EFT (also known as Emotional Freedom Techniques or Tapping) is a method that uses a combination of the manual stimulation (tapping) of acupuncture points together with western psychological tools.
Most of the EFT research is on the use of 'Clinical EFT' a standardised method of EFT delineated in the ‘The EFT Manual’ (Church, 2013). This enables fair comparison of the various research findings.
EFT is considered by the American Psychological Association to be an evidence-based treatment for anxiety, depression PTSD and phobias.
So, we can say that clinical EFT is an evidence-based treatment - at least for these issues - but, given it’s strange nature, it's understandable that clinicians want to how it works.
To put this into context, it is quite common for science to be partly or even completely in the dark about the mechanisms by which many treatments work.
We have no idea, for example, how lithium moderates the mood of people with Bipolar Disorder but we have very strong evidence that it does.
We don’t understand why antidepressants take time to work but we know that for most people they do.
We can confidently say that EMDR works extremely well as a treatment for PTSD but we’re not certain how it works.
Having said all that, we now know quite a bit about how EFT effects the brain.
The first research that is relevant was conducted at Harvard Medical School on acupuncture.
Hui et al (2000 & 2005) reported that they had demonstrated that acupuncture very significantly reduces the level of activity in certain brain areas including the limbic system.
The limbic system (often nicknamed the 'emotional brain') includes:
the amygdala - which is intimately involved in emotional responses
and the hippocampus - which is intimately involved in memory.
Our emotional responses involve activity in both of these regions and the implication is that acupuncture can reduce the levels of our emotional arousal.
This was supported by research by Fang et al (2009) who found - with acupuncture - there was a very significant lowering of arousal in areas associated with emotional processing - including the limbic system.
So, we can demonstrate that acupuncture can lower the levels of arousal in the emotional brain but the question now arises: ‘Does this also happen when the acupuncture points are stimulated with tapping (as is the case with EFT)?
And, it does.
In fact, several research studies have now shown that tapping acupuncture points very significantly lowers the levels of arousal in the limbic system. (Diepold & Goldstein, 2009, Lambro, Pratt & Chevalier, 2003 and Swingle, Pulos, & Swingle, 2004).
Recently, it has also been demonstrated through fMRI brain scans (scans that show brain activity) that EFT can also be used to reduce food cravings and fMRI scans (Brain scans that show brain activity) show considerably reduced activity in the Limbic system (Stapleton, P. B., et al, 2019).
All of this correlates with what we see in practice - that EFT results in very rapid reduction in fear, anxiety, aggression, craving and pain.
Now, one of the things that is striking about EFT in practice is that - once changes are made through EFT - those changes last. This is backed up by research studies by Church (2013), Feinstein (2012) and others.
This is significant because we can deduce from this that, because there is a lasting effect it must mean that memories are altered in the process.
To make this clearer, let's take an example. Let's say we are treating a phobia - in this case - a fear of dogs. In order for someone to have a fear of dogs, they have to have had an experience of a dog that they found traumatic. Following that trauma, if they had developed a phobia, it would mean that, each time they saw a dog, the memory of the trauma would be (often unconsciously evoked) and they would find themselves fearful of a different dog. Memory is intimately involved in this anxiety response. If there was no memory of the original trauma, there would be no phobia.
Now, if we use Clinical EFT with this person, we would process until there was no (or virtually no) anxiety associated with dogs (including the original memory). Then, if we were to do a follow-up six months or a year later, we would find that the phobia was still in remission (not there). There is no way that this could happen without the emotional component of the original memory being permanently changed.
So, how does this happen?
Well, thirty years ago, we thought memories were fixed but we now know that memories demonstrate neuroplasticity. In other words, we now know that memories can change.
So, how do they change?
Well, we now believe that memories change by a process called 'reconsolidation' (Ecker et al., 2013).
Reconsolidation requires three things:
that the memory be vividly accessed
that an experience that contradicts the original experience be concurrently present
That the juxtaposition must be repeated several times.
All of these requirements are met by EFT.
With EFT, we access distressing memories and encourage clients to feel the emotions associated with them as fully as they can.
This fulfils the first requirement - that the memory be vividly accessed.
With tapping, the level of emotional arousal is reduced.
This experience of much lower (or no arousal) in the presence of the original experience fulfils the second requirement. The lowered arousal presents an experience that contradicts the original experience in the presence of the (memory of) the original experience.
Several instances of the new experience are repeated in the EFT tapping procedure and so the third and final requirement is also met i.e. that the juxtaposition must be repeated several times.
So, the EFT procedure fits the reconsolidation model of memory change.
Even more encouraging is the fact that the reconsolidation model predicts what we find in clinical practice with EFT and so this model appears to have considerable validity.
So, we have come a long way towards understanding the mechanisms behind EFT. We know that tapping lowers arousal in the limbic system and this is the mechanism by which we experience a lowering of emotional responses.
As is always the case with every psychotherapy method much still needs to be explored.
But, we can say that we have come a long way in understanding the mechanisms underlying Clinical EFT.
References:
Church, D. (2013). The EFT manual (3rd ed.). Santa Rosa, CA: Energy Psychology Press
Diepold, J. H., & Goldstein, D. (2009). Thought field therapy and QEEG changes in the treatment of trauma: A case study. Traumatology, 15, 85–93. doi:10.1177/1534765608325304
Ecker, B., Ticic, R., & Hulley, L. (2013). A primer on
memory reconsolidation and its psychotherapeu-
tic use as a core process of profound change. The
Neuropsychotherapist, 1, 82-99. DOI: 10.12744/
tnpt(1)082-099
Fang, J., Jin, Z., Wang, Y., Li, K., Kong, J., Nixon , E. E., . . . Hui, K. K.-S. (2009). The salient characteristics of the central effects of acupuncture needling: Limbic-paralimbic-neocortical network modulation. Human Brain Mapping, 30, 1196– 1206. doi:10.1002/hbm.20583
Hui, K. K.-S., Liu, J., Makris, N., Gollub, R. W., Chen, A. J. W., Moore, C. I., . . . Kwong, K. K. (2000). Acupuncture modulates the limbic system and subcortical gray structures of the human brain: Evidence from fMRI studies in normal subjects. Human Brain Mapping, 9, 13–25.
doi:10.1002/(SICI)1097-0193(2000)9:1<13::AID- HBM2>3.0.CO;2-F
Hui, K. K. S., Liu, J., Marina, O., Napadow, V., Haselgrove, C., Kwong, K. K., . . . Makris, N. (2005). The integrated response of the human cerebro- cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. NeuroImage, 27, 479–496.
doi:10.1016/j.neuroim- age.2005.04.037
Lambrou, P. T., Pratt, G. J., & Chevalier, G. (2003). Physiological and psychological effects of a mind/body therapy on claustrophobia. Subtle Energies & Energy Medicine, 14, 239–251.
Stapleton, P. B., Buchan, C., Mitchell, I., McGrath, Y., Gorton, P., & Carter, B. (2019). An initial investigation of neural changes in overweight adults with food cravings after emotional freedom techniques. OBM Integrative and Complementary Medicine, 4(1). https://doi.org/10.21926/obm.icm.1901010
Swingle, P. G., Pulos, L., & Swingle, M. K. (2004). Neurophysiological indicators of EFT
treatment of post-traumatic stress. Subtle Energies & Energy Medicine, 15, 75–86.
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