Faith and Healing: A Forum
By Alice Park
Three experts–the Rev. George Handzo, a chaplain with the HealthCare Chaplaincy of New York City; Dr. Andrew Newberg, a radiologist and psychiatrist at the University of Pennsylvania; and Dr. Richard Sloan, a psychiatrist at Columbia University–discuss the role that belief should play in science
What role does religion play in health, and health in religion?
Dr. Richard Sloan: Spirituality and religion play a substantial role in helping patients overcome discomfort. But I don’t think that it’s any business of medicine, and I think it’s extremely difficult for science to study. I am greatly supportive of the role of health-care chaplains for patients who have spiritual or religious concerns. But I don’t think it’s the doctor’s job to be involved in that, other than to refer to a professional.
So doctors should not be taking spiritual histories?
Sloan: I don’t think they should be taking spiritual histories.
The Rev. George Handzo: Dr. Sloan and I are pretty much in agreement, but it’s important how one defines spiritual history and what actually goes into that. There’s been a lot of fuzzy talk about what’s screening, what’s history, what’s assessment. I would like to differentiate a history, and call that screening, and say that’s the doctor’s job. The physician’s job, as Dr. Sloan pointed out correctly, is to discover where the problem is and get it pointed in the right direction. An assessment, a full [spiritual] assessment, would be the chaplain’s job.
Dr. Andrew Newberg: My primary area of research has been looking at the neurobiology of different religious and spiritual practices, and one of the things I try to advocate is that we need to learn more about the best ways of enabling doctors to find out the questions that they need to ask. We need to learn how best to ask those questions, when to ask those questions and how often to ask those questions.
A lot of people have concerns about physicians playing too much of a role in the religious and spiritual beliefs of patients, so we need to understand what both the doctor’s and the patient’s motivations are and try to understand when it shouldn’t be done and why it shouldn’t be done.
I felt woefully unprepared to deal with those kinds of issues when I found myself having to tell a patient that they now had cancer or that they were going to die soon, or talking about a family member who’s going to die soon when the family brought up religious and spiritual issues. I didn’t even know who to refer to. And I think there’s been some movement to at least help with that education, but I think we need to learn more about it.
Dr. Newberg, you are careful not to talk about humans as being hardwired for religion, because hardwiring implies a hardwirer, and science hasn’t yet established that.
Newberg: The real issue for us is to try to look at data and to interpret it carefully. If you’re doing a brain scan of somebody who experiences being in God’s presence, we have to know what that means. Basically, the scan is showing you what is happening in the brain when they have the experience. It doesn’t necessarily reduce it to just what is going on in the brain, and it also doesn’t necessarily prove that the person was actually in God’s presence.
So I think we have to be cautious about what we do with the information that we have right now. I think we have a long way to go in terms of really learning what the nature of those kinds of experiences actually is. That’s why even though I think the research shows that there are a lot of different changes that go on in the brain when people engage in religious and spiritual practices, that doesn’t mean that there was somebody who came in and did the hardwiring.
Dr. Sloan, how do you react to the idea of a divine interventionist?
Sloan: Well, that conception is antithetical to science. Science doesn’t deal in supernatural explanations, and that’s a supernatural explanation. Religion and science address different concerns, and it’s perfectly plausible, I think, as Dr. Newberg has suggested, to be a scientist and still believe in divine presence. But that doesn’t mean that your belief in the divine presence finds its way into your science. Those are different things. Religion deals with a different domain.
Handzo: Yes, I would say that’s right. I think part of the reason this whole debate has raised some hackles in the religious community is the perception that we’re trying to prove the existence of God. And, of course, religious people, and I think rightfully so, say, No, no, no, that’s a matter of faith. You are now crossed over, and you are trying to take science into the realm of religion and use scientific method and methodology to say that my faith is right or wrong. That’s just not going to work, and I’m going to push back on that as a religious person.
I started out as an undergraduate as a scientist and only went to religion later, and there are those people who said to me that I couldn’t be ordained because I had been a scientist, and that polluted my thinking.
Science and religion have different ways of thinking about reality that are both helpful, and both need to be accounted for. And I think in terms of health, the issue is how do we account for–in the health-care system and in the practice of health–the process of faith? And how does that integrate into how medicine gets practiced or how chaplaincy gets practiced or psychology gets practiced?
Sloan: I frankly think there is nothing that science can do that can contribute to religion, and I think it’s a fatal flaw to think that you can use the methods of science to learn something meaningful about religion.
But can’t the tools of science be used to teach us about the subjective experience of religion–as Dr. Newberg is describing, with brain scans and the like–and teach us something about how we process it?
Sloan: Let me ask you a different question. Would it be meaningful if we did a brain scan of someone before and after eating cheese? I don’t understand the value of developing beautiful images, very appealing, aesthetic images of brain scans and people engaged in various religious experiences. I don’t see the value any more than imaging people while eating cheese.
We explore what the brain looks like in depressed people, in people struggling with memory issues …
Sloan: But why? To understand how the brain works so we can develop interventions to treat depression and to treat memory loss. And that’s absolutely appropriate. Are there interventions that will come from [imaging religious experiences]?
