psychological factors and the perceived efficacy of reiki ... · psychological factors and the...
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Psychological factors and the perceived efficacy of Reiki distant healing.
by
Peter Ostojic
A thesis submitted in partial fulfilment of the requirements for the degree of Master of Psychology (Counselling)
Faculty of Education Monash University
January, 2006
2
This project contains no material that has been submitted by the candidate for examination in any other course, or accepted for the award of any degree or diploma in any University. To the best of the candidate's knowledge it contains no material previously published or written by any other person, except where due reference is made in the text.
___________________________________ January 2006
The work undertaken for this project was duly authorised by the Standing Committee on Ethics in Research Involving Humans of Monash University on 20 December 2004: (project no: 2004/709)
___________________________________ January 2006
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Table of Contents
Acknowledgments.......................................................................................4
Abstract .......................................................................................................5
1.0 Introduction...........................................................................................7
2.0 Method ............................................................................................... 25
2.1 Participants.........................................................................................................25
2.2 Materials ............................................................................................................27
2.3 Procedure ...........................................................................................................31
3.0 Results................................................................................................ 35
3.1 Efficacy of Reiki distant healing:.......................................................................39
3.2 Individual difference..........................................................................................44
4.0 Discussion.......................................................................................... 49
References................................................................................................ 62
NB: Appendices are not included in this document APPENDIX 1: Power and sample size calculations ...............................................
1.1 Power calculation for spiritual domain..............................................................
1.2 Sample size calculation for experimental design used in this work ..................
1.3 Power calculation for “Time” ............................................................................
APPENDIX 2: Initial demographic questionnaire...................................................
APPENDIX 3: Published questionnaires and their psychometric properties ........
APPENDIX 4: Webpage for Reiki channels ..........................................................
APPENDIX 5: Descriptive statistics and SPSS outputs of major analyses............
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Acknowledgments
I would like to take this opportunity to express my thanks to Associate Professor Dr.
David Harvey of the Faculty of Education, Monash University, Clayton Campus. His
curiosity, ability to put aside scepticism and willingness to explore an area many
would consider “out there” with both humour and rigor was greatly appreciated
I also extend my gratitude to the staff “within a Division of a large Australian
corporation” who volunteered for the study and continued to give of their time when
things got rough. I wish you all well in whatever the future holds.
A special thanks to Peter Campbell, President of the Australian Usui Reiki
Association (AURA), for his help in recruiting Reiki channels and his perseverance
and patience in dealing with the seemingly endless administrative issues we
encountered.
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Abstract
The purpose of this work was two-fold. First, to quantify the effects of an energy
therapy (distant Reiki) in order to better understand its potential usefulness in clinical
applications. Second, to undertake an exploratory study aimed at identifying some of
the psychological factors hypothesised to influence personal choice in favour of
complementary/alternative medicine (CAM).
A total of 17 participants were randomly assigned to two independent groups (N1 = 9
participants, N2 = 8) and subjected to distant Reiki supplied by 130 Reiki “channels”
recruited world-wide, also randomly assigned to two independent groups (NA = 69
channels, NB = 61). Using a split-half, double-blind experimental design Group A
channels supplied in excess of 1697 hrs of Reiki to Group 1 recipients while Group B
channels supplied some 313 hrs to Group 2 over a continuous (but staggered) 21-day
period. The efficacy of distant Reiki was assessed via three administrations of a
subjective overall well-being rating scale, the Rosenberg Self-Esteem Scale (RSE),
the General Health Questionnaire (GHQ-12), the Center for Epidemiologic Studies
Depression Scale (CES-D) and the Positive And Negative Affect Schedule (PANAS).
The Life Events Survey (LES) was also included to help ensure any observed effects
could not equally well be attributed to a significant life event(s) as to Reiki. Results
of repeated measures ANOVA found no significant effect of distant Reiki on any of
the measures used. Explanations advanced include an insufficient “dose” of Reiki to
effect change, inappropriate time to allow effects to manifest before testing,
insufficient statistical power (determined to be .34), use of an inappropriate test/re-test
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interval and confounding effects associated with an organisational restructure
involving significant staff reductions, and unfortunately announced and implemented
over the course of this work. Directions for future work regarding efficacy studies
involving complementary and alternative medicine in general are outlined and the
possibility of establishing the efficacy of Reiki via the scientific method discussed.
Participants in this study naturally fell into one of two categories, “users” who
actively sought out CAM (N = 9) and “non-users” who did not (N = 8). That
classification formed the basis for the exploratory component of this work, undertaken
using the Australian Sheep/Goat scale, the Health Opinion Survey (HOS), Attitudes
Towards Doctors And Medicine Scale (ADMS), the Pennebaker Inventory of Limbic
Languidness (PILL) and the Life Orientation Tests (LOT), administered to all
participants at the outset of the study. In conjunction with demographic information
results indicated users of CAM in this work to be generally female, well-educated,
white-collar professionals on above average salaries, consistent with the profile of
CAM users reported in other studies. Users of CAM in this work were found to be no
different to non-users on all measures with the exception they more strongly believed
in the power of CAM to heal than did non-users. In light of those findings an
hypothesis suggesting cognitive dissonance may play a role in the appeal of CAM to
some people is advanced and discussed.
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1.0 Introduction
Few would argue the benefits of modern medicine in today’s world. Feared diseases
such as diphtheria and smallpox are now all but extinct, surgery to re-attach severed
limbs is commonplace and new technology has given rise to imagining techniques
that allow accurate and early detection of conditions that, as a consequence, can be
treated before they become life threatening. Modern medicine is known to be
effective and so people attend doctors trained in its ways. Yet something seems to be
missing. Increasingly in Western society people also attend
complementary/alternative medicine (CAM) practitioners often despite little scientific
evidence attesting to the efficacy of their ministrations. So great is the appeal of
CAM that in 1997 the American population was reported as spending more in out-of-
pocket expenses on CAM than on the total out-of-pocket spending for all
hospitalisations in the US (Eisenberg et al, 1998) while the Australian population has
been calculated to spend $AU930 million annually on CAM (MacLennan, Wilson &
Taylor, 1996).
Despite the obvious interest of the general population in CAM, the scientific
community seems reluctant to undertake studies into its efficacy but such studies are
important for two reasons. First, to establish if such therapies are indeed significantly,
clinically beneficial so that funding for health-related research can be appropriately
directed towards those treatments shown to be of the greatest practical good,
regardless of their origin (i.e. mainstream or CAM). Second, if such research does
establish CAM to be largely clinically ineffectual, to gain an insight into possible
psychological factors influencing personal choice in favour of CAM so that such
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factors can be appropriately dealt with, possibly even by integration into modern
health practices. Such research may allow modern medicine to “fill in” that which is
clearly missing possibly leading to improved health outcomes for all.
In the current work then, the efficacy of an energy therapy (Reiki) is assessed using a
number of psychological instruments aimed at evaluating level of depression, affect
and mood. Other instruments are used to evaluate individual differences hypothesised
to play some role in the appeal of CAM and include belief in paranormal phenomena,
degree of personal involvement in treatment and habitual style of anticipating
favourable outcomes.
Complementary and alternative medicine has been defined as “…a group of
therapeutic and diagnostic disciplines that exist largely outside the institutions where
conventional health care is taught and provided” (Zollman & Vickers, 1999, p. 693.)
and includes therapies such as aromatherapy, iridology, acupuncture and kinesiology
along with medicines derived via naturopathy and traditional Chinese medicine
(Australian Bureau of Statistics, 2001). Of all CAMs those involving “life force
energy” have perhaps received the most scientific attention primarily because of the
efforts of nursing professor Dolores Krieger and, later, metaphysician, clairvoyant and
healer Dora Kunz. Krieger’s thinking was largely based on that of nursing theorist
Martha Rogers. Rogers (1983) held the reductionist view of human beings as multi-
dimensional energy fields interacting with both the energy field of others and that of
the environment, a view supported by modern physics.
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Physicists have established that all matter is made of atoms that consist of a core (the
“nucleus”) of positively charged protons and (no-charge) neutrons around which orbit
negatively charged electrons. Those sub-atomic particles exhibit properties that can
best be explained if they are viewed as discrete packets of energy (“quanta”) rather
than as discrete solid particles. Studies of both atomic and sub-atomic particles have
established the existence and properties of a number of interacting forces. For
example, the so-called “nuclear” or “strong interaction” that binds the protons and
neutrons together to form the nucleus is known to act over a very short range (some
10 –14 metres) and to fall off quickly beyond that range, but it never reaches zero. The
electromagnetic forces that bind the positively charged protons and negatively
charged electrons are also strongest over a short range (although at some 10 –10
metres, not as short a range as the nuclear force) and also fall off rapidly beyond that
distance but, again, never reach zero. Similarly, when atoms combine together to
form matter, that matter, regardless of its size, has a gravitational field associated with
it and those gravitational forces interact between all objects regardless of their
separation (Alonso & Finn, 1975; Van Vlack, 1975).
All matter then can be viewed as quanta (energy) that interact, albeit it weakly,
through various energy fields (eg strong nuclear forces, electromagnetic force,
gravitational forces etc) with all other matter regardless of separation. As a
consequence modern physics supports the view that human beings are indeed multi-
dimensional energy fields that interact with both the energy fields of others and the
environment as Rogers suggests. While acknowledging the fields of modern physics,
CAM practitioners specialising in “energy therapies”, that is therapies involving a life
force energy, believe additional as yet undetected fields, which may overlap with
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known fields (McTaggart, 2002), to also exist. Thus in addition to strong nuclear
forces, electromagnetic force, gravitational forces etc, energy therapists believe in the
existence of a “vital” (or “etheric”) field associated with the body, an emotional field
associated with the aura, an intuitional field associated with creativity and compassion
and a mental field which incorporates thinking, concepts and visual imagery (Kunz &
Peper, 1985).
Such practitioners view individuals as interconnected, localised manifestations of an
energy system that is given life and maintains that life through a larger, permeating
energy sometimes called “prana”, an ancient Sandskrit term meaning “vital force” and
most closely associated with breath (Straneva, 2000, p2). Sickness results from
blocked or depleted prana whereas a healthy person experiences an abundance of
balanced and freely flowing prana (Krieger, 1993; Godiva, 1974). Practitioners
believe the life force energy can be directed or manipulated and in the process provide
physical, emotional, psychological and spiritual well-being to the recipient (Umbreit,
2000).
The association between “prana” and “breath” led Krieger to reason that the most
likely physiological indicator of someone receiving pranic energy would be an
increase in their blood oxygen levels and so she undertook a series of experiments on
participants at theosophical retreats over the period 1971 to 1973. Attendees at the
retreats consisted of sick children and elderly persons specifically seeking healing as
well as healthy individuals either working at the retreat or accompanying patients.
