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|Oggetto: therapeutic touch Mar 29 Set 2009 - 16:02|| |
Therapeutic touch (TT) is a type of energy medicine whereby the therapist moves his or her hands over the patient’s “energy field,” allegedly directing the flow of chi or prana so the patient can heal. TT is based on the belief that each living thing has a “life energy field” which extends beyond the surface of the body and generates an aura. This energy field can become unbalanced, misaligned, obstructed, or out of tune. Energy healers think they can feel and manipulate this energy field by making movements that resemble massaging the air a few inches above the surface of the patient’s body. Energy healers also think that they can transfer some of their own life energy to the patient. These airy manipulations allegedly restore the energy field to a state of balance or harmony, to a proper alignment, or they unblock a clog in the field or transfer life energy from healer to patient. This restoration of integrity to the field is thought to make it possible for the body to heal itself.
TT has no scientific basis but it does have a history. It was created by a nurse and a theosophist. Dolores Krieger, Ph.D., R.N., and a faculty member at New York University's Division of Nursing began TT in the early 1970s. She was convinced that the palms are chakras and can channel healing energy. She is the author of Therapeutic Touch: How to Use Your Hands to Help and to Heal (1979) and several other books on TT. Dora Kunz, president of the Theosophical Society of America, was her mentor and an intuitive healer. TT is practiced primarily by nurses, though TT is apparently being practiced worldwide by all kinds of “alternative” healers and laypersons.
Practitioners admit that there has never been any scientific detection of a human energy field. This, they say, is because of the inadequacies of our present technology. One with a trained sense, however, is allegedly able to detect the human energy field and assess its integrity. Despite the obvious metaphysical basis for this quackery, defenders of TT claim it is scientific because it is based on quantum physics. A grant proposal to study therapeutic touch on burn victims asserts: “Quantum theory states that all of reality is made up of energy fields and that over 99% of the universe is simply space.” Another defender claims
The underlying principles upon which this technique is based include acceptance of the Einstein paradigm of a complex, energetic field-like universe (i.e., the existence of a Life energy flowing through and around all of us). Further, if life is characterized by an interchange of various qualities of energy, it can be assumed that any form of obstruction -- either within the organism or between the organism and the environment -- is contrary to Nature's tendencies and therefore unhealthy. In practicing Therapeutic Touch, one attempts to influence this energy imbalance towards health to restore the integrity of this field. In this way the TT practitioner does not so much "heal" the patient as facilitate the patient's own healing processes, by gently manipulating the body's energy flow and adjusting it as a whole. With the achievement of balance in mind, body and spirit, we have a truly holistic approach (Rebecca Witmer, “Hands that Heal: The Art of Therapeutic Touch,” Healing Arts, 1995).
Let's carefully examine these claims and the inferences drawn from them. Einstein did not have a paradigm which included the notion of “a Life energy flowing through and around all of us.” He may have written of interchanges of quantities of energy. Many physicists have written of such things as transforming mechanical energy into electrical energy, for example, but would the typical physicist understand the expression “life is an interchange of qualities of energy”? From this notion Ms. Witmer infers that any form of obstruction within the organism or between the organism and the environment is contrary to Nature's tendencies and therefore unhealthy. This seems like a non sequitur, but she goes on: “if life is characterized by an interchange of various qualities of energy, it can be assumed that any form of obstruction -- either within the organism or between the organism and the environment -- is contrary to Nature's tendencies and therefore unhealthy.” This seems like an “alternative” logic using an “alternative” science to support an “alternative” therapy.
It might be true that an obstruction within an organism is contrary to Nature's tendencies, if by that we mean such things as: blockage of an air passage is unhealthy or blocked arteries are unhealthy. Yet, most rational patients with such blockages would probably want someone to physically unblock the passageway. A rational person would not think that a mystic waving her hands over one’s energy field would ever remove any such blockage. On the other hand, for most organisms the environment is mostly obstructions. This may not be healthy, but it is certainly natural. In any case, what does it mean to say that it is unhealthy to go contrary to Nature's tendencies? Are the hurricane, the tornado, the volcano, the flood, the lightning bolt and the earthquake contrary to Nature's tendencies? How could they be, since they are part of Nature. Is the lion eating the gazelle contrary to Nature's tendencies?
