Elena Scotti/FUSION

If you're a religious person, do you believe that God is on your side, gently guiding you through life's ups and downs? Or do you believe the Almighty is constantly judging, poised to punish you for your missteps?

According to a new report in the journal Cancer, believing in a benevolent God can bring both physical and mental health benefits, including experiencing milder symptoms, less anxiety and depression, and an easier time completing everyday tasks.

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This finding isn't all that surprising—the power of positive thinking has been well-documented. But what is somewhat remarkable is that believing in an angry and spiteful God can actually be detrimental.

The authors of the metastudy—the most extensive analysis to date on the effects of religious and spiritual attitudes on cancer patients, based on largely self-reported data—began by hashing out how its 44,000 participants practiced their faith.

“What we found in the literature is that when people talk about religion and spirituality, they talk about a whole host of different things,” explained John Salsman, one of the study's authors and an associate professor at Wake Forest School of Medicine in Winston-Salem. “It can be stuff from denominational or group affiliation to behaviors to feelings to thoughts about it.”

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Ultimately, the authors determined that participants' religiosity could be broken down into four dimensions: affect (their sense of spiritual wellbeing, inner peace, and purpose), behavior (whether they participated in religious activities), cognition (how they intellectually perceived God and their faith), and “other” (their general religious affiliation and social support), allowing the researchers to neatly study specific parts of their religious experiences.

(The researchers didn't specify which religions the participants identified with—nor did they study participants who identified as agnostic or atheist, mainly due to a lack of data.)

It turned out that how a person experienced his or her religion and spirituality mattered. For example, people whose religion bestowed them with a positive "affect" reaped the greatest physical, mental, and social health benefits. And this makes sense—feeling a sense of inner peace and connectedness with others and a greater, benevolent power, would naturally promote wellness.

People who felt a strong "cognitive" connection to religion and spirituality—and particularly, those who developed the ability to grow spiritually throughout their experience with cancer—also saw benefits, though this dimension was less powerful than the former.

Meanwhile, people who practiced "behavioral" religion and spirituality, which might include simply going to church or saying prayers, experienced a slight boost in social wellbeing, but the dimension wasn't linked to physical or mental health.

And then there were the cases when religion and spirituality had an adverse effect. Salsman explained that participants who were believers but struggled with their image of God—whether they "cognitively" believed in an angrier or more distant image of God or "affectively" simply felt disconnected from God or a congregation—suffered as a result of the spiritual strain.

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“Even though that’s infrequently reported by patients, when it is reported, it’s pretty consistently associated with poor quality of life,” Salsman told me.

The big takeaway? Simply "being religious" isn't enough to boost wellbeing in the face of cancer. Participants benefited most when they deeply believed—as opposed to merely intellectually relating to religion or participating in religious activities.

Of course, the report had its limits. Much of the data was self-reported—there weren’t enough previous studies that compared religion and spirituality to medical tests or diagnostic data for a more objective comparison. So while we know that some spiritual patients reported less severe physical symptoms, we don’t know if it’s because the symptoms themselves were milder or if the patient simply handled them differently.

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Research into the connection between spirituality and health still has a long way to go—but the authors hope that, as a start, the report will help medical professionals to better understand their patients' experiences and create a more holistic approach to care.