By the end of this article, the nurse will be able to:
"Nature alone cures, and what nursing has to do…is put the patient in the right condition for nature to act upon him." Florence Nightingale
For centuries, ancient cultures have referred to human energy as chi (Chinese), prana (Hindu), ka (Egyptian), lung (Tibetan), and mana (Hawaiian). Many Asian movement theories such as qi gong, tai chi, yoga and meditation work with life force energy.
Therapeutic Touch (TT) is a contemporary interpretation of ancient energy-based healing practices. It is an intentionally directed process of energy exchange during which the practitioner uses the hands as a focus to facilitate the healing process. Therapeutic Touch was developed for healthcare professionals as an extension of their professional skills. Dolores Krieger, Ph.D., RN, Professor emeritus from New York University (NYU) and Dora Van Gelder Kunz, a natural healer, developed TT in 1972. They were exploring the relationship between laying on of hands and the healing process, and began to realize that bioenergetic healing was a natural potential that could be learned by anyone when taught under appropriate circumstances. Dr Krieger began teaching the first course in Therapeutic Touch to nurses in the master's program at NYU in 1975. The class "Frontiers in Nursing," opened the door to Therapeutic Touch currently being taught in hundreds of settings including, medical centers, universities, and nursing schools. The North American Nursing Diagnosis Association recognizes TT as a nursing diagnosis.
Therapeutic Touch is based on a number of theoretical frameworks. The Science of Unitary Beings, the nursing theory of Martha Rogers. Ph.D., RN, is one of them. This theory expands on the idea that each person is a unified whole, possessing his/her own integrity and is an energy field in constant exchange with his/her environment. TT uses Rogers's basic assumption that Humans are open, complex pandimensional energy systems. In other words, we (energy systems) do not stop at our skin.
The following are several other assumptions to help you in understanding this concept of energy and TT. 1) In a state of health, life energy flows freely through the organism in a balanced symmetrical manner (Kunz). Kunz's model of the human energy field (HEF) postulates that just as the body is anatomically symmetrical, the energy field in health can also be assumed to be bilaterally symmetrical. In a healthy state the HEF is often perceived as rhythmical, flowing and ordered. In a diseased state the HEF can be perceived as imbalanced, disharmonious and disordered. 2) Human beings are capable of both transformation and transcendence (Krieger). Based on this hypothesis human beings are able to transcend their ordinary conditions of living leading to the opportunity for personal growth which in turn leads to healing and wholeness. 3) Healing is an intrinsic movement toward order that occurs in all living organisms and can be facilitated by practitioners (Kunz). This is based on the assumption the universe is organized, orderly and whole. Healing is seen as a movement toward that order and is an innate capacity to become whole. The Therapeutic Touch practitioner learns to consciously direct the energy flow in support of the universal order that is considered an innate force in all energy fields, in a movement toward wholeness.
Therapeutic Touch is considered a scientifically based intervention as a large body of research has verified TT's results. A few of the areas clinical research has validated the benefits of TT are in pain management, dermal wound healing, promoting relaxation, decreasing anxiety and increasing the hemoglobin levels. Recent studies have shown TT to have a positive effect on stress reduction and immune function in persons with AIDS. These are only a few of the studies. TT is the most researched of all of the healing modalities. Therapeutic Touch is used regularly along the continuum of the life cycle, from premature babies in hospitals to hospice patients. In the view of wholism, caring and healing are not synonymous with curing. Persons facing a terminal illness or death may come to a state of wholeness.
Since newborns, anesthetized patients and persons in comas have benefited from TT, belief in TT is not a prerequisite to its success. One's belief system and the placebo effect are important factors that can contribute to the process of healing, but these can't be completely responsible for the benefits of TT. TT mobilizes the individual's own healing energies to restore health balance and order. The practitioner is merely the conduit or facilitator, and does not do the healing. The individual does his/her own healing.
Therapeutic Touch is a dynamic process, but a student first learns it in a linear fashion using four phases. The phases are centering, assessment, balancing (intervention) and reassessment. The phases follow the nursing process. Centering is the most integral part of the TT process and includes one's strong intention of helping and healing in a compassionate manner. These components differentiate TT from most other healing practices. Centering one's consciousness and staying on center could be described as going to a quiet place of inner peace and maintaining one's mind in a state of peace with intentionalilty and resonancy throughout the process.
