What Is EFT Tapping? How and Why It Works (Backed by Science) - Dr. Michael Ruscio, DC

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What Is EFT Tapping? How and Why It Works (Backed by Science)

Key Takeaways:

  • Emotional Freedom Technique (EFT) is a mind-body practice that combines acupoint stimulation (tapping on various points on the head and torso) and cognitive restructuring (talking through triggering emotions to reduce the impact of traumatic memories).
  • Clinical trials show that EFT can effectively help reduce the symptoms of debilitating mental health conditions like anxiety, depression, and PTSD, along with everyday emotions, like irritability and frustration.
  • While the placebo effect plays its typical role in the research behind EFT, the technique still stands on its own as a powerful therapeutic tool, and the clinical results back it up. 
  • Research suggests that EFT is potentially more beneficial for mental health conditions than some well-known therapies, like cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), and even certain prescription medications.
  • EFT is an extremely simple, low-risk, low-time investment, and zero-cost practice, so it’s worth a try no matter what issue you’re dealing with. 
  • EFT has the potential to be used either in conjunction with, after, or in place of other forms of therapy, such as CBT or EMDR, empowering those with mental health conditions to take their healing into their own hands. (Literally!)

EFT tapping, also known as Emotional Freedom Technique, is a mind-body practice involving tapping on different acupressure points on the head and torso while saying various statements out loud to desensitize a traumatic memory, calm a triggering emotion, or even relieve physical pain. 

Now if you’re anything like me, you might be thinking that this sounds a bit “woo woo” or unscientific. But actually, there are some pretty incredible scientific studies around EFT tapping showing that it’s not just a placebo effect — people are experiencing significant improvements in their mental health by using this technique. I was surprised and delighted by these findings since this is a no-cost, low-time investment therapy that nearly anyone can do on their own from home.

In this article, I’ll cover what EFT is and how it can help with desensitizing traumatic memories and brain rewiring. I’ll discuss how to practice EFT, the researched conditions that EFT can help with, and how EFT really works — no “placebo effect” needed. 

What is Emotional Freedom Technique (EFT)?

Emotional Freedom Technique or EFT, is an energy psychology practice that combines cognitive restructuring, exposure therapy, and acupoint stimulation (tapping various points on the body). 

Acupoint tapping is the act of stimulating acupuncture or acupressure points with percussion (or light pressure if tapping is painful or triggering) from your fingertips. Tapping on acupoints has been used in therapies like qigong and shiatsu and has been integrated with Traditional Chinese Medicine for at least 5,000 years [1].

Acupoint stimulation alone can [2]: 

  • Release serotonin (a feel-good chemical) in the amygdala and prefrontal cortex
  • Release opioids, serotonin, and GABA (a calming neurotransmitter) into the bloodstream
  • Help regulate cortisol levels (stress hormone), which tend to rise with psychological as well as physical stress.

Combined with cognitive restructuring and exposure therapy — stating your triggered emotions or traumatic memories out loud — acupoint stimulation turns out to be a powerful brain rewiring technique that can make significant positive shifts in your mood and mental well-being. 

How to Practice the EFT Tapping Sequence

There are eight main EFT tapping points (also called meridian points) to work through in order:

What Is EFT Tapping
  • The center of the forehead, between the eyebrows
  • The outer sides of the eyes
  • Underneath the eyes on the lower, bony ridge of the eye socket
  • Under the nose on the center of the upper lip
  • The center of the chin
  • Beneath the collarbone, toward the sternum
  • About 3-4 inches underneath the armpit (need to raise the arm)
  • On top of the head, the crown
  • Optional: side of the hand, under the pinky finger

The process goes roughly like this:

  • Step 1: You use your fingertips to stimulate these acupoints on your face and torso while focusing your mind on the traumatic event you want to desensitize [1]. 
  • Step 2: You then reframe the outcome of the trauma by saying, “Even though” (insert specific trauma) happened, “I deeply and completely accept myself” [1]. An example statement is, “Even though I was badly hurt when I got in a car accident, I deeply and completely accept myself.” 
  • Step 3: You continue tapping the points while repeating a “reminder phrase” about the trauma that safely exposes you to it [1]. With enough repetition, you should be able to recall the trauma with little or no distress [2]. 
  • Step 4: Depending on the trauma or emotion, you may need to repeat the sequence several times across multiple tapping sessions to see noticeable changes, but tapping is meant to be a consistent practice.

