Liturgies of Healing

June 6, 2022 | Maria Copeland, JMU ‘22

This piece was written at the Veritas Forum 2021, an annual writing program offered by the Augustine Collective. Students from various universities work with writing coaches to write articles about virtue in the sciences or social sciences.

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When I was seventeen years old, a family friend anointed me and prayed that I would be healed from the autoimmune conditions that had wracked my teenaged body. I sat in silence on a chair in the home of close friends, conscious of the dampness of the oil on my forehead and of a grief in my heart I did not think I could courteously articulate aloud in front of the family and friends gathered about me with lowered heads. It could not possibly have any effect, I cried out to myself. It could do no good. 

My conflict arose not so much from a fear that God could not heal me—I knew such an action fell squarely within the reaches of His sovereignty—but I believed He would not. It would take more than a prayer to correct the gut disorder that, at the very least, laid out for me a lifetime of gluten-intolerance. It would require divine intervention, and I was already weary of waiting for a medical miracle.

I had sustained a tick bite that sent me into a spiral of health complications at the age of fifteen. Since then, I had earnestly searched for the right treatment to evoke the miraculous transformation that would restore me to the normal health of a teenager. If a Ziploc bag of antibiotics would set my joint pain to rights, I would swallow them all; the count reached twenty tablets when I was sixteen, and I didn’t protest. If bitter herbal tinctures in brown glass bottles would bring down the swelling in my lymph nodes, I would dilute them in water and hold my breath until the last of the taste had left my mouth. Despite my best efforts, no miracle had come my way—because, I was starting to learn, there are no cinematic victories for the chronically ill. 

In desperation, because none of the prescribed medicines or recommended treatment routines appeared to have any effect, I gradually learned to come up with my own remedies. My mom gave me a bottle of peppermint essential oil that became my go-to treatment for stomach issues. I massaged different creams into the stretched muscles of my shoulders, hoping one of them would ease the perpetual tension. I discovered that if I broke open a specific kind of probiotic capsule and stirred the powder into applesauce, I wouldn’t taste the medicine, and I never ended up with stomach pain after eating applesauce.

In his book You Are What You Love: The Spiritual Power of Habit, philosopher James K. A. Smith describes the practices that we adopt in worship of the things we love as “liturgies”: “formative, love-shaping rituals.” [1] Over the years, with my heart set on reclaiming normal health, I created for myself a veritable litany of liturgies in devout worship of that all-consuming goal: refilling my water bottle whenever it was empty, taking an exact number of vitamin pills at lunchtime, eating applesauce alone in my family’s kitchen in the evening.  

I knew my scattershot strategies functioned as glorified coping mechanisms, but I thought of them as lifelines. Peppermint oil and applesauce cups kept me tethered to normality. They weren’t anything close to a solution for the greater problem of my “mysterious illness,” to borrow a phrase from chronically ill author Sarah Ramey, but they helped me to get through the day to the night and to the day again. [2] Sometimes that was all I needed. 

Milestones went by without marking any changes in the course of my sickness. I graduated high school, walked away from Lyme treatment, and began working toward a college degree, all without having witnessed the fruit of years in specialists’ offices or of the day when I was anointed in the home of family friends. I had placed my hopes for a miracle on hold and relied wholly on my piecemeal assortment of routines—my liturgies—to equip me for each day. 

***

In the 1980s, two researchers working with a terrifying case of lupus were piecing together their own set of last-resort strategies. 

It all started a decade previously, when a pair of psychologists working at the University of Rochester were engaged in a set of experiments that explored the connection between the mind and the body, using principles of classical and behavioral conditioning as their foundation. Experiments of this kind were not unheard-of at the time, but they remained largely confined to the experimental realm or ignored by Western science. [3] 

The experiments conducted by the Rochester researchers were different from those, however: they worked. 

Robert Ader and his colleague Nicholas Cohen had administered injections of cyclophosphamide, a toxic drug used as chemotherapy to treat a variety of illnesses, to the rats in their trials, and paired it with a saccharin solution by oral ingestion. They discovered that when they halted the drug injections, the rats refused to consume the sugar water. When they forced the rats to swallow the solution, they made a still more startling discovery: some of the rats died. The taste of the sugar had stimulated the same response that the drug would have inflicted, the researchers concluded. [4] 

In 1982, Ader and Cohen followed up their initial conditioning experiments with a study in which they reversed the aim: They set out to cure a group of mice that were ill with systemic lupus erythematosus. Ader paired a sugar-water solution with a dose of cyclophosphamide, the same drug used in the first trial. By administering the two together to the test subjects, Ader succeeded in associating the response to the drug with the placebo and was able to ultimately give the conditioned mice half the standard dosage given to the control group. 

