Spiritual Practice? Energy Medicine? What’s the Diff?

Spiritual Practice? Energy Medicine? What’s the Diff?

The distinction between spiritual practice and energy medicine is often blurred, as if the two were interchangeable, or even the same. They are both valuable, but they are not the same.

The most obvious difference is that we do our own spiritual practice. We have to; no one else can do it for us. Spiritual practice is essentially self-practice.

Energy medicine, however, is done to us. We receive it from an outside source.Energy medicine techniques are subtle and varied, but they are nonetheless a form of medicine; they are interventions practiced by a therapist on someone else.

Spiritual practice is done from within. All spiritual practices, no matter what the tradition, connect with Source; that’s what makes them spiritual practices.

Connecting with source changes everything. We feel–more connected. Our systems begin to reorganize from that inner connectedness. We feel vibrant, at ease, more ourselves, more–connected.

Energy medicine techniques involve treatment plans to deliberately reorganize the biofield, the subtle vibrational field said to surround and penetrate the human body. Energy medicine techniques are like housekeeping; they sweep through areas of stagnation and restore an even flow to subtle bioenergies such as qi and prana.

This is beneficial, and brings many of the same healing effects that accompany spiritual practice. Plus it’s great to receive treatment from someone else.

But energy medicine does not reconnect one to Source. It’s medicine, which means it comes from an outside source, and from a fixing mentality, no matter how holistic the context.

Practicing energy medicine techniques consistently makes us better, healthier practitioners. Consistent spiritual practice makes us better, healthier practitioners, and better people.

Pamela Miles shares 50 years of experience with holistic health and spiritual practice.


  1. Pamela Miles, You are brilliant and I’m dazzled. Thank you.

    One of the challenges is to articulate a common description of the term “spiritual.” This word evokes such varied responses in people—one of them being the assumption that spiritual means religious. When people make that association, the result can be confusion and reaction.

  2. Pamela Miles says:

    Great point, Susan. When I am speaking to a group, I underline the distinction between religion and spirituality. Many people have never thought of it and their minds go immediately to religion if left unguided.

  3. Abby Wynne says:

    Hi Pamela,

    I don’t think I agree with you!

    Definitions of medicine include:
    the branches of medical science that deal with nonsurgical techniques
    something that treats or prevents or alleviates the symptoms of disease
    a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness

    I love how you describe the work during an energy healing treatment as “housecleaning” and I am right with you on that one. However, a client who comes to me for an energy healing, whether it be Reiki or Shamanic healing, does so because they have symptoms of dis-ease, both physical and mental, and the healing acts as the medicine. They feel better.

    Reiki as a form of spirituality, yes yes yes! But only for those who wish to invite that into their lives. It doesn’t then mean that they are immune to the medicinal like qualities of the Reiki, it just means that they incorporate Reiki into their thoughts, their belief systems and into their mindful states. And for those people who don’t want to invite Reiki as a spiritual experience but want the healing from it, do feel the medicinal affects as well.

    I suppose what I am saying is that I believe that Reiki IS energy medicine at its finest. It can be incorporated as a spiritual way of life, but that is a choice, and not a pre-requisite or a direct result of the Reiki itself.

    And I think Reiki will go on – there is no cause for worry as to it’s survival. It’s blossoming and growing at the moment at a prolific rate. It’s wonderful to behold.


  4. Pamela Miles says:

    Happy to continue the discussion, Abby. Can you speak about this without it being a matter of “I believe…?”

    You say people come to you because they have symptoms. Does anyone come because they are healthy and want to stay that way, or they are healthy but looking for deeper meaning?

    Reiki what will go on? Reiki itself always is and will always be. Reiki practice is another thing. It won’t continue without practitioners. Usui referred to his practice as the Secret to Inviting Happiness; it was and remains a practice. It was never meant to be a one-time application.

  5. Abby Wynne says:

    Thanks for the quick response Pamela.

