It's a lovely idea to think that there are no limits, and that we can have everything we want.

Certainly, a massive part of the US advertising industry is dedicated to selling that dream, precisely because it's such an appealing one. There is no shortage of people who will pay good money for the hope of living without limits.

In the realm of dreams and ideas, there may well be practically no limits to what we can imagine. But the material physical world imposes constraints, or limits, on what matter and energy are capable of, and what they cannot do.

We don't understand everything about why matter and energy behave the way they do, but over the centuries, we've observed them in enough different situations that we're pretty good at describing how they behave in those situations. It's very much like the situation with gravity--there are several different and mutually exclusive proposals for what gravity is, and why it works the way it does.

But we don't need to wait until those questions are decided to be able to predict how gravity will behave well enough for hundreds of thousands of airplanes worldwide to take off and land safely (for the most part) every day. We can predict its behavior so accurately that in 1970, when the Apollo 13 spacecraft suffered an explosion and fire on the way to the moon--an explosion which left the spacecraft badly damaged, and low on fuel to get back to earth, and oxygen for the astronauts to breathe--ground control was able, on the fly, to improvise a plan that took advantage of the Moon's gravitational field to act as a "gravity slingshot" to propel the spacecraft and all 3 astronauts safely back home.

Source: http://upload.wikimedia.org/wikipedia/en/f/fd/Gravity_Assist_analogy_Kohlhase_Hovland.jpg accessed 7 October 2012

Source: http://upload.wikimedia.org/wikipedia/commons/f/fc/Apollo_13_timeline.svg accessed 7 October 2012

The same is true for matter and energy. These behaviors are so reliable that their descriptions are called "laws of physics"--metaphorically, it's as if they "know" they have to "obey" certain "laws", so they always do so.

Of course, science never says anything is definitively, 100% certain. Some things are very uncertain, and they're likely to be revised as we learn more about them.

Other things, while not 100% certain, can be almost 99.9999% certain--so the effect is as though it's perfectly certain, even though there's always that tiny 0.0001% chance it will be changed someday in light of new evidence, if that new evidence ever does show up on the scene.

The limits of the material physical world around us have been observed, described, and discussed for thousands of years, and, because they are so reliable, you can see, many times, the same description of the consequences of those laws of physics being discovered independently in different cultures far away from each other in time and space as ancient Greece and medieval India.

Source: http://upload.wikimedia.org/wikipedia/en/8/89/Panini%2C_the_great_Sanskrit_grammarian..jpg accessed 7 October 2012

One of those consequences, borne out time and time again by the behavior of matter and energy, has been described as the "principle of non-contradiction"--that, in the material physical universe, something cannot both exist and not-exist at the same time, or that something cannot be both true and false at the same time.

Did that statement make you think of Schrödinger's Cat? If so, then that's an excellent question you raise!

At first glance, it seems as though the cat might provide an exception to that rule: the cat is both dead and alive at the same time in this thought experiment.

Yet it doesn't really, and here's why.

Source: http://upload.wikimedia.org/wikipedia/commons/9/91/Schrodingers_cat.svg accessed 7 October 2012

It is typical of these cases that an indeterminacy originally restricted to the atomic domain becomes transformed into macroscopic indeterminacy, which can then be resolved by direct observation. That prevents us from so naively accepting as valid a "blurred model" for representing reality. In itself, it would not embody anything unclear or contradictory. There is a difference between a shaky or out-of-focus photograph and a snapshot of clouds and fog banks.--Wikipedia, "Schrödinger's cat" accessed 7 October 2012

—Erwin Schrödinger, Die gegenwärtige Situation in der Quantenmechanik (The present situation in quantum mechanics), Naturwissenschaften
(translated by John D. Trimmer in Proceedings of the American Philosophical Society)

 

When we're talking about the cat being simultaneously dead and alive, we are talking about a phenomenon at only the subatomic level of organization--what Schrödinger called "an indeterminacy originally restricted to the atomic domain".

When we're engaging with clients in a therapeutic encounter, however, we are not engaging solely on a subatomic level--we're engaging at many levels, up to and including the organism level: Schrödinger's "macroscopic" level.

