Early reviews of the scientific literature on energy healing were equivocal and recommended further research,* but more recent reviews have concluded that there is no evidence supporting clinical efficacy.* The theoretical basis of healing has been criticised,* research and reviews supportive of energy medicine have been criticised for containing methodological flaws and selection bias* and positive therapeutic results have been dismissed as the result of known psychological mechanisms.*
Edzard Ernst, lately Professor of Complementary and Alternative Medicine at the University of Exeter, has warned that "healing continues to be promoted despite the absence of biological plausibility or convincing clinical evidence ... that these methods work therapeutically and plenty to demonstrate that they do not."* Some claims of those purveying "energy medicine" devices are known to be fraudulent* and their marketing practices have drawn law-enforcement action in the U.S.*
HistoryThere is a history of association or exploitation of scientific inventions by individuals claiming that newly discovered science could help people to heal: In the 19th century, electricity and magnetism were in the "borderlands" of science and electrical quackery was rife.* These concepts continue to inspire writers in the New Age movement.* In the early 20th century radioactive quackery|health claims for radio-active materials put lives at risk,* and recently, quantum mechanics and grand unification theory have provided similar quantum mysticism|opportunities for commercial exploitation.* To this day, thousands of devices claiming to heal via putative or veritable energy are used worldwide. Many of them are illegal or dangerous and are marketed with false or unproven claims.* Several of these devices have been banned.* In terms of spiritual and energetic healings there is gathering evidence of serious harm, even death.* Various commentary points to an impairment in 'critical thinking',* which at its height may lead to involvement in a cult without conscious awareness and a need for intervention and professional psychological support to achieve recovery to avoid mental ill health.*
ClassificationThe term "energy medicine" has been in general use since the founding of the non-profit International Society for the Study of Subtle Energies and Energy Medicine in the 1980s. Guides are available for practitioners* and other books aim to provide a theoretical basis and evidence for the practice.* Energy medicine often proposes that imbalances in the body's "energy field" result in illness, and that by re-balancing the body's energy-field health can be restored.* Some modalities point to healings or treatments ridding the body of negatives energies or blockages in 'mind' and a subsequent illness or episode of ill health after a treatment as a 'release' or letting go of a 'contraction' in the body-mind. Usually, a modality would recommend further treatments to heal completely unless ill health is persistent or severe, at which point most therapies would advise the client to access conventional medicine.
The US-based National Center for Complementary and Alternative Medicine (NCCAM) distinguishes between health care involving scientifically observable energy, which it calls "Veritable Energy Medicine", and health care methods which invoke physically undetectable or unverifiable energy (esotericism)|"energies", which it calls "Putative Energy Medicine":*
BeliefsEnergy healing relies on the belief that a healer can channel healing energy into the person seeking help by different methods: hands-on,* hands-off,* and distant* (or absent) where the patient and healer are in different locations. The Brockhampton Guide to Spiritual Healing describes contact healing in terms of "transfer of ... healing energy" and distant healing based on visualising the patient in perfect health.* Practitioners say that this "healing energy" is sometimes perceived by the therapist as a feeling of heat.*There are various schools of energy healing. It is known as biofield energy healing,* spiritual healing,* contact healing, distant healing, therapeutic touch,* Reiki,* Qigong, etc.*
Spiritual healing is largely non-denominational;traditional religious faith is not seen as a prerequisite for effecting a cure. Faith healing, by contrast, takes place within a religious context.* The Buddha is often quoted throughout energetic modalities, yet he did not practise "hands on or off" healing.
Energy healing techniques such as Therapeutic touch have found recognition in the nursing profession. In 2005-2006, the North American Nursing Diagnosis Association approved the diagnosis of "energy field disturbance" in patients, reflective of what has been variously called a "postmodernism|postmodern" or "anti-scientific" approach to nursing care. This approach has been strongly criticised.*Believers in these techniques have proposed Quantum mysticism|quantum mystical invocations of Quantum nonlocality|non-locality to try to explain distant healing.* They have also proposed that healers act as a channel passing on a kind of bioelectromagnetism which shares similarities to vitalism|vitalistic pseudosciences such as orgone or qi.* Drew Leder remarked in a paper in the Journal of Alternative and Complementary Medicine that such ideas were attempts to "make sense of, interpret, and explore 'psi' and distant healing." and that "such physics-based models are not presented as explanatory but rather as suggestive."* Beverly Rubik, in an article in the same journal,* justified her belief with references to biophysical systems theory, bioelectromagnetics, and chaos theory that provide her with a "...scientific foundation for the biofield..." Writing in the Journal of Bodywork and Movement Therapies, James Oschman* introduced the concept of healer-sourced electromagnetic fields which change in frequency. Oschman believes that "healing energy" derives from frequency|electromagnetic frequencies generated by a medical device or projected from the hands of the healer.
