prayer healing a case study research protocol

Prayer Healing: A Case Study Research Protocol

PMID: 28987036

Context • Prayer healing is a common practice in many religious communities around the world. Even in the highly secularized Dutch society, cases of prayer healing are occasionally reported in the media, often generating public attention. There is an ongoing debate regarding whether such miraculous cures do actually occur and how to interpret them. Objective • The aim of the article was to present a research protocol for the investigation of reported cases of remarkable and/or unexplained healing after prayer. Design • The research team developed a method to perform a retrospective, case-based study of prayer healing. Reported prayer healings can be investigated systematically in accordance with a step-by-step methodology. The focus is on understanding the healing by studying it from multiple perspectives, using both medical judgment and patients' narratives collected by qualitative methods Setting • The study occurred at Vrije Universiteit (VU) and VU Medical Center (Amsterdam, Netherlands) as well as the general medical practice of the first author. Participants • Potential participants could be any individuals in the Netherlands or neighboring countries who claim to have been healed through prayer. The reports of healing came from multiple sources, including the research team's medical practices and their direct vicinities, newspaper articles, prayer healers, and medical colleagues. Outcome Measures • Medical data were obtained before and after prayer. Subsequently, a member of a research team and of a medical assessment committee made a standardized judgment that evaluated whether a cure was clinically remarkable or scientifically unexplained. The participants' experiences and insider perspectives were studied, using in-depth interviews in accordance with a qualitative research methodology, to gain insight into the perceptions and explanations of the cures that were offered by participants and by the members of the medical assessment committee. The medical findings and participants' experiences were weighed and interpreted based on a transdisciplinary framework, including biopsychosocial and theological perspectives, with reference to a conceptual framework derived from Ian Barbour's typology of positions in the science-religion debate. Conclusion • A case-based, research study protocol that compares medical and experiential findings and that interprets and structures those findings with reference to Ian Barbour's conceptual model is an innovative way of gaining deeper insight into the nature of remarkable and/or unexplained cures.

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Prayer Healing: A Case Study Research Protocol

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APH - Societal Participation & Health (VUmc)

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Prayer and healing: A medical and scientific perspective on randomized controlled trials.

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Andrade C 1

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Radhakrishnan R | 0000-0002-8220-655X

Indian Journal of Psychiatry , 01 Oct 2009 , 51(4): 247-253 https://doi.org/10.4103/0019-5545.58288 PMID: 20048448 PMCID: PMC2802370

Abstract

Free full text , prayer and healing: a medical and scientific perspective on randomized controlled trials, chittaranjan andrade.

Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore - 560 029, India

Rajiv Radhakrishnan

1 Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore - 560 029, India

Religious traditions across the world display beliefs in healing through prayer. The healing powers of prayer have been examined in triple-blind, randomized controlled trials. We illustrate randomized controlled trials on prayer and healing, with one study in each of different categories of outcome. We provide a critical analysis of the scientific and philosophical dimensions of such research. Prayer has been reported to improve outcomes in human as well as nonhuman species, to have no effect on outcomes, to worsen outcomes and to have retrospective healing effects. For a multitude of reasons, research on the healing effects of prayer is riddled with assumptions, challenges and contradictions that make the subject a scientific and religious minefield. We believe that the research has led nowhere, and that future research, if any, will forever be constrained by the scientific limitations that we outline.

“More things are wrought by prayer Than this world dreams of.”

“Faith can move mountains.”

AUTHORS' PREFACE

This is a serious scientific article that examines conceptual and methodological issues underlying randomized controlled trials on prayer and healing. We do not intend to belittle any religion or the religious practices of those who pray, nor do we deny the medical and psychosocial benefits that have been identified to result from religious affiliations and practices.[ 1 ]

INTRODUCTION

Religious practices have been associated with healing for millennia. People pray for good health and for relief from illness. Prayer may result in health and healing through one or more of several mechanisms. We briefly consider these mechanisms.

MECHANISMS OF HEALING THROUGH PRAYER

Prayer is a special form of meditation and may therefore convey all the health benefits that have been associated with meditation

Different types of meditation have been shown to result in psychological and biological changes that are actually or potentially associated with improved health. Meditation has been found to produce a clinically significant reduction in resting as well as ambulatory blood pressure,[ 2 , 3 ] to reduce heart rate,[ 4 ] to result in cardiorespiratory synchronization,[ 5 ] to alter levels of melatonin and serotonin,[ 6 ] to suppress corticostriatal glutamatergic neurotransmission,[ 7 ] to boost the immune response,[ 8 ] to decrease the levels of reactive oxygen species as measured by ultraweak photon emission,[ 9 ] to reduce stress and promote positive mood states,[ 10 ] to reduce anxiety and pain and enhance self-esteem[ 11 ] and to have a favorable influence on overall and spiritual quality of life in late-stage disease.[ 12 ] Interestingly, spiritual meditation has been found to be superior to secular meditation and relaxation in terms of decrease in anxiety and improvement in positive mood, spiritual health, spiritual experiences and tolerance to pain.[ 13 ]

Prayer may be supported by varying degrees of faith and may therefore be associated with all the benefits that have been associated with the placebo response

Clinically significant treatment gains have been observed with placebo in numerous disorders, including anxiety, depression, schizophrenia, obsessive-compulsive disorder, tardive dyskinesia, ischemic heart disease, cardiac failure, Parkinson's disease and even cancer, among a host of other conditions.[ 14 – 20 ] Relevant to the context of prayer and healing, the placebo response is influenced by personality traits and behaviors such as optimism,[ 21 , 22 ] response expectancy,[ 23 ] motivational concordance (i.e., the degree to which the behavioral rituals of the therapy are congruent with the motivational system of the subject)[ 24 ] and degree of engagement with a ritual.[ 25 ]

Prayer may be associated with improvements that result from spontaneous remission, regression to the mean, nonspecific psychosocial support, the Hawthorne effect and the Rosenthal effect

Spontaneous remission is well known to occur in conditions that range from medical disorders (e.g., coryza and pharyngitis) to psychiatric states (e.g., depression and mania). Regression to the mean describes improvement that occurs as a result of random fluctuation in the severity of illness; in clinical trials, because patients are usually preselected for greater severity of illness, such fluctuations usually occur in only one direction (i.e., toward improvement).[ 26 ] Nonspecific emotional support provides psychological benefits through interpersonal contact, such as during diagnostic and rating exercises. Nonspecific support can reduce anxiety, depression, pain and similar constructs.

Spontaneous remission and regression to the mean may occur coincidental to prayer. Nonspecific psychosocial support related to prayer may arise in group prayer settings. Improvements in all these contexts are true improvements. In contrast, in randomized controlled studies on the efficacy of prayer as a treatment, rated improvements that are not true improvements may also occur; explanations for such improvement include the Hawthorne effect and the Rosenthal effect. The Hawthorne effect refers to change that occurs as a result of the act of observation or measurement,[ 27 , 28 ] whereas the Rosenthal effect refers to change resulting from observer or rater expectancy.[ 29 ] With regard to the former, the comforting environment of the study setting or the conscious or unconscious wish of the patient to please may result in the report of less symptoms than actually exist. With regard to the latter, the tendency of the rater to expect symptom attenuation across time may result in the attachment of lower significance to reported symptoms.

Prayer may result in benefits that are due to divine intervention

Although the very consideration of such a possibility may appear scientifically bizarre, it cannot be denied that, across the planet, people pray for health and for relief of symptoms in times of sickness. Healing through prayer, healing through religious rituals, healing at places of pilgrimage and healing through related forms of intervention are well-established traditions in many religions.

DIVINE INTERVENTION AS A MECHANISM OF HEALING THROUGH PRAYER

Meditation, the placebo response, regression to the mean, the natural course of various illnesses, nonspecific emotional support, the Hawthorne effect and the Rosenthal effect have all been studied. What about divine intervention as a mechanism of recovery of health through prayer? This has also been seriously investigated.

Astin et al. [ 30 ] conducted a systematic review of the literature on the efficacy of any form of distant healing as a treatment for any medical condition. A total of 23 trials involving 2,774 patients met the inclusion criteria and were subjected to analysis. Of these studies, 13 (57%) yielded statistically significant treatment effects favoring distant healing, nine showed no superiority of distant healing over control interventions and one showed a negative effect for distant healing. The methodological limitations of many of the studies, however, made it difficult to draw definitive conclusions about the efficacy of distant healing. Of note, Astin et al. [ 30 ] defined distant healing to include spiritual healing, prayer, and any form of healing from a distance, effected as a conscious act that seeks to benefit another person. Therapeutic touch and Reiki were both included in the definition; as both of these may elicit an expectancy response,[ 31 ] it becomes even harder to draw definitive conclusions about the literature that Astin et al. [ 30 ] examined.

In another systematic review, Crawford et al. [ 31 ] examined the quality of studies of hands-on healing and distance healing that were published between 1955 and 2001. There were 90 identified studies of which 45 had been conducted in clinical settings and 45 in laboratory settings. Crawford et al. [ 31 ] reported that 71% of the clinical studies and 62% of the laboratory studies reported positive outcomes; and that the overall internal validity for the studies on distance healing was 75% for the clinical investigations and 81% for the laboratory investigations. Major methodological problems of the identified studies were an inadequacy of blinding, dropped data in laboratory studies, unreliability of outcome measures, infrequent use of power estimations and confidence intervals, and lack of independent replication.

In the present article, we present a purposive, qualitative review of the scientific literature on possible paranormal healing through prayer. We then critically evaluate the scientific and religious implications of such research.

MATERIALS AND METHODS

The currently accepted gold standard for the investigation of the efficacy of medical interventions is the double-blind, randomized controlled trial. Most recent studies on prayer and healing have adopted this design. In such studies, commonly, a group of intercessors prays for the health of patients who are randomized to the intervention group. These patients do not know that they are being prayed for, and the persons who are praying do not come in contact with the patients for whom they pray. Medical outcomes in these patients are compared with outcomes in patients randomized to the control group who are not prayed for. Finally and importantly, the medical treatment team is also blind to the prayer group status of individual patients. Thus, these studies are triple-blind.

In this purposive review, we illustrate the nature of the research in the field by presenting one human and one nonhuman study on improved outcomes associated with prayer, one study showing no difference between prayer and control conditions, one study showing worse outcomes with prayer and one study suggesting that prayer may have a retrospective healing effect. We then provide a detailed, critical evaluation of the scientific and theological implications of such research.

Improved outcomes associated with prayer

Cha et al. [ 32 ] studied 219 consecutive infertile women, aged 26-46 years, who were treated with in vitro fertilization embryo transfer in Seoul, South Korea. These women were randomized into distant prayer and control groups. Prayer was conducted by prayer groups in the USA, Canada and Australia. The patients and their providers were not informed about the intervention. The investigators, and even the statisticians, did not know the group allocations until all the data had been collected. Thus, the study was randomized, triple-blind, controlled and prospective in design.

