Reiki
Debbie Ringdahl
Reiki is an energy-healing method that can be used as an integrative therapy for a broad range of acute and chronic health problems. Increasingly, it is gaining acceptance as an adjunct to management of chronic conditions: pain management, hospice and palliative care, and stress reduction. In 2003, Miles and True described 24 hospitals and community-based programs in the United States that use Reiki in the areas of general medicine, surgery, treatment of HIV/AIDS and cancer, and older adult and hospice care, as well as for staff and family members. In 2013, the Center for Reiki Research identified 75 hospitals, medical clinics, and hospice programs where Reiki was offered as part of standard practice. This author notes that only one of five area health care facilities using Reiki is listed, suggesting a greater usage of Reiki than these numbers indicate.
The 2010 Complementary and Alternative Medicine Survey of Hospitals (Ananth, 2011) reported that Reiki and Therapeutic Touch were offered in 21% of inpatient settings surveyed. A 2007 national survey found that 1.2 million adults and 161,000 children received one or more energy-healing sessions such as Reiki in the previous year (Barnes, Bloom, & Nahin, 2008). The National Institutes for Health (NIH) recently completed clinical trials investigating Reiki use for fibromyalgia, AIDS, painful neuropathy, stress, and prostate cancer (NCCAM, 2013).
According to the National Center for Complementary and Alternative Medicine (NCCAM), Reiki is a biofield therapy. Therapies in this category affect energy fields that both surround and interpenetrate the human body. Bioenergy therapies involve touch or placement of the hands into a biofield, the existence of which has not been scientifically proven (NCCAM, 2011). Several biofield therapies have been introduced into clinical care over the
past few decades, representing a renewed interest in the therapeutic use of intentional touch in clinical practice. Reiki, Therapeutic Touch (TT), and Healing Touch (HT) are all biofield therapies that are used to support the healing process. Although each has its own history, techniques, and practice standards, they share many similarities. All three traditions include the fundamental assumption that a universal life force sustains all living organisms (Hover-Kramer, 1996; Macrae, 1987; Ringdahl, 2010) and that human beings have an energetic and spiritual dimension that is a part of the healing process (Anderson & Taylor, 2011b). The focus is on balancing the energies of the total person and stimulating the body’s own natural healing ability, rather than on the treatment of specific physical diseases (Anderson & Taylor, 2011b; Macrae, 1987; Ringdahl, 2010). The common thread that exists among these modalities lies in their capacity to reduce stress, promote relaxation, and mitigate pain.
past few decades, representing a renewed interest in the therapeutic use of intentional touch in clinical practice. Reiki, Therapeutic Touch (TT), and Healing Touch (HT) are all biofield therapies that are used to support the healing process. Although each has its own history, techniques, and practice standards, they share many similarities. All three traditions include the fundamental assumption that a universal life force sustains all living organisms (Hover-Kramer, 1996; Macrae, 1987; Ringdahl, 2010) and that human beings have an energetic and spiritual dimension that is a part of the healing process (Anderson & Taylor, 2011b). The focus is on balancing the energies of the total person and stimulating the body’s own natural healing ability, rather than on the treatment of specific physical diseases (Anderson & Taylor, 2011b; Macrae, 1987; Ringdahl, 2010). The common thread that exists among these modalities lies in their capacity to reduce stress, promote relaxation, and mitigate pain.
A Reiki practitioner does not need to be prepared as a health care practitioner; however, nurses, physical therapists, massage therapists, and physicians who practice Reiki may have greater access and acceptability within the health care system in performing hands-on treatments. Additionally, Reiki practice by nurses supports a high-touch practice model in a high-tech practice environment. The Institute of Medicine (IOM) 2009 Summit on Integrative Medicine and the Health of the Public identified that empathy and compassion enhanced care and improved outcomes with grade A evidence (IOM, 2010). Although this evidence is not specific to physical touch, research suggests that recipients of touch therapies frequently experience an integration of mind, body, and spirit that promotes feelings of well-being (Engebretson & Wardell, 2002). Jean Watson’s conceptualization of the reciprocal nature of caring also supports the value of Reiki touch in providing nursing care (Brathovde, 2006).
