Book Review - Therapeutic Touch
Cultic Studies Journal, 18, 2001, 208-214
Bela Scheiber & Carla Selby
Amherst, New York: Prometheus Books. ISBN: 1-57392-804-6. $26 Hardcover. 300 pages.
As the smoke cleared at Ground Zero in New York, and it became depressingly obvious that there were very few people alive there to be physically treated, a group of nurses mobilized to help the victims anyway—not the survivors, but the dead ones.
From her perch in the Montana mountains, a retired New York University nursing professor, Dolores Krieger, declared that the dead are not beyond help: she and other practitioners in her healing cult of Therapeutic Touch could “assist the victims who have met a sudden and violent end to their lives.” She meant this literally. Picking names one after another from lists of the dead, she announced, “I am doing healing at a distance, which I do by visualizing myself at that person’s side and see/feel/think of myself doing Therapeutic Touch to that person. In this I am calling upon the help of the angels of compassion and am trying to work with them as best I can understand. My first thought is to help the person through the terror of dying so suddenly and so horribly.” None of this was metaphorical, or despite her talk of angels, have anything in common with most religious notions of prayer for the souls of the dead.
Therapeutic Touch (TT) is an “alternative” nursing practice wherein practitioners purport to have a panacea for the medical ills of mankind. By waving their hands some two to six inches away from a patient’s body (yes, that’s right, despite its name, it doesn’t actually involve any real touch), they claim to be able to interact with a person’s life-force and create a “healing environment” that exceeds anything imagined by conventional scientific medicine. Even claims for using TT to help the dead had been seen before, though in a way more perceptible by the living than that above (the resuscitation of clinically dead newborns).
TT is steeped in the mystery cult of Theosophy. Theosophy is the nineteenth-century invention of Madame Helena Blavatsky which is quintessential American spiritualism, replete with mediums (whom Theosophists call “sensitives”), channeled spirits (which they call “Masters”), Indian superstitions, Aryan myths, and swastikas. TT practice was invented in the mid-1960’s by two Theosophists: one was Krieger, then a doctoral candidate at NYU, and the other was Dora Kunz, a future President of the American Theosophical Society.
The two used a typical Theosophist trick of eclectically combining disparate elements to create a plausible, though completely specious, medical treatment. They publicly dubbed it a “modern” version of the laying on of hands, but it was actually a mixture of Buddhist vitalism (“kharma”), meditation (“centering”), and Theosophical channeling (“intentionality”). In the early 1970’s, they successfully introduced their creation as a nursing practice by using Krieger’s position at NYU (which has a nationally influential School of Nursing), along with a name change (to TT), heaping gobs of paeans to NYU Nursing Dean Martha Rogers and her so-called Science of Unitary Man, and a pinch of pseudoscientific research.
For two decades following, TT quietly established itself within nursing (particularly among academics) until, by at least the time of the early 1990’s, it was considered part of mainstream nursing and seemingly unassailable. Its founders had established a cult-like following (complete with apostasy and schisms). They published books on the techniques and extolling the health benefits of the procedure. They placed articles in nursing publications praising the cutting-edge quality of their science. NYU began handing out PhD’s to what some derisively called “Krieger’s Krazies,” and these sheep-skinned acolytes vectored out to countless other nursing schools around the country, teaching undergraduate and even graduate courses in the techniques. In-service and CEU-approved seminars popped up from Albuquerque to Yakima. A few hospitals established “departments of energy” with TT at their hearts. The National League for Nursing, which accredits nursing schools, produced and sold promotional videotapes on TT. The establishmentarian American Nursing Association had TT workshops at its national conventions. The nascent American Holistic Nursing Association, a motley crew devoted to eclecticism in nursing, latched onto a schismatic form of TT which called itself “Healing Touch.” The North American Nursing Diagnosis Association included “energy-field disturbances” as one of their official diagnoses, with TT as the only recognized treatment thereof. A host of popular imitators popped up with manual “aura” readings, “hands of light,” channelled angels, and similar knock-offs. Even the ghost of Blavatsky’s contemporary, Florence Nightingale, was academically conjured to give her blessing to the “caring” aspects of the enterprise. In all, nurses got to think of themselves as “healers,” on a par with physicians. TT was a winner.
