Case studies

Application of Emotional Freedom Techniques

Dawson Church, PhD; and Audrey J. Brooks, PhD

Abstract
This paper describes an intervention called Emotional order, phobias, and other psychological disorders, as well
Freedom Techniques (EFT). EFT is a brief exposure therapy as certain physical complaints. This article describes the
combining cognitive and somatic elements and focuses on techniques, how EFT is taught in a workshop setting, and
resolving emotional trauma that might underlie a present- provides case examples. The clinical benefits of EFT and
ing condition. Research indicates that EFT is an effective future research directions are discussed.
treatment for anxiety, depression, posttraumatic stress dis-

Dawson Church, PhD, is research chair, Foundation for Epigenetic Medicine,

Santa Rosa, California; and Audrey J. Brooks, PhD, is a research associate, Treatment Points for EFT Sequence
Department of Psychology, University of Arizona, Tucson.

T
Bladder
he most widely used form of energy psychologya is meridian
Emotional Freedom Techniques (EFT).2 EFT was devel-
oped by Gary Craig in the early 90s as an abbreviation of
the methods used in Thought Field Therapy, an earlier energy
Stomach Gall bladder
psychology method developed by American psychologist Roger meridian meridian
Callahan that used elaborate diagnostic and treatment protocols.3
Craig came to the conclusion that a brief standardized protocol
could treat most of the problems encountered in energy psychol-
ogy without the need for lengthy diagnoses, and he organized
these points into an easily administered method.4(p108)
EFT is practiced with considerable consistency because Kideny meridian
Craig’s The EFT Manual has been available as a free online down-
load since the mid 1990s and is also available in print. Fidelity is
Spleen Liver
enhanced by a research consensus summary of the method that meridian
meridian
has been used in reported studies of EFT (See the Figure).
Previous research indicates that EFT is an effective treat-
ment for anxiety, depression, phobias, and other psychological
disorders.5(p227)-10 Studies have demonstrated the efficacy of a
single 30-minute EFT treatment for specific phobias, with the
treatment effects sustained over a period of 6 months or more.9-
10 Studies of EFT used with victims of natural or human-caused Small intestine
disasters11 and veterans suffering from posttraumatic stress meridian
disorder12 have reported similar positive changes in psychologi- Figure 1. Emotional Freedom Techniques
cal distress. Improvements in anxiety, depression, hostility, and
phobias have been found following both weekend and half-day describes the technique as taught in a workshop setting and
EFT workshops, with the effects maintained for 3 to 6 months.8,13- provides case examples from EFT workshops.
14 Normalization of electroencephalogram patterns in both the

frontal lobes and the hindbrain was observed in a shorter time- Emotional Freedom Techniques
frame for users of EFT than that observed with cognitive behav- EFT has both cognitive and somatic components. For the
ioral therapy.4(p108) Case studies are also available showing the purposes of these reported case studies, the following protocol
effect of EFT on various psychological and physical symptoms.b was observed: Participants stated their negative cognitions,
Clinical reports suggest that by reducing emotional trauma,
EFT can have an effect on physical conditions, including joint a Energy psychology can be defined as a set of interventions, which, by (a) tapping on
pain, allergies, chronic fatigue syndrome, fibromyalgia, rashes, selected acupoints (meridians) or (b) doing imaginal exposure, will “quickly and perma-
arthritis, colds, influenza symptoms, and toothaches.4,15,16 No nently reduce maladaptive fear responses to traumatic memories and related cues.”1
adverse side effects have been reported.5,6 The present paper b Cases are searchable on www.Emofree.com.

