In my last blog post I wrote of how I’ve grown tired of fake news and biased reviews of tapping and decided to take a stand. One way I’m doing that is spreading the word about the tapping research and rebutting the biased writings of those who seek to misrepresent its benefits or spread untruths about the research.
In particular I spoke out against a biased website review article and wrote about this on my blog.
That post also stirred others to make submissions, which is great, and well done to those of you who did so. There has been some action since, with the author making contact in the comment section of my original post ( see this at the link above).
He also made a few small changes to his article, however the overall tone and intent is still very skewed and negative, and it continues to include many untruths and inaccuracies.
I’ve written another response to the author, which you can read below. You may find this and my last post helpful if you need to share the research on EFT and tapping generally.
I’ll continue to update this blog with new developments and any further responses.
Thanks for your online responses to my blog article and to my several attempts to make contact via the Healthy But Smart website.
I’m interested to read your thoughts regarding the points I made on my blog.
I would also like to add some additional points beyond those already made: In taking the time to do this I have to assume that you are, in fact, willing to consider the more recent evidence, which many people are unaware of.
The points made by many critics of EFT and in critical articles such as the one you reference in your study (Bakker, 2013) and in Wikipedia, refer almost entirely to research and writings pre-2012. Most of the really excellent research has been conducted since this time including a large number of randomised control trials published in top-flight journals, 4 meta-analyses as mentioned previously, and newer research showing various biological markers (see further below).
I am hopeful that instead of being diverted by these old criticisms, you will more fully consider instead some of the more recent literature where explanatory mechanisms of EFT have been discussed and proposed, research has been conducted which shows various biological markers which pinpoint some of what is going on when people practice EFT, dismantling studies have been conducted that show the effects of EFT compared to distraction, placebo, and much more.
I need to say at the outset that tapping on acupressure points was not discovered by Gary Craig. In fact, Emotional Freedom Techniques (EFT) evolved from Thought Field Therapy (TFT), originally Callahan Techniques, developed by Dr Roger Callahan, a California-based clinical psychologist. Thus, it did not just arise out of the blue or from the imagination of Gary Craig as is implied by your article.
There are a number of issues arising from this point. A key one is that you need to look beyond the early writings of Gary Craig, who has in fact moved on from EFT, and to only consider his early writings and the explanatory mechanisms advanced by him back then is to do an injustice to the efforts of many hundreds of researchers who have been studying EFT subsequently, and the tens of thousands of therapists using the approach worldwide.
In my blog post I mentioned that professional associations have developed which are researching EFT and accrediting practitioners. I have already mentioned the Association for Comprehensive Energy Psychology (ACEP), which has over 1300 professional members. Another professional EFT association is AAMET International (The Association for the Advancement of Meridian Energy Techniques), a voluntary, not-for-profit association and UK Registered Charitable Incorporated Organisation, which has around 2000 professional members.
You stated: There is one core group of researchers that have put out the majority of the papers on EFT at this time. You also referred many times to there only being small biased studies, most appearing in alternative journals, by one group or researchers, not enough to show effectiveness, and without comparison groups:
Apart from my point above about the large number of professional members in these professional associations, there have been over 200 researchers in 12 countries who have published studies and research papers on EFT. The results of EFT treatment have also been verified and replicated by independent researchers (the number one criteria for evidence based) for several conditions, well and truly meeting the division 12 criteria of the American psychological Association for evidence-based for those conditions.
