by Jo Marchant
Meanwhile Gail Ironson asked the HIV patients she followed how they viewed their God. (She didn’t explore the atheists in the sample because there were so few of them: 6.3%.) She measured their responses on two separate scales: whether they saw God as “positive” (benevolent, forgiving and merciful) or “negative” (a harsh judge who would punish them for their sins). Those who viewed God positively—like Sheri—had significantly slower disease progression, with five times better preservation of CD4 cells, than those who did not.18 By contrast, those who viewed God as harsh and punishing lost CD4 cells more than twice as fast as those who didn’t. The effects were significant after taking into account other aspects of lifestyle, health and mood—in fact the patient’s view of God predicted disease progression better than any other psychological factor that Ironson measured.
One of the participants who felt abandoned by God was Carlos, a man with a Catholic background who had just moved to New York to study for a BA degree when he was diagnosed with HIV. “I had no friends in New York so I had to deal with it on my own,” he told Ironson. “Any belief that I had in a higher being or in a spiritual presence was completely extinguished…I felt like I was being punished. I thought I was going to die for my sins.”19 Unlike Sheri, who remained symptom-free for the duration of the study, Carlos’s infection progressed rapidly to AIDS after he was diagnosed.
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IT’S JUST before dusk and I’m standing across the river from the grotto at Lourdes. I’m in front of the Accueil Notre Dame, one of the hospitals here that caters to sick pilgrims, waiting for the Procession of the Blessed Sacrament to begin. A group of priests appears, reverently carrying the round, white wafer in its gold stand, sheltered beneath an ornate gold-and-cream canopy.
It’s busy. The priests congregate on an open area of ground in front of the hospital, joined by a group of people in wheelchairs and on stretchers. A crowd of other pilgrims and tourists forms a circle around them, while many more sit on the wall in front of the river, in a line that stretches away down its banks. There’s a short service, then everyone starts walking towards the nearest bridge. The wafer goes first, followed by the stretchers—carrying patients with oxygen masks and drips—then the wheelchairs, pushed by nurses in white headdresses and black capes with a distinctive red cross.
After the most sick, other pilgrims fall into line, pulled along in blue, wheeled “chariots.” There’s a girl, maybe 12, dressed in a green anorak and pink jeans, with her hair in a ponytail. She’s hunched over, rocking violently back and forth, but holding her mother’s hand triumphantly in the air. Just behind her is a little boy, aged two or three with a mop of blond curls, sucking at the sleeve of his blue cardigan.
Those who can walk follow behind. There are hundreds of us, in a procession that moves slowly across the bridge then snakes around in front of the big, spired church that marks the site of the grotto. Choir music is pumped through loudspeakers along the route. A robust old woman next to me belts out, “Amen! Amen! Alleluia!” while using her umbrella as a walking stick.
Instead of going into the church, we wind down into what looks like a concrete underpass, and I wonder where on earth we’re going. Once underground, however, we turn a corner and the passageway opens out into an enormous subterranean basilica, as big as a football pitch (I read later that it can hold 20,000 people). It’s made of concrete, with lines of square floodlights and great diagonal rafters.
Scarlet banners hang along each wall, decorated with pictures of the saints. Hundreds of wooden benches line up in neat rows facing a raised central platform, with steps on all four sides that make it look a bit like a pyramid. It’s bright in the spotlights and supports a large, white altar; a silver sculpture of Christ on the cross; and a golden ball full of incense, with gray smoke that curls up towards the roof.
Directly in front of the platform are rows of those blue chariots—the sick in pride of place. And now I see the choir, over to one side, accompanied by trumpets and a pipe organ. As the service begins, screens suspended from the ceiling zoom in on the priests around the altar, showing us the action up close; pictures that are also transmitted to the faithful around the world on Lourdes TV.
We sing and chant in a range of languages—Latin, French, German, Spanish—guided by subtitles on the screens. There’s lots of standing up, sitting down, joining in. At one point, priests in cream robes walk around with the wafer, holding it up in front of each group of the congregation as they ring a bell. When they get to our section of the hall, the people around me all kneel and cross themselves.
I feel out of place amid all this singing and signing. I’ve never attended a Catholic Mass, and I usually try my hardest to avoid religious ceremonies. I get uneasy about the idea of substituting reason and clear thinking for robes, incantations and mysterious higher powers. But at the same time, it’s beautiful; a hugely impressive assault on the senses. The banks of lights, the colors of gold, red, cream, silver. The sweet but smoky smell of incense; the uplifting music; the enormous crowd. The synchronized physical exertion of standing up and sitting down.
Quite unexpectedly I feel a powerful sense of connectedness, as if I’m at the center of something much, much bigger. I get the feeling that, in this great hall, we’re bound by threads that stretch far around the world as well as forwards and backwards through time. Around me, thousands of people who have never met before today are speaking and singing in different languages yet in perfect timing and harmony. And their pictures are being beamed around the planet so that this moment can be shared by millions more. These chants and movements form a ritual that people have been participating in for centuries, and that will likely live on for centuries to come.