The origins of Reiki are unclear, but Reiki historians generally agree that this therapy may have its roots in hands-on healing techniques that were used in Tibet or India more than 2,000 years ago. Reiki emerged in modern times around 1900 through the work of a Japanese businessman and practitioner of Tendai Buddhism, Mikao Usui (Miles, 2006). According to William Lee Rand (2000), founder of The International Center for Reiki Training, Usui searched many years for knowledge of healing methods until he had a profound, transformative experience and received direct revelation of what became known as Reiki. Following this experience, Usui worked with the poor in Kyoto and Tokyo, teaching classes and giving treatments in what he called “The Usui System of Reiki Healing.” One of Dr. Usui’s students, Chujiro Hayashi, wrote down the hand positions and suggested ways of using them for various ailments.
Mrs. Hawayo Takata is credited with the spread of Reiki in the Americas and Europe. In 1973, Mrs. Takata began to train Reiki teachers (Miles, 2006). The Reiki Alliance, a professional organization of Reiki masters, grew from 20 to nearly 1,000 members between 1981 and 1999 (Horrigan, 2003).
DEFINITION
The word Reiki is composed of two Japanese words—rei and ki. Rei is usually translated as universal, although some authors suggest that it also has a deeper connotation of all-knowing spiritual consciousness. Ki refers to life force energy that flows throughout all living things, known in certain other parts of the world as Chi, prana, or mana. When Ki energy is unrestricted, there is thought to be less susceptibility to illness or imbalances of mind, body, or spirit (Rand, 2000). In its combined form, the word Reiki is taken to mean spiritually guided life force energy or universal life force energy.
The mind-body component to Reiki healing is evidenced in the underlying belief that the deepest level of healing occurs through the spirit. The emphasis is on healing, not cure, which is believed to occur by Reiki energy connecting individuals to their own innate spiritual wisdom and “highest good.” Reiki is considered a nondirective healing tradition:
Reiki energy flows through, but is not directed by, the practitioner, leaving the healing component to the individual receiving the treatment. Reiki is not only a healing technique, but a philosophy of living that acknowledges mind-body-spirit unity and human connectedness to all things. This philosophy is reflected in the Reiki principles for living: “Just for today do not worry. Just for today do not anger. Honor your teachers, parents, and elders. Earn your living honestly. Show gratitude to all living things” (Mills, 2001). These principles further support the value of living with intention, self-awareness, and in the present moment.
The ability to practice Reiki is transmitted in stages directly from teacher to student via initiations called attunements. This attunement process differentiates Reiki from other hands-on healing methods. During attunements, teachers open up the students’ energy channels by using specific visual symbols that were revealed to Dr. Usui. There are three degrees of attunement preparatory to achieving the status of Master Teacher, at which stage the practitioner is considered fully open to the flow of universal life force energy. By tradition, the Usui Reiki symbols and their Japanese names are confidential. This arises from the sacred nature of the techniques rather than from proprietary motives; the symbols are believed not to convey Reiki energy if used by noninitiates.
Level I Reiki is taught as a hands-on technique that includes basic information about Reiki history, application, principles, and hand positions. In Level II, students are taught symbols that allow transfer of energy through space and time, also known as absentee or distance healing. The higher vibration of energy available at Level II is considered to work at a deeper level of healing and with greater intuitive awareness. Level III, or the mastery level, is typically achieved through an apprenticeship with a Reiki Master, and includes more in-depth study of Reiki practice and teaching. At all levels, Reiki skill develops through years of committed practice.
In recent years, additional branches of Reiki with further degrees of attunement have developed; two of these are Karuna Reiki and Reiki Seichim. There are currently no uniform standards in Reiki education, either at the national or international level. Because of the noninvasive nature of the treatments, this does not present problems in Reiki hands-on practice, but may contribute to variable levels of professionalism among practitioners. This lack of standardization may also pose problems when working to develop practice standards for integration of Reiki into the conventional health care system.