To confuse the subatomic level of organization with the organism level is to make the same mistake as to assume that--because both sodium and chloride as elements are immediately and painfully deadly to humans at the atomic level, then their compound--salt--also shares those properties. (Although it is true that too much salt over too many years can wreck your health, but only in a very different way from elemental sodium and elemental chlorine.)

To confuse those levels of organization with each other is to "naively accept...as valid a 'blurred model' for representing reality". At the subatomic level, without an observer, we can use words or images like the previous one to imagine a cat that is simultaneously dead and alive.

In our macroscopic material physical reality, the moment an observer looks at the cat to see what is going on, the subatomic waveform collapses--it definitively commits to one state or the other, but not to both at the same time--and we have either a dead cat, or a live cat, but never both simultaneously.

Unlike the poor cat (sometimes), the law of non-contradiction is still alive and well at the organismal level of material physical reality, where our therapeutic encounters with our clients take place.

Our metaphorical "waveforms" also are forced to collapse in one direction ot the other at this point, but--unlike the electron--at least we get to choose which of the two mutually-exclusive options we commit ourselves to.

This principle shines a spotlight on where a number of the most heated battles in massage's culture wars are currently taking place.

We have to decide one way or the other on the following question--because of the law of non-contradiction, we can't just say "both", and hand-wave our way out of the profound philosophical and scientific questions it raises.

As a first principle, do we accept or reject the reality of the material physical universe?

We have the freedom to choose either answer, but--no matter how much we may want it--we can't have it both ways.

The answer we choose to that question will determine what we have to offer to clients, as well as how we relate to one another.

This, in turn, will set in motion what history will tell about how our future of massage turned out.

This is a topic which always inspires a lot of passion, so I'll just remind everyone once again of the discussion policies here at POEM.

You are free to hold any opinion you want, and you won't be censored simply for disagreement (although you may well be challenged to show your evidence and connect the dots), but you do have to express yourself in a civil, appropriate, and professional manner.

This is a place that represents massage to all stakeholders in the community; for that reason, I don't permit it to degenerate into bar-fights that diminish our efforts to become a healthcare profession.

Professionals can have different, even opposite, opinions on issues and still respect each other. I have a great deal of respect for Sandy Fritz; I just disagree with her on the issue of energy-based methods.

If I did not respect her and my audience's ability to understand the arguments I am making, I would not spend the time and effort to spell out my thought process to consider and respond to. That engagement and reciprocity is the opposite of negativity; I consider not engaging with others in the realm of ideas a much worse snub than simply disagreeing.

I refer to her by last name when I mention her directly in the post; that is not rude, abrupt, or brusque. It is an accepted form of professional discourse which levels the playing field by not implicitly favoring people with titles such as "Dr." over others, concentrating instead on the issues, facts, and evidence that they bring to their arguments.

Sandy Fritz has written a blog post about energy-based methods in massage, available by clicking here. She has clearly given a great deal of thought to these issues.

A thoughtful post deserves a thoughtful response, so I am taking the time and effort to respond clearly and in detail to the points she is raising.

I just taught a class on  incorporating energy based methods into massage.  Every time I teach this class I wonder why this area continues to be controversial.

The concept of "energy" as it is described and as claims are made about it is at the heart of the culture wars currently raging in massage.

These philosophical arguments have gone on for centuries, and we are not about to resolve them anytime soon. The only thing we can do is decide, as a developing profession, either to be on the same page about them, or to split and go our separate ways, because they are not reconcilable.

This irreconcilability is the reason that this area continues to be so controversial. The arguments that cannot be reconciled include:

• dualism versus monism:
  • Dualism is commitment to the statement that things in the universe belong in two mutually exclusive categories--matter as opposed to spirit, for example.
  • Monism is commitment to the statement that all things in the universe belong to the same category--that there are not two different categories at all. 
• vitalism versus materialism:
  • Vitalism is:

    • 1 : a doctrine that the functions of a living organism are due to a vital principle distinct from physicochemical forces

      2 : a doctrine that the processes of life are not explicable by the laws of physics and chemistry alone and that life is in some part self-determining [Merriam-Webster Free Online Dictionary: Vitalism accessed 8 December 2011]

  • Materialism, by contrast, holds that all things can be explained in terms of what we know about:
    • matter;
    • energy as it is understood in the scientific sense;
    • the interactions among those entities; and
    • emergent effects arising out of those interactions that are more than the sum of their parts.

