Science & Pseudoscience Review in Mental Health

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Debunking Thought Field Therapy™

Author:

Brandon A. Gaudiano, MCP Hahnemann University
February 2000

How does this sound? Say you're in the throws of a deep depression, or your anxiety has gotten so out of control that you experience frequent recurring panic attacks keeping you housebound; perhaps you've just experienced the death of your spouse after 40 years of marriage, or maybe your biggest problem is that you bite your fingernails too much. Now what if you I told you that I had a fast, effective, and painless treatment that could cure all your psychological problems (and even some physical ones) in a matter of minutes? And all you have to do for your troubles to miraculously vanish is to humor me by tapping with your fingers a few times on various body parts. Sound to good to be true? Nevertheless, these are just some of the eye-catching claims put forth by promoters of a fringe psychotherapy treatment called Thought Field Therapytm (TFT).

According to Roger Callahan, Ph.D., the treatment's creator, TFT

provides a code to nature’s healing system. When applied to problems TFT addresses their fundamental causes, balancing the body’s energy system and allowing you to eliminate most negative emotions within minutes and promote the body’s own healing ability.

Callahan theorizes the existence of invisible energy fields, called thought fields, within the body, based in part on the Chinese philosophy of Qi (pronounced chee). Environmental traumas or inherited predispositions cause interruptions in this energy flow, which Callahan calls "perturbations." Perturbations result in the chemical, behavioral, and cognitive symptoms that are associated with psychological problems, such as anxiety and depression. In other words, perturbations are claimed to be the root cause of all psychological problems. In order to correct these disruptions, the TFT therapist instructs the client to tap on various body parts. The tapping sequences, called "algorithms," vary depending on the particular problem. Tapping is theorized to add energy into the system, rebalancing the flow. According to Callahan, rebalancing the energy flow eliminates the distress (Callahan, 1997). One can think of TFT as a sort of psychological acupuncture.

Needless to say, Callahan makes lofty claims which, if true, would contradict everything science and medicine has learned in the last few hundred years. As the 18th century philosopher David Hume aptly states, extraordinary claims require equally extraordinary evidence to support them. Not surprisingly, scientific evidence to support TFT is almost totally lacking. For a treatment to be scientifically supported, controlled studies must be conducted to confirm its effectiveness. Once efficacy has been demonstrated, further research is needed to support the proposed mechanisms behind the treatment's results (i.e., rebalancing energy fields) before such claims should be accepted. However, after TFT's supposed "20 years of development" no controlled studies have been conducted and published in peer-reviewed journals addressing either the issue of TFT's effectiveness or of its proposed mechanisms of action. It would seem that there is little interest in scientific validation from proponents of TFT.

Instead, they present a seemingly endless stream of testimonials from "satisfied customers" and anecdotal stories of TFT successes. Reports of TFT's miraculous curative powers may be vivid and emotionally charged, but they do not provide much in the way of evidence. One only needs to peruse the late-night television channels to see similar "evidence" used to sell everything from spray-on hair to shoe magnets that cure aches and pains.

Charles Figley, Ph.D. and Joyce Carbonell, Ph.D., two Florida State University trauma researchers, have conducted the only known research on TFT (Carbonell, 1996; Figley & Carbonell, 1999). However, their studies have not been published in peer-reviewed journals. The peer-review process helps to ensure that studies are properly conducted and methodologically sound. Therefore at this point, the quality of their research has not been demonstrated. Nevertheless, careful examination of their reports reveals that TFT did not demonstrate conclusive evidence of its effectiveness (and certainly much less than is frequently claimed). Furthermore, the studies appear to have serious methodological flaws that limit interpretation of any findings.

Lack of evidence does not stop TFT-vendors from making claims that they cannot support. Regarding research findings, one TFT web site states: "All reports have been completely in favor of TFT." The reader is then referred to unsubstantiated case studies presented by TFT proponents. Declarations of empirical support are confusing in light of the fact that there are no published studies of TFT in scientific journals. In addition, a TFT web site claims:

A success rate of about 80% can be expected using TFT algorithms alone. Individual diagnosis by a diagnostically-trained practitioner raises this figure to around 90- 95%. With the use of Voice Technology™ the success rate is even higher [+97%].

