by Dr. Patricia Carrington

Dear List,

Sometimes intense emotion can block progress to therapy and can make EFT almost impossible to conduct with its usual effectiveness. This is where special strategies can be used to lessen the emotional pain and facilitate the therapy. Gary has given us an excellent strategy to use in such instances (one I often use with great effect) the Tearless Trauma Technique, and the Alternate Phrase Technique I described in my post of November is one other method which I call upon in these kinds of situations. I'd like to describe now how I recently used both of these techniques within the same session with a client, "Doris", who had been in therapy with me for close to two years.

A large portion of Doris's therapy has involved using EFT to deal with multiple personality problems ranging from phobias of being far from home to deep seated self-worth issues. These have stemmed in large part from her sense of over-responsibility for her alcoholic father whom she cared for after her mother died, until his own death from alcoholism some years later. One by one we have cut down multitudes of trees in her "forest" (to use Gary's "forest-trees" metaphor) and recently she has been doing so well in her marriage and at work and with her social life that we reduced her therapy sessions to once every other week.

It seemed as though we were just tying up some final loose ends in preparation for ending her therapy when along came one of those "last minute wonders" that sometimes occur just when a client is ready to leave for good. It's as though the person has held back from facing a certain problem all along but when they know that they are about to leave they finally decide that they had better face this before it's too late. The information that a client can come up with at that point is often a surprise. It was with Doris.

After several triumphant and constructive sessions, she arrived at my office that day quite upset. She had been dealing with a friend of hers when she had found herself feeling painfully over-responsible for her friend's problem behavior. She was furious at herself for still being caught in what she called "wimpy" behavior toward others "where I'm not really being myself".

She quickly came to the conclusion that this stemmed from her feelings of being responsible for her father's death from alcoholism, and began to tell me details about his addiction and death that she had never told me before -- it was as if she just had to get them out before it was too late.

As she was relating these facts she stopped in mid-sentence, her face flushed and her eyes fearful. "Tell me!" she cried, "Do I drink too much? Do I?". Since this was the first time Doris had ever mentioned anything about herself drinking I could only ask her to tell me about it.

She couldn't answer my question however without feeling that she was choking, and her breathing became labored (Doris doesn't have asthma but on several occasions has had to go to the emergency room with breathing problems induced by severe anxiety attacks). When this happened I immediately "backed up" as I tend to do when a client runs into trouble, and asked her to tap on:

"Even though I can't say that without choking..."

After one round of this she could breathe normally again, although she was still agitated. She wanted to tell me more details of her father's alcoholism and death. She was breathless as she described the fact that his alcoholism was the "worst I've ever seen". She remembers that he would drink so many bottles of straight Vodka a day that he didn't even have time to wash the glass between drinks and for days that glass would remain smelling of stale liquor as he kept pouring bottle after bottle into it. He would alternate the Vodka with Seagram's whiskey and would, she says, keep drinking for 24 hours, never sleeping, until he finally fell into a dead stupor.

Towards the end of his life, as his liver began failing, he was rarely lucent. This man, who was so brilliant when sober, could only slur his words and look at the world blurrily. She described all of this as a scene of horror that had made her wish he would die to get it over with.

As she talked about this, Doris became extremely upset and actually began to re-live the trauma. She was trembling and became almost incoherent as the tears streamed down her face. Because she was obviously in so much pain I stepped in to help her. Instead of marshaling positive forces or "getting things out of her system" she was actually re-traumatizing herself right before my eyes.

I decided to use the Tearless Trauma Technique to lessen the pain so she could work productively on the issue. To do this, I instructed her to tap on the issue without deliberately thinking of the original situation (the scenes about her father), but to merely ESTIMATE how she would feel if she DID think about them.

She estimated her distress level as being a "10++" on the SUDS (1 to 10) intensity scale for this issue, and the EFT reminder phrase she used was from her own words "When I think about it it's horrifying". She tapped on "Even though it's horrifying" and was able to get through one round.

At the end of it though she said that her hands felt like "pins and needles" and that she felt "as though closed in a coffin box". She still "couldn't breathe".

Instead of continuing to treat the issue directly we again backed up (side-tracked) to treat the interfering panic:

"Even though I can't breathe when I think about it.."

"Even though I feel I'm trapped in a coffin when I think about it."

At the end of these two rounds she had come down "a little bit" in her distress level and could breathe normally now--but she could only understand this on an intellectual level. Her feelings were still intense.

She then tapped on:

"Even though it's still very scary.."

As she was doing this tapping, however, she broke off in the middle of the round and gasped "Oh! You know what? Do you know why it's still scary? For the first time I realize that I'm afraid it's going to happen to ME!!! I'm drinking wine sometimes and I'm terrified I'm going to be like my father!"

