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The Placebo God

In the past three years, the number of American medical schools offering courses on spiritual-related issues has risen from three to more than forty.

A study at Dartmouth College found that among 232 open-heart surgery patients, nonbelievers were three times more likely to die within six months of the operation than those who reported that they receive solace from religious and community groups.

A recent Duke University study of some 1,700 older people reported that those who attended weekday services were half as likely as nonattendees to have high levels of interleukin 6, a protein which regulates immune and inflammatory responses in the body that has been linked to Alzheimer's, cancer, coronary disease, and osteoporosis.

Comparing the mortality rates in Israeli religious communities and secular kibbutzim over a sixteen-year period, researchers found that residents of the religious communities had consistently lower mortality rates. The study's authors concluded that belief in God, frequent prayer, and a supportive religious environment reduced stress, resulting in healthier and longer lives. Using brain imagery techniques, scientists have recently linked these "miraculous" results to the biological mechanisms that can turn an expectation of healing into an agent of change in the human body. If there was ever any doubt, it has now been medically proven that belief can be, in and of itself, an effective therapy.

The healing properties of belief were known in ancient times. The term placebo -- meaning a medication prescribed more for the mental relief of the patient than for its actual effect on his/her disorder -- is derived from the Latin root placere, to please; placebo actually means "I shall please." Wanting to please the doctor, the patient puts faith in the prescribed cure. Doctors have long recognized the power of the placebo -- "the lie that heals" -- to lower blood pressure, reduce inflammation, and shrink tumors. Placebo faith will work when one trusts the dispenser of the remedy, whether it be an Albert Schweitzer or an Elmer Gantry. The effectiveness of the "dummy pill" has nothing to do with the truth of the medicator or the medication. It proves only the power of faith in faith.

I do not doubt that the placebo effect can have real benefits in the healing process, but I am uneasy about using the "placebo argument" in a theological context -- as proof that God has had a direct hand in human healing. Some clergy have begun to seek advantage from the evidence of faith's effect on health. What a boon for membership recruitment: Join, pray, believe -- it's good for what ails you, and what have you got to lose?

But this pragmatic placebo argument is empty of meaning. It reminds me of the wager presented by the seventeenth-century theologian Blaise Pascal: "Either God exists or God does not exist. If God exists and you believe in Him, you will be rewarded with health and with prosperity. If God exists and you don't believe in Him, you will forfeit God's protection and succumb to disease and poverty. If God does not exist and you believe, what have you got to lose?"

The Pascal proposal assumes a quid pro quo: believe that there is a God and you will be rewarded. You have nothing to lose in believing, so why not believe? Why not swallow a placebo God if it promises relief?

But we do have something to lose. God demands more than belief; we are expected to emulate the Divine in our moral conduct. Authentic Jewish faith entails taxing our energies on behalf of others, especially the disenfranchised in our society. The prophet Isaiah exhorts us to examine not our beliefs but our actions:

Is this the fast I desire,
a day for men to starve their bodies?
To bow their heads like a bulrush
and lie in sackcloth and ashes?
No, this is the fast I desire,
to unlock the fetters of wickedness
and untie the cords of the yoke,
To let the oppressed go free,
to break off every yoke,
To share your bread with the hungry,
to take the wretched poor
into your house,
When you seek out the naked
to clothe him
and not ignore your own kin.

Placebo faith is amoral, for it is interested only in the self. Authentic faith, on the other hand, demands idealistic behavior, risk, sacrifice.

Magic is another form of placebo faith, an illusion that may work for those who believe in its power. That is why in the Bible we are enjoined by God to resist all forms of magic. "There shall not be found among you any one that makes his son or daughter pass through fire, or one that uses divination, a soothsayer, or an enchanter or a sorcerer, or a charmer, or one that consults a ghost or a familiar spirit or a necromancer who inquires of the dead" (Deuteronomy 18:10).

