Emotional Freedom Technique – Acupuncture for the Mind

The Emotional Freedom Technique (EFT), also referred to as tapping therapy or energy psychology, has been gaining popularity both as a self-help technique and psychological intervention. It remains firmly in the realm of pseudoscience and shows weaknesses in the psychological research infrastructure.

Specific locations on the body where energy flows are what are referred to as "meridians" in EFT. This is a typical definition.

“EFT works by tapping on acupressure meridians to release blockages. When these blockages are released, the problem feeling can be released and move through the body. The process starts with a beginning statement of what the problem feeling is and includes a complete acceptance and acknowledgement of the problem.”

Proponents claim you can free yourself from negative emotions by using energy points and repeating a reminder phrase. This is nonsense. Prescientific superstition is only one component of this claim.

The fact that there are no acupuncture points is the first thing we should discuss. According to a literature review, acupuncturists can't agree on which points to what. There isn't even an agreement on where energy points are supposed to be, even if we set aside the fatal problem that there isn't a basis for the existence of energy points in the body. When there is a general idea, the uncertainty is so great that it could be anywhere on the body.

It's not surprising, given the history of the points. It was said that there would be one point for each day of the year. The underlying concept of acupuncture is based on the astrological concepts of the heavens.

The existence, location, and function of alleged acupuncture points are all a result of tradition, philosophy, and belief. There isn't a body of research that establishes their location. There are different traditions of acupuncture points that are different in culture because the idea is not based in reality.

There is no evidence for life energy or chi. This was a prescientific idea that was credited for any life phenomenon we could not currently explain. Modern biology has pushed aside the need for appealing to a vague life energy. There is no evidence that life energy exists. The same is true for the body of water.

If life energy, meridians, and acupressure points do not exist, how could tapping them have a psychological effect? The answer is that it can. There are many clinical studies that show an apparent benefit from EFT for anxiety, fatigue, stress, depression, andPTSD. This type of clinical research is very challenging and most of the studies are small. The outcomes are mostly subjective and very easy to implement placebo effects, including demand characteristics. Exposure therapy and cognitive behavior therapy can be effective on their own.

It's hard to imagine a more challenging clinical research challenge, to properly control for and tease apart the various non-specific and placebo effects from the claims of energy psychology. The literature fails to make these distinctions, despite the claims of proponents. On the one hand, we have reliable scientific evidence that life energy and acupoints do not exist, on the other, we have very difficult, unreliable, and contaminated psychological studies. I know which evidence is more compelling. It would be possible to convince me that it works, but it would take a much higher threshold of evidence than currently exists, and that is the core problem here. In the face of extreme scientific implausibility, practitioners are too quick to accept preliminary evidence.

While being insufficiently skeptical of if it works, the supporter of EFT had some skeptical questions about how it works. They wrote.

I wanted to understand more about how tapping allegedly interrupts the body’s fight or flight signal from the brain. Why does tapping result in emotional and cognitive shifts? If we can influence the body’s fight or flight response system by tapping, why does it only work in the positive? Can we make ourselves feel worse by tapping? What if you aren’t very precise in your tapping, does it still work? Does tapping harder or softer affect results at all? If you are physically incapable of tapping some of the points (say if you only have one arm) does it still work? If so, how important was that tapping point in the first place?

There are many great questions. Real physical effects should be affected by things like dose-response and precision, and could have negative effects. Placebo effects are not dependent on things.

What about the research done in the hospital? It is generally positive, but when you take a closer look it is obvious that the research is not up to par. Most of the studies don't have adequate controls or blinding, which is critical in this context, with a high potential for non-specific and placebo effects. The best studies tend to be negative.

There was no difference in outcome between the two groups, although there was a benefit beyond other groups. There is no basis for a specific effect when it comes to the psychological intervention called EMDR. It is a great control because it shares all of the non-specific elements of treatment. There was no difference between the two treatments.

Clinical research is what I would like to see more of. Pre-registering study protocols is required. There was significant reporting bias in a recent metaanalysis of homeopathy trials. There was a positive outcome when all studies were included. The effect went away when the analysis was limited to pre-registered trials. It's a good example to use because we know with high confidence that it doesn't work, so it's a very telling window on the literature.

It can be difficult to double-blind a physical treatment. The effects vanished when we got to well-blinded studies. In psychological studies, demand characteristics are a huge problem and this is even more important.

The research is not close to where it would need to be to establish specific efficacy for EFT, even though it is based on pure pseudoscience.

• Steven Novella is an academic clinical neurologist at the Yale University School of Medicine. He is the host and producer of the popular weekly science show, The Skeptics, Guide to the Universe, and also the author of the daily neuroscience website, Neuro LogicaBlog. The Skeptics Guide to the Universe was published by Dr. Novella, as well as two courses with The Great Courses.

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