Why so many believers?
One might wonder why a group of otherwise intelligent, highly trained professionals such as nurses would be attracted to something like TT. Ms. Witmer might have the answer. She writes
Those who practice Therapeutic Touch often report reaping benefits for themselves. For example, the ability of TT to reduce burnout in health care professionals has been well-documented.
The TT therapist has powers physicians don't have: secret, mystical powers which only the practitioner can measure. You get a lot of positive feedback. You can’t hurt anyone because you’re not even touching them, much less invading their body with drugs or surgical instruments. You network and those in your network feed off of each other's enthusiasm. There is a great deal of communal reinforcement. Many patients swear they can feel your good work. You feel revitalized, empowered.
Why do so many patients testify to the benefits of therapeutic touch or other bogus therapies such as homeopathy and magnet therapy? Some commit the regressive fallacy. Most testimonials are not followed up. They are based on immediate or early impressions. Both therapist and patient are deceived into thinking a temporary lift, which may be due to expectation, is significant and will last. Or, credit is given to TT when the real causative agent was a concurrent treatment (drugs or surgery, for example). Also, the feelings associated with illness or injury can be quite complex, involving not just pain but various emotions and desires. The patient may be anxious and fearful, or hopeful and optimistic. The intervention of any caring therapist--and those who practice TT are universally admired for their caring attitude--can profoundly affect these feelings. The patient may feel better, but the feeling may have nothing to do with being cured or healed. There is scientific evidence that supportive therapy of breast cancer patients improves mood and pain control, but not longevity (Goodwin 2001; Spiegel 2007). It may be that therapies such as TT have a similar effect on mood, though they do nothing to curtail the illness or disease itself. Elevated mood may be misinterpreted as improved health. The same improvement might have been induced by watching a Buster Keaton movie.
New Age spiritualism has co-opted some of the language of physics, including the language of quantum mechanics, in its quest to make ancient metaphysics sound like respectable science. The New Age preaches enhancing your vital energy, tapping into the subtle energy of the universe, or manipulating your biofield so that you can be happy, fulfilled, successful, and lovable, and so life can be meaningful, significant, and endless. The New Age promises you the power to heal the sick and create reality according to your will, as if you were a god.
Some healers claim they can feel the energy of these elusive and ineluctable biofields, vibrations, auras, or rays. Therapeutic touch (TT) practitioners make this claim. Twenty-one practitioners, who knew from much experience that they could feel the energy around the bodies of patients, were tested. They had never been tested, however, in a situation where they could not see the source of the alleged "energy field." Nine-year-old Emily Rosa tested these energy healers to see if they could feel her life energy when they could not see its source. The test was very simple and seems to clearly indicate that the subjects could not detect the life energy of the little girl’s hands when placed near theirs. They had a 50% chance of being right in each test, yet they correctly located Emily's hand only 44% of the time in 280 trials. If they can’t detect the energy, how can they manipulate or transfer it? What are they detecting? Most likely they are detecting what has been suggested to them by those who taught them this practice. Their feelings of energy detection appear to be manufactured in their own minds. Krieger has been offered $1,000,000 by James Randi to demonstrate that she, or anyone else for that matter, can detect the human energy field. So far, Krieger has not been tested.
See also acupuncture, aura therapy, Ayurvedic medicine, alternative health practice, confirmation bias, pathological science, pseudoscience, reiki, self-deception, wishful thinking, and "Energy Healing: Looking in All the Wrong Places."
books and articles
Clark, Philip E. and Mary Jo Clark, "Therapeutic touch: Is There a Scientific Basis for the Practice?" Nursing Research, 33 , Jan/Feb 1984.
Gilovich, Thomas. How We Know What Isn't' So: The Fallibility of Human Reason in Everyday Life (New York: The Free Press, 1993).
