The biofield began as a committee’s label, then became a diagnosis

Nurses who write care plans can choose from a standardized list of diagnoses maintained by NANDA International. Many entries describe conditions a nurse can observe or measure. One, Imbalanced Energy Field, rests on the kind of energy field that the federal government’s complementary health center, writing about Reiki, says has no scientific evidence behind it. The diagnosis appears in the 2024 to 2026 edition. A method for assessing it, proposed in a 2025 paper by researchers working on the diagnosis, asks the nurse to hold both hands 5 to 10 centimeters from the patient’s body and feel for disturbances.

That diagnosis was added in 1994, removed in 2011 for lack of evidence, and restored under a new name in 2018. Its history is one strand of a larger institutional story. Another strand begins in 1992, when a committee convened for a new office at the National Institutes of Health coined the word biofield. A third is a 1998 experiment in JAMA that asked whether practitioners could feel a human energy field at all.

This article follows those three strands, then reports what clinical trials of therapeutic touch, healing touch and external qigong have measured, graded on this collection’s five-point scale. Throughout, it keeps three questions separate: whether practitioners can detect a field, whether patients feel better, and whether the field exists. Reiki’s own trial record, including its particular sham problem, gets a full treatment in the Reiki report.

A word chosen at a 1992 conference

The clearest history of the term comes from its supporters. According to a 2015 paper in Global Advances in Health and Medicine by Beverly Rubik and three co-authors writing to make the case for biofield science, the word was proposed in 1992 by an ad hoc committee of complementary medicine practitioners and researchers. The newly created Office of Alternative Medicine at NIH had convened the committee as one of several at a conference in Chantilly, Virginia, to help it set priorities.

That committee looked at manual therapies and at what it called energetic therapies, such as Reiki and therapeutic touch. Most rested on some idea of a vital force, each with its own vocabulary. The committee wanted one term that would unite them, sound acceptable to scientists, and stretch to fit different explanatory models. It defined the biofield as “a massless field, not necessarily electromagnetic, that surrounds and permeates living bodies and affects the body.”

Read that origin precisely. The biofield was a terminology decision by a committee of practitioners and researchers, not a finding by NIH that such a field exists. The same 2015 paper describes the concept as an important metaphor for guiding research. The authors also recount that the funding agency that succeeded the office later supported a round of biofield research grants.

One more 1992 decision shaped the category. According to the same history, a second committee classified distant healing, done through intention or prayer across a distance, as a mind-body practice rather than a biofield therapy. The authors acknowledge the puzzle that left: practitioners of methods such as Reiki often do both.

Federal classification has moved since. A 2007 review in the Clinical Journal of Oncology Nursing, by Beverly Pierce of Suburban Hospital in Bethesda, Maryland, described biofield therapies as a subcategory of the energy therapies domain defined by the National Center for Complementary and Alternative Medicine, the predecessor of today’s NCCIH. It listed therapeutic touch, healing touch, polarity therapy, Reiki and qigong, and described how one cancer center put them into practice.

NCCIH’s current page explaining its terms, last updated in April 2021, sorts approaches by their main therapeutic input: nutritional, psychological, physical, or a combination. It never mentions biofield, energy therapies, Reiki or therapeutic touch, and qigong turns up only in a list of psychological and physical approaches and in a note on cancer symptom research. NCCIH’s December 2018 Reiki page states that no scientific evidence supports the existence of the energy field that practice assumes.

So the claim that NIH recognizes biofield therapies needs a date and a definition. A federal office’s advisory committee chose the word in 1992. The center’s current classification does not use it.

Therapeutic touch and the nursing diagnosis

Therapeutic touch is the energy practice most closely tied to nursing. Dolores Krieger and Dora Kunz developed it from the much older laying on of hands, framing it as a meditative practice, and nursing writers trace its theoretical basis to Martha Rogers’ Science of Unitary Human Beings. As a Cochrane review summarized the method, the practitioner enters a meditative state and moves the hands above the body to locate and correct imbalances in the patient’s life energy.

Nursing’s standardized vocabulary followed. NANDA added a diagnosis in 1994, labeled in nursing papers of the mid-1990s as energy field disturbance. A 2002 article by Mari Kelley of the Veterans Affairs medical center in Hampton, Virginia, tied that diagnosis to healing touch, a related method with its own nursing curriculum, which the article described as an energy-based approach grounded in human energy field theory. According to a 2025 review in a Brazilian nursing journal, the diagnosis was removed in 2011 after members of the association in Sweden raised concerns about the lack of evidence for it and its overlap with therapeutic touch, which already sat in the companion Nursing Interventions Classification as a coded intervention.

