Kirsten Schulz, PsyD
Energy Psychology: Theory, Research, & Treatment, (2009), 1(1), 15-22.
This study evaluated the experiences of 12 therapists who integrated energy psychology (EP) into their treatments for adult survivors of childhood sexual abuse. Participants completed an online survey and the qualitative data was analyzed using the Constant Comparative method. Seven categories containing 16 themes emerged as a result of this analysis. The categories included: (1) Learning about EP; (2) diagnosis and treatment of adult CSA using EP; (3) treatment effectiveness of EP; (4) relating to clients from an EP perspective; (5) resistance to EP; (6) the evolution of EP; and (7) therapists’ experiences and attitudes about EP. These themes are compared and contrasted with existing literature. Clinical implications are discussed, as well as suggestions for future research. The results provide guidelines for therapists considering incorporating these techniques into their practices.
Keywords: psychotherapy, energy psychology, sexual abuse, TFT (Thought Field Therapy), EFT (Emotional Freedom Techniques).
The physiological, mental, and emotional damage caused by childhood sexual abuse has been a challenge to treat for mental health professionals, due to its deep-rooted and complex unraveling of the body’s natural defenses (Browne and Finkelhor, 1989; Briere, 1992). This qualitative study examined how therapists integrate energy psychology (EP) into their treatment of adult survivors of childhood sexual abuse, and how they utilize these techniques in practice to address the emotional and dysfunctional cognitive patterns manifested by the abuse.
Data was obtained from 12 therapists in various regions by means of a semi-structured, qualitative online survey. All the participants were veterans in the field of psychology, having practiced for at least 10 years. Nine had been practicing for 20 years or more. Ten therapists were trained by innovators of the field, including Roger Callahan, the originator of Thought Field Therapy (TFT), a common form of EP.
EP has demonstrated its efficacy with other traumatized populations. Feinstein (2008a) summarized published reports of its use in natural- and human-caused disasters such as the genocides in Rwanda and Kosovo, and Hurricane Katrina. War veterans with high levels of PTSD symptomatology have also achieved PTSD-negative results after EP treatments (Church, 2009; Church, Geronilla and Dinter, 2009). EP has been shown to normalize abnormal EEG patterns associated with the recall of traumatic memories (Diepold and Goldstein, 2008; Lambrou, Pratt and Chevalier, 2005), EP has also shown effectiveness with accident victims with PTSD (Swingle, Pulos, and Swingle, 2004). An analysis of EP studies published to date found that, in all studies that included long-term follow-up, participant gains held over time, making EP treatment of durable benefit to clients (Feinstein, 2008b).
This study was conducted using qualitative methodology, which enabled an extensive examination of the participants’ experiences. The research focused on therapy from the therapists’ viewpoint, rather than the investigator’s opinions of the therapy. It sought details about methods of incorporating EP into more traditional methods of therapy, and the experiences of those incorporating it into therapy.
Subjects consisted of 12 licensed clinical psychologists who completed an online questionnaire. Most participants were members of ACEP, the Association for Comprehensive Energy Psychology, and were recruited at the International Energy Psychology Conference. The inclusion criteria consisted of therapists who used EP techniques in conjunction with more traditional modalities of treatment, were licensed and practicing for at least five years, and worked with clients at least 50% of that time. Therapists provided informed consent, and were asked about clients’ specific symptoms and areas of improvement using a 20-question online questionnaire (http://freeonlinesurveys.com/rendersurvey.asp?id=107496).