There was just one little nagging fly in the soup: TT had no basis in reality. Nursing academics, particularly the Rogerians, had only been playing at science. Their supporting scientific research was sparse and specious. The theoretical underpinnings were Theosophical double-talk, ignorant of the physical sciences it evoked, though facile in term-dropping. And Nightingale, who was actually a hard-nosed empiricist, had been slandered; historical revisionists had looked past the reasons for her enduring fame—her commitment to hygiene and germ theory—in a search for any pontifical sanction they could find.
No one seemed to mind the Drosophila—except for a few skeptics, who would take potshots at TT from time to time—apparently it never seemed problematical or threatening. Then, without warning, things changed in a single day. On April 1, 1998, the prestigious Journal of the American Medical Association (JAMA) decided to weigh in. It published a review of the scientific literature on TT by Linda Rosa, RN, and a report on an experiment by her daughter, Emily. It started out as a fourth-grade science-fair experiment, with 9-year-old Emily asking fifteen TT practitioners to demonstrate their abilities. They would rest their hands, palms up, on a table, while Emily would hold one of her hands approximately four inches (TT healing distance) over one of theirs (randomly chosen by a flip of a coin). Each practitioner was asked to “sense” which of their hands was closest to Emily’s; there was a cardboard barrier placed between the subject and Emily so that the subject couldn’t see her hands or Emily’s. Each subject got 10 tries. Just by guessing, the average subject should get 5 right. These TTPs averaged 4.7. A year later, another 13 trials were run, and the average that time was 4.1. Overall, they averaged 4.4, consistent with just guessing. The odds were only 3 in 10,000 that the TTPs would have failed the test if they could actually feel Emily’s energy field at least three times out every four.
Emily’s experiment showed that TT practitioners, when put to the test, couldn’t tell the difference between a real person and empty air. Linda’s literature review showed that they never had. In a parsimonious assessment with classical scientific understatement, they together concluded, “These facts…suggest that TT claims are groundless and that further use of TT by health professionals is unjustified.”
The power of the JAMA cachet is awesome. Literally millions of people heard about TT for the first—and only—time, and simultaneously heard it was nonsense. Krieger and her followers tried mightily to explain away their quarter-century failure to validate their practice, but there was little to say when JAMA reports that your PhD has just been trumped by a sixth grader. But they tried anyway. They attacked the statistics, but JAMA’s reviewers had done their work and the calculations held up. They attacked the sample size, but the number of subjects exceeded the number found in most pro-TT clinical experiments. They actually thought Emily’s “energy field” could have been throwing off the experiment’s subjects, by being variously too small, too large, too healthy, too sick, or—ahem—too pubescent. They called the experimental protocol simplistic, a mere “parlor trick,” but couldn’t explain away its applicability to their claims for TT practice. They took aim at Emily (and Linda) for being skeptically biased, but had to admit that all of their own experiments were done by biased experimenters, too. They claimed JAMA broke its own rules in publishing the work of an elementary-school student, but the scientific community agreed with JAMA editor George Lundberg, who declared, “Age is irrelevant; it’s the quality of the science that matters.” Lundberg had gotten to the heart of the embarrassment for TT: what Emily did was good science—of the sort that the proponents should have done themselves right from the start back in the early 70s. Emily later concisely explained their dilemma to a Harvard audience: “Imagine, I was given my first big break fifteen years before I was born!”
Somebody had finally swatted the fly—and spattered the soup on the walls to boot. TT never recovered. To be sure, there was a flurry of post-JAMA pro-TT publications, mostly in nursing journals, but nothing scientifically challenged the Rosas’ conclusion. Tellingly, all the new papers were more of the same pre- JAMA—inadequate and expensive clinical outcome studies; in the succeeding three years, no TT proponent apparently dared a refutation-by-attempted-replication of the experiment that took Emily less than 20 hours and ten dollars to complete. TT is now fading into history, and Theosophy is out beating the bushes for something else to revive its own fading fortunes.
Though it is no longer of contemporary importance, the colorful origins, atavistic philosophy, and silly practices of TT, and especially the story of its slow rise and sudden fall in nursing over the space of 35 years, could still make for a fascinating book. So why didn’t Therapeutic Touch, edited by Béla Scheiber and Carla Selby (Prometheus, 2000), try to be that?
It is not clear what the putatively skeptical Committee for the Scientific Investigation of Claims of the Paranormal (CSICOP) had in mind when it published Therapeutic Touch. Was it supposed to be a popular exposé, a scientific contribution to the literature, a skeptical review, or a reference/source-book? It is certainly a failure, whichever of these, if any, was intended.