Using non-randomised assignment of participants to control groups (all healthy
people) and intervention groups (all sick people), unknown treatment methodologies
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administered by “born healers” and drawing blood for assessment at non-uniform
times following treatment (Straneva, 2000), she found a significant difference in
hemoglobin levels between control and treatment groups (Krieger, 1973). Her poor
experimental methodology was further compounded by the use of variable treatment
durations, unequal group sizes, a crude calorimetric device to determine hemoglobin
levels, not controlling for demographic effects known to influence oxygen uptake (eg
smoking, exercise or hematopoietic-related conditions) and the use of neither a single-
or double-blind experimental design (Straneva, 2000)
Krieger, with the aid of Dora Kunz, became convinced that the ability to heal others
through the manipulation of pranic energy was innate to all humans beings instead of
being restricted to select “born healers”. As a consequence they believed that ability
could be learnt and set about determining how that might be achieved, eventually
producing a technique called “Therapeutic Touch (TT)”. They distinguished
Therapeutic Touch from the Christian practice of “laying on of hands” since it
required no religious context, no faith in either the practitioner or the technique for it
to work, no physical contact and was an innate ability in everyone that could be
activated via appropriate instruction and practice.
Krieger (1987) believed the therapeutic manipulation of energy fields was best
facilitated by persons who had predominantly altruistic motivations for healing,
whose intention to heal was founded on a sound body of knowledge and who were
self-reflective and able to confront any less-than-altruistic motivations for healing.
Indeed, people who based their self-esteem on other than inner qualities were
purportedly unable to remain “centred” and so made ineffective TT practitioners
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(Macrae 1988). Krieger and Kunz felt the personality traits required of good TT
practitioners were manifest in the compassion they believed was central to modern
nursing and so TT was, initially, primarily taught to nurses. Such was the appeal of
TT to nurses that it has been endorsed by the National League for Nursing in the US,
is taught in more than 100 nursing schools across the US (Hagemaster, 2000) and is
the only treatment for “energy-field disturbance” as recognised by the North
American Nursing Diagnosis Association (Carpenito, 1995). The appeal of TT is
however no longer restricted to nurses and there are claimed to be over 100,000
people world-wide trained in its use (Maxwell, 1996) with at least 30,000 of them
being health care professionals. TT is also taught in at least 80 universities and at
over 200 hospitals throughout the world (Krebs, 2001).
Therapeutic Touch is based on four assumptions: 1) that human beings are an “open
energy system” that extends beyond their physical form and so the transfer of energy
between people is both natural and effortless. That transfer is achieved via the
compassionate intentionality of the practitioner; 2) since the human body is bilaterally
symmetrical in terms of its skeletal, circulatory and neural appearance there is also a
pattern underlying the human energy field; 3) illness results from an imbalance in the
person’s energy field that gives rise to fine energetic cues able to be sensed through
direct physical contact or a few centimetres above the body by the practitioner and; 4)
human beings have a natural ability to heal themselves (Krieger, 1986).
Practitioners of Therapeutic Touch believe that appropriately trained personnel are
able to unblock, replenish and re-pattern the life force restoring its flow and so
allowing the body to fully utilise its innate healing capabilities. They achieve that via
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a four-step process (Kreiger, 1997; Kreiger, 1986; Shearer & Davidhizar, 1998;)
involving: 1) “Centring” where the practitioner enters a state of inner quiet,
relaxation, receptiveness and concentration to “…allow access and transfer of life
energy without… being personally drained.” (Shearer & Davidhizar, 1998, p.28); 2)
“Assessment” during which the practitioner passes their open hands some 5-10 cm
above the body of the fully clothed patient, traversing the body from head to toe while
sensing areas of energy imbalance; 3) “Treatment” where the practitioner attempts to
manipulate energy imbalances via both hand motions and the transferring of energy
from self to the patient in an effort to restore balance and; 4) “Re-patterning of
energies” during which the practitioner consciously directs their excess personal
energy to aid the client in re-patterning their own energies and so maintain the newly-
restored balance.
Aware of the limitations of her earlier work, Krieger moved from the field setting to
the clinical setting and in 1974 once again undertook experimental work on
hemoglobin levels, this time using a more rigorous experimental approach. She
substituted “born healers” for nurses trained in TT and employed a single-blind design
in which laboratory technicians unaware of group assignment analysed blood samples
using the most sophisticated device for measuring blood hemoglobin levels available
at the time. Once again she found significant differences in hemoglobin levels but
once again the study had serious limitations including non-random subject
assignment, poor placebo control and inappropriate statistical tests (Straneva, 2000).
None-the-less, her work sparked considerable interest resulting in extensive research
over many years.
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Proponents of Therapeutic Touch claim it be effective in, for example, the treatment
of pain and anxiety (Kreiger, 1993; Turner, Clark, Gauthier & Williams, 1998) acute
care settings (Umbreit, 2000); aiding postpartum women (Kiernan, 2002);
accelerating wound healing (Daley, 1997; Kenosian, 1995); providing relief from
constipation and diarrhoea (Lewis, 1999); prolonging periods of drug/alchol
abstinence in persons abusing those substances (Hagemaster, 2000); supporting the
physiological development of premature babies (Krieger, 1986) and as a positive
social force (Krieger, 1997). However, criticism of Therapeutic Touch has been
intense. O’Mathuna (2000) for example used the literature associated with
therapeutic touch to illustrate the principles for accurately reporting on evidence-
based research data. He found the TT literature to improperly report research
methodologies; to make inappropriate associations; to inaccurately present original
research findings in relation to the efficacy of TT in the treatment of anxiety, pain and
wound healing (see also O’Mathuna, 1998) and to have a bias towards publishing
only supportive findings. Other authors claim issues with research methodology
including inadequate statistical power, employing non-homogeneous control/test
groups and poor baseline control (Astin, Harkness & Ernst, 2000) as well as skilled
and experienced TT practitioners unconsciously “manipulating energy” during the
control phase of experiments (Quinn, 1989) to further cast doubt on the purported
beneficial effects of that technique.
Perhaps the most contentious piece of work associated with TT was that undertaken
by Emily Rosa, a 9-year-old girl, as her school science project. In a 1996 study Rosa
recruited 15 TT practitioners who had between 1 and 27 years experience in TT.
Participants were required to sit behind a tall, opaque screen with two cutouts in the
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bottom that allowed them to fit their hands through so that they rested palms up on a
flat surface. After allowing participants to “centre” or undertake any other mental
preparations they deemed necessary, Ms Rosa hovered her right hand, palm down, 8
to 10 cms above the protruding “target hand” (randomly selected by coin toss each
time) of the participant who was then asked to state which of his/her hand was closest
to the experimenters, a total of 10 times for each participant. Of the 150 tries,
participants were able to correctly identify the position of the experimenters’ hand in
47% of cases (i.e.70 times). In 1997 Rosa repeated the study using 13 TT
practitioners, including seven from the original study, and found a similar result. Of
the 130 tries practitioners were correct in 41% of cases (i.e.53 times). Rosa’s work
was formalised with the aid of her mother (a nurse), her step-father (a statistician) and
a medical doctor. Based on a one-tailed t–test they found they could not reject the
null hypothesis that the results would be due to chance ( .05 level of significance).
Since a basic assumption of TT is that its practitioners can detect the energy field of
their patients, they reasoned such practitioners should be always able to sense that
field or, at least, more often than chance would allow. Further, they found no
correlation between practitioners’ scores and their years of practice. In agreement
with both earlier and subsequent workers they concluded TT practitioners did not
have the ability to detect the energy field of others (Eisenberg, Davis, Waletzky,
Yager, Landsberg, Aronson, Seibel & Delbanco, 2001; Glickman & Burns, 1996) and
published their work in the Journal of the American Medical Association (J.A.M.A.,
Rosa, Rosa, Sarner & Barrett, 1998).
Explanations for the results of the Rosa study by TT proponents included the
experimenter leaving a “memory” of her hand behind after each trial thereby making
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it increasingly difficult to detect the real hand in subsequent trials (Rosa, Rosa, Sarner
& Barrett, 1998); resentment for TT’s success on behalf of three of the authors in
conjunction with attempts by the editor of J.A.M.A to bolster sales (Krieger, 1999);
the application of inappropriately high standards to TT (Blank, 1998) and the
improper use of a one-tailed t–test in the data analysis (Staneva, 2000).
Research into CAM was, however, not restricted to TT and so as interest grew, so too
did the amount of published research with one database listing over 4000 randomised
trials (Zollman & Vickers, 1999). That large body of work eventually resulted in
sufficient data to allow researchers to undertake in-depth analyses of various CAM
techniques across a range of studies . Astin, Harkness and Ernst (2000) for example
searched the MEDLINE, PsychLIT, EMBASE, CISCOM and Cochrane Library
databases from their inception until the end of 1999 for studies involving “distance
healing”, a term they used to describe various non-contact CAM techniques that
involve healing through the manipulation of supraphysical energy and includes
Therapeutic Touch. They also searched the reference section of identified papers,
reviewed their own files and contacted leading researchers in the fields of interest to
further uncover relevant studies. From the articles identified they selected for
inclusion in their analysis those that randomly assigned participants to study groups,
had some form of placebo/control, had been published in peer-reviewed journals,
were clinical rather than experimental in nature and involved humans having any type
of medical condition. No language restrictions on publications were imposed but
abstracts, theses and unpublished articles were excluded. Of the 23 studies meeting
their criteria, 11 involved Therapeutic Touch across a total of 747 patients. Of those
11 studies, seven showed a positive effect, three no effect and one a negative effect
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with average effect size across the ten positive/no-effect studies reported to be d =
0.63 (ρ = 0.003). Seven other studies involved different forms of distant healing
including, but not restricted to, Reiki with four showing a positive treatment effect
and three no significant effect. The average effect size for five of the studies was
reported to be d = 0.38 (ρ = 0.073). Those findings supported the earlier work of
Peters (1999) whose meta-analysis of nine therapeutic touch studies meeting his
selection criterion found TT to produce a medium strength, positive effect on both
physiological and psychological variables. In light of the positive results the authors
of both reviews concluded that although methodological problems cloud the issue,
sufficient evidence exits to warrant further work on the efficacy of TT/distant healing.
Reiki - reported to be the re-discovery of long lost Tibetian knowledge by Japanese
theologian Mikao Usui in the mid-1800’s (Brennan, 2001) - is a form of energy
therapy that has much in common with TT but has received little scientific attention.