I think it is the mystical factor when in reality there is no mystery at all. 

Here, I respectfully disagree.

The arguments linking thermodynamic energy to the energy healing concept all, universally, without exception, require a mystical leap of faith to make that connection. When we get there in her post, I will show where Fritz does exactly the same thing.

That metaphysical leap of faith contains the mystery associated with the energy healing concept, which some of us are happy to accept without questioning, and which others of us have a large problem with.

The energy healing concept cannot be directly connected to thermodynamic energy without that leap of faith, which is what makes this issue so irreconcilable.

" Energy work" is different than spirituality but the two are often interconnected.

Fritz is quite right here that the two are linked, although I would take it further and state that the two are always interconnected.

The fundamental question that lies at the center of the debate is whether the physical material world that we can directly observe is all that there is, or whether there is a spiritual world that lies beyond physics (metaphysics = μετά/meta, "beyond" + physics).

To understand the plausibility of energy methods it is necessary to understand more about physics. 

I agree on the surface with what Fritz says here, but I think we mean very different--even opposite--things by it.

Fritz has presented foundational information about physics in a way that she thinks obviously makes her case for the connection stronger.

I disagree with her interpretation about what the facts mean, and I think the disagreement arises out of the metaphysical leap of faith that she takes in conflating three things:

• the well-understood facts about thermodynamic energy from physics;
• the way that people in New Age circles talk about "energy"; and
• emotions.

To ensure that we're all on the same page, the definition of "plausibility" is "seeming to be valid". A plausible explanation is an explanation that, on its face, makes sense or appears to be in accordance with what we know.

From the point of view of physics, whose specialty is the study of energy and matter, the energy healing concept is not plausible, because it contradicts so much of what we already know about physics.

Certainly, it is possible to find physicists who agree with New Age claims about energy, just as it is possible to find earth scientists who are skeptics about anthropogenic global climate change, despite the overwhelming consensus of scientists that it is occurring.

The point of evaluating a claim is not whether you can find a few individuals who agree with you; it's whether the claim holds up under scrutiny holistically--in light of the entire discipline and of the evidence. The way that the energy healing concept is expressed in New Age philosophy, it contradicts so much of the foundational knowledge in physics that the overwhelming majority of physicists do not find it at all plausible.

So the burden of proof that energy-healing advocates have set for themselves is not just to come up with plausible-sounding words, but to show that their hypothesis actually explains facts in the material physical world better than the consensus of mainstream physics, accumulated over centuries of observation and testing, explains them.

I also pose the question to our developing profession--how do we want to present ourselves to our potential colleagues on the healthcare team, such as medical physicists?

Do we accept and respect the work they have done to establish knowledge in their own specialties, or do we insist that we ourselves have the knowledge to evaluate the evidence in other specialist fields, and to insist on contradictory claims instead?

Which path does our profession choose, and why?

One of the e-Books under development at POEM is an introduction to foundational knowledge in physics. My intent is to provide you with the tools that--if you choose to make use of them--will equip you to evaluate claims in light of what we already know about physics, and of emerging evidence, and to determine whether those claims hold up when examined.

Here is my point. Machines that use energy waves are being studied.

Fritz is absolutely right on this point. Thermodynamic and electromagnetic energy is used in applications ranging from diagnostic medical imaging (X-rays, CAT scans, MRIs, and so forth) to ultrasound for pain relief to magnetism to treat severe depression, and much more.

Results are mixed. No one questions that humans have electrical fields.

I'm not sure what she means by "results are mixed", but it's true on many levels. For example, you can see soft tissues clearly on MRI images, not so much on X-rays.

But I think that I may be missing the point she wants to make here, and I welcome clarification.

And that human tissues have bioelectromagnetic properties is also indisputable. It's a fact that has been established decades ago.

The important question is, what is the significance of those electrical impulses? Is it nothing more than white noise, generated by millions of independent interactions at the subcellular level, or is it a top-down, coherent entity that has an independent existence and properties of its own?

