Writing about the potential benefits of Reiki in palliative care has been an interesting and enlightening journey.
The original focus of this article was to examine the “evidence” for the benefits of Reiki in terms of what is often medically considered to be sound evidence (such as that from randomised controlled trials). I found some of this, but I also found much wider and more profound sources of information and wisdom. Let me share…
I was extremely interested to read a piece of qualitative research (1) which explored the lived experience of a group of people living with advanced cancer, or as the authors' put it “living with dying”.
Qualitative research is a particular type of research which involves the researcher developing a relationship with the people they are researching and, in this case through discussion and interview, exploring and understanding deeply just what their experience is like for them and what it means to them.
When considering how and if Reiki can benefit people facing this, taking a look at what the experience means to people in that situation and what support they might need seemed like the best starting point.
Unsurprisingly, the research documented the negative effects of advanced cancer on the emotional well-being of the people in the study. Anxiety, stress and depression were seen in addition to the physical symptoms such as pain, fatigue and discomfort.
What the paper also showed was that the participants needed to make sense of their new reality and to adjust to it. Finding meaning in the situation helped to reduce the emotional distress. Facing the reality of dying was seen as an existential threat that prompted the need to reconsider ones relationship with life and with the nature of time itself. There were reports of intense “present moment” experiences. Perhaps the biggest challenge of all, it was also seen to hold the potential, like all challenges in life, to be something which ultimately led to personal growth, peace and enhanced psychological well-being in the time left. Most definitely then an emotional, psychological and spiritual challenge as well as a physical one.
Spirituality, in the field of palliative care, has been defined as:
“the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to self, to others, to nature and to the significant or sacred.”(3)
In 2014, a report was published which evaluated the benefits of an integrative Reiki service for patients with cancer in an academic medical cancer centre in the US (4).
This programme was provided by volunteer Reiki practitioners and had been running since 2008. As part of the its evaluation, data was collected which measured participants' levels of distress, anxiety, pain, depression and fatigue both before and after Reiki. It was reported that patients experienced a 50% or greater reduction in the severity of all these factors. These were reported as being both clinically meaningful and statistically significant. If a result is “statistically significant” this means that statistical tests have shown that the benefits are unlikely to have been caused by chance and are therefore more likely to be real effects of the therapy.
An overwhelming majority of the patients in this evaluation stated that they enjoyed the Reiki sessions, found them beneficial, planned to use Reiki again and would recommend it to others.
Importantly, the evaluation also collected qualitative data by asking participants an open question where they were free to describe their experiences in their own words. Whilst Reiki practitioners gave out the surveys, they were handed in anonymously to other staff, to avoid the possibility of bias. The written responses (175 of them) were analysed using “content analysis” The descriptions that people gave of their experiences fitted into the following themes:
“Relaxation and peace: The most common words used to describe the feelings evoked during a Reiki session were “relaxed,” “relaxation,” and “relaxing.” Patients also expressed feelings of peacefulness, warmth, and calm.
Symptom relief: Patients described relief from both psychological and physical symptoms, such as anxiety, stress, fatigue, muscle tension, stiffness, and pain. They often described this relief as being simultaneously psychological and physiological (not distinguishing between mind and body).
Physiological response: Several patients wrote about how the Reiki sessions lowered their blood pressure or reduced their heart rate, perhaps a physical indication of the relaxation response.
Sense of connection: Some patients wrote about how the Reiki session produced a sense of connection with others (such as deceased relatives) or with their own authentic emotions, prompting a profound feeling of well-being.
Positive thinking and sense of healing: There were a number of participants who credited the Reiki sessions with providing a sense of healing and helping them to think positively about their body’s capacity for healing.
Freedom and release: A few participants felt that Reiki allowed them to be emotionally vulnerable and to experience a sense of freedom by alleviating the burden of their diagnosis.”
I think that these responses show just how deeply healing Reiki can be, on all levels – physical, emotional, mental and spiritual. I am sure we all recognise them and it is wonderful to see them so eloquently articulated in a published study. The authors of the report felt that their evaluation provided good initial evidence of the potential of Reiki to help fulfil the unmet spiritual and physical needs of some cancer patients, by providing an enhanced experience of human connection and caring, promoting deep relaxation, symptom relief as well as enhancing a sense of healing, positivity and connectedness to others and the deeper self.
It seems then that there is clearly a match between what some patients facing advanced cancer or palliative care might need and the benefits Reiki can offer.
In the UK, NICE guidance (2) on the improvement of supportive palliative care services states that patients should be offered a range of physical, emotional, spiritual and social support in addition to services which enable people to manage the after effects of advanced cancer themselves.
In 2010, in light of this, a clinical team in Canada set up a volunteer complementary therapy programme within a 15 bed in-patient palliative care unit north of Toronto (3). Volunteer therapists were recruited in 2010 to provide massage, Reiki and therapeutic touch to patients. The effects of this were evaluated by way of a patient questionnaire which was given after one or two sessions.
86% of patients received complementary therapy interventions and 69% of the sessions had included some level of psycho-spiritual support.
The evaluation showed that pain, anxiety, low mood, restlessness and discomfort were all eased whilst inner stillness, peace and comfort were all increased.
The volunteer therapists were included in multi-disciplinary team meetings where they could raise concerns about any particular patient who had, for example, expressed emotional, psychological or other distress. Their contributions were respected and valued by the clinical team and the holistic dimension of the therapies was appreciated by patients, clinicians and managers alike. It was reported that the programme was regarded by patients and families as essential.
There is certainly a demand for Reiki amongst cancer patients. Reports (3) have stated that up to a third of cancer patients seek out complementary therapy and this demand continues to rise, whilst the attitudes of doctors and others in the medical professions generally are slowly changing from “scepticism and frank antagonism in some cases (3)” more towards cooperation and co-existence.