Reiki has been defined as “… a precise method for connecting this universal [life]
energy with the body’s innate powers of healing…..This hands-on healing art, a
powerful adjunct to conventional therapeutic modalities, fuels the body’s homeostatic
mechanisms and thereby assists in the restoration of balance on the physical, mental
and emotional levels” (Barnett & Chambers, 1996, p.2). As with TT practitioners,
Reiki practitioners believe disease results from an imbalance of energy and by re-
balancing that energy they are able to stimulate the body’s innate self-healing
capabilities. Similarly, practitioners of Reiki believe it can be learnt by anyone, it
involves compassionate intentionality on behalf of the practitioner, that its efficacy
requires no imposing values (i.e. belief that it will work, belief in a divine being,
membership of a religious group etc) and is independent of any understanding of how
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it works on behalf of either the recipient or the practitioner (Brennan, 2001). They
further believe it to involve physical, emotional, psychological and spiritual domains
and, since they are conduits for the life force energy rather than suppliers, to be able
to transmit such energy without becoming depleted themselves (Baginski &
Sharamon, 1988). It is for that reason Reiki practitioners refer to themselves as
“channels”. Although sharing much in common, two notable differences exist in the
beliefs held by Reiki channels and TT practitioners.
Reiki channels, unlike their TT counterparts, believe the universal life force energy
has an innate ability to automatically target that aspect (i.e. physical, psychological,
emotional or spiritual) of the patient where treatment is most needed and so
evaluation/manipulation of the recipients energy field is not required (Baginski &
Sharamon, 1988; Nield-Anderson & Ameling, 2000). Secondly, Reiki channels hold
the view that Reiki is a true “distant healing” technique. That is, they believe the
universal life force energy can be transmitted over great distances and so the close
proximity to patients required of TT practitioners is unnecessary (Baginski &
Sharamon, 1988; Schlitz & Braud, 1985).
As with TT, Reiki has been reported to be beneficial in a number of situations
including the treatment of post-operative patients (Alandydy & Alandydy, 1999),
lupus (Van Sell, 1996), aiding re-attachment/phantom pain associated with
amputation (Brill & Kashurba, 2001), anxiety reduction/relaxation (Brennan, 2001;
Wardell & Engebretson, 2001) and aiding various psychological conditions including
depression (Baginski & Sharamon, 1988; Shiflett, Nayak, Bid, Miles & Agostinelli,
2002).
19
Although Astin, Harkness and Ernst (2000) reported a medium positive treatment
effect for “other” distant healing techniques (which included Reiki) in their review of
non-contact CAMs, methodological issues associated with the study of Reiki (Nield-
Anderson & Ameling, 2000; Mansour, Beuche, Laing, Leis & Nurse, 1999; Schlitz &
Braud, 1985) has led to an acknowledged lack of good efficacy studies in the area
(Brennan, 2001; Nield-Anderson & Ameling, 2000), a situation similar to TT.
It should be noted that the direction and manipulating of external energy fields is not
restricted to CAM. In conventional medicine, studies involving transcranial magnetic
stimulation (TMS) have, contentiously, shown promise in improving psychological
disorders. In this non-contact approach, a magnetic field discharged near the head
penetrates the brain inducing an electric field in the cerebral cortex of sufficient
intensity to depolarise cortical neurons. The resulting action potentials give rise to
biological effects reported by some to positively impact on depression (Gershon,
Dannon & Grunhaus, 2003) and chronic pain (Pridmore, Oberoi, Marcolin & George,
2005) while others are less than convinced (Hansen et al, 2004, Martin et al, 2005;).
Regardless of the on-going scientific debate regarding their efficacy, there is little
doubt about the growing appeal of CAM to the general public.
Eisenberg et al. (1998) report that based on national surveys, the number of visits by
Americans to complementary/alternative medical practitioners increased some 47%
from 427 million in 1990 to 629 million in 1997 thereby exceeding the total number
of visits to primary care physicians in that year. Additionally, they report Americans
20
spent more than $US21.2 billion for complementary/alternative medical professional
services in 1997 with in excess of $US12.2 billion paid as out-of-pocket expenses, a
figure exceeding the total out-of-pocket spending for all hospitalisations in the US for
that year. Such is the interest in CAM in the US that the National Center for
Complementary and Alternative Medicine was formed within the National Institute of
Health by Congressional mandate in 1992 (Straneva, 2000) and CAM is taught in
some 66 % of all US medical schools as either an elective or as part of a required
course (Wetzel, Kaptchuk, Haramati, Eisenberg, 2003).
In Britain complementary medicine is increasingly available on the National Health
Service with some 39% of general practitioners providing access to such services
(Zollman & Vickers, 1999) while in Australia, a 1993 survey of 3004 South
Australians aged 15 and over found 48.5 % had used at least one form of CAM
(excluding calcium, iron and prescribed vitamins) and 20.3% had visited an
alternative practitioner. Extrapolation of the data to the Australian population as a
whole resulted in a calculated annual expenditure of $AU930 million on alternative
medicines/therapies (MacLennan, Wilson & Taylor, 1996). The trend towards CAM
is such that some authors claim it “…suggests a continuing demand for CAM
therapies that will affect health care delivery for the foreseeable future” (Kessler et
al, 2001, p. 262).
The popularity of CAM despite the lack of clear empirical evidence in support of its
efficacy, has been attributed to the underlying beliefs that unite the many disparate
CAMs, and the implications of those beliefs for the layperson. Kaptchuk and
Eisenberg (1998) for example, argue that the CAM community is united in its belief
21
in the importance of nature, vitalism, “science” and spirituality. They claim “Nature”
invokes images of wholesomeness, innocence and virtue and so embracing a “natural”
treatment allows a person to connect to a more wholesome, virtuous - and hence a less
artificial - view of self. “Vitalism” offers the patient connection and control over
benign but powerful life-supporting forces and so can have “rescuer” implications, a
central theme of existentialism (Langford, 2002). The “science” of CAM offers
patients readily understood “real” causes for any sensation, often based on a
sophisticated philosophy supported by a long intellectual history, and so affirms their
real-world experience. It is person-centred. Contemporary medical science on the
other hand offers explanations based on machines whose operation can often neither
be understood nor felt and whose output can be used to marginalise, trivialise or even
deny patients real-life sensations.
Kaptchuk and Eisenberg (1998) purport a kind of “spirituality” to be associated with
CAM owing to the fervour with which participants may pursue such approaches,
sometimes to the point of an almost religious quest for health. Exercise,
vitamin/dietary supplements, raw fruit juice and brown rice can take on liturgical
meaning and become acts of devotion, assurance and commitment (Dubisch, 1981;
Schafer & Yetley, 1975). The importance to complementary healthcare of spirituality
in its more commonly held sense has also been espoused by Krebs (2003). According
to Kaptchuk and Eisenberg (1998) then, the appeal of CAM is that it “…offer(s)
patients a participatory experience of empowerment, authenticity, and enlarged self-
identity when illness threatens their sense of intactness and connection to the world.”
(p. 1061). Other researchers suggest possible benefits of CAM include time,
empathy, personalisation, counselling and a holistic emphasis to health rather than a
22
focus on disease (Brill & Kashurba, 2001; Ernst, 1993). Consistent with those
findings is work indicating that users of CAM do so not because of dissatisfaction
with conventional medicine, but rather because CAM was more in-line with their
beliefs, values and health/life philosophies (Astin, 1998; Engebretson, 1996; Kelner &
Wellman, 1997).
Profiles of the types of people who seek out CAM paint a fairly uniform picture.
They are more likely to be women, to be better educated, to have higher household
incomes and to consider spirituality/religion as important to their lives (Kaptchuk &
Eisenberg, 1998; Kelner & Wellman, 1997; MacLennan, Wilson & Taylor, 1996).
Specific to Reiki recipients, Kelner and Wellman (1997) report them to be the most
highly educated of the five groups studied (i.e. patients seeking out family physicians,
chiropractors, acupuncturists/traditional Chinese medicine doctors, naturopaths or
Reiki channels), to more likely have higher household incomes and
professional/white-collar jobs and to be concerned with the emotional and spiritual
aspects of their lives.
The bulk of work undertaken in relation to energy therapies such as Therapeutic
Touch and Reiki appears to be aimed at efficacy studies involving clinically
significant outcomes. Although limited, well-constructed research has been
undertaken, the results have not been clear-cut possibly because such studies have
typically overlooked psychological factors reported to influence physiologic function
and health outcomes (Astin, Shapiro, Eisenberg & Forys, 2003), a short-coming
recognised by some authors (Astin, Harkness and Ernst, 2000).
23
However, on the basis of the best evidence currently available then, there appears to
be some beneficial effects associated with both Reiki and Therapeutic Touch energy
therapies. It is important to establish if such therapies are indeed significantly,
clinically beneficial or if they are simply perceived to be beneficial. Clinical
effectiveness needs to be established so that the limited funding available for health-
related research can be appropriately directed towards those treatments shown to be of
the greatest practical good, be they mainstream or CAM. Factors contributing to
patients’ perception of a particular CAM as beneficial in the absence of objective
evidence to support that view need to be understood so that they can be incorporated
into modern medical practices where possible, resulting in improved health outcomes
for such patients and perhaps, for others as well.
This work then had two goals. The first was to attempt to validate previous findings
showing a positive effect of Reiki on depression and on overall well-being. Health-
based variables associated with depression and well-being were assessed before and
after Reiki using the Rosenberg Self-Esteem Scale, the General Health Questionnaire,
the Center for Epidemiologic Studies Depression Scale and the Positive And Negative
Affect Schedule. A subjective measure of overall well-being was also included. To
help ensure any observed changes in dependent variables could not equally be
explained by significant life event(s) as by the influence of Reiki, the Life Events
Survey also accompanied administrations of the above instruments.
The second goal of this work was to gain an insight into possible psychological
factors influencing personal choice in favour of CAM. Health-based questionnaires
were again primarily used specifically, the Attitudes Towards Doctors And Medicine
24
Scale, the Health Opinion Survey, the Pennebaker Inventory of Limbic Languidness
and the Life Orientation Test. The Australian Sheep/Goat scale, a measure of the
tendency to believe in paranormal phenomena, was also used. Questionnaires were
selected to test specific hypotheses based on findings from previous researchers.
As discussed, previous research has established that users of CAM reportedly do so as
an adjunct to, rather than replacement for, conventional medicine. They might then
reasonably be expected to exhibit similar attitudes towards conventional doctors and
medicine as non-users and to visit such practitioners just as often. However, it is
expected that their need for “…a participatory experience…” (Kaptchuk & Eisenberg,
1998. p. 1061) would see them more involved in their treatment by such doctors than
non-users. It is theorised than that users of CAM would be similar to non-users in
their performance on the Attitudes Towards Doctors And Medicine Scale, that users
and non-users would be similar in the number of visits to conventional doctors but
that users of CAM would score higher on the Health Opinion Survey, a preference
measure for different treatment approaches, than non-users.
