I was asked to contribute a an article by Chiropractic Insights that explores how mind-body techniques could fit into a chiropractic approach to working with physical pain. EFT, aka tapping, aka the Emotional Freedom Techniques is one of those fast growing approaches that can provide just such a bridge.
Chiropractors, while holding to the core practice of employing a drug-free approach to health and removing nerve interference by adjusting the spine, have also continued to look forward, towards innovative methods that can complement our skills to create even better patient outcomes. Chiropractors have long been leaders in creating collaborative doctor-patient team approaches. As doctors and patient educators, we empower patients to participate in their health recovery.
Here is one innovative approach that can easily be incorporated into a chiropractic practice and taught as a self-help technique to effectively address the role of stress and associated negative emotions with physical and pain conditions. This particular method is known as EFT, or the Emotional Freedom Techniques. If you are not already aware of this “tapping technique,” it is likely that many of your patients are. It is estimated that millions of people have tried EFT and it is growing swiftly in public acceptance, media mentions and peer-reviewed research. Proponents have included Drs. Bruce Lipton, Candace Pert, Deepak Chopra, Norm Shealy, Wayne Dyer and many more respected professionals that are leaders in mind-body approaches to health. By incorporating techniques like EFT, we can offer patients a way to develop a greater sense of control over their stress-influenced pain and symptoms, which in itself can reduce a patient’s sense of frustration and stress that can occur when their condition does not improve as quickly as they had hoped.
Stress, Negative Emotions and Health
Most chiropractors teach their patients about the serious role long-term or chronic stress plays in their health and well-being. Short-term responses to stressful stimuli or situations can be self-protective, motivating even. Longer term stress has been shown to take great tolls on the body with long term excess production and circulation of catecholamines and glucocorticoids. Over long periods of time, an elevated cost or allostatic load leads to the breakdown of many body tissues and organs. Prolonged stress with elevated cortisol levels has been associated with increased biological aging, impairment of brain function and structure, as well as a deterioration of many health conditions including heart disease and cancer.
Ongoing states of elevated stress levels that may cause an individual to present at a chiropractic office may include pain syndromes such as: chronic pain, fibromyalgia, neck and back pain, headaches and many other non-traumatic mechanical pain syndromes. Chronic stress can also be causative and aggravating factors in a multitude of other conditions including cardiovascular disease and resultant states affected by impaired immune function.
Apart from stressed states, emotional states are a normal response to emotionally laden events and experiences. The problem that occurs that can lead to prolonged states of stress are when particularly intense emotions are recurrent, habitual and easily triggered or aroused by minimal stressors or situations. Recurrent states of emotional intensity like fear, anger, guilt, sadness, shame and embarrassment can have profound influences on increasing a person’s allostatic stress load that can hinder their capacity to heal despite the best of chiropractic care.
EFT and the Chiropractic Office
There are now more than 60 peer-reviewed research papers that report clinical outcomes using tapping techniques such as EFT. They have shown statistically significant reductions in pain (i.e. fibromyalgia, tension headaches), stress levels, anxiety, phobias and post-traumatic stress, enhancement of athletic performance and even the reduction of food cravings with ensuing weight loss. All these are problems that many chiropractic patients deal with. Let’s look at how to teach patients how to self-apply EFT tapping for painful conditions.
The technique itself has foundational roots from George Goodheart, DC, amongst others. It was created in its current form by founder Gary Craig. EFT combines physical stimulation (tapping) of a number of acupuncture points on the face and upper body while focusing on a symptom or on a negative emotion, along with verbalizing specific self-acceptance statements. The protocol has been demonstrated to reduce circulating cortisol levels and result in feelings of greater calm and ease. In a sense, it could be called a neuro-emotional re-wiring.
So, how would this be integrated into a chiropractic clinic? Once taught how to self-apply EFT, patients could use it at home to help decrease pain instead of using medications, thereby reducing the harmful effects of pain medications. Patients that are feeling anxiety about the chronicity of their pain and the fear that it may never go away, could now have an additional tool to reduce their stress inducing feelings of fear, anxiety and worry.
