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Therapeutictouch:searchingforevidenceof
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Searching for Evidence of Physiological Change
Author(s): Dolores Krieger, Erik Peper, Sonia Ancoli
Source: The American Journal of Nursing, Vol. 79, No. 4 (Apr., 1979), pp. 660-662
Published by: Lippincott Williams & Wilkins
Stable URL: http://www.jstor.org/stable/3462338 .
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THERAPEUTIC
TOUCH
By Dolores Krieger
Erik Peper/Sonia
Evidence
for
Searching
Ancoli
Therapeutic touch, first described
by Krieger in 1975 as an act of healing or helping that is akin to the
ancient practice of laying-on hands,
is proving to be a useful adjunct to
orthodox nursing practices.
It is being taught as an intrinsic part of the master's curriculum
in nursing at New York University,
is the subject of continuing education courses and workshops at universities throughout the United
States, and has been a part of inservice programs for nurses at several
hospitals in the country.
Basic to therapeutic touch is
the concept that the human body
has an excess of energy. The person
who administers therapeutic touch
engages in an effort to direct his
own excess energies for the use of
the ill person, who can be thought
of as being in less than an optimal
energy state(1).
This transfer of energy is intentional and is motivated by an interest in the needs of the patient. The
state of consciousness in which this
is done can best be described as
meditative; therefore, the process
touch has been
of therapeutic
DOLORES KRIEGER, R.N., Ph.D., is a professor
of
9
PhysiologicalChange
termed to be a "healing meditation"(2). In the process of therapeutic touch, the person playing
the role of the healer becomes quiet
and passively "listens" with her
hands as she scans the body of the
patient, and gently attunes to his or
her condition. The healer places her
hands over the areas of accumulated tension in the patient's body
and redirects these energies.
In the process of touching
there appears to be a transfer of
energy from healer that helps the
patient to repattern his or her energy level to a state that is comparable to that of the healer. This
appears to be done physiologically
by a kind of electron transfer resonance(3).
With therapeutic touch, as
with other meditative practices, the
iI
isS j-
of
nursing, New York University, N.Y. She
began her postdoctoral research into therapeutic touch in 1969. She has conducted
numerous workshops and has presented
many papers on the subject.
.
ERIK
PEPER,Ph.D.,is a professor at San Francisco State University, Calif. He is the author of
many articles on biofeedback and related
topics.
SONIA ANCOLI, M.S., is a doctoral
candidate,
majoring in psychophysiology at the University of California, San Francisco.
660
American Journalof Nursing/April 1979
Dr. Dolores Krieger began her practice and research into therapeutic touch in 1969.
mind is totally focused without effort upon the healing touch; no
other thoughts enter awareness.
This process, like any meditation,
requires "attentiveness training," a
mode of thought not usually taught
in our educational system.
As therapeutic touch is being
used increasingly in nursing practice, we are directing our attention
to physiological effects therapeutic
touch may have on the healer or
therapist as well as on the patient.
One such effort was a study done on
one of the authors (Krieger) while
she was doing therapeutic touch.
The study was done in the
laboratory of Joe Kamiya, Ph.D., at
the Langley Porter Neuropsychiatric Institute, UCLA, San Francisco,
over a two-day period. The final
research design developed out of
discussions between the authors,
Dr. Kamiya, and his doctoral and
postdoctoral students. This interdisciplinary approach resulted in research design and methodology that
made possible objectively discernible data on subjective healer-healee
interactions.
During the study, the group
worked as a team, making direct
observations through the window
of a testing chamber or inside the
chamber itself, and at the same
time tending the sophisticated technological equipment that measured
the physiological parameters and
simultaneously printed out the data
coming through the computer. The
technology analysis was done by
Peper and Ancoli.