Cha et al. [ 32 ] found that the women who had been prayed for had nearly twice as high a pregnancy rate as those who had not been prayed for (50 vs. 26%; P <0.005). Furthermore, the women who had been prayed for showed a higher implantation rate than those who had not been prayed for (16.3 vs. 8%; P <0.001). Finally, the benefits of prayer were independent of clinical or laboratory providers and clinical variables. Thus, this study showed that distant prayer facilitates implantation and pregnancy.

Lesniak[ 33 ] described a study on the effect of intercessory prayer on wound healing in a nonhuman primate species. The sample comprised 22 bush babies ( Otolemur garnettii ) with wounds resulting from chronic self-injurious behavior. These animals were randomized into prayer and control groups that were similar at baseline. Prayer was conducted for 4 weeks. Both groups of bush babies additionally received L-tryptophan. Lesniak[ 33 ] found that the prayer group animals had a greater reduction in wound size and a greater improvement in hematological parameters than the control animals. This study is important because it was conducted in a nonhuman species; therefore, the likelihood of a placebo effect was removed.

Absence of benefits with prayer

Aviles et al. [ 34 ] examined cardiovascular outcomes related to prayer. In this study, 799 coronary care unit patients at discharge were randomized to intercessory prayer or no prayer conditions. Prayer was conducted by five persons per patient at least once a week for 26 weeks.

Patients were considered to belong to a high-risk group if they were 70 years old or older or if they had any of the following: diabetes mellitus, previous myocardial infarction, cerebrovascular disease or peripheral vascular disease. The primary endpoint of the study was any of the following: death, cardiac arrest, rehospitalization for cardiovascular disease, coronary revascularization or an emergency department visit for cardiovascular disease.

By the end of 26 weeks, a primary endpoint had occurred in 25.6% of patients in the prayer group and in 29.3% of patients in the control group. The difference was not statistically significant. The results remained nonsignificant when data were analyzed separately for high- and low-risk patients. Thus, this study showed that, as delivered in this study, intercessory prayer did not influence the 26-week outcome after discharge from a coronary care unit.

Other recent randomized controlled trials have also reported negative results. For example, Krucoff et al. [ 35 ] reported no benefits with off-site prayer in patients ( n = 748) undergoing percutaneous coronary interventions and Astin et al. [ 36 ] found that neither remote prayer delivered by professional healers nor remote prayer delivered by nurses with no training or experience in distance healing resulted in benefits to patients ( n = 156) with acquired immunodeficiency syndrome-defining opportunistic infections.

Worse outcomes associated with prayer

Benson et al. [ 37 ] described a triple-blind, randomized controlled study that examined whether remote intercessory prayer influenced recovery after coronary artery bypass graft surgery and whether the certainty of being prayed for was associated with better outcomes. The sample comprised 1,802 patients in six hospitals in the USA. These patients were randomized into three groups: 604 were prayed for after being informed that they may or may not be prayed for, 597 were not prayed for after similarly being informed that they may or may not be prayed for and 601 were prayed for after being informed they would definitely be prayed for.

Prayer commenced one day before the surgery and continued for 14 days. Three mainstream religious sites prayed daily for patients assigned to receive prayer. Assessment of outcomes was made by nurses who were blind to the group assignments. The primary outcome was the presence of any complication within 30 days of surgery. Secondary outcomes were any major event, including death. The study sought to examine the efficacy of intercessory prayer and not to test the presence of God. The design was described by Dusek et al. [ 38 ]

In the two groups that did not know for certain whether or not they were being prayed for, complications occurred in 52% of patients who received intercessory prayer and in 51% of those who did not. In contrast, complications occurred in a significantly larger proportion of patients (59%) who knew for certain that they were being prayed for. Major events and 30-day mortality rates, however, were similar across the three groups.

This study therefore showed that remote intercessory prayer did not improve outcomes after coronary artery bypass graft surgery. In fact, the knowledge of being prayed for was associated with a slightly but significantly higher rate of postsurgical complications.

Retrospective benefits with prayer

Leibovici[ 39 ] reported the results of an unusual study that was conducted in Israel. The sample comprised 3,393 in patients diagnosed with a bloodstream infection between 1990 and 1996. Bloodstream infection was defined as a positive blood culture in the presence of sepsis.

These patients were randomized into prayer ( n = 1,691) and control ( n = 1,702) groups in July, 2000. A list of the first names of the patients in the prayer group was given to a person (details not specified) who said a short prayer (details again not specified) for the wellbeing and full recovery of the group as a whole. This prayer was said about 4-10 years or longer after the index admission. There was no sham intervention. Thus, this study sought to determine whether prayer has a retrospective healing effect.

The patients in the prayer and control groups were similar on important sociodemographic and clinical variables. Whereas the mortality rate did not differ significantly between the prayer and the control groups (28.1 vs. 30.2%, respectively), the length of stay in the hospital and the duration of fever were both significantly shorter in the prayer group than in the control group ( P = 0.01 and 0.04, respectively).

Some points about this study are worth noting. The differences between groups, although significantly favoring patients for whom prayer was offered, were very small; the medians of the two groups differed by a small margin. Thus, the significance of the findings depended heavily upon the outliers who skewed the sample. Next, no attempt was made to compare for unusual biases, such as day of admission and discharge. It is conceivable, for example, that patients admitted toward the end of the week may have been investigated and treated more slowly and those due for discharge toward the end of the week may have been retained until the start of the next week.

Importantly, considering the number of patients in each group, there must surely have been much overlap in first names. Did Leibovici consider the possibility that the prayers, then, could benefit patients in both groups to the extent of overlap? Finally, in a lighter vein, would the findings have changed had the author, in the best spirits of ethical research, offered the experimental intervention (prayer) for the control group at the conclusion of the study? More seriously, because the data were retrospective, it should have been possible for the study to have been repeated several times, with fresh randomization each time. Would the results, then, have remained unchanged? These and other issues were raised in the journal correspondence published on the Leibovici[ 39 ] article.

In the broadest sense, prayer describes thoughts, words or deeds that address or petition a divine entity or force. Chibnall et al. [ 40 ] and Sloan and Ramakrishnan[ 41 ] critically discussed the growing body of research on the healing effects of distant intercessory prayer. We expand on certain of their views and of the views expressed in the journal correspondence that followed their article, and we add our critical perspectives in the discussion that follows. Some technical notes that do not flow with the text are provided in the Appendix.

By invoking prayer, researchers invite troublesome questions about the importance of several theosophical matters:

Do the quantitative aspects of prayer influence outcomes? Quantity refers to the number of prayers, the frequency of the prayers and the duration of the prayers.

Do the qualitative aspects of prayer influence outcomes? Quality refers to the category to which the prayer belongs in the religion of the person who is praying; the fervency with which the petition is expressed; whether the prayer is expressed in thoughts, speech or song; the addition of vows and sacrifices, etc.

Does the practical content of the prayer or the actual petition matter? That is, are some petitions more or less likely to receive a favorable response, depending on how reasonable they are?

Are outcomes more likely to be favorable if the persons praying have greater belief that the outcome will be favorable, or greater faith or conviction in the deity at whom the prayer is directed?

Are outcomes more likely to be favorable if a larger number of people pray or if a team approach is adopted as opposed to an individual approach?

Might outcomes depend on the personal characteristics of the persons who pray; that is, their age, sex, income, religious denomination, position in the religious hierarchy, experience with and skills at praying and so on?

Might outcomes depend on the moral and social characteristics of the persons who pray; that is, their integrity, kindness, altruism, willingness to forgive, generosity, religiosity and so on?

Might outcomes depend on the personal, moral and social characteristics of the persons in whose favor the prayer is offered, or of the general worthiness of the cause?

Would the outcomes depend on the entity at whom the prayers are directed?

What is the nature and magnitude of response that would be considered as a favorable outcome?

These “pharmacokinetic and pharmacodynamic” descriptors of prayer are all important issues to judge from the manner in which persons pray, or if persons with strong religious affiliations are to be believed. Therefore, all of the above would need to be considered as independent or confounding variables in any scientific study on the efficacy of intercessory prayer. Curiously, no study has so far addressed these issues. And, for several reasons, such issues are disturbing because they reduce the concept of God to that of a human being with weaknesses and vanities, thereby exposing theological inconsistencies and attacking the very roots of theology and natural justice. We present some of the unsettling questions that arise in these contexts; the questions are unsettling because they invite comparison with human parallels that devalue the concept of God, something that those who pray surely would not have considered.

If the number, duration and frequency of prayer are important or if the number of persons praying is important, does God, like a businessman, market boons based on the currency value of the prayers? Or, will God pay attention only if those who pray are sufficiently bothersome?

If the type of prayer is important, is God a bureaucrat who is more likely to consider petitions that appear in the prescribed forms?

If the addition of vows and sacrifices is important, is God somebody who can be flattered or bribed into granting a boon?

If the level of fervency or intensity is important, does God distinguish between “please”, “pretty please” and “pretty please with ribbons on it”?

If the practical content of and petitions in the prayer are important, how does God make decisions about what is and what is not a reasonable request?

If the faith or conviction of the persons who pray is important, does God value the beliefs of the petitioners more than the merits of the petitions?

If the personal characteristics and qualities of the persons who pray (or the persons who are being prayed for) are important, are some people more equal before God than other people? Religions portray God as being compassionate; what sort of compassion is displayed by the selective favoring of an experimental over a control group?

If the entity to which the prayer is directed is important, do different Gods have different portfolios? Are some Gods more approachable? Do some Gods ignore some prayers? If the religious affiliation of the person who prays is important, what becomes of the other religions of the world and those who follow such religions; will their prayers remain unanswered?

If the magnitude of response to the petitions is total, then all prayers should result in miraculous or near-miraculous benefits. This, clearly, almost never happens. Thus, does God work on percentages; that is, if the petition is for an elephant, does he sanction a mouse? Or, are his responses only subtle ones? If so, how does he choose on the outcome measure to improve?

These questions are unsettling to those who pray because of their theological implications, but they are also unsettling to scientists because they challenge the design, analysis and interpretation of randomized controlled trials of the efficacy of intercessory prayer. Consider the following:

It could be difficult, if not impossible, to measure all the independent and confounding variables that are important in such research. For example, how might one measure faith, fervency, reasonableness, worthiness, religiosity, morality and other abstract constructs?

How might one define what is an acceptable response to prayer? Healing can be partial or complete. It can be psychological or physical. It can be abstract or concrete. Confounding the picture, statistically significant improvement can be identified only if the same outcome measure is improved in a sufficiently large number of experimental relative to control patients, but why should God decide to select any one outcome measure over the rest? And if different outcome measures improve in different experimental patients in response to prayer, there is no way in which the improvement can be statistically detected.

