David Feinstein contributed an article to Frontiers in Psychology’s recent edition which focused on “Changing the Score the Body Keeps: Somatic Therapies for Adverse Childhood Experiences.” David’s article, Using energy psychology to remediate emotional wounds rooted in childhood trauma: preliminary clinical guidelines appears in the October 18, 2023 edition. The paper provides a rationale and a roadmap for treating adverse childhood experiences with tapping (a form of energy psychology, or EP). It reviews EP’s efficacy and possible mechanisms of action, explores how tapping techniques interface with neural networks involved in childhood trauma, and suggests ways to incorporate tapping in therapeutic work with survivors of childhood trauma.

The ACEs

In the late 1990’s, researchers at Kaiser Permanente discovered a strong connection between adverse childhood experiences (ACEs) and problems during adulthood. ACEs are generally divided into three categories: abuse, neglect, and household dysfunction. Higher numbers of ACEs are related to increased risk in health problems, mental health, and lifestyle difficulties.

As serious as the consequences of ACEs are, few psychotherapeutic interventions are effective in treating them. As Bessel van der Kolk memorably pointed out in his book, The Body Keeps the Score – and involving the body in healing leads to better outcomes. Other researchers have pointed to mind-body therapies as effective approaches for people suffering from the aftermath of childhood trauma.

The framework

Upon this framework, David proposes EP as a mind-body tool that may be particularly helpful in overcoming ACEs. EP emerged in the 1990’s, when it was largely ridiculed and dismissed by the mainstream establishment. However, its proponents found it quite effective! Today, more than 2 million downloads of the EFT phone app testify to its popularity. Moreover, a body of research points to its efficacy.

Research

The paper includes an easy-to-digest review of the research on EP. David summarizes many studies and meta-analyses of EP. Additionally, he cites the amazing results that Sakai et al (2010) found after treating children who had survived the genocide in Rwanda. In that case, 47 out of 50 participants no longer met diagnostic criteria for PTSD after a single session. In treating PTSD, according to Stapleton et al (2023), tapping gets results in four to ten sessions. By comparison, it takes eight to 15 sessions of CBT to treat PTSD, according to Watkins et al (2018).

Mechanisms

Is acupoint tapping a worthless exercise or an essential component of EP? David points to his 2023 review which found that five of six studies found that acupoint tapping is indeed relevant. In addition, a 2021 study by Mehdipour et al adds to the list.

In his 2021 paper, David outlines five empirically-supported premises that support the validity of acupoint stimulation. These include:

  1. Tapping creates an electrical impulse.
  2. These impulses turn on, or turn off, brain regions involved in treatment.
  3. The words and images used while tapping activate the relevant brain regions, calling the electrical signals to them.
  4. This creates neural changes, which make the benefits long-lasting.
  5. Tapping leads to other physiological shifts, including stress hormones, gene expression, immune function, cardiovascular function, and brainwave patterns.

How tapping is a good neurological fit for ACEs

Three neural networks are relevant to ACEs, as they may have become impaired during childhood brain development. These are:

  1. The salience network, which distinguishes the important from the unimportant. An impaired salience network can lead to hyperarousal, numbing, or both.
  2. The central executive network, which involves attention, self-regulation, working memory, and decision-making. This is where fear structure is coded, and mis-wiring here can cause a mismatch between threat or danger and a safe or unsafe response.
  3. The default mode network, which is responsible for our relaxed thoughts, reflections, daydreams, and where we reexperience past trauma. ACES can change the default mode network, causing a distorted memory retrieval, more distress upon these retrievals, and a biased view of interpersonal experiences.

David explains that tapping can help heal the salience network by pairing exposure therapy, which is highly arousing, with tapping, which is calming. This seems to depotentiate the neural network involved in the trauma memory. As the salience network calms down, the central executive network may reprocess data unconsciously. Moreover, tapping can address the mis-wiring of this network directly. Finally, as the salience and central executive networks become calmer, the ruminations of the default mode network may shift as well, becoming less distorted.

Treating adverse childhood experiences with EP

While there are few recommendations for treating adverse childhood experiences, the International Society for the Traumatic Stress Studies has investigated approaches to treating complex PTSD (cPTSD), which often involves childhood trauma. Among the cluster of cPTSD symptoms, David reports, the most important to treat seem to be poor self-concept, poor emotion regulation, and relationship problems.

The literature recommends a three-segment approach to therapy. Focus first on safety, then on trauma memory processing, and finally on generalizing gains. Within this framework, it is important to be somewhat flexible. Other life events will almost certainly arise and need attention. These clients may need continued follow-up care for tune-ups or as new stressors arise.

Guidelines

There are guidelines for using EFT to treat PTSD, and these can inform work with clients who have experiences ACEs. It is important to remember that the symptoms were initially adaptive responses to adversity. It is essential that therapists instill hope. Goals must be collaboratively created with the client. Finally, clinicians must be extra sensitive to their clients’ trauma histories. They may do well to interface with other treatment providers to help improve understanding.

David recommends introducing tapping “as early as prudent” by using it to address a low-level stressor such as an upcoming task. EP incorporates distress rating at every round of tapping. This is a great way to keep clients engaged in the treatment and assessment of progress. Moreover, EP allows gradual approaches to trauma memories, with each session allowing for a deeper dive into the memory. Perhaps most importantly, EP allows for downregulation during treatment at any time.

For these reasons, EP may be a great tool to bring to work with clients who have experienced ACEs or who have cPTSD. Kudos to David Feinstein for another well-researched and well-written paper that helps further the field of energy psychology!

Paying it forward

Are you a teacher or school employee? You can get trained to bring powerful energy psychology techniques to your school with ACEP’s free EP in Schools training. Are you a clinician or stakeholder wanting to bring EP to your community? Enroll in ACEP’s free R4R training. Want to build your energy psychology skills? Get trained in TFT or EFT. Click here to support ACEP. Stay up to date with the research on energy psychology here.