Scheiber and Selby squander their opportunities with a puzzling mish-mash of 23 reprints and original essays that gives no particular enlightment to the uninitiated on TT. Indeed, someone who comes upon the book, without any prior knowledge of the subject, doubtlessly comes away from it with a great deal of confusion about just what TT—and all the hubbub—is about. The 31-page “brief” history of TT manages simultaneously to outline all of TT’s precursors in plodding detail and yet misses all of the really interesting bits; it’s uninformed, too—the part that details skeptics’ activism is revisionist and written without interviewing many of the real players. The only thing the editor’s introduction describes is the editors’ own story of how they came to be introduced to the practice; the foreword by CSICOP’s Ray Hyman is of more value, but that, too, is limited. There is no other editorial assistance to help the reader through the book and its welter of reprints. There is not even a cogent description of how TT is performed. As a consequence readers are left to float in a gravity-less vacuum without any handholds. To make matters worse, the book’s organization is arbitrary and maze-like; related pieces are scattered and have no rational sequencing.
The book won’t help the TT-initiated either: Its 360 pages add nothing at all significant to the body of literature about TT and its skepticism is delusory. There is a report on the “examination” of a single practitioner, which is worthless even as a case study; the “practitioner” did not even claim to do TT. There is another report, with parodic imitation of the JAMA experiment, which claims to explain what TT practitioners really feel during their practice, but without testing a single TT practioner (and totally missing the point of the JAMA paper that TTers have never shown an ability to feel anything). In a surprising move, the editors also give themselves a second chance to be red-faced over their naiveté and laxness as investigators, when they reprint their own critique of the pro-TT burn study at the University of Alabama at Birmingham. They lambaste the researchers at length for a fraudulent “final report” to the Defense Department, when it turned out Scheiber and Selby had read only a two-page final progress report from UAB—the actual Final Report had none of deficiencies they alleged. An article on the ethics of TT and its practitioners is weakly argued and unsatisfying. And all of these have appeared before in print, so there is nothing new in any of this.
The scientific literature reviews sprinkled around the book are old and uneven. One is a reprint from 1984 and covers little of the work that is cited by proponents, though it does a reasonably good job of dismissing Krieger’s early reports. Another summary is by a prominent TT proponent who concludes from it that TT “has emerged as a specialized example of the therapeutic use of touch in nursing practice.” (As has been noted before, TT involves no touch at all.) The review of “recent research” consists almost entirely of critiques of two TT-favorable studies (one of them the UAB burn study) that also happen to appear in the book.
The book’s arbitrary organization, rudderless editing, and opportunistic selectivity, all mean that it doesn’t work as a source-book of significant publications in the field. The lack of an index ensures that it is unusable as a reference work as well. The choice of what was reprinted seems dictated by what Prometheus could get permission to reprint. None of the reprints here are of the first importance to the history, evolution, practice, or criticism of TT. Nothing by Krieger or Kunz appears in the book. Indeed, none of the seminal papers or dissertations that molded TT’s rise are reprinted, nor are those most cited by proponents. (Closest is the wound-healing study by the shadowy Daniel Wirth, but this is offset by the failure to reprint that author’s own disclaimers on this research, after his failure to consistently replicate his initial results.) The editors couldn’t get permission to reprint the famous JAMA study, so they printed their own rather crude synopsis of it. (With obvious angst over that denial, they sprinkle the book with all sorts of criticisms of the study that leaves rational readers shaking their heads—do these editors really think that a 10-year-old could influence (psychically?) a coin-flip? Or that Emily should not have been listed as an author of the report on her own experiment? Or that Linda compromised her objectivity by cracking O.J. Simpson jokes? There is a lot more in this vein.) Meanwhile, the appendices are for the most part copies of utterly insignificant correspondence and reports; like so much else in this book, the reason for their inclusion is opaque. The entire stew is presented in no particular order—chronological, epistomological, or any other apparent basis. The book ends just by stopping—no summaries, no conclusions, no apologies.
The subject of Therapeutic Touch is pretty wild and wacky, but the published end product is pedantically pointless and mind-numbingly dull. There was no discernible value for the publisher wasting an ISBN on it, much less printing it. (But then there was likewise none for CSICOP/Prometheus to publish LSD-culter Arthur Janov’s ravings, which they put out at about the same time as this one.) Is their medical editor out to lunch these days? Or maybe the formerly skeptical publishing house has been touched by one of Krieger’s “angels of compassion” and is trying to resurrect the brain-dead.
