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Section 12
Emotional Freedom Technique (EFT)

Question 12 | Test | Table of Contents

In the last section, we discussed the basic steps of Eye Movement Desensitization and Reprocessing (EMDR) for treating your PTSD client.

In this section, we will discuss a similar technique called Emotional Freedom Technique (EFT).

To begin, EFT uses aspects of EMDR (eye movements and emphasis on shifting underlying cognitive belief systems), a more generalized acupuncture point tapping based on Thought Field Therapy (TFT), and additional distraction techniques. I used this technique with my client, Kurt, age 33, to help him process the negative, distressing images he had of his three tours with the military that led to his PTSD.

Kurt shared, "Some incidents in particular had never left my mind – like the horrifying sight of Gary, a close comrade and friend of mine, being blown-up by a land-mine. Even when I returned to civilian life, these images haunt me. Filing up at the gas station, for example, the smell of diesel immediately rekindled the horrific moment of being near the tanks when I witnessed Gary torn to pieces 20 feet in front of me.

At other times, I have difficulty remembering the past — as if some events were too painful to allow back in my mind. I began avoiding socializing with old military buddies, as this would inevitably trigger a new round of memories. My girlfriend complains to me that I am always pent-up and irritable – as if I were on guard. I also noticed that at night I have difficulty relaxing and falling asleep."

What is beneficial about EFT?
EFT is beneficial particularly for single-incident trauma. Interestingly enough, EFT does not require a client to believe the tapping will work for this method to be effective.

Emotional Freedom Technique:
Here are the five basic steps to outline the principles of EFT.
1. Like EMDR and other methods, the client is asked to identify a traumatic situation that stirs up anxiety or other symptoms. For Kurt, the most immediate image he wanted to work on was the paralyzing image of his friend Gary’s death.

2. Clients then do a preliminary patterned tapping on his or her own hand and accompany this with an affirmative statement. For example, Kurt found the statement, "I accept myself fully and completely, even though I am afraid of my nightmares" to be helpful for his process. When you help your client create a positive statement, it is important that your client juxtaposes a negative statement with the positive one to achieve the desired results.
By acknowledging the negative aspect of the situation, your client is allowed to gradually let go of this and not get stuck in the negative aspect. For example, in Kurt’s statement, he juxtaposes the positive, "I accept myself fully and completely" with the negative, "even though I am afraid of my nightmares."

3. While focusing on the traumatic event, the client reports on a scale of 1 to 10 how distressing the image is. The distressing image for Kurt when we first began the process was at a 10 because he felt he was unable to do anything when he thought of the image. In other words, his emotional and physiological response was debilitating.

4. While still remaining focused on the traumatic event, the client then engages in a prescribed and patterned series of activities. This includes tapping on the hand with eyes open, eyes closed, looking left and right, rolling the eyes in one direction then the other, humming a few bars of a simple tune, counting to five out loud, and then humming again. As the methods are simplified, this series of activities become simpler and briefer.

Since the tapping pattern technique can be complicated, I have included a few youtube videos that go over specific techniques that may be helpful to view with your client. For examples of the EFT process, you may find viewing the following videos helpful:

1. Introduction to EFT: https://www.youtube.com/watch?v=VFKVVP8KXd4
2. How to tap the Faster EFT style: https://www.youtube.com/watch?v=UnTwiQY2hcM
3. EFT for War Veterans with PTSD by EFT Tapping Founder Gary Craig: https://www.youtube.com/watch?v=B4hhMm8qsCs

Initially Kurt found it distracting to remember each aspect of the tapping but reviewing these helped Kurt remember what to do.

5. Your client then assesses his or her distress level again. The protocol can then be repeated if need be. A different tapping place can be used if necessary. Once Kurt went through his first round of tapping, he already began to experience a small amount of decrease in his anxiety and distress level. Your client can continue on with additional rounds of tapping if they feel it is necessary to decrease his or her anxiety and distress further.

After explaining the process to Kurt I stated, "Because you are tapping yourself, you can take this technique home with you and initiate the process on your own if additional anxiety or distress should surface later on."

