Therapeutic Touch: The Imprimatur of Nursing

Author(s): Dolores Krieger

Source: The American Journal of Nursing, Vol. 75, No. 5 (May, 1975), pp. 784-787
Published by: Lippincott Williams & Wilkins
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 Therapeutic Touch:
The Imprimatur ofNursing
Research by the author
showed that the laying-on of
hands with the intent to heal
raised hemoglobin levels in
ill persons.
DOLORES KRIEGER
Therapeutic touch by the laying-on
of hands looks absurdly simple but
is profoundly complex. The act con-
sists of the simple placing of the
hands for about 10 to 15 minutes on
or close to the body of an ill person
by someone who intends to help or
to heal that person. It is an ancient
practice, recorded in the hiero-
glyphics, cuneiform writings, and
pictographs of earliest literate cul-
tures, and it persists to this day.
However, it continues as it has been
throughout the centuries: a little-un-
derstood enigma of a signally human
interaction.
Touch is probably one of the most
primitive sensations. Neurologically,
touch and pain-two sensations one
is very much involved with when
helping ill people-are conducted by
the central nervous system fibers that
are myelinated earliest in the fetus.
One of the first sensations that the
newborn baby has, as he descends
through the birth canal, is that of
cutaneous stimulation. Devel-
opmental stages follow which derive
their certainty from a whole series of
DOLORES KRIEGER, R.N., PH.D., is a professor of
nursing at New York University, New York,
where she will be conducting a course this year
on human field interaction which focuses on
therapeutic touch.
784 MAY 1975
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touch experiences that evolve from
the first gropings of hand-mouth ex-
ploration that tell us of our world, to
the complexities of hand-eye coordi-
nations by which we make the world
our own. These functions, extending
from the far reaches of time, are
built into the very fiber of human
development throughout life.
It is perhaps because touch is so
primitive that it is so powerful a
therapeutic tool. For instance, one
can hardly imagine the most basic of
nursing skills being performed with-
out the act of touch. Indeed, touch
is, so to speak, the imprimatur of
nursing. Everyone, whether nurse or
therapist, family member or friend,
can look back on times when touch
was extremely meaningful in a per-
sonal way. I have on file over 100
first-person accounts from nurses in
this country and abroad which tell of
the spontaneous use of touch quite
unknowingly, or rather unknowl-
edgeably, during acts of nursing in-
tervention which brought therapeutic
results so unusual that they fre-
quently came as a surprise. It should
be noted, however, that even the most
renowned healers (and, I would sus-
pect, nurses) do not claim greater
than a 30 percent cure rate(l).
The therapeutic, comforting effects
of touch are such common occur-
rences that most people become all
but indifferent to them. Part of the
reason for this may lie in the strong
personal overlay that surrounds any
act of touch, whose subjective nature
understandably makes controlled
study difficult. This limitation, to-
gether with the development of mod-
ern medical technologies, has been
important in the progressive decline
throughout most of the twentieth
century in the practice of healing by
the laying-on of hands.
Early Studies
In the early 1960's Bernard Grad,
a Canadian biochemist, became in-
terested in this phenomenon. With
the cooperation of a renowned
healer, Oskar Estebany, he con-
ducted double-blind studies on mice
and on barley seeds(2-4). In the
former study, Grad selected 300
standardized mice and wounded
them all in a specific manner. One
third of the mice, used as a control
group, were allowed to heal without
outside intervention. Another 100
were treated by Estebany with the
laying-on of hands. The remainder
were held by medical students who
did not profess to heal. After two
weeks, healing in Estabany's group
had accelerated to a degree that
could have happened by chance less
than once in a thousand times.
In the double-blind study on bar-
ley seeds, Grad soaked the seeds in
saline solution to simulate a "sick"
condition, and then divided them
into groups, as in the experiment on
mice. The first control group was
watered by tap water, the second by
water from flasks held by dis-
interested persons, and the third
group (experimental group) was wa-
tered from flasks held by Estebany.
The seeds which were watered with
fluid from the flasks held by Este-
bany sprouted more quickly, grew
taller, and had more chlorophyll
than the seeds in the control groups.
In the late 1960's, another bio-
chemist and enzymologist, Sr. M.
Justa Smith, did further research on
AMERICAN JOURNAL OF NURSING
the laying-on of hands. Her basic as-
sumption was that if an energy
change occurs during healing, from
whatever means, the change should
be apparent at the enzymatic level,
for it is the enzymes that are crucial
to the basal metabolism of the body.
She developed a double-blind study
using the enzyme trypsin as the test
object and Estebany as the healer(5).
Trypsin solution was made fresh daily.