    For some things, I admit that I have to say “I believe” because I am only seeing things through the filter that is my body, my brain and my energy. I don’t know what others see, so I cannot say that something so difficult to define, “is”.

    I have one client only who comes to me regularly for what he calls a “service”, each season for one or two treatments to keep his “motor running”. He is Reiki master, but he doesn’t incorporate self-treatments into his routine, nor does he use Reiki as a spiritual practice. I need more clients like him!

    And again, yes – Reiki is and always will be. The practice of it is evolving too, and splitting off into different fields of thought, as things do over time. I felt that the survival of Reiki practice is not an issue, more like the evolution of Reiki practice, where is it going to and what is it becoming. I agree that Reiki Practitioners need to constantly monitor, scrutinise and understand where they are coming from in this to keep their integrity and credibility in check.

  6. Andrew says:

    Great points Pamela and Abby; I can see and relate to both of your interpretations. I also appreciate the hair-splitting distinctions made about Spiritual v Medical. A perspective such as this can be a tremendous aid in explaining Reiki in a holistic and balanced manner.

    If I were to contribute my view on the matter it would be a simple one: Reiki is about a spiritual and medicinal as water. Wonderfully simple and infinitely complicated, water is what you make it. Still no matter how esoteric/mystical/spiritual/ or basic/ordinary/mundane you want to approach it, it’s still water (Reiki).

    That said, (and this is 100% opinion) a complete understanding and utilization of the system is needed in order to practice Reiki efficiently. With Reiki, practicing constantly in a more regimented (not restrictive) manner will yield different results than one whom utilizes Reiki in a more reactive and thus medicinal way. In this manner, Reiki can be compared to exercise; while not considered “medicine”, an active lifestyle is essential toward establishing and maintaining optimal health. You don’t just sprint once a week to keep up – maintenance is important.

    I see the medicalization of Reiki divorcing itself from the spiritual aspects (which have always been a foundation) and thus becoming a devolution rather than an evolution. This is akin to taking 1000 supplements versus eating one’s vegetables. They may provide the same “vital” ingredients initially, but the effects in practice are bound to deviate eventually.

    As always, these are my current thoughts on the matter – Learn more everyday!

  7. Pamela Miles says:

    Andrew, I disagree that “a complete understanding and utilization of the system is needed to practice Reiki efficiently.” In my experience, all that is needed are the initiations and consistent practice. The understanding will then unfold from within, and more quickly with a contemplated practice. I would say it’s not possible to have “a complete understanding” of the system before practicing because Reiki understanding is unlimited and unfolds endlessly.

    As long as the initiations are passed intact, Reiki practice will remain a spiritual practice. It’s not possible to remove the spirituality because that is built into the initiation lineage.

    However, if Reiki practitioners lose sight of the role of initiation in this practice, and the initiation lineage is severed, that connection to spiritual essence will be lost, and what would be practiced at that point would be simply an energy intervention.

  8. Michael Snow says:

    “Lifestyle modifications do not require the same level of evidence.”

    Wow, a simple but brilliant point. This is a great way to present Reiki to medical people without getting into a lot of technical talk attempting to make Reiki acceptable to them. But I have been read a lot of what you say about Reiki, and am puzzled by one thing. You say Reiki practice does not target specific diseases, that it is used to rebalance the bodily system (for lack of a better phrase). Certainly the flow of basic hand positions is set up this way. But the guide(s) that Usui and and Hayashi put together list all sorts of ailments, with specific hand positions recommended for each ailment. This implies that Reiki practice can and was used to treat specific conditions. What’s your take on this? How does this fit in with your view on Reiki practice, and using it in a medical context specifically?

  9. Pamela Miles says:

    I was wondering when someone would bring this up! 🙂

    You are correct that Usui/Hayashi gave specific hand placements to speed relief of certain ailments, but that doesn’t indicate that they disagreed with the essential point that Reiki healing is basically self-healing. Reiki treatment does not surgically remove a diseased part, nor does it suppress symptoms. Rather, Reiki healing happens from within, through the optimization of the body’s own self-healing mechanisms.

