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Acupressure points used in EFT protocol ( from E. Leskowitz: . 

Acupressure points used in EFT protocol ( from E. Leskowitz: . 

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A multidimensional model of chronic pain includes not only physiologic and psychological/emotional factors, but also the dimension of subtle energy. In this chapter, the subtle energy dynamics of chronic pain are explored by first outlining the subtle anatomy and energy physiology described in many healing traditions around the world. Then, specifi...

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... of PLP when she was seen in clinic. She described the onset of phantom pain following a left below-knee amputation surgery to save a limb whose circulation had been severely compromised after a fall down a flight of stairs. Pain was manageable, averaging 6/10 on a numeric pain scale with a regimen of short-acting opioid analgesics. The original treatment plan to apply Emotional Freedom Technique (EFT) desensitization (described in the next section) to her memories of the fall were changed when Jeri shared that the feeling of falling had recapitulated what she had experienced in a swimming accident at age nine when she fell into a pit of water at the beach. Instead, EFT was directed at the swimming memory. After completion of the EFT treatment course, Jeri found that she no longer had the swooning internal feeling that used to accompany this memory and her leg pain had markedly decreased. She went on to experience her first pain-free period in the 7 years since the surgery. The following examples each focus on a specific energy therapy that has been effective in treating chronic pain. Of course, many other energy therapies are not repre- sented in this section, due to space limitations. Case vignettes and research citations accompany the brief descriptive overviews. Therapeutic Touch (TT) was developed by the partnership of a clinical nurse and an energy healer more than 35 years ago, in an attempt to develop a healing methodology that would be acceptable in medical settings and that would build on nursing’s tradition of compassionate hands-on caring. The technique involves no physical contact but rather an assessment of the state of the energy field surrounding the patient by using energy sensitivity of the practitioner’s hands. At the core of the practice is the assumption by the practitioner of an attitude of centered compassion toward the patient and adoption this state of mind is the key first step of the healing process (27) . The assessment phase is then followed by an unruffling/balancing process to clear any perceived blockages in the field. There is a large body of experimental evidence validating TT for a range of conditions, from pre-surgical anxiety to osteoarthritis. Unfortunately, the two best-known TT studies are marred by controversy. Briefly, a study published in JAMA in 1998 that claimed to show no benefit for TT (28) has been shown to be methodologically flawed (29) , while a 1990 study purporting to show that TT accelerated wound healing in healthy human subjects (30) has recently been shown to be fraudulent (31) . Caveats aside, TT has been taught to more than 100,000 nurses in North America and is available in many major medical centers. Joe was a 35-year-old cargo loader whose leg had been crushed in a work injury, necessitating an above-knee amputation five years before he presented to our clinic. His chronic phantom limb pain was only marginally responsive to a regimen of antide- pressants and opiates. He did not benefit from cognitive-behavioral retraining and was offered a trial of TT, about which he knew nothing. During the assessment phase, there was a similar energy presence sensed by the practitioner in the region of his missing leg that was also felt around the remainder of his intact body (much like the sensation from the Experiential Exercise in Section 3.1.1). At that moment, the patient reported sensing his phantom limb being touched. As the treatment continued, Joe reported that the pain sensations seemed to be draining out the bottom of his phantom foot. Surprisingly, he asked for the treatment to be stopped before the pain could be completely alleviated, saying that he feared becoming pain-free because this would be proof to him that his leg was in fact missing. In other words, his pain served the psychological function of defending him against the shock that would come with full acceptance of his loss (for a more detailed discussion of this case, see reference 32). The Emotional Freedom Technique (EFT) is the most widely taught and widely used protocol (33) among the array of new techniques that fall under the umbrella of energy psychology (EP). This relatively new discipline (34) derives from early observations that acupuncture treatment can cause strong emotional reactions and that certain meridians seemed to correlate strongly with specific emotions. Building on a lineage that includes acupuncture, chiropractic, psychiatry, and martial arts, EP has evolved a series of “tapping” protocols in which the major acupuncture meridians are self-activated by finger tapping or pressure at the same time that psychologically problematic material is being discussed or thought about by the patient. In a sort of “flushing out” process, the EFT activations are thought to clear or balance negative emotions. Anecdotal evidence is prolific, but well designed studies are few and far between. The following vignette is illustrative of EFT’s potential in myofascial pain syndrome. Figure 3 shows a common EFT protocol. Maria was a 35-year-old woman who received mild concussion and cervical hyperex- tension injuries in a boating accident. Her neck and shoulder pain syndrome was largely myofascial in nature and responded only minimally to standard stress management training and stretching/strengthening exercises in physical therapy. During a course of EFT, she was able to access memories of the event (she was able to remember her subjective experience of the time when she was outwardly appeared to be unconscious) in a way that triggered a dramatic healing response. She described this recovery of memory as being psychologically crucial to restoring her sense of wholeness. Within minutes of completing the EFT process, she was able to demonstrate full range of motion in her neck and shoulder, and her pain level almost completely disappeared (for a more detailed discussion of the case, see reference 35). Reiki has become the most widely known of the hands-on energy therapies, in part due to the apparent ease of training—typically attendance at a weekend workshop grants the practitioner Level 1 mastery. No graduate-level training or clinical experience is required, as it is not intended to be restricted to healthcare professionals; an estimated 80,000 Americans have been trained in the past year (36) . A recent research review (37) highlights the current challenges of working within a medical model. As with TT, the most tightly controlled studies demonstrated subjective improvements rather than organic changes. The method itself was introduced to America about 70 years ago from Japan, and involves direct hand contact to transmit a healing energy that the practitioner has been attuned to receive and transmit. No specific diagnostic steps are taken, nor does the practitioner intentionally modify the healing energy in any way. Distant healing is also felt to occur in certain forms of Reiki. Homeopathy is the energy modality that is most amenable to randomized controlled trials (RCTs) with blinded methodology because the protocols can be adapted from pharmaceutical testing. An extensive supportive literature exists, showing that in many conditions—asthma, infant diarrhea, otitis, etc.—the benefits of homeopathy are clear and not explicable by placebo or expectancy factors (38,39) . However, the literature on homeopathy for pain illustrates another common pitfall of assessing energy modalities. In classic homeopathic prescribing, the clinician arrives at a designated individualized remedy after detailed history taking; three patients with allopathically similar diagnoses (fever and productive cough, for example) might receive three different homeopathic remedies. However, research protocols are often set up to offer only a limited number of treatment options—in an extreme example with a widely reported negative finding, 500 marathon runners were all treated with the same remedy at identical dosages. They did not respond positively to a statistically significant degree (39) . However, lack of individualized prescribing, and suboptimal dosing render these study results meaningless. By contrast, a more appropriately designed trial of homeopathy for fibromyalgia (18) included fully individualized dosing and generated positive results in treating this notoriously refractory condition. A subgroup of excellent responders was identified, not only by clinical response, but also by using a novel form of EEG screening (alpha concordance measurement) to identify likely positive responders to homeopathy. For a discussion of the wide range of clinical uses of acupuncture in pain management, refer to Chapter 17. Practitioners of energy medicine typically stress the safety of energy interventions relative to allopathic medicine. The incidence of clinically significant side effects is miniscule in such modalities as Reiki and TT, while homeopathy does acknowledge the phenomenon of the “healing crisis” during which symptoms initially increase after a treatment until the body’s innate vigor can overcome the symptom and return to a state of greater balance. A similar process of initial symptom exacerbation is described in the acupuncture and energy healing literature. However, emergent symptoms are usually mild enough (headache, jitteriness, muscle soreness) that simple supportive measures like fluid and bed rest are sufficient to resolve the problem. Hence, contraindications are practically nonexistent for energy therapies. There is, however, a distinct possibility of energy “overdose” in certain situations. Patients must become familiar and comfortable with energy sensations in order to work optimally with the healing process, and overzealous use of “high voltage” interventions early on can backfire, with patient drop out a possible result. In addition, some patients may become so enraptured with the internal energy states cultivated using techniques like tai chi or qi gong that intensive practice regimens can ...


