Saturday, December 10, 2011

An Excellent Response.

The following comments to my post on  Energy based methods are excellent and I hope all that read them carefully consider the valid points made. Ravensara actually restated some of my points better than me and I agree with her. She questions me about this statement----

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

Clarification.   What I found was that the results are mixed for the affects of "machine" delivered energy methods. I wonder how we can make the evidence leap to effects of human energy fields when the evidence is inconclusive for the "machines".

I had hope that I would get some response on this post.  It was actually based on a statement Laura Allen made about energy in one of her blog posts.  We need as a profession to figure this out.  The little angel in the blog post is my beautiful granddaughter -healer extraordinaire.  She is my son Greg's little girl. Greg was killed when a distracted drive hit him when he was crossing a street. His wife was five months pregnant at the time.  This little girl absolutely carries the energy of my son for me. She heals my heart and soul. This is faith on my part. No religion - just faith.

I believe that science will actually in the future find evidence of the energetic connection between humans.  However, that is evidence does not exist currently.  I support evidence based and informed massage practice.  Anyone who has read my textbooks cannot question that.   I thank Ravensara for time, thoughts and intelligence and hope we continue this dialog.

PS.  I have encouraged my students to join POEM-----

A response to Fritz' blog post "Energy Based Methods"

 Ravensara Travillian

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).

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: 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.
    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.
    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.
    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.
    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.
    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:

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?
    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.
Similarly, in the "Methods" section of this Abstract:

"METHODS...Twenty-seven (27) physicians, psychologists, and nurses participated in a 5-day intensive bioenergy healing training course with Rev. Rosalyn Bruyere."

If energy healing is indeed independent of spirituality, is it merely a coincidence that this course was taught by a minister?

When I saw the picture that Fritz closed her post with, I could almost feel the oxytocin (popularly called the "love hormone") mainlining into my blood as my pituitary cranked it up to 11.
That child in the angel costume, with the caption "Believe", is the most winsome and appealing child I have seen in some time. It is a lovely picture for a blog post.
But despite that, I cannot go along in good conscience with the caption.
I fully support Fritz' and everyone else's freedom of conscience to believe as they wish, and to practice any form of spirituality--or none at all--in their private life and space. That is not the issue here.
The issues that I am concerned with include:
  • How do we, as practitioners, provide a safe therapeutic space for all clients, without litmus tests for belief?
  • How do we, as educators, provide a safe learning space for all students, without litmus tests for belief?
  • What are the commitments to principles that we, as an evolving profession, wish to make, and what are the impacts of those commitments on collaboration and communication with other potential partners on the healthcare team?

I applaud Fritz for putting herself out there to engage on the issues, and for advocating for her point of view honestly and frankly. As I said previously, she has given these issues a great deal of thought, and she deserves a thoughtful and engaged response.
I see these issues of vitalism, dualism, and belief (for the profession as a whole, not for individuals' consciences) as a fault line along which massage is likely to split.
There are three outcomes that I can imagine coming out of this; there may be others that I have not thought of.
  1. We come to a working arrangement with a code of ethics that practitioners of all specialties can commit to working under, one which does not require forcing any particular belief or set of beliefs on students or clients;
  2. We agree that such a working arrangement cannot be reached, and the profession splits under mutual agreement into different areas of practice that commit to varying degrees of belief in vitalism/dualism;
  3. We do nothing, and the profession splits in an uncontrolled way along that fault line, with unpredictable fallout from that split.
We need to have this discussion out in the open, as professionals, in order to decide what we want to do about these fault lines, or else history is going to decide it for us


  1. It is a joy to discuss such important matters with you in such a professional way, and I thank you for it, Sandy.

    I look forward to continuing the discussion, and I appreciate your starting it.

    As to what you said: "We all have a story with many chapters. How we turn the pages of our life influence the quality of the journey."

    That is both wise and beautifully stated. If it is all right with you, I would like to add it to the Inspiring Quotations section at POEM.

    --Ravensara, aka thalarctos

  2. Absolutely you can post the quote. I hope others weigh in on the discussion as well.