For more information on EDxTM, please see http://energypsych.com/.

Time for a second look

Richard C. Kevin, Ph.D.

Raleigh, NC

www.drrkevin.com

Reprinted with permission from The North Carolina Psychologist

(January/February 2011, v. 63, #1, pp 8-9)

Energy Psychology: Time for a Second Look

Energy Psychology (EP) occupies a unique niche in the range of modalities used by psychologists and other mental health professionals. Like other techniques early in their potential arcs of transition from untested innovation to unremarkable standard practice, EP has committed defenders and implacable detractors. Unlike most well established therapies, EP originated outside of the Western psychological/medical tradition as an integration of Western psychotherapy and several forms of Eastern medicine. EP also has the unique status of having been banned by the APA Education Directorate as a topic for which CEU’s can be granted. The controversy surrounding EP and its promise as a healing technique have the makings of a case study of how professional and academic psychology responds to innovation. What follows is a brief introduction to EP through my clinical experience and a summary of recent literature. My original interest in EP stemmed from experience with EMDR. Initially I had dismissed the reports of rapid resolution of PTSD and other symptoms through bilateral eye movements as the latest Miracle Cure de Jour and waited to see it fade or be discredited. But respected colleagues returned from trainings, utilized it in their practices, and began reporting favorable movement in their clients. Eventually I trained and cautiously began using EMDR myself. My experience was similar. Clients with relatively simple recent traumas often made rapid movement. Some long term clients with deep seated issues moved significantly faster when early traumas were addressed through EMDR. Explanations of the mechanisms of action were speculative but it was reassuring that the EMDR community encouraged and conducted empirical research. Today, while much remains unresolved and arguable regarding its mechanisms and active components, EMDR is widely accepted as a treatment for PTSD and other anxiety disorders (Van der Kolk, et. al., 2007). Reading Energy Psychology and EMDR (Hartung and Galvin, 2003) piqued my curiosity about EP. I began experimenting with the Emotional Freedom Technique (Craig, 2008) which is a form of acupressure (Clients tap themselves on a sequence of acupuncture points.) combined with low intensity imaginal exposure to traumatic or conflictual material. The results were reminiscent of my experiences with EMDR. At times nothing happened. But with some regularity clients made unusually rapid progress resolving anxieties and traumatic memories. 2.

I was encouraged with outcomes but uncomfortable with the lack of an explanatory model or research base compatible with my Western science training and values. Initial literature searches were discouraging. While several psychologists were pioneers in EP, most innovators and practitioners came from non psychological backgrounds. Their references to “subtle energies” and quantum level phenomena from high energy physics were thought provoking but not helpful in explaining the techniques to curious clients and often skeptical colleagues.

Fortunately, the maturing of the field and neuroscience findings verifying that acupuncture affects the limbic system, has led to increasingly credible research. David Feinstein (2008; 2010; 2010a) has reviewed studies ranging from early anecdotal accounts through more recently randomly controlled trials which support the assertion that EP is an effective for PTSD and other anxiety disorders.

In reviewing the current status of EP scholarship, Feinstein cited core issues which have blocked acceptance by mainstream psychology. These include reports of extraordinary efficacy unsupported by mainstream research and the lack of a verifiable explanatory model. .

Unsupported claims of extraordinary results invite valid skepticism. At present, however, an increasing body of literature which meets accepted standards, including randomized controlled trials is being published Findings in these studies have demonstrated significant positive effects of acupoint tapping on: specific phobias, test taking anxiety, speaking anxiety, weight management, and post-trauma anxiety. In addition, credible accounts of positive clinical outcomes are accumulating.

EP’s second problem is that for most psychologists it simply makes no sense that

tapping on one’s skin would bring about significant changes in affective states or symptoms. The metaphysical terminology and analogies to quantum physics employed by some non-psychologist practitioners has not aided acceptance by the mainstream. But again, as the field has matured, testable theories have emerged.

One foundation of maturing EP theories is a body of neuroimaging research which confirms that stimulating acupoints has significant modulatory effects on the limbic system (Hui et al., 2005). EP can be conceptualized as a form of exposure therapy, but with a different mechanism than traditional exposure therapies. Extant models of exposure treatment account for symptom relief by the formation of new associations that override the influence of former pathological associations which are weakened but not eliminated. It is consistent with this theory that it may take lengthy and multiple trials of exposure to form the new associations and that the fear response can be reactivated in stressful situations where the overriding normal response is weakened.