    The Reiki approach is, as Mrs. Takata frequently said, to remove the symptom by removing the cause, which is another way of saying, “by restoring balance.”

    Although there may be hand placements that are optimal to provide faster relief for certain ailments, and hand placements that are better avoided in some cases, nothing I’ve seen attributed to Usui or Hayashi has indicated that they thought the specific hand placements to be more important than making the Reiki connection.

    And, of course, Hayashi and Takata organized the overall protocol that she taught.

  10. A couple of additional thoughts: We know Reiki has a visible and positive effect on the physical body—we see it. Usui, Hayashi and Takata all spoke of and used Reiki to effect physical healing.

    At the same time, Usui was very clear that the Reiki principles (one expression of the spiritual dimension of Reiki) were intrinsic to the practice. He describes the principles as “the secret method that summons happiness. The miraculous medicine that is effective against all kinds of illness.”

    When Mrs. Takata talked about removing the symptom by removing the cause, she clearly recognized that spiritual imbalance creates dis-ease in the physical body.

  11. Yonathan says:

    Hi Pamela,

    I just found your site, and i want to share about Reiki. During my years of experience with Gendai Reiki ho, i found that what you say about spirituality and Reiki practice can’t be separated are true. I also agree when you think that knowledge about Reiki can be acquired during intense contemplation and practice ( i get some knowledge like that too).

    I felt that Reiki initiation is not just energy transfer, but also knowledge from our own predecessor teachers. That;s why when our Reiki teacher understand something, it passed down to us unconsciously. It just a matter of time, until it reveal to us consciously.

    To help me contemplate deeply, i used Shamata and vipassana techniques from Tibetan Buddhist.

    About treatment, from several clients i have, it is okay if you treat the whole body, as Reiki energy will spread autonomously everywhere. But, the question is ” How can we speed the healing process?” because the client’s suffering can’t wait.

    Therefore, we need to go directly to the cause of illnesses, feel your mind directly touch the problems’s core and send Reiki directly.

    Would you believe that Reiki can also help muscles misplace ?

  12. Margit says:

    It is all a matter of words and definitions. Words and definitions reduce and separate and are ultimately, in the context of healing, meaningless. I get tired of all this pointless discussion of what Reiki is and isn’t, or what it does, or how it works. No one can know for certain. It is ineffable. No one in the olden days even thought to discuss whether shamanism was medicine or spiritual practice because it was understood to be both. Our great talent and/or shortcoming in this society is to try to stuff everything into our left brains and understand it through words. So we create a definition of what “energy medicine” is and then try to stuff Reiki into it. Or we create a definition for “spiritual practice” and do likewise. And then when Reiki doesn’t fit into the artificial categories we created, we scratch our heads and have debates and discussions about it. That’s great, if we enjoy the exercise. Otherwise it’s quite pointless.

    • Pamela Miles says:

      I couldn’t disagree more, Margit. Words and definitions are not pointless. The words we choose arise from our understanding and then maintain that trajectory. If we never question, we cannot deepen our understanding.

      Mindful discussion and contemplation leads to greater clarity. Reiki itself may be ineffable, but we are discussing Reiki practice, which has a form and a history.

  13. Margit says:

    I still feel words limit. Trying to understand the ineffable puts barriers around it. The effectiveness of the Reiki practitioner largely depends on how open a channel he or she is, and that openness has a lot to do with how much the ego or the left brain interferes. The more the left brain interferes, the less effective the practitioner is. I doubt that Dr. Usui encouraged much discussion. He would have probably pointed students towards the five precepts and said “practice, don’t think”. This western propensity for thinking is likely what reduced Reiki from the powerful healing vehicle that it was when Mrs. Takata experienced in Japan to the “little bit of warms,” relaxation, stress reduction and “adjuvant opioid relief” that it has become in the West.

