The healing power of touch has been in practice throughout recorded history. Often aligned with spiritual or religious beliefs, the ability of certain persons in the community to heal through bodily contact or close proximity is repeated in culture around the world.

Faith healing in Judaism, Christianity and Islam, te-ate in ancient Japan, pranic healing in India, shamanistic rituals in tribal societies across the globe, the royal touch in medieval Europe; all hold as their central belief that special physical contact between two human beings can effectively cure disease, heal wounds, and remove infirmities.

Therapeutic Touch is similar to the "laying on of hands" practiced by some religious sects as a means of transferring healing energy to the believer. The idea of an energy field can be traced back to the eighteenth century work of Franz Anton Mesmer, a German doctor who believed that illness was caused by imbalances in the body's magnetic forces. He believed he could restore magnetic balance through the use of soothing words and quieting gestures, a technique he called Mesmerism.

These beliefs receded to mystical obscurity in Western culture during the Industrial Revolution and the following Scientific Revolution, during which the current drug and surgery based paradigm of Western medical science was firmly established. This paradigm ruled until the New Age movements and resurgence of alternative therapies regained popularity.

Background

Delores Krieger, RN, PhD, and Dora Kunz, a natural healer, developed Therapeutic Touch (TT) in the early 1970s. TT is an adaptation of several religious and secular healing traditions and is commonly used in nursing practice for many different conditions.

TT practitioners hold their hands a short distance from the patient without actually making physical contact. The purpose of this technique is to detect the patient's energy field, allowing the TT practitioner to correct any perceived imbalances.

Nurse Healers Professional Associates, Inc. is the primary training organization for Therapeutic Touch and teaches a standardized technique.

Treatment

TT treatment consists of steps: centering (calming the mind and focusing attention on the patient), assessing the patient's energy field for irregularities, intervention to facilitate symmetrical flow of energy through the field, and evaluation/closure to verify the effects and conclude the treatment.

The clothed patient is normally lying down, but may also be sitting or standing. There are four steps involved in a TT session, which takes between 10and 30 minutes to complete.

1. Centering, sometimes referred to as the yoga of the mind, is the first and clearly the most important step. To prepare to do Therapeutic Touch the healer must enter an intuitive state of awareness where she (or he) is relaxed and quiet. The practice of various meditation techniques (for example, the repetition of a mantra) can help a person learn to center.

2. Assessment comes next. The healer places her hands two to four inches above the patient, palms down and open, and then slowly hand-scans the patient’s entire body from head to toe, intuitively searching for any imbalances in the person’s energy field. Areas of pain and accumulated tension or inflammation are believed to be perceived in the hands as various sensations such as tingling, unusual pressure or pulsation, and heat or coldness. These sensations are thought to reflect blocked or accumulated energy.

3. Unruffling is the third step. The hands now become more active and the healer may engage in circular sweeping motions designed to "decongest" the patient’s energy, distributing any excess energy to areas of low flow and sometimes removing it altogether by sweeping it down and out through the feet. The healer will usually shake her hands vigorously to rid herself of any excess energy she may have accumulated.

4. Modulation comes next and involves transferring subtle healing energy from the healer to the patient or redirecting the patient’s own energy. The healer’s hands often hover over certain parts of the body previously assessed as imbalanced.
The Therapeutic Touch session ends when the healer "intuitively feels" the patient’s energies are back in balance. This occurs generally within five to fifteen minutes of the Therapeutic Touch process.

Treatment sessions usually last from five to thirty minutes. Currently there is a lack of formal certification or competency-based assessment for this therapy.

The concept of "life energy" or "life force" has sometimes been compared to spiritual rather than scientific principles. Some critics argue that because of its religious roots, Therapeutic Touch should be treated as a religion rather than as a healthcare therapy. Skeptics have sought to eliminate Therapeutic Touch as a nursing practice, due to questions surrounding the mechanism of action. However, suggestive results from several human studies, positive clinical experience, and case reports have led to increasing use of TT.

Several variations have emerged from the original treatment but aspects of centering and intent have remained the foundations of this technique. Janet Mentgen founded healing touch in the 1980s based on the principles of therapeutic touch. Healing touch adds patient empowerment, practitioner self care, and focuses on the impact of the practitioner-patient relationship.

Systems

There are a number of therapeutic touch systems in use today; the most popular are Dolores Krieger's Therapeutic Touch, Reiki and Pranic Healing. The differences between these schools are primarily in the realm of terminology; the theoretical mechanisms by which the systems work and the supposed benefits of these systems remain essentially identical.

