The Science & Controversy Behind Touch Therapies

Karen McIver was just 17 months old when she was diagnosed with Wilm’s tumor. Radiation and surgery saved her life then, but now, 50 years and five kids later, it’s the ancient art of touch therapy that’s helping soothe her ailing body and soul, she says.

Atrophied muscles, surgical scars, crumbling vertebrae and thin, tight skin left her in pain, unable to exercise properly and stressed. Added to that was a diagnosis in May 2004 of infiltrating ductal carcinoma of the right breast, with metastases.

But every two weeks or so, McIver goes in for an hour-long touch therapy session that includes a blend of massage, aromatherapy, essential oils, reflexology, craniosacral massage and energy work. She leaves rejuvenated, physically and spiritually.

McIver is among a growing number of people seeking relief through touch therapies and other types of alternative and complementary (CAM) medicine. Despite skepticism in some medical and scientific circles—fueled in part by lack of hard evidence as well as questionable practitioners who falsely promise cures—McIver and other proponents say the ancient techniques of touch therapy offer benefits not found in modern medicine.

“Instead of 10 to 15 minutes in a cold, clinical setting, you have 30 to 60 wonderful minutes in a quiet, comfortable room, often with gentle music playing, while someone focuses on bringing relaxation and renewal to your whole body,” says McIver, 52, of Laurel, Maryland.

Touch therapy is an umbrella term for a variety of techniques that are based on theories that touching or manipulating the body or its so-called energy field (known as the biofield) can promote physical, emotional and spiritual wellness and healing. These techniques range from the virtually mainstream massage therapy to the medical fringe, such as Therapeutic Touch—its theory that healing energy can be channeled to the body without actual touch remaining harder to grasp.

Touch therapies trace their roots to Eastern history, religion, medicine and philosophies that date back thousands of years, such as ancient Chinese, Indian, Egyptian and Japanese practices. These practices are steeped in the concept that a complex interplay of body, mind and spirit influences disease prevention and healing. Traditional Chinese medicine, for instance, is based on the belief that qi (pronounced “chee”), or the body’s vital energy, regulates a person’s spiritual, emotional, mental and physical balance.

The Western notion of massage arose in the early 19th century and has now come into widespread use in the United States, with some 21 percent of adults having a massage in a given year. Many large companies offer massage as an employee benefit and insurance plans are more willing to cover it, but there remains a lack of definitive, good-quality scientific data about how or why it works.

With the growth in these nontraditional practices has come increased scrutiny.

Quackwatch Inc., whose mission is to expose health-related fraud, is especially critical of the claims of energy-based therapies.

“The energy theory makes no sense,” says Quackwatch founder Stephen Barrett, MD. “Reiki is worthless. Therapeutic Touch is worthless. Massage may make you feel good but it has no effect on the course of cancer and no effect on the immune system. Anybody who is endorsing Therapeutic Touch is endorsing delusions.”

Dr. Barrett’s chief complaint is that the so-called biofield can’t be scientifically measured. “If it can’t be measured,” he says, “it doesn’t exist.”

Healing Touch International, which certifies healing touch practitioners, disputes that argument.

“Every new idea that has come along is first called bunk by the scientists,” says Lisa Anselme, RN, executive director of Healing Touch International, and a certified practitioner and instructor of healing touch, as well as a certified holistic nurse. “Can you see love? Do you taste love? Can you measure love? If you follow Stephen Barrett’s mindset, love must not exist because you can’t quantify it.”

But even she and other proponents see the need for more hard evidence to back up what they say are numerous anecdotal experiences of patients. Researchers are looking for proof of what cancer patients have been contending for years: that these touch therapies make a difference in their daily lives.

But to date, scientific studies have mainly been underfunded, small and ill-designed. And attempts to detect biofields with special photography and imaging, or measurement of the body’s gamma radiation levels, have fallen flat.

“It’s a fuzzy field,” concedes Janice Post-White, RN, PhD, who has published research in therapeutic massage and healing touch. “The transition from being considered a CAM therapy to a standard therapy is evidence, and although there is more evidence now, it’s somewhat weak.”

