An upcoming flight was the source of my anxiety. I recently had knee surgery and the idea of getting my bags to the terminal on my own made my heart race and my thoughts run wild: Assuming I made it to the plane without issues, would the seat be too cramped for my leg’s mobility once I boarded? I recently heard climate change was making turbulence worse and dreaded the sinking feeling bumpy air could bring. What if most people weren’t wearing masks and I got COVID-19?
As part of an interview for this story, I organized a video call with Dawson Church, a researcher and author who writes about alternative healing, and asked him to demonstrate a brief session of “Emotional Freedom Technique,” or EFT, tapping for me. Church asked me to hold the anxiety I felt about my upcoming trip in my mind and repeat a series of affirmations about it while tapping various parts of my body.
Proponents of EFT tapping say it is a simple and accessible tool with plenty of evidence supporting its use to treat everything from anxiety, depression, post-traumatic stress disorder (PTSD), phobias, and even substance use and chronic pain. It has been endorsed by alternative medicine advocate and author Deepak Chopra and has found its way into some classrooms. But some therapists are skeptical about whether it really helps to reduce symptoms of these conditions and say the body of research used to support its use is flawed.
Meditation is a part of my daily routine. My mother is a yoga teacher and I use many alternative healing practices in everyday life. I’m also a science reporter with a built-in cynicism that takes a lot to crack. My brief experience with EFT Tapping did seem to reduce my anxiety, but how could I be sure this wasn’t just a placebo effect, the chamomile tea I had before, or any number of other unknown factors? Church originally shared my skepticism when he came across EFT tapping, he told me, as did multiple practitioners interviewed for this story when they were introduced to it.
“I thought it was really unlikely that one treatment could be effective for many different things, and I dismissed it initially,” Church told Salon. “Then I experienced it myself because I was selling a business I owned and I was anxious about the sale. I tapped and my anxiety dropped by about a half. I was really struck by that.”
Building on psychotherapeutic acupuncture practices, Gary Craig introduced EFT tapping in the 1990s when he published the “EFT Handbook.” Like many holistic health practices, it combines elements of Eastern medicine and Western psychology. Similar to acupuncture, EFT tapping is thought to work by targeting various “meridian points” in the body. With an estimated one in five Americans diagnosed with a mental illness and half of those people going untreated for their condition, people are increasingly turning toward alternative and holistic medical practices designed to reduce stress and improve mental health.
“After just a few rounds of tapping, people often report feeling lighter and calmer and able to breathe more easily – almost as if they now have more space inside,” states one free manual from EFT International. “They may report that their thinking has changed, they have gained new insights or that they are feeling better overall.”
As EFT tapping became more popular, EFT International (formerly The Association for the Advancement of Meridian Energy Techniques) was formed in 1999. With close to 2,000 members today, the organization offers training programs that accredit EFT practitioners, similar to the EFT Tapping Training Institute and a handful of other organizations.
Craig Weiner, a chiropractor and director of the EFT Tapping Training Institute, said the center trains mental health care providers, social workers, addiction specialists, chiropractors and life coaches in EFT tapping. Over the past decade, “the acceptance within mental health care professions has grown significantly,” Weiner told Salon in a phone interview.
Not all of that growth has been through training institutions, however. A quick YouTube search pulls up dozens of amateur demonstrations, including videos from comedian Russel Brand and pop star Pink. EFT tapping can bring up traumatic experiences and not being able to process those emotions appropriately could be dangerous if it’s not done under the supervision of a professional, Weiner said.
“My big concern is people that see EFT tapping on YouTube and add it to their toolkit without certification or training and they start working with people with traumatic memories that are outside their practice or their skill level,” Weiner said. “If a person starts working on childhood memories that were abusive and they don’t have any skill in doing that, it can be harmful and retraumatizing.”
It’s still unclear whether EFT tapping might exacerbate certain conditions like obsessive compulsive disorder (OCD) by initiating repetitive behaviors, for example. Whether people have this condition, trauma or others, they should always discuss EFT tapping with their mental health providers before trying it themselves, said Peta Stapleton, Ph.D., a clinical psychologist and associate professor of psychology at Bond University in Australia.
“We always recommend consulting with a trained practitioner if someone wanted to use the technique for trauma processing, or found that doing it on themselves resulted in becoming distressed,” Stapleton said.
Other researchers have been resistant to endorse EFT tapping in the first place without more convincing data. In 2008, for example, David Feinstein, Ph.D., a clinical psychologist and EFT tapping researcher, performed an evidence review of “energy psychology,” which includes mind-body practices designed to reduce stress and help process trauma like EFT tapping, as well as thought field therapy (TFT). Feinstein concluded that these practices together “reached the minimum threshold for being designated as an evidence-based treatment.”
