Beyond the Technique - What 2,165 Therapeutic Experiences Taught Me About Touch — and Why I’m Asking the Questions Again

The Living Apothecary | Research & Reflection

More than twenty years into my work in complementary therapy and wellbeing, I have found myself returning to an old piece of research with new eyes.

It involved 2,165 therapeutic interventions.

Thousands of questionnaires.

People working across a network of private hospitals.

And one deceptively simple question sitting underneath much of the work:

What happens when we give somebody permission to stop — and another human being provides therapeutic care?

At the time, I was interested in workplace wellbeing, stress, tension, self-care and whether complementary therapy could provide a meaningful wellbeing intervention for staff.

Today, emerging research into reflexology, therapeutic touch and the autonomic nervous system has made me look at those findings again.

Not because new science suddenly proves what we thought then.

It doesn't.

But because it allows us to ask better questions now.

The original research

My practitioner research, A Positive Intervention, evaluated complementary therapy delivered through staff wellbeing days across a network of private hospitals in the UK.

The interventions included:

• reflexology

• Indian head massage

• neck, back and shoulder massage

• Reiki

• energy therapy.

Data were collected from 2,165 adults using questionnaires examining five principal themes:

stress, tension, workplace value, whether the experience was positive or negative, and whether participants considered complementary therapy helpful within the workplace.

There was also space for people to describe their experiences in their own words.

The findings were striking.

76.94% of respondents reported feeling stressed before their intervention.

Of those surveyed, 96.43% reported that the intervention reduced their stress.

Similarly, 83.83% reported feeling tense beforehand, while 97.18% reported reduced tension following the intervention.

All respondents recorded the experience as positive and considered the therapy helpful to offer within the workplace.

Those numbers mattered.

But looking back now, I think some of the words mattered just as much.

“I didn't realise how stressed I was”

One participant wrote:

“I feel relaxed and less stressed. I didn't realise how stressed I was until after the treatment.”

Another said:

“I feel so relaxed and more aware of my own wellbeing.”

Another described feeling:

“cared for, understood and listened to.”

And another simply recognised the intervention as:

“‘me’ time.”

At the time, we were interested in whether the intervention reduced people's self-reported stress and tension.

But read those comments again.

Something else is happening.

People aren't simply describing a massage or reflexology technique.

They are describing awareness.

Being cared for.

Being listened to.

Stopping.

Noticing the contrast between how they felt before and how they felt afterwards.

In other words, the intervention may have created an opportunity for people to recognise their own internal state.

That idea fascinates me even more today than it did then.

What exactly was the intervention?

This is the question I would ask differently now.

If somebody received reflexology and subsequently reported feeling considerably less stressed, what produced that experience?

Was it the reflexology technique?

Therapeutic touch?

The rhythm and pressure of manual contact?

Stopping work?

Closing their eyes?

Feeling cared for?

Having somebody pay undivided attention to them?

The practitioner-client relationship?

Expectation?

The opportunity for self-reflection?

Or was it a complex interaction between several of those things?

We often talk about complementary therapies as though the intervention can be neatly separated from everything surrounding it.

Perhaps it cannot.

And perhaps we shouldn't always want it to be.

A new piece of the puzzle

In 2026, Chen and colleagues published a randomised crossover trial investigating manual reflexology in 32 adults experiencing poor sleep quality.

Participants received six weekly manual reflexology treatments and, in a separate intervention period, six weekly sessions using mechanical foot-massage equipment.

The researchers didn't simply ask participants whether they felt better.

They measured sleep quality, insomnia and fatigue alongside physiological measurements including heart rate, blood pressure and heart rate variability — HRV.

Manual reflexology was associated with greater improvements in sleep quality, insomnia severity and mental and physical fatigue than mechanical foot massage.

Researchers also observed an immediate reduction in heart rate and changes in HRV measurements including SDNN, RMSSD and pNN50. Frequency-domain measures changed too.

