Are Healing Ceremonies Useful for Enhancing Quality of Life?

Abstract

Objectives:

In line with the growing interest in integrated health care approaches, both nonindigenous (e.g., Western) and indigenous people are participating in healing ceremonies. However, little is known about the potential health-related benefit of healing ceremonies. Thus, the current study sought to close this gap in the literature by exploring the effect of healing ceremonies on participant's self-rated quality of life.

Design:

Data were gathered at three time points (T1: 4 weeks before ceremony; T2: 2 days before ceremony; T3: 4 weeks after ceremony).

Participants:

25 persons with various diseases participated in the healing ceremony.

Interventions:

A 6-hour healing ceremony was conducted.

Outcome measures:

Mental, physical, emotional, and spiritual quality of life were assessed.

Results:

Participation in a healing ceremony increased mental, physical, emotional, and spiritual quality of life.

Conclusions:

As part of integrative health care, healing ceremonies are potentially useful for fostering participants' quality of life.

Introduction

There is currently a trend for people from Western cultures to participate in healing ceremonies that originate from indigenous cultures, such as Vedic cultures (e.g., yagna¹) or Native American traditions (e.g., sweat lodges)² This trend is in accordance with the growing interest in integrated health care approaches. Despite their importance for indigenous and Western participants, little research has been conducted on the potential usefulness of healing ceremonies for people today. Thus, the present study tests whether healing ceremonies affect participants' self-reported well-being (i.e., quality of life [QoL]). Because it is among the first to explore the potential benefits of healing ceremonies, this study contributes to the understanding of a possible addendum to integrative health care.

Ceremonies and Healing Ceremonies

Hewson and Rowold³ have defined ceremony as “an event, infused with ritual significance, performed on a special occasion.” Ceremonies typically include a ceremonial leader and a group of other people, such as singers, who support the ceremony. In addition to physical healing, healing ceremonies also address clients' emotional concerns, such as unhealthy relationships, and mental issues, such as an inability to focus. Because most indigenous traditions do not separate spiritual and medical issues, healing ceremonies also address the client's spiritual well-being. For example, the relationship between the client and the particular higher being in which the client places his or her faith is often addressed within the healing ceremony (e.g., blessings). In contrast to the typical interaction between doctor and patient in Western societies, healing ceremonies tend to (1) span a longer range of time, from several hours to several days; (2) explicitly include both rational and emotional aspects of healing and well-being, such as expressing emotions; (3) aim at balancing the client in a holistic way (e.g., assigning regular exercises [of consciousness], such as meditation); and (4) reconnect the client with spiritual values and practices. In addition, healing ceremonies may include some form of hands-on healing, an ancient technique intended to heal and strengthen the human energy field, which in turn is hypothesized to heal the physical body.^4,5

Potential effects of healing ceremonies on QoL

Positive effects of healing ceremonies have been reported throughout the literature. For example, Wagemakers-Schiff⁶ found that after a Native American sweat lodge ceremony, participants described their personality in more positive terms. However, more relevant to healing a client are indicators of his or her well-being. One such indicator that has gained increasing attention from the research community is QoL. Gomez and Fisher⁷ recently added the construct of spiritual QoL to the more commonly addressed notions of mental, emotional, and physical QoL. Taking account of the four aspects of mental, emotional, physical, and spiritual QoL allows for a comprehensive and holistic description of well-being.^8,9 These four aspects of QoL have been described as integral to traditional frameworks of health and well-being.¹⁰

To the authors' knowledge, researchers have not yet tested the effect of healing ceremonies on participants' QoL (or related constructs). To better understand the potential effects of healing ceremonies, the current study explores the four facets of QoL noted above: physical, emotional, mental, and spiritual. These four aspects are in accordance with the vast theoretical literature on healing ceremonies that claim healing ceremonies confer broadly positive effects on QoL^3,6,11
–13 and are congruent with a world view shared by many indigenous cultures that emphasizes the balance between mental, physical, emotional, and spiritual aspects of human life.^10,14 These four aspects of QoL are deeply interconnected with social aspects of life (e.g., friendship, mutual support). In fact, many potential beneficial ceremonial elements are typically social in nature, as will be outlined below.