Here is where Fritz takes the metaphysical leap of faith I mentioned earlier:

I think the big question is if humans can purposefully direct their energy fields.  Here is what I suggest- approach each client with  the energy of compassion, respect and  intent to help using solid massage application.

In the first sentence, she is speaking of objectively-detectable electrical activity at the subcellular level. In the second sentence, she is speaking of complex and sophisticated emotions and cognition that are not objectively detectable.

By juxtaposing the sentences, she is claiming that they are the same thing, but she is not doing the work to connect the dots to demonstrate that they are, indeed, the same thing. She is, implicitly, asking us to take the same leap of faith to consider the two phenomena (subcellular ionic activity and complex emotions/cognition) to be equivalent to each other.

Don't mix up your spirituality with your massage and respect each clients spirituality as sacred spaced.

I can totally agree with this statement, as long as it is extended to afford exactly the same respect to clients who do not have, and do not feel the need to have, any spirituality at all.

If we aspire to become healthcare providers, religious discrimination has no place in our developing profession. If we afford exactly the same respect to non-believers as to believers in the public therapeutic space, then I have no quarrel at all with people practicing their own private spirituality in their own way.

Requiring faith in untestable and unprovable metaphysical ideas as part of a healthcare profession is inconsistent with a mission to provide equal quality service to everyone who seeks it.

For that reason, the biopsychosocial model of massage, under development here at POEM, respects everyone's freedom of conscience as a human right in their unique personal space, but explicitly excludes metaphysical leaps of faith from the universally-accessible knowledge repository that is being built.

Keep an open mind -who knows what technological advances will be able to figure out. 

Fritz' principle is a good one to keep in mind, but consider this as well: many eager, earnest, committed people have been trying for decades, without success, to make the connection between the well-established principles of thermodynamic energy in physics, complex mental processes like emotions, and the concept of energy in New Age thought.

If they have spent this much time and effort in that effort without success until now, how likely is it that they are going to definitively succeed in future?

Where are our time and effort and resources, in an age of limits, best and most effectively allocated with the most likelihood of success?

At what point do we say that specific hypotheses have had a fair chance, and failed at it, to demonstrate that they work better as an explanation or a predictor of processes in the material world?

This is taken directly of the NIH web site.

At this point, Fritz is quoting someone else who wrote for the NIH website, so I am not engaging directly with her anymore, but with the anonymous author of the text at the site.

Some CAM practices involve manipulation of various energy fields to affect health. Such fields may be characterized as veritable (measurable)

Now this equivalence is not true--juxtaposing a term in parentheses with another term implies that the two terms are synonyms, but here, they are not. "Veritable" (L. veritatem [nom. veritas] "truth, truthfulness," from verus "true" Online Etymology Dictionary accessed 8 December 2011) does not mean "measurable"; it means "real", "true", "actual", or "genuine".

or putative (yet to be measured).

Whoever wrote this for NIH did the same thing with this definition as they did with the one for "veritable".

Putative means "claimed".

"Yet to be measured" is an equivocation that implies it can be measured; they just haven't gotten around to it yet. However, there are at least two other possibilities:

• it is yet to be measured, and never will be, because it is inherently unmeasurable;
• it is yet to be measured, because all attempts to do so have failed.

Reading that sentence as they wrote it, implying that the only difference between veritable and putative energy is whether it has been measured yet, is quite misleading.

A more accurate statement would be:

Such fields may be characterized as veritable (true/real) or putative (claimed).

But that comes across very differently than the other version, doesn't it?

This rewrite also serves to highlight clearly where the leap of faith occurs--between physics, which can objectively measure electromagnetic energy, on beyond physics into metaphysics, where claims are asserted, but cannot be objectively measured.

Practices based on veritable forms of energy include those involving electromagnetic fields (e.g., magnet therapy and light therapy).

Absolutely true. These kinds of therapy are solidly in the realm of physics, and while the principles understanding the forms of energy used in them are fairly well-understood from a physical point of view, new and exciting applications are being developed by researchers all over the world and applied in the clinic.

Practices based on putative energy fields (also called biofields) generally reflect the concept that human beings are infused with subtle forms of energy; qi gong, Reiki., andhealing touch are examples of such practices.