How Long Does EFT Take to Work? 

For best results, evidence suggests aiming for 4–10 sessions of EFT to work through a specific trigger [2], after which you can use it as often as you need. However, as little as one session can make a shift in your well-being. This gives it an edge over more traditional therapies, like cognitive behavioral therapy (CBT), which can take several months of regular sessions before seeing benefit. 

For example, just one online group EFT session reduced stress, anxiety, and burnout levels in nurses working with COVID-19 patients [3].

Four to ten sessions of EFT can successfully treat post-traumatic stress disorder (PTSD) [2], and just a few sessions of EFT can significantly reduce anxiety in high-performing teens [4].

Once you know the method, the idea is that you can use EFT as needed to calm your nervous system and move through difficult emotions in the moment, but you can also use it as a long-term therapeutic tool for working through older traumas such as adverse childhood experiences (ACEs). 

EFT for Desensitizing Trauma and Rewiring the Brain

One of the situations where EFT is most useful is correcting trauma responses. When you encounter something — a trigger — that resembles a traumatic experience, your autonomic (fight or flight) nervous system kicks into gear, reinforcing the negative impacts of the traumatic experience. 

One way to overcome traumatic conditioning is to use a technique called desensitization, which originally combined imagining difficult memories while imposing relaxation to alter the body’s response to them. However, using the acupoint stimulation of EFT in place of other relaxation techniques has demonstrably corrected the cycle of sympathetic overarousal faster [2].  

Combining the acupoint tapping with cognitive restructuring or cognitive behavioral therapy (talk therapy) — where you’re stating the traumatic memory or triggering feeling out loud, and then saying a statement like “Even though I feel ____, I deeply and completely love and accept myself” — helps rewire the brain to release the intensity of that negative emotion or traumatic experience. 

This, in turn, helps regulate your nervous system to be in a more parasympathetic, calm state instead of a sympathetic, hyperaroused state where you’re always on alert. This is why EFT seems to be so effective for healing PTSD [2]. But you don’t have to have PTSD to benefit from EFT therapy — it’s absolutely helpful to use when working through “smaller” forms of trauma, difficult emotions, or even physical injuries. 

What Mental Health Conditions Does EFT Help?

To my surprise and delight, there’s a lot of solid evidence showing that EFT is better than control or sham interventions and as good as proven interventions like EMDR (eye movement desensitization and reprocessing) and CBT at relieving:

  • Psychological distress [5]
  • Anxiety [3, 6]
  • PTSD [2]
  • Anxiety before giving a speech [7]
  • Stress [3]
  • Burnout [3

Since nearly all of us have dealt with one or more of these concerns from time to time, EFT really shines as a relevant and promising therapy. Let’s look a little closer at some of these studies on the benefits of EFT.

EFT for Anxiety

A systematic review and meta-analysis assessed 14 randomized controlled trials (658 participants) to determine whether EFT is an effective treatment for anxiety.

Combined controls (no treatment, waitlist, interviews, relaxation techniques, EMDR, CBT, or treatment as usual) had a small to moderate positive effect on anxiety, but EFT had a very large positive effect on anxiety. In summary, compared to many types of controls, EFT had a much larger positive effect on reducing anxiety scores [6].

A 2022 randomized controlled trial (RCT) compared the effects of EFT and breathing therapy on public speaking anxiety in nursing students. The study randomized 76 Turkish nursing students to practice EFT, breathing therapy, or nothing before presenting on chronic disease prevention in class. 

