MECHANISM QUESTIONS

A: My suggestion is always to build a bridge to people’s current knowledge or understanding. Perhaps the way EFT is first introduced is important: Whether you say it is a relaxation technique, a stress reduction tool, or a therapy technique might be useful depending on who is asking.

Some people want to know about the research and how EFT works. In this case, I highly recommend referring them to the 100+ published studies, particularly the meta-analyses that show EFT has a profound effect for anxiety, depression, and PTSD. A large effect size in a meta-analysis shows that something is actually occurring and it can be observed.

We now have research that shows EFT can downregulate (switch off) genes associated with the stress response and can reduce the stress hormone cortisol in the body after one hour of tapping. Brain scans are also showing significantly reduced activation after four weeks of EFT (for food cravings in obese adults). These trials are published in peer-reviewed journals and the EFT Universe website has links to the articles.

I find language is important to many people, particularly skeptics. Not everyone will relate to the old description of EFT as a “meridian-based therapy” that targeted energy systems in the body. Based on the solid science we have now, perhaps a better description would be that EFT is an exposure therapy with a cognitive element, but the part that induces the relaxation response is the somatic tapping on acupoints.

Common evidence-based therapies for conditions such as obsessive-compulsive disorder, phobias, and anxiety disorders all use an approach that includes exposure and then relaxation (an opposite response to the anxiety feeling). They will often use muscular relaxation and deep breathing during the exposure phase (e.g., someone has a fear of heights and is at the top of a building looking out the window and, while they are there, does deep breathing to calm themselves). In EFT, we use the tapping process as the calming response.

Approaching it this way tends to result in EFT not being seen as such a different approach; it fits the current paradigm. For more about this, see “Building Bridges from Existing Beliefs to EFT.”

My last tip is that if you have a strong reaction yourself to talking with skeptics or people who question EFT, or even when trying to share how it works, then perhaps using EFT on your own reactions will be useful. I have always found that the calmer I am when a skeptic questions me, the more easily I can access information to share with them that fits their framework.

–Peta Stapleton, PhD, Certified EFT Practitioner, Trainer, and Mentor

A: My preference is to demonstrate EFT rather than explain it. A single five-minute session is usually more effective at convincing people than reading a 500-page book. Once they feel it in their bodies, their minds usually come along for the ride. I keep my explanations brief, even when talking to medical professionals such as doctors, psychiatrists, and nurses.

EFT can be briefly summarized as:

• ·      A relaxation technique
• ·      Simple physical exercises to reduce stress
• ·      A scientifically validated method for addressing anxiety and depression
• ·      A fast way of shifting the fight-or-flight response
• ·      Acupressure such as is used in massage methods like Shiatsu
• ·      Acupuncture without needles
• ·      A body-based stress reduction system
• ·      A quick method for reducing cortisol and stress hormones
• ·      A way to regulate the nervous system
• ·      Like qigong and tai chi, exercises to balance the body’s energy system

In time and with practice, you’ll find your own brief “elevator speech” that allows you to explain EFT fast so you can get people tapping. Once you’ve given them their first experience, little more explanation is necessary.

–from The EFT Manual, by Dawson Church

A: EFT is derived from Thought Field Therapy (TFT), which was developed by clinical psychologist Roger Callahan, PhD. Both TFT and EFT combine tapping on acupoints with exposure (i.e, tapping while focusing on a physical pain or emotional upset). The techniques differ in that TFT uses elaborate diagnostic methods to determine which acupoints to tap and in which order while EFT simply taps on 13 or fewer points in any order and dispenses with the diagnostic part of TFT.

A: It takes a long time for new therapies to get accepted. The U.S. National Institutes of Health (NIH) calls this the “translational gap” between research and patient. A report by the Institute of Medicine (IOM; now called the National Academy of Medicine) explained this phenomenon: “Scientific knowledge about best care is not applied systematically or expeditiously to clinical practice. It now takes an average of 17 years for new knowledge generated by randomized controlled trials to be incorporated into practice, and even then application is highly uneven.”

