The efficacy of prayer is about the outcome of prayer requests. This topic has been discussed in many fields such as theology, philosophy, history, medicine, and psychology. Numerous religious traditions have complex understandings of the nature, function and expectations of prayer. For instance, within Jewish and Christian traditions there are diverse interpretations of prayers as requests for miraculous outcomes and also requests for relatively mundane outcomes. Some religious communities question whether the efficacy of prayer can be reliably measured or be meaningful since sacred texts such as the Bible have diverse situations and teachings such as stating that God shall not be coerced (Deuteronomy 6:16 - "You shall not put the Lord your God to the test"), some prayers for healing have been purposely rejected by God before (2 Corinthians 12:7-9 - Apostle Paul's thorn in the flesh), or specific conditions would have to be met before prayers can be heard (having guidance by the Holy Spirit). In Christianity, there is an emphasis for the need for guidance from the "Holy Spirit as to what needs to be prayed for and have taught that "God can not be coerced."
Philosophically, there is controversy on this topic which involving basic issues like statistical inference and "falsifiability as to what it may mean to "prove" or "disprove" something, and the "problem of demarcation, i.e., as to whether this topic is even within the realm of science at all.
The efficacy of prayer has been the topic of various scientific studies since "Francis Galton first addressed it in 1872. In recent decades, studies on prayer have become notable in medicine. According to the Washington Post, "...prayer is the most common complement to mainstream medicine, far outpacing acupuncture, herbs, vitamins and other alternative remedies." Recent medical studies on prayer have generally shown mixed results when it comes to healing from illnesses. The largest study, from the 2006 "STEP project, found no significant differences in patients recovering from heart surgery whether the patients were prayed for or not. The patients who knew they were receiving prayers did experience slightly higher recovery complications, possibly due to chance and the added anxiety or pressure caused from the expectations from the prayers. However, one of the authors of the study emphasized that this study did not say anything about the power of prayer itself. Dr. "Fred Rosner, an authority on "Jewish medical ethics, and others have expressed doubt that prayer could ever be subject to empirical analysis.
In comparison to other fields that have been scientifically studied, carefully monitored studies of prayer are relatively few. The field remains tiny, with about $5 million spent worldwide on such research each year. Despite all of this, the number of courses on prayer and medicine have increased in medical curriculum.
A number of studies have been performed to scientifically measure the impact of prayer, often within a medical setting. The studies performed have used different structural methods and measured both hard data (such as blood pressure variations) and soft data such as anxiety levels and number of doctor visits. They have measured first-person effects (where the beneficiary performs the prayer), second-person effects (where someone with a personal connection to the beneficiary performs the prayer), and third-party effects where a group of unknown people pray for the beneficiary.
Almost all second- and third-party studies have focused on "intercessory prayers or "direct petitions to God, while first-person studies have measured meditative prayers as well. In general, the requested outcome for a prayer as petition may be either an event in the physical world, e.g. the recovery of a person from an ailment, or an event in the spiritual world, e.g., the repose of a "soul via a "prayer for the dead. There are, of course, also certain types of prayer whose efficacy can not (by definition) be measured in the physical world, e.g. "Roman Catholic tradition includes specific prayers and devotions as "acts of reparation which do not involve a petition for a living or deceased beneficiary, but aim to repair the sins of others, e.g., for the "repair of the sin of blasphemy.
In most cases, the parameters measured within the medical studies cited here have not been all-encompassing from scientific or religious viewpoints. Mental attributes such as reverence, which are emphasized by religious figures such as popes and saints, have not been measured. The studies have also not measured whether meditation prior to prayer affects the outcome.
The studies cited here have also generally not measured physical parameters, such as "proximity to the nearest place of common worship", e.g., does a prayer by a Christian within a church have more effect than outside a church? Does it vary by the size of church? Does the effect increase or decrease if the Christian prays inside a Buddhist temple? What about a Buddhist praying in a church? Do prayers during Christmas have more or less effect than at other times of the year? And the distance between the beneficiary and the location of the prayer has not been clarified in the studies, e.g., does prayer for a person who is a continent away have the same effect as prayers for a person who is inches away? Does the "skill level" of the person praying have an effect on the outcome as stipulated by Wisneski and Anderson in their book The Scientific Basis of Integrative Medicine?
Wisneski and Anderson also hypothesize that different individuals have varying "prayer aptitude levels," just as different people have varying levels of athletic ability, and that the effect of prayer is the combined effects of ability and training. "Pope John Paul II echoed that sentiment when he said: "We have to learn to pray: as it were learning this art ever anew..." And he opposed "mechanical prayer" and emphasized the need for self-reflection before prayer. The familiarity of the person praying with the words and method of praying, and their distraction level before they start to pray is not measured as a parameter in some["which?] studies.