The practices reflect the "concept", or idea, of biofields. There is no mention of any empirical reality to justify the concept that they reflect, because research in these areas has stalled at still trying to demonstrate they exist--a state it's been in for decades now. The empirical reality does not yield results that advance the concept.

In real life, a dogwhistle makes a sound that it so high-pitched (high in the frequency of its energy) that human ears cannot hear it, although dog ears can.

Similarly, in rhetoric, the metaphor "dogwhistle" refers to a term or phrase that carries a hidden message, that some readers are able to pick up on, but which is undetectable to other readers.

The use of the term "subtle" in energy-healing contexts is a vitalist dogwhistle for "spiritual component". Readers who are familiar with vitalist writings recognize the appeal to the spiritual contained in the word; other readers interpret it as an adjective meaning "delicate" and do not recognize that this statement is a commitment to a vitalist metaphysics.

The 2007 NHIS found relatively low use of putative energy therapies. Only 0.5 percent of adults and 0.2 percent of children had used energy healing/Reiki (the survey defined energy healing as the channeling of healing energy through the hands of a practitioner into the client's body).

http://nccam.nih.gov/health/whatiscam/

When we are working with survey definitions, we are still working with concepts, not with empirical physical reality. To say that energy healing is "the channeling of healing energy through the hands of a practitioner into the client's body" is not the same thing as to actually do it.

Energy healing research is stuck in the position of trying to prove it exists in the New Age conceptualization that its advocates promote, and as a result, it has not advanced in decades.

In my opinion, if its advocates would stop trying to force a dualist/vitalist explanation onto it, and investigated it in terms of psychological processes, they would get a great deal more traction, both in the laboratory and in the clinic.

When I was looking for some sort of current "energy healing" used in the health care world I found Pulsed RadioFrequency. Pulsed RadioFrequency (PRF) is a relatively new technique derived from a well established and proven intervention, thermal radiofrequency (RF).

PRF is well within the domain of physics, and the new derivation of PRF from thermal RF is an example of the advances and new implementations from research that are being delivered to the clinic from the material physical energy side of the discussion.

Both procedures are used in the treatment of chronic pain. Unlike RF treatment, PRF does no direct damage to the nerve. During PRF treatment, electrical energy is applied with a small needle to the affected nerve using a pulsed time cycle that delivers short bursts of RF current, any frequency within the electromagnetic spectrum associated with radio wave propagation. When an RF current is supplied to an antenna, an electromagnetic field is created that then is able to propagate through space. Many wireless technologies are based on RF field propagation. 

These frequencies make up part of the electromagnetic radiation spectrum: 

• Ultra-low frequency (ULF) -- 0-3 Hz
• Extremely low frequency (ELF) -- 3 Hz - 3 kHz
• Very low frequency (VLF) -- 3kHz - 30 kHz
• Low frequency (LF) -- 30 kHz - 300 kHz
• Medium frequency (MF) -- 300 kHz - 3 MHz
• High frequency (HF) -- 3MHz - 30 MHz
• Very high frequency (VHF) -- 30 MHz - 300 MHz
• Ultra-high frequency (UHF)-- 300MHz - 3 GHz
• Super high frequency (SHF) -- 3GHz - 30 GHz
• Extremely high frequency (EHF) -- 30GHz - 300 GHz

This is excellent information, and I applaud Fritz for presenting it. I agree that we should know basic physics as foundational knowledge, both as MTs and as citizens who vote on policy issues, and that's why it will be included in POEM e-Books.

Source: http://www.astrosurf.com/luxorion/Radio/spectrum-radiation.png accessed 9 December 2011

The details of specific imaging and treatment technologies are not so important for our information needs, but understanding at a very high level what other professionals on the healthcare team do will promote collaboration and communication with them for the benefit of the client.

Fritz includes some links to PubMed articles. These articles posted here can be categorized into two groups.

The explanatory mechanisms in this group of articles fall solidly into the domain of testable, observable, medical physics.

