Time to turn off the Tap: Why Emotional Freedom Technique is dangerous nonsense

“Tapping therapy”, or Emotional Freedom Technique (EFT), has squirmed its way into mainstream media once again.

On Wednesday, BBC Midlands ran a segment on the results of a recent study using the technique, which combines tapping various points on the body with repeating positive statements. Apparently, all but one of the 36 patients in the trial had recovered. Senior doctors in the segment appeared to be pleasantly confused but utterly won over.

So if nearly every patient in the trial got better, why was there such an outpouring of derision on social media? Why exactly is “tapping therapy” a load of nonsense?

There’s no evidence it works

Firstly, as the lead author on the trial, Professor Tony Stewart, was keen to point out, the study was only a service evaluation. All they did was give a group of people with mild mental health difficulties some “tapping therapy”, to see if it was practical to do in a GP surgery. This is a very different thing to testing if a treatment works or not.

Just because the patients got better after some “tapping therapy” doesn’t mean it was the therapy that caused the change. People naturally get better anyway, especially if their problems are relatively mild. This is called regression to the mean. Even half of people with major depression recover completely within a year if you do nothing at all.

And even if the patients getting “tapping therapy” recovered quicker than they might have done without it, that doesn’t mean that there’s something special about the technique. The “tapping therapy” involves the patient saying lots of positive things to themselves while tapping – the nice comments would make you feel pretty good, regardless of whether you were tapping yourself, hopping around on one leg or watching Thomas the Tank.

But we don’t have hopping therapy, and the Fat Controller is thoroughly underqualified.

So we really can’t say whether or not the tapping did any good at all from this trial. What we need are trials that compare a group of patients who get “tapping therapy” to a group of patients who get something that cancels out the effects discussed above – perhaps a few sessions with a friendly counsellor.

 Unsurprisingly, there really aren’t any good studies out there. McCaslin published a fair review of the meagre collection trials of “tapping therapy” in 2009, finding them riddled with basic methodological errors, including:

  • Drawing conclusions from a p value of 0.09
  • Not declaring the number of patients who dropped out
  • Poor, if any, blinding
  • Not controlling for placebo effects
  • Not controlling for demand characteristics
  • Tiny sample sizes
  • Bizarre, or inadequate, control groups

In fact, the biggest study, by Waite and Holder, who used the technique on phobias, found that all four of their groups (including doing nothing, tapping on the wrong places and quite brilliantly, tapping on a doll) did equally well.

Why would it work anyway? 

Before we even ask if something works, we have to ask why we think it might. Is it plausible?

This is where “tapping therapy” really starts to get unhinged. Flicking through the 79-page manual written by Gary Craig, we find choice quotes like:

EFT was originally designed to overhaul the psychotherapy profession. Fortunately, that goal has been reached…” 

The manual states the starting point for the theory behind “tapping therapy”: 

“The cause of all negative emotions is a disruption in the body’s energy system” 

and therefore that 

“Tapping [various points of the body] sends pulses through the meridian lines and fixes the disruption”. 

The tapping is combined with making positive statements, like 

“Even though I still have some of this war memory, I deeply and completely accept myself

until the bad feelings go away.

I don’t know about you, but I sat in lectures at medical school for 5 years. I’ve assisted in countless operations, looked at hundreds of scans, and studied physiology and neurology, but I’ve never seen anything resembling a meridian line in a human being. There is nothing special about the parts of the body “tapping therapy” chooses. In real life, there is simply no rational basis why tapping on arbitrary parts of the body would have any effect – apart from giving you a sore finger if you did it hard enough.

Any benefit really is just down to people saying self-affirming, hopeful things to themselves while they look a bit silly.

Why this is dangerous 

So if “tapping therapy” doesn’t do anything special, how can it do any damage?

It can’t do any damage directly – but it can certainly harm patients who urgently need treatments that do work, by delaying and fooling them. Every second someone spends having “tapping therapy” is time they could be spending seeking effective treatment for their mental illness, or perhaps even worse, for their physical illnesses. The manual claims to be able to cure allergies and respiratory conditions, as well as cancer too – things which can kill quickly if left untreated.

Pursuing “tapping therapy” as a potential therapy, by wasting thousands of pounds on further trials and therapist training, diverts sorely needed resources from interventions that really do have rational, believable promise. Things that could help people.

On top of all of that, lending it credibility in the form of airtime and column inches will only skew the public’s idea of what real science is about – hard work and small steps. Everyone wants a miracle cure, but we can’t delude ourselves into thinking we’ve found one when it makes no sense on any level.

Time to turn off the tap.

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About Alex Langford
I am a psychiatry trainee based in South East London. Before I went into psychiatry, I used to be a general medical doctor, and I also have a BSc in psychology. I'm particularly interested in improving the public face of psychiatry, evidence based medicine, teaching and patient rights. Don't mention cricket unless you've got the next fortnight free to discuss it.

8 Responses to Time to turn off the Tap: Why Emotional Freedom Technique is dangerous nonsense

  1. You forgot to mention your large ego and over inflated sense of self importance.
    There is plenty of proof of the validity of EFT or meridian tapping if you care to look without your obvious purpose of finding fault and expressing biased opinion.

    I encourage readers with a more open mind to examine the scientific proof that some people crave. Besides the numerous studies including RCTs (randomized controlled trials) there are thousands of anecdotal real life experiences that the layperson can relate much better to.

    budurl.com/EFTproof

    p.s. I always encourage others to “do your own thinking” by making up their own minds i.e. don’t take Alex’s word or my word —> examine the boatload of evidence & info via the above link

  2. Lucy says:

    Hurray for calling out EFT as the utter humiliating, bullying bunkum that it is. It’s a heart sink moment reading that a therapy is based on treating something deemed to be ” a disruption in the body’s energy system” Will EFT be prescribed for those who have just had massive heart attacks? Probably the wrong sort of energy.