It did not stay out. After a concept review that included a survey of 426 holistic nurses, the diagnosis returned in the 2018 to 2020 edition as Imbalanced Energy Field, defined as a disruption in the vital flow of human energy. It was revised for 2021 to 2023. A 2026 study in the same journal, in which 12 expert judges rated each element, recommended dropping 7 of the diagnosis’s 22 defining characteristics and rewording 10, and reports that its changes were approved and published in the 2024 to 2026 edition.

The limits of that record matter. It comes from papers by researchers working to validate the diagnosis, one of whom is affiliated with the Therapeutic Touch International Association, not from NANDA International’s own book, which was not available for this article. And those same authors write that the diagnosis “has not yet been validated for its effective applicability in clinical practice.”

Two common readings fail here. The skeptical one, that no serious institution entertains energy fields, misses a current entry in a major nursing taxonomy and a coded nursing intervention. The credulous one, that a recognized diagnosis must be a validated one, misses that it was removed for lack of evidence and that its own advocates say validation is still pending.

The 1998 experiment and its critics

The proposed assessment method, hands held near the body to sense the field, rests on a perceptual claim. That claim was tested directly in a paper published in JAMA on 1 April 1998.

Twenty-one practitioners with between 1 and 27 years of therapeutic touch experience were tested without being able to see. Each was asked whether the investigator’s hand was hovering over their right hand or their left, with the placement decided by a coin flip. Fourteen practitioners were tested 10 times and seven were tested 20 times, for 280 trials in all.

They chose correctly 123 times, or 44 percent, close to the 50 percent expected from guessing. Scores did not improve with experience. The authors said their study had enough statistical power to show a reliable ability if one existed, and they concluded that the practice’s claims had no foundation and that continued professional use could not be justified.

Who ran it matters to how it was received. The first author was listed with the Questionable Nurse Practices Task Force of the National Council Against Health Fraud, a skeptic organization, and the study grew out of a science fair project by a co-author, Emily Rosa.

Critics answered in print. A 2003 reanalysis in Alternative Therapies in Health and Medicine by Thomas Cox, a nurse-statistician at Virginia Commonwealth University, argued that the design and analysis were inappropriate, that statistical assumptions were wrong, and that the authors’ recommendations should be challenged. JAMA itself printed a set of letters responding to the study in December 1998, along with a reply from the authors.

What the experiment tested is narrower than its reputation. It tested whether practitioners could sense a nearby hand, which the authors treated as the practice’s most fundamental claim. It did not test whether patients feel better after a session. Failing to perceive a field does not show that patients get no relief, and patients getting relief would not show that a field exists. Those are separate questions, and treating either answer as settling the other is a mistake.

External qigong: the same claim in another tradition

External qigong is a practitioner directing qi, the vital energy of Chinese medicine, into a patient through hand movements and focused attention. The movement form, practiced on oneself, belongs to the qigong article, which also examines a 2007 review that pooled two small trials into a strikingly large effect.

The most instructive trial came from the Robert Wood Johnson Medical School in New Jersey, published in 2008. Researchers led by Kevin Chen randomized 112 adults with knee osteoarthritis to external qigong from one of two China-trained healers or to a sham. The sham healer, a man with no qigong experience, was trained to mimic the movements and told to do mental arithmetic during sessions, so he would not send healing energy by accident. Patients wore eye covers behind a curtain. The two healers made separate analysis of their results a condition of taking part.

The sham alone was not idle: its patients reported a 26 percent drop in pain, a placebo response the authors likened to sham acupuncture in a large knee trial. Patients of the second healer improved more than the sham group in pain and function, and the benefit held at three months. Patients of the first healer did no better than sham, even though an earlier uncontrolled pilot had recorded about a 70 percent drop in pain among six of his patients.

One detail complicates the positive result: after the first session, 91 percent of the second healer’s patients believed they were getting real treatment, against 47 percent for the first healer and 45 percent for the sham. The authors called the study inconclusive and said healers are not equivalent. They also noted there is no standard procedure for external qigong in the field.

Belief played a measurable part. Two-thirds of participants said they believed in complementary therapies, and that belief predicted better results immediately after treatment, though not at three months. Adjusting for that belief did not erase the second healer’s advantage, the authors reported.

A Mayo Clinic trial published in 2010 randomized 50 people with chronic pain at a qigong healing center to external qigong or an equal amount of attention. Most were already receiving other treatments for their pain. Pain fell more with qigong during weeks two through four. By week eight the difference persisted but was no longer statistically significant, and the two groups had differed at the start in how many had heard of qigong.

