Emotional Freedom Technique

Emotional Freedom Techniques (EFT) is a psychotherapeutic alternative medicine tool based on a theory that negative emotions are caused by disturbances in the body's energy field and that tapping on the meridians while thinking of a negative emotion alters the body's energy field, restoring it to "balance." There are two studies which appear to show positive outcomes from use of the techniques, but another study has suggested that it is indistinguishable from the placebo effect. Critics have described the theory behind EFT as pseudoscientific and have suggested that any utility stems from its more traditional cognitive components, such as distraction from negative thoughts, rather than from manipulation of supposed "energy meridians".

Background
EFT was created by Gary Craig in the mid 1990s, and is meant to be a simplification and improvement of Roger Callahan's Thought Field Therapy (TFT) techniques. Craig trained with Callahan in the early 1990s. In 1993, Craig was the first person Callahan trained in his most advanced procedure, a proprietary procedure known as Voice Technology. Craig found through his experience that the sequence of tapping points did not matter and that special proprietary procedures were therefore unnecessary, so by the mid 1990s he had simplified Callahan's procedures.

Theory
Proponents of EFT claim it relieves many psychological and physical conditions, including depression, anxiety, post-traumatic stress disorder, general stress, addictions and phobias. More extreme claims have been made for multiple sclerosis and even "everything from the common cold to cancer.'" The basic EFT technique involves holding a disturbing memory or emotion in mind and simultaneously using the fingers to tap on a series of 12 specific points on the body that correspond to meridians used in Chinese medicine. There are 15 points, if one includes points nicknamed the "karate-chop point," "gamut spot," and the "sore spot," used to enhance the effectiveness of treatment. The theory behind EFT, based on an ancient theory of acupuncture, is that negative emotions are caused by disturbances in the body's energy field and that tapping on the meridians while thinking of a negative emotion or event alters the body's energy field, restoring it to "balance."

The theory states that negative emotions are built in the following stages: A negative experience occurs; negative emotions are felt in response to this negative experience, leading to inappropriate programming inside the body; and then the body's energy system gets disrupted due to these negative emotions. The contention of EFT is that in order to remove the negative responses, tackling the negative experience is not enough, because doing so cannot correct the energy imbalance. Rather, the energy imbalance must be restored along with curing the negative emotions.

The main difference between EFT and TFT lies not in principles, but in application. In TFT, a specific sequence of tapping points (known as an algorithm) is used for a particular problem. This sequence is determined using muscle testing, a procedure also used by applied kinesiology.

In EFT, the sequence of tapping points is deemed to be unimportant, and therefore individual algorithms are not required for different problems. Instead, a comprehensive algorithm is used for all problems, and no diagnosis or muscle testing is required. Fewer than all the points may be needed for a particular problem, but because there are so few, it is deemed not worth discovering which are necessary.

Effectiveness
EFT has been the subject of three peer-reviewed publications as of 2007.

Wells et al. study
The first study, published in the Journal of Clinical Psychology in 2003 (indexed in the MEDLINE database) and funded by the Association for Comprehensive Energy Psychology, involved 35 patients with a phobia of small animals receiving a single treatment with EFT. The authors concluded that their findings were "largely consistent" with the hypothesis that EFT can reduce phobias of small animals in a single treatment session, but that methodological limitations in the study prevented any firm conclusions being drawn.

Waite and Holder study
The second study, published in The Scientific Review of Mental Health Practice in 2003 (indexed in the PsycInfo database), was conducted by Waite and Holder on 119 University students who reported specific fears or phobias. This study compared four groups: A group that received a single-round regular EFT; a second group that received the same treatment except that they tapped on points in the arm that are not part of the standard EFT protocol; a third group that received the same treatment except that they tapped on the corresponding meridian points on an inanimate object (a doll) and a fourth group that was asked to make a toy. The participants were asked to self-report their fears before and after treatment on a SUDS scale.

The first three groups did statistically better than the fourth group, but there were no significant differences between the three tapping groups. That is, the groups that tapped on sham points and on the doll did just as well as the EFT group, but all three groups did better than the no-treatment group. Since the group that used the doll was not tapping on meridian points yet still benefited equally, the authors suggested this as a falsification of the claim that EFT is effective because of an energy meridian system.

One proponent has tentatively suggested that the efficacy of EFT in the 'doll' group reflects the action of mirror neurons.

Rowe study
The third study, published in Counseling and Clinical Psychology in 2005 (an erratically published journal not included in either the PsycINFO or MEDLINE databases), a subset of the validated SCL-90-R symptom checklist was used to test the levels of psychological distress in 102 participants in an experiential Emotional Freedom Techniques (EFT) workshop before treatment, after treatment, and at six-month followup. There was a statistically significant decrease in all measures of psychological distress as measured by the SA-45 from pre-workshop to post-workshop which held up at a 6-month follow-up study. . Because the study lacked a control group, it was not able to rule out placebo effects or regression to the mean, which often produce reductions in pathology following any treatment.

Criticism
EFT has been labeled as pseudoscience in the Skeptical Inquirer magazine, based on what the journal describes as its lack of falsifiability, reliance on anecdotal evidence and aggressive promotion via the Internet. Gary Craig, the developer of EFT, has argued that tapping anywhere on the body will manipulate "energy meridians". There are many points used by acupuncturists which are not included in EFT methodology, and tapping one of those may have an accidental effect not yet explored. Skeptics have asserted that such an argument renders EFT untestable via the scientific method, and therefore a pseudoscience. This argument is also addressed by the Waite and Holder paper, in which the participants tapped on a doll, rather than themselves. Waite and Holder have suggested that EFT's successes are likely to stem from "characteristics it shares with more traditional therapies", rather than manipulation of supposed "energy meridians" via tapping. The 2003 study showed that EFT, a modeling treatment and a placebo all produced a significant decrease in anxiety and fear over a control group. A recent article in the Guardian, written by journalists, suggested that the act of tapping parts of the body in a complicated sequence acts as a distraction, and therefore can appear to alleviate the root distress. The therapist repeats a reminder phrase every few seconds throughout the treatment, to draw the client's attention back to the problem.