Many in the medical world however seek evidence from clinical trials to back up the effectiveness of a therapy before they will really consider it to be of use. Writing for the American Journal of Hospice and Palliative Medicine in 2015, Ashley Henneghan and Rosa Schnyer (5) completed a focussed literature review which looked for this kind evidence base for the use of energy therapies like Reiki in palliative care.
They did not find any published trials which specifically related to palliative care, but there were quite a few papers which looked at the benefits of Reiki and similar energy therapies (Therapeutic Touch and Healing Touch) in relation to some of the specific symptoms which are very relevant to palliative and end of life care.
They concluded that the evidence supports the use of energy therapies in relieving pain, improving quality of life and well-being and in reducing symptoms of stress.
In 2008, a Cochrane review (6) was published which looked at the value of energy touch therapies for pain relief in adults. It concluded that they reduced pain levels in the trials examined, potentially over and above any placebo element and that Reiki was the most promising energy touch treatment.
A more recent systematic review looking specifically at Reiki, conducted in 2014 by Kumar et al. (7) also concluded that Reiki may have value in the management of pain.
Also in 2014, a literature review concluded that Reiki holds potential in the reduction of both pain and anxiety, as discussed in my post on 12thMay 2016 (8).
Way back in 2003, a small clinical trial (9) was conducted which compared the effects of Reiki in addition to standard medical treatment for patients with advanced cancer against rest with standard treatment. It was a small trial, but it concluded that the addition of Reiki improved both pain control and quality of life for those people who received it, over and above the benefits received by the group who simply rested.
In 2011, a larger trial with 118 patients was reported which examined the use of Reiki in a cancer infusion and day centre. Improvements in well-being, relaxation, pain relief, sleep quality and anxiety were shown (10).
Whilst this all sounds very positive, it must also be remembered that the trials which have been conducted so far are comparatively small ones, and many are not reported well enough for some to accept as valid. We can say however that there is early indicative research which shows the benefits of Reiki in these areas. There is clearly enough evidence to persuade many cancer centres to introduce services for patients, even if many are still provided by volunteer practitioners.
In the UK, NICE guidance³ on the improvement of supportive palliative care services acknowledges that the level of evidence required for complementary therapies which aim to relieve rather than cure does not need to be as stringent as it would be for curative, invasive or pharmcologic treatments.
They do encourage those who provide Reiki in cancer and palliative settings to contribute to the evaluation of their effectiveness, much in the way that was done by the two teams mentioned above.
It is an ongoing journey for Reiki. More research and evaluation needs to be done, and will be done. I think what my journey has shown me is that we need more than just data from clinical trials to demonstrate just how Reiki helps. Qualitative data which shares peoples lived experiences is vital as well as other forms of research such as case studies and service evaluations.
In different ways we are all part of the Reiki journey and there are opportunities to join the conversation and make a difference.
But believe me, I totally understand the fears of many Reiki practitioners when it comes to research. Some worry that because the treatment is aimed at the recipients highest good, not at a single measurable outcome that research might not be able to capture the benefit.
Others worry that somehow the research might show that Reiki doesn’t work, what then?
Have no fear. Research is being done and it is starting to show some positive outcomes.
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1. Willig, C. (2015). "My Bus Is Here": A Phenomenological Exploration of "Living With-Dying". Health Psychology, 34(4), pp. 417-425. doi: 10.1037/hea0000176 ONLINE: http://openaccess.city.ac.uk/11639/ [Last Accessed 21/07/2016].
2. NICE (2004) Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer, The Manual. ONLINE: https://www.nice.org.uk/guidance/csg4/resources/improving-supportive-and-palliative-care-for-adults-with-cancer-773375005 [Last Accessed 21/07/2016].
3. Berger, L. et al. (2013) A Canadian Experience of Integrating Complementary Therapy in a Hospital Palliative Care Unit. Journal of Palliative Medicine, 16 (10).
4. Fleisher, K.A. et. al. (2014) Integrative Reiki for Cancer Patients: A Programme Evaluation, Integrative Cancer Therapies, Vol. 13(1) 62 –67
5. Henneghan, A. M. & Schyner, R. N. (2015) Biofield Therapies for Symptom Management in Palliative and End-of-Life Care. American Journal of Hospice and Palliative Medicine, vol. 32, no. 1, p. 90-100, 1049-9091 (February 2015).
6. So, P.S. et al. (2012) Touch therapies for pain relief in adults (Review). The Cochrane Library. 2012 Issue 8.
7. Kumar, S.P. et. al. (2014) Efficacy of Therapeutic Touch and Reiki for Pain Relief in Disease Conditions: A Systematic Review, Journal of Psychiatric Nursing, 3 (1) 1 – 40.
8. Thrane, S. & Cohen, S.M. (2014), Effect of Reiki Therapy on Pain and Anxiety in Adults: An In-Depth Literature review of randomized Trials with Effect Size Calculations. Pain Management Nursing, 15(4) pp 897 – 908.
9. Olsen, K. Hansen, J. Michaud, M. (2003) A Phase II Trial of Reiki in the Management of Pain in Advanced Cancer Patients, Journal of Pain and Symptom Management, 26 (5)
10. Birocco, N. et.al. (2011) The Effects of Reiki Therapy on Pain and Anxiety in Patients Attending a Day Oncology and Infusion Services Unit, American Journal of Hospice & Palliative Medicine® 00(0) 1-5
Angela established the Reiki Incentive for Reiki practitioners who want to see Reiki more widely accepted and to see it reach new people. She enjoys sharing her passion for authentic practice as well as research into the benefits of this wonderful therapy.