Terence Hines - Pseudoscience and the Paranormal

The Long, Bernhardt, and Evans (1999) study raises one question and helps to shed light on why Therapeutic Touch practitioners believe they can detect a human energy field. First the question: Why were subjects in the Rosa et al. (1998) study unable to use body heat to detect the experimenter’s (Emily’s) hand? I don’t know. Perhaps the room was too cool, Emily’s hand was too small, or some other uncontrolled variable was responsible. As to the belief of Therapeutic Touch practitioners, this study shows that they can detect a human energy field—body heat. Nothing mystical, nothing unknown to science, just plain old body heat. I suspect that this is the source of their belief in their abilities. By not doing even simple experiments to rule out alternative explanations, they have misinterpreted their ability to sense body heat as the discovery of a totally new type of energy field previously unknown to science.

Having said all the above, the issue still remains as to whether Therapeutic Touch actually has any effect on patients. Does it make people better, compared to a placebo treatment? Therapeutic Touch proponents certainly think so. Proponents claim that much research has proven that Therapeutic Touch really works. For example, Scheiber (1997) quotes an article in the popular press that “more than 200 studies have tested the technique’s effectiveness on conditions including wound healing, chronic anxiety, tension headaches and post-chemotherapy nausea and vomiting” (p. 13). Somewhat more vaguely, Schuller and Pennachio (1998) speak of twenty-five years of research on Therapeutic Touch. Does such research really exist? What does it show? Scheiber (1997) set out to examine the research on the effectiveness of Therapeutic Touch. One listing (Quinn 1992, cited in Scheiber 1997) contained references to two hundred publications on Therapeutic Touch. Of these, only thirty were reports of actual outcome research on the technique; the rest were general articles in the popular press, books, and articles about the technique in the nursing literature that did not report the results of research. Of the thirty that reported research results, fifteen reported results that did not support Therapeutic Touch. Five more could not be found from the citations given. The remaining ten purported to show that Therapeutic Touch was effective. Even if these ten studies were flawless in terms of methodology, which they certainly were not, in light of the fifteen critical studies, the overall results were not particularly favorable for the technique. In fact, these ten studies suffered from numerous methodological flaws, as detailed in Scheiber and Selby (2000) and Bullough and Bullough (1998).

More recent studies alleging that Therapeutic Touch is effective fare little better when examined. Often cited by proponents of Therapeutic Touch is a study by Wirth (1990) which found that skin wounds treated with Therapeutic Touch healed faster than wounds not so treated. Proponents fail to cite other studies by Wirth that showed different results. Wirth has performed five different studies of the effects of Therapeutic Touch on wound healing (Beyerstein 2000; Wirth 2000). In two of these studies, wounds treated by Therapeutic Touch healed significantly faster than control wounds. In one study there was no difference. In two other studies, the control wounds healed significantly faster than the treated wounds. Across the group, then, there was no effect.

Turner et al. (1998), in a study funded by a $355,000 grant from the Defense Department, examined whether Therapeutic Touch reduced pain and anxiety in patients who had been burned, using six measures of pain and one measure of anxiety. In their published report, the authors state that three of these seven measures showed a significant advantage for the group treated with Therapeutic Touch. However, they adopted a very lax criterion for judging statistical significance (called a one-tailed test) that was inappropriate. In addition, the two pain measures that were significant were very highly correlated ( r = .89) and were really measures of the same thing. Taking these factors into account, Turner et al. actually found that only one out of six of their measures showed an advantage for the Therapeutic Touch group. This is not a very strong showing.

Gordon et al. (1998) used subjects suffering from osteoarthritis in the knee to test the effectiveness of Therapeutic Touch. One group (n = 8) received Therapeutic Touch, a second group (n = 11), a placebo; and a final group (n = 8), standard treatment. A major problem with this study is the tiny number of subjects used in each group. Further, the authors performed a welter of statistical tests on the data. It is often difficult, if not impossible, to tell from the published paper just how many analyses were actually performed and which showed significant effects. Those fascinated by detailed discussions of statistical problems can find such a discussion of both the Turner et al. and Gordon et al. studies in Wagner (2000).

The most reasonable conclusion that can be drawn from the extant literature on the effectiveness of Therapeutic Touch is that no one has even come close to showing that the technique is effective. Given this, is strikes me as unethical for the treatment to continue to be used (and billed for!).

Of all the areas of alternative medicine, the one that is probably best known and most used by the general public is that of herbal remedies. The impression one gets from the “alternative” medicine literature is that herbal medicines are something new and the idea of using natural substances to treat disease originated with the “alternative” medicine movement. This is simply incorrect. Many widely used conventional medicines have plant origins. For example, digitalis, which is used to treat certain heart conditions, is found naturally in the deadly nightshade berries. Even the active ingredient in aspirin, salicylic acid, is found in many plants. The difference between established medicines with a herbal origins and the numerous herbal substances promoted by “alternative” medicine is that the former have had their effectiveness proven by scientific methods. The latter have generally not been subjected to any such analysis. In fact, herbal remedies are almost always marketed as “dietary supplements.” Substances marketed in this way have been specifically exempted by law (Dietary Supplement Health and Education Act of 1994, Public Law 103–417) from the requirements that all other drugs must meet. Specifically, there is no legal requirement that these substances be proven (1) effective, (2) safe, or (3) even that the ingredients claimed to be in the product are really present and in the dosage claimed. The Dietary Supplement Act was, as might be expected, heavily supported by the “alternative” medicine community and especially the diet supplement industry. Angel and Kassirer (1998) note, for example, that studies of herbal ginseng found that the actual amount of the active compound in each pill “varied by as much as a factor of 10 among brands that were labeled as containing the same amount.” To make matters worse, “some brands contained none at all” (p. 840). It is worth noting that homeopathic remedies have been exempt from any sort of regulation since 1938 (Wagner 1997).

Since many established drugs have herbal origins, it is likely that at least some of the “new” herbal compounds may have real, beneficial effects. Recent studies suggest that ginko biloba may have an effect on cognitive function in Alzheimer’s patients. The effect is quite small, however—only a 3 percent increase (Oken, Storzbach, and Kaye 1998).

Gold, Cahill, and Wenk (2002) reviewed the literature on ginkgo effects on cognitive function in humans. They concluded that the evidence is just suggestive enough “to sustain our interest in finding out whether ginkgo does improve cognition” (p. 9). Maclennan, Darlington, and Smith (2002) have reviewed the effects of ginkgo in a more physiological context, focusing on effects of this herbal or its extract (Egb-761) on central nervous system function. They conclude that while “there is some evidence to support the idea that Egb-761 can enhance cognitive function in neurologically intact humans and animals, many studies suffer from methodological flaws such as a lack of double-blind protocols” (p. 251). They find the evidence for ginkgo’s positive effects in brain-damaged humans “more persuasive, although inconsistent” (p. 251). Their review does show that ginkgo extract can protect the central nervous system against certain types of damage in animal studies. Future research will be needed to determine whether these effects in animals translate in any way to humans.