Wholistic Hybrid EFT/ EMDR (WHEE):
I also want to acknowledge in this section an additional method created by British psychiatrist Daniel Benor called the Wholistic Hybrid EFT/EMDR or WHEE. In the WHEE method, Benor uses the butterfly hug which requires clients to cross their arms so that their hands rest on the bicep of the opposing arm and then they do alternate tapping on each arm with the hands. Benor found that this tapping had the added benefit of being a comforting gesture in and of itself, and that children and adults alike found it easy and pleasant to use.

To this butterfly hug, Benor included the EFT element of stating an affirmation aloud. An example statement would be, "Even though I have a fear of [client’s fear], I completely and totally love and accept myself." This statement is able to be shaped to whatever they find the most comforting to say.

Similar to the other methods we have been discussing in other sections and in this one, WHEE requires clients to assess the intensity of the problem on a scale of zero to ten. This technique uses the SUDS (Subjective Units of Distress Scale) which we have discussed in a previous section.

Since this technique is beneficial as a technique to use outside of the office and out in the real world, more covert tapping techniques can be used. This can be tapping one’s tongue on one’s teeth on alternate sides of the mouth, lightly touching on the acupuncture points of the eyebrows, or a certain kind of breathing can be used where one hand is over the center of the chest.

I have included a few helpful videos regarding WHEE that you can share with your client:
1. Saying WHEE with Awesome Pain Relief in Minutes: https://www.youtube.com/watch?v=aHuJkzkBArw&list=PL3727107577BC46CD
2. I AM Worthy - Self Talk with WHEE Tapping: https://www.youtube.com/watch?v=_iQw4Wpx3-E
3. I Approve of Myself- Self Talk with WHEE Tapping: ttps://www.youtube.com/watch?v=yIUShJtcDSs

Kurt found this method particularly helpful to use while he was in the middle of work. He stated, once he had used the technique a few times outside of my office, "It is something simple that I can easily remember and do for myself." The videos also allowed him to review the technique on his own whenever he needed a refresher.

Do you have a client who is dealing with PTSD and could benefit from reducing distress from reoccurring PTSD images by using EFT or WHEE methods?

In this section, we discussed Emotional Freedom Technique (EFT) and the five steps of EFT: identify traumatic situation, tapping while using an affirmative statement, report distress on scale, go through series of tapping activities, and reassess distress. We also discussed the WHEE method or Wholistic Hybrid EFT/EMDR. Using the WHEE technique, your client can use more covert tapping techniques such as tapping one’s tongue on one’s teeth on alternate sides of the mouth, lightly touching on the acupuncture points of the eyebrows, or a certain kind of breathing can be used where one hand is over the center of the chest.

Naparstek 297- 301 case study: http://psychcentral.com/lib/two-stories-of-ptsd/000165
Reviewed 2023

Update
Emotional Freedom Technique (EFT): Tap to relieve stress and burnout

Blacher S. (2023). Emotional Freedom Technique (EFT): Tap to relieve stress and burnout. Journal of interprofessional education & practice, 30, 100599. https://doi.org/10.1016/j.xjep.2023.100599


Peer-Reviewed Journal Article References:
Bakır, N., Irmak Vural, P., & Körpe, G. (2021). The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized control trial. Perspectives in Psychiatric Care.

Church, D. (2010). The treatment of combat trauma in veterans using EFT (Emotional Freedom Techniques): A pilot protocol. Traumatology, 16(1), 55–65.

Church, D., & Palmer-Hoffman, J. (2014). TBI symptoms improve after PTSD remediation with emotional freedom techniques. Traumatology, 20(3), 172–181. 

Green, M. M. (2002). Six trauma imprints treated with combination intervention: Critical Incident Stress Debriefing and Thought Field Therapy (TFT) or Emotional Freedom Techniques (EFT). Traumatology, 8(1), 18–27.

Mitchell, S. M., Taylor, N. J., Jahn, D. R., Roush, J. F., Brown, S. L., Ries, R., & Quinnett, P. (2020). Suicide-related training, self-efficacy, and mental health care providers’ reactions toward suicidal individuals. Crisis: The Journal of Crisis Intervention and Suicide Prevention. Advance online publication. 

Stapleton, P., Crighton, G., Sabot, D., & O'Neill, H. M. (2020). Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 869–877.

QUESTION 12
What are the five basic steps of Emotional Freedom Technique? To select and enter your answer go to Test.

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