REIKI—REVIEW OF A BIOFIELD THERAPY
HISTORY, THEORY, PRACTICE, AND RESEARCH
Pamela Miles and Gala True, PhD
STATE OF THE RESEARCH LITERATURE ON REIKI
The preponderance of Reiki studies reported in the literature to date consists of a limited number of case reports, descriptive studies, or randomized controlled studies conducted with a small number of patients. This is in keeping with much of the current research on complementary therapies. For example, Ke and colleagues reviewed CAM studies from 11 American Medical Association journals, and found that one third of the studies were traditional or narrative reviews and one fifth were randomized, controlled trials.48 Although few of the published studies of Reiki are randomized controlled trials, it is important to review this literature in order to understand the context of current practice patterns of Reiki and to plan future research from health services research to randomized controlled trials. Because of parallels between Reiki, Therapeutic Touch, and distant healing such as intercessory prayer, these modalities have sometimes been studied together, further confounding the ability to evaluate the separate effects of these therapies. Relevant randomized, placebo-controlled studies looking at Reiki in combination with these other forms of energy healing will be included here.
Randomized controlled studies of Reiki and other
energy healing and distance therapies.
Astin and colleagues undertook a systematic review of randomized trials of any form of “distant healing,” defined as “strategies that purport to heal through some exchange or channeling of supraphysical energy.”49 This review included randomized placebo- controlled studies of Reiki, and it is worth reviewing selected findings. Through an electronic review of MEDLINE, PsychLIT, EMBASE, CISCOM, and Cochrane Library databases, the researchers identified 23 trials involving 2774 patients. Only studies that included random assignment and placebo or other control were included in the analysis. Studies were also limited to those published in peer-reviewed journals and which were clinical, rather than experimental in nature.
Astin et al identified over 100 clinical trials of distant healing, with 23 meeting the criteria outlined above. These studies were broken down into 3 subcategories: distant healing including Reiki, prayer, and Therapeutic Touch. Each study was evaluated for methodological quality using Jadad’s guidelines on method of randomization, description and method of placebo-control, and description of withdrawals and dropouts.50 Each study was also evaluated as to whether or not it was adequately powered and whether randomization was successful. The effect size for other distant healing which included Reiki was 0.38, (P=0.073), for prayer the effect size was 0.25 (P=0.009) and for Therapeutic Touch the effect size was 0.63 (P=0.003). Effect sizes were also calculated for the 16 studies in which both patient and evaluator were blinded, which yielded an effect size (0.40, P<.001). In a series of studies beginning in the early 1990s, Wirth and his colleagues investigated the efficacy of Reiki, in combination with various other forms of energy and distance healing, on pain after extraction of the third molar;51 wound healing;52 hematological measures;53 and multi-site surface electromyographic measurements (sEMG) and autonomic measures.54 Wirth demonstrated significant reduction in pain and blood urea nitrogen (BUN) and a trend toward normalization of blood glucose for those subjects who had higher than normal levels.53
Mansour and colleagues undertook a study to evaluate whether subjects and independent observers could be successfully blinded to “sham” versus “real” Reiki.55 The study used a 4- round, crossover experimental design with 20 blinded subjects (12 college students, 4 breast cancer survivors, and 4 observers). Two Reiki practitioners were recruited, and 2 “actors” who closely resembled them were trained in the movements of Reiki.33 Subjects received consecutive treatments from 2 different practitioners during each round of the intervention. The following combinations of practitioners were used: Reiki plus Reiki, or placebo plus placebo, or Reiki plus placebo, or placebo plus Reiki. The subjects were asked to evaluate the interventions and guess which treatments were administered by a real Reiki practitioner and which by a placebo Reiki practitioner. None of the subjects accurately distinguished the Reiki practitioners from the placebo practitioners, suggesting that studies using hands-on Reiki therapy can be blinded. These findings support the work of Ai and colleagues, who reported successful blinding of patients and independent observers in the use of placebo versus real Qigong therapy.56 Another interesting finding from the Mansour study came from subjects’ self-report of “sensations,” such as tingling and heat, that were experienced during each round of treatment. Subjects indicated that these sensations were most intense during the second round of the intervention, when they received Reiki plus Reiki. The investigators noted this might suggest a cumulative Reiki effect.55
Finally, a study by Shiflett et al15 used a modified doubleblind placebo control design to investigate effects of Reiki on 50 subacute ischemic stroke patients. Ten patients were treated by a Reiki master, 10 were treated by practitioners trained in First degree, and 10 were treated by “sham” practitioners who had been trained in Reiki techniques but had not received initiation into Reiki. An additional 20 historical control subjects identified through hospital records were used as a no-treatment comparison group. Results showed no evidence of short-term benefit in terms of functioning or depression, as measured by standardized instruments. However, the authors note that data on long-term and cognitive change were not available, and so it was not possible to measure the potential impact of Reiki on these dimensions.
