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A
modern variation of the 'laying on of hands', therapeutic touch
is one of the most controversial forms of alternative therapy.
Uses
Practitioners
say that it heals by correcting imbalances in the energy field that
emanates from the body, while mainstream critics respond that there
is no evidence that such a field exists, or that it would have anything
to do with health if it did. In any event, its proponents say therapeutic
touch can heal wounds, relieve tension headaches and reduce stress.
According to Nurse Healers, the therapy's leading advocacy group,
it also reduces pain and anxiety, promotes relaxation and facilitates
'the body's natural restorative processes'. Therapeutic touch is
usually employed as a supplement to, rather than a replacement for,
standard medical therapies. For example, it is sometimes used to
relieve discomfort between scheduled doses of pain medication for
hospitalized patients. It is also employed by hospice nurses to
relieve pain in terminally ill patients and to help the family accept
the impending death of their loved one.
Procedure
of Treatment
Despite its
name, therapeutic touch rarely involves physical contact between
practitioner and patient. Instead, the therapist will move his or
her hands just above your body. You will be asked to sit or lie
down before the procedure begins. No disrobing is necessary. The
session is conducted in four steps:
Centering: The practitioner begins by 'centering' himself-attaining
a quiet, meditative state in which he is focused on and attuned
to the patient's needs. Experienced practitioners can usually complete
this process within a few minutes.
Assessment: The practitioner will then move his hands from
head to foot along your body, holding them two to four inches away.
This is done to assess the condition of the energy field that is
thought to surround the body. Clues to the status of the field include
feelings in the palms of the hands and 'other intuitive or sensory
cues' that signal areas of 'congestion' or 'blockage'.
Treatment: Once he discovers a 'blocked' area, the practitioner
will move his hands in a flowing motion from the top of the location
down and away from your body. This action is repeated until the
practitioner no longer feels the blockage, or until you relief.
Evaluation: After you have had a chance to rest, the practitioner
will ask you about your response to therapy and reassess your 'energy
field' to make sure that no blockages remain evident. Some practitioners
add another step to the treatment. Called energy transfer,
it calls for the therapist to place one hand on your back, in the
kidney area, and hold the other hand two to three inches from the
corresponding location on your abdomen. He then visualizes energy
passing from the hand on your back to the one held above you.
Treatment Time: Most sessions take 10 to 20 minutes; few
exceed 30 minutes. Treatment stops when the practitioner no longer
senses problems in the energy field, or feels you have had enough.
Treatment Frequency: The number of treatments needed varies
according to the problem and the patient. A headache in an otherwise
healthy person may require only one session; a person with a chronic
illness may require multiple sessions. For frail, sick, and very
young or very old patients, proponents recommend keeping the sessions
short and conducting them more frequently.
Benefits
Therapeutic
touch was developed in the early 1970s by Dolores Krieger, Ph.D.,
a professor of nursing at New York University, and Dora Kunz, a
'natural healer'. Krieger and Kunz first taught the technique to
Krieger's graduate nursing students, and it remains primarily a
nursing intervention today. It has been taught at more than 100
colleges and universities since the 1970s, and is currently offered
in about 70 health care facilities nationwide. All told, Krieger
says she has taught the technique to more than 43,000 health care
professionals and several thousand lay persons. Controversy over
therapeutic touch focuses on the 'energy field' that its practitioners
seek to balance. Krieger claims that the field can be sensed through
'hand chakras', centres of consciousness posited in Indian mystical
writings. As proof of the field's existence, other proponents cite
images of an energy aura taken with Kirililan photography, a technique
in which the hands are placed on film and a low-amp electrical current
produces the picture. Critics dismiss the entire energy theory as
mystical, and ascribe any benefits of the technique to a positive
psychological response to the care and attention provided by the
practitioner. They argue that Kirilian images of the energy field
are nothing more than the result of increased pressure or moisture.
They also cite a recent study published in the Journal of the
American Medical Association in which 21 self-described practitioners
of therapeutic touch failed to detect energy from the nearby hand
of an investigator when their view of the hand was blocked. Advocates
of therapeutic touch charge that the study was seriously flawed.
They point out that the participants' credentials were never checked,
that the number of participants was inadequate, and that one of
the authors (a coordinator of the National Council Against Health
Fraud's Task Force on Questionable Nursing Practices) was hopelessly
biased. They add that therapeutic touch is not simply a mechanical
manipulation of energy fields, but an act of compassion that requires
personal interaction between patient and therapist. Some proponents
of therapeutic touch speculate that mechanisms other than an energy
field may be at work. In fact, Krieger herself states that the procedure
conveys a 'sense of deep peace that presages a rapid (two-to-four
minute) relaxation response', thus laying the groundwork for positive
changes in the patient's immune system. Whatever the explanation
may be, a number of studies have detected genuine improvements following
the administration of therapeutic touch. In one trial, in which
the patients did not know whether or not they were being given the
therapy, skin wounds healed significantly faster in those who received
it. Another trial found that therapeutic touch effectively reduced
headache pain, and a third investigation found that it reduced the
time needed to calm hospitalized infants and toddlers after stressful
experiences such as examinations and surgery. Nevertheless, other
studies have failed to show conclusive results. In one trial for
postoperative pain, therapeutic touch reduced discomfort by only
13 per cent, versus a 42 per cent reduction afforded by standard
pain medication. Researchers were forced to conclude that although
the technique might reduce the need for drugs, it cannot be used
to replace them. Likewise, the editor-in-chief of the Journal
of the American Medical Association has admonished patients
to 'refuse to pay for this procedure until or unless additional
honest experimentation demonstrates an actual effect'.
Who Should
Avoid This Therapy?
There are no
medical conditions that preclude treatment with therapeutic touch.
However, some people seem more susceptible to it than others. Among
those best suited to it are pregnant women, newborns, children,
older adults and people with psychiatric disorders. Mainstream critics
of the procedure warn everyone to avoid it, saying that there is
no reason to believe that it will have any effect.
Side-effects
There have been
reports of nausea and dizziness following the procedure, although
it is unlikely that therapeutic touch was the cause. In addition,
one expert warns that directing too much energy into a person's
energy field can cause 'discomfort and irritability'.
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