As atheists, in general, form a minority in most populations, in any randomized controlled trial of intercessory prayer, there is likely to be a number of persons (friends, relatives and the patients themselves) praying for members of both experimental and control groups, unknown to the researchers. If prayer works, this unmeasured source of healing could diminish intergroup differences in outcomes.

As inferential statistical tests will be applied to the data generated by randomized controlled trials of intercessory prayer, is it valid to assume that acts of God conform to normal, t or other statistical distributions? Or that God responds mechanistically to prayer, in a manner that follows laws of probability? In this context, miraculous healings are considered to be outside the provisions of nature, and so divine intervention could actually be expected to violate probability.

Alternately, if prayer is a nonlinear variable, the merits and demerits of which are decided upon by God, then one prayer made by a control patient or relative can statistically offset a multitude of intercessory prayers offered on behalf of the experimental patients. In fact, if divine intervention is selective or arbitrary in response to petitions, the entire basis of randomized controlled design and inferential statistical analysis becomes invalid.

From a scientific perspective, if prayer is indeed considered to work, thought should also be given to the possibility that it may not require a deity. It may, instead, invoke some hitherto unidentified mental energy that has healing power. If so, might prayer be more effective if those who pray are in closer proximity to those who are being prayed for? Might the direction in which persons face (while praying) matter? Might the assistance of the physical sciences be required to identify the nature of the biological energies at work?

It should be noted that the distant healing, intercessory prayer studies specifically test the intervention of a divine entity. This is because the intercessors are usually blind to the identities of the patients for whom they pray, or (at least) because the intercessors do not have any contact with these patients. Therefore, it is left to a sentient being to miraculously divine the intent of the prayers and apply the intercession to the correct target.

Of note, distant healing, intercessory prayer studies address soft diagnoses with soft outcomes. No study, for example, has examined whether prayer can result in the disappearance of medically proven tumors and metastases, reversal of traumatic paraplegia or revival from a state of brain death. It would seem that the results of such studies could be more convincing than the results of studies on wound healing or successful pregnancy. Could it be that those who pray believe that God has or sets limitations?

We close our critique with two final questions:

If research on intercessory prayer is positive, does it suggest to us ways and means by which we can manipulate God or make his behavior statistically predictable?

Why would any divine entity be willing to submit to experiments that attempt to validate his existence and constrain his responses?

In this context, we must keep in mind that religion is based on faith and not on proof. This implies that, if God exists, he is indifferent to humanity or has chosen to obscure his presence. Either way, he would be unlikely to cooperate in scientific studies that seek to test his existence.

Where does this leave us? God may indeed exist and prayer may indeed heal; however, it appears that, for important theological and scientific reasons, randomized controlled studies cannot be applied to the study of the efficacy of prayer in healing. In fact, no form of scientific enquiry presently available can suitably address the subject. Therefore, the continuance of such research may result in the conducted studies finding place among other seemingly impeccable studies with seemingly absurd claims (Renckens et al. [ 42 ] 2002). Whereas we have attempted to be scientifically and politically correct in our critique, other authors, such as Dawkins,[ 43 ] have been humorous, nay even scathing, in their criticism.

The aim of science is not to open a door to infinite wisdom but to set a limit to infinite error (attr., Galileo[ 44 ]).

Source of Support: Nil

Conflict of Interest: None declared

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The Science Behind the Healing Power of Prayer

Holistic Health

The Science Behind the Healing Power of Prayer

Feb 27, 2024 | Holistic Health , Research Findings

Disclosure: This post may contain affiliate links that I may earn a small commission from, at no additional cost to you. I only recommend products I use or have used myself. All opinions expressed here are my own.

An Ancient Practice with Modern Applications

I think we have all heard of instances where radical healing occurred without a medical explanation. Many times these cases involve the beliefs and spiritual practices of the patient. While it can be difficult to pinpoint the exact cause of radical, unexplained healing, researchers have attempted to unravel the mystery by examining medical records, experiential data, and patient narratives. However, these sources are often conflicting and require an extra level of investigation, which questions medical assumptions against the background of the science-spirituality debate.

Considering “82% of Americans believe prayer can cure serious illness, 73% believe that praying for others can cure illness, and 64% want their physicians to pray with them”, this is a topic worth exploring. 1 Here we will examine a case study involving a woman with advanced Parkinson’s disease who experienced remarkable healing after intercessory prayer, along with several additional examples of individuals who had unexplained recoveries.

Advanced Stage Disease and Unexplained Healing

A 2021 retrospective, case-based study published in the journal Advances in Mind-Body Medicine may give you pause for thought. Described as a ‘remarkable’ healing by a medical team at the Amsterdam University Medical Centre (UMC) in the Netherlands, the study included a range of medical, psychological, theological, and philosophical perspectives. 2

The case involved a female patient born in 1959 with advanced and rapidly progressing Parkinson’s disease that medical interventions failed to control, even with high doses of oral medication. The patient presented major debilitating symptoms. In 2012 she experienced “instantaneous, nearly complete healing after intercessory prayer.” 2

The medical assessment team described her recovery as ‘remarkable’. According to the study, “The patient reported that she had always ‘lived with God,’ and that at a point when she had given up hope, ‘life was given back to her.’ This recovery did not make her immune to other illnesses and suffering, but it did strengthen her belief [in a higher power].”

The team concluded:

“This remarkable healing and its context astonished the patient, her family, and her doctors. The clinical course was extraordinary, contradicting data from imaging studies, as well as the common understanding of this disease. This case also raised questions about medical assumptions. Any attempt to investigate such healings requires the involvement of other disciplines. A transdisciplinary approach that includes experiential knowledge would be helpful.” 2

Likewise, a PhD study involving the same medical center in Amsterdam reviewed 27 ‘unexplained’ cases, which fit the criteria of a well-documented medical history followed by subsequent recovery associated with prayer. The assessment team consisted of medical specialists in internal medicine, hematology, surgery, psychiatry, and neurosurgery. They represented a wide range of ideological backgrounds, both agnostic and spiritual to minimize bias. Out of the 27 cases, 14 were chosen for their ‘medically remarkable’ and/or ‘medically unexplained’ qualities.

The participants ranged in age from 29-71 and all but one had a medium to high education level. The duration of their medical conditions varied from 7 weeks to 30 years. The period between the healing and the study interview was between one and 16 years.

“The medical conditions from which they experienced recovery are: cuff rupture of the shoulder, pelvic instability and one-sided deafness, Crohn’s disease, cerebrovascular accident (CVA), iatrogenic aortic dissection, ulcerative colitis (N = 2) and psoriatic arthritis, multiple sclerosis (MS), anorexia nervosa, Parkinson’s disease, drug-induced hepatitis, severe asthma and impaired hearing, alcohol addiction and posttraumatic dystrophy, and congenital hearing impairment.” 4,5,6

In the paper, “A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation”, the researchers observed:

“Scientific and technological progress in medical sciences has not eliminated the uncertainties within the available knowledge and explanations, but rather is making them more complex. That is why the patients may be left looking for their own sources of explanation, where medical explanation comes up short. The persons who have experienced a spiritual journey may well frame it in terms of a miracle (unexplained but positive). … For the patients, healing is much more than a repair of a bodily function. It underscores the necessity of what Miles calls medicine for the whole person, which implies that disease is just a partial aspect with respect to a person, and that not everything that ‘…is right to the disease is automatically right for the patient’.” 6

Where to Go From Here

Regardless of whether or not you hold spiritual beliefs, I think most would agree there is a strong association between the mind and body, and recognize the importance of community and connection for health and healing. It shouldn’t come as a surprise there are plenty of studies to back this up — just have a look at the long-lived and exceedingly healthy people in Blue Zone communities around the world.

I know for myself, my healing was multi-faceted and involved radically shifting my perspective, focusing on the positive, gratefulness, adopting a supportive diet and lifestyle, connecting with my community, and, of course, utilizing supplements and herbal medicines. This holistic approach is what I focus on in The Holistic Guide to Wellness – my best resource for science-backed holistic health.

Nicole Apelian and her Holistic Guide to Wellness

If you find yourself struggling with a health condition, The Holistic Guide to Wellness: Herbal Protocols for Common Ailments is an outstanding resource. Not only does it provide the exact protocol I use every day to manage my multiple sclerosis, but it also covers an additional 44 common ailments with easy-to follow, science-backed holistic protocols, such as:

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Each protocol includes specific foods, exercises, stress-relief techniques, vitamins, minerals, herbs, massages, stretches, detoxes, natural remedies, and other holistic practices that can help you heal your body and mind naturally.

Don’t let chronic illness rob you of your happiness and vitality. Order The Holistic Guide to Wellness: Herbal Protocols for Common Ailments today and discover the power of natural healing for yourself! Tap here and get ready to transform your health and life!

Nicole Apelian

Ameling A. (2000). Prayer: an ancient healing practice becomes new again. Holistic nursing practice, 14(3), 40–48. https://doi.org/10.1097/00004650-200004000-00008
Kruijthoff, D. J., Bendien, E., Doodkorte, C., van der Kooi, C., Glas, G., & Abma, T. A. (2021). “My Body Does Not Fit in Your Medical Textbooks”: A Physically Turbulent Life With an Unexpected Recovery From Advanced Parkinson Disease After Prayer. Advances in mind-body medicine, 35(2), 4–13.
Kruijthoff, D. J., Bendien, E., van der Kooi, C., Glas, G., & Abma, T. A. (2022). Can you be cured if the doctor disagrees? A case study of 27 prayer healing reports evaluated by a medical assessment team in the Netherlands. Explore. https:// doi. org/ 10. 1016/j. explo re. 2022a. 07. 008
Kruijthoff, D. J., Bendien, E., van der Kooi, C., Glas, G., Abma, T. A., & Huijgens, P. C. (2021). Three cases of hearing impairment with surprising subjective improvements after prayer. What can we say when analyzing them? Explore, 18(4), 475–482. https:// doi. org/ 10. 1016/j. explo re. 2021b. 05. 001
Kruijthoff, D. J., van der Kooi, C., Glas, G., & Abma, T. A. (2017). Prayer healing: A case study research protocol. Advances in Mind-Body Medicine, 31(3), 17–22.
Bendien, E., Kruijthoff, D. J., van der Kooi, C., Glas, G., & Abma, T. (2023). A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation. Journal of religion and health, 62(3), 1731–1755. https://typeset.io/papers/a-dutch-study-of-remarkable-recoveries-after-prayer-how-to-127fouba

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A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation

ORIGINAL PAPER
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Published: 04 February 2023
Volume 62 , pages 1731–1755, ( 2023 )

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prayer healing a case study research protocol

Elena Bendien ORCID: orcid.org/0000-0002-5527-7563 1 ,
Dirk J. Kruijthoff 2 , 5 ,
Cornelis van der Kooi ORCID: orcid.org/0000-0002-4240-0067 2 ,
Gerrit Glas ORCID: orcid.org/0000-0002-8216-0934 3 &
Tineke Abma ORCID: orcid.org/0000-0002-8902-322X 1 , 4

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This article addresses cases of remarkable recoveries related to healing after prayer. We sought to investigate how people who experienced remarkable recoveries re-construct and give meaning to these experiences, and examine the role that epistemic frameworks available to them, play in this process. Basing ourselves on horizontal epistemology and using grounded theory, we conducted this qualitative empirical research in the Netherlands in 2016–2021. It draws on 14 in-depth interviews. These 14 cases were selected from a group of 27 cases, which were evaluated by a medical assessment team at the Amsterdam University Medical Centre. Each of the participants had experienced a remarkable recovery during or after prayer. The analysis of the interviews, which is based on the grounded theory approach, resulted in three overarching themes, placing possible explanations of the recoveries within (1) the medical discourse, (2) biographical discourse, and (3) a discourse of spiritual and religious transformation. Juxtaposition of these explanatory frameworks provides a way to understand better the transformative experience that underlies remarkable recoveries. Uncertainty regarding an explanation is a component of knowing and can facilitate a dialogue between various domains of knowledge.