• http://www.ncbi.nlm.nih.gov/pubmed/20440207
  Snidvongs S, Mehta V. Pulsed radio frequency: a non-neurodestructive therapy in pain management. Current Opinion in Supportive and Palliative Care. 2010 Jun;4(2):107-10.
• http://www.ncbi.nlm.nih.gov/pubmed/18721175
  van Boxem K, van Eerd M, Brinkhuizen T, Patijn J, van Kleef M, van Zundert J. Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence. Pain Practice. 2008 Sep-Oct;8(5):385-93.
• http://www.ncbi.nlm.nih.gov/pubmed/12535508
  Niemisto L, Kalso E, Malmivaara A, Seitsalo S, Hurri H. Radiofrequency denervation for neck and back pain. A systematic review of randomized controlled trials. Cochrane Database of Systematic Reviews. 2003;(1):CD004058.
• http://www.ncbi.nlm.nih.gov/pubmed/22008239
  Rohof O. Intradiscal Pulsed Radiofrequency Application Following Provocative Discography for the Management of Degenerative Disc Disease and Concordant Pain: A Pilot Study. Pain Practice. 2011 Oct 19.
• http://www.ncbi.nlm.nih.gov/pubmed/21116663
  Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review. Acta Neurochirugica (Wien). 2011 Apr;153(4):763-71.

The explanatory mechanisms in this group of articles, by contrast, fall into the domain of metaphysics:

• http://www.ncbi.nlm.nih.gov/pubmed/15750367
  Nelson LA, Schwartz GE. Human biofield and intention detection: individual differences. Journal of Alternative and Complementary Medicine. 2005 Feb;11(1):93-101.

Note the following sentence in the "Methods" section of the Abstract:

"METHODS...Subjects were also assessed on their awareness of their own biofields, and they filled out various questionnaires, including estimates of how well they thought they would do and their openness to spiritual beliefs and experiences."

If, as advocates claim, energy healing is independent of spirituality, why did they survey subjects on their openness to spiritual beliefs and experiences?

• http://www.ncbi.nlm.nih.gov/pubmed/15025891
  Schwartz GE, Swanick S, Sibert W, Lewis DA, Lewis SE, Nelson L, Jain S, Mallory L, Foust L, Moore K, Tussing D, Bell IR. Biofield detection: role of bioenergy awareness training and individual differences in absorption. Journal of Alternative and Complementary Medicine. 2004 Feb;10(1):167-9.

• http://www.ncbi.nlm.nih.gov/pubmed/15025885
  Creath K, Schwartz GE. Measuring effects of music, noise, and healing energy using a seed germination bioassay. Journal of Alternative and Complementary Medicine. 2004 Feb;10(1):113-22.
• http://www.chalicebridge.com/Oschman&Daily/OschmansOnTheirBook.html

(UPDATE, 2 October 2011: link to the free fulltext PDF article is here; as well, the text of the article will be posted here at POEM for us to read through together, per their Creative Commons license. Cheers, to rchunco, for the improved suggestion!)

Let's go through this article together, sharing our insights along the way.

A Randomised Controlled Single-Blind Trial of the Efficacy of Reiki at Benefitting Mood and Well-Being

Deborah Bowden, Lorna Goddard, and John Gruzelier

Psychology Department, Goldsmiths, University of London, ITC Builidng[sic], New Cross, London SE14 6NW, UK

 

Abstract: This is a constructive replication of a previous trial conducted by Bowden et al. (2010), where students who had received Reiki demonstrated greater health and mood benefits than those who received no Reiki.

In the space of only one sentence in the abstract, a great deal of meaning is contained.

Let's save the first specialized term, "constructive replication", for last, as it is the most-complicated concept in the sentence.

The rest of the sentence is relatively straightforward.

The previous trial (or study) conducted by Bowden et al. (and others) is the following:

D. Bowden, L. Goddard, and J. Gruzelier, “A randomised controlled single-blind trial of the effects of Reiki and positive imagery on well-being and salivary cortisol,” Brain Research Bulletin, vol. 81, no. 1, pp. 66–72, 2010.

Unlike the study we're going through now, the 2010 article is behind a paywall, so I can't post it for reference. I can, however, quote relevant parts of it under the Fair Use provision, and so I'll do that as appropriate in discussing this article.

Bowden summarizes the results of the 2010 study as showing that "students who had received Reiki demonstrated greater health and mood benefits than those students who received no Reiki". This study is an attempt to replicate, or reproduce, those results.

