A Close Look at Therapeutic Touch

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article about mythbusting therapeutic touch

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<ul><li><p>A Close Look at Therapeutic TouchLinda Rosa, BSN, RN; Emily Rosa; Larry Sarner; Stephen Barrett, MD</p><p>Context.Therapeutic Touch (TT) is a widely used nursing practice rooted inmysticism but alleged to have a scientific basis. Practitioners of TT claim to treatmany medical conditions by using their hands to manipulate a human energy fieldperceptible above the patients skin.</p><p>Objective.To investigate whether TT practitioners can actually perceive ahuman energy field.</p><p>Design.Twenty-one practitioners with TT experience from 1 to 27 years weretested under blinded conditions to determine whether they could correctly identifywhich of their hands was closest to the investigators hand. Placement of the inves-tigators hand was determined by flipping a coin. Fourteen practitioners were tested10 times each, and 7 practitioners were tested 20 times each.</p><p>Main Outcome Measure.Practitioners of TT were asked to state whether theinvestigators unseen hand hovered above their right hand or their left hand. Toshow the validity of TT theory, the practitioners should have been able to locate theinvestigators hand 100% of the time. A score of 50% would be expected throughchance alone.</p><p>Results.Practitioners of TT identified the correct hand in only 123 (44%) of 280trials, which is close to what would be expected for random chance. There was nosignificant correlation between the practitioners score and length of experience(r=0.23). The statistical power of this experiment was sufficient to conclude that ifTT practitioners could reliably detect a human energy field, the study would havedemonstrated this.</p><p>Conclusions.Twenty-one experienced TT practitioners were unable to detectthe investigators energy field. Their failure to substantiate TTs most fundamen-tal claim is unrefuted evidence that the claims of TT are groundless and that furtherprofessional use is unjustified.</p><p>JAMA. 1998;279:1005-1010</p><p>THERAPEUTIC TOUCH (TT) is awidely used nursing practice rooted inmysticism but alleged to have a scientificbasis. Its practitioners claim to heal orimprove many medical problems bymanual manipulation of a human energyfield (HEF) perceptible above the pa-tients skin. They also claim to detect ill-nesses and stimulate recuperative pow-ersthroughtheir intentiontoheal.Thera-peutic Touch practice guides1-6 describe 3basic steps, none of which actually re-quires touching the patients body. Thefirst step is centering, in which the prac-</p><p>titionerfocusesonhisorherintenttohelpthe patient. This step resembles medita-tion and is claimed to benefit the practi-tioner as well. The second step is assess-ment, in which the practitioners hands,from a distance of 5 to 10 cm, sweep overthe patients body from head to feet, at-tuning to the patients condition by be-coming aware of changes in sensorycues in the hands. The third step is in-tervention, in which the practitionershands repattern the patients energyfield by removing congestion, replen-ishing depleted areas, and smoothing outill-flowing areas. The resultant energybalance purportedly stems disease andallows the patients body to heal itself.7</p><p>Proponents of TT state that they haveseen it work.8 In a 1995 interview, TTsfounder said, In theory, there should beno limitation on what healing can be ac-complished.9 Table 1 lists some claimsmade for TT in published reports.</p><p>BACKGROUNDProfessional Recognition</p><p>Proponents state that more than100 000 people worldwide have beentrained in TT technique,38 including atleast 43 000 health care professionals,2</p><p>and that about half of those trained ac-tually practice it.39 Therapeutic Touch istaught in more than 100 colleges and uni-versities in 75 countries.5 It is said to bethe most recognized technique used bypractitioners of holistic nursing.40 Con-sidered a nursing intervention, it is usedbynurses inat least80hospitals inNorthAmerica,33 often without the permissionor even knowledge of attending physi-cians.41-43 The policies and proceduresbooks of some institutions recognizeTT,44 and it is the only treatment for theenergy-field disturbance diagnosisrecognized by the North AmericanNursing Diagnosis Association.45 RN,one of the nursing professions largestperiodicals, has published many articlesfavorable to TT.46-52</p><p>Many professional nursing organiza-tions promote TT. In 1987, the 50 000-member Order of Nurses of Quebec en-dorsed TT as a bona fide nursing skill.32The National League for Nursing, thecredentialing agency for nursing schoolsin the United States, denies having anofficial stand on TT but has promoted itthrough books and videotapes,3,53,54 andthe leagues executive director and a re-cent president are prominent advo-cates.55 The American Nurses Associa-tion holds TT workshops at its nationalconventions.Itsofficial journalpublishedthe premier articles on TT56-59 as well as arecent article designated for continuingeducation credits.60 The associations im-mediate past president has written edi-torials defending TT against criticism.61The American Holistic Nursing Associa-tionofferscertificationinhealingtouch,a TT variant.62 The Nurse Healers andProfessional Associates Cooperative,which was formed to promote TT, claimsabout 1200 members.39</p><p>The TT HypothesisTherapeutic Touch was conceived in</p><p>theearly1970sbyDoloresKrieger,PhD,RN, a faculty member at New York Uni-versitys Division of Nursing. Althoughoften presented as a scientific adapta-tion of laying-on of hands,63-68 TT is im-bued with metaphysical ideas.