Mental QoL

Healing ceremonies are hypothesized to improve participants' mental QoL (hypothesis 1). The ceremonial leader creates a “shared mythic world,”¹² often through storytelling or sharing key concepts about the meaning of life,¹⁵ so that the client can reorder his or her cognitive domain. Typically, the mythical world in which the ceremony is embedded offers to the client cognitive resources that have been neglected. For example, sacred creation myths may present a world view engendering positive thoughts and emotions. Sacred creation myths also reposition the client within the stream of all of creation. In addition, anthropologic case studies also suggest that healing ceremonies can help clients with mental problems, such as depression.¹⁴

Physical QoL

For clients with disease, healing ceremonies aim to strengthen their health. Several pathways might exist that potentially account for physical healing through these ceremonies. First, through drumming, meditation, and other ceremonial elements, participants might enter altered states of consciousness.^11,13,16 Empirical evidence suggests that this can reduce stress and promote health effects. For example, studies have shown that mindfulness meditation can foster the production of antibodies.¹⁷ In addition, meta-analytic evidence indicates that transcendental meditation is beneficial for treating substance abuse¹⁸ and helpful for reducing increased blood pressure.¹⁹ Finally, a meta-analysis on meditation has reported medium effect sizes for stress-related constructs, such as anxiety.²⁰

A second pathway through which taking part in a healing ceremony might lead to improved health consists of the human energy field or biofield. Independent of culture or historical period, indigenous healers and ceremonial leaders around the world claim to manipulate and strengthen the biofield of their respective clients for the purpose of healing.²¹ The biofield is conceptualized as the partial electromagnetic body that surrounds and interpenetrates the physical body.^22,23 At the same time, various authors have hypothesized that the biofield is the vehicle for thoughts,^5,24 emotions,^5,25 spiritual experiences,^21,25 and the physical body.^22,24 In support of this notion, results indicate that hands-on healing positively affected clients' cortisol slope, an indicator of stress response.²⁶ Thus, techniques such as hands-on healing, dancing, and blessings are often designed and used to strengthen the biofield, which can help the immune system to fight diseases.⁵ Because these techniques are frequently used in healing ceremonies, it is thus hypothesized that healing ceremonies have a positive effect on physical QoL (hypothesis 2).

Emotional QoL

Numerous spiritual traditions, including Christianity, use healing ceremonies that focus on the celebration of life, oftentimes through feasting. Typically, these types of ceremony happen in groups and involve acting out and communicating strongly positive emotions, for instance sharing one's personal story.²⁷ When participants get in touch with their emotions, internal issues might be resolved more effectively.²⁸ In addition, healing ceremonies generally include several people, such as relatives, who care deeply about the client's story, thus creating an atmosphere of strong emotional support. According to an interview study with a sample of Vietnam combat veterans,²⁸ ceremonies are “highly effective vehicles for accessing and containing intense emotions.” On the basis of this preliminary empirical result and the theoretical notions described above, it is hypothesized that healing ceremonies have a positive effect on emotional QoL (hypothesis 3).

Spiritual QoL

Ceremonial methods, such as blessings and prayers, are explicitly designed to reconnect the client with a higher source or power. The content of songs and prayers also gives the client a spiritual framework for inner healing and growth. The benefits of storytelling have been noted not only for ceremonies but also within a current trend in family medicine called narrative medicine. The expression of spiritual values in prayers, for example, can help people find orientation and courage in an increasingly complex and stressful world.²⁹ In general, practicing a form of religiosity represents a powerful resource for improving health-related indicators, such as blood pressure, as well as QoL.³⁰ Similarly, spiritual well-being has been closely linked to subsequent happiness,⁹ self-esteem,³¹ and reduced cortisol.³² In light of these theoretical arguments and empirical findings, it is assumed that spiritual QoL increases through participation in a healing ceremony (hypothesis 4).

Materials and Methods

Participants and procedure

Potential participants were contacted across several clinics and offices of hands-on healers and medical doctors in Germany. The study goals were communicated and full anonymity was assured. Eligible participants had to be able to attend a healing ceremony, chronically ill for at last 3 months, older than age 17 years, free from acute conditions, under the supervision of a medical doctor, without prior experience with healing ceremonies, and free from psychiatric conditions.