What reviews of the clinical trials show

The favorable reviews come largely from the field’s own researchers. A 2010 best-evidence synthesis in the International Journal of Behavioral Medicine, titled to ask whether biofield therapies were helpful or full of hype, by Shamini Jain and Paul Mills, examined 66 clinical studies and reported strong evidence that biofield therapies reduce pain intensity in people with pain conditions, with moderate evidence for pain in hospitalized and cancer patients, for behavioral symptoms in dementia and for anxiety in hospitalized patients. The authors rated the studies as medium quality overall, and their method was a narrative grading of studies rather than a pooled statistical analysis. Jain later co-wrote the 2015 biofield history paper described above.

A 2014 review led by Richard Hammerschlag, another of that paper’s co-authors, looked only at trials of external qigong, healing touch, Johrei, Reiki and therapeutic touch in which practitioners never touched patients. Of 90 randomized trials of biofield therapies, 28 with 1,775 participants qualified. After 10 low-scoring trials were set aside, 12 of the remaining 18 reported at least one significant primary outcome: 7 of therapeutic touch, 3 of external qigong, 1 of Reiki and 1 of healing touch. The authors argued that non-contact trials matter because, with touch removed, any effect would point to mechanisms outside current biomedicine.

An effect without touch could also come from attention and expectation, which is why the comparison group decides what such a trial can show. The authors themselves said the pilot-scale nature of essentially all the trials prevented firm conclusions. In 2023 Hammerschlag and colleagues published a reporting checklist for biofield trials, a sign the field itself sees how inconsistently its studies are described.

The most quality-sensitive review points the other way. A 2022 review from Jena University Hospital in Germany found that among cancer patients, higher-quality studies of these therapies showed no difference from active or passive comparison groups, and only lower-quality studies showed effects.

Cochrane’s record is thinner still. A 2007 review of therapeutic touch for anxiety disorders found no randomized trials at all. A review of therapeutic touch for healing acute wounds, which had found no reliable evidence of benefit across four trials of experimental wounds, all at high risk of bias, was withdrawn on 23 August 2016 over serious concerns about the validity of the studies it included. A broader touch-therapy review for pain, withdrawn as out of date in 2013, is discussed with the Reiki evidence.

Grading the claims

• Practitioners can perceive a human energy field with their hands. Tested and not supported. One blinded test came in at chance, with a published methodological rebuttal on record.
• Therapeutic touch helps wounds heal. Insufficient evidence to assess. The only Cochrane review was withdrawn over the validity of the trials behind it.
• Therapeutic touch treats anxiety disorders. Insufficient evidence to assess, because Cochrane’s 2007 review found no randomized trial. This one is untested.
• Biofield therapies reduce pain. Positive trial evidence, contested interpretation. Reviews by the field’s researchers rate it strong, while the review that weights quality most heavily finds effects only in weaker studies.
• Biofield therapy given without any contact helps patients. Insufficient evidence to assess. Twelve of 18 better-scoring trials reported a benefit, but essentially all were pilot-sized, as their own reviewers said.
• External qigong reduces pain. Insufficient evidence to assess, for both reasons the scale allows. The trials are small, and with no standard procedure and results that depend on the healer, the intervention is hard to define well enough to test.
• A human energy field exists and explains the results. That is a proposed cause rather than a measured result, and the grades here cover results only. NCCIH’s statement, made about Reiki, is that no scientific evidence supports such a field, and a measured benefit would not confirm one.

Harm, and the questions to bring

No documented case of direct injury from therapeutic touch, healing touch, Reiki or external qigong turned up in the research for this article. The knee trial logged seven reports of increased or continuing pain, five with real qigong and two with the sham, and three had eased by the next visit. The Jena review judged the risk of side effects relatively small. What the record does point to is indirect: time spent on sessions in place of a medical evaluation. No dataset isolates energy healing on that point, and readers weighing what postponed care can cost will find the evidence gathered in the report on substitution.

If a practitioner or a care plan attributes your symptoms to an energy imbalance, the symptoms still need their own medical explanation. Chest pain, shortness of breath, a new lump, weight loss you did not intend, fever, or pain that is severe or getting worse all call for a clinician. So does any wound that shows spreading redness, warmth, swelling or drainage, or that is failing to close.

Three questions help sort any energy-healing claim you meet:

1. Which question is it answering? Sensing a field, helping a patient and proving the field exists are three different claims, and evidence for one says nothing about the others.
2. What was the comparison? A trained mimic, an equal amount of attention, usual care and nothing at all give different answers.
3. Did results depend on who delivered it? When one healer succeeds and another fails against the same sham, the finding is about those healers, not about the method.

The Takeaway

Energy healing’s institutional standing, a word chosen for an NIH office in 1992 and a nursing diagnosis restored in 2018, records decisions made by committees, not results from tests. The one direct test of whether practitioners can sense the field came out at chance. The clinical trials show short-term benefits concentrated in weaker studies and dependent on the healer. Before weighing any claim, ask which of the three questions it answers.

Sources

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