Once centered, the TT Practitioner (TTP) begins the assessment by holding the hands approximately 2 to 4 inches from the body and scanning the client/patient's (c/p) energetic field from head to toe looking for cues. The most common cues sensed by the TTP are heat, coolness, tingling, and seem to vary widely with individual perception. With practice and guidance, TTP's gain a better understanding of what specific cues mean to assist them in developing an intervention or plan of care to balance the field.
The balancing or intervention consists of unruffling or clearing the energy field so that it flows more smoothly. The TTP modulates or tempers the energy flow to meet the needs of the c/p. Energy is directed or transferred between the therapist and client, or from one area of the c/p's body to another. A number of skills are utilized in this phase to bring harmony and order into the client's energy field such as using the law of opposites, color, sound, visualization and guided imagery.
The final phase of reassessing the field and getting feedback from the c/p assists the TTP in determining if the work has brought the desired result. This phases is also referred to as closure. TT can be learned quite quickly; however one's ability to effect a consistently beneficial outcome is developed over years of practice and ongoing classes.
According to Dora Kunz "one needs to have self discipline and a strong intention to help the person" to become a TT practitioner. Optimal attributes are compassionate non attachment and a sense of well-being and non judgement. The individual learns Therapeutic Touch beginning with a Basic class that constitutes at least 12 contact hours. The student can begin practicing with family, friends and coworkers. A mentorship for at least a year with a Therapeutic Touch teacher is strongly recommended along with regular practice of TT at least twice weekly. The individual will be ready to take an Intermediate class and with regular practice and mentoring, after a year, they would be able to take an Advanced class. It is strongly recommended that classes be repeated with different teachers.
Nurse Healers-Professional Associates International, Inc. (NH-PAI) is the official organization for Therapeutic Touch. In 1976 Dr Dolores Krieger formed NH-PAI, which sets the standards of practice and policy and procedure for the practice and teaching of TT. I serve on The Board of Directors as Education Trustee for this organization.
In working with this wonderful healing process I have witnessed many of my c/p's begin to live life with more quality and wholeness. Each time I do a Therapeutic Touch intervention I am in awe of the order of the universe and each individual's power of self actualization. They come to find an inner self that is a source of strength and intuition.
My personal healing journey began with the first TT class I took from Dr Dolores Krieger in 1987 while I was at NYU. As a TT practitioner for 13 years and a TT teacher for 6 years, I have found Therapeutic Touch to be as beneficial in my own inner awareness and growth. I am a more fully integrated person and have never felt healthier. I am confident that this resonance of wholeness and well-being that I experience from the practice of Therapeutic Touch benefits the recipient. Since coming to Utah in 1993, in addition to my private practice, I have been teaching TT with two other Nurse Healers who are also recognized as Qualified TT Teachers through NH-PAI. They are Sharon Gately, RN,C and Elaine Wallace RN,C. We have taught more than 90 nurses in Utah, Wyoming, and Idaho. Our students have expressed to us that TT brings them back to why they chose nursing as a career.
References
Krieger, Dolores, (1993). Accepting Your Power to Heal - The Personal Practice of Therapeutic Touch.. New Mexico: Bear & Company, Inc..
Macrae, Janet, (1987). Therapeutic Touch: A Practical Guide. New York: Alfred Knopf Publishing.
Wager Susan, (1996). A Doctor's Guide to Therapeutic Touch. New York: The Berkley Publishing Group.
Resources
Nurse Healers-Professional Associates International, Inc.
The official Organization for Therapeutic Touch 1211 Locust St Philadelphia, PA 191907 (215) 545-8079
Rebecca Good, MA, RN,C, ACRN, LPC Utah Networker for NH-PAI
(801) 942-5900
About the Author
Rebecca Good, MA, RN, C, ACRN, LPC is Certified by the ANCC as a Psychiatric and Mental Health Nurse, is an AIDS Certified RN, and a Licensed Professional Counselor. She has been an active RN for more than 30 years with experience in many areas of clinical practice and case management. She is recognized by NH-PAI as a Qualified Therapeutic Touch Teacher and Practitioner. Rebecca has a private practice at 1088 South 1100 East where she offers Therapeutic Touch and Holistic Counseling and Therapy. She is also a lecturer and clinical consultant.
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