The authors interpreted the overall HRV pattern as being consistent with increased parasympathetic activity and autonomic modulation.

Suddenly we have another way of looking at what happens during a manual complementary therapy.

Not simply:

“Did you feel relaxed?”

but:

“Did anything measurable change while you were experiencing it?”

That is an important development.

But this doesn't prove my earlier research

This distinction matters enormously.

My 2,165 questionnaires cannot retrospectively tell us that participants experienced particular autonomic nervous system changes.

We didn't measure HRV.

We didn't measure physiological markers.

The interventions weren't restricted to reflexology.

There wasn't an equivalent mechanical-treatment control.

Participants knew they were receiving a wellbeing intervention, and questionnaires were completed in the presence of therapists — all factors that have to be considered when interpreting the findings.

My research captured real-world, self-reported experience.

The 2026 trial captured a much smaller, tightly defined population and combined validated self-report measures with physiological measurement.

They are different studies answering different questions.

We shouldn't pretend otherwise.

But put them beside one another and something interesting happens.

One gives us breadth of lived experience.

The other begins to give us physiological clues.

And between them lies an enormous research question.

What is therapeutic touch doing?

Touch is one of our earliest forms of human communication.

Long before language, human beings experience warmth, pressure, movement, proximity and contact.

Yet therapeutic touch is complicated to research.

A practitioner's hand isn't a machine.

Touch occurs within a relationship.

The person receiving it has expectations, experiences, memories, preferences and boundaries.

The practitioner continually adapts pressure, pace and contact in response to the person beneath their hands.

There is communication occurring even when nobody speaks.

That makes therapeutic touch scientifically messy.

But human beings are scientifically messy.

Removing every contextual element may help us understand one mechanism while simultaneously removing part of the experience we are actually trying to understand.

Human hands and mechanical touch

This makes the mechanical comparison in the 2026 reflexology study particularly intriguing.

Both interventions involved the feet.

Both involved physical stimulation.

Both required the participant to spend time receiving an intervention.

Yet manual reflexology produced broader improvements than mechanical foot massage within this small study.

We cannot conclude from that that the therapeutic relationship caused the difference.

Nor can we conclude that a particular reflexology map or reflex point caused it.

But we can ask:

What was different about the human-delivered intervention?

Pressure?

Sequence?

Responsiveness?

Expectation?

Human contact?

Therapeutic relationship?

Or an interaction between all of them?

That is a question worth researching.

Relationship-centred care was already hiding in my data

When I returned to my original work, I realised how frequently the therapeutic relationship appeared within it.

I wrote about the importance of a supportive practitioner-client relationship.

I considered caring attitudes, whole-person approaches, self-reflection and self-care.

I questioned whether the clinical environment itself was as important as the relational experience occurring within it.

Participants told us they felt valued.

Cared for.

Understood.

Listened to.

More aware of themselves.

Those weren't necessarily incidental comments surrounding the treatment.

Perhaps they were describing part of the treatment experience itself.

The therapeutic landscape

My earlier research also questioned something else that now feels remarkably relevant.

These treatments weren't taking place inside beautiful complementary therapy clinics.

They occurred within working hospitals.

There wasn't necessarily the carefully constructed therapeutic environment we might associate with a treatment room.

And yet participants still reported substantial changes in their experience of stress and tension.

At the time, I wondered whether relationship and shared therapeutic values could compensate for the absence of a traditional therapeutic landscape.

I still wonder.

Because if the room isn't the essential ingredient, what is?

And conversely, if we combine therapeutic relationship with an intentionally designed sensory environment, does something different happen again?

That question now sits at the heart of my work within The Living Apothecary.

Touch is only part of the sensory story

Today my curiosity has widened beyond touch.

I am interested in:

touch.scent.sound.environment.ritual.attention.relationship.stillness.

Contemporary research into olfaction gives us another fascinating route into understanding how sensory information interacts with memory, emotion and the brain.

Research into HRV provides one way of observing autonomic responses.

Research into therapeutic touch offers another strand.

