Therapeutic Touch continued – page 2

Review of previous literature

Although there has been much anecdotal evidence over the past few decades attesting to the efficacy of TT, only a comparative handful of studies have examined the phenomenon in a scientifically rigorous matter. Several of those studies are examined here. To meet scientific standards for inclusion, the study must utilize randomized, double-blind, placebo-controlled protocols to analyze the effect of TT.

Barbara Daley (1997) analyzed a series of experiments that attempted to "test the hypothesis that TT performed without physical contact . . . can accelerate the healing rate of surgically administered full thickness human dermal wounds" (Daley, 1997, 125). In the first study, subjects in the treatment group placed their biopsied shoulder through an occlusive opening in a shielded door, whereupon they received a five-minute non-contact TT session. Subjects were unaware of the TT practitioner. The control group underwent the same procedure, but without the TT intervention. Results showed that "57% of the treated group exhibited fully healed wounds at the end of the experiment, whereas none of the control group wounds were fully healed" (Daley, 1197, 1126).

Placebo effects and the possible influence of suggestion and expectation of healing were eliminated by isolating them from the Therapeutic Touch practitioner, by blinding them to the nature of the therapy during the study, and by the use of an independent experimenter who was blinded to the nature of the therapy (Wirth, 1990).

But critics asserted that the healing occurred because of heat transfer between the practitioner and the subject. To eliminate this possibility, a second study was conducted, using a door fitted with a one-way mirror. Subjects were unaware of group assignment and the use of TT. Analysis showed "a highly significant rate" of healing when compared to the control group (Daley, 1997, 1126).

To answer criticisms of the earlier studies, the experimenters introduced complex, randomized, double-blind, within subject, crossover methodological design protocols. In one study (the third examined by Daley), visualization, relaxation, and biofeedback techniques were used in conjunction with TT. This experiment was performed in two sections. In the first section, two TT practitioners administered treatment through a one-way mirror and via a real-time video monitor image of the subject. The control group differed from the treatment group only in that a plastic sheet was added to the patient's side of the mirror, to test whether this interfered with the patient's "energy field" (Daley, 1997, p. 1127). In the control group for the second section of the experiment, the TT practitioners were told that the patient was in the adjacent room behind a sheet of opaque glass. The subjects, however, were located in a different room on another floor. The treatment group was told the true location of the subject, in order to examine the effect of distance and belief on the TT process. Using these techniques and controls, results were inconclusive (Daley, 1997, 1127).

The fourth study included a "design feature where the subjects concentrated on a specific intent to relax or a specific intent to heal their wounds" (Daley, 1997, 1127-28). Although the results indicated "significance for the control condition and not for the treatment condition" (Daley, 1997, 1128), the researchers attributed this to a carryover effect from prior sessions. [The subjects had previously participated in the second study in the series (Daley, 1997, 1125).] Thus, results were inconclusive.

The fifth study replicated the second study, even to the extent of using the same TT practitioners. In this case, however, results "demonstrated statistical significance for the control group" (Daley, 1997, 1128). This reverse significance was attributed to a transference effect. For example, if the TT practitioner was ill, the subjects, who were physically healthy prior to their treatment sessions also began exhibiting the same symptoms, although there was no way to transmit the illness directly between practitioner and subject.

While the results of the studies were inconsistent overall, the series of experiments nonetheless expanded the theoretical boundaries and understanding of the TT process, and laid the groundwork and guidelines for further study into TT.

Not all of the literature supports the efficacy of TT. In an article published in 1998, Rosa et al. tested 21 practitioners of TT under blinded conditions to determine whether they could detect the investigator's "energy field." Practitioners were successful in 44% of trials, close to what the investigators would expect through random chance (Rosa et al., 1998, 1005). Thus, the authors reached the conclusion that "failure to substantiate TT's most fundamental claim is unrefuted evidence that the claims of TT are groundless and that further professional use is unjustified" (Rosa et al., 1998, 1009).

However, the results of one study do not constitute sufficient evidence to render a scientific theory null and void. Moreover, this was only a single-blind experiment. Therefore, to ascertain whether TT as an intervention is a legitimate form of therapy rooted in science, We suggest replicating a study conducted by D.P. Wirth and J.R. Cram (1993, 47-53).

In this study, subjects were blinded to the true nature of the experimental protocol as well as to the fact that a healing study was being conducted, to control for placebo and expectation effects. This is the greatest strength of the study, that it was a blinded, controlled experiment. Impact was assessed by electromyographic (EMG) recording as well as measurement of autonomic indicators, including hand and head temperature, heart rate and end tidal CO2 levels. Thus, there were specific, quanifiable data to be measuured in each test.

The volunteer subjects in this study consisted of six men and six women, ranging in age from 21 to 52, residents or regular visitors at a Northern California yoga center. Eleven of the subjects were formally trained in a system of mantra meditation, and one subject was a self-taught meditator. Perhaps, the sample could have been larger and drawn from a more general population.