The following demographic data was obtained: 1) Gender, 2) Age, 3) Ethnic and Racial Background, 4) Degree Obtained, 5) Years as a Licensed Psychologist, 6) Work Setting, and 7) City and State of Practice. (Table 1)
|Therapist #||Gender||Age||Ethnic/ RacialBackground||DegreeObtained||Years as a Licensed Psychologist||Work Setting||City and State of Practice||Religious and SpiritualOrientation (optional)|
|1||Male||63||White||Ph.D.||More than 20||Private Practice||Philadelphia, PA||Christian|
|2||Female||55||White||Ph.D.||More than 20||Private Practice||Charleston, WV||Interfaith Minister|
|3||Female||61||White||Ph.D.||More than 20||Private Practice||Saint Louis, MO||Metaphysical Christian|
|4||Female||60||White||Ph.D.||More than 20||Private Practice||Los Angeles, CA||N/A|
|5||Female||64||Asian/Pacific Islander||Ph.D.||11-15 years||Private Practice||Honolulu, Hawaii||Christian|
|6||Female||63||White||Ph.D.||5-10 years||Private Practice||Escondido, CA||Non-practicing Jewish|
|7||Female||52||White||Ph.D.||16-20 years||Private Practice||San Diego, CA||N/A|
|8||Female||54||White||Ph.D.||16-20 years||Private Practice||San Diego, CA||Unitarian Universalist|
|9||Male||64||White||Ph.D.||More than 20||Private Practice||Colorado Springs, CO||Agnostic|
|10||Female||67||White||Ph.D.||16-20 years||Private Practice||Clinton Township, MI||N/A|
|11||Male||55||White||Ph.D.||More than 20||Hospital/MentalHealth Unit/ Private Practice||Stevenage,United Kingdom||N/A|
|12||Female||43||White||Ph.D.||11-15 years||Private Practice||San Diego, CA||Jewish/12 Step/Personal beliefs relevant to work|
After a review of the existing literature on childhood sexual abuse and EP, questions were constructed to explore the relationship between the two areas. The interview topics were chosen based upon the research questions, as well as the symptoms and diagnoses associated with childhood sexual abuse. The EP portion of the questionnaire explored the practitioners’ perception of their experiences with Energy Psychology. Topics included: 1) how they learned about EP 2) how they prepared themselves to use EP with their clients, 3) the EP technique they used, 4) how they introduced EP to their clients 5) which symptoms they found to be most effectively treated by EP techniques, 6) the common symptoms and diagnoses they noticed in clients of CSA, 7) the treatment options for clients with CSA 8) the changes they noticed throughout therapy for clients with CSA, 9) whether or not they taught clients to use EP techniques on themselves, 10) any experienced opposition to EP, 11) how they saw EP evolving in the future, and finally, 12) suggestions for therapists aspiring to use EP in their practice.
The Constant Comparative method was used to organize the information into themes, and to compare and contrast the information. Data from the demographic responses were analyzed to discover any patterns in relation to the “interview” responses. Most questions were open-ended. Glaser and Strauss (cited in Lincoln and Guba, 1985, p. 339) describe the Constant Comparison method as following four distinct stages: comparing incidents applicable to each category, integrating categories and their properties, delimiting the theory, and finally, writing the theory (p. 339). (Table 2)
Common Themes Among Therapists
|Category 1Learning About Energy Psychology|
|1.||How Therapists Discovered EP||X||X||X||X||X||X||X||X||X||X||X||X|
|2.||Education Recommendations for Therapists Aspiring to Use EP||X||X||X||X||X||X||X||X||X||X||X||X|
|3.||Educating Clients about EP||X||X||X||X||X||X||X||X||X||X||X||X|
|Category 2Diagnosis and Treatment of Adult CSA Using EP|
|4.||Common Symptoms and Diagnoses of Adult CSA Clients||X||X||X||X||X||X||X||X||X||X||X||X|
|5.||Therapists Used Multiple EP Techniques||X||X||X||X||X||X||X||X||X||X||X||X|
|6.||Talk Therapies and CBT Along with EP and EMDR for Adults of CSA||X||X||X||X||X||X||X|
|Category 3Treatment Effectiveness of EP|
|7.||Anxiety Disorders and Mood Disorders Most Effectively Treated by EP||X||X||X||X||X||X||X||X||X||X||X||X|
|8.||Improved Interpersonal Relationships, Mood, and Self-Esteem in CSA Clients||X||X||X||X||X||X||X||X||X||X||X||X|
|9.||Improvements in Clients’ Intrapersonal Relationships||X||X||X||X||X||X||X||X||X||X||X|
|Category 4Relating to Clients from an EP Perspective|
|10.||Client Permission or Informed Consent||X||X||X||X||X||X|
|11.||Introduce EP in a Way That Helps Client Feel Comfortable||X||X||X||X||X||X||X|
|Category 5Resistance to Energy Psychology|
|Category 6The Evolution of Energy Psychology|
|14.||EP Evolving in a Positive Direction in the Future||X||X||X||X||X||X||X||X||X|
|15.||More Research Needed or Foreseen in the Future of EP||X||X||X||X||X||X||X|
|Category 7Therapists’ Experiences and Attitudes|
|16.||EP Has Transformed Their Lives||X||X||X||X||X||X||X||X||X||X||X||X|
EP Techniques Used. The therapists discussed the specific EP techniques that were used. TFT, which utilizes the body’s meridian points, was used by all 12 of the therapists. TFT is theorized to use the same mechanisms of action as acupuncture. Gallo (1999) and Sheets (1997) agreed with Kaptchuk (1983) and Diamond (1985) that acupuncture utilizes the body’s energy system, which is comprised of specific pathways or meridians through which the energy flows. TFT uses tapping with the fingertips to stimulate acupoints in specific sequences. Most therapists in the study mentioned utilizing muscle testing as a tool to measure emotional distress, and to identify any unconscious effects of the abuse. Callahan (2000) proposed that manual muscle testing can be used to identify an unconscious block, or what might be called an “internal disagreement.” The unconscious effects of childhood abuse, for example, may lead to such a reverse polarization. If a person is repeatedly abused, an underlying belief might be that “Emotional distance from others keeps me safe.” Correcting such a “psychological reversal” for survivors of trauma and abuse is an essential first step (Lambrou and Pratt, 2000).
