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Reiki Doesn’t Work Either

by Steven Novella, Oct 17 2011

I don’t think I have written specifically about Reiki before. This is a form of “energy healing,” essentially the Asian version of faith healing or laying on of hands. Practitioners believe they are transferring life energy to the patient, increasing their well-being (sound nonspecific enough?). The practice is popular among nurses, and in fact is practiced by nurses at my own institution (Yale).

Reiki is very similar to therapeutic touch, another energy healing modality that was popular among nurses, and although it continues to be used it is much less popular after 9 year old girl (Emily Rosa) performed an elegant experiment to show that it was nothing but self-deception. Reiki nicely moved in to fill the void.

The research on Reiki, and energy healing in general, is similar to that of many similar modalities – those with very low scientific plausibility that are not taken very seriously by medical scientists. The research is of generally low quality, poorly controlled small studies that seem designed to justify Reiki rather than see if it actually works. A 2011 review concluded just that:

The existing research does not allow conclusions regarding the efficacy or effectiveness of energy healing. Future studies should adhere to existing standards of research on the efficacy and effectiveness of a treatment, and given the complex character of potential outcomes, cross-disciplinary methodologies may be relevant. To extend the scope of clinical trials, psychosocial processes should be taken into account and explored, rather than dismissed as placebo.

In other words – existing research is a such poor quality we cannot draw any useful conclusion from it. I disagree, however, that this necessarily means that more research is needed. The low plausibility of using magical energy that has never been demonstrated to exist by medical science argues otherwise. Further, the last sentence is odd – it suggests the authors are trying to spin placebo effects into real effects. This is increasingly the strategy of alternative medicine advocates as it becomes clear that most of the modalities they favor do not work any better than placebo (which means they don’t work).

Reiki is now squarely in that camp. Published at about the same time as the review (and therefore not included in the review) is a well-designed study of Reiki where Reiki was compared to placebo Reiki (someone not trained in Reiki simply goes through the motions) vs usual care (no intervention). Not surprisingly, both the real Reiki and the sham Reiki groups did better on self-reported well-being than the no intervention group, but they were indistinguishable from each other. Therefore Reiki did not better than placebo. That means Reiki doesn’t work (at least in the regular world of science-based medicine).

The authors conclude:

The findings indicate that the presence of an RN providing one-on-one support during chemotherapy was influential in raising comfort and well-being levels, with or without an attempted healing energy field.

Hmmm…I notice they did not conclude “Reiki doesn’t work.” That’s odd. Both the treatment and placebo groups had the same effect on subjective outcomes. With regular medical interventions, we conclude the treatment does not work. Imagine a pharmaceutical company concluding:

The findings indicate that taking a pill during chemotherapy was influential in raising comfort and well-being levels, with or without an active ingredient.

Therefore – taking pills is helpful. Let’s not fret about whether the active ingredient has any specific physiological effects. Reiki supporters appear to have taken a page out of the Acupuncture handbook. If real and sham acupuncture are both better than no intervention (they argue), than acupuncture works, whether real or placebo.

This article by Edzard Ernst recently published in the Guardian also discusses this Reiki study. Ernst points out that, not only is it scientifically dubious to conclude from such studies anything other than the treatment does not work, it is ethically dubious to give such treatments as a placebo intervention. He writes

By insisting that patients must not be treated with placebos like reiki, scientists also advocate that they receive treatments that demonstrably work better that placebo. For instance, massage has been shown to improve the wellbeing of cancer patients beyond a placebo effect. If a patient receives a massage with empathy, sympathy, time, understanding and dedication, she would benefit from the placebo effect – just like the reiki patient – but, in addition, she would also benefit from the specific effect of the treatment that massage does and Reiki does not offer.

This is a critical point that I have been making also. Essentially, you cannot justify ineffective treatments simply because they provide a placebo effect. That is because effective treatments also provide the same placebo effect, but also provide specific benefits because they actually work.

I would argue that there are also many potential harms from convincing patients that unscientific treatments are effective because of their non-specific placebo effects. This is a deception, violates patient autonomy and informed consent, and sets them up to perhaps rely on ineffective “magical” treatments for non-self-limiting illnesses.