Neuroscientist Andrew Newberg argues that rituals like this are a hugely important component of how religion and spirituality affect us physically as well as mentally. They have such a powerful effect, he argues, because their roots stretch back deep into our evolutionary history. In the animal world, they started out as mating rites. But as our brains have become more complex, he says, we have adopted rituals for other purposes too, from a baby shower to the Olympic opening ceremony. “Part of what rituals ultimately do is connect us with each other,” says Newberg. Whereas mating rituals connect two individuals, in religious or other cultural contexts they help to bring a society or community together in a common set of actions and beliefs.
When it comes to religion, rituals bind us together so forcefully because they make the abstract beliefs we share seem more concrete. “When you hold a particular belief you can feel pretty strongly about it,” he says. “But if it is incorporated into a ritual, it makes it a far more powerful kind of experience, because it is something that you not only think about in your brain but feel in your body.”
This can be as simple as reciting the Rosary, which links a set of religious beliefs with the physical act of counting beads between your fingers. But rituals are probably more powerful when they involve groups of people all doing the same thing together, as we are in this giant underground hall.
Lourdes hasn’t turned me into a believer. But after attending this giant underground service, I’m struck by the physical force that religious belief can have. Here in this basilica, a shared vision is translated into something that we can all see, hear, feel, smell (and for those who take communion, taste). Religious belief might be intangible but this ritual has made it a solid thing in the world. Suddenly I don’t find it so hard to accept that such belief might have a potent effect on the body too.
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IF THE physiological effects of religious belief can be explained by mechanisms such as stress and rituals, does God even need to be in the picture? We’ve already seen some of the physical benefits of secularized meditation programs such as CBCT and MBSR, but do they lose anything in translation?
Hardly anyone has studied this, but psychologist Kenneth Pargament believes the spiritual aspect does make a difference. He and colleague Amy Wachholtz asked volunteers
to meditate on a particular phrase. One group of volunteers chose between spiritual phrases, such as “God is peace” or “God is love,” while those in another group were asked to select a non-religious phrase, such as “grass is green” or “I am happy.” The volunteers meditated 20 minutes a day for two weeks, then Pargament and Wachholtz tested their pain tolerance. Those in the spiritual meditation group were able to keep their hands in a bath of ice-cold water for almost twice as long (92 seconds) as either the secular meditation group, or people who spent the same amount of time learning a relaxation technique.20
In a second study of 83 migraine sufferers, those who practiced spiritual meditation for a month had fewer headaches and greater pain tolerance than the secular meditation and relaxation groups.21 (They also felt less anxious and generally happier.) “Content counts,” Pargament tells me. “The spiritual phrase seems to magnify the impact of meditation.”22 These are small studies that need repeating, but if the results hold up, Pargament thinks that a spiritual perspective may help to reduce the emotional impact of the pain by placing it in a larger, more benevolent context. “It shifts the mind away from physical and mundane concerns to a focus on the larger universe and the individual’s place within it,” he says.23
Encouragingly for me, Pargament argues that spirituality doesn’t have to mean belief in a distinct creator, and that you don’t need to be religious in order to benefit from its effects. In his studies, volunteers who didn’t want to meditate on a religious mantra could choose an alternative, for example substituting God for “Mother Earth” (although only one person actually did this). Anything we perceive as having divine character and significance—as set apart or special—should work. In the U.S., this is typically understood as meaning some kind of divine figure: God, Jesus, something transcendent, he says. But it can be something else.
In Sweden, for instance, nature is often seen as sacred, with people responding to and experiencing nature similarly to how a religious person might experience God through prayer. “People write about their experience of being outdoors, being one with nature, feeling a pulse in nature that never ends,” says Pargament.
Someone might hold their work as sacred; the idea of a more just, loving world; or their family. Pargament quotes a mother of two young children: “To see my kids is to realize that they are—well, godlike…not because they are particularly unusual children, but because I could not with my own two hands have created anything as wonderful or amazing as they are…Just tickling their feet and hearing them giggle—that’s cosmic, that’s divine.”24
Pargament’s ideas dovetail with other research suggesting that seeing ourselves as part of something bigger, or having a meaning or purpose beyond ourselves, helps us to do better physically. For example, we heard in chapter nine how in a study of a three-month meditation retreat high in the Colorado mountains, stress researchers Elizabeth Blackburn and Elissa Epel found that meditators had higher levels of the enzyme telomerase—which slows cellular aging by protecting telomeres—than a group of controls. When the researchers looked at which psychological changes might be contributing to this effect, they found that the effect on telomerase was stronger in people who reported feeling a greater sense of control and an increased sense of purpose in life.25
The lead researcher of that study, neuroscientist Clifford Saron of the University of California, Davis, argues that this psychological shift towards purpose and control may have been more important than the meditation itself. The participants were already keen meditators, he points out, so the study gave them three months to do something they loved.26 Simply spending time doing what’s important to you, whether gardening or volunteer work, might similarly benefit health. What the study really shows, says Saron, is “the profound impact of having the opportunity to live your life in a way that you find meaningful,”27 whether that involves God or not.
