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Articles & Ideas


Dr. Patricia Carrington's use of "Choices" in the EFT Setup Phrase

Important Note: This article was written prior to 2010 and is now outdated. Please use my newest advancement, Optimal EFT. It is more efficient, more powerful and clearly explained in my free e-book, The Unseen Therapist™.  Best wishes, Gary

Hi Everyone,

Celebrities appear to have it all--money, fame, power and the ability to wave their hands and have the world bend to their every whim. That may be so, at least from an outsider's perspective, but their inner worlds are just as prone to frailties as yours and mine.

Dr. Patricia Carrington takes us on a unique tour inside a celebrity client of hers and develops not only several useful insights for us but also suggests a "choices" version of affirmations.

Hugs, Gary

By Dr. Patricia Carrington

Part I

Dear List,

Frequently, if a client has been cleared of a block by using EFT the problem may be gone forever, or only require a few "booster" tapping sessions at home before the treatment really 'takes'.

But what of the issues which, having been successfully tapped on, still need to be assimilated into a person's life pattern to have their greatest effect? The way a person has lived their life up until now - their self-image and habitual ways of being -- can work against even the most beneficial changes, and although they may not wipe out the gains made, they can make these gains less pervasive and influential. In this event we will not have gotten everything we could out of that stunning switch in perspective that can occur with EFT.

Here is where the use of "Choices" (a form of affirmation which I find more effective in many instances than the straight declarative form) comes in. I 've found that the "Choices" method can assist a client to consolidate and make permanent the beneficial changes brought about by EFT, thus helping these EFT-created changes to generalize to many aspects of the person's life. When that happens, we see true transformation.

Let me give you an example.

"Tara" came into therapy for help with intermittent depression and marital problems. She is an accomplished singer who grew up in a world of theatre people. Her mother played a regular bit part on a TV series, her father was a well-known TV director. Their friends were all show biz people.

An only child, Tara recalls that she was always dressed up in "adorable" clothes with an ever-different colored bow in her soft blonde curls. She would often recite Longfellow poems and do a little tap dance at age 3 to excited rounds of applause from their guests, which of course was the highest form of compliment from show people. At superficial glance one might conclude that she was "over-valued" since her every move was subjected to exaggerated attention (either praise or criticism), and her mother professed incredible pride and seemed to glory in her daughter's achievements, never missing a detail of one of her recitals. In fact, the mother seemed almost to have lived vicariously through her daughter, enjoying a triumph that she had never achieved in her own modest career.

When Tara came into therapy she acted as though she had "no identity" of her own, and this became a main focus for her treatment. In her year and a half of therapy we have made heavy use of EFT, with many sessions of tapping on her original family situation, on her fear of being more successful than her pretty actress mother, on her fear of failing to please her "highly directive" director father, and on the depression she feels today when she isn't getting what she considers enough attention (no applause in other words) from others.

During this time, Tara has changed remarkably. She now walks with dignity where before she seemed to flutter into a room. She now speaks more slowly and with a new sincerity and directness that make her come across as a "real person" to others for the first time. Her life in general, and her relationships have become much more real and very much richer. It often seems as though I am greeting a different person when she walks into the office.

Despite all these gains, however, she still had a residual sadness in her face, the look of a person gazing at some far away painful scene

When she came for a session recently, her sadness had come to the surface (which was good because now we could deal with it directly), and as we tapped on the sadness, it became evident that it was not due to anything in the present, nor was it about her being forced in childhood to uphold a facade for their guests -- none of that. In fact, it was not about attention per se -- rather it was about being in people's awareness, having them AWARE of her.

In the middle of this session, Tara's eyes lowered, and she became silent. Then she said in a low voice: "It's not about my worry about pleasing people anymore -- that's doesn't bother me the way it did. It's just that, attention or no attention, , and no matter how much she SAID she loved me, and no matter how much she boasted about me -- my mother wasn't really AWARE of ME." Her eyes welled up with tears as she spoke about this, and she explained that even when she had performed beautifully, and tap-danced and sung and recited the way her parents wanted her to, that she now realized that her mother never really saw the real "her".

"She saw the little puppet she'd created. She was so proud of that puppet, but she never saw ME...." She said. Here was a source of some of the deepest sadness within Tara -- and we were able, gently and with respect for the difficulty it was for her to articulate this, to dissipate this painful memory through quietly tapping on it:

"...even though Mommy never really saw me"...

"...even though Mommy didn't know I was there...",

"...even though her eyes didn't really look at me..."

As she tapped away, a quiet came over Tara, a peace I hadn't seen there before.

There was a new clarity in her eye as she said very slowly, "I never -- really -- realized this before. She saw the performer. She loved her. She never saw me. ... " . She then said that she had a peaceful feeling about this and that it was a tremendous relief to have faced it and been able to tap right on it, not on issues "around it". It was clear that this was a turning point for Tara.

I knew how fundamental the session had been and I wanted to help her consolidate her gain, to allow this insight and understanding to become a basis for her life from now on. To help this along, I suggested that we make a few "Choices" relating to what she had discovered. She was familiar with making Choices since we'd used them a number of times during her therapy. So she worked with me to create several to take home with her.

These choices evolved from a discussion which she and I then had about how we can "see" and respect ourselves even though someone as vital in our life as a parent may not have been truly aware of us as a child. Our discussion led to Tara realizing that her mother had not seen "her" (but only the little budding stage star) because the mother had never seen herself as real, but only as a would-be "star." None of this was because because she didn't love Tara. Love had nothing to do with it. It was her mother's sense of insignificance that was the factor operating here.