    I would also add EMDR and Group Based CBT to a list entitled “Cheap Bunkum That Does Not Work But Can Harm Individuals Badly”

    • I am a registered psychotherapist working both in the NHS and private practice. I use NICE-recognised approaches such as CBT and EMDR, but from my clinical observations I believe that EFT greatly enhances effectiveness of my work, it typically makes treatment quicker, gentler, more effective, and the clients less likely to drop out of treatment and/or relapse.

      Yes plenty more research is needed, but some of the existing studies (regardless of their limitations) and clinical experience of many mental health and medical professionals who already use EFT are promising and I believe it is short-sighted of the author to dismiss them altogether.

      • Thanks for the comment.

        My response is that your clinical observations – all of our clinical observations – are not a relaible guide to what works and what doesn’t. Like I discuss in the piece, just because someone has tapping therapy doesn’t mean it was the tapping that helped, or that they wouldn’t have improved without anyone of it.

        That’s why we have trials.

        The existing evidence base is highly biased, confounded and based on a completely unscientific premise – “energy lines”.

        It isn’t irresponsible of me to critique this, it’s my duty as a doctor to point out poorly evidenced bunkum.

  3. I do not dispute that currently available evidence is insufficient in volume and in quality. I used to be a scientist in the past so understand the importance of rigorous and unbiased scrutiny in research.

    However the study you are writing about was based on a small-scale pilot service evaluation, and never intended to fulfil the criteria of “gold standard” research – this would have been unrealistic, unnecessary and very, very expensive.

    In terms of quality of evidence, there have been a few small scale RCTs conducted already, and as far as I understand more are in progress, so we’ll just have to wait and see.

    You seem to be automatically assuming that all those who practise EFT base their understanding on the concept of “meridians” /“energy lines”. Whilst that is the case for many, as the technique originated in the field of complementary therapy, there are also a number of other theories and hypotheses based on neuroscience that are shared by others (admittedly none of them are entirely satisfactory or proven as yet, but some make rather more sense to me as a lapsed scientist). I would personally not categorise EFT within “alternative therapies” as for me it sits much better within psychotherapeutic approaches such as EMDR and various body psychotherapies.

    In my clinical experience the effects of EMDR and EFT are extremely similar (which was something suggested by the outcome of the recent small-scale study comparing these two treatments for simple PTSD, conducted by Edinburgh University / Forth Valley Behavioural Psychology Service). No, we don’t have a clear understanding of the mechanisms of either (and EMDR had its fair share of flack in the past, and is still continuing to in some quarters, despite a hefty volume of research and approval by NICE). On a pragmatic level, whilst seemingly having similar outcomes in clinical practice, EFT tends to be gentler than EMDR, with fewer contra-indications and side-effects, and is more amenable for self-help (of course this is based just on my personal experience / opinion and anecdotal evidence from my colleagues).

    Whilst I use a wide range of psychotherapeutic interventions in my work, including those based on good quality evidence and widely implemented within NHS, if someone was to put a gun to my head and say “You are allowed to keep just one technique/intervention and have to discard all others”, I would not hesitate for long before I would choose to keep the tapping.

    As I am writing this I am smiling to myself remembering how 10 years ago when EFT was first introduced to me, my initial reaction was “what a load of b****cks!” (this was also my second reaction, and the third one, and some more after that). Despite my extreme scepticism and initial reluctance to even consider this nonsensical-looking approach I’ve eaten my hat since, and wish you the same :-)

  4. Andy says:

    A great article on sloppy and uncritical reporting by the BBC. Some of the negative comments here seem to miss the especially in light of the Waite and Holder trial. And that point is that EFT ( a registered trade mark) does show signs of offering some benefit. These benefits however may not be a result of EFT but rather exposure, distraction and cognitive bias and that tapping on meridians is merely smoke and mirrors to create the impression of novelty thereby allowing Mr Craig ( a realtor by profession) the right to charge license and franchise fees.

    If Craig genuinely had the interests of humanity at heart then he would finance large scale, double blind RCTs, maybe he could get his big Alt Med supporters such as Chopra, Mercola and Hay to chip in, but then again these folk are only interested in making money from the sick and vulnerable not spending money helping them.

  5. Pingback: Claim: Tapping Therapy’s Effectiveness “was proved” – True or False?

  6. Chris says:

    When I was introduced to E.F.T. by a person who had just returned from America, there was just one website when searched on the big G. emofree dot com

    I have just found this article whilst carrying out the second search, and at the same time discovered that more than 20 million websites now exist.

    Over the years, I have introduced and used E.F.T. for the purpose of helping people, who, in my opinion, would benefit at that particular timeframe of their “emotional condition”.

    In general, I have found two things.

    ONE. Despite the subject sounding a little “different” most people were happy to try it, and like myself, the results they experienced were positive, dramatic and instant.

    TWO. A very small amount of people, instantly dismiss the subject as “BlaBlaBla” and do not even want to hear any more, but will rant on and on and on, with negative remarks, such as “making money from the sick and vulnerable”

    Note: I have never charged for E.F.T. just used it as another tool in my “Bag”

    In my experience, all results have been positive and without side effects.

    Like the World Wide Web, E.F.T. is a powerful tool used properly, and should be free to all.

    Chris from Hampshire

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