Goodwin, Pamela J. et al. "The Effect of Group Psychosocial Support on Survival in Metastatic Breast Cancer," New England Journal of Medicine, Volume 345, Number 24 December 13, 2001.
Hover-Kramer, Dorothea. Healing touch: a resource for health care professionals with contributing authors, Janet Mentgen, Sharon Scandrett-Hibdon (New York : Delmar Publishers, 1996).
Montagu, Ashley. Touching : The Human Significance of the Skin (HarperCollins, 1986). (Touching really is therapeutic.)
Selby, Carla and Bela Scheiber. "Science or Pseudoscience? Pentagon Grant Funds Alternative Health Study, " in the Skeptical Inquirer, July/August 1996.
Selby, Carla and Bela Scheiber. Therapeutic Touch (Prometheus, 2000).
Williams, Susan M. "Holistic Nursing," in Examining Holistic Medicine ed. by Douglas Stalker (Buffalo: Prometheus Books, 1989).
"Nursing irrationality" by Sarah Glazer in Spiked Health
Experimental Protocol: Therapeutic Touch by Observatoire Zététique July 2004
Hands Off, Doctor by Howard Fienberg
"Therapeutic Touch" by Stephen Barrett, M.D.
Quantum Quackery by Victor J. Stenger
A Scientific test of TT done by PhACT Date: 14 November 96
"Pentagon's 'Healing Hands' Study," by John Elliston
Rocky Mountan Skeptics on TT
The Jama TT Article Critiqued by Carla Selby
THERAPEUTIC TOUCH: Healing Therapy or Hoax?
Support groups don't extend survival of metastatic breast cancer patients
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|Oggetto: Re: therapeutic touch Mar 29 Set 2009 - 16:05|| |
Therapeutic touch was a dubious nursing practice even before its founder suggested practising the technique long-distance, on those who died on 11 September.
by Sarah Glazer
Of all the offers of help pouring in for victims of the World Trade Center explosion last month, the one from the Nurse Healers professional association was surely the strangest.
The organisation, based in Salt Lake City, Utah, promotes a healing technique known as therapeutic touch (TT). The way it works, according to the organisation, is through an 'energy exchange' that takes place when the TT practitioner passes her hands over the patient's body without ever actually touching the patient.
However, the organisation's website (1) now suggests that the dubious no-touch therapy can be performed long-distance on people who died at the World Trade Center. The week after the New York City tragedy, the website posted this advice to its members from Dolores Krieger, a former New York University professor of nursing and founder of the TT technique within the nursing profession:
'I suggest the following.…I am doing healing at a distance, which I do by visualising myself at [a dead victim's] side and see/feel/think of myself doing therapeutic touch to that person. In this I am calling upon the help of the angels of compassion.…My first thought is to help the person through the terror of dying so suddenly and so horribly....I project that wondrous blue that is connected with the Mother of the World in all belief systems....'
If this were simply one of many independently operating New Age cults, it would be of little interest to the general public. But TT has been endorsed at the highest levels of the nursing profession. The National League for Nursing, the agency that accredits nursing schools in the USA, has promoted the technique through books and videos. The technique is used by nurses in scores of hospitals in the USA and Canada. Proponents have claimed that at least 43,000 healthcare professionals have been trained in the technique (2).
No well-designed study has demonstrated any health benefit from therapeutic touch
The North American Nursing Diagnosis Association calls TT the only appropriate treatment for a diagnosis it dubs 'energy-field disturbance'. There is no scientific evidence that such an energy-field exists, and experts consider it implausible. The technique was publicly discredited in 1998, when the Journal of the American Medical Association published a study showing that TT healers did no better than random chance when asked to 'sense an energy field' in another person (3). No well-designed study before or since has demonstrated any health benefit from TT.
Yet TT continues to be practised in hospitals and taught in nursing schools, and PhD nurses continue to defend the method in nursing journals (4). If there has been any backing off, it seems to be in the claims for what TT can heal. Only a few years ago, adherents were claiming it could heal broken bones, arthritis and wounds and even boost the immune system (5). The 'official' website now claims only 'reduction of pain and anxiety' and 'promotion of relaxation'.