    I have re-taught and reattuned many Reiki practitioners whose experience with Reiki after their initial teaching was “a little bit of warmth”. I encouraged all of them to experience it without thinking, without hand positions, without trying to stuff it into the box of left brain understanding. Every one of them told me that they had no idea Reiki could be this huge, and every one of immediately discovered that they had the ability to do byosen scanning.

    I am saddened that the West’s most prominent spokesperson for Reiki works so hard at limiting it. On the other hand I also understand that spokespeople need words to communicate, so the service was necessary, and you had to put Reiki into words that the medical community you were trying to communicate with would accept and understand. You have been an essential bridge between Reiki and the medical community, but maybe now it’s time for something more than bridging.

    • Pamela Miles says:

      Margit, words don’t limit; attachment limits. I also encourage my students to practice Reiki rather than try to figure it out. The words are not to figure out “Reiki,” but rather to continue to develop clarity in our understanding, weed out delusion, and enable us to communicate better with people who might benefit from Reiki practice.

      I am no stranger to practice. I’ve practiced daily self-treatment for 25 years and intend to continue doing so for the rest of my life.

      We can be committed Reiki practitioners and engage our minds in our practice. Contemplation was part of Usui’s practice.

      If we don’t contemplate and examine our experiences to develop clarity, we remain limited by prejudice and delusion.

    • Pamela Miles says:

      It’s not the words that delude, but rather the lack of self-examination. Looking at our words can be a powerful entry into self-reflection.

      I agree, dialogue is good. And I would like to articulate what you perhaps were implying — dialogue is good when we are reflective and respectful.

      Thank you so much for staying in the conversation, Margit.

  14. Margit says:

    BTW another Western notion is to rescue Reiki from delusion and superstition. Reiki comes from from the home of Zen Buddhism. Dr. Usui initially started it as a meditation practice. Zen Buddhism is about “dropping” into silence, dropping the ego, dropping thought. When you drop thought and ego, there can be no delusion, no superstition, because delusions and superstitions live in thought and in ego. All these things get in the way of Reiki practice. Just drop into silence so the Source can come through.

  15. Rose says:

    No one in the olden days even thought to discuss whether shamanism was medicine or spiritual practice because it was understood to be both.

    I know I’m a little late to the dialogue, but found this thread interesting.
    Margit, I think what you wrote above summarizes it nicely for me. I wish we didn’t have to discuss it, either. But we’re in a different ballgame now.

    Pamela, what I hear you comparing is reiki practice and energy medicine, not reiki and energy medicine. As a reiki practitioner and an energy medicine practitioner, I can clearly see the difference between the two. I’m well aware of using my left brain when practicing energy medicine. I am clearly involved in helping the client’s energy make specific shifts–ie a chakra open, or a meridian balance. I can bring some of that focus to reiki (ie focus my hands on a diseased organ), but I’m well aware I’m little more than a conduit for an intelligent energy out to do what is best for the person at the time.

    Pamela, I like what you said in your blog: Medical techniques–energy or otherwise–are deliberate interventions designed to fix symptoms while minimizing risk. The process follows the medical model of diagnosis, treatment plan, treatment implementation, evaluation, and recommendations for future care. When I practice energy medicine, I am thinking in these terms for the most part. Not entirely.

    Here’s what I would throw into the mix. I’m thinking this through as I write. Reiki helps me to spiritualize energy medicine. My reiki practice helps me to drop into that silent place where I am aware of my relationship to Source, so that when I practice energy medicine I can bring to it that same level of mindful awareness.

    On the other hand, if I apply the principles of energy medicine to Reiki, it can stifle the experience. I think I have found times when I can fairly seemlessly integrate these two systems–more or less flowing and dancing between the two. But I cannot medicalize reiki. It just doesn’t happen.

    Having said that, I’m reminded of something someone said to me years ago. Very simple. Very true. It’s all spiritual.

  16. Pamela Miles says:

    Thank you for adding to the discussion, Rose.

