Biofield Therapies: Helpful or Full of Hype? A Best Evidence Synthesis

Shamini Jain & Paul J. Mills

Published online: 24 October 2009
# The Author(s) 2009. This article is published with open access at Springerlink.com

Abstract

Background Biofield therapies (such as Reiki, therapeutic touch, and healing touch) are complementary medicine modalities that remain controversial and are utilized by a significant number of patients, with little information regarding their efficacy.

Purpose This systematic review examines 66 clinical studies with a variety of biofield therapies in different patient populations.

Method We conducted a quality assessment as well as a best evidence synthesis approach to examine evidence for biofield therapies in relevant outcomes for different clinical populations.

Results Studies overall are of medium quality, and generally meet minimum standards for validity of inferences. Biofield therapies show strong evidence for reducing pain intensity in pain populations, and moderate evidence for reducing pain intensity hospitalized and cancer populations. There is moderate evidence for decreasing negative behavioral symptoms in dementia and moderate evidence for decreasing anxiety for hospitalized populations. There is equivocal evidence for biofield therapies’ effects on fatigue and quality of life for cancer patients, as well as for comprehensive pain outcomes and affect in pain patients, and for decreasing anxiety in cardiovascular patients. Conclusion There is a need for further high-quality studies in this area. Implications and future research directions are discussed.

Keywords: Biofield, Therapeutic touch, Qigong, Pain, Cancer, CAM

Introduction

The concept of subtle energy and methods of its use for healing has been described by numerous cultures for thousands of years. These vital energy concepts (which include the Indian term prana, the Chinese term ch’i, and the Japanese term qi) all refer to so-called subtle or nonphysical energies that permeate existence and have specific effects on the body-mind of all conscious beings. Similar concepts in the West are reflected in the concepts of Holy spirit, or spirit, and can be dated back to writings in the Old Testament as well as the practice of laying on of hands [1].

Despite differences in ontologies of these proposed forces, a common thread within their theories is the development of specific techniques that purport to use subtle energy to stimulate one’s own healing process. These are clearly reflected in internal (intrapersonal), movement- oriented practices such as yoga, tai-chi, and internal qi-gong, for example; and are often noted as part of the experience of meditation and prayer. In addition, different cultures have developed external (interpersonal) practices that purport to specifically use subtle energies for the process of healing another. These include local or proximal practices such as external Qigong, pranic healing, and laying on of hands, where a healer transmits or guides energy to a recipient who is physically present; as well as distance practices where a healer sends energy to a recipient in a different physical location, such as intercessory prayer or distance healing.

Although many of these practices have been used over millennia in various cultural communities for the purpose of healing physical and mental disorders, they have only recently been examined by current Western empirical methods. The impetus for the research in the West is likely due to a resurgence of public interest in some of these modalities, such as therapeutic touch, healing touch, and Reiki. These modalities, collectively termed by the National Center for Complementary and Alternative Medicine as biofield therapies1, began to be more widely taught and used by U.S. nurses in many clinical and hospital settings starting in the 1970s. Concurrently, patient demand and utilization of these modalities outside of conventional medicine settings have prompted scientists and clinicians to examine more closely these so-called healing techniques and their claimed effects. However, such studies are still in their infancy, in part due to the dearth of research funding in this area to conduct large-scale randomized controlled trials (RCTs) of biofield therapies.

Despite the lack of scientific study of biofield ther- apies, they are actively used by patients with or without the knowledge of their physicians and with or without information based on scientific studies. A survey from the National Center of Health Statistics estimated that over 5% of respondents had used Reiki, Qigong, or healing rituals [2]. Within clinical populations, energetic and spiritual healing is notably highly used as complementary medicine by cancer, pain, and palliative care patients [2–9].

This review integrates a variety of published studies with different biofield therapies for the purpose of systematically examining whether such modalities might affect positive outcomes for health and reduction of disease symptoms. The review combines clinical studies that examine the efficacy of biofield-based modalities as they are used proximally (i.e., with the patient and practitioner in the same room). Several recent reviews have examined the literature surrounding a specific biofield-based technique while excluding others [10–14]. Other more integrative reviews have included distant healing and nonhuman populations [15] and/or have been of a purely descriptive nature [16]. In this review, we examine study quality of the current literature, provide a best evidence synthesis of studies with specific clinical populations, and discuss methodological issues as well as directions for future research.

Method

Methodological details for this review were performed according to QUORUM checklist guidelines and are listed below.

Search Strategy

A literature search for clinical studies in biofield modalities was conducted using the PUBMED, PSYCINFO, AMED, and CINHAL databases. “spiritual healing,” “subtle ener- gy,” “energy healing,” “biofield healing,” “external qi therapy,” “emitted chi,” “emitted qi,” “qi-therapy,” “Joh- rei,” “pranic healing,” “polarity therapy,” “Reiki,” “thera- peutic touch,” and “healing touch.” In the case where a multitude of nonclinical studies or articles not related to the subject matter appeared (e.g., the keywords “therapeutic touch” in PUBMED yielded 576 publications), search terms were narrowed to include only clinical studies (e.g., a search with “therapeutic touch” with the limit of “clinical trials” yielded 62 publications). Reference sections of eligible studies and other review papers were also searched for additional studies.

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