In the most common forms of EP, relatively brief and mild imaginal exposure is paired with acupoint stimulation. This appears to down regulate activation in the amygdala. One 3.

hypothesis is that the EP intervention eradicates rather than overrides the link between the conditioned stimulus and the fear response. While this is a preliminary formulation, it is consistent with research by Ruden, (2005: 2010) which identifies electrochemical mechanisms by which these links can be erased. It is also consistent with emerging research trends that brief and mild imaginal exposure is often sufficient to resolve symptoms with a very low relapse rate when paired with an EP intervention.

The literature summarized above discusses one form of EP and is only a starting point for understanding the controversy swirling around the emerging field. So what tentative conclusions can be drawn? Feinstein reminded us that you never get a second chance to make a first impression. I would argue that there is now a research and clinical experience base for professional and academic psychologists to take a measured second look at EP.

In taking that second look it will be important to keep in mind that despite how they are often described, EP interventions are not stand alone modules independent of a therapeutic relationship. EP provides one more tool, which is often less stressful than some accepted techniques to help clients move toward their goals of healing.

REFERENCES

Craig, G. (2008). The EFT Manual. Fulton, CA: Energy Psychology Press.

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.

Feinstein, D. (2008). Energy Psychology: A Review of the Preliminary Evidence.

Psychotherapy: Theory, Research, Practice, Training. 45(2), 199-213.

Feinstein, D. (2010). Rapid Treatment of PTSD: Why Psychological Exposure with Acupoint Tapping May Be Effective. Psychotherapy: Theory, Research, Practice, Training. 47(3), 385-402.

Feinstein, D. (2010a). The Case for Energy Psychology. Psychotherapy Networker 34(6), 46-60.

Hartung, J.G. & Galvin, M.D., (2003) Energy Psychology and EMDR. New York: W.W. Norton

Ruden, R. A. (2005). A neurological basis for the observed peripheral sensory modulation of emotional responses. Traumatology, 11, 145-158. 4.

Ruden, R. A. (2010). When the past is always present: Emotional traumatization, causes, and cures. New York: Routledge.

Van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J.W., Hopper, E.K., Korn, D.L., & Simpson, W.B. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenance. Journal of Clinical Psychology, 68, 37-46

for the Canadian Association for Integrative and Energy Therapies 13th Annual Conference

From Healing To Wholeness

Toronto, Ontario, October 21 – 23, 2011.

Deadline: Tuesday, February 15th, 2011

Main Conference: October 21 – 23, 2011
Pre-Conference Workshops October 20
Post-Conference Workshops: October 24

We are currently accepting proposals for 2-hour breakout presentations at the 13th Annual Canadian Energy Psychology Conference, EPC Canada 2011.
This will take place at the Novotel Toronto Center hotel, located in the very heart of exciting downtown Toronto a world-class city renowned for its theater, art galleries and gourmet restaurants. We are planning on no more than a manageable 30 breakouts in five concurrent sessions during the three main conference days, as well as morning warm ups, evening activities and keynote addresses.

Deadline for submitting proposals is Tuesday February 15th, 2011. There will be no extensions to this deadline.
New this year, all proposals are being submitted online. Please submit your proposal electronically at http://caiet.org/proposals

We strongly advise you to submit your proposal prior to the deadline as proposals may be returned for revision if directions are not followed.
All revisions must be resubmitted by February 25.  No extensions will be granted.

Proposal guidelines (PDF) are attached and will shortly be downloadable from the conference website http://www.epccanada.ca/

Warm regards,

Sharon Cass-Toole, PhD, CCA, DCEP

director@caiet.org
416-221-5639

Click here for general information about the Canadian Association for Integrative and Energy Therapies.

http://www.nmr.mgh.harvard.edu/~vitaly/PDF/hui_hbm00.pdf

According to Pennsylvania psychologist, Carole Stern, ACEP’s President-elect, “As disheartening as it has been for us as psychologists to realize that our professional organization did not take immediate and decisive ethical steps with members who participated in the government’s use of torture, the harm being done by the APA’s position here is actually much more far-reaching. Some 5 million people in the United States suffer with PTSD, including more than 300,000 veterans of the Iraq and Afghanistan wars. PTSD is a debilitating and agonizing affliction, and the early evidence is showing Energy Psychology to be much quicker and more effective than existing treatments. To block therapists from learning it is unconscionable. “

ACEP has been actively attempting to get the APA to lift its ban for more than a decade. Because emerging research on Energy Psychology supports ACEP’s position, the controversy has been gaining increasing attention. Studies using the method with individuals suffering from PTSD have shown striking outcomes. As a result, the method is finding its way into conventional health care settings and receiving growing popular attention. More than a million people have obtained a guide book for using Energy Psychology on a self-help basis, and clinical trials are being conducted by Kaiser Permanente, Walter Reed, and Britain’s National Health Service.