Before the interventions, the students had similar levels of anxiety. After the interventions, those who practiced EFT and breathing therapy had significantly less anxiety, but EFT was more effective than breathing therapy in reducing speech anxiety. So, both EFT and breathing therapy significantly reduced speech anxiety, but EFT was more effective (7).

It’s also worth noting that I found no evidence showing that EFT does not benefit anxiety or any research suggesting that it could make anxiety worse. This suggests that trying EFT for anxiety can only help or do nothing at all, making it a low-risk therapy and worth trying for anxiety relief. 

And if you’re currently benefiting from another therapy, you don’t need to give it up to also benefit from EFT. Just let your provider know that you’re adding tapping into your regimen.

EFT for Depression

A meta-analysis assessed 20 clinical trials (859 participants) to find out if EFT can reduce depression.

Compared to no treatment, diaphragmatic breathing, supportive interviewing, and sleep hygiene education, EFT had a moderate to large positive effect on depression. Compared to EMDR therapy, EFT was similar at improving depression. Notably, researchers found that improvements from EFT were larger than those from antidepressants and psychotherapy. Altogether, EFT was highly effective at reducing depression in groups and individuals, and it helped people maintain its benefits over time [8].

A 2021 RCT examined the effect of EFT on depression in postmenopausal women. The study randomized 88 postmenopausal women in Iran to practice EFT or a sham therapy (each after 2 sessions of training) once a day for eight weeks. 

The EFT group’s average depression score dropped by nearly half (from 21 to 11), whereas the control group’s score dropped only about 2 points (from 19 to 17).

The number of those with moderate depression dropped from 57% to 9% after practicing EFT, whereas the control group’s frequency dropped from 50% to 30%. At the end of the study, 63% of the EFT group was completely free of depression, compared to only 34% of the control group.

Overall, Using EFT once a day for 8 weeks significantly reduced depression in postmenopausal women [9].

These are remarkable results, and again knowing the low-risk, cost, and time investments in practicing EFT, I do think it’s worth trying as a part of a treatment plan for depression. However, don’t suddenly stop your medications if you decide to try out EFT for depression — you’ll want to work with a healthcare provider to determine the best course of action.  

EFT for PTSD

A meta-analysis looked at seven RCTs (247 participants) to find out whether EFT is an effective treatment for PTSD.

Compared to controls, EFT had a large positive effect on PTSD. Compared to other evidence-based therapies like eye movement desensitization and reprocessing (EMDR) and cognitive behavioral therapy (CBT), EFT was at least similarly effective at treating PTSD.

Overall, researchers found that just 4–10 sessions of EFT can effectively treat PTSD, and EFT can be used as a self-help tool after therapy is over [2]. Many with PTSD see substantial benefit with regular therapy, but find that getting relief between sessions or after “graduating” from therapy can be difficult. This is why “DIY” approaches, like EFT, play such an influential part in maintaining long-lasting mental health.

Other EFT Applications

EFT also seems to be effective for improving: 

  • Sleep quality [10, 11].
  • Chronic pain [12]
  • Food cravings [13]
  • PMS [14]
  • Happiness [10]

Anecdotally, I’ve also heard of EFT being used for integrating positive affirmations and promoting self-acceptance, helping with weight loss, and even healing eating disorders and addiction. The research is still catching up with these experiences of course, but I suspect we’ll see more clinical evidence on EFT as the discussion around mental health, trauma, and nervous system resilience continues to gain popularity. 

Are Any of the Benefits of EFT due to the Placebo Effect?

I want to return to the study on EFT for depression in postmenopausal women to discuss the role the placebo effect plays in the results of EFT tapping [9]. By the end of this study, 63% of the EFT group was free of depression, compared to 34% of the control group. My point here is that even some people in the control group experienced significant improvement in their depression — over a third of the group, in fact — just from believing what they were doing was EFT therapy. 

