The Science of Tapping

By John Freedom, CEHP

John Freedom, CEHP, is a counselor, educator and trainer in private practice in Santa Rosa, California. The author of Heal Yourself with Emotional Freedom Technique, he serves as research coordinator for the Association for Comprehensive Energy Psychology (ACEP) and the executive director of Finding Recovery and Empowerment from Abuse (FREA). In addition to being a Certified Energy Health Practitioner (CEHP), John holds certifications in Emotional Freedom Technique (EFT), Neurolinguistic Programming (NLP), Eye Movement Desensitization and Reprocessing (EMDR) and Auricular Acupuncture, and he specializes in helping clients experience high-level wellness. He leads seminars and trainings throughout the US and in Europe.

You may have heard about the new energy therapies, sometimes called “tapping.” I coordinate research for ACEP, and I sit on the Board of Trustees for EFT International. Every week articles and blurbs and blogs about energy therapies float across my screen. In February 2023 an article about tapping for anxiety appeared in the UK edition of Reader’s Digest. Energy therapies are becoming mainstream. When I mention energy psychology people will often listen politely, and then sooner or later, pop the question: “But what exactly is ‘energy psychology’? And is there any research on this stuff?”

The term “energy psychology” is an umbrella term for therapies which treat psychological conditions with techniques that purportedly affect the body’s energy systems. Energy psychology includes acupoint tapping techniques such as Thought Field Therapy and the Emotional Freedom Techniques (TFT and EFT), as well as the Tapas Acupressure Technique, Heart Assisted Therapy, Advanced Integrative Therapy and others. Just as psychiatry is a branch of medicine, so also energy psychology is a branch of energy medicine. The scope of energy medicine is very broad, and includes all the different forms of vibrational healing: Therapeutic Touch and Healing Touch, Reiki and pranic healing; Eden Energy Medicine; homeopathy and Bach Flowers; acupuncture, acupressure, Qi Gong and Traditional Chinese Medicine; healing with light, color, sound and music; and devices using frequencies such as Transcutaneous Electrical Nerve Stimulation (TENS) units and Rife machines (Gerber, 1988). This article will focus on energy psychology only.

While energy psychology as a field is relatively new, the use of energetic metaphors to illuminate psychological processes is not. Sigmund Freud explained his theories using energetic concepts such as libido, repression, cathexis and catharsis in terms of the physics (Maxwell’s thermodynamics) of his time (Galatzer-Levy, 1976). Carl Jung related new discoveries in physics to explore his notions of synchronicity and acausality in terms of quantum mechanics (Enz, 2009; Jung, 1969). Energetic concepts were central to the work of Wilhelm Reich and have been retained in contemporary somatic psychotherapies such as bioenergetics (Pierrakos, 1990; Shapiro, 2002). Notions of “energy” play a central role in cross-cultural healing traditions worldwide, such as the Christian practice of “laying on of hands,” shamanistic practices (Krippner & Rock, 2011), Native American healing (Braswell & Wong, 1994), and Traditional Chinese medicine (Hammer, 2005).

One of the biggest blocks to acceptance of Energy psychology is the use of the term “energy.” For some academics, the mere mention of the word “energy” invites eye rolling and skepticism. David Feinstein (2022a) has written a thoughtful article discussing these issues. He discusses five different forms of energy: electrical signaling in the afferent and efferent nerves to and from the brain; energy in the brain measured by qEEG; and the energy in electromagnetic fields. (Every organ and every cell has its own electrical field!) Additionally, there are “subtle energies” – by definition too subtle to measure at this time – and quantum influences. Although the specific mechanisms underlying energy psychology are still being debated, the measurable electromagnetic effects associated with psychological states support the use of the term “energy psychology.”

A central premise of energy psychology is that both surrounding and infusing our physical bodies there is a subtle “energy body,” also called the human biofield, that affects our thoughts, emotions and behaviors. Just as electromagnetic fields affect the behavior of ions, it is theorized that the biofield affects our psychological and emotional states (Rubik, 2002). Traditional Chinese medicine teaches that pain is caused by blockages in the energy flow in one or more meridian channels.