The treatment slowed the progression of the disease in the conditioned mice and allowed them to live longer, Ader and Cohen observed. [5] Conditioning struck a vital balance in the disease treatment regimen: it continued to suppress the immune system with the use of the drug, while simultaneously preventing the toxic doses from killing the subject. 

With these studies, Ader and Cohen became co-founders of the field of psychoneuroimmunology, the discipline that recognizes the physical connection between the mind and the immune system. But the true test of their work would not arrive until several years later, when psychologist and pediatrician Karen Olness called in Ader for help.

Olness was assisting a patient named Marette Flies, who had been diagnosed with a serious case of lupus at the age of eleven. Between her symptoms and the drugs her doctors had given her, Flies’ condition deteriorated to the point that Olness grew concerned that, if the illness didn’t kill her, the cyclophosphamide Flies had just been prescribed might have that consequence. [3]

Ader agreed to join, and the third experiment began.

Olness and Ader started out by recreating the mice trials with Flies, but with a different set of routines. To better reinforce the conditioning treatment, they introduced a more vivid form of sensory stimuli into the experiment and had the patient consume doses of cod liver oil, rather than the saccharin solution used for the mice, along with cyclophosphamide. They also added rose perfume, which Flies breathed in while taking both medications.  

The treatment proceeded slowly, month by month. Over the course of a year, Flies took six cyclophosphamide doses, one every two months, instead of the prescribed twelve doses, and took cod liver oil paired with rose perfume during the off months. In the end, “the patient improved clinically,” reads a 1992 report of the case by Ader and Olness. [6] Flies made so much progress toward recovery that she was able to stop the cod liver oil and rose perfume routine after 15 months, according to Mosaic. 

If the experiment had succeeded due to the conditioning system, as Ader and Olness assumed, then Ader had accomplished again the effect he had wrought in his initial trials: he had bought time for his patient, navigating the fine line of suppressing the immune system while preserving the patient’s life. 

***

I was studying at community college, a sophomore knee-deep in honors research papers and student government responsibilities, when I came across the case study of Marette Flies after my psychology professor referenced the story in a lecture on classical conditioning. It was not the miracle I’d ceased hoping for, but it felt like the introduction to one. 

Flies’ own body had prompted her recovery, assuming that the experiment had worked due to the conditioning routine. The weight of the implications struck me immediately. If the experiment had worked as it had been designed, although the use of cyclophosphamide was necessary in order to stifle the flares raging from her immune system, the drug did not act as the solitary agent responsible for Flies’ recuperation. And, without the system of stimuli and behaviors that Ader and Olness had coordinated into a life-giving routine, their patient’s life could have been lost to the effects of the drug. 

The idea of training the body to heal itself transformed the way I viewed my own condition. The idea that the habits I created for my body could be the overlooked instrumental actors in my healing refocused the way I viewed my routines. It didn’t mean that I could forever shut myself out of specialists’ offices, I knew, nor that every autoimmune disorder or other chronic illness could be resolved simply by identifying the correct set of disciplines to order one’s life around.

But it did mean that the practices I had created for myself had more power than I had realized, because they in themselves could be responsible for training my body into a rhythm of recovery. It meant that my liturgies were in fact the lifelines I had imagined them to be, and the direct highway to the life I desired. 

***

In 2002, a team of researchers led by Manfred Schedlowski at the University of Essen in Germany set out to prove that behaviorally conditioned immunosuppression could be viewed as a standard treatment, not merely a possibility based on the one-time success story of Marette Flies.

A group of thirty-two test subjects ingested a new variation on the conditioning stimulus—a bright green, lavender-scented strawberry milk concoction—which half the group took paired with the immunosuppressive drug cyclosporine, and the other half with a placebo. Five days later, and then again eleven days, they were all given a placebo alongside the drink. When the experiment concluded, the control group remained unchanged, while the immune systems of the focus group were notably inhibited. 