This is the power of the placebo effect and why it’s so important to have randomized controlled trials to assess a given therapy or other variables. Knowing that 34% of the control group was improved with the placebo effect alone, the 63% who improved in the EFT group becomes that much more impactful and really shows the relative effectiveness of EFT therapy. 

While the placebo effect certainly played a role in these findings (as it does in most clinical trials), this study truly highlights how well EFT holds up in the research.

Try EFT for Real Improvements in Mental Health and Nervous System Resilience 

Emotional Freedom Technique is a powerful, science-backed therapy for mental health and potentially many other applications, including pain and other physical illness. I’m excited to see more research come out on tapping and see how it might be used in different populations. 

If you’re curious to try out EFT for yourself, I would suggest searching for free tapping videos on YouTube and following along with the process. You might be surprised by the shifts you can see with EFT tapping!

Learn more about the gut and the role it plays in brain and mental health in my book, Healthy Gut, Healthy You.

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➕ References
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. Clond M. Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis. J Nerv Ment Dis. 2016 May;204(5):388–95. DOI: 10.1097/NMD.0000000000000483. PMID: 26894319.
  7. Dincer B, Özçelik SK, Özer Z, Bahçecik N. Breathing therapy and emotional freedom techniques on public speaking anxiety in Turkish nursing students: A randomized controlled study. Explore (NY). 2022;18(2):226–33. DOI: 10.1016/j.explore.2020.11.006. PMID: 33309466.
  8. Nelms JA, Castel L. A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials of Clinical Emotional Freedom Techniques (EFT) for the Treatment of Depression. Explore (NY). 2016 Aug 18;12(6):416–26. DOI: 10.1016/j.explore.2016.08.001. PMID: 27843054.
  9. Mehdipour A, Abedi P, Ansari S, Dastoorpoor M. The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial. J Complement Integr Med. 2022 Sep 1;19(3):737–42. DOI: 10.1515/jcim-2020-0245. PMID: 34013673.
  10. Kalroozi F, Moradi M, Ghaedi-Heidari F, Marzban A, Raeisi-Ardali SR. Comparing the effect of emotional freedom technique on sleep quality and happiness of women undergoing breast cancer surgery in military and nonmilitary families: A quasi-experimental multicenter study. Perspect Psychiatr Care. 2022 Oct 3;58(4):2986–97. DOI: 10.1111/ppc.13150. PMID: 36192125.
  11. Souilm N, Elsakhy NM, Alotaibi YA, Ali SAO. Effectiveness of emotional freedom techniques (EFT) vs sleep hygiene education group therapy (SHE) in management of sleep disorders among elderly. Sci Rep. 2022 Apr 20;12(1):6521. DOI: 10.1038/s41598-022-10456-w. PMID: 35444166. PMCID: PMC9020420.
  12. Rometsch-Ogioun El Sount C, Windthorst P, Denkinger J, Ziser K, Nikendei C, Kindermann D, et al. Chronic pain in refugees with posttraumatic stress disorder (PTSD): A systematic review on patients’ characteristics and specific interventions. J Psychosom Res. 2019 Mar;118:83–97. DOI: 10.1016/j.jpsychores.2018.07.014. PMID: 30078503.
  13. Stapleton P, Bannatyne AJ, Urzi K-C, Porter B, Sheldon T. Food for thought: A randomised controlled trial of emotional freedom techniques and cognitive behavioural therapy in the treatment of food cravings. Appl Psychol Health Well Being. 2016 Jul;8(2):232–57. DOI: 10.1111/aphw.12070. PMID: 27140673.
  14. Bakır N, Irmak Vural P, Körpe G. The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized control trial. Perspect Psychiatr Care. 2022 Oct;58(4):1502–11. DOI: 10.1111/ppc.12957. PMID: 34610147.

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