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Folks -

There previously was a discussion on this site in which a skeptical attitude toward energy work was being discussed, but that discussion eventually got deleted. The reason seems to be that it was judged not to belong in the location where it was taking place, which was inside one of the energy work groups.

I was the person who introduced the skepticism to the discussion. Some people did not appreciate that, but others did. Given how many participants there are on this site, and how many threads and groups are dedicated to discussing energy work with no skepticism, I thought maybe it was time to open a discussion where such skepticism is invited and welcomed.

I look forward to seeing how this discussion might develop. Is there interest?

-CM

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What purpose does it serve to administer the cream to both groups?

It might make blinding easier. Let's say participants have had carpal tunnel surgery to their wrists and present with bruising and swelling. If we physically apply the same methods to both groups they wouldn't know who is actually receiving the energy work. So, the MT gently apply's the ointment or cream and then just holds the participants wrist; except one intervention group is receiving focused energy and the other is not. Participants would not know if they are receiving energy work or not because it's a simple holding method lasting about a minute or two.

I would prefer an experiment with ointment as the placebo to the control and energy work to the intervention, but it might make blinding more difficult in this scenario. Unless there is no touching with the energy work; just hovering over the area.


Christopher A. Moyer said:
Blind both groups (controls and intervention), apply a placebo cream to both groups, and energy work to the intervention group only.

What purpose does it serve to administer the cream to both groups?

How are you going to blind both groups, but apply energy work to one of them? Those recipients will be aware of the fact that they are receiving energy work, wouldn't they?
The squirrel has a couple of q's:
- Does the application of a "sham" ointment not add to the complexity of it?
- I can see how hiding the arms in boxes might make it really "blinded" but is the point not to make it like the "real world" scenario as much as possible?
- I'm with Rick on the "no touch" aspect since touch adds more complexity also. So, could it not be a blinded randomized study with a sham group of MTs, doing work off the wrists mixed with real energy workers doing their thing off the wrists. The measurements could be the speed at which swelling (circumference measurements of the wrists) and pain levels decrease?
- How much will the health of the recipients come into play? Someone that works out and looks after himself diet wise will probably heal faster than someone that doesn't. I suppose this is where numbers in the study comes into play big time, eh?
Thanks Rick, any other suggestions, cause I'm just brainstorming here?

Rick Britton said:
I would go for the 'no touch' method of energy work if that could be arranged.
If the subject and the therapist both wore a blindfold would this count as doing a double blind trail ?
Just curious Robin, why the reference to 10 years of experience? Did you just choose the number of years of involvement at random, or do you have a reason?

Robin Byler Thomas said:
Yes, sorry, thought the randomization and blinding were assumed based on previous comments.

Blind both groups (controls and intervention), apply a placebo cream to both groups, and energy work to the intervention group only.

Use of trained MT's, who practice energy work, and have at least 10 years experience.

OR, use of one MT group who do not practice energy work compared to a group receiving treatment from MT's who do practice energy work; with10 years experience. Holding only, no other body work applied.

Actually, Bert, for this experiment I am advocating use of energy work only; just to see simple effects of speeding up the process of bruising without any massage or other body work.

Christopher A. Moyer said:
Robin Byler Thomas said:
Not sure; help me out here; maybe ice only, oh I know, an ointment of some kind.

But even if 'energy' works, we don't know ahead of time if it works better or worse than those things. Also, the recipients' beliefs in those different treatments are likely to differ in ways that we can't accurately quantify.

It would be better to randomly assign all subjects to treatment and nontreatment groups, and then have blinding so that no one knows whether they've been treated or not. That would actually control for the placebo effect.

This might require every subject to place their injured limb under a screen which would prevent them from seeing whether or not they were being treated.
What about the possibility of entrainment? Granted, I'm certainly not a physicist, but the concept of entrainment gave me an idea of why energy work might "work," at least for some.

Christopher A. Moyer said:
I absolutely agree that placebo effects are possible from conducting a session or energy work; in fact, I'd go on to say that's the only type of effect that is possible.
This is just me guessing:
"Some" specifications on the groups being studied can get 'round this, but since external validity is also key, we'd have to be careful . The higher the numbers in the study, the better for sure, I'm not actually sure if there's an "optimum" number that people would say "this is good enough".