Combining EP with Other Techniques. The treatment of adult CSA clients is complex, and may involve a combination of techniques. Seven of the therapists used a combination of techniques with their adult clients of CSA–including cognitive talk therapies and eye movement desensitization reprocessing (EMDR). Initially, talk therapy might be used to help teach assertive communication techniques, self-care, and coping skills. EP is then used to relieve the trauma in a non-invasive manner. One therapist noted that energy methods are ideal for sexual abuse survivors because there is less necessity to talk about, or relive, trauma. This lessens the possibility of re-traumatization. EMDR, CBT, and solution-focused therapy were also mentioned.
The literature on the stages of change for CSA survivors explain that using conventional cognitive or psychodynamic models, therapists may be able to foster the processes in mid-stage therapy by teaching, modeling, practicing, and reinforcing behavioral techniques such as contingency management (e.g., positive reinforcement), stimulus control (e.g., avoidance of problematic stimuli), and self-liberation (e.g. re-evaluation of choices and beliefs).
EMDR was mentioned as a technique used to alleviate symptoms of trauma, and one therapist declared her belief that EMDR is, in fact, an EP method. Literature speaks to the effectiveness of EMDR, both by itself, and with other techniques. EMDR requires the client to perform bilateral eye movements while concentrating on the trauma memory. The procedure consists of a structured sequence of treatment components (Shapiro, 1995) that have been identified as being effective across trauma treatment modalities (Hyer and Brandsma, 1997), including psycho-education, coping skills training, and exposure (including emotional processing and cognitive restructuring components).
Cognitive behavioral therapy was mentioned by the participants as another technique used in conjunction to EP. The research done on CBT relaxation-exposure techniques for PTSD has shown significant results. Reciprocal inhibition is utilized, which is defined as relaxation paired with exposure to anxiety-producing stimuli (Wolpe, 1973). Baranowsky, Gentry, and Schultz (2005) suggest that CBT is organized around this principle, and the relaxation-exposure combination is found in some form in virtually all effective treatments for post-traumatic stress disorder. CBT typically includes some combination of psycho-education, coping skills training, and exposure.
Treatment Effectiveness of EP. All participants in the study found anxiety-related symptoms to be most effectively treated by EP techniques. The therapists’ responses correlated with the literature regarding trauma and PTSD. Carbonell & Figley (1995) examined EP as a treatment modality for trauma. They invited the innovators of four clinical approaches to the treatment of PTSD to meet with their colleagues. The four interventions included traumatic incident reduction, visual kinesthetic dissociation, EMDR, and TFT. They reported that all four methods generated clinically significant results. However, they stated that the thought field therapy treatments enabled the traumatized client to become desensitized (non-anxious) to their traumatic experiences without re-experiencing the trauma, and without any apparent side effects.
Besides the effective treatment of anxiety using EP techniques, therapists noted improvements in both interpersonal and intrapersonal relationships in their clients. Ten of the therapists noted significant improvements in their clients’ relationships. All relationships were mentioned–relationships at work, romantic partners, platonic friends, and family members. One therapist mentioned that clients set better limits with others and communicated more clearly, which caused their relationships to improve. All 12 therapists noted changes in their clients’ mood and affect after using EP.Therapists described client reactions in the following ways: clients had less anxiety, flashbacks, anger, fear (PTSD symptoms); clients could think of the situation and view it neutrally or positively, clients could no longer access the problem (“It has floated away.”), clients had improvements in confidence levels, self-esteem, and assertiveness; and clients exhibited better self-care and less self-harming behaviors.
The literature is compatible with the therapists’ findings regarding client improvements after experiencing EP. According to Sheets (1997), as the negative emotion is eliminated at the energy field level in the body, the client may notice changes in other levels such as chemical (the person is less depressed), or neurological (the person is less confused and more focused), or cognitive (the person thinks with much more objectivity and confidence). Ten of the therapists noted a decrease in their clients’ dissociative symptoms. Confusion and memory problems diminished. Seven of the therapists noticed a reduction or elimination of pain syndromes in their clients. Two therapists mentioned that although somatic symptoms improve, they are generally more resistant to treatment than psychological symptoms, and so the improvements are less dramatic. Although dissociative symptoms were not specifically examined in this study, therapists reported positive treatment outcomes for trauma in general.