Less commonly accepted are types of touch therapy that are based on human biofields, such as Therapeutic Touch—which typically doesn’t involve actual touch—and healing touch. Western adaptations, tied to their ancient past, arose in the past few decades and are based on the belief that practitioners promote healing and harmony by influencing the biofield within and around patients.

Touch therapies trace their roots to Eastern history, religion, medicine and philosophies that date back thousands of years, such as ancient Chinese, Indian, Egyptian and Japanese practices.

“If they’re here because they want a cure or rather than going to their oncologist, we tell them that’s not our purpose,” says Wendy Miner, massage therapy manager of Memorial Sloan-Kettering Cancer Center’s Integrative Medicine Service. “We’re here to help manage symptoms, to make them feel better. It’s not a cure.”

Despite such temperance, Sloan-Kettering is actually a leader in the field of complementary medicine. It opened its spa-like Integrative Medicine Service in 1999 to offer complementary treatments to inpatients and outpatients, as well as family members, caregivers, staff and the general public. The facility also conducts scientific research and offers training programs in touch therapies. And, although its programs include reflexology and reiki, Sloan-Kettering doesn’t purport to work on biofields or organ correlations with the feet, says Miner, who has been a licensed massage therapist in New York since 1986.

"There’s no scientific evidence to support those theories,” Miner says. “What we do is help manage symptoms, and people are getting good results. They have decreases in nausea, pain, anxiety and fatigue.” The bottom line, she says: An improved quality of life.

Dr. Post-White, an adjunct professor at the University of Minnesota and a research consultant in CAM, was the lead author on a study published in 2003 in Integrative Cancer Therapies. The study was billed as the first published randomized study to report positive effects of healing touch in cancer patients.

The study included 164 cancer patients who were randomized to receive massage therapy, healing touch or to simply be in the presence of a healthcare provider. The study concluded that both massage and healing touch induced a relaxed state, with lowered respiratory and heart rates and lower blood pressure. The therapies also reduced short-term pain, mood disturbances and fatigue.

“There’s no evidence that they affect the outcome of cancer, and they may not boost the immune system,” says Dr. Post-White, whose own son, now 12, had massage therapy throughout his four-year treatment for acute leukemia starting at age 4. “But these kinds of therapies can reduce anxiety; they can help you cope better, feel more confident.”

Indeed, even proponents recommend touch therapies only as an adjunct to standard medical care, not a substitute.

Although no study has been able to measure an energy field or explain how healing touch works, other studies do support the theory that some touch therapies afford an improved quality of life.

Researchers at Memorial Sloan-Kettering published findings in the September 2004 issue of the Journal of Pain and Symptom Management supporting the benefits of massage therapy in cancer patients. The study, the largest on massage for cancer patients, analyzed findings from 1,290 patients over a three-year period. It found that patients undergoing massage had significant reductions in pain, fatigue, nausea, anxiety and depression.

And in a study published in the May/June 2004 issue of Alternative Therapies, a group of 62 women undergoing radiation treatment for breast or gynecological cancers were randomized to receive healing touch or a mock therapy. Those receiving healing touch reported a better quality of life across nine areas, such as pain, social function, physical functioning, vitality and mental health.

Numerous other studies are ongoing, many under the auspices of the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. Studies include the effects of reiki on prostate cancer patients, healing touch in advanced cervical cancer, massage for cancer-related pain, massage for breast cancer-related lymphedema and others. In addition, the National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine is evaluating nontraditional therapies being used by healthcare professionals and developing research strategies based on actual patient responses.

Meanwhile, for people like Karen McIver, the only proof that matters is how she feels after one of her massage sessions.

“It’s like a mini-vacation, and even the traditional medical community will agree to the positive benefits of that,” McIver says. “Having someone minister to your body, especially where it’s been screaming out, does something for you mentally. I come out of there relaxed and uplifted. Even if we don’t have clinical, measurable evidence, it’s hard to argue with these feelings.”