A common theme reported by researchers is the importance to CAM users of
spirituality/connectedness/belief in powerful extra-sensory forces. It is therefore
hypothesised that a possible source of the appeal of CAM to users is that it provides
socially acceptable validation for their belief in an extra-ordinary domain. Hence
users of CAM would be expected to have a stronger belief in the paranormal than
non-users and so score higher on the Australian Sheep/Goat scale, a measure of the
tendency to believe in paranormal phenomena.
25
Some users of CAM are reported to be concerned with the emotional aspects of their
lives raising the possibility that the appeal of CAM to those people might be related to
their being more pre-disposed to experiencing, and hence more likely to notice and
report on, their emotional state than non-users of such medicine. Similarly, some
users of CAM believe it to benefit physical well-being suggesting they may be more
acutely aware of, and hence more likely to notice and report on, their physical state
than non-users. Thus, users of CAM are hypothesised to be more aware of their
emotional or physical state when compared with non-users and so are expected to
score higher on the Positive And Negative Affect Schedule (assess the predisposition
to experience positive and negative affective mood states) and/or the Pennebaker
Inventory of Limbic Languidness (assesses the tendency to attend bodily sensations)
respectively, than non-users.
Finally, it is postulated that since some users of CAM attest to its benefits despite a
clear lack of scientific evidence to support their view, a pre-disposition towards
anticipating favourable outcomes may be involved. As a consequence, users of CAM
are expected to score higher on the Life Orientation Test (a measure of habitual style
of anticipating more favourable outcomes) than non-users.
2.0 Method
2.1 Participants
Twenty-nine people initially responded to an “all staff” e-mail circulated within a
Division of a large Australian corporation outlining the study and inviting interested
26
staff or their immediate family to further discuss the work on a one-to-one basis with
the researcher, before deciding if they wished to participate. Subsequently 22 people
went on to volunteer for the study and of those, 17 actually completed the study.
Those 17 participants had a mean age of 43.94 years (SD = 7.58 years) and consisted
of nine males and eight females. Twelve participants were staff members (mean age
= 45.00 years, SD = 6.77 years) while the remaining five were immediate family
(mean age = 41.40 year, SD = 9.60 years). All but three participants had completed
post-secondary study with one obtaining an associate diploma level qualification,
three a diploma level qualification, one a graduate diploma, four a degree, two a
masters and three a doctorate. All but three held professional/white-collar jobs and all
but two had salaries exceeding the national annual average of some $59,000 (as at
August 2005; Australian Bureau of Statistics, 2005).
Recruitment of Reiki “channels” was effected through the President of the Australian
Usui Reiki Association (AURA), himself a Reiki master. Using a combination of
personal contacts and e-mail the President of AURA recruited a total of 389 channels
world-wide who purported themselves capable of “distant Reiki” (i.e. transmitting
Reiki energy over great distances). Of that number, a minimum of 130 (112 female,
14 male, 4 missing) actually completed the study with the high attrition
rate/uncertainty as to exact numbers attributable to a number of factors. On-going
administrative issues repeatedly delayed the start of the project, some channels
experienced difficulties with the web-page (see section 2.3) and so were unable to
provide their information while others attempted to submit their data weeks after the
“Reiki end” date necessitating the imposition of a cut-off date after which no more
data would be accepted (i.e. 3 weeks after Group 2 stopped receiving Reiki).
27
Additionally, postal delays resulting in some channels receiving their “Letter of
Instruction” (see section 2.3) after their start date.
Of the 130 channels known to have participated 79 were from the USA, 13 from
Australia, 13 from Canada and 10 from the UK with the remainder from a handful of
countries including Italy, Israel, Scotland, Mexico and Sweden. Channels reported
they had been practising Reiki for an average of 5.88 years (SD = 4.89 years) and 64
claimed they typically practised every day, 43 claimed they typically practised more
than 3 times per week, 16 typically practised once per week with the remainder
practising a few times per fortnight or less.
2.2 Materials
A digital image of the head and shoulders of all participants was obtained using a 0.3
mega pixel digital camera. Those images were digitally manipulated to enhance
image quality and ensure, as far as possible, uniformity of finished head/shoulder size
before being colour printed at a size of some 50x40mm and distributed to Reiki
channels (discussed further in Section 2.3). Those participants then were the people
who received Reiki energy in this study and so are subsequently referred to as
“recipients” in this report.
The reported medium strength, positive impact of TT on physiology and psychology
(Astin, Harkness & Ernst, 2000; Peters, 1999) targeted those domains as the most
appropriate from which to select dependent variables for use in this study. Within
those domains the reported efficacy of energy therapy techniques such as Reiki, TT
and TMS in the treatment of depression focussed the selection of suitable
28
psychological dependent variables on those associated with that condition and those
likely to detect changes in mood. The spiritual domain, purported to also benefit from
Reiki, was not covered in this work since no scientific literature investigating the
value of Reiki or TT in that domain could be found. Further, efficacy studies of other
non-contact “distant healing” techniques involving manipulation of supraphysical
energy in that domain (e.g. prayer), reported an average effect size of d = 0.25 (ρ =
.009) across four studies (Astin, Harkness & Ernst, 2000) from which the chance of
detecting a change on a measure in that domain in the current work was calculated to
be some 14% at best (see Appendix 1).
The efficacy of Reiki in this study then was assessed using a subjective measure of
overall well-being developed by the researcher (range of possible scores 0 to 64, see
question 6 in Appendix 2), as well as four health-based dependent variables.
Specifically (see Appendix 3 for questionnaires):
Rosenberg Self-Esteem Scale (RSE) – measures self-esteem with possible
scores ranging from 10 to 40 (Rosenberg, 1989).
General Health Questionnaire (GHQ-12) – detects non-psychotic psychiatric
disorders in medical and community settings. Possible scores range from 0 to
12 (Goldberg, 1992).
Center for Epidemiologic Studies Depression Scale (CES-D) – measures
presence and severity of depressive symptomatology in the general population.
Possible scores range from 0 to 60 (Radloff, 1977).
29
Positive And Negative Affect Schedule (PANAS) – assess the predisposition to
experience positive and negative affectivity mood states (denoted PA and NA
respectively) over a specified time frame (“in the past few weeks” in this case).
Possible scores range from 10 to 50 on both sub-scales (Watson, Clark &
Tellegen, 1988).
The Life events survey (LES, Sarason, Johnson & Seigel, 1978; see Appendix 3 for
questionnaire), which provides a measure of the subjective impact of both positive
and negative significant life events likely to affect change that recipients may have
encountered up to a year earlier, also accompanied administrations of those
questionnaires. The LES was incorporated into the study for two reasons. First, to
provide an insight into the possible cause(s) of any significant mood changes
occurring during the course of the study so allowing for an alternative explanation for
such changes other than attributing them to Reiki. For example, a significant
reduction in depression and negative affect along with greatly increased positive
affect over the course of the study could simply be attributed to a number of recipients
experiencing positive life events (eg marriage, winning the lottery, birth of a child)
over the test period rather than to Reiki. Secondly, by comparing LES scores before
and after Reiki, the Life Events Survey provided a means of pre-emptively testing the
possible claim of channels that significant and beneficial life events were bought
about by Reiki. To support such a claim recipients of Reiki would have to show a
significant increase in positively viewed life events when compared to those who had
not received Reiki.
30
In addition to the questionnaires already discussed, recipients were asked to complete
a number of other questionnaires prior to commencement of the study. An initial
questionnaire aimed at obtaining demographic information as well as subjective
measures of their perceived overall well-being and strength of belief in the ability of
one person to heal another through means other than conventional medicine (range of
possible scores 0 to 100; see question 8 in Appendix 2), the Australian Sheep/Goat
scale, a measure of tendency to believe in paranormal phenomena (Thalbourne, 1995)
and four health-based questionnaires. Specifically (see Appendix 3 for
questionnaires):
Health Opinion Survey (HOS) – measures preferences for different treatment
approaches. It consists of two subscales, the Information (I) subscale which
measures attitudes towards self-treatment and active behavioural involvement in
medical care; and the Behavioural Involvement (B) subscale which assesses the
need to ask questions and be involved in medical decisions (Krantz, Baum and
Wideman, 1980).
Attitudes Towards Doctors And Medicine Scale (ADMS)– has four subscales
that provide measures of: 1) Positive attitude towards doctors, 2) Negative
attitude towards doctors, 3) Positive attitude towards medicine and 4) Negative
attitude towards medicine (Marteau, 1990).
Pennebaker Inventory of Limbic Languidness (PILL) – assesses the tendency to
attend bodily sensations and hence report health complaints (Pennebaker, 1982).
31
Life Orientation Test (LOT) – measures a habitual style of anticipating
favourable outcomes (Scheier & Carver, 1985).
Those questionnaires were aimed at gaining a better understanding of possible
psychological factors influencing personal choice in favour of CAM (i.e. the second
goal of this study).
Due to both the number and the national/international location of Reiki channels a
purpose-built webpage was considered to be the most efficient way of obtaining
demographic and trial data (eg hours spent sending Reiki energy during the test
period) from those individuals (see Appendix 4).
2.3 Procedure
A split-half, double-blind experimental design was decided upon for this work and is
represented pictorially in Figure 1. The design was achieved as follows.
During the one-on-one discussions that occurred with each of the initial 29
respondents to the “all staff” e-mail, potential recipients were informed that the
experiment would last six weeks and that sometime over that period they would
receive Reiki energy. Their normal routine would not however be interrupted since
this work involved “distant Reiki” and so they would not, for example, be required to
meet with any Reiki channels or undertake any special arrangements to receive Reiki
energy. Although informed they would receive Reiki energy, potential recipients
were not told when that energy would be sent, how much they would receive or the
time period over which they would receive it.
32
21 days 21 days
Time 0 Time 1 Time 2
Subjective well-being, PANAS, RSE, GHQ-12, CES-D
Subjective well-being, PANAS, RSE, GHQ-12, CES-D LES
Demographic, RSE, GHQ-12, CES-D, PANAS, LES, ADMS, LOT, PILL, HOS, Sheep/goat
Group 1
Group 2 Reiki energy supplied by Group B channels
No Reiki
Reiki energy supplied by Group A channels
No Reiki
Figure 1. Pictorial representation of the split-half experimental design used in this work. Recipients of Reiki were randomly assigned to one of two groups (Group 1 or 2) and received that energy over a period of 21 days from Reiki channels also randomly assigned to one of two groups (A or B).