Theory

The use of therapeutic touch presupposes a belief in "life energy," which is interpreted variously as spirit, soul, yin/yang, electricity, magnetism, or Einstein's energy based universe theories. According to this system, all living beings produce life energy, and the combined total of the overlapping energy fields in an area creates an environmental life energy field in which we live, which is in turn a part of the limitless energies of the universe. Ideally, life energy is produced in the living and flows freely to and from the environment. However, this state is only maintained when an individual is at unity with itself. If desires are being repressed, rejected, fought, or frustrated, the individual falls out of harmony with his environment, either absorbing too much energy or releasing too much. Equally damaging, irregularities may develop in the individual's field which channel too much energy to one part of the body at the expense of others. The damaged energy field reflects its ailments in the physical body as "dis-ease," which is not the bacterial/viral/syndrome version of disease connoted by popular usage, but instead simply a state of imbalance that impairs the natural, proper functioning of the organism. Generally, this results in the weakening of the immune system, a slowing down of the healing process, the appearance of various psychological disorders, and an across the board decline in faculties.

The purpose of therapeutic touch, then, is to remove the irregularities of the energy field which cause dis-ease, both as a preventative mechanism and as a treatment for manifested illness. Therapeutic touch practitioners attempt to smooth out irregularities in the human energy field and attempt to center the energies of the individual, diverting excess energies back into the environment. Alternatively, the therapist may channel some of the limitless energy of the environment through themselves to "jump start" the weakened energies of the individual. It is this recentering and smoothing that is the operative technique of therapeutic touch; the practitioner is not actually healing the patient, but instead orienting the patient's body correctly so that it operates at peak levels of efficiency.

The way therapeutic touch may affect the body is unknown. It is theorized that TT affects patients through the connection of energy fields within and outside of the body. Energy is thought to stimulate internal mechanisms to treat physical symptoms. The autonomic nervous system is felt to be particularly sensitive to TT, followed by the lymphatic, circulatory, and musculoskeletal systems. Female endocrine disorders are believed to be more sensitive than those affecting males. Manic and catatonic patients have been reported to respond to Therapeutic Touch. Most scientific studies of TT have examined the effects on pain and anxiety.

A controversial study published in the Journal of the American Medical Association in 1998 reported that a group of Therapeutic Touch practitioners were unable to sense energy fields. The study was widely publicized and hailed as a landmark article, but has been criticized by some TT providers because it did not measure improvements in patient symptoms or patient satisfaction.

Principles

The five principles that are the basis of Therapeutic Touch are:

1. Human energy field
Therapeutic Touch and Healing Touch are based on the belief that that humans and animals possess an energy field that permeates the body and extends beyond it. The energy fields especially emanate from seven areas, called chakras, based on ancient practices from India.

2. Effects of energy field
Disease, illness, injury or discomfort show up as changes or differences in the energy field. Eliminating these differences can relieve discomfort and aid in the healing process.

3. Perception
People can be trained to perceive the energy field of others and thus determine problem areas in the patient. The intention of the practitioner is important in perception. Often the motion of a pendulum over chakra areas is used to indicate the state of the energy field.

4. Changing field
A trained practitioner can manipulate the energy field to relieve discomfort and promote healing. The intention of the practitioner is important in affecting the field.

5. Using hands
The practitioner's hands are used to perceive and change the energy fields. A pendulum held in the hand is often used to indicate the state of the energy field.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. Pain

Therapeutic touch may reduce pain and improve joint mobility in people with osteoarthritis, decrease pain and anxiety caused by burns, and improve chronic muscle and joint pain in elderly patients. Preliminary research reports that patients treated with therapeutic touch may need less pain medication after surgery. However, most studies of therapeutic touch have not been well designed and therapeutic touch has not been clearly compared to common pain treatments such as pain-relieving drugs. Further research is needed before a firm conclusion can be drawn.

An Office of Alternative Medicine has also been established within the National Institutes of Health (NIH) to fund research on unconventional interventions. This attests to the popularity of Therapeutic Touch and related practices.

Psychiatric disorders (children)

There is some evidence that therapeutic touch may reduce anxiety in children with life-threatening illnesses, reduce stress in teenagers with psychiatric disease, and help relax premature infants. More research is needed before therapeutic touch can become a standard treatment for psychiatric disorders in children.