Here is the citation for the full IOM report: Committee on Quality of Health Care in America, Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

For further information on this subject, see the article by Dawson Church and colleagues on clinical innovations: Church, D., Feinstein, D., Palmer-Hoffman, J., Stein, P. K., & Tranguch, A. (2014). Empirically supported psychological treatments: The challenge of evaluating clinical innovations. Journal of Nervous and Mental Disease, 202(10), 699—709. doi:10.1097/NMD.0000000000000188

A: EFT can be used in a variety of ways for pain. In the beginning, people usually use tapping for the physical sensation of pain (e.g., severity, intensity, or the impact in their lives), but it can also be applied to any emotions associated with pain. People with acute pain (e.g., an injury that has just happened) report that EFT helps with coping until they receive medical care. EFT is not designed to stop pain that is appropriate. Acute pain is a signal there is something wrong, but EFT can help with coping until you obtain medical intervention.

Chronic pain, however, is typically described as pain that persists beyond the period of time when the body has repaired an injury. Sometimes there is no origin for chronic pain either; it just starts one day without an event or incident. In this case, EFT can be applied to symptoms (pain rating out of 10), everyday coping, the emotions associated with having this long-lasting pain (e.g., angry it never goes away), or even to the event that started it (if there was one).

In my own study of chronic pain sufferers, an overwhelming 82% discussed the stigma they experienced from health professionals not believing the extent of their pain, and only 4% indicated they received any pain relief from psychological treatment. We taught them EFT for four hours in an intensive workshop. They reported a significant de­crease in the severity and impact of pain during this time and a significant improvement in their overall psy­chological distress. There was also a sig­nificant improvement in their depres­sion, anxiety, and stress symptoms. A significant asso­ciation was found between pain and psycho­logical distress. After six months, the participants still reported positive gains.

–Peta Stapleton, PhD, Certified EFT Practitioner, Trainer, and Mentor

Answer 1 by Certified EFT Practitioner and Trainer Jan Watkins: Yes, when you clear the physical and emotional charges related to an experience, you will have a perspective switch, a cognitive shift, that updates your beliefs and reorganizes your library of experiences. The emotional reaction to the specific tapping target does not return. You might experience something that looks and feels similar to the target, or a slightly different aspect of the initial problem. Problems have multiple layers. We don’t experience our emotional lives for the first time each day. Instead, we have a rich history of events and layers of memories filed away.

We come to today’s experience with that historical reference and we interpret our world from our own unique perspective. Sometimes, you can pull a weed out of a garden and there are multiple pathways under the ground and the roots are deep. Other times, you can pull a tiny little weed and you pull the whole root system out intact.

It’s the same thing with tapping. You don’t always know what’s underneath. A “simple” tapping session for toe pain can become a “one-minute wonder” and clear the pain instantly, or it can unearth difficult memories from the past that need to be addressed. It just means we have more work to do. So if you get toe pain relief and then it returns or gets worse, it just means that you didn’t tap on all of the related aspects. It does not mean that the results do not last.

Example: I recently worked with a client who wanted to tap about a book that had been disturbing in childhood. When he thought of the book, it always left him feeling sad and uneasy. This seemed straightforward enough, right? Wrong. The scenario in the book that revolved around a helpless animal being mistreated tied in to several major themes in the client’s life. These included someone in need not receiving help, betrayal, confusion, inability to deal with dangerous predators, and more. It took several sessions to work through all the issues that were tied in to the reactivity to this childhood book. The root system of this book was very widespread. If we had simply tapped on the plot in the book and some but not all of the underlying issues presented, the book charge would lessen and temporarily seem to be cleared, but eventually, the person would realize that the book still had a haunting aura about it. Once we cleared the many issues around this book, the client was able to think about the book as a work of fiction without any emotional reactivity. He still does not care for the book, but the emotional and physical sensations no longer occur when he thinks of the book. This result has and will continue to last. The sadness and uneasiness will not “come back.” All the root systems of that “weed” were pulled and that particular weed will not grow back!

If something seems to “come back,” you need to consider other options, such as: some of the tapping was incomplete, the possibility of resistance to clearing out the issue, or the existence of additional aspects.

Answer 2 from The EFT Manual, by Dawson Church: Generally, yes. In all the studies that have included a follow-up assessment, the effects of EFT last over time (Feinstein, 2012a). That’s true whether the problem was posttraumatic stress disorder (PTSD), phobias, depression, or anxiety. Once people reduced their psychological trauma with EFT, they tended to remain at that reduced level. In our Healthcare Workers study, my colleagues and I compared those who did more EFT with those who did less (Church & Brooks, 2010). We found that those who did more EFT after their initial one-day workshop had a better long-term result than those who did less.

