Although it is called therapeutic touch, nurses who practice the treatment keep their hands about two inches above their patients. To date, about 100,000 American nurses have been trained in therapeutic touch, and it is considered the fastest-growing alternative nursing practice--in part, because of its appeal as being noninvasive, nontoxic, and useful for pain reduction and the promotion of healing.
Yet, despite many testimonials and diverse applications, therapeutic touch has garnered an outspoken chorus of critics. Some researchers allege therapeutic touch is medical quackery, while others, including some conservative Christians, have labeled it a New Age religious practice inappropriate for use in health care.
Since the introduction of therapeutic touch 24 years ago, the method--in spite of the controversy--has gained support nationally from groups such as the National League for Nursing, a nursing school accreditation organization.
Many nurses are first introduced to therapeutic touch through continuing education seminars and professional meetings. Last August, at a routine nurses' meeting at Our Lady of the Resurrection Medical Center in Chicago, registered nurse Barbara Kinast was handed a pamphlet: "Introduction to Energetic Modalities. [A nurse] will address the use of energetic touch as a therapeutic modality. This presentation will teach participants how to incorporate touch in a nonthreatening and comforting way. She will explain the newly approved nursing diagnosis, 'Energy,' so that it can be effectively employed in your nursing practice. [She] will demonstrate how to engage and assess the energy field."
Kinast had just returned from a retreat of Christian nurses where speakers had described therapeutic touch, including its roots in Eastern religions. At the medical center's seminar, Kinast says the speaker told nurses the practice had no philosophical or religious underpinnings. Yet she ultimately acknowledged, at Kinast's insistence, that the original proponents of therapeutic touch were New York University professor Doloris Krieger, a Buddhist, and Dora Kunz, a self-proclaimed psychic and former president of the Theosophical Society in America. Theosophy blends Eastern religious ideas with mysticism.
Kinast left the meeting convinced that the new alternative modalities in nursing, such as therapeutic touch, needed to be challenged. "I think it would have been much easier to sit back and say or do nothing," Kinast says, "but I didn't feel that that was the right thing to do."
Across America, nurses such as Kinast are being confronted in similar situations. For Christians in nursing, there are deep divisions on, first, whether the method works, and, second, whether it is incurably tainted by non-Christian religious ideas.
Therapeutic touch's advocates say that careful research ultimately will prove the usefulness of the methods as well as precisely how it works. Also, defenders, some of them Christian believers, maintain that therapeutic touch, while having wellsprings in Eastern religious thought, is not a threat to essential Christian belief or practice.
ALTERNATIVE THERAPY: The definitive method of therapeutic touch involves a practitioner moving his or her hands several inches away from the patient's body in order to remedy "energy imbalance."
A central concept in therapeutic touch is that life forms, including human beings, generate an energy field beyond their surface. When an energy imbalance occurs, illness may result. Sickness, then, may be overcome in part through therapeutic touch. This idea about life force is associated with the concept of prana, an Indian religious belief that an "organic," all-pervasive energy constitutes everything in the universe, including the human body.
Starting in the 1970s, Kunz and Krieger developed therapeutic touch to utilize a four-step process: centering, assessment, treatment, and evaluation. Practitioners are to view themselves as conduits of a "healing universal energy."
Today, more than 80 nursing schools in America and 70 foreign schools are teaching some form of therapeutic touch.
The federal government has initiated research to determine its effectiveness. The Division of Nursing at the U.S. Department of Health and Human Services granted $200,000 to D'Youville Nursing Center in Buffalo, and the Department of Defense granted $355,000 to the University of Alabama at Birmingham to study therapeutic touch.
Recently, a federal health panel announced its blessing on alternative treatment methods. "A number of well-defined behavioral and relaxation interventions are now available, some of which are commonly used to treat chronic pain and insomnia," concluded a panel of a dozen experts in behavior, pain and sleep medicines, nursing, psychology, and neurology.
Krieger herself attempted an early research effort to examine the claimed merits of therapeutic touch. She divided 64 patients into two groups. Half received care that included therapeutic touch, and the rest had treatment without it. Subjects receiving therapeutic touch registered higher hemoglobin levels, which gauge the amount of oxygen present. Krieger contends this proves there is a higher "prana energy flow," because prana in Eastern religious thought is believed to be inherent in oxygen molecules. Another study reported lower anxiety levels in a group receiving therapeutic touch, while another reported reduced headache pain.
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THE POWER OF TOUCH: Some analysts of the treatment contend that scientific evidence supporting these methods are in short supply, and that until the "Does it work?" issue is resolved, therapeutic touch should be avoided.