    This is the first time in recorded history in which medicine and spirituality have been artificially separated. In other times, it would have been unnecessary to refer to Reiki as a spiritual healing practice because it was understood that real healing involves healing the person’s spirit as well. African traditional medicine asserts clearly that there is no lasting healing without a change in consciousness.

    Spirituality is the largest context. Everything that manifests does so within the spiritual, timeless context. It is because we touch our timelessness that spiritual practices are so deeply refreshing, and why we need to access spirituality in order to have lasting benefit.

    • Rose says:

      Or at least in other cultures, maybe? It seems the eastern cultures have had less trouble maintaining the marriage of spirituality and medicine, as well as the tribal traditions. The challenge seems uniquely ours (ie Western), don’t you think?

  17. Pamela Miles says:

    I hesitate to use the word Western, Rose, because this approach to medicine is used around the world. I refer to it as conventional medicine in order to distinguish it from traditional, indigenous medical systems.

  18. Benjamin Brochstein says:

    There is a difference between Reiki and meditation when used in health care. Meditation requires the patient learn a skill and actively practice it. Reiki practitioners know that a patient can benefit from passively receiving a session. Your idea, Pamela, of viewing Reiki as a spiritual practice is lovely, but misses the point of regulation. If practitioners are to be compensated for providing sessions in a health care setting, they should be regulated to assure that they are properly trained and qualified. If the sessions are uncompensated, there is no need for regulation. I am committed to seeing energy medicine continue to gain support in clinical settings. Arguing against regulation for practice in clinical settings is counter-productive. I agree that Reiki should be continue among friends and family free of regulation – just like massage. If you want to be compensated for providing treatments, you should be licensed. Nurses, MD’s, PA’s, massage therapists, etc. all have necessary licenses – but practitioners outside of these groups need more than a weekend workshop. Once Reiki becomes a profession, its spiritual components are permanently altered.

    • Pamela Miles says:


      I am aware of the differences between meditation (which I have practiced for 50 years) and Reiki (which I have practiced for nearly 27 years), but it’s not my idea to understand Reiki as a spiritual practice — it’s actually Mikao Usui’s.

      Reiki practice is not energy medicine. It doesn’t follow the medical intervention model (assessment, compose treatment plan, implement treatment plan, assessment and recommendations) as discussed here http://reikiinmedicine.org/healthful-lifestyle/practice-or-medicine.

      Don’t know why you think I’m arguing against regulation. This article doesn’t even mention regulation.

      But since you brought it up, your distinction that only when Reiki practice is compensated should it be regulated doesn’t make sense. Most hospital Reiki is done by volunteers who receive no compensation. Yet it is imperative that hospitals have policies spelling out the education and experience necessary for a Reiki practitioner to be allowed to volunteer. It would also help if hospitals were better informed about what reasonable requirements are. For example, some hospitals require volunteers to be Reiki masters, not realizing that many Reiki masters have less training than First degree Reiki practitioners who are traditionally trained.

      The spiritual aspect of Reiki practice cannot be altered because that’s what the practice is. As a culture, we can fail to recognize it, and that is to our detriment. When I teach hospital staff, I teach them a spiritual practice with a foundation in self-care. Those values are agreed upon before the classes are set up.

      Licensed health care staff also need more than a weekend class. They need daily self-practice, maybe even more than lay people, because they are at high risk for burnout, and because their training is to intervene and force an outcome, which is the opposite of what Reiki practice, or any spiritual practice, does.

      • Benjamin Brochstein says:


        Compensation is indeed a critical distinction. Obviously volunteers need to be trained in protocols for hospitals. For Reiki to reach maximum potential, it must be available like massage and acupuncture and paid for by medical insurance. Licensing is absolutely necessary for this.

        As for Mikao Usui’s ideas, if you have received these through a direct transmission from his spirit whilst in one of your expert meditative states, let us know. Otherwise, please reference your sources.