Exploratory studies of physiological changes associated with Reiki.
One study by Wetzel, investigated the hypothesis that touch therapies increase oxygen-carrying capabilities as measured through changes in hemoglobin and hematocrit values.57 Wetzel measured changes in these values over a 24-hour period, during which the intervention group, 48 essentially healthy adults, participated in Level I Reiki training. The intervention group demonstrated significant changes in both hemoglobin and hematocrit values, as compared to a small control group of 10 healthy medical professionals, which demonstrated no change.
Wardell and Engebretson used a single group repeated measure design to study the effects of 30-minutes of Reiki on 23 healthy subjects.58 Data on biological markers related to the stress reduction response, including state anxiety, salivary IgA and cortisol, blood pressure, galvanic skin response, muscle tension, and skin temperature were collected before, during, and after the Reiki session. Results indicated biochemical changes in the direction of increased relaxation and immune responsivity, with significant reduction in state anxiety, drop in systolic blood pressure, and increase in salivary IgA levels. There was a non-significant reduction in salivary cortisol, which has been linked to longevity in breast cancer survivors.59
Brewitt, Vittetoe, and Hartwell studied 5 patients with a variety of chronic illnesses (multiple sclerosis, lupus, fibromyalgia, and thyroid goiter) who received 11 Reiki treatments over a 9- week period.60 They measured changes in electrical skin resistance at over 40 sites corresponding with acupuncture/conductance points, and collected patient reports of anxiety, pain, and mobility. Significant changes occurred at 3 skin points corresponding to acupuncture meridians, and patients also reported increased relaxation, reduced pain, and increased mobility. While results may have been biased by the lack of prior hypotheses regarding which specific points would be active, the study suggests interesting directions for future research.
Descriptive and phenomenological studies.
A number of recent observational and descriptive studies have focused on the effects of Reiki in reducing pain and increasing relaxation and a sense of well-being in patients. In 1997, Olson and Hansen investigated the impact of Reiki on chronic pain using a pre- and post-test design and validated self-report measures. Twenty volunteers who experienced chronic pain from a variety of causes, including cancer, demonstrated a significant decrease in pain after receiving a single 75 minute Reiki session.61This study is limited by its design and the existence of a number of potentially confounding variables, but it does point to possible clinical applications of Reiki that should be studied further.
The Windana Society in Melbourne, Australia has operated a Reiki clinic for more than 10 years and provides holistic care to clients who are undergoing treatment for withdrawal from drugs and alcohol.62 The staff reviewed clinical records and conducted a client survey. Both clients and staff attribute a number of client outcomes to Reiki therapy, including reduced pain and improvements in clients’ sleep patterns, mood, and clarity of thinking. Their data supports the hypothesis that Reiki promotes a greater sense of self-awareness and connectedness, and brings profound relaxation. Clients described Reiki as bringing them a sense of peace and well-being that enabled them to continue with their recovery and enhanced their counseling sessions.