This was one of those "EFT insights" that can occur spontaneously and unexpectedly in the course of the treatment, and be so extremely valuable.

At my request she tapped on : "I'm terrified I'm going to be like my father".

After a round of this she reported that she felt "a little better" for the first time in the session. "I feel really good that that's the truth and I said it out loud." she explained.

Then she told me that she had been drinking some wine every night, something she didn't think was wise. "I feel I've been covering up and it's so good to tell you." She said. Then she went on say that actually when she DIDN'T drink it didn't bother her at all, but that nevertheless she was getting into the habit of drinking wine every night. Knowing Doris's openness, I was quite certain that she was telling the truth about both sides of this - her drinking of the wine, and her feeling ok when she didn't drink it. It seemed to me that we could address both sides of the issue using the Alternate Phrase technique to balance the picture and to bring a positive perspective into Doris's bleak picture of self-condemnation.

I asked her to start with the negative statement first (in this case "I'm terrified I'm going to be like my father" ) and use this for the set-up phrase and for the first reminder phrase (repeated at her inner eyebrow point). She was then to follow with the positive reminder phrase:"When I don't drink I feel ok about it." (used at the outer edge of the eye), then with the negative phrase while tapping under the eye, then the positive one for under the nose, and so forth, for the full round.

As she did this, color began to come back into Doris's face (which had been very pale) and at the end of this round she said "I feel quite a bit better." Her SUDS level was now a 5.

Because the SUDS level was so much reduced I asked her if it would feel okay to her to substitute the word "afraid" in the reminder phrase for the word "terrified". Would that fit better? She said it would and used this phrase, as once again she used both negative (first) and then positive statements for the tapping.

Halfway through this round her wording spontaneously changed from "When I don't drink I feel ok" to "When I don't drink I feel BETTER." Knowing that clients' changes of wording while they are tapping can be very important for healing, I didn't interrupt her. I could see that she looked very different, her body was becoming relaxed, her eyes much more focused.

"I feel calm now." she said at the end of that round. "I feel like I told you a big secret I've been hiding even from myself." I asked her to return to the phrase "My father died of alcoholism" to see where she was with it. The SUDS level was a "2" now. "I still have some anxiety about my own drinking" she added.

At this point I had to make a decision about which direction to go. I decided to let her switch to this aspect. The end of the session was approaching and I felt that this was the most important issue at stake at this point. I realize that another therapist might have decided to pursue the theme of her father's alcoholism until the SUDS was zero. That might have worked well too. But I wanted to follow her own lead and emphasize the importance of dealing with her feelings about herself and her own drinking.

I asked her to alternate phrases once more with:

"I'm afraid of being an alcoholic like my father" (negative phrase)

"I feel better when I'm not drinking" (positive phrase)

She started to do this, but broke off in the middle of this exercise exclaiming "I suddenly know I won't be like my father!" This was in the nature of an "Aha!" experience for her and she spontaneously substituted (for the positive phrase) the words: "I won't be an alcoholic!" instead of what I had suggested, repeating this loudly with great confidence. She had created her own "positive installation"!

At the end of this round she told me about the new understanding that she had just experienced. "My father would never have been sitting here talking to you about this." she said. "I'll never be an alcoholic."

We discussed briefly plans to limit her wine to every third evening, an idea which she suggested and which felt right to her. Then she said:

"I feel that this was the best hour of therapy I've every had in my life!"

Doris returned the following week to announce that she was now ready to finish therapy. She looked radiant and told me that she had experienced a remarkable sense of confidence ever since our last session. "I feel I was set free by it" she said. This triumph has held for her. The session was apparently a true breakthrough.

Would Doris have achieved this same degree of self-acceptance and self-understanding had she been allowed to flounder in her painful memories of her father during the previous session without being offered relief from them through the Tearless Trauma technique and the use of alternate reminder phrases? Would it, in other words, have been useful to have followed the "no pain, no gain" maxim and have assumed that re-experiencing the PAIN of the trauma was the best road to healing?

My opinion is that while we might have eventually come to some form of healing over a NUMBER of sessions had we remained only with the negative and not taken steps to remove the pain of the trauma, we would not have seen as rapid or dramatic an improvement as we did. Also, because we all seek to avoid pain, there is the possibility that Doris would simply have backed off from the issue and buried it once again somewhere within her had the treatment become too painful, rather than face it fully and get to the other side of it as she did.

This is an important question to consider. Perhaps some day someone will devise an experiment that can test these two possibilities. Until then, I think the best we can do is to honor our own clinical hunches. In this case, mine proved fruitful.

Pat Carrington