Overall, 40 persons, all of whom were white, participated in the study. Twenty-five of the 40 participants returned both pre- and postceremony surveys. The mean age was 53 years (standard deviation, 12). Eighty-four percent were female. The main symptom/diagnoses were: neck/back pain (n=8), digestive problems (n=8), severe stress (n=7), carcinoma (n=6), other (n=6), neural disorders (n=3), thyroid dysfunction (n=2), anorexia (n=2), depression (n=2), neurodermatitis (n=2), sleep disorder (n=2), compromised immune system (n=2), heart disorder (n=1), Parkinson disease (n=1), migraine (n=1), memory disorder (n=1), multiple sclerosis (n=1), myoma (n=1), and rheumatism (n=1).

The present study was based on a pretest/post-test and quasi-experimental design. The participants served as their own control group^33,34 during a 4-week period before the healing ceremony. Each participant assessed his or her respective QoL 4 weeks before the healing ceremony (T1), again 2 days before it (T2), and then 4 weeks afterward (T3).

Intervention

The ceremony was designed for the purpose of the present study, and its aim was to improve QoL of the participants. A ceremonial master with 10 years of experience led the proceedings. Given that each participant has a unique life story and health profile, the master prepared the healing ceremony by studying the personal histories that the participants provided and information that the medical doctors shared about the participants' health-related issues. In addition, 12 hands-on healers with a professional tenure greater than 3 years supported the ceremony. These healers were all successful participants in the Crucible Training (see www.rosalynlbruyere.org), a long-term program led by Reverend Rosalyn Bruyere, DD, and designed to develop hands-on-healing abilities. For 4 decades, Rev. Bruyere has been an internationally renowned healer, teacher, and researcher, whose numerous research projects have had a profound impact on alternative and complementary medicine. For example, her collaboration with Dr. Valerie Hunt yielded a detailed understanding about the process of structural integration³⁵ and correlates of the biofield, such as high-frequency electromyographic patterns.²¹

The healing ceremony started by welcoming the participants. The ceremonial master then delivered a short sermon, which was followed by a prayer. The hands-on healers danced and sang. For each participant, an individual hands-on healing session was conducted under the supervision of the ceremonial master. Thereafter, the participants were advised to sit in a circle and meditate together. An individual healing ritual was then performed for each participant separately, in which the respective participant stood in the middle of a circle of all of the other participants. The ceremonial leader shared the life story of that participant with the group, prayed, and blessed the client. The healing ceremony ended with a feast, which gave the participants the chance to express personal issues. Overall, the healing ceremony lasted 6 hours. The ceremonial master, on the basis of his training, experience, and ethics, required that to prevent potential damage to the participants, only experts trained in ceremonial work should be involved with the healing ceremony. Furthermore, the master carefully designed the specific elements of the individual healing rituals and the content of the prayers, and he stressed that for participants with other needs, life stories, and backgrounds, other ceremonial elements would likely have been required.

Instruments

Validated scales for the assessment of various facets of QoL were used in the present study. Rowold's⁹ scales to assess mental, physical, and emotional QoL were used because adequate construct validity and reliability of these scales have been established.⁹

Mental QoL

Six items were used to assess mental QoL (sample item: “I was confused,” reverse coded). Internal consistency estimates at both time points (i.e., α=.79) were good.

Physical QoL

Seven items were used to assess physical QoL (sample item: “Pleasant sensation of the body,” α=.81).

Emotional QoL

To assess emotional QoL, four items were used (sample item: “Experiencing positive emotions [e.g., joy, admiration, enthusiasm],” α=.84).

Spiritual QoL

A German validated (Rowold, 2011)⁹ version of Gomez and Fisher's⁷ Spiritual Well-Being Questionnaire was used for assessing aspects of personal, environmental, communal, and transcendental spiritual QoL (sample item: “Experiencing unity with god”), with a good internal consistency estimate for the overall scale (16 items, α=.87).

All items were Likert-type items with 5-point response categories (i.e., from 1=totally disagree to 5=totally agree).

Statistical analysis

To test the effect of the healing ceremony on the four QoL scales, repeated-measures analyses of variance were conducted. In addition, the effect size was calculated, where the effect size d was equal to the difference between the intervention (T3−T2) and control (T2−T1) group gain scores, divided by the pooled standard deviation and corrected for potential sample-size bias. All statistical analyses were performed with IBM SPSS Statistics Version 22.0.

Results

Descriptive statistics about all four aspects of QoL for the three time points are summarized in Table 1. In line with the hypotheses, the healing ceremony had a positive effect on participants' mental QoL (F=8.89; p<.01; η_partial ²=.16; d=0.82), as suggested by hypothesis 1. It also had a positive effect on physical (F=4.32; p<.01; η_partial ²=.23; d=1.05) QoL (supporting hypothesis 2), on emotional QoL (F=18.06; p<.01; η_partial ²=.27; d=1.36; supporting hypothesis 3), and on spiritual QoL (F=13.01 p<.01; η_partial ²=.21; d=0.88; supporting hypothesis 4).