SCIENTIFIC BASIS
Researchers have attempted to study the biological effects of biofields on biomolecules, in vitro cells, bacteria, plants, and animals, as well as clinical effects on hemoglobin, immune functioning, and wound healing (Movaffaghi & Farsi, 2009). There is increasing evidence that living systems are sensitive to bioinformation and that biofield therapies can influence diverse cellular and biological systems (Abbot, 2000; Bowden, Goddard, & Gruzelier, 2010). The notion that cellular and molecular changes occur within the energy spectrum of biofields is congruent with the view that subtle energy shifts may manifest as a physiological cause or effect and also play a role in inter- and intracellular communication (Movaffaghi & Farsi, 2009). Morse and Beem (2011) reported a case with an increase in absolute neutrophil count following Reiki, resulting in toleration of interferon and subsequent clearance of hepatitis C virus.
There have also been studies focused on identifying the physical properties of biofields in order to determine potential mechanisms of action (Movaffaghi & Farsi, 2009). An emerging body of evidence confirms the existence of energy fields and suggests new ways of measuring energy, although these are not specific to Reiki. Traditional electrical measurements such as electrocardiograms and electroencephalograms can now be supplemented by biomagnetic field mapping to obtain more accurate information about the human condition. Electromagnetic information has been used to both diagnose and treat disease (Oschman, 2002).
Superconducting quantum interference devices have been used to show the effect of disease on the magnetic field of the body, and pulsating magnetic fields have been used to improve healing (Oschman, 2002). In a small experimental study of the effects of one type of energy therapy, researchers found consistent, marked decreases in gamma rays measured at several sites within intervention subjects’ electromagnetic fields during treatment (Benford, Talnagi, Doss, Boosey, & Arnold, 1999). Charman’s
research (2000) suggests that intention to heal transmits measurable wave patterns to recipients. These studies suggest that in the future it may be possible to directly measure subtle elements of the human energy field and to elucidate mechanisms by which Reiki and other energy-healing techniques lead to changes in health outcomes.
research (2000) suggests that intention to heal transmits measurable wave patterns to recipients. These studies suggest that in the future it may be possible to directly measure subtle elements of the human energy field and to elucidate mechanisms by which Reiki and other energy-healing techniques lead to changes in health outcomes.
A Reiki treatment commonly puts the recipient’s body into a state of relaxation, presumably by downregulating autonomic nervous system tone, which lowers blood pressure and relieves tension and anxiety (Meland, 2009). Mackay, Hansen, and McFarlane (2004) concluded that Reiki has some effect on the autonomic nervous system by comparing heart rate, cardiac vagal tone, blood pressure, cardiac sensitivity to bar reflex and breathing activity among three groups of subjects: those resting, receiving Reiki, or receiving placebo Reiki. Friedman, Burg, Miles, Lee, and Lampert (2010) found an increase in high-frequency heart rate variability in patients recovering from acute coronary syndrome who received Reiki compared with those listening to music or resting. Kerr, Wasserman, and Moore (2007) theorize that sensory reorganization is the mechanism for pain and stress reduction that occurs with touch healing therapies. To date, the strongest support for the measurable physiological effect of Reiki was demonstrated in an animal model (Baldwin & Schwartz, 2006; Baldwin, Wagers, & Schwartz, 2008).
Methodological problems, which hinder the interpretation of results, have been identified in a number of studies. Although case studies and anecdotal examples have been relatively consistent in reporting positive responses to Reiki treatments, this does not represent the scientific rigor that is demanded within an evidence-based health care system. Efforts to strengthen research design and mitigate the confounding effects of human touch have led to the development of sham or placebo Reiki (Mansour, Beuche, Laing, Leis, & Nurse, 1999), now frequently incorporated into randomized controlled trials.
