one thing. It is legitimate to help him try to find what he feels he is missing. But often such a person feels no sense of missing something. To the contrary, he may be actively deepening his connection to another one of the great pathways to the highest meanings in life. Skepticism, said Santayana, is the chastity of the intellect. That chastity–that integrity–may have been a lifelong friend for a lover of nature, family, friends, art, music, science, reason, or animals. Someone who sees mind as an epiphenomenon of the brain and nothing more; who sees humanity as a lonely species in the universe finding only such meaning as it assigns to its journey; and who values the courage to face these realities without what he regards as the narcotic comforts of religion or spirituality–such a man or woman is, for me, as close to spirit as I am.
Whether spirit has meaning beyond the psychological and social significance we assign to it is one of the greatest questions of our time. I believe it does. Watching the opening of many people with cancer to spirit and spirituality in their lives has strengthened that belief. But I have watched others, equally “spiritual,” live and face death without any wish to move toward the use of spiritual language or categories. The spirit to which I pay homage is the one that equally embraces us all.
Notes and References
1 This chapter owes a special debt to Rachel Naomi Remen, M.D., because my thinking about healing and spirituality has borrowed so much from her lifetime study of this question.
2 Max Lerner, Wrestling with the Angel (New York: Touchstone, 1990), 109.
3 David Aldridge, “Is There Evidence for Spiritual Healing?,” Advances 9(4):4 (1993).
4 J. Hiatt, “Spirituality, Medicine and Healing,” Southern Medical Journal 79(6):b 736-43, quoted in Aldridge, ibid., 5.
5 Lotus Prayer Book (Buckingham, VA: Integral Yoga Publications, 1986), 189.
6 Hugh Prather and Gerald Jampolsky, foreword to Arnold R. Beisser, Flying Without Wings: Personal Reflections on Loss, Disability, and Healing (New York: Bantam Books, 1990), vii.
7 Arnold Toynbee, A Study of History [illustrated abridged] (New York: Weathervane Books, 1972), 333.
9 Ibid., 336.
10 Sri Swami Satchidananda, The Living Gita: The Complete Bhagavad Gita (Buckingham, VA: Integral Yoga Publications, 1988).
11 Sri Swami Satchidananda, Integral Yoga: The Yoga Sutras of Patanjali (Buckingham, VA: Integral Yoga Publications, 1988), 3-7.
12 Ibid., 93.
13 Swami Rama, Lectures on Yoga (Honesdale, PA: The Himalayan International Institute of Yoga Science and Philosophy, 1979), 10-12.
14 John 14:2.
15 Lawrence LeShan, Ph.D., Cancer as a Turning Point: A Handbook for People with Cancer, Their Families, and Health Professionals (New York: E.P. Dutton, 1989), 22.
16 C.G. Jung, The Practice of Psychotherapy: Essays on the Psychology of the Transference and Other Subjects translated by R.F.C. Hull, Bollingen Series XX, The Collected Works of C.G. Jung, volume 16, edited by William McGuire, et al. (Princeton, NJ: Princeton University Press, 1966), 116.
17 Howard Brody, Stories of Sickness (New Haven: Yale University Press, 1987), 5.
18 Joan Borysenko, Minding the Body, Mending the Mind (Reading, MA: Addison-Wesley Publishing Company, Inc., 1987).
19 Joan Borysenko, Jean Waldman Memorial Lecture, University of California, San Francisco, 26 November 1990.
20 Robert M. Nerem, Murina J. Levesque, and J. Fredrick Cornhill, “Social Environment as a Factor in Diet-induced Atherosclerosis,” Science 208(27 June):1475-6 (1980).
21 R. Glaser, “Stress, Loneliness, and Changes in Herpesvirus Latency,” Journal of Behavioral Medicine 8(3):249-60 (1985).
22 J.K. Kiecolt-Glaser, “Stress and the Transformation of Lymphocytes by Epstein-Barr Virus,” Journal of Behavioral Medicine 7(1):1-12 (1984).
23 Aldridge, op. cit., 15.
24 Randolph C. Byrd, “Positive Therapeutic Effects of Intercessionary Prayer in a Coronary Care Unit Population,” Southern Journal of Medicine 81(7):26-9 (1988). For critical review, see Kent Harker, “Onward Christian Healers,” Basis: Bay Area Skeptics Information Sheet 8(July 1989). For positive review, see “Cardiologist Studies Effect of Prayer on Patients,” Brain-Mind Bulletin 11(25 March 1986).
25 Byrd. Abstracted in Journal of the American Medical Association 261(3):372 (1989).
26 Aldridge, op. cit., 83.
27 Lotus Prayer Book, 95-6.
28 Ibid., 7.
29 Ibid., 26.