Originally published in Massage & Bodywork magazine, February/March 2004.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
With its simplicity and gentleness, reiki is capturing the attention of the traditional medical field as a practical, effective component of integrative care. Not all complementary and alternative medicine (CAM) approaches are without contraindications, and some not so easily adapted to administration during procedures such as in acute trauma situations or surgery. Reiki, a subtle energy therapy, can be applied with or without actual touch and only requires the presence of the practitioner. It can also be of value in continuing self-care for patients who have been educated in its use, enhancing not only their health but sense of empowerment.
Reiki master Pamela Miles, founding director of the Institute for the Advancement of Complementary Studies in New York, N.Y., has been instrumental in the implementation of reiki within major hospital settings as well as having participated in reiki clinical trials. Her most recently published research (Alternative Therapies in Health and Medicine, March/April 2003) involves utilizing an educational program to train HIV/AIDS patients in reiki self-care.
"Reiki has a fast response time, certainly within five minutes," she says. "It can be learned so easily. It has no medical contraindications. The delivery is very flexible. You can do a full treatment, but also just resting your hand on someone during the (medical) exam process is effective."
Miles defines reiki as primordial consciousness, like primordial chi. "It's different from chi that's being manipulated in acupuncture and shiatsu." The term "reiki" refers both to the subtle healing pulsation itself and the process of accessing it. Through vibration, reiki balances the biofield and enhances the body's ability to heal itself. Although typically applied with light touch, it can also be administered from a distance.
"Because reiki isn't limited to being given as full treatment, it can be included during other care," Miles says. It can be introduced without being physically intrusive, whether during a rape exam or during surgery while the patient is under anesthesia. "Anecdotally, surgeons comment that the patient is recovering faster (with reiki)." In fact, Miles notes she repeatedly hears the comment that healing is occurring three times as fast as expected. Practitioners and Research
An important concern in reiki research is practitioner qualification. The core of reiki training is "initiation," a process that honors the tradition and lineage of this healing practice. Speaking of the initiation, Miles says, "You can think of it like a subtle chiropractic manipulation -- creating an alignment within our vibrational body such that access to primordial consciousness is ever present." Once the initiation takes place, the connection is always there, but it can be expanded upon. "The initiation is like a very potent blessing or treatment in classic Asian tradition," Miles says. "You can't just pick up a book and learn how to do it. You have to have a teacher who is proficient in that practice to initiate you.
"When it comes to people's own practice, if we're talking about hospital practice, there is a point at which we owe it to the patients to ascertain that something is happening here, even if we don't completely understand the mechanism of action." As one who has been involved with reiki for more than 17 years, Miles expresses concern that some practitioners in the field have not respected the traditions. "What we can hope is that the medical profession is so conservative by nature that practitioners who are not adequately trained cannot present themselves in a form the medical field would find palatable." Miles suggests practitioners trained in first degree reiki continue their practice for at least a few months before entering second degree, and at least several years before training as a reiki master. Research Review
As with many CAM therapies, literature on reiki research contains too few and mostly flawed randomized controlled trials (RTC), along with observational and descriptive studies, and exploratory studies of physiological changes. In an overview of reiki in the same issue of ATHM, Miles and associate Gale True, Ph.D., provide a summarization of the current state of this research, pointing to the usefulness of a more inclusive criteria -- one that also embraces qualitative and mixed methodological design. Noting that patient-centered outcomes can be as meaningful as clinical ones, they state, "Randomized, controlled trials may not be the ideal strategy in cases where the outcomes being measured are related to chronic disease with uncertain trajectory, or where the treatment being investigated is not easily standardized or consists of multiple components."1
Nevertheless, there will continue to be a demand for RTCs in this field, and this need must be addressed.
