Time to turn off the Tap: Why Emotional Freedom Technique is dangerous nonsense
January 16, 2014 50 Comments
“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.