</p><p>Krieger initially identified TTs activeagent as prana, an ayurvedic, or tradi-tional Indian, concept of life force. Shestated,</p><p>Health is considered a harmonious relation-ship between the individual and his total envi-ronment. There is postulated a continuing in-</p><p>From the Questionable Nurse Practices Task Force,National Council Against Health Fraud Inc (Ms L. Rosa),and the National Therapeutic Touch Study Group (MrSarner), Loveland, Colo; and Quackwatch Inc, Allen-town, Pa (Dr Barrett). Ms E. Rosa is a sixth-gradestudent at Loveland, Colo.</p><p>Ms E. Rosa designed and conducted the tests andtabulated her findings. Mr Sarner did the statisticalanalysis. He and Ms L. Rosa recruited the test subjects,performed the literature analysis, and drafted this re-port. Dr Barrett added background material and editedthe report for publication.</p><p>Corresponding author: Stephen Barrett, MD, PO Box1747, Allentown, PA 18105 (e-mail: sbinfo@quackwatch.com).</p><p>Reprints: Larry Sarner, National Therapeutic TouchStudy Group, 711 W Ninth St, Loveland, CO 80537(e-mail: nttsg@ezlink.com).</p><p>JAMA, April 1, 1998Vol 279, No. 13 A Close Look at Therapeutic TouchRosa et al 1005</p><p>1998 American Medical Association. All rights reserved.</p><p>Downloaded From: http://jama.jamanetwork.com/ by a Universidad de Chile User on 08/16/2014</p></li><li><p>teracting flow of energies from within theindividualoutward,andfromtheenvironmentto the various levels of the individual. Healing,it is said, helps to restore this equilibrium inthe ill person. Disease, within this context, isconsideredanindicationofadisturbance inthefree flow of the pranic current.68</p><p>Krieger further postulated that thispranic current can be controlled by thewill of the healer.</p><p>When an individual who is healthy touches anill person with the intent of helping or healinghim, he acts as a transference agent for theflow of prana from himself to the ill person. Itwas this added input of prana . . . that helpedthe ill person to overcome his illness or to feelbetter, more vital.68</p><p>Others associate all this with the Chi-nese notion of qi, a life energy allegedto flow through the human body throughinvisible meridians. Those inspired bymystical healers of India describe thisenergy as flowing in and out of sites ofthe body that they call chakras.</p><p>Soon after its conception, TT becamelinked with the westernized notions ofthe late Martha Rogers, dean of nursingat New York University. She assertedthat humans do not merely possess en-ergy fields but are energy fields and con-stantly interact with the environmentalfield around them. Rogers dubbed herapproach the Science of Unitary Man,69which later became known as the moreneutral Science of Unitary Human Be-ings. Her nomenclature stimulated thepursuit of TT as a scientific practice.Almost all TT discussion today is based</p><p>on Rogers concepts, although Easternmetaphysical terms such as chakra2,70and yin-yang71 are still used.</p><p>The HEF postulated by TT theoristsresemblesthemagnetic fluidoranimalmagnetism postulated during the 18thcentury by Anton Mesmer and his follow-ers. Mesmerism held that illnesses arecaused by obstacles to the free flow of thisfluid and that skilled healers (sensi-tives) could remove these obstacles bymaking passes with their hands. Someaspectsofmesmerismwererevivedinthe19th century by Theosophy, an occult re-ligion that incorporated Eastern meta-physical concepts and underlies manycurrentNewAgeideas.72 DoraKunz,whois considered TTs codeveloper, waspresident of the Theosophical Society ofAmerica from 1975 to 1987. She collabo-rated with Krieger on the early TT stud-ies and claims to be a fifth-generationsensitive and a gifted healer.20</p><p>Therapeutic Touch is set apart frommany other alternative healing modali-ties, as well as from scientific medicine,by its emphasis on the healers intention.Whereas the testing of most therapiesrequires controlling for the placebo ef-fect (often influenced by the recipientsbelief about efficacy), TT theorists sug-gest that the placebo effect is irrelevant.According to Krieger,</p><p>Faith on the part of the subject does not makea significant difference in the healing effect.Rather, the role of faith seems to be psycho-logical, affecting his acceptance of his illness orconsequent recovery and what this means tohim. The healer, on the other hand, must havesome belief system that underlies his actions, ifone is to attribute rationality to his behavior.65</p><p>Thus, the TT hypothesis and the en-tire practice of TT rest on the idea thatthe patients energy field can be de-tected and intentionally manipulated bythe therapist. With this in mind, earlypractitioners concluded that physicalcontact might not be necessary.13 Thethesis that the HEF extends beyond theskin and can be influenced from severalcentimeters away from the bodys sur-face is said to have been tested by JanetQuinn, PhD, and reported in her 1982dissertation.14 However, that studymerely showed no difference betweengroups of patients who did or did nothave actual contact during TT. AlthoughQuinns work has never been substanti-ated, nearly all TT practitioners todayuse only the noncontact form of TT.