Three patient volunteers from
the Pain and Stress Control Outpatient Department of a hospital in
California consented to participate
in this study. Mr. A., a man in his
sixties, had had severe neck and
back pain for several years following the injection of contrast dye
into the spinal canal for myographic studies. Since then, he had
been unable to walk without the aid
of crutches. The second participant,
Ms. B., was a 30-year-old woman
with a history of fibroid tumors.
The third participant was Ms. C., a
young woman in her early twenties
who had a history of severe chronic
migraine headaches as well as one
reported grand mal seizure.
Krieger was studied for two
consecutive days while she was attached to electroencephalographic,
electromyographic, and electro-oculographic leads.
On Day 1, baseline data was
recorded on Krieger while she was
doing therapeutic touch to a patient, as well as while she was alone.
While alone, she spent part of that
time in meditation. No attempt was
made to record from patients on
Day 1.
Usually Krieger did therapeutic touch while standing. Data was
collected for both conditions of
eyes open and eyes closed, while
sitting as well as standing. The
patients either sat or lay in a supine
position on a cot, whichever was
more comfortable for them. The
testing site was a neutrally lit, electrically-shielded, sound-deadened
acoustical chamber, large enough
to hold two chairs and a cot. On one
side of the chamber was a small
observation window.
Different electrode configurations were used to explore the therapeutic touch process. Grass cup
electrodes and Grass electrode
paste were used for bipolar EEG
patterns. The electro-oculograms
EOG) were recorded with slow or
nonpotential skin electrodes attached to the outer and inner canthi
of each eye.
In addition, frontalis electromyographic (EMG) and left palmar
galvanic skin response (GSR) leads
were recorded.
The EEG, wrist-to-wrist heart
rate (EKG), palmar GSR, and temperature from the hands were also
monitored for each patient.
The most significant finding in
this study was Krieger's EEG and
EOG data. In all experimental conditions, her record shows an unusual amount of fast beta EEG activity. The frontalis muscle activity
(EMG) was also recorded as a control for extraneousbeta activity due
to excessive muscle tension. For
this reason, Krieger'sfrontalis EMG
was compared with her EEG.
The EEG demonstrated that
even when the action of the frontalis muscle subsided, the rapid rhythmical beta activity continued. This
indicates that the rapid synchronous beta was not an artifact of
muscle action.
Usually Krieger was not actively attending to outside cues.
The EOG records Krieger's eyes
open in slight divergence with no
movement; that is, no slow rolling
or saccadic movements of the eyes
took place during the time Krieger
was doing therapeutic touch. This
indicates that she was in a state of
steady concentration, as if gazing
far away at nothing.
During this period, no significant changes were recorded for the
patients' EEG, EMG, GSR, temperature, or heart rate. The records of
all three patients show them in a
relaxed state, with a high abundance of large-amplitude alpha activity in both the eyes-open and the
eyes-closed states. Alpha is usually
present when subjects are not visually orienting, and this can be construed to indicate relaxation.
On analyzing the data, it can
be considered that the predominant
rapid synchronous beta in Krieger's
EEG represents the physiological
style of therapeutic touch that, as
indicated above, can be considered
to be in actuality a healing meditation. When a person closes his eye
gently and is in a calm state of
mind, he usually is in an alpha state.
When a person is in a normal state
of waking awareness, he is in a beta
state. The significance of the fast,
rhythmical beta state in Krieger
was that it indicated a state of deep
concentration. The significance of
the patients' being in an alpha state
with their eyes open is that, aside
from study done on Zen Buddhist
masters (priests), the alpha state is
usually accomplished in the (-losedeyes state by most people. The
patients' eyes were in the open
state, they did not think they were
in an alpha state; when questioned
they said they felt a state of wellbeing.
Each patient reported relaxing
during therapeutic touch, and the
physiological indices indicated that
the subjects were indeed relaxed.
After the study was over, Mr.
A. walked out of the laboratory,
down a standardflight of stairs and
out into the street carrying his
crutches somewhat casually under
his arm instead of using them. On
follow-up examination, Ms. B.'s fibroid tumors were no longer observable, and the severity of Ms. C.'s
migraine headaches diminished.
