Mind, body, and medicine

What if some sorts of religious belief turn out to be helpful in preventing and curing disease?

I’m approximately one-third as outraged as Harold and Mike are about the NPR “faith-healing” story.

First, the one-third: No, “quantum entanglement” doesn’t have anything to do with the the price of beef. And NPR shouldn’t have presented the idea that it might as a reasonable viewpoint. Too many New Agers think that the mantra “quantum mechanics” is a license to believe whatever bullsh*t makes them feel good, and NPR has no business encouraging that sort of mental and moral laziness.

But the other two-thirds of the broadcast were actually pretty interesting — actually counted as “science” according to the usual canons of scientific inquiry — and shouldn’t just be blown off because we think of faith-healers as people who don’t bathe often enough.

The story started out with someone looking at a group of people with long-standing HIV infection who hadn’t progressed to AIDS, and who also didn’t have the one known protective genetic variation. They seem to have in common a strong belief in God, and (if I understood what the scientist was saying) the result seemed to stand up in a prospective study: of HIV-infected people, those who took their infection as an occasion to become more religious had better health than those who became less religious as a result.

Now I can think of at least two obvious confounding factors: Maybe those who were progressing faster felt sicker, in ways the research didn’t pick up, and therefore were more likely to feel anger toward their previous object of worship. Maybe reacting by moving in a more-religious direction correlates with high positive affect, and positive affect also correlates with not getting sick. The reporter should have asked the researcher whether she’d controlled for those factors, thus helping the audience learn not only about the phenomenon but about how to think about question scientifically.

That said, the result is still sitting there, until someone knocks it over. And it’s no more mysterious than any of the other mind-body stuff that’s well established in the literature. Attitudes matter, and we’re not spending enough effort figuring out just how they matter and how patients might be taught to use mental exercises to improve their outcomes, in part because respectable medical researchers don’t want to rub elbows with Christian Scientists and holistic healers and suchlike riffraff.

Harold is outraged because the finding that attitudes mediate disease progression might be taken to imply that those who progress more quickly have only themselves to blame. And he’s outraged twice because he fully empathizes with those whose reaction to misfortune is anger at the forces they thought were protecting them rather than increased devotion.

But that outrage is a reason to think carefully about what we say, especially to patients, not a reason to disregard the finding. Yes, the people who ask cancer patients “Why do you think you needed to give yourself cancer?” ought to be strung up by their thumbs. But if it’s true — as it seems to be — that there are healthier and less healthy attitudes to take towards having one or another disease, we need to learn how and why, and if possible how to use that knowledge.

There’s a deeper question here for us atheists. (For these purposes, my own religious position is equivalent to atheism.) What if the sort of religious belief we think is not just false but rather cowardly — the idea that adults ought to entrust their welfare to an imagined super-parent in the sky rather than taking responsibility for it — turns out to be an aid to recovery? We already know that some sorts of false belief are healthy to have: the technical term for “not suffering from the illusion that one’s social standing and popularity are greater than they in fact are” is “depression.” But should we encourage false beliefs that happen to be healthy?

The other part of the show wasn’t really about healing by prayer; it acknowledged that the original studies suggesting that prayers might help people who didn’t even know they were being prayed for didn’t stand up to more rigorous tests. The study reported — done at the Institute for Noetic Scientists, which is a pretty respectable outfit — seemed well-designed, at least as described.

Put a subject in a room designed not to let any sort of information in. Point a camera at the subject. Sit a second subject, emotionally attached the first, in a separate room with a screen, which shows the subject when it’s lit, and which goes on and off at random intervals. Direct the second subject’s attention to the screen, and then monitor some basic physiological characteristics of the first subject: perspiration and blood flow.

Now physics tells us that the physiological readings ought to be uncorrelated with whether the screen is on or off, because there’s no physical way for the first subject to perceive whether or not the second subject is currently watching. (That’s when the researchers started babbling about “quantum entanglement.”) But the results showed an effect, as if the first subject came alert when the second subject started to pay attention, at what the researchers said was a .0001 level of confidence.

Now my best Bayesian guess is that they somehow did the experiment wrong. That can happen, especially when the people doing the experiment have a strong preference for one outcome over the other. If the experiment was done right, we either have to change our ideas about physics or admit that there is some non-physical connection between two minds. I’d need a hell of a lot of evidence before taking either step.

Still, since we have no account, or anything resembling an account, of how consciousness — not brain function, but subjective experience, with states such as “intending” and “knowing” — could arise from mere matter-in-motion-under-fields, I don’t think we should be too dogmatic about the limits of the possible interactions between consciousness and the physical world. I would have liked to hear the reporter ask the skeptical scientist just how he thinks the experiment went wrong.

Right now, we have a problem. We have a hugely successful biomedical research-and-therapy enterprise that’s fixated on understanding those aspects of disease and its cure that don’t depend on the beliefs and intentions of the patient. It has succeeded in part by walling itself off from the believers in the Evil Eye and demonic possession as causes of disease and of superstitious manipulations as cures. But it leaves out a bunch of stuff we know to be empirically important, and in doing so it has allowed those areas of study (even nutrition) to be colonized by quacks and airheads. (When the NIH started to study “alternative medicine,” that unit (never given much prominence or budget) was quickly captured by the “nutritional-supplement” industry.) It’s a cliche by now, but it’s still true: that research-and-practice machine is focused on disease, not on health.

The sort of biomedical research most likely to win a Nobel Prize is not necessarily the sort that yields the most improvement per dollar in human well-being. It would require an exceptionally brave NIH Director to take on that problem.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com