Stress

There is some evidence that therapeutic touch may reduce anxiety in chemically dependent pregnant women, reduce stress and anxiety in the work place, and reduce stress in teen-agers with psychiatric disease. Further study is needed to show that therapeutic touch is an effective way to reduce stress and promote relaxation.

Alzheimer's dementia

Studies suggest that therapeutic touch may reduce behavioral symptoms of dementia such as searching and wandering, tapping and banging, anxiety, agitation, and vocalization in people with dementia. Well-designed studies are needed before a firm conclusion can be drawn.

Carpal tunnel syndrome

Therapeutic touch may provide limited benefit in carpal tunnel syndrome. More studies are needed to determine if therapeutic touch is an effective treatment for carpal tunnel syndrome.

Central nervous system disorders

There is some evidence that therapeutic touch may affect some properties of the central nervous system. However, further research is needed to examine whether therapeutic touch could have any effects on central nervous system disorders.

Depression

Therapeutic touch may offer some benefits when used with standard therapies to treat depression. More research is needed.

Diabetes

Therapeutic touch may not have any effects on blood sugar levels in diabetics. There is not enough evidence to recommend therapeutic touch as an effective treatment for diabetes.

Fibromyalgia

Preliminary research suggests that therapeutic touch may be an effective treatment option in relieving pain in patients with fibromyalgia. Further research is needed before a recommendation can be made.

Headache

Therapeutic touch may reduce pain in patients with tension headache. Further study is necessary in order to make a recommendation.

HIV/AIDS

There is currently not enough evidence that therapeutic touch can benefit immunity or emotional well-being in AIDS patients. More research is needed.

Hypertension (high blood pressure)

Therapeutic touch has been suggested to relieve anxiety and stress, which may help to lower blood pressure. However, there is currently insufficient evidence that therapeutic touch is effective in treating hypertension. More research is needed.

Mastectomy adjunct

Therapeutic touch may affect physical and emotional outcomes in women who have had mastectomies. However, there is not enough evidence for or against using therapeutic touch in patients undergoing mastectomies.

Phantom limb pain

There is very little evidence that therapeutic touch can relieve phantom limb pain after amputation. More research is needed before therapeutic touch can be recommended as a treatment for phantom limb pain.

Well-being in cancer patients

Early research suggests that therapeutic touch may improve well-being in advanced cancer patients. Pain, anxiety, depression, and fatigue have been reported as improved in patients receiving therapeutic massage and healing touch. More studies are necessary to confirm these results.

Wound healing

Although some studies report an improvement in wound healing with therapeutic touch, others show no benefits.

Tradition

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Arthritis, bone fractures, bone healing, cancer, cardiovascular disease, childbirth preparation, chronic fatigue syndrome, dystonia, epilepsy, grief, heart disease, multiple sclerosis, palliative care, Parkinson's disease, postpartum care, promoting flow of breast milk, rehabilitation, sarcoidosis, sinusitis, sleep enhancement, trauma (recovery), well-being during pregnancy.

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Therapeutic touch is believed to be safe for most people. Treatment sessions may be briefer for children than adults. Therapeutic touch should not be used for potentially serious conditions in place of more proven therapies. Restlessness, anxiety, dizziness, nausea, and irritability may occur. Tension headache and crying have also been associated with therapeutic touch. Some TT providers believe that this therapy should not be practiced on people with fever or inflammation and should be avoided on body areas with cancer. Some believe that if the Therapeutic Touch provider is experiencing emotional difficulties, these feelings may be displaced onto the patient.

Education

In recent years the tension between Western medical science and so called "holistic" or "traditional" medicines and therapies has been increasing, as demand for these services forces hospitals to include theraputic touch or else lose patients to competitors.

Therapeutic Touch has been taught as a required or elective part of the curriculum in over 80 colleges and universities, with research-based and popular anecdotal articles abounding in nursing journals. Furthermore, Therapeutic Touch has gone mainstream in society. It was the subject of a recent segment on NBC’s popular Unsolved Mysteries. The Reader’s Digest Association also helped popularize it with an article in their Family Guide to Natural Medicine

Funding for Therapeutic Touch is readily available and much of it is federal. Examples include a $200,000 grant by The Division of Nursing, U.S. Department of Health and Human Services to D’Youville Nursing Center in Buffalo, New York to train student nurses in the technique, and a Department of Defense grant of $355,000 to a research team at the University of Alabama, Birmingham to study the effects of Therapeutic Touch on burn patients.