EFT can be taught to patients in a variety of ways. The procedure may be taught individually by the chiropractor (once trained) or by a staff person. Patients can also be taught in a group class format as well. As EFT is often described as emotional acupuncture without the needles, here is a list of the acupoints that are stimulated in the Clinical EFT Short Cut procedure:
Karate Chop or Set Up point, Small Intestine 3
Top of head, Governing vessel (or Du) 20
Inner brow- Urinary Bladder 2
Outer brow – Gallbladder
Under eye – stomach 2
Upper lip Governor (du) 26
Chin Point – Conception (or Ren) 24
Collar bones – kidney 27
Under arm/side of chest- Spleen 21
The beginning method is called the “Chasing the Pain” technique. Before tapping begins, the patient is asked to name the physical complaint, specifically the pain, and rate the level of intensity from 0 to 10, zero being the least intense. The acupoints are to be tapped gently, with two to four fingers of the dominant hand, though bilateral tapping is equally as effective. The first point to e stimulated is referred to as the Karate Chop point, appropriately named for the lateral ulnar pad where one might karate chop a piece of wood. It is tapped repeatedly for three “rounds” that includes a verbalized specific description of the physical complaint, including its location and quality, as well as a “Set-Up” phrase. It is followed by a statement of self-acceptance. So, if teaching a patient that is suffering from severe tension headaches, it might sound something like this:
While tapping the Karate Chop point repeatedly and saying aloud “Even though I have this gripping headache that feels like a vice squeezing my temples… I completely accept myself.” Have the patient repeat this two more times.
Next, the person would be instructed to tap on each of the acupoints, in the order described above beginning with the Top of Head Point, approximately seven to eight times at each point while saying a “Reminder Phrase.” The Reminder Phrase, for simplicity sake is kept to a shortened version of the Set Up Phrase, as in:
“This Gripping Headache,” “This Gripping Headache” said while stimulating each of the points.
After the round, the patient should be asked for a new 0 to 10 level and asked if the headache has changed in intensity, location or quality. If either the location/quality has not changed or the intensity has decreased to some degree, re-apply several rounds until the symptoms dissipate. If however, the location or quality has changed, amend the set up phrase accordingly to describe the change with a revised 0 to 10 intensity level that includes the changed complaint, i.e.:
While tapping the Karate Chop point repeatedly and saying aloud “Even though I have this hot sensation that’s moved to the back of my skull… I completely accept myself.” Repeated three times.
Followed by a tapping round of “This hot sensation” on all the points. Followed by an intensity level check.
The tapping appears to cause a reduction in the sympathetically induced physiological state of hyper-arousal, allowing for a return to an improved state of homeostasis with a corresponding reduction is stress-induced pain and symptoms.
A clinical case scenario would be that of Dan, a local contractor and periodic patient who came in for relief from acute lower back pain devoid of any recent trauma. After four visits that included moist heat, specific spinal adjustments with trigger point work and home back exercises, he improved only 25%. During our treatments, he revealed that he had been under significant stress at work and had been losing sleep for weeks. Sensing just how much stress he was under, I create a meaningful discussion that allows him to better understand the connection of the stress he is feeling to increased muscle contraction and an ensuing exacerbation of his back pain. I taught him this simple Chasing the Pain Technique and in five minutes his pain was reduced from a seven to a two. I gave him a handout with tapping instructions to perform at home for five to 10 minutes twice a day between his visits. This assisted him in having more control over his back pain and, as a result, he was able to stop taking NSAIDS every four hours and within two visits his back pain had resolved.
Chasing the Pain is one simple method that can be taught to patients to assist them in managing their symptoms more independently and complement a chiropractic drug free approach. In my next article, I will review an even more effective method that includes emotional aspects that are commonly interconnected with physical symptoms and conditions.
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