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Introduction

Julia was diagnosed with post-traumatic dystrophy in 1990 (also known as CRPS) and became Dick's patient in 1992. She had pain in the right side of her body and was wheelchair bound. As a general medical practitioner (GP) Dick had a moderately large practice in a rural region of the Netherlands. His patients had various socio-economic backgrounds. He knew Julia’s medical history well. In 2007, after 17 years of suffering, Julia and her husband took part in a prayer healing session, that was organised by a well-known Dutch evangelist. After the prayer Julia stood up from her wheelchair and started walking around without a trace of pain. Her physical condition has remained stable during the past 15 years. Dick was pleased but also intrigued by Julia’s sudden full recovery. In search for an explanation he conducted a literature study but came up empty-handed. His inquiry led to research, supervised by an interdisciplinary team, consisting of a theologian, a psychiatrist-philosopher, a social scientist and a qualitative researcher in the field of medical humanities.

The turn to patient-centred medicine has been accompanied by an increased interest in the spiritual needs and beliefs of the patients (Mezzich, 2011 ; VanderWeele, 2017 ). This is reflected in publications about the influence of spirituality on wellbeing and other measures of quality of life. Some of these studies focus on healing after prayer (Banerjee et al., 2014 ; Miranda et al., 2019 ). With healing after prayer (further HP) we mean that a person’s health improved after intercessory, individual, or other types of prayer.

In Western countries HP was considered to be controversial as a field of medical and social research for a long time (Andrade & Radhakrishnan, 2009 ), but the number of publications that address the positive effects of prayer on health is steadily growing today (Shattuck & Muehlenbein, 2020 ). Most of the available empirical research on HP has been conducted with the use of Randomised Control Trials (RCTs) (Hodge, 2007 ) and usually reflects scepticism about the positive effect that prayer can have on a person’s health (Roberts et al., 2009 ). Only a handful of published empirical studies make use of qualitative methodologies (Austad et al., 2020 ; Harris & Koenig, 2016 ; Helming, 2011 ).

In RCTs, prayer is usually operationalised as an intervention, with a possible cause-effect (or even dose–effect) relationship between action and outcome. Some concerns about RCT as a suitable method to study HP are based on a large variety of HP-practices and the validity of operationalisation (Chibnall et al., 2001 ; Pagliaro et al., 2018 ). Can prayer be conceived as an act that is demarcated in time and can it be quantified in terms of frequency, strength, fervency, numbers of intercessors or who prays to whom (see e.g. Klitzman, 2022 )? Besides, the outcome may extend beyond the usual, clinically measurable variables, and encompass changes in body, mind and spirit (Kruijthoff et al., 2021a , 2021b ). In short, underneath the epistemological question how to study HP (De Aguiar et al., 2017 ), lies the conceptual issue how to understand a phenomenon that does not fit well with the currently dominant biomedical paradigm, that is based on the presumed duality between body and mind.

Against this background, we present a qualitative study based on the 14 (out of 27) cases, which were evaluated by a medical assessment team at the Amsterdam University Medical Centre, location VUmc (for review of the medical data of all 27 evaluations see Kruijthoff et al., 2022a ). We will use the terms healing and recovery interchangeably. Recovery is understood as a long-lasting or permanent clinical improvement of the medical condition.

Each case we study has a well-documented medical history and has been submitted to a rigorous assessment by an independent medical team, concluding that the recovery could be medically remarkable or unexplained. Each case is characterised by an experience of (sudden) recovery related to prayer, and the participants are all inclined to search for other than medical explanations for the recovery. Our aim is to investigate how people who experienced remarkable recoveries, re-construct and give meaning to these experiences, and examine the role epistemic frameworks that are available to them play in this process. We demonstrate how established medical epistemologies are put to the test and how conflicting frameworks of understanding interact and are dealt with by the participants.

Theoretical Perspective

The challenge of the choice for a theoretical framework that can help studying and interpreting HP cases from a multidisciplinary perspective, lies in the absence of developed theoretical approaches that match the existing data (Levin, 2020 ). Reports on remarkable recoveries range between cases that are (un-)related to HP but are medically verified (Engebretson et al., 2014 ), cases that are described on the Lourdes pilgrimage site (François et al., 2014 ) and self-reported narrative accounts of patients, to name just a few. The authors who endeavour to provide an explanation for HP, usually take an eclectic approach. Barasch ( 2008 ) makes an attempt to summarise the processes that can have influenced remarkable recoveries, such as psychosocial interventions (Spiegel et al., 2007 ), biological modifiers, diets, psychological states like mindfulness or meditation (Rediger & Summers, 2007 ), immune responses and social connections. He also points to the lack of thorough accounts of the cases, and the difficulty to replicate the conditions under which these recoveries took place (see also Rediger, 2021 ). These accounts indicate that biomedical, biopsychosocial and even holistic explanatory frameworks can be of use when addressing certain physiological, lifestyle and relational aspects of remarkable recoveries (see, e.g. Engebretson et al., 2014 about social connections), but they come short in describing the spiritual or the transformative experiences of the patients.

Communication about remarkable recovery is a challenge of its own. Cases of medically unexplained symptoms (MUS) can be instructive about how this kind of communication unfolds. The interaction between patients and doctors is crucial in situations where diagnosis, treatment and recovery prospects do not fit within the mainstream clinical practice. It can result in the patient being treated as an “unreliable narrator of bodily events” (Scarry, 1987 ). In the absence of an evidence-based explanation for the symptoms of a disease or a sudden recovery, the patient-doctor interaction can be characterised by conflicting feelings of uncertainty or hope on the part of the patient, and mistrust or even animosity on the part of the doctor (Greco, 2012 , 2017 ).

The positions that patients and doctors find themselves in, can affect the credibility of both parties. Safe ways out to explain a remarkable recovery from the point of view of the specialist, are to admit that the patient was misdiagnosed, or to describe the condition as self-resolving, or to suggest that the recovery is nonreplicable (Barasch, 2008 ). The patient can feel torn between relief and fear that the recovery is only temporary, and not knowing what to further expect from the doctor. The doctor can become nervous and start second-guessing the diagnosis that was made in the first place (Salmon et al., 2007 ). In such cases the consultation can turn into a battle (Wileman et al., 2002 ) about whether the recovery has actually taken place or, broader still, about the legitimacy of the parties to ascertain the improvement.

The examples with remarkable recoveries and MUS demonstrate the same shortcomings where explanation and communication are concerned. The theoretical approaches and communicative tools that are used to interpret and discuss these cases, do not address the spiritual aspects of healing, even though the positive influence of spirituality on physical health is well-established (Koenig, 2015 ; Thoresen & Harris, 2002 ).

Our conceptual framework is built on a combination of approaches: positive health, horizontal epistemology, which addresses amongst others the asymmetry in the doctor-patient interaction, and trans-somatic recovery, that allows to place the recovery in the context of the person’s spiritual development.

The framework of positive health focuses on agency and the adaptability of the patient, who may still be able to live a good life, after having been diagnosed with a chronic condition. Recovery is defined as ‘the ability to adapt and self-manage in the face of social, physical and emotional challenges’ (Huber et al., 2011 , p 343). This definition reaches beyond the healthcare system, since it includes non-health factors (Andersen & Knudsen, 2015 ), such as life-events, identity-forming and sense-making. Attention to self-management in the face of the challenges that a positive health-framework promotes, allows us to link our study to the field of research on biographical disruption and identity (Bury, 1982 ; Charmaz, 1983 , 1995 ). Our attention will however be less on the biographical disruption as a consequence of a medical diagnosis, and more on the disruption resulting from spontaneous recovery followed by restoration of the self (Locock & Ziebland, 2015 ).

Horizontal epistemology (Abma, 2020 ) refers to the way of knowing where a hierarchic division between various types of knowledge (scientific, expert, experiential) becomes restrictive. Fricker ( 2007 ) has pointed to the epistemic injustice of hierarchic systems of knowledge, where certain people are being systematically wronged in their capacity as knowers and denied the possibility to tell their story (Carel & Kidd, 2014 ). When certain perspectives and types of knowledge are structurally left out of the process of knowledge production, this will lead to a limited understanding of our world.

Horizontal epistemology suggests that different epistemic perspectives and different types of knowledge should be dealt with as equally important in the interpretation of research findings. The approach has two advantages: it includes experiential knowledge as a legitimate source of knowing (Sturmberg & Martin, 2008 ) and it allows for a broad dialogue between various types of knowledge and knowing, including tacit forms of knowledge (Polanyi, 1958 ).

Horizontal epistemology is performative by nature; it is enacted in the interaction between various discourses about illness and recovery. It generates new insights by bringing various disciplines and stakeholder perspectives together, based on empirical data. On a positive side, it is transformative to our understanding of complex phenomena, and it broadens the existing explanatory possibilities of complex cases. On a challenging side, horizontal epistemology is rooted in interpretation of data, which includes interpretation by the researcher, who uses personal experiences as a source of knowledge and explanation. Here the role of the researcher is not that of a distanced impartial investigator. That is why ethical and emotional aspects of knowing carry a heavy weight within horizontal epistemology (Abma, 2020 ).

Horizontal epistemology entails the possibility that the medical specialist is no longer the (only) person who decides whether recovery has taken place. In fact, the self-reported functionality of a patient can outweigh the available medical readings (Kruijthoff et al., 2021b ). This leads to a broader issue, whether recovery can be understood on the basis of untraditional somatic explanations. There is a wealth of critical literature about how patients and doctors use somatisation in order to explain a condition that is not supported by the available medical measurements (Greco, 2017 ; Salmon, 2006 ). Following this logic, in order to be legitimate, recovery should be substantiated by quantitative somatic measurements or by standardised verbal reports of the patient’s experience. Recoveries that cannot be measured or articulated by standardised means, represent a challenge to explanation.