Replication of studies has a long history in science. The entire point of an effect being universal, objective, and mind-independent (as opposed to unique, subjective, and mind-dependent) is for anyone to be able to reproduce the effect or outcome in question. Replication is how you demonstrate that anyone can do so.

It's also how you can ethically offer the possibility of specific outcomes to the client. No outcome is ever guaranteed, of course, but a reliably reproducible outcome at least holds the potential of your being able to deliver it to your client. If it can't be reliably reproduced, on the other hand, then how can you promise the client that there is a good chance that you will be able to deliver it?

For these reasons, replication studies are very important in scientific and clinical research in general, and specifically in massage research, as it can help us build our validated knowledge base.

"Constructive replication" is a very specific kind of replication, where researchers try to reproduce a study using methods that are different from the original study. At first, that may sound like a contradiction in terms, but it's actually a technique that has an established history in clinical research.

The primary reason that people carry out constructive replication is to try to demonstrate that--even when the study is carried out in a different way--the treatment is still associated with the desired results. It's like the cause-and-effect connection is so strong that it will come about one way or another; not just in the one way that was demonstrated in the previous study.

So what she's saying is that she's satisfied that the previous study validated the connection strongly enough that a constructive replication will expand and generalize the results from the ones in the first study.

We can add that to our list to check as we read through this one:

How methodologically sound was the 2010 study that this study is trying to generalize from?

The next sentence is straightforward:

The current study examined impact on anxiety/depression. 40 university students—half with high depression and/or anxiety and half with low depression and/or anxiety—were randomly assigned to receive Reiki or to a non-Reiki control group.

When we're reading the rest of the article, we'll look for an indication of how that number of 40 students was determined to have sufficient power for this study:

How was the number of 40 participants chosen, and what steps did the authors take to ensure that 40 participants made up a sufficiently-sized sample? 

The next sentence is somewhat unclear, although I expect the main article will clear up the ambiguity:

Participants experienced six 30-minute sessions over a period of two to eight weeks,

Does that mean some people got 6 sessions in 2 weeks, while others got 6 sessions in 8 weeks? That seems like a pretty wide variation in the treatment--such a large variation, in fact, that I would question whether or not we're comparing apples to oranges.

We'll look for a fuller explanation of this difference in the main article:

What is the actual discrepancy in timing of treatments, and what does this mean for the study?

The next note is totally one of style, not of substance, and doesn't affect the conclusions we'll draw from this article:

where they were blind

The correct word here is "blinded", rather than "blind". As mentioned, this won't affect our assessment of the article itself, but when you are writing research articles, you'll want to make sure you get that detail right.

to whether noncontact Reiki was administered as their attention was absorbed in a guided relaxation.

This sounds like a standard approach to providing a control for an intervention such as Reiki or massage.

The efficacy of the intervention was assessed pre-post intervention and at five-week follow-up by self-report measures of mood, illness symptoms, and sleep.

This looks fairly standard for testing for the capacity of the treatment to have an effect on the outcomes measures listed. We'll look at this in more detail in the Methods section.

The participants with high anxiety and/or depression who received Reiki showed a progressive improvement in overall mood, which was significantly better at five-week follow-up, while no change was seen in the controls.

Bowden is saying here that the students with either high anxiety, high depression, or both, showed an improvement in mood that continued to get better after the end of the study for the 5 weeks leading to the followup assessment. Additionally, she reports that this improvement is statistically significant, which means they've determined that the probability that this is a chance result, rather than a real treatment effect, is less than 5%, or 1 chance out of 20.

While the Reiki group did not demonstrate the comparatively greater reduction in symptoms of illness seen in our earlier study, the findings of both studies suggest that Reiki may benefit mood.

Bowden reports that the constructive replication did not show the same effects in the Reiki group with regard to reducing illness symptoms, but that both studies suggest that Reiki may benefit mood.

Notice her use of the word "suggest" and "may". This tentativeness is quite correct when drawing conclusions from a study. It is extremely rare to definitively determine cause and effect in this way; much more usual is the slow building of a solid body of evidence, which tends to point in one way or the other.

So that's what I've gotten our of the abstract. Did you get anything else from it?

Please share it with us in the comments, if so, and we'll proceed to the Introduction section shortly.