Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
Understanding the scientific evidence that supports the use of this empowering mental health modality.
Emotional Freedom Technique (EFT) is a mode of therapy that uses tapping combined with a “reminder phrase” to help desensitize patients with anxiety or past trauma.
The tapping helps release “feel-good hormones” that, when paired with thoughts of a traumatic event or difficult emotion, can shift the associations around this event and neutralize the pain they cause you.
Research overwhelmingly supports the use of EFT tapping for anxiety.
While some studies indicate a potential placebo effect, it doesn’t account for the majority of the benefit.
EFT was developed in the 1990s by a psychotherapist to empower patients to treat themselves.
EFT can easily be adapted to provide relief for generalized anxiety disorder.
This therapy is worth a try for those with anxiety, especially since there’s such a low barrier to entry & no real risks or downsides.
What if there were a simple technique to help you manage your anxiety and depression at home, without medication, without expensive talk therapy? What if all you needed were your own two hands to give it a try? Would you try it?
Emotional Freedom Technique (EFT tapping) is just that technique. Before diving into the technique itself, I’ll start by saying that I’m in total support of medication and talk therapy for those who need them and find them helpful. But not everyone does find them helpful. In fact, there’s plenty of research out there to support alternatives to SSRIs (antidepressants and anti-anxiety meds) that are as effective, or more effective. This includes diet and exercise changes, probiotics, and cognitive behavioral therapy. And now I’m adding EFT tapping to that list.
EFT tapping to support mental health is backed by a surprisingly robust amount of scientific literature, which I’ll get into in detail in this article. The mechanism behind this type of therapy lines up with traditional Chinese medicine (TCM)—tapping or putting pressure on acupressure points or meridian points—but it adds a positive self-talk element to encourage self-acceptance.
This tapping technique has been shown to be effective for anxiety, post-traumatic stress disorder (PTSD), depression, and even physical pain relief [1, 2, 3, 4]. What’s more, it’s completely void of the kinds of side effects associated with more conventional medical interventions.
Let’s take a closer look at EFT tapping for anxiety and other mental health challenges, how experts think it works, and the best way to get started with this incredibly promising therapy.
What is EFT Tapping?
Emotional Freedom Technique (EFT) tapping is a mode of Energy Psychology that combines cognitive restructuring, exposure, and acupoint stimulation through tapping or light pressure. Research supports its efficacy in stress relief (including PTSD), anxiety relief (including situational anxiety), depression relief, addressing phobias, and chronic pain relief [1, 2, 3, 4].
It’s been shown to be effective for people of all ages, even after only one session in some cases. The benefits seem to be greatest after four to 10 sessions, and while some placebo effect* was observed in some of the studies, it didn’t account for the majority of the benefit [3, 5].
In one study, a group of healthcare workers who were working with COVID-19 patients did a single online group EFT tapping session and reported a reduction in stress, anxiety, and feelings of burnout . Pretty remarkable!
A Note on the Placebo Effect: It’s true that our expectations play a role in our outcomes, which is why the highest standard of the scientific method is a double-blind, randomized controlled trial—it completely removes expectations from the participants and the researchers, thus eliminating the possibility of a placebo effect.
We tend to associate the placebo effect with a “false positive” when it comes to evidence-based, scientific studies. In many cases (and when it’s possible), controlling for that makes good science, but in the case of EFT—a non-invasive, low-risk, zero-side-effect treatment—if a person benefits mentally and emotionally from the intervention, the mechanism is almost beside the point. It’s a win-win if the person experiences relief.
Psychotherapist, Dr. Roger Callahan, developed the precursor to EFT—Thought Field Therapy (TFT)—in the 1980s, but it was a complex treatment that required a professional to administer. In the 1900s, his student, Dr. Gary Craig, modified what he learned about TFT to create EFT, a simplified approach that patients could self-administer. By empowering patients to help themselves, EFT became the more widespread technique that’s most commonly used today, either on its own or as an adjunct to more traditional psychotherapy.