To do justice to this complexity, we frame our findings in terms of trans-somatic recovery. With this modifier we aim to highlight dimensions of recovery that go beyond its customary physical and mental characteristics. The term draws attention to the transformative and transcending nature of the recovery experiences.

Transformative recovery refers to healing experiences that extend beyond the functionality of body and mind. The term refers to instances in which healing leads to existential self-reflection, spiritual development, and/or religious transformation. Trans indicates the transcending aspect of recovery, understood as a process that brings patients to a level at which they can see their existence from a new overarching perspective. The transformative experience places their existence in a different light. The new perspective does not erase or replace other experiential dimensions. It includes them and transforms them into a new, meaningful, but sometimes disruptive, experience. Such experiences can vary from physical sensations, mood changes, experiences of improved health, to feelings of belonging to the universe or of undergoing a radical change, for example due to an encounter with God (Austad et al., 2020 ; Lundmark, 2010 ). All these experiences can unfold simultaneously and influence one another.

All in all, trans-somatic recovery does not imply that the body has become non-essential or subsidiary to other aspects of life. It rather means that there exists no hierarchy between the various dimensions of recovery, including the spiritual dimension, and that we should focus on discourses that do justice to the inclusive nature of transformative and transcending healing experiences.

The findings presented in this article form a part of the second author’s PhD study. The full design protocol of that study has been published elsewhere (Kruijthoff et al., 2017 ). It is defined as a retrospective naturalistic case-based study (Abma & Stake, 2014 ) and consists of a preparation phase, that includes data collection, followed by three phases of analysis: medical assessment, qualitative data analysis and interdisciplinary meta-analysis. Most of the results of the PhD study have been published already (Kruijthoff et al., 2017 , 2021a , 2021b , 2022a , 2022b ). For the PhD study two sets of data have been used: medical records of (former) patients and transcripts of qualitative interviews with the patients. In this article we use the second set of data and focus on qualitative data analysis of the 14 interviews.

Procedure and Participants

In 2016 a Dutch newspaper announced that the Faculty of Theology of the Vrije Universiteit Amsterdam would, in cooperation with researchers from the Amsterdam University Medical Centre, location Vumc, be supervising a PhD study, which was being conducted by a GP, on the topic of healing after Christian prayer. The article generated a huge response, both positive and critical. In due course the second author received 83 reports from prospective respondents with accounts about their HP (for the detailed overview of all cases and the follow-up data that was collected in 2019 and 2021 see Kruijthoff et al., 2022a , 2022b ).

The research protocol (Kruijthoff et al., 2017 ) describes in detail the criteria for inclusion in the study: the participants must have a well-documented medical history, followed by subsequent recovery related to Christian prayer. Based on these criteria 27 cases were presented for review to a medical assessment team, consisting of five medical specialists in the fields of internal medicine, haematology, surgery, psychiatry, and neurosurgery. According to the research protocol they represent a variety of ideological backgrounds, both agnostic and religious, in order to minimise bias (Kruijthoff et al., 2017 ). None of them consider HP as a medical intervention. All available medical files were collected – with written informed consent of the participants – from the medical institutions and hospitals where they had been treated (for the detailed overview of the 27 cases see Kruijthoff et al., 2022a ).

The medical assessment team marked 14 (out of 27) cases as possibly medically remarkable or unexplained, and selected them for in-depth interviews. The term ‘medically remarkable’ refers to a healing which is surprising and unexpected in the light of current clinical and medical knowledge and that has a remarkable (temporal) relationship with prayer, while ‘medically unexplained’ indicates that no scientific explanation could be found at the time of assessment (Kruijthoff et al., 2017 ).

Subsequently the first author conducted semi-structured interviews with the 14 participants in 2017–2019. The transcripts of the interviews form the primary data for this article. For the participants’ characteristics see Table 1 .

The participants are women ( N = 9) and men ( N = 5), between 29 and 71 years old. They are all white Dutch ( N = 13) and Belgian ( N = 1) citizens. The duration of their medical conditions, prior to their healing, varies between 7 weeks and 30 years. The period between the healing and the interview varies between one and 16 years, on average 8 years. The medical conditions from which they experienced recovery are: cuff rupture of the shoulder, pelvic instability and one-sided deafness, Crohn’s disease, cerebrovascular accident (CVA), iatrogenic aortic dissection, ulcerative colitis ( N = 2) and psoriatic arthritis, multiple sclerosis (MS), anorexia nervosa, Parkinson’s disease, drug-induced hepatitis, severe asthma and impaired hearing, alcohol addiction and posttraumatic dystrophy, and congenital hearing impairment. An analysis of these cases has been published elsewhere (Kruijthoff et al., 2022a , 2022b ). Some of the cases were analysed more extensively in detailed case studies (Kruijthoff et al., 2021a , 2021b ).

The interview guide included: general background information, social and physical conditions during childhood, (professional) education, religious background, marital status, employment, history of the illnesses, symptoms before and after the recovery, a detailed reconstruction of the moment/period of recovery, including bodily sensations, the respondent’s knowledge about HP prior to recovery, the time frame between the prayer and the experience of being healed, the reactions that the participants received to the recovery, the impact of the recovery on the participants’ lives and the meaning they ascribe to the recovery.

The interviews were conducted at the homes of the participants ( N = 13) and at the university ( N = 1). The duration of the interviews was 1, 5—2 h; they were audio-recorded and transcribed verbatim. The final versions of the interviews were adjusted in accordance with the suggestions of the participants during a member check. Subsequently the interviews were presented to the medical assessment team for final evaluation.

Data Analysis

The first and the second author conducted the analysis of the interviews, which was inspired by the principles of constructivist grounded theory (Charmaz, 2008 , 2014 ). Use was made of ATLAS.ti software for open and focused coding. An iterative approach to the data collection and analysis has been applied. The insights obtained from the analysis of the first interviews and the feedback provided by the interviewer regarding non-verbal interaction, were discussed and incorporated in the later interviews. Hence, the question about personal sense-making in relation to the healing experience was posed more explicitly in the later interviews.

The main guideline during the open coding was interacting with the data and comparing the codes from different interviews that were generated by the two authors. In order to avoid bias, in vivo codes were prioritised. The research goal, namely to look for categories that would contribute to an exchange between various explanatory frameworks and allow for juxtaposition, guided the researchers during the process of comparing codes and notes. During the focused coding we intentionally searched for categories that could enrich or transcend monodisciplinary discourses, in order to match the complexity of the data and to allow for an elaborated epistemological framework to emerge.

We started theoretical sampling by comparing our data with the medical explanatory framework that was available to our participants and to our research team (through participation of the medical assessment team). In search for theoretical saturation and led by the rich data at hand we eventually broadened our theoretical sampling by investigating whether the life-course, spiritual-quest and sense-making explanatory frameworks might answer our question as well. At that stage of analysis we used not only inductive but abductive logic of reasoning as well (Reichertz, 2019 ), which allowed for a better understanding of surprising findings (e.g. similar physical experiences by various participants) and emergent themes, like the role of miracles in the life of our participants, which ‘invoked imaginative interpretations’ among the members of the research team (Charmaz, 2008 , p 157)). Our analysis pointed out to a juxtaposition of three explanatory frameworks: medical, life-course and religious and spiritual transformation.

Reflexivity

This study was initiated because of a personal experience and curiosity of one of the authors. Constructivist grounded theory does not demand from the researcher to be totally impartial during the research process, but rather to continuously reflect on how the researcher’s perspectives and also the context within which research takes place, can be made explicit (Charmaz, 2008 ). Such reflexivity is in accordance with the demands of horizontal epistemology as well. To ensure that personal perspectives of the researchers do not determine the results of the analysis, the research team had regular meetings in the course of several years, during which they reflected on the results, the process of the research and their own role in it. The second author has remained in contact with the participants to date and informs them regularly about the progress of the research. One of the participants became a co-author of one of the published articles (Kruijthoff et al., 2021a ).

A noteworthy feature of the interviews is the temporal correlation between the moment of prayer and the experience of healing. In 10 cases the actual healing was experienced instantaneously, and in four cases the onset of the healing started immediately after the prayer and then continued for several days or weeks. Most of the participants did not have any previous experience or detailed knowledge about HP. Those who attended a service ( N = 8) had low or no expectations. The participants who prayed on their own ( N = 6) asked for an end to their sufferings one way or another.

Each story about a remarkable recovery emerges from a combination of different discourses, which we summarised in three themes: ‘authenticity of the illness and recovery (un-)warranted by medical discourse’; “remarkable recoveries in the context of biographical discourse”; and “feeling healed and whole again: discourse of spiritual and religious transformation”. For schematic representation of the findings (see Fig. 1 ).

Key finding

Authenticity of the Illness and Recovery (un-)Warranted by Medical Discourse

The first theme is about the role of the medical discourse and the certainty of explanations during the interaction between medical specialists and participants, from the perspective of the participants. They talk about a large part of their illness and recovery in clinical terms, using a biomedical explanatory framework. Although they are convinced that their recovery is associated with the influence of a divine source, each of them seeks medical confirmation for the authenticity of their condition and recovery. Each case starts with a history of the disease, hence large parts of the interviews contain meticulous descriptions of diagnoses and impairments, as experienced by the participants:

I had osteoarthritis, abdominal pain, depression, I took 22 pills in the end, 60 mg morphine, prednisone. I had to be washed twice a week. Then …they scheduled CT-scans, bronchoscopy, breathing tests, blood tests. And I had braces on my hands and on my knee. Then I got a device at home with flasks of oxygen and medicines, and I had to put a tube into my mouth and then go to sleep. (P4) (participant four, see table 1 )

The use of medical terminology is abundant and appears to give more strength to the accounts of the participants, in order for their suffering to be acknowledged:

I ended up in hospital with a hernia at L5-S1. And then there was a rheumatologist standing next to my bed, and they said, you have Bechterew and you will never recover. Later they reversed that diagnosis, but they said that my pelvis was totally broken… (P2)

A noteworthy aspect of the last quote is the definitiveness with which, according to the participant, the medical specialist communicates the diagnosis, which is similar to experiences of other interviewees. For some of them this leads to taking decisions that worsen their condition. The participant with Crohn’s disease hears that her condition is incurable when she is 24. Her reaction can be described in terms of diagnostic shock (Belgrave & Charmaz, 2015 ). As she puts it, she feels devastated, because she has other plans for her life. Her distress and unwillingness to accept the diagnosis makes her look for alternative treatment. She stops with the prescribed medication and embarks on a diet, which makes her condition worse. Looking back, she calls it a big mistake, but she emphasises that the certainty with which the label ‘incurable’ was given, was not helpful either.