In the words of Qi Gong Master Hong Liu: “Qi is the fundamental life force that permeates all things. Qi connects and animates everything in the universe. When the flow of qi is impaired, we have disease. When it flows easily, we have perfect health” (Liu & Perry, 1997, p. ix). Energy psychology methods are behavioral desensitization techniques which combine psychological exposure and cognitive reframing with the manual stimulation of acupoints, deriving from the well-documented phenomena of acupuncture and acupressure analgesia (Church et al., 2022; Kober et al., 2002). They are grounded in classical behavioral theories of exposure, conditioning, and reciprocal inhibition (Lane, 2009); and fit well with the theory of memory reconsolidation (Ecker & Bridges, 2020). The stimulation of acupuncture points has been shown over the course of a ten-year research program at Harvard Medical School to rapidly reduce limbic system arousal (Fang et al., 2009).

Church et al. (2022) conducted a recent systematic review of the evidence base for EFT. This review found that acupoint tapping results in improvements for a range of psychological conditions (anxiety, depression, phobias, and PTSD); some physical conditions (pain, insomnia, and autoimmune conditions); professional and sports performance; and (d) biological markers of stress. Recent independent meta-analyses confirm benefits for three common psychological conditions: anxiety, depression, and PTSD with moderate to large effect sizes. Clinical trials on anxiety, depression, PTSD, phobias, sports performance, and cortisol levels have been successfully replicated (Church et al., 2022).

To date, authors of over 300 peer-reviewed journal articles have studied energy psychology methods. Feinstein recently conducted a review of this research using a “hierarchy of evidence” model. In this type of analysis, the evidence is organized according to the relative strength of the kinds of studies being reviewed. The hierarchy of evidence for acupoint tapping includes 28 systematic reviews or meta-analyses; over 125 clinical trials including over 75 randomized controlled trials; 24 case studies; 26 reports describing systematic observations; 17 mixedmethods clinical trials; and 88 theoretical articles. This review noted consistent positive outcomes for a range of conditions, and weaknesses in methodology of some studies were discussed. All but two of the 125+ clinical trials reported statistically significant improvement in at least one of the target outcomes (Feinstein, 2023).

Energy psychology methods are noteworthy for their speed and efficiency. Psychologists Carolyn Sakai and Suzanne Connolly conducted research on 50 teenagers living in an orphanage in Rwanda. The teenagers were survivors of the Rwandan Genocide, and some had witnessed their parents, aunts, uncles and other relatives brutally murdered with machetes. They suffered from classic PTSD symptoms: flashbacks, nightmares, acting out, bedwetting, bullying, difficulties in focusing, etc. Sakai et al. (2010) conducted one TFT acupoint tapping session with each child. After receiving one 45 minute session through an interpreter, their flashbacks and nightmares ceased and other symptoms diminished. These results were sustained when the psychologists returned and re-assessed them one year later (Sakai et al, 2010).

These studies are also demonstrating strong durability. Of 81 studies reporting follow-up, 79 found that “benefits were sustained,” sometimes for as long as one and two years afterwards (Feinstein, 2023). Dr. Peta Stapleton at Bond University conducted a series of studies exploring the effectiveness of EFT for obesity and food cravings. She found that as participants’ anxiety and depression scores decreased so did their food cravings, along with their weight and BMI (body mass index). These results held up when assessed again two years later. Interestingly, some participants were even unable to remember which foods they had formerly craved.

Recent studies using fMRI scans have documented physiological changes in the brain correlating with clinical improvements. A research study by Stapleton et al (2022) showed that areas of the brain associated with food cravings were no longer activated after EFT treatment. Decreased activation in the limbic areas of the brain paralleled reduced desire for specific foods. A series of three fMRI studies at Hannover University showed that acupoint tapping while focusing on fearful images catalyzed measurable changes in the amygdala while decreasing activation in the ventromedial prefrontal cortex (Wittfoth et al., 2022). They suggest that fear expression can be extinguished via behavioral disruption of memory reconsolidation, using either somatic (or imaginal!) tapping.