Acupoint tapping is the act of stimulating acupuncture or acupressure points with percussion (or light pressure if tapping is triggering) from your fingertips. Tapping on acupoints has been used in TCM therapies like qigong and shiatsu for at least 5,000 years .
This self-help technique can be guided or done on your own. You tap or stimulate acupoints along meridian lines of the body with your fingertips while focusing on a traumatic or highly stressful event. In the case of anxiety, you would focus on your emotions and how you feel in your body rather than a specific event (https://link.springer.com/article/10.1007/s10879-015-9310-7). You’ll then recite a reframing language to shift your reaction to that event. The reframing language, or “reminder phrase,” consists of a set-up statement (the reference to the traumatic or distressing event) and an affirmation of self-acceptance.
For example, you may have made a mistake at work that you can’t release from your mind, and now you’re anxious about tomorrow’s workday. In this case, you might say, “Even though I made a mistake and felt terribly embarrassed in front of my coworkers, I deeply and completely love and accept myself” .
Repeat the “reminder phrase” as you make your way through the tapping sequence. While tapping these places on your body, your “reminder phrase” helps your brain reframe the outcome of the traumatic event you’re addressing during your EFT session.
The tapping points include spots on your head, face, torso, and hands :
Eyebrow Points: The innermost edge of the eyebrows in the center of your face, at the bridge of the nose
Sides of the Eyes Points: Along the outside of both eyes, where you can feel bone of your eye socket
Under the Eyes Points: Tops of your cheekbonesunder both eyes
Under the Nose Point: The area between the bottom of your nose and upper lip
Chin Point: The crease of your chin beneath your bottom lip
Collarbone Point: Beneath where your collar bones meet, about two inches down and two inches out toward your shoulders
Underarm Points: On each side of the body, about four inches beneath the armpits on your rib cage
Top of the Head Point: The crown of your head at the very top
Karate Chop Point: The outer edge of the hands, where it would hit a block if you were to chop it with your hand, as if in karate.
With enough repetition as you tap the points, you should be able to recall the trauma with little or no distress . This is especially important for anxiety and the obsessive thoughts that sometimes result from it. From the outside, the subject of anxiety might not objectively seem like a big deal, but when it consumes your mind, it can be crippling. Taking charge of these obsessive thoughts through safe exposure to them in this way can provide the emotional freedom this technique is named for.
How EFT Tapping Works
Trauma can be overwhelming for the mind. As a result, the limbic system (amygdala) may retain memories of trauma instead of integrating them into long-term memory . When you encounter something—a trigger—that resembles the traumatic experience, your autonomic (fight or flight) nervous system kicks into gear, reinforcing the negative impacts of the traumatic experience .
EFT tapping, in combination with an empowering “reminder phrase” pertaining to a specific trauma, works as a desensitization tool to aid in the release of negative emotions. Desensitization is a psychotherapeutic technique that involves imagining difficult memories while imposing relaxation to alter the body’s response to them .
Eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT) are two other therapeutic ways to use desensitization that are supported by a large body of clinical research. EFT, EMDR, and CBT all showed similarly impactful results for the treatment of PTSD in a 2017 meta-analysis, despite the mechanistic differences in interventions .
In the case of EFT, acupoint stimulation releases serotonin in the amygdala and prefrontal cortex, in addition to stimulating the release of opioids, serotonin, and GABA (a calming neurotransmitter) into the bloodstream. It can also help regulate cortisol levels, which tend to rise with psychological stress .
The release of these hormones helps to turn off the stress response (fight-or-flight) and turn on the parasympathetic nervous system (PNS), which governs resting and digestion. An active PNS also reduces pain, slows the heart rate and blood pressure, and reduces anxiety. Researchers have also noted that the release of these hormones is concurrent with improvements in brain wave activity that occur after a tapping session . You can also begin to activate the PNS with deep breaths.
The desensitization and reframing pieces become effective when tapping is paired with thoughts of the stressful event. The physical release of “feel-good hormones” happening concurrently with thoughts of a traumatic event triggers your brain to shift the associations around this event and neutralize the pain they cause you.
