Therapeutic Touch in Popular Psychology

A classic example of pseudoscience, therapeutic touch (TT) was invented in the early 1970s by Dolores Krieger, R.N., a professor of nursing. It was originally based on the Hindu idea of prana, the vital force that flows around and through the body and keeps it alive, focused in various chakras, or energy centers, throughout the body. After various critiques focused on the unscientific nature of this, Krieger quietly moved to an explanation centered on the more scientific-sounding human energy field, which essentially sounds the same as an aura. The central assumption of TT is that this field surrounds and envelops the entire body and that physical and mental illness is caused by disturbances and imbalances in this field. Trained TT practitioners can detect and manipulate these imbalances using their hands, thus treating the problem. Oddly, practitioners can’t seem to agree on how they detect these imbalances, variously describing them as feeling like pressure, tingling, pulling, hot or cold areas, or “spikes” of energy. Also, despite the name, therapeutic touch has evolved from its beginnings to a practice that doesn’t actually involve touching the patient at all. Instead the practitioner moves his or her hands through the energy field, several inches away from the patient’s body.

A standard session begins with a centering exercise, during which the practitioner meditates and focuses on the intent to heal. This is followed by the assessment phase, during which the practitioner waves her or his hands over the patient’s entire body at a distance of a few inches, as a way of detecting “imbalances” (although it is difficult to discover a clear definition of what an imbalance is) in the patient’s human energy field. This is followed by unruffling, a process of redistributing energy that has become congested, and sweeping away the excess negative energy, usually accompanied by a wringing of the hands that resembles shaking off excess water.

After nearly thirty years, no scientific evidence whatsoever exists that TT practitioners can actually do what they say they can, or for that matter, any evidence of the existence of the energy field that they claim to manipulate. Despite this, the practice has become enormously popular in the nursing profession, as well as with independent practitioners. As many as 100,000 people have been trained in TT, and training centers have existed at more than 100 colleges and universities. The North American Nursing Diagnosis Association was even persuaded to include “Energy Field Disturbance” as an official nursing diagnosis, for which TT is the recommended intervention.

Big money is to be made here: initial certification in TT costs up to $400 to obtain, making this a multimillion-dollar enterprise. Furthermore, the Nursing Diagnosis Association includes the requirement that TT should only be performed by persons who have obtained certification, with a minimum of twelve hours of instruction, and that the practitioner should be supervised by a nurse with a master’s degree, who has thirty hours of instruction in TT theory and an additional thirty hours of supervised TT practice (this of course adds significantly to the amount of money involved). When big money becomes a factor, the pseudoscientific dragon can be difficult to slay, but a clever sixth grader did more than anyone else has thus far to raise doubts about TT in the public mind.

Emily Rosa was preparing a project for her science fair, originally focused on using a bowl of candy to demonstrate probability, but she changed her direction when her skeptical nurse mother showed her a videotape about TT. For her science project, Emily conducted a simple, elegant empirical test of therapeutic touch practitioners. Where James Randi has had great difficulty getting anyone to submit to a controlled test of TT abilities, even with a one million-dollar prize on the line, Emily Rosa convinced twenty-one therapeutic touch practitioners to participate in her test. The design was extremely simple: she set up a wall with two holes in it, and had the TT practitioners stick their hands through the holes. Her hand was positioned over one of their hands; their task was to indicate which one. Each practitioner got twenty trials. In the end, they were only able to “detect” Emily’s hand 44 percent of the time, less often than the 50 percent hit rate that could be expected from random guessing. Some of these test subjects were quite well known and had even published articles on therapeutic touch. In April 1998, Emily’s data were published in the Journal of the American Medical Association, making her the youngest author ever to publish in that prestigious journal.

Reaction to that study from TT practitioners and advocates has been predictably hostile, with many ad hoc hypotheses put forward to explain away the sometimes bizarre results. These hypotheses include the following:

• The experiment was not double-blind. There’s no reason why it should have been. It was important that the practitioners be uninformed about which hand she was targeting, but there’s no reason why Emily should have been unaware of it, as that knowledge couldn’t logically influence the outcome. To the contrary, in order to place her hand near one or the other, Emily had to know which one she was targeting.
• Expecting the practitioners to get most of the trials right was unreasonable. They either can detect the human energy field or they can’t. If they can, 100 percent correct would be a reasonable expectation.
• Emily’s energy field was wrong for such a test. It was a wild pubescent field, or it was too perfect or too unhealthy, or it had too short a range, or it was so large it surrounded both hands, making a single hand impossible to detect, or she somehow was able to suppress her field. This might be a good place to mention that all practitioners got to examine her hands and “sense” her field ahead of time, and they also got to pick which of her hands had the easier field to detect.
• A practitioner doesn’t actually have to be able to feel the Human Energy Field. Since practitioners have used their ability to do so as the justification for the practice since its inception, this argument is especially bizarre.
• It doesn’t matter if it works or not—so what if it is a placebo effect? If it makes people feel better, let’s keep doing it. If it is a placebo effect, why is costly certification and oversight required to practice?
• JAMA published the results because TT is cheap and doesn’t require the services of doctors or pharmaceutical companies—they’d never publish studies critical of them. The best retort to this criticism is to simply look at an index of articles published by JAMA over the years. If a treatment is found ineffective or harmful, that gets published too.

This last criticism may contain a small kernel of the truth about the open embrace of TT by the nursing profession. In the medical field, most of the patient care is done by nurses, while most of the power rests with doctors. This is a treatment carried out by nurses without any help from doctors, using specialized training that the doctors haven’t had. It has served the purpose of giving many nurses a sense of power in patient care, an ability to heal that only they have. It is true that nurses should probably have more influence over patient care than they often do, but this is the wrong way to go about wielding it. When JAMA published Emily Rosa’s study, the article included the following statement:

To our knowledge, no other objective, quantitative study involving more than a few TT practitioners has been published, and no well-designed study demonstrates any health benefit from TT. These facts, together with our experimental findings, suggest that TT claims are groundless and that further use of TT by health professionals is unjustified.

At the moment, scientifically speaking, that is the last word on therapeutic touch (see also Acupuncture; Psychology, Research Methods in; Thought Field Therapy). 

References:

1. Rosa, L., Rosa, E., Sarner, L., and Barrett, S. “A Close Look at Therapeutic Touch.” Journal of the American Medical Association, 279(13) (1998): 1005–1011;
2. Sarner, L. “The ‘Emily Event.’” Skeptic, 6(2) (1998): 32–38.