At the conclusion of the discussion and after all questions had been answered, the
researcher requested each person NOT to indicate their intention to participate in the
study at that time. Instead, potential recipients were asked to make that decision by a
specified date and if deciding in the affirmative, to contact a research assistant who
would assign them a number at random, take their photograph and provide them with
a sealed envelope containing the 11 questionnaires outlined above complied in a
counter-balanced manner. Upon collection of those envelopes, recipients were
advised by the research assistant not to put their name on any of the questionnaires but
to use their assigned number instead. They were also advised that completed
33
questionnaires were to be returned to him by a prescribed date in a sealed envelope
identified only with the recipients assigned number. Those unopened envelopes were
then forwarded to the researcher for scoring and later analysis. Data so obtained
comprised the “Time 0” data (see Figure 1. i.e. the “before” data since at that time no
recipients had received any Reiki energy from any of the channels participating in this
study).
In addition to the above functions, the research assistant also randomly assigned
recipients to one of two groups; “Group 1” comprising nine people (7 employees and
2 immediate family members) and “Group 2” the remaining eight (5 employees, 3
immediate family members. Recipients were unaware they had been assigned to one
of two groups. Similarly, Reiki channels were randomly assigned to one of two
groups by the President of AURA with “Group A” comprising 69 people and “Group
B” the remaining 61. Reiki channels, like recipients, were unaware they had been
assigned to one of two groups. This approach ensured that neither recipients,
channels nor researchers knew to which group a particular individual belonged and
that neither group of recipients/channels knew of the existence of the other groups.
At the outset of the study recipients were asked to briefly describe any “sensation or
feeling that is unusual to you” they might experience over the course of the
investigation, note the date and time of that sensation(s) and forward the information
in a sealed envelop with their assigned number on the outside to the research assistant.
Once having established the two groups of recipients, the research assistant produced
a single A4 sheet of paper containing the 50x40mm digital colour images of all
34
recipients in a particular group, identifying recipients on that sheet only by their
assigned number. Colour copies of that sheet were inserted into envelopes by the
research assistant along with a “Letter of Instruction to Reiki Channels”. That letter
indicated the dates at which channels should start and end the transmission of distant
Reiki to the recipients shown on the enclosed sheet either as a group or, if treating
recipients individually, to spend the same amount of time on each individual. A web
address for inputting their demographic and trial details and a request they do so after
the date they were to cease distant Reiki were also included. Channels were told the
study would involve “…a series of psychological 'before and after' tests” but were not
told what those tests were nor what they were designed to measure.
The research assistant sealed and stamped the envelopes before delivering them to the
President of AURA who then addressed them and posted them off. Group 1 photos
were mailed to Group A channels and Group 2 photos to Group B channels with
approximately a two week interval between the mailings. The enclosed “Letter of
Instruction to Reiki Channels” was different between postings in that it contained
different “Reiki start” and “Reiki end” dates. Those dates were timed such that Group
2 recipients began receiving Reiki energy from Group B channels some two days after
Group 1 recipients had ceased to receive energy from the Group A channels (“Time
1” in Figure 1). For both Groups 1 &2 the interval between “Reiki start” and “Reiki
end” dates was 21 days.
At “Time 1” all recipients provided a subjective measure of their perceived overall
well-being using the same scale as in the original demographic questionnaire (e.g.
question 6, Appendix 2) in addition to completing the RSE, GHQ-12, CES-D,
35
PANAS and the LES. Questionnaires were complied in a counter-balanced manner
and obtained/returned/forwarded via the research assistant as described earlier.
Recipients again repeated that process at the conclusion of the study (i.e. “Time 2” in
Figure 1). Also at that time the research assistant provided the researcher with a list
aligning recipients assigned numbers with either Group 1 or Group 2.
In summary then, the methodology employed ensured that the researchers were
unable to identify recipients at any point in the study, that the identity of the Reiki
channels was completely unknown to both researchers and recipients and that
channels knew recipients only by their photo and assigned number. It further ensured
neither recipients nor channels knew they had been randomly assigned to one of two
groups and no group knew of the existence of the other groups. Neither recipients nor
researchers knew when an individual would receive Reiki energy, from whom they
would receive that energy or how much energy they would receive. Additionally,
recipients did not know over what period they would receive Reiki energy (i.e. 21
days).
3.0 Results
Although 22 people initially volunteered to receive Reiki in this study, five dropped
out at various stages owing to organisational changes that occurred in the corporation
for which they worked during the course of this investigation (discussed further in
section 4.0). The following then is based on the responses of the 17 remaining
recipients.
36
All recipients in this work, except one, had visited a conventional medical practitioner
at least once in the 12 months immediately preceding the study (M = 4.85, SD = 3.98).
Nine recipients reported also seeing a CAM practitioner (e.g. acupuncturist,
kinesiologist, reflexologist, aroma therapist etc) at least twice during that time. The
sole recipient who had not visited a conventional medical practitioner in the 12
months immediately preceding the study reported consulting a CAM practitioner a
total of eight times during that period. None of the remaining eight recipients
reported seeing a CAM practitioner at all in the 12 months immediately preceding the
study. No recipient had seen a Reiki channel in that time. Recipients in this study
then naturally fell into one of two categories, “users” who actively sought out CAM
(N = 9) and “non-users” who did not (N = 8). As a consequence, recipients in this
study were classified twice according to two different criteria. They were assigned to
one of two groups (i.e. Group 1 or 2, denoted “Group” in the text) on a random basis
(see Section 2.3) as well as quite independently classified into “User/Non-user”
(denoted “User”) groups. Demographic details for both classifications are shown in
Table 1.
37
Table 1 Summary of Demographic Details for Classifications of Reiki Recipients. Recipients were Randomly Assigned to a Group (1 or 2) and, Independently, Categorised as “User” or “Non-user” of CAM.
Recipients of Reiki
Group 1 N= 9
Group 2 N= 8
User N= 9
Non-user N= 8
Composition 7 employees
2 family 5 employees
3 family 5 employees
4 family 7 employees
1 family
Gender 6 male, 3 female
3 male, 5 female
4 male, 5 female
5 male, 3 female
Age in years M = 45.44
SD = 6.88 M = 42.25 SD = 8.43
M = 45.67 SD = 6.00
M = 42.00 SD = 9.05
Years of education M = 17.75
SD = 3.10 M = 16.63 SD = 5.99
M = 16.11 SD = 2.57
M = 18.57 SD = 6.42
Visits to conventional practitioners in preceding 12 mths
M = 5.11 SD = 4.51
M = 4.56 SD = 3.58
M = 3.50 SD = 2.21
M = 6.37 SD = 5.07
Visits to CAM practitioners in preceding 12 mths
M = 2.11 SD = 3.02
M = 5.63 SD = 5.18
M = 7.11 SD = 3.52
0
Table 2 provides a summary of the demographic details for the two Reiki channel
Groups (i.e. A and B) and the time each of those groups spent on sending distant
Reiki to their respective recipient Group (i.e. 1 or 2) during each of the three weeks
(21 days) they were requested to do so.
38
Table 2. Summary of Demographic Details of Reiki Channel Groups A and B and Time Spent on Sending “Distant” Reiki to Their Respective Recipient Group (i.e. 1 or 2).
Reiki Channels
Group A
N= 69 (Reiki sent to Group 1)
Group B N= 61
(Reiki sent to Group 2)
Gender 58 Female, 9 Male (2 missing)
54 Female, 5 Male (2 missing)
Age in years M = 49.76
SD = 10.1 M = 50.85
SD = 10.84
Years practising Reiki M = 6.44 SD = 5.82
M = 5.26 SD = 3.56
Frequency of practice 35 Every day
22 More than 3 times/wk 10 Once/week
1 Few times/fortnight 1 (missing)
29 Every day 21 More than 3 times/wk 6 Once/week
1 Few times/fortnight 2 Less than once/mth 2 (missing)
Total minutes of Reiki Week 1:
28969 5221
Total minutes of Reiki Week 2:
33195 6946
Total minutes of Reiki Week 3:
39662 6666
Total minutes of Reiki received by Group 1.
101826 (= 1697.10 hrs)
Total minutes of Reiki received by Group 2.
18833 (= 313.88 hrs)
Table 2 indicates that while Groups A and B were closely matched in terms of size,
gender composition, age and years/frequency of practising Reiki, Group A channels
delivered over 5 times more Reiki to recipient Group 1 than Group B channels did to
recipient Group 2. Examination of the data found that largely attributable to two
39
channels in Group A claiming to have sent distant Reiki 24 hrs/day during each week
of the study (i.e. 10080 mins/week) with the aid of a “crystal grid” (an arrangement of
crystals into a particular configuration that practitioners believe may be charged with
Reiki energy and so can subsequently send that energy over a continuous period.
Reiki Living, 2003).
Descriptive statistics for all variables used can be found in Appendix 5 along with
SPSS printouts of the major statistical analyses.
3.1 Efficacy of Reiki distant healing:
In the following, analyses involving repeated measures ANOVA sometimes revealed
Mauchly’s test of sphericity to be significant indicating the variance-covariance
matrices were not circular in form (Huynh & Mandeville, 1979). As a consequence, a
violation of the assumption of homogeneity of variance-covariance matrices occurred
(Mauchly, 1940) necessitating the use of a correction factor, epsilon. While a number
of such correction factors exist, they tend to either over- or under-correct (Keppel,
1982) and so it has been recommended that where epsilon is less than .75 (as was
found to be the case with the present data) the Huynh-Feldt correction be used (Huynh
& Feldt, 1976). Consequently, for some of the results that follow the actual degrees
of freedom are shown but the significance of the F-statistic reported is based on the
Huynh-Feldt epsilon corrected degrees of freedom. Such results are denoted
“corrected” in the text.
40
Scores for the six dependent variables (i.e. the subjective perceived overall well-being
measure, the RSE, GHQ-12, CES-D and the positive and negative components of the
PANAS) were subjected to the Kolmogorov-Smirnov Z-test for normality as were the
positive and negative sub-scales of the LES. All were found to be normally
distributed (Z < 1.10, ρ > .05 in all cases, two-tailed) indicating parametric data
analysis to be appropriate.
A 2 x 3 repeated measures ANOVA (i.e. “Group” x “Time” (0, 1 or 2)) was used for
each dependent variable to analyse data unless otherwise stated.
No significant effect for “Group” (F(1,15) = .11, ρ > .05) or “Time” (F(2,30) = .77, ρ
> .05) was found on the subjective overall well-being measure (refer question 6,
Appendix 2) and no significant “Time” x “Group” interaction observed (F(2,30) =
.10, ρ > .05). Recipients therefore did not display marked differences in their
perceived overall well-being as the study unfolded.