What's the harm?
Proponents have sometimes argued that even if TT hasn't been proven to heal any better than a placebo, at least it won't do any harm. One proponent has argued that nurses should go ahead and use TT anyway because the placebo effect is so powerful (6).
Nurse critics say this would be an unethical use of their position. 'Doing TT automatically entails telling the client a lie', Kevin Courcey, a registered nurse at Humboldt County Mental Health in Eureka, California, said in an email. 'There is absolutely no evidence that such a thing exists, that it is subject to manipulation or that this individual practitioner has such a skill. This is not nursing. It is medical fraud and malpractice.'
Moreover, a recent review of clinical trials suggests the placebo effect is not as powerful a clinical tool as has long been supposed. A placebo was no more effective than 'no treatment' in most clinical studies, suggesting that many patients just get better naturally as the course of their disease improves (7).
For some patients the practice of such voodoo methods can be both physically harmful, because they are getting it in place of standard medical treatment, and emotionally distressing. Colorado registered nurse Linda A Rosa, a leading critic of TT, describes one malpractice case settled out of court.
'Doing therapeutic touch automatically entails telling the client a lie', said Kevin Courcey, a registered nurse
A patient who entered the hospital for a liver biopsy complained of severe pain. Instead of calling a doctor, the nurse's response was to call a practitioner of 'healing touch', a variation of TT. When the patient saw the practitioner waving her hands above him, he thought he was dying and was receiving the Last Rites. Three days later the patient returned to the hospital with an infected bladder, which had to be surgically removed.
Irrational fads invading nursing
As holistic techniques adopted by nurses go, TT is being joined and possibly overtaken by other New Age fads, including aromatherapy, Reiki and herbalism, a multimillion dollar, unregulated business in the USA. 'It's a sham', says nurse practitioner Linda Pearson, talking about the current marketing of herbal supplements for every imaginable ailment.
Pearson is editor-in-chief of the Nurse Practitioner Journal, the premier journal for nurse practitioners in the USA. Nurse practitioners are registered nurses who have at least two years of graduate-level education in nursing. Because the US government does not regulate herbal medicines, the herbal industry can freely market its products with outlandish, unsubstantiated claims, Pearson points out. It is impossible to know the real contents of any bottle, because the ingredients do not have to be listed or tested. Few scientific studies have been conducted on the safety of most herbal medicines on the market. As for what dose would be safe, that is also unregulated and often unknown, even though some supplements can be quite dangerous.
Yet, according to Pearson, almost every nursing conference - as well as physician conferences - these days includes a seminar on herbal medicine. 'The universities that offer these conferences know there's money to be made because everybody's taking herbal supplements. You've got nurse practitioners saying, "I've got a large percentage of my patients taking this stuff. I have to know about it".'
She adds, 'It's a snake oil era. The public's scientific sophistication is being eroded by the false advertising of the herbal and diet supplement industry that is making billions [of dollars] off gullible consumers. While some nurse practitioners and physicians endorse the taking of herbs for treatment, most attend the conferences to help them understand what their patients are taking'.
In spring 2001, respected Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, offered a nine-week course on 'The Art and Science of Herbalism' for continuing education credit to nurses. The course was taught by Rosemary Gladstar, author of the popular book Herbal Healing for Women. The book proudly pronounces that 'Alchemy and magic are integral parts of herbalism and healing'.
Almost every nursing conference these days includes a seminar on herbal medicine
Gladstar's book encourages the use of herbs like comfrey, and dismisses health concerns that comfrey has compounds known to be toxic to the liver and carcinogenic. A small number of case reports have documented liver toxicity after people ingested these herbs. Because of these health concerns, the US Food and Drug Administration has urged firms to remove any product containing comfrey from the market and to alert their customers to stop using the product immediately. Rosemary Jacobs is a resident of the Dartmouth area who was disfigured by argyria - a permanently grey skin discoloration - as a result of taking silver, which is now sold as a 'dietary supplement' in the United States. Jacobs was given nose drops containing silver as a child. She was shocked to learn that Dartmouth was training nurses in Gladstar's technique. 'It is without a bit of exaggeration that I say that I'm horrified at the thought of myself or a loved one being incapacitated and alone at night in a hospital under the care of one of the many nurses in my area who believes in magic medicine-the kind Gladstar practices', or that is practised by local nurses who believe in aromatherapy, Jacobs said in an email.
