Psychological factors and the perceived efficacy of Reiki ... · Psychological factors and the...

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

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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).

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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

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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



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


33195 6946


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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