On March 18 of this year (2023) EFT International held its annual research symposium. The theme was “EFT and Issues of Cancer.” Dr. Philip Debruyne and colleagues at the University of Ghent explored the efficacy of EFT treatment for cancer-related cognitive impairment (aka “chemo brain”). After 16 weeks of treatment they found statistically significant reductions on the Cognitive Failures Questionnaire (CFQ) score, distress, depressive symptoms, and fatigue as well as improvement in quality of life (Tack et al, 2021). While it is not a stand-alone treatment in itself, acupoint tapping can be part of a Whole Person approach to treating chronic illness. Baker and Hoffman (2015) studied the effectiveness of EFT to reduce side effects associated with tamoxifen and aromatase inhibitor use in women with breast cancer. Patients received a threeweek course of EFT, consisting of one session three hours per week, followed by self-use. Selfreport questionnaires were used to assess mood, pain, fatigue, menopausal symptoms, hot flashes and night sweats, together with a hot flash diary at baseline, 6 and 12 weeks. The researchers found statistically significant improvements in mood disturbance, anxiety, depression, and fatigue at both 6 and 12 weeks compared to baseline. Numbers of hot flashes on the hot flash rating score decreased at both 6 and 12 weeks.

Some of this research has been conducted by nurses. Several recent studies have documented: improvements in students with test anxiety and public speaking anxiety (Dincer et al, 2020); reductions in anxiety in patients with Stage 2 and 3 breast cancer (Ningsih et al, 2015); reductions in fatigue in women with multiple sclerosis (Ghaderi et al, 2021); improvements in sleep quality and happiness in women with breast cancer (Kalroozi et al., 2022); PMS symptoms (Bakır et al., 2021); and reductions in cravings for substance abuse (Balha et al., 2020). Several studies have documented the effectiveness of meridian tapping modalities for chronic pain as well (Farzad et al., 2021; Stapleton et al., 2022).

Energy psychology methods are being used to treat survivors of catastrophes, both natural and man-made. Numerous reports have documented the use of acupoint tapping with survivors of mass shootings, genocide, ethnic warfare, earthquakes, hurricanes, tornadoes, floods, wildfires, and the COVID pandemic. These techniques have been used in the aftermath of disasters such as Kosovo, Rwanda, Hurricane Katrina, Newtown, Parkland and others. Reports from the field show a pattern of strong outcomes following the use of energy psychology both immediately following disasters and in the subsequent treatment of trauma-based psychological difficulties (Feinstein, 2022b).

Please note that EFT and other forms of meridian tapping are not a “cure” for cancer or anything else. However, they are simple, self-healing, self-empowerment techniques that patients, practitioners and medical professionals can use to treat themselves and their families. They can be used for rapid stress reduction, as traditional one-to-one therapy, and in groups or workshops or online. Practitioners who use these tools often assign their patients “tapping homework” to follow up at home. Self-healing can be as close as your fingertips. The first peer-reviewed research on acupoint tapping was published in 2003 – a mere twenty years ago (Wells et al, 2003). The field of energy psychology is in its infancy. More research, including larger and more rigorously designed replication studies, as well as studies to elucidate the specific mechanisms of action are needed. However, the results of the overwhelming majority of these early studies have been both positive and promising. We look forward to further research and discussion of this fascinating subject.

References

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Bakır, N., Irmak Vural, P., & Körpe, G. (2021). The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized controlled trial. Perspectives in Psychiatric Care, 58(4), 1– 10. https://doi.org/10.1111/ppc.12957

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Tack, L., Lefebvre, T., Lycke, M., Langenaeken, C., Fontaine, C., Borms, M., Hanssens, M., Knops, C., Meryck, K., Boterberg, T., Pottel, H., Schofield, P., & Debruyne, P. R. (2021). A randomised wait-list controlled trial to evaluate Emotional Freedom Techniques for self-reported cancerrelated cognitive impairment in cancer survivors (EMOTICON). EClinicalMedicine, 39, Article 101081. https://doi.org/10.1016/j.eclinm.2021.101081

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Additional Resources

A list and overview of energy psychology research studies can be found at: www.energypsych.org/research/. Also see Dr. Peta Stapleton’s free online video series, “The Science of Tapping,” and related resources at www.evidencebasedeft.com/online-programs.