The use of symbols and hand positions constitute a kind of ritual and a procedural learning that parallels shaping the kind of intentions needed to bring about a healing intervention. This is tapping into innate wisdom within the being because of your spiritual nature. So it is a process of acclimation, learning, conditioning, and feedback to utilize the instructions for a Reiki session that provide an inner desire and a series of rituals to help reinforce belief and confidence one can do something special, but it is that intention that is cultivated, not the rituals themselves that bring the power of healing to bear. So you are correct that these are truly not needed as long as you get where you need to go in tapping into inner healing intentions that can be directed outward, in a meaningful way, at a meaningful level of energy. So those adjuncts for a Reiki session are simply helpful in teaching a process, because this has historically been proven to be useful in turning out students who are productive healers. There are many, many potential rituals that could be entrained in a similar way to build confidence, focus the mind, and cultivate inner connections to the right intentions to summon divine energy—that is what will get results, not the energy of the practitioner alone—that is a more profound partnership than something that can be conjured up by a symbol or gesture, and that is another way of putting into perspective the relative value of those adjuncts.
The fact this can be done at a distance and not in the presence of the person is a property inherent with the energy you summon, it is consciousness reinforced by the divine, and that is unlimited in its reach, with the power being governed by the level of intention of the practitioner primarily, and the receptivity, perhaps limited by levels of belief, especially by the recipient, that can cause intended healing to be deflected and result in a disappointing session. Your intuition, that in the presence of the person some will develop inner tension and anxiety, feeling somewhat on the spot, or feeling fearful because there are inner concerns about what might happen based on prior trauma of being punished for doing healing, and so on, having it done from a distance without a visible reminder for the client can be advantageous so they will not be tense and their mind putting up additional barriers consciously, if by a lower part of the mind wanting to gird the defenses, so to speak, even though the conscious self might be open to healing and want it desperately.
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