Commentaries published in the same journal, however, said many studies showing energy psychology to be ineffective were omitted from the review, one study was misclassified as a randomized controlled trial and much of the research was in general riddled with “serious flaws.” In one editorial, the authors concluded Feinstein’s conclusions were “premature” and based on “incomplete evidence.”
EFT tapping is thought to work by decreasing activity in the regions of the brain associated with pain and fear like the amygdala. Meanwhile, the practice can also activate the executive functions of the prefrontal cortex that help patients manage anxiety-provoking experiences they want to work on, Feinstein said.
“It brings a somatic quality to the treatment that you don’t have in talk therapy or even cognitive behavioral therapy,” Feinstein told Salon in an email. “While it uses the methods of talk therapy and CBT [cognitive behavioral therapy] — specifically cognitive restructuring and psychological exposure — it amps up their effectiveness.”
However, another study published in the journal Scientific Review of Mental Health Practice examining EFT tapping’s impact on fear and anxiety seems to suggest the main benefit might come from some of the CBT elements incorporated into EFT tapping. In the study, patients were assigned to perform EFT tapping on the meridian points commonly used in EFT Therapy, perform them on points that were not the designated meridian points, perform them on a doll or perform no tapping at all. What researchers found was that all of the tapping groups had decreased fear and anxiety, indicating that “the reported effectiveness of EFT is attributable to characteristics it shares with more traditional therapies” rather than the tapping of these points, specifically.
“The small successes seen in these therapies are potentially attributable to well-known cognitive and behavioral techniques that are included with the energy manipulation,” according to another editorial. “Psychologists and researchers should be wary of using such techniques, and make efforts to inform the public about the ill effects of therapies that advertise miraculous claims.”
In response to those commentaries, Feinstein agreed that the mechanism of action behind EFT Tapping paralleled that of other psychiatric techniques like exposure therapy and pointed to the fact that in the study where participants were asked to tap on dolls, EFT tapping did indeed decrease fear and anxiety, even if some of the other interventions did as well.
"Whether the active ingredient turns out to be acupuncture points, energy fields, some artifact of stimulating the surface of the skin, or a yet undetermined agent, the mechanisms leading to such rapid outcomes are not explained by traditional clinical paradigms," he wrote.
The debate surrounding the efficacy of EFT tapping and energy psychology fits into a larger paradigm clash between psychiatry and traditional Eastern medicine. The thousands-year old practice of meditation, for example, was originally viewed skeptically by many in the medical profession, although a growing pile of evidence suggests it can help with depression, anxiety and pain. Just this week, a study published in the Journal of the American Medical Association found a Chinese medicine compound reduced the chances of a group of patients who had previously had a heart attack from having another cardiac event when taken in addition to other guideline-recommended therapies. Skeptics were quick to question that study, too.
In Feinstein's 2008 review, he called for more definitive research but said the studies he looked over provided preliminary evidence that EFT tapping worked. Since it's publication hundreds of studies have examined its effect on the body, with some showing physiological changes that occur with EFT tapping.
Stapleton, cited more than 300 trials that have been published on EFT tapping, including one 2012 study published in the Journal of Nervous and Mental Disease by Church that found cortisol levels among patients who used EFT tapping were significantly lower than a control group of participants who received supportive interviews. Stapleton conducted another study with a similar format in 2020 and produced similar results.
“Mostly people are using EFT to reduce stress (sensations, thoughts, emotions),” Stapleton told Salon in an email. “But because of the role of stress in many other concerns, it has been researched for many conditions.”
Many people who begin EFT tapping are skeptical that it will actually work — like I was. I felt foolish tapping my forehead and repeating the same phrases to myself again and again. In the end, no harm was done performing these repetitive motions. They grounded me in the present moment, much like meditation could calm the mind or a massage could calm the body. Did it matter to me whether the CBT elements of EFT tapping or the tapping itself produced a calming effect? Not really. But the same might not hold true for those with different mental health conditions, past trauma or for whom this practice might simply not work.
Larger-scale trials comparing EFT tapping to other therapies or among larger groups of patients could answer some of the questions that remain about the mechanism behind the positive results that have been reported anecdotally and in small studies, as well as for whom and in which scenarios EFT tapping is most effective.
"While it is possible that expectancy effects, other non-specific factors, and financial interests by promoters ... have induced a mass hysteria toward rapidly overcoming long-standing emotional problems in thousands of individuals, it is more reasonable to consider that the large body of anecdotal evidence claiming improvement using tapping/exposure protocols may have some bearing on the efficacy of the method," Feinstein wrote in his response to the commentaries.