And people's own accounts of their experiences provide another form of information altogether.

These things should not be treated as interchangeable evidence.

But they can sit at the same table.

Perhaps we have been asking the wrong question

Complementary therapy has spent decades being asked:

“Does it work?”

I increasingly think that question is too crude.

A more useful research conversation might be:

What changes?

For whom?

Under what conditions?

Which elements of the intervention matter?

What can be measured physiologically?

What can only be described experientially?

How much comes from the technique, and how much comes from therapeutic relationship and context?

What happens when several sensory experiences occur together?

And perhaps most importantly:

What helps a human being recognise that it is safe to stop?

From 2,165 questionnaires to one person on the treatment couch

There is something rather lovely about returning to this research now.

Thousands of questionnaires gave me numbers.

Years of clinical practice gave me stories.

Education taught me to keep asking questions.

And contemporary research is giving us increasingly sophisticated ways of measuring things that practitioners have observed for years.

None should be allowed to swallow the others.

A person's experience isn't invalid because we cannot yet attach a biomarker to it.

Equally, a compelling personal experience isn't proof of a physiological mechanism.

Both require intellectual honesty.

That space between experience and evidence is where I find myself most interested.

Where science meets soul

The Living Apothecary Method™ didn't begin with a treatment protocol.

Looking back, I can see its foundations in work I was doing long before I gave it a name.

Person-centred care.

Therapeutic relationship.

Self-reflection.

Sensory experience.

Touch.

Education.

Curiosity.

And the importance of creating somewhere — even temporarily in the middle of a busy hospital — where somebody could stop long enough to notice themselves.

More than two thousand people helped me begin asking those questions.

Research today is giving us new ways to continue asking them.

And perhaps that is what evidence-informed complementary therapy should do.

Not search endlessly for research that proves what we already believe.

But remain curious enough to allow new evidence to change the questions.

The Research Café Question

If you were designing the next study, what would you measure?

Would you measure HRV?

Heart rate?

Cortisol?

Sleep?

Stress?

Touch preference?

The therapeutic relationship?

The environment?

Expectation?

Or would you combine physiological measures with people's own descriptions of what happened to them?

And then comes the harder question:

How would you separate the effect of the technique from the experience of being cared for — and should we always try to?

References and further reading

Chen, S-P., Gao, M-H., Huang, C-C. & Huang, W-C. (2026). Effects of a programmed reflexology therapy on sleep quality, insomnia, and fatigue among individuals with poor sleep quality: evidence for autonomic nervous system modulation. Complementary Therapies in Medicine, 101, 103409. DOI: 10.1016/j.ctim.2026.103409.

Connor, J. A Positive Intervention. Practitioner research examining 2,165 complementary-therapy interventions within workplace wellbeing provision across a UK private-hospital network.

Barry, C.A. (2006). The role of evidence in alternative medicine: Contrasting biomedical and anthropological approaches. Social Science & Medicine, 62, 2646–2657.

Long, A.F. (2009). The potential of complementary and alternative medicine in promoting well-being and critical health literacy: A prospective, observational study of shiatsu. BMC Complementary and Alternative Medicine, 9, 19.

Long, A.F., Mercer, G. & Hughes, K. (2000). Developing a tool to measure holistic practice: A missing dimension in outcome measurement within complementary therapies. Complementary Therapies in Medicine, 8, 26–31.

Rakel, D., Guerrera, M., Bayles, B., Desai, G. & Ferrara, E. (2008). Complementary and alternative medicine education: Promoting a salutogenic focus in health care. Journal of Alternative and Complementary Medicine, 14(1), 87–93.

Research note: The studies discussed here use different methodologies and investigate different questions. Associations between complementary-therapy interventions and self-reported or physiological changes should not be interpreted as evidence that complementary therapies diagnose or treat medical conditions, nor do they establish a single mechanism responsible for observed effects.

The Living Apothecary Method™ Where science meets soul, wellbeing begins with trust.