Rick Britton said:
I was thinking about this too. How will the various natural healing rates of patients in different states of health and of different age affect the outcome. Would you need 1000s of experiments to reduce the 'noise'?

Vlad said:
The squirrel has a couple of q's:
- Does the application of a "sham" ointment not add to the complexity of it?
- I can see how hiding the arms in boxes might make it really "blinded" but is the point not to make it like the "real world" scenario as much as possible?
- I'm with Rick on the "no touch" aspect since touch adds more complexity also. So, could it not be a blinded randomized study with a sham group of MTs, doing work off the wrists mixed with real energy workers doing their thing off the wrists. The measurements could be the speed at which swelling (circumference measurements of the wrists) and pain levels decrease?
- How much will the health of the recipients come into play? Someone that works out and looks after himself diet wise will probably heal faster than someone that doesn't. I suppose this is where numbers in the study comes into play big time, eh?
Erica Olson said:
What about the possibility of entrainment? Granted, I'm certainly not a physicist, but the concept of entrainment gave me an idea of why energy work might "work," at least for some.

Erica, an extremely interesting point. One can either consciously or unconsciously start synchronizing with another's "rhythms", such as breathing or movement patterns. The effects can be profound. I'd, years ago, been trained in a technique of actively pacing a person's breathing pattern with a hand placed upon the chest as part of a class on Ericksonian Hypnosis and Bodywork that I took at Esalen Institute. I later found a very similar technique description in Clyde Ford's book "Compassionate Touch". An experienced practitioner is likely to start "pacing then leading" (i.e. synchronizing and then making a change) without even consciously being aware of the process. There's a short description of Erickson's use of pacing and leading in The Man Behind the Curtain.
Stephen Jeffrey said:
If the subject and the therapist both wore a blindfold would this count as doing a double blind trail ?

Maybe we should use people who are blind to begin with? :)
Marilyn St.John said:
Just curious Robin, why the reference to 10 years of experience? Did you just choose the number of years of involvement at random, or do you have a reason?

There's an interesting rule of thumb that gaining expertise in an area takes about 10,000 hours of reflective practice. Another observation is that experts don't use the rule-based approaches that novices start with, but are much more likely to unconsciously match patterns of prior experience to current sensory input and react to them. A good health care review of this is in Benner et al.'s Expertise in Nursing Practice.
The squirrel has a couple of q's:
- Does the application of a "sham" ointment not add to the complexity of it?


That's my thought too. I don't see what it does for the study, though Robin did explain how it could work as a rationale for making physical contact with all the participants. Still, I see it as extraneous if what she wants to test is 'energy.'

- I can see how hiding the arms in boxes might make it really "blinded" but is the point not to make it like the "real world" scenario as much as possible?


Honestly? No. That is not the goal at this stage. Why would we need to do a 'real world' study before we even know if the active ingredient (this specific energy) even exists? In fact, what we need is a study high in internal validity to determine this. If it is discovered, then a later step would be to do a study high in external validity to see how that active ingredient works in the 'real' world.

On this subject, I invite you to read one of my all-time favorite articles in psychology, In Defense of External Invalidity.

- How much will the health of the recipients come into play? Someone that works out and looks after himself diet wise will probably heal faster than someone that doesn't. I suppose this is where numbers in the study comes into play big time, eh?

This needn't be an issue if a) subjects are randomized to groups, b) they are blinded, and c) the number of subjects is sufficient. If those conditions are sufficiently maintained, the RCT design ensures that this validity threat is equal in the treatment and control groups.
I was thinking about this too. How will the various natural healing rates of patients in different states of health and of different age affect the outcome. Would you need 1000s of experiments to reduce the 'noise'?

A good question. But no, it won't take thousands. A few dozen is more like it.

The specific way this is addressed is to do a statistical power analysis. First, we make an educated guess about the size of the statistical strength of the effect we are examining (in this case, 'energy'). Once we know that, it is just math (or even easier, consulted precalculated tables) to see how many subjects are needed to test our hypothesis for a given tolerance to Type I error.

I realize that's some technical language - read up on "power analysis" as it applies to statistics if it interests you. The short answer is "trust me, we don't need thousands - dozens should do." :)

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