The Jewish rabbinic tradition also rails against psychic and faith healers. In his Code, Maimonides cautions, "If you whisper a spell over a wound while reciting a verse from the Torah or recite a verse over a child to save it from terrors, or place a scroll or phylacteries on an infant to induce it to sleep, you are not only included in the category of sorcerers and soothsayers but among those who repudiate the Torah. For these people use the words of the Torah as a cure of the body whereas they are exclusively a cure of the soul" (Hilchot Avodah Zarah 11:12). Jewish tradition prohibits healing one's body with sacred words or objects (Talmud Shavuoth 15b). Cure of the body calls for the services of a physician, not a soothsayer. The Jewish reality principle leads the Jerusalem Talmud to declare, "It is prohibited to live in a city that has no medical doctor."

Yet, Jewish tradition understands that magic can work. The Bible opposes magic not because it fails to produce results, but because it constitutes a threat to moral intelligence. Our tradition goes to great lengths to warn against magical thinking which bewitches and seduces us into taking dangerous shortcuts to spirituality. In times of great distress, it is all too common to become impatient with rationality. We are easily tempted to suspend reality, intellect, credulity, and even moral sense to a placebo healer -- a psychic, a guru, even a rabbi who promises instant gratification.

Two examples: During one of our congregation's adult education lectures, a woman approached me to ask what I thought about a particular Kabbalah center she had been attending. She showed me a red string around her wrist that, she was told, was keeping away shedim, demons. She then volunteered that a rabbinic guru at the center had persuaded her to purchase an expensive set of volumes of the Zohar, the central work of the Kabbalah. I asked her whether or not she could read Aramaic. "Oh," she said, "my rabbi said that was not important." All she had to do was to open the book, choose a page, and cross her fingers over any line and her petitions would be answered. There was no need to understand anything, no need to define or elevate her character. Just do it.

At the Western Wall, a man wearing chasidic garb approached me and offered to place the tefillin phylacteries on my arm and my head. He did so quickly and competently, without offering an explanation as to the meaning of the boxes and the winding of the leather thongs. It was indistinguishable from a magical rite. My edification or elevation was unimportant; what counted was the sheer performance. Just do it.

Magic is beguiling, and can be confounded with prayer. But magic is not prayer. Magic is obsessed with results, however achieved. Authentic Jewish prayer is concerned with the effect it has on the character of the worshiper.

I fear the magicization of Judaism and the mechanization of ritual. Jewish faith is not blind or mute; it is open to the tests of reason, morality, conscience, and character.

I also fear that health has become a new religion in which prayer and belief have been reduced to means. The new spiritual imperatives are to lower LDL and raise HDL. The medicine cabinet has become the new aron kodesh, the holy ark. We exercise religiously on the treadmill of salvation. This augurs a dangerous reversal of means and ends. It tends toward an unhealthy narcissism and produces its own sickness: hypochondria.

Authentic Jewish wisdom affirms that good health is both a prerequisite and a byproduct of a good life, but it must not be the end-all of our lives. Authentic Jewish religion says, yes, prolong your life, but what for? Yes, become slimmer and trimmer, but what for? Yes, pursue pleasure, but what for? Contemplating this question -- "what for?" -- is the beginning of spiritual wisdom. The Psalmist summed it up in his refrain, "Not for my sake Lord but for Thine." "I shall not die but live in order to recount the works of the Lord" (Psalm 118).

When faith and religion are restored to their proper place in the order of our values, the pursuit of health can help us achieve a deeper, more moral meaning in our lives. Then we can engage not in placebo prayer but in real Jewish prayer. For what do we pray? "Give me health so that I can help care for others." "Give me strength so that I can support the fallen." "Give me joy so that I can rejoice the joyless." "May I acquire in order to give away."

Let not the pursuit of health consume us. Let us direct ourselves instead toward real and worthy goals: toward prayer that enjoins us to invest our lives with meaning and high purpose.

Harold M. Schulweis is rabbi of Temple Valley Beth Shalom in Encino, CA and author of For Those Who Can't Believe.