After dividing the trypsin solution
into four aliquots, she exposed one
fraction to high ultraviolet rays to
break the bonding sites and thus
simulate a "sick" condition. This
fraction and a second unaltered frac-
tion were held in flasks by Estebany
for 75 minutes a day. A third frac-
tion was kept in its natural state as a
control, and the fourth sample was
exposed to a high magnetic field.
During the first hour of each day of
the study, the sample held by Este-
bany and the sample exposed to the
high magnetic field demonstrated
similar qualitative and quantitative
effects, as demonstrated by graphs of
their daily relative percents of activ-
ity. Sr. Justa repeated these tests
with other healers and also used a
variety of other enzymes. Her con-
clusions were that the healer's ability
does not affect all enzymes the same
way-in fact, some are not affected at
all. However, within the context of
what enzymes do in the human
body, the substantive effects all seem
to contribute to improving or main-
taining health(5).
Observations
I became interested in research on
the laying-on of hands as a nurse.
Both the Grad studies and those of
Sr. Justa challenged me as a prac-
titioner, teacher, and nurse re-
searcher. However, because I am a
nurse, my concern is with the total
human being rather than the dis-
sociated enzyme, or plants, or ani-
mals. I have concentrated on human
studies to help clarify the underlying
bioenergetics in people who were
treated by the laying-on of hands.
Over several years I had an oppor-
tunity to use my nursing abilities
during the few weeks each year that
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Using her hands, the author
searches for temperature changes
or other energy differences as clues
to underlying pathology. Then she
concentrates therapeutic touch on
the diseased area.
Estebany visited the United States to
set up a temporary healing clinic
with Dora Kunz, a well-known ob-
server of paranormal healing(6). I
took case histories, checked vital
signs, and, in general, acted as a
nurse as the need arose. Many
people came from all over the coun-
try as patients. I was able to observe
their interactions with the healer
quite closely. What I saw was not
startling. The atmosphere was
friendly and quiet, and conversation,
when it occurred, was natural and
spontaneous. Estebany's touch was
light and relaxed. To a casual ob-
server it might have appeared that
nothing was happening. However, a
significant number of these patients
got better. Most of them had verified
medical histories and had been re-
ferred by physicians who, when the
patients returned for follow-up ex-
amination, confirmed their improve-
ment. Nothing in my previous expe-
rience had prepared me for these
findings, so I decided to study thera-
peutic touch in considerable detail.
Searching for the Relationship
An extensive search of the litera-
ture from Western countries, how-
ever, did not yield a clue to the
modus operandi of this healing pro-
cess. I have a considerable back-
ground in the study of comparative
religions, particularly the Eastern re-
ligions. so I reread material I had
come upon several years ago for
clues that might guide my search;
The East holds different assump-
tions about man and a different view
of the dynamics of human relation-
ships than the West. particularly
about the personal interaction that
occurs during the laying-on of hands.
The basis for this interaction be-
tween healer and subject is thought
to be a state of matter for which we
in the West have neither a word nor
MAY 1975 785
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The practice of therapeutic touch is a natural potential in
physically healthy persons who are strongly
motivated to help ill people.
a concept. In Sanskrit it is called
prana. Our nearest translation would
be vitality or vigor. Eastern literature
states that the healthy person has an
overabundance of prana and that the
ill person has a deficit. Indeed, the
deficit is the illness(7). Prana can be
activated by will and can be trans-
ferred to another person if one has
the intent to do so. The literature
also states that prana is intrinsic in
what we would call the oxygen
molecule(8).
As I pieced together the literature
and previous research findings, I re-
alized that my test object might well
be hemoglobin. Hemoglobin is the
oxygen-carrying pigment of the red
blood cells which transfers oxygen to
the tissues. I recalled that Grad's
studies on barley seeds showed an
increase in the chlorophyll content of
the sample that had been irrigated
with water that Estebany had held,
and that chlorophyll and hemoglobin
are tetrapyrroles and have a similar
stereochemical structure. Their major
differences are that the chlorophyll
molecule has magnesium atoms at its
center while the hemoglobin mole-
cule centers about iron atoms, and
that there are some differences in the
side chains. A second deduction,
based on Sr. Justa's findings that en-
zymes are sensitive to the laying-on
of hands, was that hemoglobin, both
in its biosynthesis and in its utiliza-
tion functioning, is involved with
several enzyme systems. Therefore, it
became apparent that studying he-
moglobin would be a valid method
to study the bioenergetics underlying
the laying-on of hands.
In 1971 I conducted my first pilot
study, using 19 ill persons in the ex-
perimental group and 9 ill persons in
the control group. The ages and
sexes of both groups were com-
parable. Estebany served as the
healer(9). My substantive hypotheses
were that the mean hemoglobin val-
ues of the experimental group after
786 MAY 1975
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treatment by the laying-on of hands
would exceed their before-treatment
hemoglobin values, and that the
mean hemoglobin values of the con-
trol group at comparable times
would show no significant difference.