The reverence with which the prayer is recited has been emphasized by other religious writers, such as St. "Louis de Montfort in his book "Secret of the Rosary. In section 41, he emphasized the "purity of intention" and stated that it is not the length of a prayer that matters, but the fervor, purity, and respect with which it is said, e.g., a single properly said "Hail Mary is worth many that are badly said. Sections 42 and 43 of Montfort's book are devoted to "Attention" and "Fighting Distractions".
An example of a study on meditative prayer was the Bernardi study in the British Medical Journal in 2001. It reported that by praying the rosary or reciting yoga mantras at specific rates, "baroreflex sensitivity increased significantly in cardiovascular patients.
A study published in 2008 used "Eysenck's dimensional model of "personality based on "neuroticism and "psychoticism to assess the mental health of high school students based on their self-reported frequency of prayer. For students both in Catholic and Protestant schools, higher levels of prayer were associated with better mental health as measured by lower psychoticism scores. However, among pupils attending Catholic schools, higher levels of prayer were also associated with higher neuroticism scores.
Many accept that prayer can aid in recovery due to psychological and physical benefits. It has also been suggested that if a person knows that he or she is being prayed for it can be uplifting and increase morale, thus aiding recovery. (See "Subject-expectancy effect.) Many studies have suggested that prayer can reduce physical stress, regardless of the god or gods a person prays to, and this may be true for many reasons. According to a study by Centra State Hospital, "the psychological benefits of prayer may help reduce stress and anxiety, promote a more positive outlook, and strengthen the will to live." Other practices such as "Yoga, "T'ai chi, and "Meditation may also have a positive impact on physical and psychological health.
A 2001 study by Meisenhelder and Chandler analyzed data obtained from 1,421 Presbyterian pastors surveyed by mail and found that their self-reported frequency of prayer was well-correlated with their self-perception of health and vitality. This research methodology has inherent problems with "self-selection, "selection bias, and "residual confounding, and the authors admitted that the direction of perceived prayer and health relationships "remains inconclusive due to the limits of the correlational research design".
One condition that may affect the efficacy of intercessory prayer is whether the person praying has a connection to the person prayed for. A 2005 study published by The Journal of Alternative and Complementary Medicine alleges evidence that eleven healers in a variety of "distant intentionality" (defined as "sending thoughts at a distance") modalities were able to remotely influence the "MRI-measurable brain activity in chosen partners who were physically and electrically isolated. As the authors explained, "the study is not about healing per se, but whether there is some correlation in the intention to connect at a distance with a person." The experiment has not yet been reproduced by the authors or by others.
The "Victorian scientist "Francis Galton made the first "statistical analysis of third-party prayer. He hypothesized, partly as satire, that if prayer was effective, members of the "British Royal Family would live longer than average, given that thousands prayed for their well-being every Sunday, and he prayed over randomized plots of land to see if the plants would grow any faster, and found no correlation in either case.
The amount of formal research performed on intercessory prayer is quite small, with about $5 million spent worldwide on such research each year. The parameters used within the study designs have varied, for instance, daily or weekly prayers, whether to provide patient photographs, with full or partial names, measuring levels of belief in prayer, and whether patients underwent surgery.
The third party studies reported either "null results, correlated results, or contradictory results in which beneficiaries of prayer had worsened health outcomes. For instance, a "meta-analysis of several studies related to distant intercessory healing published in the "Annals of Internal Medicine in 2000 looked at 2774 patients in 23 studies, and found that 13 studies showed statistically significant positive results, 9 studies showed no effect, and 1 study showed a negative result.
A 2003 "levels of evidence review found evidence for the hypothesis that "Being prayed for improves physical recovery from acute illness". It concluded that although "a number of studies" have tested this hypothesis, "only three have sufficient rigor for review here" (Byrd 1988, Harris et al. 1999, and Sicher et al. 1998). In all three, "the strongest findings were for the variables that were evaluated most subjectively, raising concerns about the possible inadvertent unmasking of the outcomes' assessors. Other "meta-studies of the broader literature have been performed showing evidence only for no effect or a potentially small effect. For instance, a 2006 meta analysis on 14 studies concluded that there is "no discernable effect" while a 2007 systemic review of intercessory prayer reported inconclusive results, noting that 7 of 17 studies had "small, but significant, effect sizes" but the review noted that the three most methodologically rigorous studies failed to produce significant findings.