While you might get immediate relief from EFT, you’re strongly encouraged to continue using it long-term. Sometimes our immediate problem goes away after we tap and we then don’t do any more tapping. Although that positive experience is a good thing in and of itself, it’s better to regard it as a pointer toward the direction we should take for the rest of our lives. We can work on many more issues and release stress whenever and wherever it affects us.

It’s interesting to note how some clients stop tapping once their immediate problem is solved. In the Healthcare Workers study, about a third of participants didn’t use EFT again after the workshop. Another third used it a few times over the next six months. Only a few became regular tappers.

To me this represents a missed opportunity. Why release only a small portion of your suffering and live with the rest? Yet you’ll find many clients are quite content with having the immediate problem solved and don’t continue to use EFT. You might want them to heal further, but it’s up to them to make that choice. You can certainly encourage people to clear more of their emotional distress after their first positive experiences, but many won’t respond. As practitioners, we love and validate people where they are and know that when the time comes for the next step on their healing journey, help will be available to them.

A: Funnily enough, EFT works more effectively when someone is in the present moment (as in mindfulness) rather than distracted. Because the technique is focused on acknowledging one’s current problem/level of distress, being distracted means it won’t actually work. EFT works by someone staying present with the Reminder Phrases and continuing to tap to reduce any distress/discomfort. The research trials with long-term follow-ups (e.g., pain, PTSD, food cravings, depression, anxiety studies, and more) are all aimed at examining whether the effects of an EFT trial remain. The studies typically show that the gains made during the intervention remain many months and even years later. Participants don’t report a return to their baseline state; they usually report the gains are still there.

Placebos are common in medical trials and usually involve subjects taking a sugar pill, for example, but they believe, or are told, it is an active medication. When they take the sugar pill but report positive medical outcomes anyway, it is called the placebo effect. It is the subjects’ belief rather than the content of the sugar pill that impacted their outcomes. Exactly why the placebo effect works is still unknown, but many studies have shown that practically any treatment can induce healing as long as the patient feels they are being looked after and their problem is being treated. Fundamentally, if you think a treatment is going to work, then it will; if you believe you can and will get better, this allows your own mind to do the healing for you.

There have now been six dismantling studies of EFT, which have indicated that the acupressure component of EFT (tapping) is an active ingredient and not a placebo. The fact that EFT can still help relieve someone of distress even if they don’t believe it will work may be proof that belief is not required and that the placebo effect is not occurring.

–Peta Stapleton, PhD, Certified EFT Practitioner, Trainer, and Mentor

Answer 1 by David Feinstein, PhD: In almost all acupoint stimulation protocols, the physical procedure is done simultaneously with the mental activation of a psychological problem or desired state. In this sense, energy psychology is an exposure technique. Bringing to mind an emotional trigger, problematic scene, or unresolved traumatic memory activates the amygdala, arousing a threat response. Stimulating selected acupoints, according to a 10-year research program at Harvard Medical School, simultaneously sends deactivating signals to the amygdala. Repetition of the physical intervention resolves these opposing signals by reducing the arousal while the trigger is still mentally active. The hippocampus records that the memory or trigger is being safely engaged without a stress response, and the neural pathways that initiate the associated stress response are permanently altered. Being able to encounter the memory or trigger without limbic system arousal becomes the new normal. While a vast oversimplification, this explanation fits both the clinical data and the brain image findings.

–Excerpted from: Feinstein, D. (2012). Acupoint stimulation in treating psychological disorders: Evidence of efficacy. Review of General Psychology, 16, 364—380. doi:10.1037/a0028602

Answer 2 by Expert EFT Practitioner Valerie Lis: Several explanations have been proposed as to how EFT works. Here is a possible answer based on its origin in acupuncture. This traditional Chinese medicine has been practiced for thousands of years and has been extensively researched. Acupuncture is based on the concept that the body is an energy field. The core belief is that life energy (chi) flows through the body in channels of energy called meridians. If the flow of chi is disrupted or blocked, it can lead to physical, emotional, and/or mental problems; if left untreated, it will eventually result in disease.

EFT tapping points are placed at the beginning or end point of each of the 12 meridians (the 12 tapping points in the Full EFT Recipe). As each meridian is associated with a different emotion, this sequence ensures that every emotion is tapped on.

Tapping with fingertips at the beginning/end of the meridians “shakes up” or dislodges blockages so that the energy flows freely again. This energy flow induces relaxation, which signals the brain to turn off the emotional trigger/conditioned link. With the link that caused the initial blockage broken, the trigger is neutralized, usually resulting in a permanent shift.