In spite of a thorough search of the literature, no studies have been found that relate directly to the focus of this study, the holistic experience of healing. The literature review is not the theoretical foundation on which the study is based, but is presented in order to illustrate the current state of the relevant literature. The initial review established the appropriateness of this study. The majority of the review was accomplished after the data were analyzed and was guided by the findings. Literature from both the initial review and the later review have been combined in this section.
Connections between the literature and the results of this study will be explored in the latter chapter. Topics will also be discussed that might relate to the experience of healing, such as health status, recovery, and survival. In this related literature the independent variables such as social support, optimism, and hardiness are often well defined with reliable and valid measures. The dependent variables such as “being healthy, having minor health problems, suffering from chronic disease, being disables, and being dead are treated as equally-spaced points on a continuum” (Hobroyd & Coyne, 1997, p.
364), and are not often well-defined or measured. Other measures sometimes defined as “healthy” are help seeking behaviours and compliance with medical recommendations. Attempts are often made to define personality characteristics that relate to health and survival. Krantz and Hedges (1997) believed that enthusiasm outweighs the evidence about how personality traits, psychological factors, and behaviours relate to disease. Nevertheless, there are some interesting studies in which attempt is made to measure the factors that might be relevant to holistic healing.
The popular literature claims much more knowledge than can be substantiated with valid research but this literature has stimulated a research interest that may lead to more knowledge about healing. Healing Techniques In the literature related to specific techniques, such as biofeedback, therapeutic touch, imagery, and hypnosis, holistic healing is discussed directly. Each of these areas has a body of research but the studies do not define healing and often do not give enough information for the reader to make a judgement on whether the outcomes are credible. Imagery is thought to be promising as a healing technique (Achterberg, 2005).
One type of imagery related to healing is the visualization of processes within one’s own body to healing is the visualization of processes within one’s own body that are used to promote specific physiological changes. Oncology has been the primary focus of healing through imagery, but research is being expanded into other illnesses, both chronic and acute. Achterberg believed imagery focused on activating some internal mechanism, beyond the physical process. Based on clinical experience, not empirical evidence, she identified the characteristics that relate to successful healing through imagery.
Increased hope, self-esteem, and positive feelings were thought to be important. Relaxation and ability to focus on the imagery were considered essential for effective healing. The images themselves were best if they came from a thorough knowledge of the disease but were not concrete (symbolic as opposed to anatomically correct). Ideally, images should incorporate visualization of the disease; effective medical treatment; and effective personal defence. The characteristics of successful imagery need to be tested empirically to gain more knowledge about the process of healing.
Holden (1995) conducted a study hypothesizing that relaxation with guided imagery would reduce the stress reaction related to surgery, lessening the cortisol levels, and improving would healing. She used an experimental design, having the treatment group (n=12) listen to recorded relaxation and positive suggestion tapes prior to surgery. On each of the first three postoperative days they listened to tapes of relaxation and positive suggestion tapes of relaxation and imagery describing progressive stages of normal wound healing.
The control group (n=12) remained quite with no interruptions during a similar period of time. A wound healing instrument was developed by the author measuring edema, erythema, and exudates. Content validity was assessed by four experts using a four-point Hambeton scale. All items achieved 3 or 4 by all ratters. Pilot testing was done to assess interrater reliability (n=10, r=. 70). The other variables were measured by the state-trait anxiety inventory and laboratory measure of urinary free cortisol. Analysis of variance was the main statistical analysis.
Anxiety patterns were found to be significantly changed by the treatment (F= 6. 24, p < . 01). The pattern of urinary cortisol was not significantly different between groups (F= 3. 51, p < . 06). Urinary cortisol levels were then analyzed by the Dunn test and were found to vary significantly between groups on the first postoperative day. (p < . 05). Wound assessment did not vary significantly between groups (F=30. 5, P<. 09). It was thought that additional observations may have dictated more differences. Holden`s study concluded that in some ways stress is connected to healing.
Increased stress is thought to relate to a higher incidence of disease but this does not mean that the reduction in stress relates to healing. Hypnosis has been considered to be similar to imagery and has been discussed by many authors as a means t assist healing. Hall (2003) reviewed the hypnosis literature on “cancer and the psychology of healing” (p. 2). The studies reviewed were most often single successful cases. Occasionally studies had 5 to 10 subjects and one had 27. Issues of design were not addressed.
One issue of control was addressed in several studies. The subjects of these studies were given the hypnotic suggestion to clear up a skin disease everywhere but one arm, or to have an allergic reaction on one arm and not the other. Statistically analysis was not done in even the largest study. Hall reported “healing” of skin rashes, warts, cancer, and positive tuberculin skin tests. There was no explanation or definition of the phrase the “psychology of healing”. Krieger (1994) discussed therapeutic touch as a tool to enhance healing.
Practitioners were taught to focus intensely, thus redirecting the patient’s energies and transmitting a force of a well being to the patient. Krieger identified significant increases in hematocrit with the use of therapeutic touch. Increased haemoglobin presumably would increase the oxygen and electron carrying capacity of the blood, and enhance healing, but this connection was not clearly documented. No measure of holistic healing was discussed in the article. Biofeedback requires the client’s active participation in treatment. The individual must do “something” with the mind to activate some physical change in the body.
High blood pressure, Raynaud`s syndrome, excess stomach acid, and headaches, have responded to biofeedback interventions (Pelletier, 2004). The results are usually symptomatic controls, rather than a more holistic representation of healing. Kewman and Roberts (2003) discussed biofeedback in general. They found that the studies were not often well-controlled. Studies showed positive results but when the studies were more controlled they did not support the idea that biofeedback directly mediates target symptoms. Biofeedback is often associated with therapeutic results but it is unclear what is therapeutic and how it works.