Journal of Holistic Nursing Vol. 35 Number 4 (December 2017) pp. 369-381
A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice
Mary Anne Hanley, PhD, RN, QTTT, Sul Ross State University/Rio Grande College
Denise Coppa, PhD, APRN-CNP, FNP-C, QTTT, University of Rhode Island College of Nursing
Deborah Shields, PhD, RN, CCRN, AHN-BC, QTTT, Capital University
[QTTT = Qualified Therapeutic Touch Teacher]
Abstract
For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.
https://journals.sagepub.com/doi/full/10.1177/0898010117721827Excerpts:
"Healing as a human potential was one of the primary assumptions underlying the early development of Therapeutic Touch (TT) by Dolores Krieger and Dora Kunz (Krieger, 1979). Initially, described as a contemporary interpretation of ancient healing practices (Krieger, 1979; Macrae, 1987), through research and experience, TT has evolved as a holistic evidence-based therapy that is practiced worldwide (Coppa, 2008; Hanley, 2008; Therapeutic Touch International Association, 2012).
"During the subsequent 45 years, TT has been practiced in a variety of health care settings and taught in undergraduate and graduate programs around the world. Doctoral and postdoctoral research studies using quantitative and qualitative approaches contributed to the evolving knowledge base of TT.
"This body of knowledge provides support for ongoing inquiry into development of TT as a transpersonal holistic therapy. Healing has emerged as an important central concept experienced by both providers and recipients of TT. While there is a large body of literature related to healing as a process, there is not a clear and succinct theory of healing derived from experiential knowledge of health care providers or practitioners.
"The purpose of this article is to build on existing work and describe the developmental process for establishing a practice-based theory of healing based on the narratives of advanced TT practitioners. An interpretive narrative approach was used to highlight theoretical potentials of TT as an exemplar for a practice-based theory of healing."
"Kunz and Krieger developed TT, in what Krieger (2010) described as 'a time of transitional consciousness.' In 1972, they used specifically designed experiences and research evidence to establish TT as a healing modality. Their premise was that TT used the human energy field as a means to help and heal others (Baldwin & Hammerschlag, 2014; Krieger, 2002; Levin, 2011). Acknowledged as a compassionate transpersonal healing practice (Krieger, 2002), the goal of TT is to help facilitate the recipient’s innate healing potential. Three underlying principles of TT are compassion, the willingness of the practitioner to help or heal another, and nonattachment to outcome (Krieger, 1979; Kunz & Krieger, 2004).
"TT reflects the nursing process within the context of the unitary energy field process reflective of Rogers’s (1970) science of unitary human beings. TT was specifically designed as a human–environment energy process. The elements of the TT process begin with centering or quieting the mind to focus on the needs of the healing partner. Once centered, the practitioner assesses the person for discomfort, stress, or signs of distress, which may be expressed as energetic imbalances, such as anxiety. Based on the assessment, a plan is devised to provide compassionate support, comfort, and promote a sense of balance. Last, the treatment session is evaluated to measure the results of the session. Depending on the situation, the practitioner may or may not make physical contact with the person receiving TT.
"As a transpersonal approach to helping another participate in personal change, TT provides a purposeful and intentional means of acting, creating, promoting, and ordering patterns of wholeness through the compassionate use of self. One of the unique aspects of TT as a healing process is the integrality of the complex concepts that emerge and merge between the practitioner and recipient throughout the process."
"Evidence supporting the usefulness of TT is reflected in the research base, initiated by Krieger (1973) with the first study of TT and changes in hemoglobin levels, conducted in 1972, in which she demonstrated significantly improved heme levels in persons who received TT in comparison with persons who did not receive TT, and it continues to develop through clinical research conducted by bench scientists (Gronowicz, 2007; Gronowicz, Secor, Flynn, Jellison, & Kuhn, 2015) and through clinical studies exploring the application of TT to persons experiencing a variety of health challenges."
"Rogers (1970, 1994) proposed a unitary science, since described within a simultaneity and transformative paradigm (Fawcett, 2013), that outlined and described the nature of human beings as energy fields in continuous relationship with the environment. Rogers’s (1994) principles of homeodynamics describe the nature, direction, and characteristics of change. The increasing capacity to be aware of oneself in relation to others and to appreciate the unity of all things (Kunz & Krieger, 2004) underscores the relational nature of healing and the potential mutual transformation of self and others central to both the process and outcome of healing. Within a unitary transformative framework, theory is context based and used to describe or explain a phenomenon of concern (Malinski, 2006)."
"Theory is a dynamic organizing framework that supports knowledge development and application to practice (Kim, 2010; Reed & Shearer, 2011) based on the philosophies of holism, health orientation, person centeredness, and caring (Kim, 2015)."
"Theories designed to encompass a broad area of science (i.e., Rogers’s science of unitary human beings) are considered grand theories."