A message about a chronic condition that is delivered unemphatically can cause, to use Hadler’s metaphor, an erosion of dreams (1996) and stimulate a rebellious response, as with a participant who has a severe hearing impairment:

In the hospital I was told: you cannot choose a social profession, because your hearing is severely impaired. I was 11. And I was such a social being! That clashed completely with who I was. So, I became defensive. I did not want to be deaf. And I wanted to stop not-wanting-to-be-deaf. (P13)

This participant chooses for a profession for which interactive skills are indispensable, but soon she has to stop due to a burnout. The ways in which our participants make use of- and react to the medical discourse, demonstrate their dependence on it and at the same time their wish to regain control of their lives.

According to the participants, the reactions of the medical professionals to the announcements about HP vary from incredulity, anger and irritation to neutral contemplation or sincere curiosity. The participants expect joy from the medical professionals, but the majority is confronted with doubt:

I had no complaints at all. [The doctors] didn’t know what to say. I sat there and thought: if I were talking to a patient who says to me that he is feeling well, I would reply ‘how nice and how did that happen?’. And now it was like ‘we think that is very odd’. It became even crazier when the doctor suggested ‘using maintenance medication.’ (P9)

The participant who had recovered from a cuff rupture of the shoulder just a few days before the scheduled operation, describes eloquently the reaction of his doctor:

I think of waltzing over to that hospital, but …the specialist was super sceptical when I said that the operation was no longer necessary. He became furious and started throwing Latin names at me. ‘Surely that muscle has not seen the Light!’ He didn’t give in, and I was not allowed to have an ultrasound, because ‘that muscle could not be healed anymore’. (P12)

The participant with CVA had a similar experience. His physiotherapist puts him through extra heavy physical tests on the walking belt, because, according to the participant’s account, he does not believe in his recovery. This participant mentions how angry the physiotherapist becomes and his own determination to prove his recovery: ‘I’d rather drop dead than stop.’

At least half of the interviews contain this kind of examples. Based on them, we suggest that medical professionals regard it as a challenge to think beyond the scope of their clinical experience and the biomedical concept of the disease. In several cases, however, the professionals do accept that contemporary medicine cannot explain each and every clinical phenomenon. The recovery from ulcerative colitis of one of the patients was confirmed by a medical examination. According to the participant, the specialist who conducted the test was astounded by the improvement. Another doctor formulates it explicitly: ‘Medically speaking I have to admit that something happened that I cannot explain. I cannot substantiate it, but this is what I see’.

Both participants and doctors keep looking for confirmation of the initial diagnosis and the recovery by using the medical explanatory framework, albeit for different reasons. The account of the participant recovered from MS is very telling:

I used to go to the neurologist in a wheelchair, but that time we went on the motorbike. That was such a kick! I wanted a new MRI. …Then [the doctor] called and said: the MRI is unchanged; we will not retract the diagnosis. That was very important to my story. On the one hand, I thought it was a real shame, because I would have so much liked to have all those spots gone. That would have been visible, tangible evidence for me. On the other hand, I can function normally, so it doesn’t bother me anymore. The only strange thing is that the neurologist never sent a letter to my GP. (P8)

This example shows how various epistemic frameworks can juxtapose, while both the participant and the doctor are searching for an explanation of the recovery. A somatic examination can increase the trustworthiness of the participant’s story, but it can also raise doubts about the correctness of the initial diagnosis. An unchanged MRI can lead to various conclusions: for the participant it is an additional proof of divine interference, for the medical specialist it entails the question of responsibility for the patient, who declares she is healed, whereas evidence tells otherwise. The possibility that the neurologist never sent a letter to the participant’s GP can be seen as a sign of uncertainty, time pressure or simply as a lack of communicative skills in cases of medical uncertainty.

A few participants with measurable improvements, receive acknowledgment of their remarkable recovery. One of the doctors asked the participant for permission to follow the process of his remarkable recovery. Another doctor shared the participant’s line of thought:

He says: ‘I have no explanation for it, I know one thing: we, doctors, really don’t know everything’. I asked: ‘What will you write down in your file?’ And he wrote ‘a spectacular improvement after prayer.’ (P5)

The medical staff seem to remain ambiguous about joining the celebration of their patients’ unexpected recoveries. According to one participant, her doctor put it as follows: ‘To be a doctor is not just to master the craft of treatment, it is about the art of healing. This is not an easy profession, and the theory does not always show you the way forward.’ In addition, the fact that recovery occurs after a prayer, makes all parties uncertain about how to articulate it.

Remarkable Recoveries in the Context of Biographical Discourse

The second theme allows to look at the medical history of the participants from the perspectives of their life-course and spiritual development. Each of the interviews includes a life-story, where the recovery is placed into the social and cultural contexts of the participant’s life and their relationships with others. It also contains an account of the participant’s spiritual journey, including a detailed description of their experiences with HP. An in-depth analysis of one of the cases has been published elsewhere (Kruijthoff et al., 2021a ).

Illness catches up with the participants at different stages in life and is often followed by a biographical disruption and changes in perception of self (Bury, 1982 ). In that respect their experience is not different from that of any other patient with a diagnosis of a chronic illness (Charmaz, 2000 ). Their life expectations come into conflict with the consequences of their debilitating condition. Therefore, some of them try to conceal their illness or to cope with its consequences, since they are unwilling to accept the label of for ever being a patient with a chronic condition (Hadler, 1996 ). The participant with MS diagnosis states bluntly: ‘The moment you tell them, you will become Multiple Sclerosis’ (P5).

The duration of the participants’ impairments varies between months and decades. The coping strategies are often directed at preservation of the participants’ psychological wellbeing. The participant with MS makes ‘armed peace’ with her illness, because she does not want to feel like a victim. The participant with a hearing impairment learns to hide her condition by lipreading so well, that people simply don’t believe her when she finally reveals it. The participant with an inflammatory bowel disease convinces herself that she is meant to accumulate all the hereditary conditions of her family, thus allowing the others to remain healthy, because she is the one ‘who can bear them best of all’ (P9). The ability to be self-reflective is used as a coping strategy as well. The participants tell openly that coping with their condition takes its toll on their psychological wellbeing, their relationships with others and their self-image. Some of them have severe psychological complaints as well, like suicidal thoughts (P2), depression (P9), burnout (P13) or various forms of psychosis or addiction (P6, P14).

Each participant has had a connection with Christian religion since childhood, but only a few of them speak about having faith in their early years. Two of them bring up a faith-versus-autonomy issue, namely how making your own choices can coexist with faith. One of them remembers seeing God as ‘dangerous’, because people make themselves dependent on God and therefore cannot live their own lives. Another participant does not believe in God because as a child she found it ‘too easy’ to make yourself dependent on such a force, which can turn you into a weak person. There are two patterns that unite all the accounts: at some point in their lives the participants embark on a quest for ‘their’ God, who would satisfy their spiritual needs. They also keep their relationship with God separate from the church as an institution, resorting to a privatised form of religion: ‘In church, I noticed, faith is something distant that you are told about, while for me it is something very personal’. (P9).

Some of the incentives to search for faith or to become converted, are feelings of loneliness, weak family ties, or previous experience with remarkable recovery. Several of the participants undergo changes in their faith, from unquestioning faith to faith that they call ‘relationships with God’, that meets their need to belong, to becoming part of a community. One of the participants explains it to a stranger as follows:

I believe very simply in God, as a child. I have a place where I can cry out, vent my frustration, share my joy. God gives me strength, he protects me. The man had to laugh, and I asked: ‘Do you have anything better?’ He had to think, and then said that, in fact, he didn’t. I said I’ll stand my ground then. (P1)

Another participant states directly: ‘We simply need each other. Some people do that in church, and that’s fine.’ (P6).

Four of the participants connect their faith with the witnessing of miracles. They do not use the term ‘miracle’ as a technical theological notion. They refer to miracle as an unexplained positive event, something transcending the rational world they are living in, an opening into a spiritual dimension. One of them witnesses the remarkable survival of a family member after a car accident. When a passer-by prays for the victim she comes back to life, after which our respondent embarks on a quest for his ‘relationship with God’. A participant who has recovered from anorexia nervosa, considers her own recovery to be a miracle and although she is critical about the church as an institution, she starts believing in God after that. In fact, all participants consider their recovery to be a gift of God.

The medical, life-story and spiritual-quest discourses come together in a description of the moment when the healing takes place, which is central in all interviews. Initially none of them sees a connection between the possibility to recover and faith. When the recovery takes place, it comes unexpected and can therefore not be interpreted as a result of high expectations. The attention to the somatic symptoms that the participants provide in the description of their medical condition, stands in contrast with the description of the prayer-moment and its consequences, whereby the physical sensations form only a part of the entire healing experience. Although each of the 14 healings is experienced differently, the discourse that the participants use to describe them, can be called poetic. It is affective, full of metaphors and often refers to the sensation of being freed from something malignant:

I have wondered many times, what is trapped inside me? And when they prayed for me, someone put his hands on my back. Later I felt as if my back was completely bruised, as if someone had drawn two claws from it. It felt like something had been ripped out. Later I thought, apparently there was something that I was suppressing with medication, but that is no longer there. Yeah, it sounds a bit crazy… (P9)

The participants tell us about the affective side of the healing, that was experienced as being ‘touched inside your head and feeling a slow current going from your toes through the entire body’ (P2), ‘a sudden feeling of joy and the warmth of a hand felt on the exact place’ where the aorta was damaged (P7), the feeling of quiet and such a profound peace within, ‘as if somebody had wrapped a blanket around me and I felt that I am allowed to be’ (P4), ‘a large warm cloud, and the feeling that something is happening now, as if a small net has been taken away from my brain’ (P8). The last quote belongs to the participant with Parkinson, who adds: ‘It seems as if God has operated on my head’, an interesting addition that can be seen as an attempt to reconcile the medical and spiritual discourses from an overarching, transcendent perspective.