Apart from whether prayer affects other beneficiaries, research has suggested that prayer has benefits on the person performing the prayer, e.g. in May 2011 a study was conducted that suggested a "significant specific indirect effect" between meditative prayer and hope, adult attachment, and forgiveness. Research has also suggested that prayer has a direct relation to a sense of overall gratitude in life. Prayer may also aid those dealing with alcoholism, e.g. a 2010 study suggested that there is a strong correlation between prayer and reduction of alcohol consumption. Those who actively pray during the week reported half as many consumed alcoholic drinks.
An increasingly more researched area within "psychology of religion has been the relational implications of prayer, e.g. a study in 2011 conducted by Lambert et al. stated that when compared to a control group that experienced positive interactions with their significant other those in the prayer condition reported much higher feelings of unity and trust toward their significant other. Studies have also shown that there are increased feelings of marital enrichment through prayer. A study conducted in 2010 has also shown a correlation between prayer within relationships and reduction of infidelity. As with other areas of research about prayer, some debate whether these effects are a result of the prayer or a "placebo effect." However, Dr. "Herbert Benson, a professor of medicine at "Harvard Medical School, suggests that they may not be mutually exclusive.
An article in the Medical Journal of Australia says that "One common criticism of prayer research is that prayer has become a popular therapeutic method for which there is no known plausible mechanism."
Medical professionals are skeptical of new claims by studies until they have been experimentally reproduced and corroborated. For instance, a 2001 study by researchers associated with Columbia University has been associated with controversy, following claims of success in the popular media. 
In the early 20th century, "Florence Nightingale, a pioneer of modern nursing, was a believer in the effects of prayer. She wrote, "Often when people seem unconscious, a word of prayer reaches them".
Today, although different medical studies have been at odds with one another, physicians have not stopped studying or recommending prayer. This may be partly because prayer is increasingly used as a coping mechanism for patients. According to "Larry Dossey M.D.: "In 1993, only three U.S. medical schools had courses devoted to exploring the role of religious practice and prayer in health; currently, nearly 80 medical schools have instituted such courses", though many factors other than the efficacy of prayer are involved in such courses.
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In a debate/interview in "Newsweek with Christian evangelical "Rick Warren, atheist "Sam Harris commented that most lay perceptions of the efficacy of prayer (personal impressions as opposed to empirical studies) were related to "sampling error because "we know that humans have a terrible sense of probability." That is, humans are more inclined to recognize confirmations of their faith than they are to recognize disconfirmations.
Harris also criticized existing empirical studies for limiting themselves to prayers for relatively unmiraculous events, such as recovery from heart surgery. He suggested a simple experiment to settle the issue:
Get a billion Christians to pray for a single amputee. Get them to pray that God regrow that missing limb. This happens to "salamanders every day, presumably without prayer; this is within the capacity of God. I find it interesting that people of faith only tend to pray for conditions that are self-limiting.
Within Christian teachings, the comment by Harris regarding what he called the self-limiting nature of prayer had been addressed years before by multiple authors. For instance, in the 19th century William Peabody discussed the efficacy of prayer in the face of what he called the immutability of the laws of nature. He said:
Night follows day, and day night. The seasons preserve their succession... We may not hope to suspend their operation by our prayers... And yet notwithstanding all of this, we hold in an undoubting faith the doctrine of the efficacy of our prayers, or to use the language of another, "of an influence from above as diversified and unceasing as are the requests from below".
Peabody then argued at length that prayers may have efficacy in a form that does not interfere with the arrangement of the laws of nature, and that God may respond in ways that are not anticipated, without changing the arrangement of nature. George Burnap echoed the same concept when he wrote:
God governs the universe by fixed and uniform laws, not only for the sake of order, but for human good... The fulfillment of every human desire would break up this order, and bring everything into disorder and confusion.
The view expressed by Harris above regarding the "relatively unmiraculous" petitions used in prayers has been addressed in religious circles in the context of miraculous outcomes for prayer. There are different theological classifications of miracles, one of the most common being the three categories: "surpassing nature" (Latin supra naturam), "against nature" (Latin contra naturam) and "alongside nature" (Latin praeter naturam).
The raising of the dead is considered a "supra naturam" event and is not reported in theological writings beyond the Christian Bible, where ten resurrection events are recorded. Contra naturam events require significant changes to the "order of the world" (e.g. regrowth of limbs) and are also hardly ever reported. Praeter naturam events can proceed along the laws of nature. They have been reported in a number of cases, and have been subject to a large amount of debate. Examples include the claims of miraculous cures at pilgrimage site such as "Our Lady of Lourdes. Many of these claims have been analyzed and only a few have been accepted by the "Lourdes Medical Bureau.