Meanwhile UCLA’s Steve Cole, whose work on loneliness and gene expression we learned about in chapter ten, has also investigated happiness. He found in one study that people who score high in eudaimonic well-being (the satisfaction that comes from engaging in activities with a greater meaning or purpose) have lower expression of genes related to inflammation than those driven by shallower pleasures like shopping or having sex.28 Cole argues that having a higher purpose may make us less stressed about threats to our personal wellbeing. If we die, the things we care about will live on.
In other words, feeling part of something bigger may help us not only to deal with life’s daily hassles but to defuse our deepest source of angst: knowledge of our own mortality. John Cacioppo argues in his 2008 book, Loneliness, that we have an innate biological need for this connection. “Just as finding social connection is good for us, finding that transcendent something appears to be very good for us, whether it is a belief in a deity or a belief in the community of science,” he says. “It is only through some ultimate sense of connection that we can face our own mortality without despair.”29
Western society tends to value maximizing control and breaking through limits, says Pargament. “We try to solve problems. We try to enhance longevity.” But at some point, we all face events and experiences that we cannot control. And while Western medicine has brought huge advances in health and life expectancy, it isn’t very good at helping us to deal with those barriers when they hit. “The classic description is physicians when they realize there is nothing more they can do for their patients,” says Pargament. “Unfortunately at times they will just walk away. Sometimes even angrily because they face the limits of their control and they don’t know what to do with that.”
Spirituality, he argues, fills that gap by helping us to accept that we are frail, finite people. No matter how good medicine gets, “We’re all going to face problems that are somewhat intractable, including physical pain,” he says. “And eventually, we are all going to die.”
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I WANT to know about the miracles.
“If there’s one place in the Western world where there is a link between science, religion and health, it is Lourdes.” Alessandro de Franciscis, head of Lourdes Medical Bureau, is lounging with his legs crossed and his right arm hooked over the back of his chair. His office, a stone’s throw from the entrance to the underground basilica, is spacious and elegant, with sofa and armchairs—coffee-colored, padded, carved from walnut—arranged around a Persian rug. Behind them, a huge wooden desk sports an upright crucifix and an old-fashioned green desk lamp. On the bookshelf, Richard Dawkins’s The God Delusion and Stephen Hawking’s The Grand Design are prominently placed beneath four framed photos of de Franciscis meeting the Pope.
De Franciscis himself looks scholarly, with a high forehead and dark, graying hair. A former pediatrician from Naples, Italy, he also has a degree in epidemiology from Harvard. He’s charming but combative—he repeatedly fires names of scholars at me to see whether I’m familiar with their work, and refuses to be interrupted as he tells long stories, like a meandering but unstoppable train.
If anyone reports a cure in Lourdes, de Franciscis oversees the process of checking it. The bureau was created in 1883, “as a defense against the accusation of Lourdes as a place where there was too much superstition, too many miracles,” he says. “In France they felt very proud of being the country in which they had invented modern times. Rationalism, Cartesianism, all of that. That there was a place where people came in growing numbers to experience prayer and in some instances cures, it was disturbing.”30
Doctors affiliated with Lourdes began to examine and document every cure that took place. The aim, says de Franciscis, was nothing less than “proving the existence of God through the power of scientific explanation.” Pope Pius X sanctioned the endeavor in 1905, when he decreed that claims of cures at Lourdes should be submitted to “a proper process.”
Led by de Franciscis, that process continues today. If a cure is reported, he convenes a meeting of affiliated doctors present in Lourdes at the time. They gather information
on the case. Was the person definitely sick? Are they definitely better? Did anyone witness the moment of the cure? They also request records and scans from the claimant’s home country, from before and after their Lourdes visit; check whether the person has received any treatment that might explain their recovery; gather medical opinions; and wait, sometimes decades, to ensure that the cure is lasting.
If the bureau doctors are satisfied, they send their notes to the International Medical Committee of Lourdes (CMIL), which votes on whether the event is definitely an unexplained cure, and produces a formal medical report. As doctors, that’s as far as they can go, says de Franciscis. The report is sent to the claimant’s local bishop to decide whether the cure represents a divine miracle.
De Franciscis argues that this process gives Lourdes “a seriousness, an accountability in the relationship between faith and medicine” that isn’t found at any other pilgrimage site in the world. I had wondered if he might be defensive about the medical evidence supporting the 69 miracles announced so far, but he’s clearly proud of the reports and gives me copies of anything I want to see.
The documents he hands me include reports on cures from conditions such as cancer, blindness and paralysis dating from throughout the twentieth century. It strikes me that several of the original diagnoses, including that of a Frenchman said to have multiple sclerosis, are based on the patients’ experience and symptoms rather than physical tests. These people were dismissed by their doctors as hopeless cases, and the cures were clearly miraculous to those concerned. But rather than providing proof of paranormal or divine intervention, I wonder if what these recoveries really demonstrate is the power of the mind to impose devastating symptoms of illness upon us, and the power of religious belief to lift that burden.