</p><p>As originally developed by Krieger, TTdid involve touch, although clothes andother materials interposed between prac-titioner and patient were not consideredsignificant.56 ItwasnamedTTbecausetheaboriginal term laying-on of hands wasconsidered an obstacle to acceptance by</p><p>curriculum committees and other insti-tutionalbulwarksoftodayssociety.66 Themysticismhasbeendownplayed,andvari-ous scientific-sounding mechanisms havebeen proposed. These include the thera-peutic value of skin-to-skin contact, elec-tron transfer resonance, oxygen uptakeby hemoglobin, stereochemical similari-ties of hemoglobin and chlorophyll, elec-trostatic potentials influenced by healerbrain activity, and unspecified conceptsfrom quantum theory.66,67</p><p>Therapeutic Touch is said to be in thevanguard of treatments that allowhealing to take place, as opposed to thecuring pejoratively ascribed to main-stream medical practice. TherapeuticTouch supposedly requires little train-ing beyond refining an innate ability tofocus ones intent to heal; the patientsbody then does the rest.5 Nurses whoclaim a unique professional emphasis oncaring are said to be specially situated tohelp patients by using TT.56,59 Nonethe-less, proponents also state that nearlyeveryone has an innate ability to learnTT, even small children and juvenile de-linquents on parole.2,17,32</p><p>Proponents describe the HEF as realand perceptible. Reporting on a pilotstudy, Krieger claimed that 4 blind-folded men with transected spinal cordscould tell exactly where the nurseshands were in their HEFs during theTherapeutic Touch interaction.5 In or-dinary TT sessions, practitioners gothrough motions that supposedly inter-act with the patients energy field, in-cluding flicking excess energy fromtheir fingertips.3</p><p>Therapeutic Touch is claimed to haveonly beneficial effects.39 However, someproponents warn against overly lengthysessions or overtreating certain areas ofthe body. This caution is based on thenotion that too much energy can be im-parted to a patient, especially an infant,which could lead to hyperactivity.5,73,74</p><p>Literature AnalysisAlthough TT proponents refer to a vo-</p><p>luminous and growing body of valid re-search,63,75,76 few studies have been welldesigned. Some clinical studies, mostlynursing doctoral dissertations, have re-ported positive results, principally withheadache relief, relaxation, and woundhealing.* However, the methods, cred-ibility, and significance of these studieshave been seriously questioned.41,87-95One prominent proponent questions thevalidity of the typical placebo controlused in these studies.96</p><p>Twooftheauthors(L.R.andL.S.)haveconducted extensive literature searchescovering the years 1972 through 1996.</p><p>*References 5, 13, 14, 23, 24, 26, 28, 30, 68, 77-86</p><p>Table 1.Claims Made for Therapeutic Touch</p><p>Calms colicky infants,9 hospitalized infants,10 womenin childbirth,11 trauma patients,12 and hospitalizedcardiovascular patients13,14</p><p>Promotes bonding between parents and infants15Increases milk let down in breast-feeding mothers16Helps children make sense of the world17Protects nurses from burnout18 and effects changes</p><p>in their lifestyle19Helps to evaluate situations where diagnosis is</p><p>elusive9Relieves acute pain,20 especially from burns21Relieves nausea,22,23 diarrhea,5 tension headaches,24</p><p>migraine headaches,21 and swelling in edematouslegs and arthritic joints7</p><p>Decreases inflammation25Breaks fever21Remedies thyroid imbalances5Helps skin grafts to seed9Promotes healing of decubitus ulcers7Alleviates psychosomatic illnesses5Increases the rate of healing for wounds, bone and</p><p>muscle injuries, and infections26Relieves symptoms of Alzheimer disease,27 acquired</p><p>immunodeficiency syndrome,5 menstruation,28 andpremenstrual syndrome21</p><p>Is an innovative means of social communication29Is effective with the aged,30,31 asthmatic or autistic</p><p>children, stroke patients, and coma patients9Supports people with multiple sclerosis and Raynaud</p><p>disease32Treats measles33 and many different forms of cancer34Comforts the dying35-37Helps to bring some dead back to life2</p><p>1006 JAMA, April 1, 1998Vol 279, No. 13 A Close Look at Therapeutic TouchRosa et al</p><p>1998 American Medical Association. All rights reserved.</p><p>Downloaded From: http://jama.jamanetwork.com/ by a Universidad de Chile User on 08/16/2014</p></li><li><p>Using key words such as therapeutictouch, touch therapies, human energyfield, quackery, and alternative medi-cine, we have searched MEDLINE, In-dex Medicu...</p></li></ul>

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