Of the 101 outcome studies which have been conducted on EFT, 48 were randomized controlled trials, and more than half met all seven of the American Psychological Association’s essential criteria for study design that were in use at the time. These essential criteria included (a) randomization, (b) sample sizes that are adequate for detecting statistically significant differences, (c) clearly defined treatment populations, (d) assessment tools with established reliability and validity, (e) blinded assessments, (f) use of treatment manuals or other means for ensuring uniform interventions, and (g) enough data provided in the paper reporting the clinical trial that the study’s conclusions can be reviewed for appropriateness. (Feinstein)
Regarding your accusations of pseudoscience and claims that there is a lack of evidence in highly regarded scientific journals:
Among the scientific journals that have published studies or reviews which include favorable evidence about energy psychology are three journals of the American Psychological Association (Psychotherapy, Review of General Psychology, and Archives of Scientific Psychology); Clinical Psychology; Depression Research and Treatment; Primary Care and Community Psychiatry; Emergency Mental Health; the Journal of Behavior Therapy and Experimental Psychiatry; the Journal of Aggression, Maltreatment, and Trauma; and the Journal of Nervous and Mental Disease, among many others. The Journal of Nervous and Mental Disease – which is the world’s oldest still-active mental health journal (established in 1874), currently edited by a former president of the American Psychiatric Association – has published five foundational papers examining energy psychology. None of the 101 published studies listed on the ACEP site appeared in a “junk” or “predatory” journal (according to web-based lists of predatory journals).
You state that “There is no properly designed study to date that suggests EFT has any benefits beyond a placebo treatment or a comparison treatment.” This is incorrect.
When a treatment is first introduced the initial research question is whether it produces an effect. Therefore, the first thing is to demonstrate that it produces an effect beyond chance by having a control group who does not have the treatment, and ideally randomisation to groups. Once the treatment can be shown to have an effect (and anyone who looks at the research would have to concede this for EFT), then comes time to compare it with alternative treatments, firstly to “treatment as usual” and then to gold standard evidence based treatments such as CBT and EMDR. This has now been done and there are a number of studies showing EFT superior to a range of comparison treatments, and some also comparing it to these two gold standard treatments and in each case finding it to be equivalent.
To say or imply as you have that when EFT produces results that are not significantly different to CBT this is somehow a bad thing is false: In fact, producing results equivalent to a gold standard treatment is excellent! Also, the usual treatment length for a standard CBT treatment is typically much longer than EFT treatment, among other things.
Specifically in regards your placebo accusation, the following was sent to me by David Feinstein:
A review of six studies that compared EFT protocols with otherwise identical protocols – except an alternate technique replaced the tapping – showed that acupoint tapping is an active ingredient, independent of placebo, nonspecific therapeutic effects, or other clinical features. (Reported in: “Is Tapping on Acupuncture Points an Active Ingredient in Emotional Freedom Techniques (EFT)? A Review and Meta-Analysis of Comparative Studies” (Journal of Nervous and Mental Disease, in press).
Much of the controversy regarding EFT and acupoint tapping generally includes debate and speculation regarding it’s possible mechanisms of action. In fact, I believe this entire issue has prevented many professionals (including yourself) from looking at the actual results.
Yet, as Harvard psychiatrist Eric Leskowitz (2018) points out in his article in press in the Journal of Alternative And Complementary Medicine,
“does it actually matter if we cannot explain a treatment’s mechanism of action? Surgeons continue to use general anesthesia, even though they cannot explain why it works. Energy-based therapies should be held to a similar standard: as long as they are proven effective, they should be endorsed while we work to outline a plausible mechanism of action.”
As he also writes (In this excerpt EP = Energy Psychology):
“EP is so widely used that lack of fast-track consideration by institutional gatekeepers is puzzling. For example, an online training guide has been downloaded over 2 million times, e-mail rosters of two EP-oriented organizations (Innersource, and EFTUniverse) have over 800,000 subscribers, a web-based conference (the World Tapping Summit) has averaged 500,000 viewers annually over the past 10 years, and EP’s professional organization (the Association for Comprehensive Energy Psychology [ACEP]) has 1300 members, primarily graduate-degreed clinicians (www.energypsych.org). In addition, over 100 published studies—including 48 randomized controlled trials (RCTs), 5 systematic reviews, and 4 meta-analyses—consistently show statistically significant clinical benefits to patients suffering a wide range of ailments, including post-traumatic stress disorder (PTSD) and chronic pain.”
