Research in Energy Psychology

© 2004 Fred P. Gallo, Ph.D.

Although over a dozen studies have been completed in the area of energy psychology, only a few have been published in peer reviewed journals.  Several preliminary studies have supported the effectiveness of thought field therapy in the treatment of phobias and anxiety (Callahan, 1987; Leonoff, 1995), phobias and self-concept (Wade, 1990), posttraumatic stress disorder (Carbonell and Figley, 1995, 1996, 1999; Figley, C. R., Carbonell, J. L., Boscarino, J. A., and Chang, J. A., 1999; Diepold and Goldstein, 2000; Johnson, Shala, Sejdijaj, Odell, and Dabichevci, 2001), acrophobia (Carbonell, 1997), blood-injection-injury phobia (Darby, 2001), public speaking anxiety (Schoninger, 2001), and a variety of other clinical problems (Sakai, Paperny, Mathews, et al., 2000; Pignotti and Steinberg, 2001).

While the Callahan (1987) and Leonoff (1995) studies revealed significant decreases in subjective units of distress (SUD) ratings, given the nature of the methodologies, which involved treating call-in subjects on radio talk shows, they could not include control groups, placebo treatments, follow-up evaluations, or other evaluative measures. Although the most demanding researcher would dismiss these studies since they merely demonstrate that the procedure was able to decrease the subjects’ discomfort at the time, it is interesting that the same level of criticism is not invariably raised when a psychopharmacological study demonstrates that a benzodiazepine or a beta blocker is able to relieve anxiety or deter a phobic response. Follow-up studies would seldom support the effectiveness of the psychotropic in relieving the phobia or anxiety disorder over time, after the agent has been discontinued.  Nonetheless, the ability of a treatment to afford even temporary relief is considered acceptable by the medical community and as far as the general public is concerned [1].

The Callahan (1987) and Leonoff (1995) studies entailed the same number of subjects, 68, with various phobic and other anxiety complaints. All told, 132 of the 136 subjects were successfully treated thought field therapy. This translated into a 97% success rate, which is really unheard of in the field of psychotherapy. What is perhaps even more significant in some respects is the fact that the total treatment times were exceptionally low, which is also uncommon in the field. Callahan’s average treatment time was 4.34 minutes and Leonoff’s was 6.04 minutes. Within those time frames, the mean decrease in the subjective units of distress was 6.25 for Callahan’s subjects and 6.61 for those treated by Leonoff. Across both studies, an overall mean decrease in the subjective units of distress was 6.43. Table 3 shows a summary of those statistics.

Telephone Therapy of Phobias and Anxiety on Call-In Radio Programs

*Treatment time included discussions with subjects in addition to providing treatments.

The Carbonell and Figley (1995, 1996, 1999) study was a systematic clinical demonstration project, evaluating the effectiveness of thought field therapy (TFT) and a number of other approaches, including visual/kinesthetic dissociation (V/KD), eye movement desensitization and reprocessing (EMDR), and traumatic incident reduction (TIR) in the treatment of posttraumatic stress disorder symptoms (see Chapter 2 for details). This study was sophisticated and detailed in evaluative measures and also included follow-along and follow-up assessments.  Follow-up evaluations within the 4- to 6-month range revealed that all of the approaches yielded sustained reduction in subjective units of distress, although minimal rebound in subjective units of distress was evident in many cases. Although follow-up evaluation time frames and the number of subjects varied considerably across treatment conditions, notably imposing variables, respective mean group treatment times and post treatment follow-up subjective units of distress ratings were as follows:

Table 1: Florida State University Active Ingredients Project Data[2]

The Wade (1990) and Carbonell (1997) studies included control groups, randomization, paper-pencil measures, and SUD ratings. The Carbonell study also included double-blind procedures, placebo controls, and behavioral measures.

