In my 27 years of practice as a clinical psychologist, I have been guided by a continuous curiosity to study and implement the most effective tools for helping my clients experience relief and healing. Whether the techniques are firmly rooted in the psychotherapeutic establishment or newly emerging, the main question for me has always been, “Do they work?” And like most scientist clinicians, I start off in a skeptical, yet open place.
My toolkit at this stage is rather expansive—including hypnosis, solution-oriented therapy, and systems approaches to name a few. Central to my work in the past decade, however, is the practice of Energy Psychology (EP), a psychotherapeutic strategy that integrates established clinical principles with methods derived from various healing traditions of Eastern cultures (acupuncture, yoga, etc.).
The most prominent EP modalities being practiced today—Emotional Freedom Techniques (EFT), Thought Field Therapy (TFT) and Tapas Acupressure Technique (TAT)—combine brief psychological exposure with the manual stimulation of acupuncture points (acupoints) in the treatment of a variety of emotional conditions.
Though the field of EP is only 30 years old, it is fast growing due to its ability to provide swift results with no abreaction in most cases—particularly with trauma patients. For instance, in the spring of 2006, 50 orphans of the Rwandan genocide (many of whom witnessed their parents die by machete) were treated with a single TFT session.
Following this session, scores on a PTSD checklist completed by caretakers and on a self-rated PTSD checklist had significantly decreased. The number of participants exceeding the PTSD cutoffs decreased from 100 percent to 6 percent. Retesting a year later showed that the improvements held.
There have been many other outcome studies describing the effectiveness of EP methods in quickly and permanently reducing maladaptive fear responses to traumatic memories and related cues.
Even so, the approach has been controversial. Some consider EP to fall under the rubric of pseudoscience. This is, in part, because the mechanisms by which EP works have not been established.
In his 2010 “Rapid Treatment of PTSD” article in Psychotherapy: Theory, Research, Practice, Training, psychologist David Feinstein, Ph.D., speculates that adding acupoint stimulation to psychological exposure is unusually effective in its speed and power because deactivating signals are sent directly to the amygdala, resulting in reciprocal inhibition and the rapid attenuation of maladaptive fear.
Another possibility is that Energy Psychology techniques share certain characteristics with EMDR (Eye Movement Desensitization and Reprocessing), hypnosis, and other therapies that use highly focused patterns of treatment. First the client is asked to pick a specific target and rate how distressing it is with a SUDs (Subjective Units of Distress) number between 0-10. What proceeds next is some sort of therapeutic operation, which could be tapping on meridian points, bilateral stimulation, or the use of imagery.
The client is then asked to report on his/her experience as well as the current SUDs level. If the SUDs is zero, the therapy is essentially done for this target issue. If it is not zero, whatever remains becomes the new target of the intervention. The therapeutic operation is performed again and a new SUDs assessment is taken. This continues until the SUDs is zero or close to zero.
Cognitive psychologists Miller, Galanter, and Pribram refer to this therapeutic strategy as a TOTE (Test – Operate – Test – Exit). Psychotherapy approaches incorporating the TOTE pattern are distinguished from the standard Rogerian or psychoanalytic talk therapy in many ways—most notably by the swift nature of the healing reported in outcome studies, peer-reviewed articles, randomized controlled trials, and case studies.
Could it be that this very pattern is the source of the effectiveness rather than the specific intervention (e.g. tapping on meridian points) in the “Operate” section of the TOTE? It is a fascinating question.
Nevertheless, a recent randomized controlled trial in the Journal of Nervous and Mental Disease has shown EFT to significantly lower cortisol-related stress levels and self-reported psychological symptoms after a single treatment session. It’s exciting to see more robust research validating years of anecdotal positive outcomes with EP – many of which, as in the case of the Rwandan orphan study or the rapid relief of PTSD symptoms experienced by U.S. combat veterans treated with EFT, have seemed incredible from a talk therapy perspective. While more sophisticated (and more expensive) studies need to be done, the data continue to stack up in favor of EP.
I cannot help but think that Energy Psychology is following the path described by Williams James a century ago: “A new idea is first condemned as ridiculous and then dismissed as trivial, until finally it becomes what everybody knows.”