Regarding mechanisms of action, if you take a look at the research you will discover that a range of biological markers have been shown to follow EFT treatment including: reductions in cortisol production, normalization of brain wave patterns, shifts in activation of brain regions associated with targeted problems, and changes in the expression of genes related to emotional regulation and learning. References to these studies, all of which used well-established scientific instruments for taking the measurements, can be found in the overview paper at http://overview.EnergyPsychEd.com
To give one example, EFT treatment to reduce food cravings found, using functional MRI, that areas of the brain activated by photos of junk foods were less activated after the treatment, and this corresponded with decreased craving for those foods (reported in Peta Stapleton’s forthcoming book The Science Behind Tapping (Hay House, in press)
Regarding the paper that debunks EFT’s results by Waite and Holder (2003): if you take a closer look at this paper you will find several things:
1. The Waite and Holder study does not actually follow the EFT protocol yet it claims to make conclusions about EFT.
2. The study uses for its subjects university students and uses for its measures nothing more than self-reported SUDS measures. That’s all! Rate your fear 0 to 10! They had the group rank their fear 0-10 then had them do some tapping (and a few other things) or not, then had them rank it again. And this is considered a good study?? Surely you see the problems here with the subjective and unreliable issue of SUDS ratings as the only measure in a study conducted by sceptical researchers?
Conversely, take a good look at the results of studies conducted on EFT and you will see a large variety of more reliable and objective measures are used including those with actual biological markers as mentioned above.
Using reliable and validated measures is surely more compelling scientifically than self-report? In addition, what better than either biological markers, which are unobjective, or actual behavioural evidence of results? This must surely be more compelling than self-report.
For example, in our 2003 study of EFT treatment of phobias, apart from including SUDS ratings we included a well validated fear questionnaire and a behavioural measure of how close participants could approach the feared animal prior to and after treatment. That is something which cannot be faked and I defy you to produce those results using distraction or any of the other methods that you have proposed explain these results. For example we had one woman who would sleep in her car if she knew there was a mouse in her house so fearful was she of this, and similarly refused to enter the room on pretesting when she knew a mouse was inside, yet after a single 30 minute treatment with EFT she was able to walk right up to the mouse and even touch it without any fear. These results held up nine months later. When you have actually seen results like this it is something which makes one a believer, as opposed to a reader or maker of opinions.
3. The Waite and Holder study actually found positive results, i.e., a significant improvement and reduction in fear levels for EFT treatment. The fact they also found reductions for a group who tapped on a doll does not invalidate EFT’s fear-reducing results at all (and again it was self-report from university students!!). It should also be considered that by using the fingers to tap on a doll the individual is stimulating the meridian points on the fingers which were used in the original long version of EFT. In any case, even if we accept these results despite the very unreliable self-report nature of the measures used and the protocol which differed significantly from EFT, the study still demonstrates that EFT does produce an effect in reducing subjective fear. What it also does is raise questions about the mechanisms of action by which those results are being produced, which is the very issue I raised earlier.
You wrote regarding this study: Every experimental group had a similar reduction in fear, suggesting it does not matter where you tap or if you tap at all.
This is factually incorrect. Whilst the experimental groups all showed a reduction in fear this was in each case statistically significant compared to the no treatment group who did not tap. Therefore there is nothing in this study to suggest that it does not matter whether you tap at all. The study showed that tapping produces results, full stop.
I could go on ad nauseum, however let me stop here for now.
I look forward to your response.
Where to from here?
As mentioned above, I will continue to update this blog with any future developments.
Please continue to join me in spreading the word about the research that has been done and to respond to those who would misrepresent this. That way, as I wrote in my previous post: “Sure, the closed-minded cynics still won’t listen to you or look at it, but the true skeptics (the real definition of a skeptic is someone who needs proof) and the general public will make up their own minds once they see the actual evidence.” Let’s continue to work to give them that opportunity.