Feeling Healed and Whole Again: Discourse of Spiritual and Religious Transformation

The third theme addresses the transformative power of healing: the changes in self-image of the participants before and after their recovery and the meaning that they give to the healing. The transformation of the self-image can undergo gradual as well as abrupt changes from the period before the diagnosis, during the disease, which is characterised by a partial loss of self, and after the recovery, resulting in a restored self (Charmaz, 2000 ). The onset of the disease shows how personality features become somatised, i.e. dependent on physical manifestations of the body. The participants become their disease (Dings & Glas, 2020 ; Hadler, 1996 .) According to the accounts, the participant's spiritual needs are felt to be disconnected from the malfunctioning body. This detachment is underlined by the medical treatment, which is directed at physical recovery. Thereby, albeit unwillingly, both participants and doctors put the body-mind dualism into effect:

I didn't feel good in my body at all. From my 16 th they stuffed me with prednisone, which worked very fast, but because of it I gained a lot of weight in no time. Such a big face. And when I looked in the mirror I thought I did not feel the way I looked. That was very crazy. (P9) You become a different person because of the disease. Everything turns around in your body, completely, also your feelings. You become kind of selfish, because you are in so much pain. (P11)

Becoming the embodiment of your own disease is often a devastating process for the participants. But their ability to survive is tested even more after their recovery. The participants have to reinvent themselves, which paradoxically is experienced as a burden. They have to leave the safe cocoon, as one participant puts it, where she had total control:

You have been outside the society for 14 years and it was quite a job to come back. I thought getting ill was a job. I believe it took me three years to surrender to it. But recovering took time as well. Because you had your own world, but now people expect you to be there. …I felt overwhelmed... (P2) You’re 46, like a beautiful dead bird, you can’t do anything anymore. Eventually you climb up again a little bit. But you can do about 30 percent of what you did before. 24 years go by, and you are 70 [recovery date]. And then you must find out who you are. At 70, that’s a tough matter. (P1)

All participants are happy with their recoveries, but physically and mentally, they need time to extend their everyday life space beyond the restrictions imposed by their medical conditions. Their experiences, to use Bury’s terminology, can be seen as a second biographical disruption, or as a first step towards restoration of one’s wholeness. The participants feel the need to overcome uncertainty, to participate again. But this also means to be open to all kinds of reactions from their surroundings, including suspicion, distrust, jealousy and direct accusations of being a fraud or being a conduit of the devil’s work:

I had a lot of doubts about what was being said, am I healed, am I an impostor? ‘Was it not all in my mind?’ Because I heard that too: it was just in your head. I found that so difficult. Because how can I prove it? …Now I’ve learned, I don’t have to explain. People can believe it or not. My family believes it. I believe it. (P10)

Negative reactions to the recoveries within the church communities, families and among friends are mentioned in each of the interviews. The participants have to cope with an overwhelming number of questions, including self-doubts. Unsurprisingly, three of them end up with a burnout soon after their recovery, and at least two of them make use of psychological help and support.

Still, the positive transformative power of recovery appears to outweigh its challenges. More things are healed than the debilitating physical conditions, for instance the doubt whether the participant is worthy to be in this world, to be God’s child. Before the recovery some of them felt that they were not allowed to belong or to be special, like the participant who had been intimidated by his parents during his entire life because he was born as a boy and not a girl as they had expected, or like another participant, who questions her right to accept the healing: ‘I was standing onstage completely petrified, afraid that [disease] would come back, that I’m not good enough’. (P13).

This last participant learns to harness her uncertainty by straightening out her relationship with her mother, for whom she has become a social worker. Another participant takes the difficult decision not to see her sister anymore, because she feels she is being used by her. Another one speaks openly for the first time about things that felt wrong in her parental home, which gives her a feeling ‘as if the sky was falling’. The participants seem to experience the healing as just a first step in their pilgrimage towards feeling whole again.

The participants give a meaning to their recovery in relation to their life goals and future work, which leads to restoration of their selves that were temporarily lost to the illnesses. The pattern that emerges from the analysis comes close to a holistic outlook on life. The post-anorexia participant feels that her ‘mind and body have completely reunited’. All the participants maintain that their physical condition will remain stable, and that they are now concentrating on a more profound transformation after ‘being touched in your head or in your heart’ (P9):

God goes a little deeper. …It’s not just a physical healing, but it touches the soul. It is a relationship. This is not a doctor who does an operation. God gets really close. I think there is a lot more to heal within me too. (P13)

All the participants feel strengthened in their faith after their recovery. The majority feel a more profound connection with the world than before, which transcends the materiality of their existence. They give testimonies about their healing both within and outside church communities. Many have published their testimonies on the web or have written books about their experiences. When asked for clarification about their recovery, our participants react differently. Some of them are still looking for answers: ‘I still notice that this is the only thing I feel lonely about, because I’m so happy, but I have so many questions!’ (P6). Others simply feel content:

I am not interested in explanations. I’ve stopped trying to find any. Healing comes from God, because I don’t know anybody else who could do it. (P8)

The article presents the analysis of 14 cases of medically remarkable healings after prayer. Two aspects unite these cases and at least one distinguishes them from the studies on MUS or the placebo effect. Firstly, our cases follow a non-medical intervention, which sets them apart from recoveries within a clinical context. Secondly, the recoveries have a transformative power on various aspects of the participants’ lives, including their spiritual development. This second aspect unites our cases with other types of recoveries, like spontaneous remissions, which have been described elsewhere (Radin, 2021 ).

Since their remarkable recoveries, most of our participants chose to become engaged with their social environment: they do community (voluntary) work and use their own experiences in order to help others. They also engage in conversations about the transformative power of their recoveries (Levin & Steele, 2005 ), by making the accounts about their recoveries public (see e.g. Doodkorte, 2016 ). Most of them see it as their calling to spread the word about the extraordinary experiences they have gone through, whereas others are still searching for answers to questions like ‘why me?’ and ‘how can I share this gift with others?’.

To do justice to these complex processes, we developed a study design, based on several frameworks, including grounded theory and horizontal epistemology. By doing so we remained as closely as possible to the accounts of the respondents about their medical conditions, but also broadened the interpretative framework stepwise, by subsequently adding new perspectives: a biographical perspective, including the histories of spiritual development and the role of the life-events that shaped the patients’ views on life; a self-experiential perspective, with detailed descriptions of the healing, focusing on emotions and bodily sensations; and a spiritual perspective, including the patients’ personal views about God and their effect on their faith. A juxtaposition of the perspectives can be productive, even when they do not line up. This reaches the surface in the divergent reactions to the remarkable recoveries, including the reactions from the participants themselves. Doubt and confusion that the patients and doctors express, resonate with some of the responses within the church communities to which our patients belong, and also among their friends and families. Disbelief, suspicion or even jealousy of people who prayed but did not heal, emphasise the limitations of the cause-and-effect logic, which, in the Western cultural climate of naturalism offers little room for the unexpected (Jüngel, 1977 ).

Our framework, which contains medical, life-course and spiritual-quest discourses, emerges empirically and points at uncertainty as an important issue in both medical and spiritual reactions to HP. In the method-section we referred to inductive and abductive types of reasoning that we had used in order to understand unexpected and sometimes surprising examples in our data, like the temporal coincidence between recovery and HP. Abductive logic provided us with an opportunity to question existing (for example psychosomatic) explanations, and, while using logical inference, remain open for an unexpected insight (Reichertz, 2019 ).

Both doctors and patients are uncertain about how to deal with a remarkable recovery and how to integrate the discourse of spiritual development into the history of illness and recovery. Uncertainty does not fit well within the prevailing medical epistemology (Miles, 2009 ). This is somewhat surprising, because, as Fox points out, uncertainty is inherent in medical research and practice ( 2002 ); it has been present in the medical-sociological discourse since the work of Parsons ( 1951 ) and has been described in-depth in a number of publications (see e.g. Fox, 2002 on epistemological uncertainty and critique of evidence-based medicine; Han et al., 2021 ).

Scientific and technological progress in medical sciences has not eliminated the uncertainties within the available knowledge and explanations, but rather is making them more complex (Fox, 2002 ). That is why the patients may be left looking for their own sources of explanation, where medical explanation comes up short. The persons who have experienced a spiritual journey may well frame it in terms of a miracle (unexplained but positive). They can illustrate the trans-somatic aspect of their healing by showing the transformative effect that HP has had on their spiritual development and how a new transcendent dimension has been added to their lives. For the patients, healing is much more than a repair of a bodily function. It underscores the necessity of what Miles calls medicine for the whole person, which implies that disease is just a partial aspect with respect to a person, and that not everything that ‘…is right to the disease is automatically right for the patient’ ( 2009 , p 944). In order to cover the full complexity of HP, follow-up studies are required, where cohesion of the physical, mental and spiritual aspects of recovery can be elucidated with the help of theological and philosophical theoretical perspectives.

This study has practical and academic implications. Firstly, we should look critically at the interaction between the patients and medical professionals, the persistent asymmetry of which has already been addressed in literature (Pilnick & Dingwall, 2011 ). Insight in the medical discourse can bring the patient closer to the medical specialist and ensure that they are on the same page where disease and treatment are concerned. But when unexpected healing takes place, confusion tends to take over. Our data suggest that in modern Western medicine we are hardly able to get a grip on such experiences of recovery. This can lead to self-suppressive and self-stigmatising behaviour on the part of the patients, with corresponding consequences for their mental and physical health (Charmaz, 2000 ).

There is no literature known to us about the language that is used during medical consultations where HP is discussed. We do see some similarities in the psychiatric literature regarding spiritual dimensions (Glas, 2021 ) and in the research on explanations that are used by doctors during consultations on MUS (Ring et al., 2005 ). Some authors focus on the psychosocial dimension of the disease (Stortenbeker et al., 2022 ). However, many patients feel offended by the association of their ailment with psychosomatic disorders. As Greco explains, labels such as ‘symptoms all in the mind’ touch on ‘moral failure’ and can ‘imply that the illness is imaginary, fake or inauthentic, possibly even intentional’ ( 2019 , p. 104). The discourse surrounding HP touches on existential matters of life and therefore can be similarly ambiguous, and yet, based on our analysis, we advocate for making it part of medical consultation.

Secondly, the literature about the positive influence of spirituality and beliefs on health is abundant, but often overlooked in the Western medical literature reviews (Levin, 2020 ). The benefits of spiritual beliefs about health are therefore often wasted where medical treatment is concerned (Balboni & Peteet, 2017 ). Our analysis points out the importance of a multi-layered approach to the patient’s history, whereby the medical history forms only a part of the entire picture.

It is a challenge to implement that kind of approach, because patient-centred care and the efficiency of care ask for more and for less time respectively. Patient-centred care (Epstein, 1995 ) has brought along opportunities and tensions at the same time. Greco ( 2017 ) presents an analysis of those tensions, raising amongst others the important question of accountability. Following Stengers ( 2008 ), Greco advocates ‘creative accountability’ which, given our analysis, we can translate into being open to tentative or provisional and therefore uncertain forms of explanations. In that way the explanatory framework for the cases of remarkable recovery can be presented as a process of co-creation, where patients, doctors and possibly other stakeholders together are in search of an inventive understanding of a recovery (Glas, 2019 ; Savransky, 2017 ).

Finally, we have demonstrated that horizontal epistemology offers a fruitful approach to study HP. Horizontal epistemology departs from the assumption that there is no clear hierarchy or meta-theory to demonstrate why some types of knowledge matter more than others to understand a phenomenon (Abma, 2020 ). Horizontal epistemology is contrary to vertical epistemology, in which it is assumed that certain types of knowledge are more true than others. Yet, it is impossible to prove this convincingly, because there is no meta-theory that can be used.