Handzo: Well, certainly some work is pure research in order to fathom things better. There are no particular interventions that come from picking up rocks on the moon, but we do it because it teaches us more about the world around us.
Sloan: Fair enough, but there’s a seductive appeal about neuroscience explanations, that there must be something significant here because you can see it in the brain scan. We’re infatuated with neuroscience because of the very beautiful images that we can see, but the real question is, What do those images tell us that’s of any value, whether it’s basic science or applied?
Handzo: Neuroscience may be a smaller case of a larger reality. We live in a culture where I think science, the evidence of science, trumps the evidence of faith. If you give a drug that’s supposed to work in six months, and three years later you get a remission, that’s called delayed effect. And I’ve said to my oncologist colleagues, Why is that not a miracle? What evidence do you have, because you have no evidence that this is delayed effect–it’s just what you’re calling it. Tell me that that’s not a miracle?
And the same thing in psychiatry. To be ordained in most religions, at least in Christian religions, you have to prove to a group of other people that God has spoken to you. This in psychiatry is called thought insertion. It’s a diagnosis. So if I believe God has spoken to me, in the religious world I get to stand for ordination; in the scientific world, I could be diagnosed. Maybe both are right.
If you walk into my hospital room, and I say I don’t believe in God, and you still provide a service, is this really spiritual at all? Could the care be the equivalent of such secular practices as meditation or yoga, and how would you distinguish that?
Handzo: Well, I think it’s important to differentiate and to define spirituality and religion. Religion has to do with an organized set of beliefs. So I’m a Lutheran; I adhere to a set of beliefs that has been defined as Lutheran, and I identify with a community that’s Lutheran.
Spirituality, I think, is a much broader concept, and it has to do with probably a personal quest. Lutheran is what some other people have said Lutheran is. Your spirituality is what you say it is, and so my job as a chaplain is to discover what you say it is and to help that spirituality be helpful to you in coping with the illness or whatever is going on in your life.
Newberg: I think trying to define it is absolutely one of the areas that we really need to get a handle on, because one of the mistakes that is often made in the medical context can be that, oh, somebody is this particular religion, so they believe in these things. We have to be careful about how we define and slot everybody into these different categories. Atheists as well.
Getting back to brain structure–Dr. Sloan, would you see the varying degrees of spirituality in people as being rooted in something as simple as brain architecture?
Sloan: Well, all our experience in some way derives from the brain–everything we experience, from meditation to eating cheese. So in some way, it’s rooted in the brain. The concern I have is that science operates in a reductionist way, and if you try to understand a spiritual experience or a religious experience from the science perspective, ultimately you are going to reduce it to the coursing of neurochemicals in the brain. And while that may be satisfying to a scientist, it’s anathema to a theologian, which illustrates the limits of science. There are some questions for which science can’t provide an adequate answer.
So, Rev. Handzo, how do you give that coursing of neurochemicals meaning? If you are counseling a patient, someone who has received a diagnosis of terminal cancer, what do you say?
Handzo: The secret is, we say as little as possible. There’s nothing you can say. I mean, that alludes to this whole theological question of why does this happen–and we simply do not know. I agree with Dr. Sloan: I don’t think that I want to know why God does it that way. Maybe God has nothing to do with it. I’m not sure any of those things are things I want to know, being a person of faith.
My job is to help them discover the meaning for themselves. What is the meaning for you? An example of that: I remember a mother of a child with cancer who said, “God is going to heal my son.” Well, the doctors knew that God wasn’t going to heal her son–I still held out–but eventually she came to the understanding that God was not going to heal her son. She said, “Well, you know, I didn’t listen to God well. God has another plan for my son, a greater plan.” For her, the fact that she could feel that God was still in control and understand that what God does is good–that was enough.
Sloan: So this is an issue that is periodically in the news. What do physicians–what does the health-care system–do for the patient if the mother assumes a religious stance that interferes with treatment?
Handzo: I think ethically we as a society have some duties to people who are unable to make judgments for themselves, and we have to make some judgments, right or wrong. And so I think we’ve done the right thing in saying sometimes, for whatever reason it is, whether it’s faith or psychopathology or whatever, people who have responsibility for minor children don’t make right decisions, are not fit to make right decisions –I don’t care why–and the state has an interest in preserving that life.
Just as free speech has a limit, freedom of religion has a limit. There are limits in our society. And that’s the way we’ve set society up.
Newberg: I’ll be idealistic for a moment. I would love to see the practice of medicine be a team event. In a hospital setting, you can have a team where you can bring in somebody from pastoral care to talk to them about that, you can bring in a social worker to deal with the social issues, a therapist if need be. And then just as you hope that they as a family are going to make a decision, you as a team can make a decision, and then that way you have the best way of optimizing what I think are really the four dimensions of the person–the biological, the social, the psychological and the spiritual. I think we as a society, and the medical profession in general, need to really think through these issues, because it would be great to function as a team, to really take care of the whole person and to heal that person in whatever way that means.