"In the case of the evolving theory of healing, TT experts initially focused on the steps and the specific processes of the practice. These evolved as meanings of the experiences within the community were articulated and synthesized into an illustrative narrative of healing and underlying concepts. The organization of this practice-based theory of healing evolved through analysis of group narratives and in-depth reviews of the literature encompassing healing, the human energy field, and TT."
"From 2010 to 2016, Krieger invited expert TT practitioners, teachers, and researchers to convene annually, in what has become known as the Montana TT Dialogues in Columbia Falls, Montana...At the conclusion of the first year’s meeting, Krieger posed the question about whether it was possible to elaborate a theory of healing derived from the practice of TT. This question guided the participatory explorations that took place over subsequent years.
"Over a 5-year period, between 2011 and 2016, more than 89 TT practitioners met in Columbia Falls. Supplied with decades of philosophy, assumptions, and deepening experiences of TT, the group moved into what Krieger (2010) described as 'a time of participatory consciousness,' which enabled the community to explore the meaning of healing through TT."
"By adopting participatory processes, the authors were empowered to move beyond the original constructs of TT to envision more abstract patterns that emerged as new conceptual connections. The focus of the dialogues shifted from describing TT to understanding the healing potential of TT by the practitioner and recipient—the healing partners—and gaining insights into the assumptions and concepts associated with healing. Through reflective dialogue and narrative analysis, we began to articulate a beginning theory of healing through the practice of TT."
"Koerner (2011) asserted that healing begins with consciousness. This proposed practice-based theory of healing evolved within the context of the experiential knowledge of TT practitioners."
"Healing is an inner experience, a human potential and function, expressed as a shift in consciousness in which the practitioner and healing partner experience transformation or change."
"Healing is experienced as transcendence, and reflects a therapeutic reciprocity that is continuous and simultaneous."
"The practice-based theory of healing, drawn from TT practice, is situated within a unitary framework and is consistent with Rogers’s (1994) assumption that humans are unified wholes. Rogers’ Science of Unitary Human Beings provides the foundation for examining the human experience of healing. Interrelated concepts, including human energy field, wholeness, compassion, intention, relationship, and change, were identified that elucidate the relational experiences of the practitioner and healing partner."
"The human energy field is a vital energy, a continuous whole recognized by its unique pattern, more than and different from the sum of parts; it is dynamic, creative, nonlinear, and unpredictable and flows in lower and higher frequencies (Shields et al., 2016). The human–environmental field is a unitary system in continuous process. The fields are pandimensional, 'without spatial or temporal attributes' (Rogers, 1992, p. 29). Healing, as a human potential (Krieger, 2012), can be actualized as the practitioner draws on the universal network of intelligent forces that underlie human healing (Krieger, 2011)."
"Intention is focusing of the mind with the purpose of directing universal and vital energy to help another. Within the theory of healing, intention is a purposeful shift in consciousness that allows the practitioner to communicate energetically with the healing partner leading to the healing state."
"Later narratives revealed that consciousness plays a central role in the process of healing and is a predominate function of the intuitive. Compassion is a necessary state for healing to occur. During TT, the practitioner intentionally shifts consciousness to a sustained centered state of consciousness for the benefit of the person in need."
"As a fundamental property of the universe, order was described by the TT experts who identified this concept as the relationship 'we experience [as] being internally related with or connected to the wholeness of the universe.'..Within the context of healing, order contributes to the organization of the human energy field and manifests through patterns or characteristics of the unique human energy field in relation to the environment."
"Healing emerges through epiphanal experiences when an individual’s wholeness is recognized by another, when resources for healing are made available, and the individual manifests a change in health patterning."
"Within the context of the engaging presence, the TT practitioner uses his/her centered state to create a healing relationship, acknowledging within that relationship the higher consciousness of self and partner. This construct is central to creating an environment for connection and the potential for change."
"This theory of healing articulates a theory that streams from practice, specifically the practice of TT practitioners. It represents a vital step in articulating a complex, unitary process that has long been a mystery."
"Frequently, the term healing is used alongside the term curing. Healing is not, however, limited to those with a health challenge but rather applies to all who experience shifts in consciousness."
"Mary Anne Hanley is a faculty member of Sul Ross State University and Rio Grande College, education trustee for the Therapeutic Touch International Association, and former board member of the American Holistic Nurses Association. A Therapeutic Touch practitioner, teacher, and researcher, she has explored Rogers’s Unitary Science as a theoretical underpinning of nursing as a healing practice..."
"Denise Coppa has practiced and taught Therapeutic Touch for 30 years. She is an associate professor of nursing and coordinator of the Family Nurse Practitioner Program at the University of Rhode Island. She is active in Therapeutic Touch practice, education, and research, while maintaining her teaching and practice as a nurse practitioner. She has published in various journals on Therapeutic Touch and nurse practitioner practice..."
"Deborah Shields is a Therapeutic Touch practitioner, teacher, and board-certified advanced holistic nurse. As a professor of nursing at Capital University in Columbus, Ohio, she sits in the community with undergraduate and graduate learners exploring and deepening self and holistic nursing practice..."