Introducing EP to Clients. Before beginning any treatment, it is important to get permission from clients and obtain informed consent. Therapists in the study introduced EP to clients in various ways. Five of the therapists educated clients about the mind-body connection to stress and trauma. Therapists explained how trauma is stored in the body as well as the mind, and that using EP will help to identify the subconscious patterns, releasing the trauma on a deeper level. Therapists in the study mentioned that they introduce EP in a way that helps the client feel comfortable. One way to do that is to try to relate it to their existing paradigm. Six of the therapists introduced the topic of EP by relating it to the acupressure points in Chinese medicine. The therapists believed that clients may have heard of acupressure or had positive experiences with it, and therefore may be more open and accepting to trying it. One therapist reminds clients that acupuncture is accepted by the NIH, insurance companies, and hospitals. Such an explanation of the mind-body connection is consistent with the literature. Gallo (1999) concurred with Diamond (1985) that most problems begin at an energy level, and that using the acupuncture meridians described in Chinese Medicine can rebalance the flow of life energy in the body. Five of the therapists mentioned incorporating EP slowly into existing therapy. Mentioning that it is “weird” may help prepare clients for the techniques, as well as sharing personal experiences where the technique has helped in similar situations.
EP as a New Paradigm. Research in EP is fairly recent. It is understandable that a certain amount of resistance would occur while practitioners and researchers are better able to grasp the new way of viewing the mind-body connection. Gallo (1999) described EP as “a new paradigm for understanding and intervening in the treatment of psychological disorders.”
Skeptics assert that muscle testing is subjective. Because of the nature of the technique, it is difficult to empirically measure the results. The Subjective Units of Distress Scale (SUDS) is used to measure the level of emotional distress in the body. The critics of thought field therapy argue that the results are “subjective,” or the opinion of the client or therapist. Gaudiano and Herbert (2000) believe that applied kinesiology is a scientifically discredited procedure and declared that Kenny, Clemens, and Forsythe (1988) found that those using the techniques did no better than chance in determining nutritional status using muscle testing.
One therapist in the study stated, “I acknowledge that the research is lacking in EP but express confidence that it will be done and will show the effectiveness of EP. I tell my colleagues I’m not waiting until the data is in to use something that my own anecdotal data shows to be so positive.” Herbert (2000) declared that without adequate controls, it is impossible to exclude the hypothesis that any potential positive effects of TFT are attributable to the placebo effect, or the tendency of individuals to improve merely as a consequence of the expectation of improvement. Lilienfeld (2002) states that both Hecker and Herbert concur that TFT might ultimately be proven to be effective in future research, but that a demonstration of such efficacy requires adequately controlled, randomized studies that take placebo effects and other nonspecific factors into account.
Clinical Implications. The findings have several implications, as they were based on the responses of experienced clinicians. One of the clinically noteworthy reports is that EP reliably reduces trauma without having the client re-experience the distress. EP does not require the clients to talk about their trauma. Verbal recapitulation may even be counterproductive, causing more pain and discouraging further treatment. If the distressing emotions are no longer a hindrance after EP, therapy can proceed much more quickly. The core issues can be discussed without client discomfort.
The rapid rate of healing also may affect the treatment goals. Long-term therapy goals may have to be modified accordingly. Managed care and payment schedules may be affected, as the client may not need as many sessions as initially anticipated.
Participants noted the strong possibility of transference issues with an adult CSA population, as the client may transfer feelings from his/her relationship with the perpetrator onto the therapist. It is not unexpected for the client to reenact his/her anxieties and insecurities within the therapeutic environment. For example, a male therapist may trigger anxiety and anger in the female client. It is important for the therapist to model appropriate behavior and communication for the client.
EP has been shown to address a complex of conditions, including anxiety, depression, cravings, and pain (Church & Brooks, 2009; Rowe, 2005). As client addictions, somatic symptoms, and emotional distress improve–as these clinicians find is common with EP–the therapist may need to work with the client to regain a new sense of self (“Who would I be without this problem?”). The therapist can help the client develop new hobbies, skills, and interests.
The participants in this study, all licensed clinical psychologists with a minimum of 10 years in private practice, found EP to enhance their ability to treat adult survivors of childhood sexual abuse. They all stated that treatment of CSA is very complex, and many used EP in conjunction with other techniques such as CBT, EMDR, and solution-focused therapy. Participants agreed that anxiety-related disorders were most effectively treated by EP techniques, but that because EP represents a new paradigm in healing, it must be introduced to clients gradually, within the client’s frame of reference, and after informed consent has been obtained. They concurred that the integration of EP into therapy has enriched their personal lives, as well as the lives of their clients. They expect EP to become an accepted psychotherapeutic treatment in the future, as empirical research validates their clinical experience. The study provided guidance for clinicians on topics such as how to introduce EP to clients, what combination of techniques to use, and which symptoms are most effectively treated.
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