Let’s get back to the authors conclusions from the Reiki study – they argue that this study shows that the:

“presence of an RN providing one-on-one support during chemotherapy was influential in raising comfort and well-being levels…”

The part about “with or without an attempted healing energy field” is entirely irrelevant, and you could just as well substitute any ineffective or magical treatment for “healing energy” is that statement. But the first part of the conclusion is also dubious, in that we did not need this study to come to this conclusion.

It has already been well-established, to the point that it is appropriately taken as a given, that people feel better when they get the kind attention of someone else, especially if they are sick and that person is a health care professional with training and experience in comforting sick patients. We don’t need to keep studying this over and over again.

Kind attention plus X makes people feel better, just as well as kind attention alone. Great. We do not need to study this with every possible form of nonsense filling in for X. And it is deceptive and unscientific to suggest that whatever fills in for X has some value because of this equation.

This is what I call the “part of this complete breakfast” fallacy. Even as a child I recognized that when a commercial advertised their pastries as being part of the complete nutrition offered by an otherwise nutritious breakfast, the pastries were nutritionally irrelevant. They added nothing, and the commercial was being deceptive in trying to make me think that they were nutritious simply by their proximity to a nutritious breakfast.

Reiki, acupuncture, homeopathy, and similar methods may be “part of this feel-good intervention,” but they are an irrelevant and superfluous part. It is the kind attention of the practitioner that matters – and only that attention. So such attention might as well be part of legitimate science-based interventions that also have a specific physiological benefit.

Or – just give the kind attention by itself, without the magical mumbo jumbo. What is wrong with that? Why isn’t that good enough anymore?

21 Responses to “Reiki Doesn’t Work Either”

  1. Max says:

    “If real and sham acupuncture are both better than no intervention (they argue), than acupuncture works, whether real or placebo.”

    I’m reminded of a study that found real and sham acupuncture to be more effective than conventional therapy.

    • qbsdm says:

      The joke’s on the acupuncturists; my Hakke’s Method acupuncture class will cost $50 and take about 1hr to train prospective students in the state of the art in acupuncture, while their schools charge thousands of dollars and take weeks to teach students to achieve the same effects. And they have to recognize my degrees as providing equal value to theirs.

    • The real problem is that this isn’t homeopathic reiki. If you dilute your hands in water 60 times, first, then the reiki becomes powerful. Ditto for the acupuncture needles.

  2. Greg says:

    Thank you for discussing this topic. I agree that more research is needed. If legitimate scientific research completely ignores the claims made by advocates of potentially dubious techniques, it might just contribute to the notion that these modalities are outside of the scientific world view, and can not be held up to the same scrutiny we would demand for other techniques in the medical community.

  3. Or – just give the kind attention by itself, without the magical mumbo jumbo. What is wrong with that? Why isn’t that good enough anymore?

    What’s wrong with that? Fewer Fees.

  4. Retired Prof says:

    Why isn’t kind attention good enough?

    It’s plenty good enough for me, but I know people whose world-view may require some of what you and I agree is “magical mumbo-jumbo” just to authenticate caregivers’ efforts and trigger the placebo effect. I’m thinking of my relatives who request that their congregation remember them in prayer for their ailments; the thought eases their minds. Likewise, people who actually believe in acupuncture may feel relief from it (and it’s good to know it doesn’t have to be “genuine”).

    You’re right that placebos should never substitute for real treatment, of course. But it seems to me they can supplement actual remedies.

  5. Chris Howard says:

    Couldn’t Emily Rosa “rebrand” her previous experiment?

  6. Alan says:

    @Retired Prof – Sorry but you’ve reached the wrong conclusion. The point is not that placebos can supplement actual remedies but the fact that actual benefit is attributed to placebo remedies when that’s not the case. The placebo effect is a statistical artifact of a study and not an alternative method of treatment.

    Giving people an impression of benefit from treatment which offers none is evil and despicable. Sure, if they understood that ANYTHING which was substituted for the treatment was EQUALLY effective there wouldn’t be any harm. But people don’t act that way – they believe that the placebo treatment provided REAL benefit and it didn’t.