EFT Tapping for Anxiety
There are many different forms of anxiety—generalized, situation-specific, performance anxiety (like giving a speech), and more. In the case of a specific situation or impending performance, the way to use EFT to address the specific stressor that’s causing the problem is exactly as I’ve outlined above. You create the set-up statement in the context of a specific challenge or fear.
But in many cases of generalized anxiety disorder (GAD), there likely isn’t a specific thing to point to or focus on during an EFT session—you’re just anxious all the time about everything and nothing, and you can’t reason your way out of it, even if you rationally know that your worries are baseless or overblown.
The good news is that EFT has still been shown to be effective in the case of generalized anxiety [1, 4, 5, 6]. For people with GAD, EFT works by (https://link.springer.com/article/10.1007/s10879-015-9310-7):
Helping you overcome avoidance through experiential tasks that highlight the costs of worrying and obstructing your own needs; this helps you fight the avoidance (worry).
Helping you transform your chronic, painful, dreaded feelings (sadness/loneliness, shame, and fear/terror) through experiential tasks that help you respond to the chronic pain and unmet needs with compassion and protective anger; this is a way of restructuring your problematic emotional schemes.
Building a soothing relationship between you and the EFT therapist.
In other words, by changing the focus from a traumatic event to the state of anxiety itself, and providing yourself with reassurance and embodied acceptance while tapping, EFT can hugely benefit those with anxiety.
By focusing on the emotion—where it is in your body, what it feels like viscerally (be super specific), and rating it from one to 10—you can create your reframing statement around the anxiety itself rather than focusing on an event in the past. Here’s an example:
Even though I feel a thick, heavy, consuming tightness in my throat, and my anxiety is at a 7, I deeply and completely love and accept myself.
You would then use the tapping solution above to release the stress hormones and replace them with all the feel-good hormones I mentioned above.
EFT Tapping is Worth a Try
When it comes to mental health relief, there are seemingly endless modalities to try. Some are backed by Western science, and some are considered more “folk medicine” or “woo woo.” I’ll be the first to admit that I was skeptical of EFT when I first learned about it. But the research on its efficacy for anxiety, PTSD, depression, and other mental health challenges is vast, even when taking into account the potential placebo effect.
I love finding and recommending effective, holistic treatments that bear little-to-no risk or side effects, and EFT certainly fits that bill. If you’re interested in trying EFT, you have the option of starting on your own, joining a group guided by a clinical EFT practitioner, or even finding a group online. You can also book a session with an expert, and once you get a feel for it, you can do it on your own whenever you need to. There are also youtube accounts and/or apps that will help you get started for very little cost or for free.
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Dincer B, Inangil D. The effect of Emotional Freedom Techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial. Explore (NY). 2021;17(2):109–14. DOI: 10.1016/j.explore.2020.11.012. PMID: 33293201. PMCID: PMC7834511.
Sebastian B, Nelms J. The Effectiveness of Emotional Freedom Techniques in the Treatment of Posttraumatic Stress Disorder: A Meta-Analysis. Explore (NY). 2017;13(1):16–25. DOI: 10.1016/j.explore.2016.10.001. PMID: 27889444.
Church D, Stapleton P, Yang A, Gallo F. Is Tapping on Acupuncture Points an Active Ingredient in Emotional Freedom Techniques? A Systematic Review and Meta-analysis of Comparative Studies. J Nerv Ment Dis. 2018 Oct;206(10):783–93. DOI: 10.1097/NMD.0000000000000878. PMID: 30273275.
Gaesser AH, Karan OC. A Randomized Controlled Comparison of Emotional Freedom Technique and Cognitive-Behavioral Therapy to Reduce Adolescent Anxiety: A Pilot Study. J Altern Complement Med. 2017 Feb;23(2):102–8. DOI: 10.1089/acm.2015.0316. PMID: 27642676.
Gilomen SA, Lee CW. The efficacy of acupoint stimulation in the treatment of psychological distress: A meta-analysis. J Behav Ther Exp Psychiatry. 2015 Sep;48:140–8. DOI: 10.1016/j.jbtep.2015.03.012. PMID: 25863484.
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