For some, prayer is a way of actively changing oneself from within. In an interview Hasan Al Turabi, the head of the National Islamic Front in Sudan, sees prayer as a means of personal communication with God, but also as a form of self-improvement. In fact he also says prayer grants your request because it changes you and how you interact with other people. Morning prayers allow you to plan your day. Midday prayers give you a running assessment of how things are going. Night prayers allow you to reflect on what you have done right and wrong and to think about how you might do better tomorrow.

Today 50 of the 130 medical schools in America are teaching courses on spirituality and medicine. And that number is growing every day.

David Larson, M.D., President of the National Institute for Healthcare Research, and adjunct Professor at the Department of Psychiatry at Duke Medical Center and Northwestern Medical School, says that spirituality can become of paramount importance in medicine in death and dying. Dr. Larson maintains that 70-75 percent of gravely sick people cope with God's help, and half of those become more religious as they deal with their illness. And in her work with dying patients, Christina Puchalski, M.D., Assistant Professor and Director of Clinical Research at the Center to Improve Care of the Dying at George Washington University School of Medicine, and Director of Education at the National Institute for Healthcare Research, has found that number to be even higher, at 80-85 percent. "Man is not destroyed by suffering. He is destroyed by suffering without meaning," wrote Victor Frankl, M.D., in his classic Man's Search for Meaning; and the sick, even more than the healthy, find meaning through spirituality. When thinking of death and dying, patients? stress and anxiety levels go up dramatically, and people with religious commitment have lower levels of death anxiety, more coping skills, and more social support from their congregations. Since one-third of a person's lifetime health care cost is spent in the last year of life, the health benefits of spirituality also lower health care cost.

"I don't think we should just be looking at prayer and religious commitment; we should also look at spirituality in the more general sense of the term," Dr. Larson says. By spirituality, Dr. Larson means your relationship to a transcendent that gives meaning and purpose to your life - this transcendent that is greater than you can be a divine being, God, or something else, such as nature, an energy force, or even art. "Spirituality seems to be helped by a structure," Dr. Larson says; in other words, if you are practicing your spirituality with others within a belief system (e.g., going to church or synagogue or mosque), you seem to be able to reap greater health benefits. "We should look first at spirituality, then at religious or spiritual commitment, and then at the role of prayer in spiritual or religious commitment."

Prayer is communication with a transcendent. This communication can take two forms: prayer as speaking to the transcendent; or meditation as contemplating or listening to the transcendent.

Guide to Prayer

Develop your own spiritual program

Although the choice of a specific faith is not a medical but a personal decision, several physicians now actually recommend that people incorporate spirituality in their lives. "I encourage a spiritual program consisting of a) prayer, b) reading of scripture, c) worship attendance, and d) involvement with a faith community," says Dale A. Matthews, M.D., author of The Faith Factor and Associate Professor of Medicine at Georgetown University School of Medicine.

a) Prayer: Although I can't create a formula for you because details of prayer are individually based, try to pray every day.

b) Reading of scriptures: Whatever your faith, read some sacred scripture every day.

c) Worship attendance: If you have religious belief, attend a religious service at least once a week.

d) Involvement with a faith community: Become involved with a worship community; find a comfortable place. People in worship communities help and encourage one another through good and bad times.

Of course I am only suggesting that you undertake prayer and worship if you have a religious belief; if you don't, try using meditation by itself.