        To be clear, as a scholar interested in Medicine and Religion, I am in favor of promoting Reiki. I volunteer my time to teach students about the effects and benefits of Reiki at UTHealth medical school. It is my position that the term “spiritual practice” limits the possibilities for Reiki’s growth. There is excellent evidence showing the benefit of Reiki. Use of the term “spiritual” is gratuitous and practically meaningless in health care settings and repulses some medical professionals who would otherwise evaluate Reiki’s merits.

      • Pamela Miles says:


        Why the sarcasm? Is it possible to discuss different perspectives in a respectful way, as colleagues?

        I didn’t reference the statement that Usui saw his practice as a spiritual practice because it seems self-evident from the fact that Usui chose to share the practice through initiation (a spiritual interaction) and create an initiation lineage, which is the way spiritual practices are shared. He didn’t create an academy. His organization, the Gakkai, doesn’t have classes. People come together, receive initiation, and practice. That’s how they learn. And Usui was a lifelong spiritual aspirant, not an academic or a health care professional.

        Conventional medicine understands the benefits of spiritual engagement. Doctors know that patients with inner resources tend to have better medical outcomes and are easier to work with. Hospital chaplains don’t just talk to patients who are dying.

        My experience integrating Reiki practice into conventional medicine for 20 years — including the NIH, and Harvard and Yale medical schools (I taught Reiki at Yale) — has been that spiritual practice is welcomed in medicine, as long as it is communicated well. For example, it is wise to distinguish between spiritual practice and religion or New Age belief systems. It’s well documented that spiritual practices such as meditation, yoga and tai chi have health benefits.

        It is important to communicate Reiki practice in a way that is relevant to whatever the audience is, but it is equally important to be upfront and transparent, and not whitewash the spirituality of the practice to manipulate inclusion.

        You are wrong in saying “licensing is absolutely necessary…” Licensing is enacted by the respective state legislatures as a result of a complicated, lengthy, expensive political lobbying process. We won’t see that happening for licensing. What we are likely to see more of is regulation by state massage boards, and the Reiki community can affect this process by being informed and articulate.

  19. Sue Neering says:

    Hi Pamela,
    My name is Sue. I’ve been a Reiki Master since 1995. I find it interesting that you don’t acknowledge Reiki to be a form of spiritual energy healing. I also follow a lot of Donna Eden‘s work “energy medicine” and it’s absolutely an internal practice. It’s not just a practitioner doing the work on somebody else. Although that can happen with it. It’s really about doing the work for oneself. And EFT (tapping) definitely an internal practice. Many other forms of healing whether done alone or with and by a practitioner are more deeply enhance when done as a spiritual practice.
    I’m interested to get your description of Reiki without referring to Universal Life Energy which is in its name?

    I worked for Hospice as an Integrative Therapist for 8 Years. We provided Reiki as well as other forms of touch and Aromatherapy for End of Life Patients. I found this both a spiritual practice and Energy Work.

    Please help me understand. I have read much of your material and followed you for quite some time. I admire your reputation in the Reiki community. I’m now working at a substance abuse treatment center. And they want to write a description in the literature describing Reiki. I’m interested to hear your descriptive.

    Thank You. 🙏

    • Pamela Miles says:

      Thank you for your comment and your kind words, Sue. End-of-life care is an especially poignant setting for Reiki practice. How fortunate you are to have had that experience.

      I’ve gone into the distinction between spiritual practice as balancing and process-oriented as compared to “energy work” or “energy medicine” as fixing and goal-oriented in an article on ReikiInMedicine.org:
      Reiki: Spiritual Practice or Energy Medicine

      The distinction can perhaps be summed up in practice helps the person balance so their system can address the situation, whereas medicine attempts to fix the situation irrespective of the individual’s balance. That distinction is less polarized when discussing energy medicine than conventional medicine, but it illustrates a fundamental difference in approach, balancing/support v fixing/taking over.

      You might also be interested in What Is Reiki Energy?

      I spark these discussions to help practitioners go deeper into their practice, contemplating their motivations, and clearing more space for the person they’re attending.

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