According to Arlene Miller, nursing professor at Messiah College in Grantham, Pennsylvania, additional research indicates that the "placebo effect" may be the cause of patient improvement after therapeutic touch, meaning that the patient's expectations of improvement, not the therapy itself, brought about physiological changes.
Other Christians are not waiting for research to be completed before criticizing therapeutic touch. Several Christian nursing scholars are openly speaking out against the mainstreaming of therapeutic touch and other alternative "holistic" nursing methods, warning that practicing them is equal to dabbling in the occult and can become spiritually destructive.
"It has legal problems both from an Establishment Clause perspective as well as an informed consent issue for patients and nurses," says Craig Branch, regional director of Watchman Fellowship, an evangelical counter-cult ministry in Birmingham. "Can state schools promote the ideology and practices of Eastern mysticism and occultism?"
Branch organized a summit meeting last month to challenge the use of federal funds to study therapeutic touch.
He contends a research assistant in the Birmingham study altered the protocol of a mimic group after data showed no difference between patients that received therapeutic touch and those that did not. Branch says the study was scientific misconduct at the least, fraud at the worst.
"Increasing numbers of evangelicals are getting caught up into alternative therapies with questionable theological roots," says Journal of Christian Nursing editor Judy Shelly of Frederick, Pennsylvania. "They stridently defend their practices, attacking those who attempt to point out the theological inconsistencies as 'narrow-minded.' The predominant attitude is, If it works, use it."
However, Sarah Wuthnow, chair of the Department of Nursing at Eastern College in Saint Davids, Pennsylvania, says it is "ridiculous" to think practitioners of therapeutic touch and other alternative, holistic nursing practices are leading people away from essential Christian belief. "There is power in the human touch. God made us this way," she says. "If it's truth, it's God's truth."
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One nursing professor, Chris Jackson, says she senses it. "I feel it as a thermal thing," she says, noting that when she passes her hands a few inches from a patient's body, areas of low energy are warmer to her hand. "Every time I demonstrate it, not only do I pick up different things, but I always end up feeling better."
Who are Jackson's subjects? Eastern College nursing students. For more than a decade, Jackson, who is also a licensed hypnotist, has been showing in her Christian college classroom a teaching video produced by Krieger explaining therapeutic touch. "It seems to make perfect sense to me that the human body is an energy field," she says. In a recent seminar, students practiced sensing one another's "energy fields" for headache pain.
Jackson has used the method on her dog. "I even picked up that he had arthritis in his hip." A later trip to the veterinarian confirmed her diagnosis, which she says resulted from sensing with her hands low energy areas in her dog.
Wuthnow acknowledges that the originators of therapeutic touch drew their understanding of human energy fields from religious teachings about prana. It does not bother her that to practice therapeutic touch a person is counseled to meditate or center, whereby practitioners relax and focus on the patient, not themselves. "To read John of the Cross or Theresa of Avila, you've got yourself emptying yourself in Christian contemplation," she says. "It's not opening yourself up to evil spirits."
Jackson and Wuthnow both say that anything that heals and does good cannot be evil and must ultimately please God. And both claim that therapeutic touch and other holistic nursing practices do not push people away from Christian faith but lead them toward a fuller expression of Christian belief.
THE DEATH OF TRUTH? According to Do'nal O'Mathu'na, a professor at a nursing college in the Midwest, the controversy about therapeutic touch is framed amid a larger, ongoing debate over how Christians function in an American culture of conflicting beliefs, cultures, and practices.
O'Mathu'na, who holds a doctorate in medicinal chemistry from Ohio State University and a master's degree in biblical studies from Ashland (Ohio) Theological Seminary, says it should be clear that therapeutic touch draws most of its ideas "from Eastern religions, not from postmodernism." O'Mathu'na says in a forthcoming book on postmodernism, "The Death of Truth" (Bethany House), that without the advent of postmodern thinking, therapeutic touch would not have a place in modern health care. "Postmodernism isn't the source for alternative medical practices, but it's the Trojan Horse that has brought primitive outlooks like alternative medicine to prominence and acceptability."
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O'Mathu'na notes that therapeutic touch and other alternative health care methods are attractive to professionals who are looking for other means to facilitate patient healing.
Many in the field of nursing, which was pioneered by Christians, see hands-on, interpersonal methods as underutilized means of assisting patients on the road to a full recovery since the advent of twentieth-century wonder drugs and sophisticated surgical procedures. "Nurses have always felt a bit abused by medicine," says Messiah's Miller, who holds a master's degree in public health and a doctorate in religion. "For some nurses, these practices have come to be defined as what nurses have uniquely to contribute. They are 'noninvasive,' so it is kind of an antitechnology move also. Nurses can do it without physicians' orders. For many, it is a power issue."