The heightened state of awareness and sense of inner peace and calm reported by clients at Windana were also identified as a major theme in qualitative data collected by Engebretson and Wardell.58 Subjects expressed feelings of safety and perceived relationship with the practitioner. Some also described what the authors defined as a liminal state of consciousness, hovering between awareness and sleep. The authors noted that such liminal states are often associated with spiritual experiences and cross-cultural ritual healing practices. They propose that the subjective nature of the experience may be related to its effectiveness and that commonly used research methods may lack the complexity needed to capture the non-linearity of the subjects’ experience. Incorporating these viewpoints is essential to the effective design of future studies of Reiki. The sense of connectedness felt by the above subjects towards an unfamiliar practitioner is of interest in light of studies that have identified practitioner-patient bonding as an important factor in healing.63 Descriptive and qualitative data provide us with important insights into the perceived benefits of Reiki from the viewpoint of those who use it in a real world healthcare setting.
DIRECTIONS OF FUTURE RESEARCH
Although it comes mostly from descriptive studies or randomized controlled trials with design limitations, evidence of the beneficial effects of Reiki makes a compelling case for the need for further research. Future studies to identify possible mechanisms should build upon work already done and be informed by emerging theories in the physical sciences. At the same time, it is critical to undertake well-designed studies of specific biological effects, as well as potential clinical benefits of Reiki.
In the case of biofield therapies, it is important to understand what practitioners consider to be essential to the transmission of healing energy. In Reiki, it is initiation and passive vibrational flow rather than intention that is essential and this explanatory model should be taken into account. Involving practitioners who are knowledgeable regarding the theory and practice of Reiki and familiar with the methods and constraints of scientific inquiry in the earliest stages of study design will greatly enhance the quality of research.
A greater incorporation into CAM research of qualitative methods and mixed methodological design (where qualitative methods are used to expand upon and elucidate findings from quantitative data) would be useful in research in energy medicine.46,-64-65 Thus, for example, if qualitative and descriptive data described above tells us that recipients of Reiki report greater self-awareness, feelings of “centeredness,” and overall well-being, then these are important outcomes to try to measure, even if associations between these “patient-centered” outcomes and “clinically meaningful” outcomes, such as improvement in function or greater receptivity to therapeutic counseling, are difficult to measure. Randomized, controlled trials may not be the ideal strategy in cases where the outcomes being measured are related to chronic disease with uncertain trajectory, or where the treatment being investigated is not easily standardized or consists of multiple components.66
Further research using objective markers to track response to an intervention may be able to use cutting edge genetic tools such the TheraTrak gene and protein expression system from Source Precision Medicine (Boulder, CO).67 Here a patient’s blood is mixed with a panel of highly sensitive and calibrated inflammatory genetic markers that track a patient’s response to a therapeutic intervention (such as Reiki) in much the same way we have historically used a patient’s hematocrit to track response to iron supplementation. Currently, 3 studies of Reiki funded by NCCAM are in progress. One at the University of Michigan is investigating the use of Reiki for patients with diabetic neuropathy. A second study at Albert Einstein Medical Center in Philadelphia examines the use of Reiki to improve quality of life and spiritual well-being for patients with advanced HIV/AIDS.70 The third, a study for patients with fibromyalgia, is being conducted out of the Department of Family Medicine of the University of Washington School of Medicine.69 Whereas biofield therapies such as Reiki, Qi gong and Therapeutic Touch may themselves have different mechanisms of action, they all share with meditation the effect of moving the system in the direction of relaxation, which has been linked to health and healing. Research that builds on this commonality would advance our understanding of the process of healing while offering patients and clinicians the choice as to which technique is the best match for a particular situation or individual.
Many CAMs, and subtle energy therapies in particular, aim to relieve suffering, restore balance, and return each person to wholeness. The standards of replicability and generalizability so central to the scientific paradigm can be at odds with the inherent individualization of actual Reiki practice and treatment. However, the fact that so many people adopt Reiki as a spiritual and healing practice and so many more seek treatment from a Reiki provider, means that we must find ways to study its potential benefits and applications. Research using currently available and emerging methods will provide us with data about possible mechanisms, but more importantly, we must investigate how Reiki might benefit patients, and in what specific areas. The experiences and reports of Reiki's benefits from patients, healthcare providers, and Reiki practitioners require that we do so.
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