Based on these assertions it would seem easy to be able to demonstrate TFT's effectiveness in studies, if such high success rates actually existed. No references are provided to substantiate these numbers.

Furthermore, double-talk and logical inconsistencies can be found throughout TFT theory and practice. For example, therapists claim that TFT is not only effective in alleviating psychological problems, but that TFT "is probably the only therapy currently available for the treatment of psychological problems and emotional challenges that can genuinely claim to offer a cure." What if symptoms return? This is not a problem for supporters: "In the event of a return of the problem, this doesn't mean that a cure was not achieved in the first place, only that it has been undone." TFT proponents further claim: "Once all aspects or complexities of a problem have been successfully treated (i.e. all perturbations have been removed from the Thought Field) and anything that may have undone the cure has been identified and eliminated, the effects appear to be permanent." In other words, TFT is claimed to permanently cure a person's problem; and if that problem should return, it is not TFT's fault but simply the case that something has come along to "undo" the cure. How does the TFT therapist know when all the things that can undo the TFT "cure" have been eliminated? It is when, of course, the person no longer experiences the problem. Unfortunately, this is just one example of the circular logic and explaining away of TFT failures that is commonly found in the statements by supporters.

Even though TFT has no true evidence to support its success rates, it would not be surprising to find that sometimes it alleviates symptoms for some people. However, this does not mean that TFT necessarily "works" because it rebalances the body's energy fields. No scientific evidence is produced, even by Callahan that would demonstrate this mechanism of action. One of the simplest explanations involves placebo responding. A placebo psychotherapy is one in which the primary effects of the treatment are produced by nonspecific mechanisms (e.g., demand characteristics) rather than the specific components of the treatment (e.g., tapping algorithms) (Grunbaum, 1985; Lohr, Lilienfeld, Tolin, & Herbert, 1999). However, Callahan asserts that placebo does not account for TFT's effects (Hooke, 1998). According to Callahan, intentional TFT placebos do not work in his experience. However, Carbonell's (1996) unpublished study reported that the placebo algorithm produced reductions in anxiety in acrophobics. In addition, Callahan claims that placebo is not a factor because many people do not believe that the treatment will work. Callahan demonstrates a misconception of placebo here, because it is only necessary for the person to believe that they are receiving some sort of "active" treatment (which they are told by the therapist that they are receiving) for placebo effects to be produced--not that they necessarily believe the treatment will work (Dodes, 1997). Changes that occur for other reasons may be incorrectly interpreted as resulting from the tapping. Finally, Callahan claims that he has seen evidence that using TFT corresponds to changes in the autonomic nervous system (ANS), which cannot be affected by placebo. Again, Callahan is mistaken because many "psychological" events, including placebo, can produce changes in the ANS (Ross & Buckalew, 1985).

In addition to placebo, other commonly understood phenomena can help us understand any possible effects of TFT. The tapping could distract the individual from their problems and alleviate distress temporarily (Fennell, Teasdale, Jones, & Demle, 1987). In addition, TFT requires the person to hold the distressing experience in their mind, which exposes them to these unpleasant thoughts. Imaginary exposure techniques have been shown to reduce the intensity of the negative emotion associated with the distressing thoughts over time (Foa & Meadows, 1997). Furthermore, TFT therapists use coping statements (e.g., "I accept myself, even though I have this anxiety"), which have been shown to be an effective component of cognitive therapies (Swartz & Garamoni, 1986). Over time, the distressing thoughts can lose their negative association through conditioning mechanisms (Hooke, 1998). Other established treatments use similar and additional techniques that have proven success. Therefore, the apping procedures, which are the heart of TFT, may be completely superfluous.