The Wade (1990) study was a doctoral dissertation. It included 28 experimental subjects and 25 controls. Two self-concept questionnaires were employed in the study, the Tennessee self-concept scale (TSCS) and the self-concept evaluation of location form (SELF). Approximately 1 month after these instruments were administered, the experimental subjects were treated in a group with the following thought field therapy treatment points: Stomach-1 (ue or under the eye), Spleen-21 (ua or under the arm), Bladder-2 (eb or beginning of the eyebrow), and treatment for psychological reversal which includes Small Intestine-3 in conjunction with the associated affirmation. Sixteen of the subjects evidenced a drop in subjective units of distress ratings of four or more points, while only four of the no treatment controls showed a decrease in the subjective units of distress of two or more points. Two months after treatment and three months after the original questionnaires were administered, the questionnaires were repeated. Analysis of variance revealed modest but significant improvements in three of the scales: the self-acceptance scale of the Tennessee self-concept scale and the self-esteem and self-incongruency scales of the self-concept evaluation of location form. Results support the effectiveness of a thought field therapy phobia treatment and the hypothesis that the treatment can affect one’s self-concept.

The Carbonell (1997) study investigated the effectiveness of thought field therapy in the treatment of acrophobia or fear of height. The 49 subjects of the study were college students, initially screened from a total subject pool of 156 students with the Cohen acrophobia questionnaire (Cohen, 1973). All subjects completed a behavioral measure which involved approaching and possibly climbing a 4-ft ladder. A 4-ft path leading to the ladder was also calibrated in 1-ft segments. As the subject approached and climbed the ladder, subjective units of distress ratings using a 0–10 scale were taken at each floor segment and rung. Subjects were permitted to discontinue the task at any time. After these preliminary measures were obtained, the subject met with another experimenter in a separate room and a subjective units of distress rating was obtained while the subject thought about an anxiety-provoking situation related to height. Subjects were then randomly assigned to one of two groups: thought field therapy phobia treatment or placebo “treatment.” While all of the subjects did the psychological reversal treatment at the onset, as far as the tapping sequence is concerned, the placebo group tapped on body parts not employed in thought field therapy. After these procedures were conducted, subjective units of distress measures were obtained again. If the subject did not obtain a rating of 0, the respective procedure (experimental or placebo control) was administered once again. Post testing was invariably conducted after the second administration of the procedure. Afterward, the subject returned to the initial experimenter, who was “blind” to the treatment received by the subject, for post testing. Post testing was the same as pre testing, which involved in vivo assessment of subjective units of distress ratings as the subject approached and possibly climbed the ladder. Prior to data analysis, comparison of the groups on pretreatment measures revealed that the groups were essentially equivalent. “Although both groups got somewhat better there was a statistically significant difference between those subjects who had received real thought field therapy and those who received placebo, with the thought field therapy subjects showing significantly more improvement. There was a significant difference when all the subjective units of distress scores were averaged for each subject and the difference was more pronounced when examining the subjective units of distress scores of the subjects while climbing the ladder” (Carbonell, 1997, p. 1).   Unfortunately, this study has not yet appeared in a professional journal.

Darby (2001) reported on his doctoral dissertation that involved the utilization of thought field therapy in the treatment of 20 patients with blood-injection-injury phobia.  Measures included subjective units of distress and a fear inventory.  Treatment time was limited to one hour with the diagnostic approach to thought field therapy.  Although the study contains many methodological flaws (i.e., the experimenter collected the data and administered the treatments), one month follow-up measures yielded statistically significant treatment effects.

Diepold and Goldstein (2000) conducted a case study of thought field therapy with evaluation by quantitative electroencephalogram (QEEG).  Statistically abnormal brain-wave patterns were recorded when the patient thought about a trauma compared to a neutral (baseline) event. Reassessment of the brain-wave patterns associated with the traumatic memory immediately after thought field therapy diagnosis and treatment revealed no statistical abnormalities. An 18-month follow-up indicated that the patient continued to be free of emotional upset regarding the treated trauma. This case study supports the hypothesis that negative emotion has a measurable effect and also objectively identified an immediate and lasting neuro-energetic change in the direction of normalcy and health after thought field therapy.