A small but growing number of nurses are practising Reiki, a Japanese practice in which the practitioner 'channels' energy to various parts of a patient's body in need of healing. One website promoting Reiki claims it can heal any mental or physical disease. The practitioner does not even have to be in the same location as the recipient for it to work, according to the site, because 'the healing energies are not bound by space and time' (
'I've read half a dozen case reports from hospitals saying patients love Reiki and it works wonders. And so the hospitals are offering it', says Donal P O'Mathuna, a professor of biochemistry and ethics at Mount Carmel College of Nursing in Columbus, Ohio and a critic of New Age fads. 'I see Reiki as going the next step towards spiritual practices, compared to TT, which was more covert about its spiritual side', O'Mathuna says. 'I think it needs to be made clear to a patient if you're moving out of the realm of the physical and into the spiritual.'
Sarah Glazer is a journalist in Larchmont, New York, who writes on health and social policy issues. Her articles on therapeutic touch and nursing have appeared in The Public Interest, The Washington Post Health Section, and in the book Research in Science and Technology Studies: Gender and Work (From the series Knowledge and Society, Vol 12, JAI Press, 2000).
Put alternative medicine back in its box, by Dr Michael Fitzpatrick
Touching a nerve, by Sarah Glazer
The rise and rise of CAM, by Bríd Hehir
Watered-down science, by Howard Fienberg
Head cases, by Bríd Hehir
(1) Nurse Healers - Professional Associates International
(2) A Close Look at Therapeutic Touch, Rosa L, Rosa E, Sarner L, Barrett S, JAMA 279:1005-1010, 1998
(3) A Close Look at Therapeutic Touch, Rosa L, Rosa E, Sarner L, Barrett S, JAMA 279:1005-1010, 1998
(4) Postmodern Nursing, Glazer, Sarah, The Public Interest, Summer 2000, p3-35
(5) The Mystery of Therapeutic Touch, Glazer, Sarah, Washington Post health section, 19 December 1995
(6) 'Therapeutic touch and postmodernism in nursing', Glazer, Sarah, in Research in Science and Technology Studies: Gender and Work (from the series Knowledge and Society, Vol 12, JAI press, 2000)
(7) Is the Placebo Powerless? An Analysis of Clinical Trials Comparing Placebo with No Treatment, Hrobjartsson A, Gotzche PC, New England Journal of Medicine, May 24, 2001, vol 344 (21), p1594-602
See a Reiki Treatments website
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|Oggetto: Re: therapeutic touch Mar 29 Set 2009 - 17:13|| |
Why Therapeutic Touch Should Be Considered Quackery
Stephen Barrett, M.D.
Therapeutic touch (TT) is a method in which the hands are said to "direct human energies to help or heal someone who is ill." Proponents claim that the patient's "energy field" can be detected and intentionally manipulated by the therapist. They theorize that healing results from a transfer of "excess energy" from healer to patient. Their reports claim that TT is effective against scores of diseases and conditions.
Therapeutic Touch was conceived in the early 1970s by Dolores Krieger, Ph.D., R.N., a faculty member at New York University's Division of Nursing. The "human energy field" TT theorists postulate resembles the "magnetic fluid" or "magnetic force" hypothesized during the 18th century by Anton Mesmer and his followers . Mesmerism held that illnesses are caused by obstacles to the free flow of this fluid and that skilled healers ("sensitives") could remove these obstacles by making passes with their hands. Some aspects of mesmerism were revived in the nineteenth century by Theosophy, an occult religion that incorporated Eastern metaphysical concepts and underlies many current "New Age" ideas. Dora Kunz, who is considered TT's co-developer, was president of the Theosophical Society of America from 1975 to 1987. She collaborated with Krieger on the early TT studies and claims to be a fifth-generation "sensitive" and a "gifted healer."