46 Integrative Medicine • Vol. 9, No. 4 • Aug/Sep 2010 Church and Brooks—Application of EFT
identified a particular emotionally traumatic event associated detention, she reported a score of 0.
with them, and paired these with a statement of self-acceptance.
This is called the “setup statement,” as in, “Even though I have Individual Case 2: Broken Wrist
[problem statement], I deeply and completely accept myself.” A 52-year-old female physician presented with a broken
While thinking of the problem, the participant identified a part wrist that had occurred on a camping trip 2 weeks earlier. The
of the body where the feelings of distress were focused and rated pain was self-reported as 7 on a scale of 1 to 10. When asked to
the degree of emotional intensity on a Likert-type scale from 0 identify an emotionally triggering incident associated with the
(minimum) to 10 (maximum). This scale is referred to as the fracture, she stated that there was none. When asked to review
Subjective Units of Distress Scale (SUDS).16 If a physical pain the circumstances around the fracture for possible emotional
was felt, the participant also reported on the pain intensity with factors, she said, “I was camping with my daughter. I didn’t want
a Likert-type scale from 0 to 10. to go hiking that day, but she made me go with her. I was resent-
The somatic component of EFT involved tapping specific ful.” On the actual hike, however, she reported that she had been
parts of the body in 2 phases. In the first phase, participants “having a good time.” When asked to recall the incident with her
tapped the fleshy outside part of the opposite hand (called the daughter, she pointed to her solar plexus, and rated the emo-
karate-chop point; see Figure) while saying the setup statement tional intensity as a 7.
3 times. In the second phase, they tapped 11 additional points (5 She was then asked to recall the first time she had felt that
on the head, 2 on the trunk, and 4 on the hand) 5 to 7 times each same feeling in her solar plexus. She unhesitatingly replied that
while repeating a brief phrase, called the “reminder phrase,” that it was when she was in elementary school. She had scored sec-
evoked the traumatic memory. This is referred to as a “round” of ond in her class during the first test of the school year. She took
EFT “tapping.” After completing such a tapping round, the par- her examination results home and proudly presented them to
ticipant recalled the original memory and rated their distress via her father. His comment was, “Why weren’t you first?” The par-
a SUDS score and, if relevant, a pain score. Rounds of EFT tap- ticipant rated this incident as 10 out of 10 in emotional intensity.
ping were repeated until the SUDS and pain scores were 0 or She tapped on various aspects of the particular experience with
close to it. her father as well as on general statements such as “My father
When taught in a conference or group setting, participants was harsh” and “My father was doing the best he could.” The
were requested to “tap on” traumatic memories that underlie participant was then asked to assess the intensity of the feeling
their own issues while a demonstration subject or the workshop in her solar plexus; it was now 0. She was then asked to rate her
leader self-administered EFT. This technique is called “borrow- wrist pain. Initially she was unable to locate any pain but eventu-
ing benefits.” The concept of borrowing benefits is that, while ally rated it as a 2.
tapping along with another on their issues, a person may achieve
resolution of their own issues. The following case illustrations Group Setting Cases
are drawn from workshops, and the psychological distress out- Women with pain in the following areas were treated in a
comes will be described in a future companion paper. group setting:
Bone spur: The first had a bone spur, with a pain level of 8.
Emotional Freedom Techniques in Practice: Her emotional issue occurred during high school, when class-
Case Illustrations mates walked behind her and taunted her about the way she
Individual Case 1: Limited Range Of Motion walked and the shape of her body. Although she is now a dancer
A 67-year old woman had limited range of motion (ROM) and dance instructor, she still had a SUDS emotional charge of 9
in her right arm She could place her left arm behind her back around the incident. After 1 administration of EFT, her pain
easily but could not do so with her right arm. The ROM in the score dropped from 8 to 5 and her emotional intensity score
left arm joint, between the humerus and the radius and ulna, from 9 to 2. After a second round, both scores were 0.
was 66˚ as measured using a goniometer and recorded by a phy- Back pain: The second group participant had had back
sician attendee. The ROM in her problematic right arm was pain since she was a teenager, with a pain intensity of 4. Her
limited to 80˚ (in this case, a smaller number indicates increased emotional issue was feeling unsupported by her family. She had
range of motion) and had been so for most of her life. been able to play freely at neighbors’ houses while a small child,
This woman expressed great frustration with her ROM but around 12 years old her father had forbidden her to play
limitation. When asked where the frustration came to focus outside the family’s backyard. She felt so alienated from her fam-
somatically, she indicated her solar plexus, with a SUDS score of ily that she often wondered, as a child, if she was adopted. Her
8. When asked to recall a traumatic incident, she said that she SUDS emotional intensity score was 8. After a single session of
had been unjustly served with detention in elementary school, EFT, both her back pain and emotional intensity ratings were 1.
which angered her. Sacroiliac pain: The third participant had sacroiliac pain
She was treated with 1 round of EFT and the ROM in her after a recent fall. Her pain level was rated as 7. Her emotional
right arm improved to 75˚. After a second round of EFT, the issue was vulnerability, which was felt most strongly in her chest.
goniometer reading in her right arm was 68˚; the ROM differ- She described being held down by an uncle when she was a tod-
ence between the 2 arms had become indistinguishable. When dler. Her uncle was only 4 years older, so the relationship was
asked about how she felt in her solar plexus about the unjust more akin to that of a brother. Her uncle would cover her mouth

Church and Brooks—Application of EFT Integrative Medicine • Vol. 9, No. 4 • Aug/Sep 2010 47
 and nose so she could not breathe, and she came close to suffo- 13. Church D, Brooks AJ. The effect of a brief Emotional Freedom Techniques (EFT) self-
intervention on anxiety, depression, pain, and cravings in healthcare workers. Integr
cating. Her SUDS score was also 7. After EFT, both her pain and Med Clin J. In press.
SUDS emotional intensity scores were 2. 14. Church D, Brooks, AJ. The effect of EFT (Emotional Freedom Techniques) on psycho-
logical symptoms in addiction treatment. Presented at: Science and Consciousness:
Tenth Annual Energy Psychology Conference; October 24-26, 2008; Toronto, ON.
Discussion [[TK to Anne]]
15. Brattberg G. Self-administered EFT (Emotional Freedom Techniques) in individuals
EFT studies have shown it to be efficacious whether taught with fibromyalgia: a randomized trial. Integr Med Clin J. 2008;7(4)30-35.
one-to-one, in a small group, or in a large conference setting, 16. Wolpe J. The Practice of Behavior Therapy. 2nd ed. New York, NY: Pergamon Press;
1973.
making it a versatile technique applicable to many settings and
audiences. Once learned, EFT is typically self-administered.
The number of treatment hours required for efficacy is
lower than for many other interventions. Studies demonstrate
improvements in both psychological and physiological function-
ing, making it a cost-effective intervention. EFT can simultane-
ously address common physical and psychological symptoms,
such as pain, anxiety, depression, and cravings, due to its useful-
ness in reducing affect.
EFT research to date has often been conducted on small
samples, sometimes using what are called “within-subjects”
designs that obtain pre- and postintervention measurements
from each subject. Fortunately, an increasing amount of research
is now being done using randomized control-group designs
across multiple samples and problems, so we will see studies
being published that yield more generalizable results.

[sub 1] Conclusion

EFT is a brief and effective method for reducing the disor-

ders associated with intense emotional memories that may
underlie physical symptoms. The case examples shown here
provide typical scenarios of how EFT can relieve such symptoms
in individual and in group settings. As more research results
become available, EFT is showing itself to be a fast, efficacious,
cost-effective, and easily taught means of addressing disorders
such as anxiety, depression, and posttraumatic stress, as well as
physical symptoms such as cravings and pain.

References [[NOT FINAL]

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48 Integrative Medicine • Vol. 9, No. 4 • Aug/Sep 2010 Church and Brooks—Application of EFT