No significant effect for “Group” (F(1,14) = 1.10, ρ >.05) or “Time” (F(2,28) = .83, ρ
>.05) was found on the CES-D scores and no significant “Time” x “Group”
interaction observed (F(2,28) = 1.80, ρ >.05). Further, no significant effect for
“Group” (F(1,15) = .12, ρ >.05) or “Time” (F(2,30) = .74, ρ >.05) was found on the
GHQ-12 scores and no significant “Time” x “Group” interaction noted (F(2,30) = .18,
ρ >.05). Recipients overall level of depression then did not vary markedly in this
work and was independent of the group to which they had been randomly assigned.
41
No significant effect for “Group” (F(1,15) = 2.42, ρ >.05) or “Time” (F(2,30) = 1.62,
ρ >.05) was found on the RSE scores nor was the “Time” x “Group” interaction
significant (F(2,30) = .85, ρ >.05) indicating that overall, recipients’ self-esteem did
not vary significantly between groups during the course of this study.
No significant effect for “Group” (F(1,15) = .08, ρ >.05) was found on the PA scale of
the PANAS and no significant “Time” x “Group” interaction noted (F(2,30) = .27, ρ
>.05). However, a significant effect for “Time” was observed (F(2,30) = 3.51, ρ <
.05). Further analysis subsequently revealed participants to be significantly more
positive in affect at “Time 0” (M = 29.94, SD = 6.40) than at “Time 1” (M = 27.41,
SD = 7.25) or “Time 2” (M = 27.76, SD = 7.13). Recipients in the study then
appeared to be at their most positive at the commencement of the study and prior to
receiving Reiki.
No significant effect for “Group” (F(1,15) = .88, ρ >.05) or “Time” (F(2,30) = .28, ρ
>.05) was observed on the NA scale of the PANAS however a significant “Time” x
“Group” interaction was noted (F(2,30) = 3.41, ρ < .05). Subsequent analyses aimed
at establishing if the interaction extended to both groups or was confined to one
proved inconclusive with Helmert contrasts indicating there to be no significant
interactions (level 1 vs later F(1,15) = 3.13, ρ > .05; level 2 vs level 3 F(1,15) = 4.28,
ρ > .05). However, polynomial contrasts found the (possible) interaction to be linear
(F(1,15) = 4.54, ρ < .05) and increasing with time for Group 1 but decreasing with
time for Group 2. Thus, Group 1 recipients may have experienced significantly more
negative affect as the study unfolded whereas Group 2 participants may have
experienced significantly less.
42
No significant effect for “Time” (F(2,30) = 2.85, ρ >.05) or “Group” (F(1,15) = .08, ρ
>.05) and no significant “Time” x “Group” interaction (F(2,30) = .12, ρ >.05) was
observed on the positive events sub-scale of the LES. Similarly, no significant effect
for “Time” (F(2,30) = 1.38, ρ >.05) or “Group” (F(1,15) = .07, ρ >.05) was found on
the negative events sub-scale of the LES and no significant interactions noted
(F(2,30) = .64, ρ >.05). The impact of both positive and negative life events
occurring to recipients during the course of this study then was similar regardless of
the group to which they had been randomly assigned.
The results indicate that, with the exception of the PANAS, there were no significant
changes overall in the dependent variables between Times “0”, “1” and “2”, no
significant differences in the impact of positive or negative life events occurring over
the test period and no significant interactions for recipients in either Group 1 or Group
2. The effect of “Time” associated with the positive affect scale of the PANAS
indicated all recipients to be at their most positive at the commencement of the study
and prior to receiving Reiki. The inconclusive “Group” x “Time” interaction
observed on the negative affect scale of the PANAS possibly indicated Group 1
recipients to have experienced significantly more negative affect as the study
progressed whereas Group 2 recipients possibly experienced significantly less. Since
affect is influenced by life events it was considered worthwhile to further investigate
the LES data.
Figure 2 shows the negative sub-scale scores of the LES for recipients 2, 6, 13 and 20
(all employees) at Times 0, 1 and 2. The figure indicates that although they all
43
reported a significant negative life event(s) over the six weeks of the study, the impact
of that event(s) was not uniform. Recipient 6 for example experienced a significant
negative event whose impact did not diminish over the trial or experienced a string of
negative events over that time, unlike recipient 13 where the impact of their negative
event decreased with time. The event occurring to recipient 2 on the other hand,
appeared to be viewed more negatively at “Time 1” (or another event occurred) and
then abate whereas the negative event reported by participant 20 seemed to have been
viewed consistently as of minimal impact.
0
10
20
30
1 2 3Time
Neg
ativ
e L
ES
sco
res
261320
0 1 2
Figure 2. Life Events Survey scores (negative sub-scale) for recipients 2, 6,13 & 20 (all employees) at Times 0, 1 & 2.
The time interval between successive administrations of the same test to the same
group of participants (i.e. the test/re-test interval) is known to impact on their
response. If that time interval is too short there is increased risk that participants will
44
respond to subsequent administrations by remembering their previous answers rather
than according to their situation at the latest administration (Furguson & Takane,
1989; Kaplan & Saccuzzo, 1997) with the result that their responses do not accurately
reflect true changes over time. Some evidence supporting memory effects influencing
questionnaire completion in the present study was found in increases in correlation
between results obtained at Times “0” and “1” and those obtained between Times “1”
and “2” on all measures used to assess the efficacy of Reiki in this work with the
exception of subjective overall well-being (correlations between tests in time should
decrease as memory of the test fades, Furguson & Takane, 1989). The correlation in
GHQ-12 scores between Times “0” and “1” was found to be r(17) = .55 and increased
to r(17) = .88 (ρ < .05, two-tailed in both cases) between Times “1” and “2”. For the
CES-D the correlation increased from r(17) = .65 between Times “0” and “1” to r(17) =
.83 between and Times “1” and “2” (ρ < .05, two-tailed in both cases) and from r(17) =
.18 (ρ > .05, two-tailed) to r(17) = .57 (ρ < .05, two-tailed) for the RSE betweens Times
“0” and “1” and Times “1” and “2”. For the PANAS, correlation increased from r(17) =
.79 to r(17) = .84 on the PA component and from r(17) = .69 to r(17) = .85 on the NA
component at those times (ρ < .05, two-tailed in both cases).
3.2 Individual difference
Recipients scores on all the scales and sub-scales used in this section (eg Australian
Sheep/Goat scale, PILL, LOT, ADMS etc) were subjected to the Kolmogorov-
Smirnov Z-test for normality. All were found to be normally distributed (Z < 1.13, ρ
>.05 in all cases, two-tailed) and so parametric data analysis was used.
45
It was earlier theorised that since users of CAM reportedly do so as an adjunct to,
rather than replacement for, conventional medicine they would display similar
attitudes towards conventional doctors and medicine as non-users and so visit such
practitioners equally as often. However, because of their liking for “…a participatory
experience…” (Kaptchuk & Eisenberg, 1998. p. 1061) they would be more involved
in their treatment by such doctors than non-users.
Independent samples t-testing comparing results of the positive attitude towards
doctors sub-scale of the ADMS for both users (M = 8.78, SD = 4.08) and non-users
(M = 11.13, SD = 3.22) of CAM found no significant difference (t(15) = 1.30, ρ >.05
two-tailed). A similar result was also found when scores on the negative attitude
towards doctors sub-scale of the ADMS were compared across those groups with
t(15) = .48, ρ >.05 two-tailed (User: (M = 17.00, SD = 4.15; Non-user: M = 16.13, SD
= 3.13). Further, independent samples t-testing comparing results of the positive
attitude towards medicine sub-scale of the ADMS for both users (M = 12.78, SD =
4.52) and non-users (M = 14.25, SD = 2.65) found no significant difference (t(15) =
.80, ρ >.05 two-tailed) as did a comparison of scores on the negative attitude towards
medicine sub-scale of the ADMS, t(10.24) = .42, ρ >.05 two-tailed (note that since
Levene’s F = 4.83, ρ < .05 in the latter case equal variances were not assumed. User:
M = 15.44, SD = 3.77; Non-user: M = 14.88, SD = 1.35). These results indicate users
and non-users of CAM in this work appeared to hold similar attitudes towards doctors
and medicine.
Users of CAM were found to have visited conventional medical practitioners an
average of 3.50 times (SD = 2.20) in the 12 months preceding the study and non-users
46
an average 6.37 times (SD = 5.07). Independent sample t-testing found no significant
difference in the number of visits to conventional medicine practitioners by both
groups (t(15) = 1.55, ρ >.05 two-tailed) indicating users of CAM in this study visited
conventional medicine practitioners as often as non-users. However, the large
standard deviation relative to the mean observed for non-users indicated it appropriate
to confirm that result via a non-parametric test. Application of the Mann-Whitney U-
test did indeed supported the findings of the independent sample t-test (U(17) = 24.50,
ρ >.05 two-tailed).
In light of the above results, the profile of people in this study who seek out CAM is
consistent with those of earlier studies in that they were generally female, well-
educated, white collar professionals on above average salaries who used CAM as an
adjunct to, rather than a replacement for, conventional medicine (Kaptchuk &
Eisenberg, 1998; Kelner & Wellman, 1997; MacLennan, Wilson & Taylor, 1996).
Comparing results of both users (M = 6.00, SD = 1.41) and non-users (M = 4.63, SD =
2.26) on the Information subscale of the HOS using an independent samples t-test
found no significant difference (t(15) = 1.52, ρ >.05 one-tailed). Similarly no
significant difference was found (t(15) = 1.64, ρ >.05 one-tailed) when results for
users (M = 5.78, SD = 2.99) and non-users (M = 3.63, SD = 2.32) were compared on
the Behavioural subscale of the HOS.
Consistent with the stated hypothesis then, users and non-users of CAM in this study
shared the same attitudes towards doctors and medicine and visited conventional
medical practitioners equally frequently. However, contrary to that hypothesis users
47
of CAM did not show more involvement in their treatment by such practitioners than
non-users. Not surprisingly though, users of CAM were found to have a significantly
stronger belief in the possibility one person can heal another through means other than
conventional medicine (see question 8, Appendix 2) than non-users (independent
samples t-test: t(15) = 2.18, ρ < .05 one-tailed; Users: M = 74.44, SD = 28.88; Non-
users: M = 44.63, SD = 27.03).
The importance of spirituality/connectedness/belief in powerful extra-sensory forces
to users of CAM lead to the hypothesis that its users would have a stronger belief in
the paranormal than non-users. However, no support for that could be found in an
independent samples t-test of user (M = 14.44, SD = 9.44) and non-user (M = 11.88,
SD = 11.03) groups on their Australian Sheep/Goat scale scores (t(15) = .51, ρ >.05,
one-tailed) with non-parametric testing confirmed that result (U(17) = 33.00, ρ >.05
one-tailed). Further, no correlation was found between recipients’ self-rated belief
that one person can heal another through means other than conventional medicine and
their scores on that scale (r(17) = .33, ρ >.05, two-tailed).