My hypotheses were confined, the
former at the .01 level of confidence.
In 1972 I did a full-scale study, using
43 ill persons in the experimental
group and 33 ill controls. The groups
were comparable in sex and age dis-
tribution. Again the hypotheses were
confirmed at the .01 level of con-
fidence(10).
In 1973, I replicated my research
with 46 subjects in the experimental
group and 29 in the control
group(l 1). This time I was able to
-control for a number of possible in-
tervening variables which might af-
fect hemoglobin values, such as the
practice of meditation, breathing ex-
ercises by subjects who did yoga or
strenuous exercises, biorhythm
change, smoking (in reference to its
effect on carboxyhemoglobin), diet,
and medications. I also used a more
rigorous instrument to determine he-
moglobin values. My hypotheses
were again confirmed at the p.>.001
level of confidence in spite of firmer
control over the research design.
During these research studies, I
became convinced that healing by
the laying-on of hands is a natural
potential in man, given at least two
intervening variables that I think are
critical to the process: the intent to
help heal another, and a fairly
healthy body (which would indicate
an overflow of prana).
With the help of doctoral students
who observed and took notes of my
actions during the practice of thera-
peutic touch, I tried out these ideas.
As a result, I know that when I lay
my hands on or near an ill person
he has a subjective sense of heat in
the area that is ill or diseased, a
sense of relaxation and well-being,
and his hemoglobin values change
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following treatment. It can also be
stated that faith on the part of the
subject does not make a significant
difference in the healing effect.
Rather, the role of faith seems to be
psychological, affecting his accep-
tance of his illness or consequent re-
covery and what this means to him.
The healer on the other hand, must
have some belief system that under-
lies his actions, if one is to attribute
rationality to his behavior. Con-
vinced that the practice of therapeu-
tic touch is a natural potential in
physically healthy persons who are
strongly motivated to help ill people,
and that this potential can be actua-
lized, I conducted another study in
1974.
Nurses as Healers
More than 75 registered nurses in
metropolitan New York volunteered
to take part in this research as heal-
ers. However, because of the control
which I thought necessary for the re-
search design, only 32 nurses quali-
fied for inclusion in the study. The
more important delimitations were
that the participating nurse had to
secure the patient's informed con-
sent, and the cooperation and per-
mission of the patient's physician
and the health facility's department
of nursing. Where there was a board
of research review in the health fa-
cility, a formal request for approval
was presented, including materials
on the proposed research and papers
describing previous research.
Finally, nurses in the experimental
group had to use therapeutic touch
on a minimum of two patients. If
the nurse was in the control group,
she would do the simple touch re-
quired in routine nursing procedures
but refrain from using the therapeu-
tic touch involved in the laying-on of
hands.
All participating nurses were
taught methods of therapeutic touch
by me or by Kunz, who had been
my teacher. As an added precaution,
tape recordings of both teaching ses-
sions were compared for similarity.
I believe that there must be a
strong motivation in a healthy per-
son to help or to heal in order for
AMERICAN JOURNAL OF NURSING
 MEAN STANDARD SCORES OF 32 RN's ON 6 SCALES AND THE
SUPPORT RATIO OF THE PERSONAL ORIENTATION INVENTORY (POI)1
POI Scales Experimental (N = 16) Control (N = 16)
Inner directed
Self actualizing value 58.1 53.6
Spontaneity 57.3 55.9
Self-regard 55.9 53.1
Self-acceptance 48.7 47.9
Capacity for intimate contact 53.7 52.8
**Support
*On the adult norms for the POI, the mean standard score for these scales is 50,
with a standard deviation of 10.
**The ideal for self-actualizing persons is 1:3.
1Adapted from Shostrum, reference 13.
therapeutic touch to be effective. Be-
cause these qualities are found in
Maslow's concept of the self-actua-
lized person, all participating nurses
were asked to answer a forced-choice
questionnaire by Shostrum which is
designed to measure self-actualiza-
tion(12,13).
As the table shows, the means of
both groups exceeded or approached
the means for the self-actualized
sample on whom the test was stan-
dardized. Based on Shostrum's inter-
pretation, therefore, the general char-
acteristics of all nurses participating
in this study appeared to be inner
directed, independent, self-support-
ive, freely expressive of feelings, pos-
sessing a high sense of self-worth,
accepting of themselves in spite of
weaknesses, and having a positive
capacity for intimate contact. Fur-
thermore, an appropriate proportion
of their personal orientation was di-
vided between a sensitivity to the
opinions and approval of others and
an inner directedness which guided
their actions. These qualities, I be-
lieve. might well serve as a basic de-
scription of the humanistic nurse.
