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The Case for Energy Psychology

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Clinical psychologist David Feinstein describes some of the compelling research behind energy psychology, a method based on tapping selected acupuncture points to address psychological problems, including post-traumatic stress disorder.

By David Feinstein


Drawing from contemporary psychological understanding as well as ancient spiritual practices and healing traditions, Energy Psychology (EP) provides simple methods for shifting the brain’s chemistry, specifically through a variation of Emotional Freedom Techniques (EFT). Using a combination of acupressure points, along with advanced psychological methods, EFT releases traumatic memories and facilitates healing.

The Evidence Accumulates for Energy Healing

Despite continuing professional skepticism, empirical evidence for the effectiveness of Energy Psychology (EP) has been accumulating. Treatment teams have been deployed to more than a dozen countries to provide mental health services following natural and human disasters. Outcome data systematically collected in at least five of these countries, and corroborated by local health-care authorities who had no stake in EP, were encouraging.

The first research using established measures to investigate treatment outcomes with disaster survivors was conducted in 2006 by a team led by psychologist Caroline Sakai, working with an orphanage in Rwanda. Of the 400 orphans living or schooled at the facility, 188 had lost their families during the ethnic cleansing 12 years earlier. Many had witnessed their parents being slaughtered, and they were still having severe symptoms of post-traumatic stress disorder (PTSD), including flashbacks, nightmares, bedwetting, withdrawal, or aggression.

The study focused on the 50 teenagers identified by the caregivers as having the greatest difficulties. All 50 were rated on a standardized symptom inventory for caregivers and scored above the PTSD cutoff. Each then received a single acupoint-tapping session lasting 20 to 60 minutes, combined with approximately six minutes spent learning two simple relaxation techniques.

Not only did the scores of 47 of the 50 adolescents fall below the PTSD range following this brief intervention, these improvements in serious conditions that had persisted for more than a decade held at a one-year follow up.

In the first randomized controlled trial of the use of EP with combat veterans, presented at the Society of Behavioral Medicine Conference in Seattle, 49 vets showed dramatic improvement after six treatment sessions—42 of them no longer scored above the PTSD cutoff. Conducted under auspices of the Vets Stress Project, participants were recruited from throughout the United States and were treated by volunteer practitioners. The gains persisted at the six-month follow-up. In contrast, less than one 1 in 10 of the 49,425 veterans of the Iraq and Afghan wars with newly diagnosed PTSD who sought care from facilities run by the Department of Veterans Affairs actually completed the conventional treatments recommended.

An Infantry Soldier Case Study

After the Seattle report, I contacted the study's principal investigator and asked whether I could interview some of the therapists involved. One of them, Ingrid Dinter, described to me her work with Keith, an infantry soldier who had served in the Mekong Delta during the Vietnam War. In his initial therapy session in April 2008, he reported that he had seen "many casualties on both sides." More than three decades later, he was still tormented with nightmares and repeated flashbacks.

"Sometimes I think I see Viet Cong soldiers behind bushes and trees," he added. His severe insomnia, complicated by the nightmares, made him fatigued and unable to function during the day. He'd been diagnosed with PTSD and reported that his group and individual therapy through the Department of Veterans Affairs (VA) hadn't helped with his symptoms.

Keith had six hour-long sessions with Dinter, during which she had him tap on acupoints while he focused on traumatic war memories and other psychological stressors. In their first session, he reported that since the war's conclusion, he'd rarely gotten more than one to two hours of sleep at a stretch, and averaged about two nightmares each night.

By the end of the six sessions, he was getting seven to eight hours of uninterrupted sleep and was having no nightmares. He said that other symptoms, such as intrusive memories, startle reactions, and overwhelming obsessive guilt, had abated as well.

Can Tapping Change the Brain?

Studies continue to confirm that Energy Psychology works and works quickly, but the fundamental question remains: How does it work? How could tapping on the skin be an ingredient in producing rapid cures for severe psychological disorders? How, in fact, can any intervention reliably overcome PTSD within a few sessions?

The emerging understanding of neuroplasticity—particularly the ways that thought and experience can decisively change the brain—suggests that significant therapeutic shifts can happen far more rapidly than we once believed. It's now at least plausible that therapeutic interventions can be developed that quickly alter the neural pathways maintaining emotional and behavioral patterns that were once protective (like trauma-based hyperarousal), but have become dysfunctional.

A series of studies conducted over the past decade as part of the Neuroimaging Acupuncture Effects on Human Brain Activity project at Harvard Medical School provides clues to why acupoint tapping may be such an approach. According to project leader Kathleen Hui, "functional MRI and PET studies on acupuncture at commonly used acupuncture points have demonstrated significant modulatory effects on the limbic system."

How does that apply to EP? It's always been obvious that psychological exposure is an ingredient in EP. Traumatic memories or other cues that trigger unwanted emotional responses are mentally activated during the acupoint tapping. Since exposure is the single therapeutic component present in virtually all studies of effective PTSD treatments, the success of EP has often been attributed simply to its use of that approach.

But this doesn't address the fact that clinicians utilizing the technique, and numerous studies, have found that by adding acupoint tapping, the exposure can be much briefer, requires fewer repetitions, and leads to positive outcomes with a greater proportion of clients. The new understanding provided by the Harvard neuroimaging studies is that stimulating specific acupoints generates signals that instantly reduce arousal in the amygdala.

So rather than relying on repeated or prolonged exposure to extinguish the threat response, EP introduces acupoint tapping during a brief exposure, which immediately counters the threat response. The process appears to work like this:

  • The client is asked to bring to mind an anxiety-provoking memory, thought, or related cue, activating an alarm response in the amygdala;
  • The simultaneous stimulation of acupoints sends deactivating signals to the amygdala, initiating an opposing process, reminiscent of Joseph Wolpe's "reciprocal inhibition";
  • The signals sent by the acupoint stimulation turn off the alarm response, even though the trigger is still present.
  • With a few repetitions, the trigger no longer evokes fear, and this innocuous experience, which becomes the defining memory about the trigger, is stored in the hippocampus.

The apparent operating principle, although not yet demonstrated by laboratory research, is that when a traumatic memory or other trigger is paired with an intervention that turns off the alarm response, such as the stimulation of selected acupoints, the neural pathways that were keeping the alarm response in place are altered.

When the maladaptive fears that are at the core of PTSD have been eradicated in this manner, associated symptoms also diminish. A marked decrease of flashbacks, nightmares, intrusive thoughts, concentration problems, numbing, and even self-defeating thoughts and behaviors has been reported by clinicians, and is now being corroborated by systematic research. So while EP utilizes psychological exposure, the acupoint tapping allows for a kinder intervention, requiring far fewer and much shorter exposures to traumatic material.

While empirical studies to fully demonstrate the speed and power of EP are still needed, it's hard not to be deeply moved seeing emotionally devastated people come back into happier, more effective lives after a few EP sessions.