In addition to the importance of spirituality/connectedness/belief in powerful life-
supporting forces, some users of CAM are reported to be concerned with the
emotional aspects of their lives giving rise to the hypothesis that the appeal of CAM
may be related to its users being more pre-disposed to experiencing, and hence more
likely to notice and report on, their emotional state than non-users. One-way ANOVA
testing of user and non-user group scores on the Negative Affect (NA) sub-scale of
the PANAS at “Time 0” (M = 18.35, SD = 7.65), “Time 1” (M = 19.18, SD = 7.17)
and “Time 2” (M = 19.59, SD = 8.33) however found no support for that view
48
(F(1,16) < .45, ρ >.05 in all cases). A similar calculation involving the Positive
Affect (PA) sub-scale of the PANAS at those time also failed to support the
hypothesis (F(1,16) < .55, ρ >.05 in all cases. “Time 0”: M = 29.94, SD = 6.40;
“Time 1”: M = 27.41, SD = 7.25; “Time 2”: M = 27.76, SD = 7.13). Additionally, no
correlation between recipients’ self-rated belief that one person could heal another
through means other than conventional medicine and their scores on those scales was
found (Positive Affect: Time “0” r(17) = .01, Time “1” r(17) = .04, Time “2” r(17) = .18;
Negative Affect: Time “0” r(17) = .02, Time “1” r(17) = .14, Time “2” r(17) = .16, ρ >.05
two-tailed in all cases). Contrary to the hypothesis then, recipients who used CAM
were not more inclined to experience and report on either positive or negative changes
in their emotional state than non-users over the course of this study.
The purported benefits of CAM to physical well-being lead to the proposition that the
appeal of such medicine may be related to its users being more acutely aware of, and
hence more likely to notice and report on, their physical state than non-users.
However, independent samples t-testing of users (M = 12.22, SD = 7.24) and non-
users (M = 10.38, SD = 6.50) on their PILL scores found no evidence in support of
that proposition (t(15) = .55, ρ >.05, one-tailed) and no correlation between recipients’
self-rated belief that one person could heal another through means other than
conventional medicine and their scores on that scale was found (r(17) = .21, ρ >.05 two-
tailed).
The fact that some proponents of CAM attest to its efficacy despite a lack of scientific
supporting evidence resulted in the contention that users of CAM may have a habitual
style of generally anticipating more favourable outcomes than non-users. Independent
49
samples t-testing of user (M = 23.33, SD = 4.69) and non-user (M = 19.38, SD = 6.36)
scores on the LOT however failed to support that contention (t(15) = 1.47, ρ > .05,
one-tailed). Further, no correlation between recipients’ self-rated belief that one
person could heal another through means other than conventional medicine and their
LOT scores was found (r(17) = .09, ρ >.05, two-tailed).
4.0 Discussion
Two independent groups of recipients were subjected to distant Reiki for a total of 21
days each. Reiki was supplied by two independent groups of Reiki channels. The
efficacy of Reiki was assessed using a subjective overall well-being rating scale, the
RSE, GHQ-12, CES-D and both the PA and NA components of the PANAS. In
addition, the LES was also administered to potentially provide an alternative
explanation to Reiki for any observed changes on those measures. Those instruments
were administered to all recipients at three times throughout the study; before any
group had received Reiki (Time “0”), after Group 1 had received Reiki but Group 2
had not (Time “1”) and after Group 2 had received Reiki while Group 1 had ceased to
receive Reiki (Time “2”, see Figure 1 in section 2.3). A split-half, double-blind
experimental design was used which ensured neither recipients nor researchers knew
when an individual would receive Reiki energy, from whom they would receive that
energy or how much energy they would receive. Recipients were also unaware of the
time period over which they would receive Reiki energy (i.e. 21 days). The design
also resulted in neither group of recipients nor channels knowing of the existence of
the other groups.
50
Results of repeated measures ANOVA on the efficacy measures used found that in
excess of 1690 hours of Reiki did not significantly influence the perceived overall
well-being or mood of recipients in this study on any of the measures used and, in
fact, recipients were at their most positive before experiencing any Reiki. A number
of explanations can be advanced to account for that result.
In seeking to establish a “treatment” effect it is usual to undertake preliminary work to
assess the upper and lower limits of that treatment. In a drug trial for example,
preliminary work would establish the frequency of administration and dosage of the
drug that would prove harmful (the upper limit) as well as the frequency and dosage
required to provide any benefit at all (the lower limit). The trial would then be
conducted using administration/dosage data selected from within those limits. Time
constraints prevented such preliminary work being undertaken in this study and so
there may simply have been too little Reiki energy supplied over the 21-day treatment
periods to produce a noticeable effect on the measures used (Reiki channels believe
there can be no harmful effects associated with Reiki so establishment of an upper
limit is unnecessary).
If enough Reiki energy had been supplied, testing of recipients may have been
curtailed before sufficient time had elapsed to allow any effects to manifest. That is,
the effects of Reiki may have required some time to “incubate” before achieving a
sufficient level to be detected on the measures used in this work and the research may
have unwittingly been concluded before that time had elapsed. The lack of significant
effect even 21days after cessation of Reiki on Group 1 (ie no significant difference in
results between Times “1” & “2” for that Group) indicates that, for the recipients and
51
measures used in this study, an incubation time in excess of 21 days may have been
required.
Surprisingly, the issue of “dosage” (i.e. how much Reiki energy is needed to produce
a noticeable effect for a given condition) and “incubation time” (i.e. how soon after
administration the effect of that dose manifests) has not been systematically
addressed. Research involving Reiki seems to assume that the amount of Reiki
energy supplied during the study will be sufficient for the task at hand and, in the
main, its effects will be immediate. Indeed, in the current study the amount of Reiki
energy supplied by individual recipients over a 21-day period ranged from 2 minutes
to 30240 minutes (mean time = 928.15 mins, std. dev. = 3826.38) even though
channels were unaware of the exact nature of the dependent variables. Nonetheless,
71% of channels were at least 90% sure the experiment would find a positive effect.
Mansour et al (1999) reported some recipients in their study experiencing sensations
such as “heat” or “tingling” at the conclusion of two, 15-minute Reiki sessions1.
Schlitz and Braud (1985) looked for changes in recipients’ autonomic activity
immediately following ten, 30 second Reiki “influence periods” while Alandydy and
Alandydy (1999) claim one, 15-minute Reiki treatment both before and after surgery
to benefit patients. Wardell and Engebretson (2001) in their study of biological
correlates with Reiki, reported significant changes in systolic blood pressure and
salivary immunoglobulins (IgA) levels as well as a significant reduction in anxiety (as
determined by the State-Trait Anxiety Inventory) directly after recipients experienced
a single 30-minute Reiki session. Shiflett et al (2002) sought to assess the 1 Only one participant in this study reported any sensation at all - one of “feeling very gratified that someone was trying to do Reiki on me” and that “someone had a positive intent towards me”- but had received no Reiki at the time.
52
effectiveness of Reiki as an adjunct to standard rehabilitation for stroke patients using
a maximum of 10, 30-minute Reiki treatments over a 2 ½ week period. None of the
researchers had attempted to establish the correct “dosage” for their particular study
and most assumed a more-or-less immediate effect although Mansour et al (1999) felt
that some of the effects of Reiki in their study may be have been accumulative and
Shiflett et al (2002), upon finding no short-term effect, postulated a longer term
impact of Reiki may have occurred but had not undertaken work to investigate that
contention.
In light of the reported changes resulting from Reiki treatments totalling a matter of
minutes to some 3 hours as assessed immediately after treatment or, at the latest, 2 ½
weeks later, it is difficult to conclude that a “dose” of some 313 to 1697 hours of
Reiki experienced by recipients in this study was insufficient to produce a detectable
change on parameters purportedly responsive to Reiki (eg depression, affect, well-
being) and that the selected incubation times - immediately after cessation of Reiki for
both Groups 1 and 2 and 21 days later for Group 1- were inadequate. Other factors
giving rise to the observed lack of effect must be considered with one such factor
being statistical power.
The statistical power of a test has been defined as “… the probability we reject the null
hypothesis when we should have rejected it.” (Johnson, 1988, p.541) and is dependent
on aspects including the level of significance, the difference between the two means
being tested (i.e. the effect size) and the sample size (Johnson, 1988; Ferguson &
Takane, 1989). If sufficient Reiki energy had been supplied and the duration of the
trial were long enough to allow effects to manifest, the combination of medium
53
treatment effect size and small sample size may have resulted in the statistical power
of the repeated measures ANOVA’s used to examine the data being too small to allow
for detection of any but the largest treatment effects. Smaller but significant effects,
while having possibly occurred, may simply have gone undetected by those tests.
Indeed, power calculations indicate the chances of rejecting the null hypothesis that
there would be no difference across time on the measures used to assess the efficacy
of Reiki in this study to be 34% at the .05 level of significance (see Appendix 1). It
should be noted however that some effects were observed in this study indicating the
power was not completely inadequate.
The findings of Astin, Harkness and Ernst (2000) provide a means of approximately
determining the sample size required to ensure a power of .8 in the current study i.e.
the sample size required to have an 80% chance of detecting an effect of Reiki across
time if such an effect really existed. Astin, Harkness and Ernst (2000) reported an
average effect size across ten positive/no-effect studies involving Therapeutic Touch
of d = 0.63 (ρ = 0.003) and an average effect size of d = 0.38 (ρ = 0.073) for five
studies involving other forms of distant healing including Reiki. Averaging those
values results in a value for d of .50. Using appropriate power tables and taking α =
.05, we find a sample size of 41 recipients would have been required to achieve a
power of .8 in the current work (see Appendix 1).
Issues with power are not uncommon in studies involving CAM. Shiflett et al (2002)
for example in their pilot study on the effect of Reiki in poststroke rehabilitation,
chose a sample size of 50 in order to achieve a statistical power of .80 in attempting to
detect an 8 to 10 point difference on their primary measure (the Functional
54
Independence Measure), but without success. Astin, Harkness and Ernst (2000)
attribute inadequate sample size/low statistical power to negative findings in many of
the distant healing studies they reviewed.
The test/re-test interval may have also detrimentally contributed to the results
obtained. The increased correlations observed between Times “0” and “1” and
between Times “1” and “2” for all but one of the measures used to assess the efficacy
of Reiki in this work indicates the test/re-test interval to have been too short.