... Some disorders, like chronic pain, show energy dynamics that align with this proposed energy/emotion linkage: 59 In myofascial pain, the characteristic trigger points are palpable, painful knots in the fascia and muscle that are often located at common acupoints. 9 They are over-energized because of unacknowledged emotional distress 95 and can be "sedated" (TCM for "relaxed") by acupuncture and acupressure massage, or by dry needling and trigger point injections of saline solution (Western analogues of acupuncture). ...
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The field of energy medicine (EM) is perhaps the most controversial branch of integrative medicine: its core concept - the existence of an invisible healing energy – has not yet been validated by Western medicine, and the mechanism(s) of action of its techniques have not been fully elucidated. In this paper, these problems are addressed by first outlining the organization of the human subtle energy system, and noting which components of that structure (meridians, energy centers and biofield) are impacted by various EM techniques. Evidence regarding the existence of this “subtle anatomy” is then presented from three realms: basic science research into electromagnetic fields (EMF), subjective experiences of EM, and clairvoyant perceptions of EM in action. Secondly, EM’s mechanisms of action are explored by describing how these techniques alter energy dynamics and affect biologic processes, a subject that could be termed “energy physiology”, to parallel conventional medicine’s foundation in anatomy and physiology. Finally, research into “energy physiology” is proposed, focusing on unusual experiences that are not fully explained by the current mechanistic biomedical model, but which do have plausible and verifiable energy-based explanation. These subjects include phantom limb pain, subtle energy-induced oxidative stress, emotional entrainment in groups, and the invisible templates that guide cell growth and differentiation. Keywords: biofield, subtle energy, energy medicine, phantom pain, energy psychology