Nurse Healers-Professional Associates. A special way of caring in this time of crisis. http://www.therapeutic-touch.org/Crisis/2/med_pray_hope.htm. Accessed 1 Dec 2001.
Rosa, Linda A. Therapeutic Touch: skeptics in hand-to-hand combat over the latest New Age health fad. Skeptic. Fall 1994, 3(1):40-4.
Krieger, Dolores. Therapeutic Touch: the imprimatur of nursing. American Journal of Nursing. May 1975, 75(5):784-787.
Krieger, Dolores. Therapeutic Touch: an ancient, but unorthodox nursing intervention. Journal of the New York State Nursing Association, Aug 1975, 6(2):6-10.
Krieger, Dolores. Living the Therapeutic Touch: Healing as a Lifestyle. New York, NY: Dodd Mead, 1987.
Johnson, K. Paul. The Masters Revealed: Madame Blavatsky and the Myth of the Great White Lodge. Albany, NY: State University of New York Press, 1994.
Karagulla, Shafira; Kunz Dora v.G. The Chakras and the Human Energy Field: Correlations Between Medical Science & Clairvoyant Observation. Wheaton, IL: Theosophical Publishing House, 1989.
Kunz, Dora v.G., comp. Spiritual Aspects of the Healing Arts. Wheaton, IL: Theosophical Publishing House, 1985.
Rogers, Martha E. An Introduction to the Theoretical Basis of Nursing. Philadelphia, PA: Davis, 1970.
North American Nursing Diagnosis Association (1995). Energy field disturbance. in Lynda J. Carpenito, ed., Handbook of Nursing Diagnosis (Philadelphia, PA: Lippincott, 6th ed., 1995), pp. 355-358.
Brennan, Barbara A. Hands of Light: A Guide to Healing Through the Human Energy Field. New York, NY: Bantam, 1987. New York, NY: Pleiades, 1987.
Myss Carolyn M. Anatomy of the Spirit: The Seven Stages of Power and Healing. New York, NY: Harmony, 1996.
Mentgen, Janet L.; Bulbrook, Mary Jo T. Healing Touch Level I Notebook. Carrboro, NC: North Carolina Center for Healing Touch, 1994.
Shames, Karilee H. The Nightingale Conspiracy: Nursing Comes to Power in the 21st Century. Staten Island, NY: Power, 1993. Montclair, NJ: Enlightenment, rev. ed., 1996.
Croll-Young, Crystal. The door to a healing lifestyle: Therapeutic Touch and the New Physics. The Theosophical Research Journal. 1985, 2(3):72-81.
Rosa, Linda A.; Rosa, Emily C. R.; Sarner, Larry W.; Barrett, Stephen. A close look at Therapeutic Touch. Journal of the American Medical Association. 1 Apr 1998, 279(13):1005-1010.
Monmaney, Terence; Sahagun, Louis. 4th-grader’s study rebuts touch therapy. in Los Angeles Times, 1 Apr 1998, pp. A1,A14.
Sarner, Larry W. Acknowledging authorship. [letter] The Scientific Review of Alternative Medicine. Spring–Summer 1999, 2(2):12.
Turner, Joan G. The effect of Therapeutic Touch on pain & anxiety in burn patients. Final Report, MDA 905-94-Z-0080 (N94-020A1). Uniformed Services University of Health Sciences, 1997. [UAB principal investigator’s final report]
Wirth, Daniel P. Complementary healing intervention and dermal wound re-epithelialization: an overview. International Journal of Psychosomatics. Mar 1995, 42(1):48-53.
Sarner, Larry W. The “Emily Event”: Emily Rosa and the Therapeutic Touch wars. Skeptic. Fall 1999, 6(2):32-34.
Sarner, Larry W. The top 10 objections to the Rosa paper…with retorts. Skeptic. Fall 1999, 6(2):35-37.
Janov, Arthur. The Biology of Love. Amherst, NY: Prometheus Books, 2000.
Larry Sarner, Chairman
National Therapeutic Touch Study Group
Co-author of forthcoming, Your Very Last Chance: The Therapeutic Death of Candace Newmaker (Greenwood, 2002).
Cultic Studies Journal, Vol. 18, 2001, 208-214.