Recipients appear to have responded to subsequent administrations of the
questionnaires by remembering their answers to previous administrations rather than
according to their situation at the time.
A possible factor confounding detection of any treatment effects attributable to Reiki
in this study may have arisen from a re-structure in the organization from which most
participants were recruited, that occurred over the duration of this work. Quite by
chance significant milestones in that re-structure coincided with Times “0”, “1” and
“2”. Announcement of the re-structure, which was to include a sizable reduction in
staff numbers, was made during the week recipients were asked to complete and
return the Time “0” questionnaires. Some recipients had returned their questionnaires
before the announcement and so were unaware of the impending staff reduction while
others returned their questionnaires after. In the weeks that followed more details of
the new structure emerged including information as to which areas of work were no
longer required and which would be scaled down. At Time “1” then some recipients
knew there would be no job for them in the new structure while others were unsure
with both groups applying for positions both within and outside of the organization
55
and waiting to hear if they were successful. By Time “2” allocation of staff to the
new structure was all but complete with some recipients finding employment within
that structure, others finding employment elsewhere while the remainder faced
redundancy and/or on-going employment uncertainty.
Loss of employment is recognised as a primary psychological stressor and has been
linked to depression and lowering of self-esteem (Guindon & Smith, 2002; Hanisch,
1999). Recipients undoubtedly experienced varying degrees of uncertainty regarding
their employment status at critical times over the course of this work with that
uncertainty potentially confounding the depression/mood/self-esteem measures used.
Most employees undeniably viewed the announcement of potential loss of
employment at Time “0” as negative however some may have held a contrary view.
Two employee recipients for example, were within three years of their retirement age
and one had exceeded it raising the possibility that redundancy, with its associated tax
effective payment, may have been viewed as positive by those people. Further, one
employee recipient aged 36 and so many years from retirement, responded
affirmatively and positively to item 14 of the LES (“New job”) at Time “0”
suggesting they may have viewed the re-structure as an opportunity to take their
redundancy payment and “move on”. Some evidence to support the view that not all
recipients viewed the announcement of impending redundancies as negative can be
found in the Positive Affect sub-scale of the PANAS which showed recipients to have
been most positive at the commencement of the study, although a contributing factor
to that may also have been that at Time “0” some recipients had returned their
questionnaires before being aware of potential job loss.
56
Further confounding the measures used to assess the efficacy of Reiki in this work is
the likelihood that the level of certainty regarding employment within or outside of
the organization varied over the duration of the study among recipients who did not
consider redundancy as positive, resulting in varying levels of depression, self-esteem
and positive/negative affect. Figure 2 indicates that employee recipients in this study
did indeed exhibit differing patterns of negative affect over the course of this work
that doubtless impacted on their level of depression and their self-esteem. Those
variations in employee recipients views towards redundancy and in their level of
employment certainty as the re-structure progressed, appears to have resulted in an
“averaging” effect giving rise to the observed lack of effect for “Time” on the CES-D,
GHQ-12, RSE and both LES scales at Times “0”, “1” and “2”.
The inconclusive finding that Group 1 recipients possibly experienced significant and
increasing negative affect as the study unfolded can perhaps be explained in terms of
the composition of that Group. As indicated in Table 1, Group 1 consisted
predominately of males (6 male, 3 female) and was made up of 7 employees and 2
immediate family members. Increasing negative affect associated with possible
redundancy and uncertainty regarding future employment in a group containing a high
proportion of both males and employees (i.e. Group 1) is not unexpected.
No explanation is advanced to account for the inconclusive finding that Group 2
recipients possibly experienced decreasing negative affect over the course of this
investigation. It is of interest to note however, that Group 2 recipients appeared to
57
display decreased negative affect after the application of Reiki whereas Group 1
recipients showed increased negative affect following their exposure.
In this study then no significant effect of distant Reiki was found on recipients’
subjective perceived overall well-being, level of depression, self-esteem or their
experience of positive or negative affect after having received at least 1697 hours of
Reiki energy over a period of 21 days. Too small a “dose” of Reiki energy to effect
change and/or inappropriate incubation times have been advanced as possible
explanations. The small number of recipients in the study raised concerns of poor
statistical power (calculated to be .34) possibly resulting in any small but significant
effects that may have occurred simply going undetected. Calculations indicated at
least some 41 recipients would be needed in order to detect the modest changes
reportedly associated with energy therapies at the 0.05 level of significance and future
work duplicating the experimental design used here should aim to involve at least that
number. The 21-day test/retest interval also appears to have been problematic with
evidence that recipients may have responded to questionnaires “from memory” rather
than in a manner truly indicative of their situation at the time of administration.
Additionally, and specific to this work, was the untimely announcement of an
organisational restructure coinciding with, and unfolding during, the trial period that
undoubtedly introduced confounding effects on the very psychological measures the
study utilised as dependent variables.
As a consequence of the above, no firm conclusions regarding the efficacy of Reiki
distant healing can be derived from this study and it is doubtful the efficacy of Reiki
(distant or otherwise) can be established by any study involving a scientific method.
58
Unlike other energy therapies, Reiki practitioners believe that the universal life force
energy they are able to channel has an innate ability to automatically target that aspect
of the patient where treatment is most needed, be it physical, psychological, emotional
or spiritual. That philosophy confounds application of a scientific method. Consider
for example, an experiment designed to assess the efficacy of Reiki in the treatment of
depression. The philosophy allows for a “no effect on depression by Reiki” result to
be re-interpreted as the researchers assuming the patients’ primary problem was their
depression when, in fact, they may have been developing a life threatening kidney
condition of which neither they, nor the researchers, were aware. Owing to Reiki’s
innate ability to target that aspect of a patient that will result in the most good,
practitioners would argue that it was the kidney condition rather than the depression
that was successfully treated by Reiki. Finding perfectly healthy kidneys upon
subsequent testing could then be interpreted as “proof” that Reiki had indeed worked
and that the researchers had merely looked for its effects in the wrong place.
Confirming or failing to confirm such a claim is extremely difficult and is made even
more so by the two other domains not included in this example that practitioners
could argue were positively influenced by Reiki (i.e. the emotional and spiritual
domains) had the researchers only bothered to look.
In addition to philosophical issues, the problem of establishing the efficacy of Reiki is
further compounded by some of the methodological issues identified in this work. In
the absence of any guidelines to the contrary, channels could argue that a “no effect
on depression by Reiki” result (continuing on with the previous example) could be
attributable to improper dosage and/or poorly selected incubation time(s) as well as
59
possible memory/practice effects associated with repeated test-taking while seeking to
establish if any effects had manifest yet. In light of the combination of philosophical
and pragmatic issues associated with Reiki it is difficult to envisage how an efficacy
study could be constructed to both overcome those issues while simultaneously
meeting the requirements of a scientific method.
The second stated goal of this study was to attempt to shed some light on possible
psychological factors influencing personal choice in favour of CAM and it is to that
goal that we now turn.
Results indicated users (and non-users) of CAM in this work were generally well-
educated, white-collar professionals on above average salaries consistent with
recipients in other studies on CAM. Users of such medicine in this work were found
to hold no stronger belief in extra-sensory phenomenon than non-users nor were they
more aware, and hence more likely to notice and report on, either their emotional or
physical state. They did not display a habitual inclination to generally anticipate more
favourable outcomes than non-users nor did they visit conventional doctors any less.
Further, they did not hold different attitudes towards conventional doctors and
medicine and were no more involved in their treatment by conventional medical
practitioners than non-users. The only significant difference between users and non-
users of CAM found in this study was that users more strongly believed in the power
of CAM to heal than non-users. In light of these findings it is hypothesised the appeal
of CAM may be related to cognitive dissonance.
60
Since some CAMs (eg Reiki) have philosophical underpinnings and/or
methodological issues that make the scientific assessment of their efficacy difficult,
that lack of objective validation may contrast sharply with the plethora of subjective
claims as to their benefits (Engebretson, 1996; Kiernan, 2002; Lewis, 1999; Newshan
& Schuller-Civitella, 2003). It is proposed that the inability to discount such
medicines on scientific grounds on the one hand, conflicts with positive subjective
opinion on the other, producing a conundrum that cannot readily be resolved. The
resulting uncertainly leads to cognitive dissonance which those swayed by the lack of
scientific proof resolve by dismissing CAM on that basis (non-users). Those
sufficiently swayed towards subjective opinion on the other hand, reduce their
cognitive dissonance by attending both conventional and CAM practitioners (users).
Such people are simply unsure if CAM works but believe it might and so attend “just
in case”. Consistent with the findings of this work, such people would be expected to
more strongly believe in the power of CAM to heal than non-users, visit conventional
doctors the same amount, share similar attitudes towards those doctors and towards
conventional medicine and be no more involved in their treatment than non-users.
Contrary to earlier workers (Astin, 1998; Brill & Kashurba, 2001; Engebretson, 1996;
Ernst, 1993; Kaptchuk & Eisenberg, 1998; Kelner & Wellman, 1997) the appeal of
CAM to this group of users then is not hypothesised to involve empowerment,
authenticity, empathy, personalisation, counselling, a holistic emphasis on health or
better alignment with personal beliefs, values and health/life philosophies. It simply
involves uncertainty and a willingness to accept that modern science may not have all
the answers. It also suggests users of CAM are not an homogenous group, a view
shared by Kelner and Wellman (1997).
61
While attempts to quantify the effects of Reiki energy therapy in order to better
understand its potential usefulness in clinical applications (the first goal of this work)
proved inconclusive, attempts to shed some light on possible psychological factors
influencing personal choice in favour of CAM (the second goal) proved more fruitful,
identifying cognitive dissonance as a possible factor. Owing to the increasing usage
of CAM in the Western world, research into its efficacy should continue as should
attempts to better understand the psychological motivators behind its use. In view of
the limited funding available for health-related research, efficacy studies should first
focus on those CAMs whose philosophy is amenable to the scientific method. The
twin issues of dosage and incubation time are fundamental yet critical areas for future
researchers to address and should be a primary focus of attention. Future work should
also ensure adequate statistical power and possible test/retest issues are satisfactorily
addressed.
Complementary/alternative medicine may, ultimately, prove to be of little practical
value or alternatively, some of it may prove immensely beneficial. Rigorous and un-
biased scientific research is needed to establish its true benefit. As stated by Bobrow
(2003):
“Scientific advancement begins with an observation which cannot be explained
by existing schemata. Unexplained events are regularly reported in the medical
literature, and are a valuable substrate for research. Given the significant
number of patients who believe in them, our analytical attention to such
phenomena can, at the very least, allow us better communication with the
people we care for. Our colleagues’ reports and our patients’ beliefs deserve
attention, not a Procrustean fit into current paradigms.” (p. 868).
62
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