In light of the evidence, TFT appears to share many of the qualities of a pseudoscience (Herbert, et al., in press). A pseudoscience makes claims that are presented as scientific but in actuality lack empirical support (Shermer, 1997). First, Callahan couches his theory in scientific-sounding language to appear credible. For example, he uses concepts from physics that are taken out of context and distorted to fit his beliefs (Callahan, 1997). Second, Callahan ignores established scientific explanations for TFT's benefits and instead relies on his unsupported theory to explain all results. Third, Callahan consistently fails to test TFT in controlled, independent studies and instead relies on unconfirmed reports. Fourth, Callahan keeps TFT's methods, such as Voice Technology, which supposedly allows a therapist to diagnose and treat people over the telephone, a secret by making trainees sign non-disclosure contracts. Fifth, Callahan aggressively markets his therapy over the Internet and recommends that trainees take only "approved" seminars to learn his methods. Also, he charges trainees $100,000 for his Voice Technology. Sixth, Callahan touts a virtual "panacea," claiming that he can train a therapist to be over 97% successful, but provides no evidence of these results. Seventh, Callahan explains away TFT failures by appealing to made-up concepts such as "psychological reversal," which is said to involve a reversed energy flow, or "energy toxins," which are claimed to be thought field allergies, to explain away instances when TFT fails to work.

Recently, the Board of Psychologist Examiners in Arizona has sanctioned a psychologist who was using "secret" TFT techniques with clients (Foxhall, 1999). In addition, the American Psychological Association instructed its sponsors of continuing education programs not to offer CE credits for training in TFT (Murray, 1999). Unfortunately, this does not stop hundreds of therapists around the world, many without any conventional training in psychology or psychotherapy, from using and marketing TFT services to individuals who are in desperate need of help. Therefore, let the buyer be ware. Consumers "shopping" for psychotherapy should be just as careful and do just as much research as they would if they were buying a new car. If your therapist recommends that you start tapping away your troubles, you might want to look elsewhere for treatment.


References

Callahan, R. (1997). Thought Field Therapy: The case of Mary. Electronic Journal of Traumatology, 3 [On-line].

Carbonell, J. L. (1996). An experimental study of TFT and acrophobics. Callahan Techniques [On-line].

Dodes, J. D. (1997, January/February). The mysterious placebo. Skeptical Inquirer [On-line].

Fennell, M. J., Teasdale, J. D., Jones, S., & Damle, A. (1987). Distraction in neurotic and endogenous depression: An investigation of negative thinking in major depressive disorder. Psychological Medicine, 17, 441-452.

Figley, C. R., & Carbonell, J. L. (1999). A systematic clinical demonstration of promising PTSD treatment approaches. Electronic Journal of Traumatology, 5 [On-line].

Foa, E. B, & Meadows, E. A. (1997). Psychosocial treatments for posttraumatic stress disorder: A critical review. Annual Review of Psychology, 48, 449-480.

Foxhall, K. (1999, September). Arizona board sanctions psychologist for use of Thought Field Therapy. APA Monitor [On-line].

Grunbaum, A. (1985). Explication and implications of the placebo concept. In L. White, B. Tursky, & G. E. Schwartz (Eds.), Placebo: Theory, research, and mechanisms (pp. 9-36). New York: Guilford Press.

Herbert, J. D., Lilienfeld, S. O., Lohr, J. M., Montgomery, R. W., O'Donohue, W. T., Rosen, G. M., & Tolin, D. F. (in press). Science and pseudoscience in the development of Eye Movement Desensitization and Reprocessing: Implications for clinical psychology. Clinical Psychology Review.

Hooke, W. (1998). A review of Thought Field Therapy. Electronic Journal of Traumatology, 3 [On-line].

Lohr, J. M., Lilienfeld, S. O., Tolin, D. F., & Herbert, J. D. (1999). Eye Movement Desensitization and Reprocessing: An analysis of specific versus nonspecific treatment factors. Journal of Anxiety Disorders, 13, 185-207.

Murray, B. (1999, December). APA no longer approves CE sponsorship for Thought Field Therapy. APA Monitor [On-line].

Ross, S., & Buckalew, L. W. (1985). Placebo agentry: Assessment of drug and placebo effects. In L. White, B. Tursky, & G. E. Schwartz (Eds.), Placebo: Theory, research, and mechanisms (pp.67-82). New York: Guilford.

Schwartz, R. M., & Garmoni, G. L. (1986). A structural model of positive and negative states of mind: Asymmetry in the internal dialogue. In P. C. Kendall (Ed.), Advances in cognitive behavioral research and therapy (Vol. 5) (pp. 1-62). New York: Academic Press.

Shermer, M. (1997). Why people believe weird things: Pseudoscience, superstition, and other confusions of our time. New York: W.H. Freeman & Company.