It has also been speculated that energy healing impacts outcome in a way that is difficult to measure. “The phenomenon of energy has a qualitative nature and can never be completely knowable, measurable, or ultimately predictable” (Todaro-Franceschi, 2009, p. 135). Engebretson and Wardell (2002) concluded that many research models are not complex enough to capture the experience of a Reiki session. In their qualitative study they found that participants had a diverse and descriptive language that accompanied their experience, creating a more complete picture of the subjective experience of a Reiki session.
Rogers’s Science of Unitary Human Beings has been used as a theoretical framework for understanding the experience of Reiki. This theory connects scientific principles of energy as matter to the human energy field and energetic interconnections that occur in the environment (Ring, 2009; Vitale, 2007).
INTERVENTIONS
Technique
The Reiki practitioner acts as a conduit for this healing-intended energy to self or others. A Level I Reiki practitioner employs a series of 12 to 15 hand positions for a full session and six to seven hand positions for a seated session (Exhibit 25.1). A Level II Reiki practitioner also uses hand positions, but may use various Reiki symbols to focus the Ki energy or perform distance healings. If touch is contraindicated for any reason, the hands can be held 1 inch to 4 inches above the body. A full Reiki session usually lasts 45 minutes to 90 minutes and a seated session usually lasts 15 minutes to 20 minutes. Reiki practitioners, especially if they are nurses working in a clinical setting, often do not have the luxury of providing a full session. At such times, shorter and more targeted treatments may be offered for specific purposes. In The Original Reiki Handbook of Dr. Mikao Usui (Petter, 1999), the use of particular hand positions is recommended for addressing specific health problems.
Reiki energy flows through the hands without employing cognitive, emotional, or spiritual skills. The attunement process provides access to the energy without requiring ongoing practice or conscious intention. This makes Reiki particularly easy to learn and simple to use. Potter (2003) compared her experience with therapeutic touch after receiving a Level I attunement. She found that her work became less directive and the effort to stay centered was no longer a concern.
Guidelines for Hands-On Reiki Session
The recipient may sit or lie down, and either method is suitable for Reiki practice. Because Reiki tends to be very relaxing it is often preferable to lie down, but a seated session may be more practical if a table or bed is not available.
Patients typically remain clothed during a Reiki treatment. A massage table or hospital bed for a full session is ideal, providing comfort for both client and practitioner. After practitioners center themselves and establish intent to heal with Reiki, the energy flows automatically from their hands without cognitive effort. The hands rest gently on the person’s body with the fingers touching so that each hand functions as a unit. Reiki can also be provided with the hands 2 inches to 3 inches off the body. The sequence of hand positions may vary, but will generally include all seven major chakras and the endocrine glands. The success of a Reiki treatment does not depend on the use of certain hand positions, for the Ki energy goes where it is needed.
Patients typically remain clothed during a Reiki treatment. A massage table or hospital bed for a full session is ideal, providing comfort for both client and practitioner. After practitioners center themselves and establish intent to heal with Reiki, the energy flows automatically from their hands without cognitive effort. The hands rest gently on the person’s body with the fingers touching so that each hand functions as a unit. Reiki can also be provided with the hands 2 inches to 3 inches off the body. The sequence of hand positions may vary, but will generally include all seven major chakras and the endocrine glands. The success of a Reiki treatment does not depend on the use of certain hand positions, for the Ki energy goes where it is needed.
Exhibit 25.1. Reiki Seated Session
(Each hand position is held for approximately 2-3 min)
1. General approach: Use touch therapy competencies: apply hands for approximately 2 to 3 minutes of light touch in each hand position; vary positions and duration based on individual needs
2. Hands on shoulders (introduction to light touch)
3. One hand on forehead, one hand on upper nape of neck
4. One hand on chest, other hand on upper back
5. One hand around each on ankle
6. Hands on shoulders (conclusion to light touch)
In clinical practice, four basic principles of physical touch should be considered: (1) ask permission to touch, (2) provide basic information about what you will be doing, (3) describe anticipated benefits and range of outcomes, (4) assure the right to decline or discontinue receiving physical touch. Standards of practice have been developed by several professional Reiki organizations and include ethics related to intention, healing environment, healing principles, and the nondiagnostic nature of the work (International Association of Reiki Professionals [IARP], 2010; International Center for Reiki Training [ICRT], 2012). The American Holistic Nursing Association (2007) developed scope and standards of practice for holistic nursing, but these are not specific to any one integrative therapy. In the book Creating Healing Relationships: Professional Standards for Energy Therapy Practitioners, Hover-Kramer (2011) describes parameters for level of competence, record keeping, professional responsibility, boundaries, confidentiality, marketing, and informed consent. General competencies for Reiki practice are provided in Exhibit 25.2.