So far most research on HP is grounded in a vertical epistemology. As a result, studies favour medical evidence over patient experiences and over psychological, sociological and theological interpretations of HP. The benefit of horizontal epistemology is that different explanations as well as frictions between epistemic discourses, are welcomed and can form a starting point for learning. This has offered new insights in how patients use and appropriate various discourses, to cope with an unexplained healing and how this can lead to tensions with people around them as well as with medical doctors. Also, it has enlarged and deepened our understanding of HP and offered a starting point for dialogue and deliberation across epistemic discourses, also within our project’s medical assessment team. We recommend that future studies of HP will be grounded in horizontal epistemology.

Limitations

This study has several limitations. We focused on cases of recovery related to Christian prayer only. This decision was made intentionally, in order to keep a clear focus on the subject at hand. It prevents us however from comparing experiences of people with different beliefs and of non-religious people. Furthermore, we are aware that our interpretations only mirror attitudes that are existing in the Western cultures, where all the members of the research team are living and working. Finally, due to our limited time and resources, we have interviewed former patients only. Their medical specialists were contacted with requests to provide the medical files only. It would be worthwhile to gather first-hand data from medical specialists about their experiences with remarkable recoveries and HP, in order to fully enact horizontal epistemology. Church members, friends and family members of the participants were not interviewed, which limits our understanding of the context within which our participants live.

Summarising, our analysis of the data allows us to see that in the effort to understand cases of remarkable recovery, we require a combination of discourses and interpretative frameworks that include uncertainty as a means of (not-)knowing. Each of the discourses and frameworks has its value and none of them can be sufficient on its own. In order to understand the cases better, transdisciplinary analysis is required, where various discourses challenge each other in a process of co-creation. Allowing uncertainty of the unknown into a consultation, confession or interview, can boost the inventive side of our ability to understand and explain these cases.

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Acknowledgements

The authors of the article are most grateful to the members of the medical assessment team for their invaluable contributions to the study: C.J.J. Avezaat, MD, PhD, emeritus Professor of Neurosurgery at Erasmus University Medical Centre, Rotterdam, the Netherlands; P.C. Huijgens, emeritus Professor of Haematology; A.J.L.M. van Balkom, MD, PhD, Professor of Evidence-based Psychiatry; and M.A. Paul, MD, PhD, Thoracic Surgeon; and J.M. Zijlstra-Baalbergen, MD, PhD, Internist and Professor of Haematology, all from the Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands.

The qualitative part of this research, like the interviews by a senior researcher, was partially funded by Dimence Group, Institute for Mental Health care, Zwolle, the Netherlands.

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Elena Bendien & Tineke Abma

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Dirk J. Kruijthoff & Cornelis van der Kooi

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Gerrit Glas

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The Medical Ethics Review Committee of the Amsterdam University Medical Centre, VUmc, confirmed on June 4, 2015, that the Dutch Medical Research Involving Human Subjects Act does not apply to the study ‘Healing and prayer, post aut propter?’ (2015.192). The Privacy Desk of the VU University reported on October 22, 2015, that this study complies with the relevant privacy standards (VU2015-79).

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Bendien, E., Kruijthoff, D.J., van der Kooi, C. et al. A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation. J Relig Health 62 , 1731–1755 (2023). https://doi.org/10.1007/s10943-023-01750-6

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Prayer Healing: A Case Study Research Protocol
Objective • The aim of the article was to present a research protocol for the investigation of reported cases of remarkable and/or unexplained healing after prayer. Design • The research team developed a method to perform a retrospective, case-based study of prayer healing. Reported prayer healings can be investigated systematically in ...
(PDF) Prayer Healing: A Case Study Research Protocol
At Vrije Universiteit, Amsterdam, and Amsterdam UMC, location VUmc, a protocol was developed to facilitate a retrospective, case-based study of prayer healing (HP) reports (Kruijthoff et al. 2017 ...
Prayer Healing: A Case Study Research Protocol
Objective • The aim of the article was to present a research protocol for the investigation of reported cases of remarkable and/or unexplained healing after prayer. Design • The research team developed a method to perform a retrospective, case-based study of prayer healing. Reported prayer healings can be investigated systematically in ...
Prayer Healing: A Case Study Research Protocol
A case-based, research study protocol that compares medical and experiential findings and that interprets and structures those findings with reference to Ian Barbour's conceptual model is an innovative way of gaining deeper insight into the nature of remarkable and/or unexplained cures. Context • Prayer healing is a common practice in many religious communities around the world.
Prayer Healing: A Case Study Research Protocol
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PDF VU Research Portal
VU Research Portal Prayer Healing: A Case Study Research Protocol Kruijthoff, D.J.; van der Kooi, C.; Glas, Gerrit; Abma, Tineke A published in Advances in Mind-Body Medicine
Can you be cured if the doctor disagrees? A case study of 27 prayer
At the Vrije Universiteit, Amsterdam, and Amsterdam University Medical Center, location VUmc, a protocol was developed to facilitate a retrospective, case study research of prayer healing (HP) reports (ref 6). The study took place between 2015 and 2020. Recruitment, initial assessment and selection
Prayer Healing: A Case Study Research Protocol
Prayer Healing: A Case Study Research Protocol. Dirk J Kruijthoff, Cornelis van der Kooi, Gerrit Glas, Tineke A Abma. Ethics, Law & Medical Humanities (VUmc) APH - Quality of Care (VUmc) APH - Societal Participation & Health (VUmc) Research output: Contribution to journal › Article › Academic › peer-review.
Prayer and Healing: A Case Study
The belief of the praying person in the power of the prayer itself may stimulate healing, as the placebo effect suggests. The relaxation response and the sense of self-efficacy gained through the act of praying may enhance the immune system. Despite these explanations of the mechanisms through which prayer promotes healing, there sometimes ...
PDF CASE STUDY Prayer Healing: A Case Study Research Protocol
healing must have ascribed the healing to prayer, although the prayers may have differed among individuals; (2) the prayer could have been performed by the individual, his or her loved
Prayer Healing: A Case Study Research Protocol.
Prayer Healing: A Case Study Research Protocol. ... API case studies; SOAP web service; Annotations API; OAI service; Bulk downloads; Developers Forum; Help. Help using Europe PMC; Search syntax reference; ... Prayer Healing: A Case Study Research Protocol. Kruijthoff DJ, van der Kooi C ...
Prayer and Healing: A Study of 83 Healing Reports in the Netherlands
The healing sparked nationwide interest in the Netherlands and its aftermath led us to conduct this research. Other experiences and narratives as well as a lack of knowledge further motivated the authors to set up a study. A number of studies in the field of healing and prayer (HP) can be found in medical literature.
A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with
The research protocol (Kruijthoff et al., 2017) describes in detail the criteria for inclusion in the study: the participants must have a well-documented medical history, followed by subsequent recovery related to Christian prayer. Based on these criteria 27 cases were presented for review to a medical assessment team, consisting of five ...
Research methodology for studies of prayer and distant healing
The double-blind randomized clinical trial is the gold standard for trials of prayer and distant healing. Adequate blinding and randomization procedures should be followed and documented. The intervention must be well defined (include frequency, amount of time and training and/or experience level of healers).
Prayer and healing: A medical and scientific perspective on randomized
Most recent studies on prayer and healing have adopted this design. In such studies, commonly, a group of intercessors prays for the health of patients who are randomized to the intervention group. ... Prayer Healing: A Case Study Research Protocol. Kruijthoff DJ, van der Kooi C, Glas G, Abma TA. Adv Mind Body Med, 31(3):17-22, 01 Jun 2017 ...
Can you be cured if the doctor disagrees? A case study of 27 prayer
A case study of 27 prayer healing reports evaluated by a medical assessment team in the Netherlands." ... A case-based, research study protocol that compares medical and experiential findings and that interprets and structures those findings with reference to Ian Barbour's conceptual model is an innovative way of gaining deeper insight into the ...
A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with
A case-based, research study protocol that compares medical and experiential findings and that interprets and structures those findings with reference to Ian Barbour's conceptual model is an innovative way of gaining deeper insight into the nature of remarkable and/or unexplained cures.
The Science Behind the Healing Power of Prayer
Order The Holistic Guide to Wellness: Herbal Protocols for Common Ailments today and discover the power of natural healing for yourself! Tap here and get ready to transform your ... Prayer healing: A case study research protocol. Advances in Mind-Body Medicine, 31(3), 17-22. Bendien, E., Kruijthoff, D. J., van der Kooi, C., Glas, G., & Abma ...
A Dutch Study of Remarkable Recoveries After Prayer: How to ...
The findings presented in this article form a part of the second author's PhD study. The full design protocol of that study has been published elsewhere (Kruijthoff et al., 2017).It is defined as a retrospective naturalistic case-based study (Abma & Stake, 2014) and consists of a preparation phase, that includes data collection, followed by three phases of analysis: medical assessment ...
Three cases of hearing impairment with surprising subjective
A case study of 27 prayer healing reports evaluated by a medical assessment team in the Netherlands. D. Kruijthoff E. Bendien ... A case-based, research study protocol that compares medical and experiential findings and that interprets and structures those findings with reference to Ian Barbour's conceptual model is an innovative way of gaining ...
Transdisciplinary Conceptual Structure
Download scientific diagram | Transdisciplinary Conceptual Structure from publication: Prayer Healing: A Case Study Research Protocol | Context • Prayer healing is a common practice in many ...

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Abstract

Rajiv Radhakrishnan

Prayer is a special form of meditation and may therefore convey all the health benefits that have been associated with meditation

Prayer may be supported by varying degrees of faith and may therefore be associated with all the benefits that have been associated with the placebo response

Prayer may be associated with improvements that result from spontaneous remission, regression to the mean, nonspecific psychosocial support, the Hawthorne effect and the Rosenthal effect

Prayer may result in benefits that are due to divine intervention

Improved outcomes associated with prayer

Absence of benefits with prayer

Worse outcomes associated with prayer

Retrospective benefits with prayer

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Citations & impact

Self reported benefits of participating in group prayer in a hospital outpatient setting: A cross-sectional observational study.

A Dutch Study of Remarkable Recoveries After Prayer: How to Deal with Uncertainties of Explanation.

Role of Faith healers: A barrier or a support system to medical care- a cross sectional study.

Explaining the Process of Spiritual healing of Critically-ill Patients: A Grounded Theory Study.

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Introduction

Theoretical Perspective

Procedure and Participants

Data Analysis

Reflexivity

Authenticity of the Illness and Recovery (un-)Warranted by Medical Discourse

Remarkable Recoveries in the Context of Biographical Discourse

Feeling Healed and Whole Again: Discourse of Spiritual and Religious Transformation

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