Johnson, Shala, Sejdijaj, Odell, and Dabichevci (2001) reported on uncontrolled treatment of trauma victims in Kosovo with thought field therapy during five separate 2-week trips in the year 2000.  Treatments were given to 105 Albanian patients with 249 separate violent traumatic incidents.  The traumas included rape, torture, and witnessing the massacre of loved ones.  Total relief of the traumas was reported by 103 of the patients and for 247 of the 249 separate traumas treated.  Follow-up data averaging five months revealed no relapses.  While this data is based on uncontrolled treatments, the absence of relapse ought to pique our attention, since a ninety-eight percent spontaneous remission from of posttraumatic stress is unlikely.

Sakai, Paperny, Mathews, et al. (2001) reported on an uncontrolled study of 1,594  applications of thought field therapy in the treatment of 714 patients with a variety of clinical problems including anxiety, adjustment disorder with anxiety and depression, anxiety due to medical condition, anger, acute stress, bereavement, chronic pain, cravings, panic, posttraumatic stress disorder, trichotillomania, etc.  Paired t-tests of pre- and post treatment subjective units of distress were statistically significant at the .01 level in 31 categories.

Pignotti and Steinberg (2001) reported on thirty-nine uncontrolled cases that were treated for a variety of clinical problems with thought field therapy, observing that in most cases improvement in subjective units of distress coincided with improvement in heart rate variability (HRV), which tends to be stable and placebo-free.  The authors suggest that heart rate variability can be employed to objectively evaluate the effectiveness of psychotherapy treatment.

Several additional energy psychology approaches have be subjected to experimental tests.  A recent trial compared diaphragmatic breathing with a meridian-based technique (emotional freedom techniques (EFT)) that involves tapping on several to all of the 14 meridian acupoints used in thought field therapy for the treatment of specific phobias of small animals (Wells, Polglase, Andrews, Carrington & Baker, 2003).  Subjects were randomly assigned and treated individually for 30 minutes with meridian tapping (n = 18) or diaphragmatic breathing (n = 17). Statistical analyses revealed that both treatments produced significant improvements in phobic reactions, although tapping on meridian points produced significantly greater improvement behaviorally and on three self-report measures. The greater improvement for the energy technique was maintained at 6 to 9 months follow-up on the behavioral measure (i.e., avoidance behavior). These results were achieved in a single 30-minute treatment without inducing the anxiety typical of traditional exposure therapies and without in vivo exposure to the animals during the treatment phases. Since similar levels of imaginary exposure, experimental demand and cognitive processing were present in the two treatment conditions, this suggests that additional factors contributed to the results achieved by the energy psychology treatment. It is postulated that intervening in the body's energy system through the meridian acupoints may have been the differentiating factor.  While there is a need to corroborate these findings through comparing energy tapping to traditional behavior therapies and to investigate other clinical conditions in which this method may be of value, these results are certainly encouraging about the effectiveness of meridian-based therapies with specific phobias[3].

Another study of emotional freedom techniques, focused on subjects who had been involved in motor vehicle accidents and who experienced posttraumatic stress associated with the accident (Swingle, P. G., and Pulos, L., 2000). All subjects received two treatment sessions and all reported improvement immediately following treatment. Brainwave assessments before and after treatment indicated that subjects who sustained the benefit of the treatments had increased 13-15 Hz amplitude over the sensory motor cortex, decreased right frontal cortex arousal, and an increased 3-7 Hz / 16-25 Hz ratio in the occipital region.