The scientific measurement of the efficacy of massive prayer requires the coordination of the activities of a large number of people, and no direct citations for the existence of such studies appear in the scientific literature. However, non-scientific instructions for massive prayer have been issued in the past, and conclusions about the effects of the prayer have been drawn by a large number of believers, outside a scientific framework.
In a historical context, in 1571 "Pope Pius V called for all of Europe to pray the "Rosary for victory at the "Battle of Lepanto, in which the Christian belligerents included the "Papal States. Trophies from the battle are now enshrined in various Christian churches which attribute the victory to the massive prayers.
Directions for even more massive, long term prayers were provided by the messages of "Our Lady of Fatima reported by "Lucia Santos, who stated that the "Virgin Mary specifically asked believers to pray for the conversion of Russia. The 9-day Fatima "Novena prayer includes a petition for the "conversion of Russia. With a blessing from "Pope Pius XII (who called himself "the world chief against communism") millions of members of the "Blue Army of Our Lady of Fatima were instructed to pray for several years in publications such as Soul Magazine. Some["who?] Christians attribute the fall of communism in the "Revolutions of 1989 to massive prayers, while economists attribute them to market forces and socioeconomic conditions. 
Religious and philosophical objections to the very study of prayer's efficacy exist. Many interpret "Deuteronomy (6:16 "You shall not put the Lord your God to the test") to mean that prayer cannot, or should not, be examined.
The religious viewpoint objects to the claim that prayer is susceptible to experimental designs or statistical analysis, and other assumptions in many experiments, e.g. that a thousand prayers are statistically different from one. The objections also include the complaint that religion generally deals with unique, uncontrollable events; statistics, and science in general, deal with recurring phenomena which are possible to sample or control and are susceptible to general laws.
Religious objections also include the complaint that as prayer starts to be measured, it is no longer real prayer once it gets involved in an experiment and that the concept of conducting prayer experiments reflects a misunderstanding of the purpose of prayer. The 2006 STEP experiment indicated that some of the intercessors who took part in it complained about the scripted nature of the prayers that were imposed to them, saying that this is not the way they usually conduct prayer:
Prior to the start of this study, intercessors reported that they usually receive information about the patient's age, gender and progress reports on their medical condition; converse with family members or the patient (not by fax from a third party); use individualized prayers of their own choosing; and pray for a variable time period based on patient or family request.
To pray for particular favors is to dictate to Divine Wisdom, and savors of presumption; and to intercede for other individuals or for nations, is to presume that their happiness depends upon our choice, and that the prosperity of communities hangs upon our interest.
During the 20th-century, philosopher "Bertrand Russell believed that religion and science "have long been at war, claiming for themselves the same territory, ideas and allegiances". And Russell believed that the war had been decisively won by science. Almost 40 years earlier, a 22-year-old Russell also wrote: "For although I had long ceased to believe in the efficacy of prayer, I was so lonely and so in need of some supporter such as the Christian God, that I took to saying prayers again when I ceased to believe in their efficacy."
The 21st-century evolutionary biologist "Richard Dawkins, describing how "Richard Swinburne explained away the STEP experiment's negative results "on the grounds that God answers prayers only if they are offered up for good reasons", says that some["which?] elements of religion are testable.
Other theologians joined "NOMA-inspired sceptics in contending that studying prayer in this way is a waste of money because supernatural influences are by definition beyond the reach of science. But as the Templeton Foundation correctly recognized when it financed the study, the alleged power of intercessory prayer is at least in principle within the reach of science. A double-blind experiment can be done and was done. It could have yielded a positive result. And if it had, can you imagine that a single religious apologist would have dismissed it on the grounds that scientific research has no bearing on religious matters? Of course not.
"John Tillotson, the 17th-century "Archbishop of Canterbury argued that the efficacy of prayer depends on the Holy Spirit. "Reformed Presbyterian scholar Wayne R. Spear argues that the person praying needs to be "guided by the Holy Spirit" as to what needs to be prayed for and that given the "right petition" the Holy Spirit will then intercede for the prayer.
The "Catechism of the Catholic Church states that:
"Christian existentialist philosopher and theologian "Paul Tillich argued that prayer is not possible in a subject-object dichotomy in which the person is separated from God, for God cannot be the object of a prayer without being at the same time the subject.
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