INTOLERANCE ALLEGED: Critics of the technique often are branded as narrow-minded and intolerant. O'Mathu'na says some local residents recently questioned teaching therapeutic touch at the University of Colorado's Center of Human Caring.
"They complained that tax monies should not be spent teaching a technique that was based, not in science, but in New Age religion." A university faculty peer panel concluded there was insufficient scientific data to support the technique, and that its practice should cease.
"The [center's] response to this report was very postmodern," O'Mathu'na says. "The center's [directors] viewed the findings as 'male-dominated medical imperialism against female-dominated nursing.'"
Yet, for some Christians, therapeutic touch is not hostile to people, medicine, or orthodox Christian doctrine. Christian supporters believe that the use of therapeutic touch may actually lead to a better understanding of the scriptural practice of laying on of hands.
Judy Chuster, a registered nurse practitioner, has practiced the technique for the past 15 years. "Feeling the energy fields gives me something tangible, although certainly the Holy Spirit is greater than just the energy fields. Being in nursing is a wonderful way to witness my Christianity."
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Chuster frequently uses the practice with people suffering from depression or anxiety, or for acute burns and lacerations to ameliorate pain and to intensify the healing process. In one case, efforts at conventional rehabilitation on a woman who had a leg amputated at the knee had proven unsuccessful, making it impossible to fit her for a prosthesis. The patient agreed to Chuster's request to try therapeutic touch.
"I went back in three days, and the incisions had made a remarkable change. Within a week from that time it was healed over." For Chuster, such examples demonstrate the reality and effectiveness of therapeutic touch. But they do not resolve the grave concerns of Christian scholars about the theological wellsprings of therapeutic touch.
HOLY SPIRIT OR SATAN? From the Christian theological perspective, questions about therapeutic touch are focused on whether its power and potential effectiveness ultimately come from God.
Sharon Fish, who is doing a doctoral dissertation on therapeutic touch at the University of Rochester in New York, has written extensively to challenge therapeutic touch and report its religious roots.
While some who oppose the practice argue that laying hands on someone simply communicates feelings of love or care, or stimulates psychosomatic recovery, Fish, coauthor of "Spiritual Care: The Nurse's Role" (InterVarsity Press,1988), believes the practice could indeed involve some kind of energy flow.
Fish has begun studying healing practices in various streams of the American charismatic movement, phenomena in which proponents say the Holy Spirit ministers to people through powerful physical manifestations in their bodies (CT, Sept. 11, 1995, p. 22).
While she notes that the jury is still out on many of these claims from mostly charismatic Christians, she nonetheless questions whether therapeutic touch may be a "counterfeit of Satan" compared to possible legitimate action by the Holy Spirit.
Miller contends that the theological idea of any energy transferred via therapeutic touch actually being the Holy Spirit is ill-founded. She notes that the Bible presents the Holy Spirit as a personal being rather than a vague force, as in Eastern thought.
"When the Spirit is seen as a personal member of the Godhead, the very idea of directing and modulating [energy] from within oneself into another person approaches blasphemy," Miller writes in the "Journal of Christian Nursing." "The Holy Spirit is not an impersonal energy to be directed and modulated by us!"
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Miller says therapeutic touch is not the same as the laying on of hands in the New Testament. "When Christians practice the laying on of hands for healing, they pray to the personal God in the name of Jesus, and they are strengthened by the Holy Spirit."
Whatever the case, unlike Chuster, Fish believes that when practiced under non-Christian guise, therapeutic touch may lead people astray. "In virtually every culture where this type of healing takes place, there is also the occult association."
Both O'Mathu'na and Fish also say that often Christian nurses become enamored with the practice, end up losing their moorings, and head into Eastern religious concepts that God dwells in all things and is not a transcendent, sovereign deity. "Practitioners have a change in belief after participating in this technique, and they will be open to the belief that perhaps we are divine," Fish says.
Some say the greatest concern is that therapeutic touch is now generically packaged as nonreligious in nursing literature and seminars, such as the one Kinast attended. Nursing ethicist Susan Salladay, who has a doctorate in philosophy of social and applied ethics, says that in nursing today it is taboo to address the transcendent dimensions of spiritual care--from a specifically Christian perspective.
"We can't talk about divine healing, much less about healing through Jesus Christ," says Salladay, director of the Center for Bioethics at Bryan Memorial Hospital in Lincoln, Nebraska. "But at these seminars, nurses learn techniques about how to help patients heal themselves. And so they teach things like how to help patients get in touch with the divine within, [and] that's not considered religious."
In coming years, the mystical, ephemeral nature of therapeutic touch will make it exceedingly difficult for scientists and theologians to form solid consensus about the therapy's value. Yet there will continue to be some patients with needs beyond medical science whose sole measure of the therapy will be: Was I helped?