ACEP’s current President, Gregory J. Nicosia, a psychologist and an APA member since 1977, notes: “The APA’s criteria for appropriate CE content are clear and straightforward. By any reasonable reading of our applications or of our 80-page appeal brief, we have met these criteria many times over. In blocking the dissemination of this approach, the APA is following a different agenda than its own rules. I have no idea what that agenda might be, but the bottom line is that it is hampering one of the most important clinical interventions for treating trauma that has appeared in recent years from reaching those who are in desperate need and could benefit from it most.”

Clinical psychologists are increasingly speaking out about being actively blocked by their own professional organization from learning or promoting the approach. In a recent interview, California psychologist and ethics expert David Gruder stated: “The [APA] should be shouting from the rooftops about this new clinical development. Instead it has persisted for over a decade in putting up roadblocks.” Read the entire interview with Dr. Gruder athttp://www.energyme d.org/pr1. htm

http://www.military.com/news/article/tapping-energy-to-deal-with-ptsd.html%20

As most of you know, EXPERIMENTAL RESEARCH TENDS TO LAG BEHIND CLINICAL EXPERIENCE, often by years. It took the British Navy more than 75 years to begin issuing limes to their sailors to prevent scurvy, after Dr James Lind brought it to the attention of the British Royal Commission. Because it was not (yet!) ‘evidence based’, and even though the ‘mechanism of action’ (ie. Vitamin C) was not identified until the 20th century, it is estimated that 100,000 sailors died during that period, whose lives could have been saved, had they implemented Lind’s recommendations immediately.

It is interesting to note that many current medical practices, e.g. the use of Caesarean section (which has increased dramatically in the last 30 years), has never been experimentally ‘proven,’ and is not really ‘evidence based’ either.

In a 2003 article in the British Medical Journal,

“Parachute use to prevent death and major trauma related to gravitational challenge: A systematic review of randomised controlled trials,” Drs Gordon Smith and Jill Pell point out that

“the effectiveness of parachutes has never been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of ‘evidence based medicine” organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.” (BMJ 2003;327:1459-1461 (20 December)).

2. While EFT, TFT and TAT  are not (yet) on the ‘official’ DMH list of ‘evidence based psychotherapies,’ we have approximately 15 small studies demonstrating efficacy of EP modalities in the treatment of phobias, anxiety, depression, weight loss maintenance and PTSD.

Dawson Church has completed five pilot studies demonstrating efficacy (as demonstrated by significant drops in anxiety, insomnia, flashbacks and depression) with PTSD in veterans; and there are two studies currently in progress, one at Columbia Pacific Medical Center (San Francisco), and the other at Walter Reed Medical Center, which will be comparing EFT to CBT in treating PTSD. Dr. Charles Elder and colleagues are completing a major study (500 subjects), for which they received an NIH grant, exploring the efficacy of TAT in weight loss maintenance; this study will be completed in November, 2010.

Thus, ‘evidence based’ research has been done, and larger studies are currently underway.

3. Another way of reframing these discussions is to recognize that EFT, TFT, etc are new ‘hybrid therapies,’ and, as David Feinstein has pointed out, are a form of ‘acupressure assisted exposure therapy.’ EP modalities combine ‘evidence based’ therapies (exposure therapy, exposing the subject to an imagined stimulus, while challenging negative cognitions (via setup statements —- a form of CBT!)), with acupressure desensitization.

For a fuller discussion of this issue, see Dr. James Lane’s paper, “The Neurochemistry of Counterconditioning,’ http://www.energypsych.org/associations/6267/files/NeurochemistryCounterConditioningLane.pdf

Thus, it is only a matter of time before TFT, EFT, TAT, AIT, ETC get on the official lists of ‘evidence based therapies,’ and become more widely accepted and practiced. I personally am hopeful that this will occur over the next five years.

John Freedom