Table 1.

Quality of Life in Control Group and Experimental Group

	Control Group (n=25)		Experimental Group (n=25)
Aspect of Life Quality	T1	T2	T2	T3
Mental	3.37 (0.51)	3.34 (0.64)	3.34 (0.64)	3.79 (0.47)
Physical	2.94 (0.62)	2.77 (0.67)	2.77 (0.67)	3.29 (0.65)
Emotional	3.26 (0.54)	2.98 (0.79)	2.98 (0.79)	3.63 (0.60)
Spiritual	3.51 (0.41)	3.44 (0.50)	3.44 (0.50)	3.78 (0.47)

Values are means (standard deviations).

Discussion

Healing ceremonies pervade both medical and religious history. From ancient Egyptian to Native American cultures,⁶ healing ceremonies have typically been an important part of the holistic approach to medicine. The current study explored for the first time the potential effect of healing ceremonies of participants' QoL. The findings from the current study support the notion that healing ceremonies foster participants' physical, emotional, mental, and spiritual QoL, which is in line with earlier claims from the theoretical literature on healing ceremonies.¹² However, while prior papers on healing ceremonies have been theoretical¹⁵ or case studies,²⁷ the present study explored the effect of healing ceremonies on QoL based on a sample of patients. Another interesting finding from the present study was that the effects obtained from the healing ceremony were observed after a 4-week-period following the ceremony. Thus, this healing ceremony appears to have had an effect that persisted for some time after it took place.

Interestingly, the magnitudes of the effect sizes were large (i.e., 0.82<d<1.36). Given that this was the first study on the potential effects of a healing ceremony on participants' QoL, and that the ceremony lasted only for about 6 hours, the size of these effects underlines the potential usefulness of healing ceremonies. As a comparison, the effect sizes are in the upper range of those found for the effect of a therapeutic intervention on various outcomes, such as QoL. For example, a recent meta-analysis found that typical psychosocial interventions, such as coping skills training, can improve the QoL of patients with cancer by an average effect size of d=0.65.³⁶ In addition, a meta-analysis on the effects of mindfulness meditation found that this type of meditation had a medium positive effect on mental (d=0.50) and physical (d=0.42) QoL.³⁷ These comparisons make clear that healing ceremonies present an interesting and vibrant area for future research.

Implications for practice

Healing ceremonies bring together elements from various traditions and techniques. Potentially, they can be seen as a valuable platform for fostering clients' well-being, both in both indigenous and nonindigenous cultures. They are also compatible with trends in Western medicine toward a more integrated and inclusive approach to health.² Although prior approaches have incorporated isolated elements from healing ceremonies, such as prayers, a total healing ceremony might confer greater benefits on a patient's QoL. More specifically, as the ceremonial leader suggested (see Materials and Methods section), a healing ceremony consists of a set of techniques that are arranged in a specific, client-centered way to bring maximum benefit for the participants. This stands in contrast with conventional medical treatments, in which treatments are addressed via algorithmic approaches to improving average outcomes. Thus, for health care clinics interested in fostering clients' QoL, healing ceremonies could be used for the benefit of clients. As a necessary precondition, experts for conducting healing ceremonies, such as Native American medicine leaders, should be consulted.

Limitations and directions for future research

On the basis of the design and results of the present study, several avenues for future research can be proposed. First, future studies should include an independent control group. Participants should be randomly assigned to the control or treatment group. Second, to gauge the effect of healing ceremonies on different client populations, future studies should focus on specific diseases, such as cancer or chronic back pain. Third, healing ceremonies combine several elements to yield maximum benefit for the participants' QoL. However, which of the specific elements have the strongest impact remains unclear. Fourth, it might be argued that various attitudes of the participants, such as their belief in the effect of a specific ceremonial element (e.g., blessing or hands-on healing), can moderate the effectiveness of healing ceremonies.

Footnotes

Acknowledgment

The authors would like to thank Rosalyn L. Bruyere and Ken Weintrub for guidance, and the hands-on healers who assisted in the healing ceremonies.

Author Disclosure Statement

No competing financial interests exist.

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