Waite and Holder (2003) conducted a study of emotional freedom techniques for phobias and other fears with 119 university students (non-clinical population). An independent four-group design was used and subjects were treated in group settings.  The treatment conditions included emotional freedom techniques, placebo (tapping sham points on the arms), modeling (tapping the acupoints on a doll), and no treatment controls.  Although the difference between the emotional freedom techniques and control groups did not reach significance, a statistically significant decrease in subjective units of distress at post-treatment occurred with all three groups.  Discomfort ratings decreased from baseline to post-treatment for the emotional freedom techniques (p=.003), placebo (p<.001), and doll tapping (p<.001) groups, but not for controls (p=.255). Although the authors suggest that the effects of emotional freedom techniques are related to systematic desensitization and distraction, it should be noted that the placebo and modeling groups also involved simultaneous physical stimulation, treatment for psychological reversal, a simplified collarbone breathing exercise, reminder phrases, and the nine gamut treatments. I believe that these factors significantly blurred the distinction among the various treatment conditions and compromised the results. Additionally the study was limited to subjective units of distress and did not involve follow-up evaluations as was the case with the Wells et al. study (2003). Also it should be noted that the treatment effects for all groups was quite minimal, statistically but not clinically significant.  The researchers conclude, “The clinical significance of EFT, including the duration of treatment effectiveness, still needs to be ascertained” (p. 26).   

A doctoral dissertation experimental study of the original BE SET FREE FAST (BSFF) procedure, which involves a 4-point tapping routine combined with statements regarding elimination of emotional distress, suggests that this approach is effective in the treatment of insect phobia (Christoff, 2000)[4]. This research involved four single case design studies. Specifically, two of the subjects were phobic of crickets, one of ants, and one of caterpillars and worms.  For each subject, extensive pre- and post-testing was done during six twice-weekly sessions to establish baselines followed by six treatment sessions and evaluation. Continued monitoring with psychological instruments was conducted at the following six sessions. Also subjective units of distress and heart rate measures were obtained throughout the study.  The major portion of phobic reduction occurred during the seventh session (i.e., the first treatment session), with some additional improvement in the next one to two sessions. In all four cases the tests confirmed and the clients experienced sharp drops in their phobic experience and the subjects reported that they were no longer having difficulty or discomfort in the presence of the phobic object.

A pilot study examined the effects of energy psychology on claustrophobia with four claustrophobic subjects and four normal controls (Lambrou, Pratt, & Chevalier, 2001).  All subjects were evaluated with pencil-paper tests, biofeedback measures, and subjective and behavioral measures before and after treatment and at approximately 2-week follow-up. A unique feature of this study is that the electrical properties in the acupuncture system were measured. Statistical analysis revealed significant differences before and after treatment between the control group and the claustrophobic group. The researchers noted that the measures of autonomic functions included in the study are less susceptible to placebo or positive expectancy effects.

The most extensive preliminary clinical study on the effectiveness of energy psychology was conducted in South America over fourteen years with 31,400 patients (Andrade & Feinstein, 2004).  A sub-study of this group took place over 5 ½ years with 5000 patients diagnosed with PTSD and many other psychological disorders. Included in the sub-study were only those conditions in which energy psychology and a standard of care control group (cognitive-behavior therapy (CBT) plus medication when indicated) could be used. At the end of treatment and at follow-up periods of one month, three months, six months, and twelve months, the patients were interview by telephone by interviewers that had not been involved in the patients’ treatment. These follow-up interviews revealed a 90% positive clinical response and 76% complete elimination of symptoms with energy psychology alone and a 63% positive response and 51% complete elimination of symptoms with CBT/medication (p <.01). These results are highly significant, indicating that energy psychology was superior to CBT/medication for a wide range of psychological disorders.  Furthermore the average number of sessions in the energy psychology group was three (3) and the average number of sessions in the CBT/medication group was fifteen (15).  The principal researcher, Joaquin Andrade, concluded, “Letting aside our enthusiasm and everyday clinical observations (some of our clinicians are seasoned cognitive-behavior therapy practitioners), we never forgot that the goal of the study was just to assess the usefulness of the procedure in our practice. From a strictly scientific and bio-statistical perspective, no other conclusions can be made and we didn't. We can conclude by now that different meridian tapping procedures are capable of producing very rapid and positive clinical responses in the pathologies studied, in our clinical settings. Further and more focused studies will deepen those conclusions” (p. 198).