What role does spirituality play in CAM?

Overview

For many around the world, spirituality plays an integral part in complementary and alternative medicine, or CAM. Large-scale surveys conducted in the United States, Europe, and other parts of the world show that spirituality is associated with higher levels of CAM usage and with the use of a wider variety of CAM modalities to treat many illnesses, including depression, headaches, back and neck pain, gastrointestinal problems, allergies, diabetes, and cancer.

Prayer and other Modalities

Spirituality is considered by some researchers and practitioners to constitute CAM practices per se. Some CAM modalities, such as prayer, are explicitly spiritual in nature, while other modalities, particularly mind/body therapies, often have a spiritual component. The most prominent example of spirituality as CAM is that of prayer, an active process of appealing to a higher spiritual power. Prayer as CAM includes solitary and group prayer on behalf of oneself or others. Based on data from the 2002 National Health Information Survey, the National Center for Complementary and Alternative Medicine (NCCAM) (later renamed as the National Center for Complementary and Integrative Health (NCCIH)) reported in 2004 that prayer for oneself was the most widely used CAM modality among Americans. (It was endorsed by more than 60 percent of survey respondents.) Prayer for others was the second most commonly used modality, and prayer in groups was the fifth most commonly used modality. Older adults, women, and ethnic and racial minorities were more likely to use prayer as CAM.

The NCCIH, however, no longer considers prayer a form of CAM, a change that has led to much controversy. For example, considering prayer a form of CAM leads to increased estimates of CAM usage. Excluding prayer from the definition of CAM, however, does not reflect the true numbers of CAM users.

Another spiritually based CAM is faith healing. This includes therapeutic approaches based on religious faith. Faith healing is most commonly associated with some Christian denominations and is typically conducted in religious communal settings. The therapeutic powers of faith healers are attributed to their evocation of divine or supernatural influences, which may bring about miracles. Relatedly, other cultural and religious traditions feature spiritual healers, such as shamans and curanderos, whose healing powers are largely spiritual in nature. Many traditional cultures do not draw clear distinctions among physical, mental, and spiritual health. In addition to explicitly spiritual modalities, other CAM modalities, such as meditation, yoga, Tai Chi, qigong, and Reiki, often have a spiritual component.

Effectiveness

Evidence regarding the effectiveness of spirituality- based forms of CAM is preliminary, given the many limitations of research and the complexity of the issues. For example, the most common spiritual CAM modality, prayer, is complex and can take many forms, including conversation, intercession, contemplation, and ritual; these different types of prayer may have different effects on health and well-being. Research suggests that some types of prayer can be beneficial to the person praying and can include the alleviation of emotional distress and pain. Such effects have been attributed to increased relaxation, less distraction, an increase in positive emotions, and divine intervention. Research indicates that most people who use prayer as CAM find prayer to be helpful.

More controversial is distance or intercessory prayer, which involves the influence of praying for the health of another person independent of that person’s knowledge of the prayer. Intercessory prayer has received much research attention, including attention from researchers using large, randomized control trials. In the aggregate, results are inconsistent and the interpretation of findings remains hotly debated.

Evidence of the effectiveness of faith healing, for example, is sparse. A small
but growing body of literature suggests, however, that CAM modalities such as
meditation and yoga are more effective in alleviating
pain and improving functioning when they include an explicit spiritual
component.

Although persons rarely discuss with health care providers their reliance on spirituality as part of their approach to personal health, evidence suggests that such communication may facilitate understanding and promote better care. Approaches to integrative medicine now emphasize the need to pay attention to the spiritual issues and concerns of one’s patients.

Bibliography

Barnes, P. M., B. Bloom, and R. L. Nahin. “Complementary and Alternative Medicine Use Among Adults and Children: 2007 United States.” National Health Statistics Reports 12: 1–23. Print.

Barnes, P. M., et al. “Complementary and Alternative Medicine Use Among Adults: United States, 2002.” CDC Advance Data Report 343 (2004). PDF file.

McCaffrey, A. M., et al. “Prayer for Health Concerns: Results of a National Survey on Prevalence and Patterns of Use.” Archives of Internal Medicine 164.8 (2004): 858–62. Print.

Roberts, L., et al. “Intercessory Prayer for the Alleviation of Ill Health.” Cochrane Database of Systematic Reviews (2009): CD000368. Reviews findings regarding intercessory prayer and describes the limitations of research on this topic. Available through EBSCO DynaMed Systematic Literature Surveillance at http://www.ebscohost.com/dynamed.

Tippens, K., K. Marsman, and H. Zwickey. “Is Prayer CAM?” Journal of Alternative and Complementary Medicine 15 (2009): 435–38. Print.