  7. Dear Steven,

    I was thinking that perhaps the belief in strong magical powers could lead to a stronger psychological effect on the patient — sort of a stronger placebo than just a pill. If that’s the case then the deception is a necessary part of the treatment, one needs it to obtain better results. When doing experiments both the “real” and fake healers are perceived as “real” by the patients and thus have the same effect, but if the patient is told that the healer is not trained, the placebo effect diminishes or disappears. Are there studies of how to correlate the effect of a placebo with the strength of the belief in it?


  8. Old Rockin' Dave says:

    The main reason I can see for the success of woo-woo “therapies” is a simple one: people want some concrete evidence that something is being done for them. It reduces anxiety. It’s just the same as waiting on a stalled train; you will be calmer if someone lets you know what’s going on. The patient can see the hand-waving of reiki, can feel the acupuncture needle, can convince himself that by taking spirulina or passing up a Big Mac that some active measure is in progress. It’s a truism that medical personnel don’t spend enough time with patients and often there is little that can be done to change that, but it is possible that some of that time can be used more wisely, to let the patient know what is happening. “I called radiology again. “We can’t do the MRI we need before we treat you because the machine is being repaired” or something similar is not very comforting, but it’s a lot better than silence and far better than someone waving their hands in the air over the patient.

  9. BillG says:

    To a degree, it’s possible a placebo or a “mumbo jumbo” takes effect only by knowing one has a good health insurance policy. Perhaps “worried sick” is only because simply you’re worried by the possbilty of being sick – if not only for monetary reasons.

    • tmac57 says:

      Hey,maybe if a Dr. decides to treat his patient with placebo,the patient can return the favor and pay him in counterfeit money. If he’s none the wiser,what’s the harm?

  10. whatnot says:

    “part of this complete breakfast” — great.

  11. Matt says:

    Why can’t they use massage or something similar which can actually improve comfort?
    Money better spent.

  12. BramKaandorp says:

    I have often heard believers of Reiki (and other such human-centered woo, such as seeing dead people) say that “everyone has it to some degree”.

    I never actually saw the implications of that claim.

    Now I do.

    One way out of any study using “real” and “fake” Reiki is to say “Well, since everybody has it in them to some degree, how do you know that the placebo group WASN’T receiving some real energy?”

    A last resort if there ever was one, but it is very effective in keeping other believers from looking into it more critically.

  13. I often lament that I have derived my sense of ethics from reason. If only I could rely on some supernatural essence to determine right from wrong, I would be able to develop my own method of convincing people I was helping them. Thus successfully separating them from their money, while making them feel good about it. Unfortunately, I could not do that and respect myself in the morning.

  14. QuilledMind says:

    Thank you kindly, Steven, for finally tackling this crazy issue.
    I should say though, I am a writer so all the spelling mistakes were sort of bugging me (proof-read, my friend!) though.
    Thanks again! Take care!

  15. oldebabe says:

    The efficacy of reiki is just another kooky wishful thinking. One (me, anyway)can only wonder from where all that energy is purportedly originated, and why/how it never runs out…

  16. Julien Rousseau says:

    The equation is simple:

    effect_of_reiki + effect_of_kindness = effect_of_kindness
    effect_of_reiki = effect_of_kindness – effect_of_kindness
    effect_of_reiki = 0.

  17. i Karamba says:

    If you have the Will and the Force everything works.
    If Reiki does not work, it means one thing only…
    There is no Will to make it Work.
    Thats it.

  18. Skeptigal says:

    Reiki is one of the silliest examples of CAM. If one reads up on the powers of a Reiki “Master” there is a time/space travel component. Reiki healing can be done by telephone (or over distance) and a Master can send their healing energy “back in time”. It leaves the curious to wonder why don’t they just retroactively heal the sick? It is also not unusual for Reiki to be among a list of nonsense “treatments” available from one quack. In my opinion, if Doctors practicing science based medicine just listened to their patients w/ more kindness a lot of this CAM nonsense wouldn’t be profitable.