Among the reports to date, a number have studied reiki together with other energy therapies, "confounding the ability to evaluate the separate effects of those therapies."2
Wirth et al. conducted a series of small studies throughout the 1990s focused primarily on measurable physiological reactions, all fraught with limitations but indicating some promising results. In a 1996 report on hematological measures, the team documented significant effects of reduced pain and blood urea nitrogen (kidney function), as well as a trend toward normalizing blood glucose following reiki.3
In a study to determine if blinding in reiki research is possible, Mansour et al. (1999) reported participants were unable to distinguish reiki practitioners from placebo practitioners. Despite the subjects' personal evaluation of therapist status (reiki or placebo), it was noted in participants' self-report that the most intense sensations of tingling and warmth were experienced during reiki sessions versus placebo.4
Shiflett et al., evaluating effectiveness of reiki for subacute stroke patients (2002), concluded, "Reiki did not have any clinically useful effect on stroke recovery in subacute hospitalized patients receiving standard-of-care rehabilitation therapy."5
Although there was no short-term benefit for depression and function, researchers did note some limited effect on mood and energy.6
Included in this study was an assessment of double-blinding in training procedures for reiki practitioners. The team found no reported difference between blinded practitioners of reiki and sham (sham being those trained in reiki technique who only went through the motions) in ability to feel energy flowing through the hands.7
In exploratory studies of physiological changes attributed to reiki, researchers have documented increased oxygen-carrying capability in the blood (Wetzel 1989); biochemical markers indicating increased relaxation and immune response (Wardell and Engebretson 2001); and changes in electrical skin resistance at sites corresponding to acupuncture meridians, with accompanying relaxation and reduction of pain in chronically ill subjects (Brewitt et al. 1997). Additional observational and descriptive studies have indicated multiple benefits of reiki, including pain reduction (Olson and Hansen 1997), and profound relaxation and sense of well-being (Chapman and Milton 2002).8The HIV/AIDS Project
In Miles' feasibility study on reiki education for HIV/AIDS patients, 30 volunteers from an inner-city, outpatient clinic received first degree reiki training in four-hour sessions over four consecutive days. To assess the benefits of reiki in reducing pain and anxiety, pre- and post-treatment measurements were taken on days three and four through student self-report using the State Trait Anxiety Inventory and Visual Analog Scale.9
On evaluation, decreases in rating were noted for both values: mean anxiety rating down from 32.6 to 22.8 (20-80=range of possible responses); and average pain down from 2.73 to 1.83 (11-point scale). In her preliminary report, Miles states, "There was no significant difference in pain or anxiety reduction as a function of whether the reiki was self-administered or administered by another."10
"As part of the class, there are sessions in which we practice on ourselves and on each other. Actually, students start practicing informally in the first class session. In the second session, they learn a protocol which they practice in the class and at home."
During student training, Miles used absentee (distant) initiation rather than hands-on. While all subjects in the room had the same outer experience, only half received initiation (the remaining half were initiated at conclusion of the study). Therefore, during the treatment process only those subjects specifically initiated were actually administering reiki to themselves or others in the class.
Just as some individuals have a better sense in discerning color than others, Miles notes, some students sense energy vibration more easily than others. Whether a matter of comfort level or talent, with practice their confidence will grow, she says.
Given the challenges HIV/AIDS patients are facing, both the results and the high completion rate in this project are encouraging. "Across the board there's a high dropout rate in this population," Miles says. "People with HIV/AIDS are frequently not feeling well and have to overcome a lot of obstacles to take care of themselves." In addition to the cost-effectiveness of such an approach, reiki offers patients an empowering tool for self-help, both to support biomedical treatment and to ease disease-associated symptoms.11Gleaning from Research
I think that in terms of science," Miles says, "the fact that we're seeing different research studies indicating that reiki may be helpful with pain and anxiety is encouraging. It may make some physicians and hospitals more comfortable in instituting a reiki program or to increase interest in research." She notes these results may also encourage lay people to consider reiki as an option in their healthcare, especially to learn first degree self-treatment.
While reiki research, with proper attention to fulfilling the scientific model, can certainly be adapted to the gold standard of RTCs, there is also value in continuing qualitative, observational studies. "Having more focus on what is the patient's experience certainly seems important," Miles says. "We can't study reiki directly, but we can certainly study the impact it has on people. More and more doctors are accepting that we cannot bring traditional knowledge into the conventional medical model without understanding the difference in paradigms and involving the practitioners of traditional healing practices in every aspect of the design and implementation of research studies. With low-risk practices such as reiki, it makes sense to focus on the way reiki improves quality of life rather than getting bogged down in inappropriate and clinically meaningless studies."
Overall, Miles points out, another important direction for research is a careful examination of the healing process itself. "There is so much for us to understand about what is generalizable. It appears that one major happening in all of these CAM approaches -- the nonscientific interventions -- is they give patients stress reduction. When you think of well-being as a state of dynamic balance and resilience, if people are so stressed their capacity to heal is maxed out, it sets the stage for disease.
"Maybe we don't need to show that each of these interventions has a positive effect on the immune system. If we know they are giving stress reduction and that enhances immunity, why do we have to prove all these different modalities individually? We need to focus on the commonalities and also develop greater understanding of the process of healing." Shirley Vanderbilt is a staff writer for Massage & Bodywork magazine. References