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 wound 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 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. Statistical 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 headache, 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 often not 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.