The improvements in'condition may not be related to the therapeutic touch experience and no
claims can be made; however, it
American Journal of Nursing/April 1979 661
THERAPEUTIC
TOUCH
was evident that the experience was
important to the patients.
The authors do not claim
knowledge of the extent to which
the improvement of the patients
was related to therapeutic touch.
To study the healing properties of
therapeutic touch, controlled studies need to be done; this was simply
one intensive study done on one
person playing the role of healer
with three patients.
One problem in this type of
research is that the conditions of
baseline and postbaseline experimental treatment are artificial
boundaries that the experimenter
sets up. For the adept nurse-healer
these dichotomies and distinctions
may not exist, since Krieger started
attuning to the patient the moment
she entered the testing chamber;
therefore, the baseline condition is
actually a combined process of the
baseline plus the healing meditation.
That the patients reported
feeling better during these sessions
could be explained by "placebo."
Even if therapeutic touch is just
"placebo," placebo has been noted
to help in over 30 percent of
illnesses. Learning to systematically maximize this process through a
healing meditation would, in itself,
be a significant contribution to
nursing. The authors believe, however, that therapeutic touch goes
beyond placebo and involves an
undefined but learnable method of
human energy balancing.
There is much further study
that needs to be done before these
findings can be generalized, of
course. However, the report is presented to encourage further inquiry
of an area of nursing practice that
appears to be of continued interest
and use, and to support continued
unbiased investigation in its evaluation by peers.
References
1. Evans-Wentz, W. Y., ed. Tibetan Yoga and
Secret Doctrines. 2d ed. London, Oxford Press,
1968.
2. Peper, E., and Ancoli, S. Two Endpoints of an
EEG Continuum of Meditation. Paper presented at Biofeedback Society of America, Conference held at Orlando, Florida, March, 1977.
(Reprint request: E. Peper, 2236 Derby, Berkeley, Calif. 94705.)
3. Krieger, D. Healing by the laying-on of hands as
a facilitator of bioenergetic change: the response of in-vivo human hemoglobin. Int.J.
Psychoenergetic Systems 1:121-129, 1976.
662
American Journalof Nursing/April 1979
?B
I-A
...
em
i
Janet Quinn found that she was able to use therapeutic touch after she
stopped worrying about how she felt and stopped doubting her ability.
One
Nurse's
Evolution
By Janet F. Quinn
Five years ago I was graduated
from a four-year baccalaureate program. Armed with 60 (count 'em60) credits of nursing to ensure my
professional competence, and 68
credits of arts, science, and humanities to "round me out," I emerged
with the confidence of a veteran
matador about to begin his umpteenth bullfight.
I had worked my way through
school doing general medical and
surgical nursing, so I decided to
tackle bigger and better things. My
sword raised high, I marched headlong into the arena to do battle with
the bulls of illness and pain, death
and dying.
I worked first in an emergency
room. "This is nursing," I said.
JANET F. QUINN, RN., M.A., is an instructor
in
nursing, Hunter College-Bellevue School of
Nursing, New York, N.Y.
as
a
Healer
Then I moved to the medical ICU,
"Now this is nursing," I thought, as
I became more and more proficient
in the care and maintenance of
complex machinery, with people
attached. "Now this is professional
nursing," I thought, as I diagnosed
arrhythmias and "suggested" to the
new interns what medication we
should use to treat that arrhythmia,
somehow also with a person attached. Yes, I was winning the battle.
With this belief in mind, it was
a mystery to me why I faithfully
read the help-wanted classified ads,
always looking-but for what? For
the teaching position that I found
one lucky day, and secured the
next.
By the end of that first year of
teaching, I was hard pressed to even
define professional nursing. I enjoyed my students and loved seeing
them grow. I taught them the importance of nursing the whole per-