Mike,
You misunderstood my second post. I did not say the healing happened while "setting up" of one's ritual to do the actual healing. Ritual involves more than arranging or setting up a space to work in. During that time I connect, in prayer to higher spirits, or the master's energy. I ask for help in doing what I am about to do. "That" is when I think the healing "sometimes" can take place. I have the intention of what I am about to do, I sometimes may see what I am going to do, and I have connected to the "masters energy".
This all can happen before going through the physical motions of doing the healing. Ritual is a personal preference. I am not even taking in account what the patient may be doing on their own. They may be doing something on their own that facilitates their healing.
I am not sure how to respond to your last paragraph. I don't see the transmission of energy, without its physical perception by the person receiving it , a problem.