Exhibit 25.2. Reiki Practice Competencies
1. Ask permission to touch before any encounter.
2. Provide basic information about what you will be doing, including use of light touch, basic hand positions, length of session.
3. Describe the areas of the body you will be touching and what sensations the client may experience. Ask whether there are areas they would prefer not to be touched.
4. Describe anticipated benefits and range of outcomes.
5. Let them know you will stop at any time. Ask whether they prefer to be wakened if they fall asleep.
6. Create an environment that promotes feelings of safety. If possible, assure privacy. In a hospital setting, consider putting a sign on the door asking to not be disturbed.
7. Clearly communicate that Reiki practice is not diagnostic or used to treat specific disease conditions.
In an effort to provide guidelines to assure safety and protection of the public using integrative therapies, a diverse group of complementary and alternative providers, health care providers, ethicists, legal consultants, health policy specialists, and consumers recently developed ethical guidelines for boundaries of touch in the practice of complementary medicine (Schiff et al., 2010). They provided guiding principles and ethical rules addressing behavior and language regarding inappropriate touch and exposure, as well as right of the client to discontinue treatment.
As more health care institutions offer complementary therapies, policies and guidelines must be developed that provide standards for implementation. Brill and Kashurba (2001) provide an outline for starting a Reiki program in a health care facility, including development of program objectives, training health care providers, and tracking and reporting outcomes. Reiki practice at a Magnet-designated facility in Pennsylvania requires evidence of competency in Reiki practice and adherence to written hospital policy when administering Reiki (Kryak & Vitale, 2011). A protocol for Reiki use in the operating room was developed at a hospital in New Hampshire following a request to have a Reiki practitioner present during surgery (Sawyer, 1998). This author developed a Reiki protocol for use by nurses providing care to chemotherapy patients (Ringdahl, 2008).
Measurement of Outcomes
Recipients’ subjective feelings during a Reiki session are not considered indications of effectiveness. Patients may feel sensations similar to those of the practitioner, but they may also feel nothing. Sensations may include heat, cold, numbness, involuntary muscle twitching, heaviness, buoyancy, trembling, throbbing, static electricity, tingling, color, and heightened or decreased awareness of sound (Engebretson & Wardell, 2002). It is not uncommon for clients to fall asleep during a treatment with reports of increased relaxation, peacefulness, and reconnecting to their center. These subjective feelings are supported in research studies that demonstrate physiological and psychological evidence of stress reduction following a Reiki session (Bowden et al., 2010; Caitlin & Taylor-Ford, 2011; Engebretson & Wardell, 2002; Friedman et al., 2010; Potter, 2003; Richeson, Spross, Lutz, & Peng, 2010; Ring, 2009; Shore, 2004; Vitale & O’Connor, 2006; Wardell & Engebretson, 2001; Witt & Dundes, 2001).
Reiki research outcomes are focused primarily on reducing stress and pain, increasing relaxation and an overall sense of well-being, particularly in the area of chronic disease and pain management. Application of Reiki for pain management among patients with cancer, undergoing rehabilitation, and recovering from surgery has been the focus of several studies (Beard et al., 2010; Birocco et al., 2012; Dressen & Singh, 2000; Olson, Hanson, & Michaud, 2003; Pocotte, & Salvador, 2008; Shiftlett, Nayak, Bid, Miles, & Agostinelli, 2002; Tsang, Carlson, & Olson, 2007; Vitale & O’Connor, 2006).
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