Pretest blood samples were drawn
from all patients included in the
study. Change in the mean hemoglo-
bin value following treatment by
therapeutic touch in the experimen-
tal group was chosen as the critical
variable that would indicate the dif-
ference of this mode of treatment.
Hemoglobin values were also deter-
mined at comparable times for the
patients in the control group so that
there were pre- and post-test hemo-
globin values available for both
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54.2 52.1
Ratio 1:3 1:2.8
groups. The laboratory technicians
were not told that a study was going
on and did not know that the
patients were in any way differ-
entiated from the rest of the health
facility's population. A further deli-
mitation was that only blood data
analyzed by the same apparatus
(Coulter) were included in the study;
otherwise there would have been
little basis for comparison of the
data.
To ensure basic comparability, the
pretest blood data of both groups of
patients were statistically analyzed.
No significant difference was found
between the means of the initial he-
moglobin values of the experimental
and control groups. This com-
parability also held for the mean age
and the proportion of either sex in
each group. Both age and sex have
important effects on hemoglobin.
The nurse experimental group
consisted of 16 registered nurses who
included treatment by therapeutic
touch while caring for their patients;
the control group included 16 regis-
tered nurses who gave nursing care
to their patients without using thera-
peutic touch. Each nurse worked on
two patients, for a total of 64
patients in the study.
The hypotheses were that follow-
ing treatment by therapeutic touch
the mean hemoglobin values of the
patients in the experimental group
would change significantly from their
pretest value and that there would
be no significant difference between
the pre- and post-test hemoglobin
values of the patients in the control
group. These hypotheses were sup-
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ported by statistical analysis (Fisher's
t Test for the Difference Between
Correlated Means) at the .001 level
of significance. For the control
group, the difference between the
pre- and post-test means was not sta-
tistically significant.
As technology and research grow
more sophisticated, research findings
of a previous day frequently are seen
to be but artifacts of a deeper real-
ity. I well realize that future studies
may relegate current research on he-
moglobin change as a function of
therapeutic touch to that category.
Nevertheless, the results of these
studies hold many significant infer-
ences for the broad spectrum of
nursing. There is need for deeper
studies on therapeutic touch and
serious discussion of these inferences.
I invite the reader to the dialogue.
References
1. Harry Edwards, quoted in HAMMOND,
SALLY. We are All Healers. New York, Har-
per and Row, 1973, p. 129.
2. RORVIK. D. M. The healing hand of Mr. E.
Esquire 81:70, 154, 156, 159-160, Feb. 1974.
3. GRAD, BERNARD, AND OTHERS. The influence
of an unorthodox method of treatment on
wound healing in mice. Int.J.Parapsychol.
3:5-24, Spring 1961.
4 GRAD, BERNARD. A telekinetic effect on
plant growth, Part 2. Experiments involving
treatment of saline in stoppered bottles.
Int.J.Parapsychol. 6:473-498, Autumn 1964.
5. SMITH, SISTER M. J. Paranormal effects on
enzyme activity. Hum.Dimensions 1:15-19,
Spring 1972.
6. KARAGULLA, SHAFICA. Breakthrough to
Creativity. Los Angeles, DeVorss and Co.,
1967. pp. 123-146.
7. GOVINDA, A. B. Foundations of Tibetan Mys-
ticism. London, Rider and Co., 1969,
pp.122, 137, 148, 150-159.
8. ATHAWA-Veda, Hymn to Prana. IN Prashno-
panishad, verse XI, line 47.
9. KRIEGER, DOLORES. The response of in-vivo
human hemoglobin to an active healing
therapy by direct laying-on of hands.
Hum.Dimensions 1:12-15. Autumn 1972.
10. . The relationship of touch, with in-
tent to help or to heal. to subjects' in-vivo
hemoglobin values: a study in personalized
interaction. IN American Nurses' Association
Ninth Nursing Research Conference, held at
San Antonio. Tex., Mar. 21-23, 1973. Kan-
sas City, Mo.. American Nurses' Associa-
tion, 1974, pp. 39-58.
11. Healing by the laying-on of hands
as a facilitator of bioenergetic change: the
response of in-vivo human hemoglobin.
Psychoenergetic Systems, Vol. 3, number 3,
1974.
12. MASLOW, A. H. Motivation and Personality.
New York. Harper and Brothers, 1954.
13. SHOSTRUM. E. L. Personal Orientation In-
ventory Manual. San Diego, Calif., Educa-
tional and Industrial Testing Service, 1966.
MAY 1975 787