In the late 1990s, proponents stated that more than 100,000 people worldwide had been trained in TT technique, including at least 43,000 health care professionals, and that about half of those trained actually practiced it. TT generally involves four steps:
"Centering," a meditative process said to align the healer with the patent's energy level
"Assessment," said to be performed by using one's hands to detect forces emanating from the patient.
"Unruffling the field," (also called "clearing"), said to involve sweeping "stagnant energy" downward to prepare for energy transfer,
"Transfer of "energy" from practitioner to patient.
The most common form of TT is "non-contact therapeutic touch," which is done with the "healer's" hands held a few inches away from the patient's body. TT is sometimes used together with massage.
There is no scientific evidence or logical reason to believe that the "energy transfer" postulated by proponents actually occurs. It is safe to assume that any reactions to the procedure are psychological responses to the "laying on of hands."
In 1996, Linda Rosa, R.N., published a critique of all of the studies related to TT she could locate in nursing journals and elsewhere. She concluded: "The more rigorous the research design, the more detailed the statistical analysis, the less evidence that there is any observed—or observable—phenomenon." 
TT advocates state that, "Baseline assessment of the energy field is necessary in order to intervene effectively during the TT intervention."  At age 9, Rosa's daughter Emily figured out a way to test whether practitioners could detect her alleged "energy field." During the next two years, she tested whether 21 of them could detect one of her hands near theirs if they couldn't see it. Each subject was tested 10 or 20 times. During the tests, the practitioners rested their forearms and hands, palms up, on a flat surface, approximately 10 to 12 inches apart. Emily then hovered her hand, palm down, a few inches above one of the subject's palms. A cardboard screen approximately 3 feet high and 1/8th of an inch thick was used to prevent the subjects from seeing which of their hands was selected. The practitioners correctly located Emily's hand only 122 (44%) out of 280 trials, which is no better than would be expected by guessing . A score of 50% would be expected through chance alone. The study was reported in 1998 in the Journal of the American Medical Association (JAMA) whose editor, George D. Lundberg, M.D., commented that: (a) TT practitioners hencforth had an ethical duty to disclose its results to potential patients, (b) third-party payers should question whether they should pay for TT procedures, and (c) patients should refuse to pay for TT "until or unless additional honest experimentation demonstrates an actual effect." .
Drawing by Pat Linse, Skeptics Society
In 1996, the James Randi Educational Foundation offered $742,000 to anyone who could demonstrate an ability to detect a "human energy field" under conditions similar to those of our study. Although more than 80,000 American practitioners claim to have such ability, only one person attempted to demonstrate it. She failed, and the offer, now at $1 million, has had no further takers despite extensive recruiting efforts, including a direct appeal to Dr. Krieger. That's not surprising, of course, because TT's proponents have nothing to gain by submitting to honest testing of their most basic assumption.
If you are on the staff of a hospital in which TT is practiced, please lodge a protest.
Ball TS, Alexander DD. Catching up with eighteenth century science in the evaluation of therapeutic touch. Skeptical Inquirer 22(4):31-34, 1998.
Rosa L. Survey of Therapeutic Touch "Research." Loveland, Colorado: Front Range Skeptics, 1996.
Therapeutic touch policy and procedure for health care professionals. Nurse Healers-Professional Associates International Web site, accessed Feb 3, 2008.
Rosa L, Rosa E, Sarner L, Barrett S. A Close Look at Therapeutic Touch. JAMA 279:1005-1010, 1998. To obtain a reprint of this article, send a self-addressed stamped envelope to the National Therapeutic Touch Study Group, 711 W. 9th St., Loveland, CO 80537.
Lundberg GD. Editor's note. JAMA 279:1040, 1998.
For Additional Information
Further Notes on Therapeutic Touch
Responses to Objections to the JAMA Paper
Philadelphia Association for Critical Thinking (PhACT)
How a Nurse Protested Successfully against TT Use at a Hospital in Oregon
Why Extraordinary Claims Require Extraordinary Proof
Skeptic Dictionary Article
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