“This study demonstrates for the first time in humans in a double-blind, placebo-controlled design that behavioral conditioning is able to mimic the immunological effects of an immunosuppressive drug,” the researchers reported. [7]

A decade later, Schedlowski and another team ran another round of trials, using the same lavender milk stimulus, to refine their findings and collect more information. The results were promising: Conditioning protocols “might be employed as a supportive therapy in clinical settings.” [8]

Then in 2018, Schedlowski ran experiments that worked with renal transplant patients who were receiving immunosuppressive treatment. Once again, they concluded that the use of behavioral conditioning increased the efficacy of immunosuppressive medication. [9] 

Mosaic quoted Schedlowski in 2016 as saying he liked to joke that his team at the University of Essen was one of the best in the world––“Because there is nobody else!” [3]

***

My case is relatively mild in comparison with Flies’ story and those of many who are chronically ill. I pay a price for swerving from the health disciplines I’ve created for myself, but as troublesome as severe stomach pain and brain fog are, they won’t send me to the hospital, or endanger my life. Many who are chronically ill cannot say the same. A 2018 study reports that chronic diseases are responsible for seven out of ten deaths in the United States. [10]

The jury is still out on whether the human body really can be relied upon to train itself to heal—in the United States, at least. But, as Annie Dillard wrote, how we spend our days is how we spend our lives. [11] For the chronically ill, our days can be concentrated simply on making it through to spend the next one with our life intact. Marette Flies’ case taught me that the daily discipline of dedicated routines can build up to create lasting changes, no matter how difficult the day may be. 

The same is true for spiritual disciplines and their contribution to daily formation. Living with chronic illness teaches me to reframe my routines as true liturgies—as acts of worship. Every habit with which I inscribe each day serves simultaneously as a memento mori and a liturgy of restoration, because I am training my body to worship even as I encourage it to heal.  

“The new life into which we are baptized is lived out in days, hours, and minutes,” Anglican priest and writer Tish Harrison Warren notes in Liturgy of the Ordinary. “God is forming us into a new people. And the place of that formation is in the small moments of today.” [12]

As a seventeen-year-old, I grieved that I could not be swiftly anointed into the life of normal health I so deeply desired. But I am learning now to be baptized into a new life, day by day, one liturgy at a time. 

Maria Copeland is a graduating senior at James Madison University, majoring in journalism.

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[1] A., Smith James K. You Are What You Love: The Spiritual Power of Habit. Brazos Press, a division of Baker Publishing Group, 2016.

[2] Ramey, Sarah. The Lady's Handbook for Her Mysterious Illness. New York: Doubleday, 2020.

[3] Marchant, Jo. “You Can Train Your Body into Thinking It's Had Medicine.” Mosaic Science, February 9, 2016. https://mosaicscience.com/story/medicine-without-the-medicine-how-to-train-your-immune-system-placebo/.

[4] Ader, R, and N Cohen. “Behaviorally conditioned immunosuppression.” Psychosomatic Medicine vol. 37,4 (1975): 333-40. doi:10.1097/00006842-197507000-00007

[5] Ader, R, and N Cohen. “Behaviorally conditioned immunosuppression and murine systemic lupus erythematosus.” Science (New York, N.Y.) vol. 215,4539 (1982): 1534-6. doi:10.1126/science.7063864

[6] Olness, K, and R Ader. “Conditioning as an adjunct in the pharmacotherapy of lupus erythematosus.” Journal of Developmental and Behavioral Pediatrics: JDBP vol. 13,2 (1992): 124-5. doi:10.1097/00004703-199204000-00008

[7] Goebel, Marion & Trebst, Almuth & Steiner, Jan & Xie, Yu & Exton, Michael & Frede, Stilla & Canbay, Ali & Michel, Martin & Heemann, Uwe & Schedlowski, Manfred. “Behavioral conditioning of immunosuppression is possible in humans.” FASEB Journal: official publication of the Federation of American Societies for Experimental Biology. 16 (2003). 1869-73. 10.1096/fj.02-0389com.

[8] Albring, Antje et al. “Placebo effects on the immune response in humans: the role of learning and expectation.” PloS One vol. 7,11 (2012): e49477. doi:10.1371/journal.pone.0049477

[9] Kirchhof J, Petrakova L, Brinkhoff A, et al. “Learned immunosuppressive placebo responses in renal transplant patients.” Proc Natl Acad Sci USA (2018);115:4223-4227.

[10] Raghupathi, Wullianallur, and Viju Raghupathi. “An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach.” International Journal of Environmental Research and Public Health vol. 15,3 431 (2018): doi:10.3390/ijerph15030431

[11] Dillard, Annie. The Writing Life. New York: Harper Collins, 1989.

[12] Warren, Harrison Tish. Liturgy of the Ordinary: Sacred Practices in Everyday Life. Downers Grove, IL: IVP, an imprint of InterVarsity Press, 2019.