Physicists and skeptics roundly criticize these explanations as pseudophysics — a branch of pseudoscience which explains magical thinking by using irrelevant jargon from modern physics to exploit scientific literacy|scientific illiteracy and to impress the unsophisticated.* Indeed, even enthusiastic supporters of energy healing point out that "there are only very tenuous theoretical foundations underlying healing."*
Distant healingA systematic review of 23 trials of distant healing published in 2000 did not draw definitive conclusions because of the "methodologic limitations of several studies".* In 2001 the lead author of that study, Edzard Ernst, published a primer on complementary therapies in cancer care in which he explained that though "about half of these trials suggested that healing is effective" he cautioned that the evidence was "highly conflicting" and that "methodological shortcomings prevented firm conclusions." He concluded that "as long as it is not used as an alternative to effective therapies, spiritual healing should be virtually devoid of risks."* A 2001 randomized clinical trial by the same group found no statistically significant difference on chronic pain between distance healers and "simulated healers".* A 2003 review by Ernst updating previous work concluded that more recent research had shifted the weight of evidence "against the notion that distant healing is more than a placebo" and that "distant healing can be associated with adverse effects."*
Contact healingA selective review of only positive results published in 1995 recommended on the basis of personal testimony and anecdote that healing as a concept be incorporated into health care programs.* A 2001 randomized clinical trial randomly assigned 120 patients with chronic pain to either healers or "simulated healers", but could not demonstrate efficacy for either distance or face-to-face healing.* A Cochrane collaboration systematic review* of the use of touch therapies published in 2008 analysed the results of 24 trials and concluded that the attempted review suffered from "a major limitation: the small number of studies and insufficient data. As a result of inadequate data, the effects of touch therapies cannot be clearly declared." A systematic review in 2008 concluded that the evidence for a specific effect of spiritual healing on relieving neuropathic or neuralgic pain was not convincing,* and in their 2008 book Trick or Treatment Simon Singh and Edzard Ernst concluded that "spiritual healing is biologically implausible and its effects rely on a placebo response. At best it may offer comfort; at worst it can result in charlatans taking money from patients with serious conditions who require urgent conventional medicine."*
Evidence baseAlternative medicine researcher Edzard Ernst has argued that although an initial review of pre-1999 distant healing trials* had highlighted 57% of trials as showing positive results,* later reviews of non-randomised and randomised clinical trials conducted between 2000 and 2002* led to the conclusion that "the majority of the rigorous trials do not support the hypothesis that distant healing has specific therapeutic effects". Ernst described the evidence base for healing practices to be "increasingly negative".* Ernst also warned that many of the reviews were under suspicion for fabricated data, lack of transparency and scientific misconduct. He concluded that "Spiritual healing continues to be promoted despite the absence of biological plausibility or convincing clinical evidence ... that these methods work therapeutically and plenty to demonstrate that they do not."*
Alternative explanations for positive resultsThere are many, primarily psychological, explanations for positive outcomes after energy therapy such as the placebo effect or cognitive dissonance. A 2009 review found that the "small successes" reported for two therapies collectively marketed as "energy psychology" (Emotional Freedom Techniques and Tapas Acupressure Technique) "are potentially attributable to well-known cognitive and behavioral techniques that are included with the energy manipulation." The report concluded that "Psychologists and researchers should be wary of using such techniques, and make efforts to inform the public about the ill effects of therapies that advertise miraculous claims."*There are primarily two explanations for anecdotes of cures or improvements, relieving any need to appeal to the supernatural.* The first is post hoc ergo propter hoc, meaning that a genuine improvement or spontaneous remission may have been experienced coincidental with but independent from anything the healer or patient did or said. These patients would have improved justas well even had they done nothing. The second is the placebo effect, through which a person may experience genuine pain relief and other symptomatic alleviation. In this case, the patient genuinely has been helped by the healer, not through any mysterious or numinous function, but by the power of their own belief that they would be healed.* In both cases the patient may experience a real reduction in symptoms, though in neither case has anything miraculous or inexplicable occurred. Both cases, however, are strictly limited to the body's natural abilities.
Positive findings from research studies may also be explained by such psychological mechanisms, or as a result of experimenter bias, "methodological flaws"* or publication bias, and positive reviews of the scientific literature may show selection bias, in that they omit key studies that do not agree with the author's position.* All of these factors must be considered when evaluating claims.