This was a time of deep understanding for Tara, a melting of a resentment she had carried around against her mother for years. She realized now that the two of them had both been caught in the same dilemma--that both had felt they were nonentities.

Several Choices (which Tara took home with her to work on) came out of this session, each dealing with a slightly different aspect of the problem and stating her preferred solution for it. These were worded as follows:

"I choose to know and love the 'real' me, even if Mommy couldn't."

"I choose to understand why Mommy could never 'see' me."

"I choose to feel close to Mommy because we both had the same problem."

And finally,

"I choose to allow my real self to be seen."

This was probably the most important choice of all for Tara because she had been terribly afraid to take this chance before.

She took home the little blue cards with her choices written on them (I'll explain the process in a moment) and has used them ever since. The feeling that she could "know my real self" has grown in her as a result of this to a point where she has been largely able to dispense with the fagade she had had all her life.

She is now an intentionally fine and studied performer on stage (in fact she claims to be an even better one now) but unlike before, she is now able to be a 'real' person off stage, one whom she genuinely likes and respects, as do many others. Her choices have strongly reinforced the insights she gained during the EFT process.

If you would like to make use of Choices to consolidate gains made with EFT, here is the procedure I use:

At the end of an EFT session, when we have cleared, or partly cleared, important emotional blocks, I will suggest that the client formulate, along with me, a meaningful choice or series of choices (the latter covers more than one aspect) relating to the issue they have just been tapping on.

I then write down each choice for them, using their exact words, on a 3" by 5" card (usually light blue colored), a separate card for each choice, and hand these to the client at the end of the session. This little ritual has the effect of serving as a symbolic gift from me and is almost always treated with respect and seriousness because of this.

I then instruct the client to read over their choices at home, out loud, twice a day (at a minimum) -- when first waking in the morning, and before going to sleep at night. They may carry the cards with them and read aloud the choices when they find themselves with spare moments during the day -- such as in the car waiting for a traffic light to change, etc. Many people do this and some have even recorded their choices and listened to them on tape as they drive.

I tell the client not to bother to think about what is on the card between times, rather to just read aloud each choice once and then let it slip out of their mind, to enter their "subconscious" mind, which will do the work FOR them. That is, in fact, exactly what happens.

After that, from time to time during therapy, I will inquire about how a particular choice is progressing (is it manifesting in their life? If so, how?) since I keep a record of their choices in the patient records.

The formulating of the choice (or affirmation) is in itself a part of the therapy, serving to clarify the positive goals of the client. I use choices regularly hand in hand with EFT to achieve profound therapeutic change. In a future posting I'll talk about why I prefer to use Choices rather than straight affirmations (in most cases) and how I formulate the wording of them so they will be at their most effective. I'll also tell how I apply Gary's strikingly effective way of using EFT to deal with emotional blocks to the choices or affirmations and thereby greatly increase the effectiveness of the affirmations (see Gary's article) This is the opposite in a sense from using choices to assist EFT. I have found the combination of choices (affirmations) and EFT to be a powerful one that can greatly increase our helping skills. I hope you will enjoy trying it!

With best wishes,

Pat Carrington

Hi Everyone,

Dr. Patricia Carrington had many positive responses to her recent message on Choices. Many of you asked her to say more on this subject and so Pat, as usual, graciously accepted.

Hugs, Gary

Part II

Dear List,

I'm continuing here with my discussion of Choices (a type of affirmation used to consolidate gains made in EFT) which I described in my previous post. As a reminder, a way of wording a "Choice" for a person with a fear of public speaking would be, "I choose to feel confident and at ease when speaking before groups". This is different from a traditional form of affirmation addressing the same issue which would be, "I am confident and at ease when speaking before groups." Both are productive ways of using affirmations, but they differ somewhat in their effects, and in my experience are different in terms of their likelihood of being accepted by the average client.

There are of course times when I find traditional affirmations to be more suitable with EFT or with other forms of therapy, I'll speak about this later, but for the most part I use Choices to help carry over the effects of an EFT session into a client's everyday life. I have found this extremely helpful in solidifying changes outside of treatment sessions.

Choices seem to be more acceptable to many people because the conventional affirmation, which asserts that something is "so" in present time (which another part of the same person perceives as NOT being so), tends to invite what Gary has referred to as "tail-enders" (unspoken thoughts and reservations about the affirmation which can rob it of its effectiveness). Of course this isn't the only reason or even the primary reason that people have tail-enders, but my thinking goes like this -- Why invite trouble? If we can make an affirmation more comfortable and inviting by casting it in the form of a Choice - why not do that?

Familiarity and positive associations play a big role here. Choices are not perceived as "far out" because we all make choices every day and "having a choice" in a situation versus "having no choice" is clearly preferable. This is important because when we use EFT we are asking the average person to do a pretty unorthodox thing-- tapping on acupoints. And I find it helpful not to stretch their acceptance of new and unusual things too far by following this with the suggestion that they use a traditional affirmation -- unless the person is very used to and comfortable with these.

The use of Choices has been a pillar of my practice for years now and has enabled me to help my clients bring about transformations in their lives, not just symptom alleviation. It has helped to make permanent some magnificent insights that have appeared in the course of EFT. I estimate that about 75% of my sessions with clients at the present time end up with us formulating some "Personal Choices" which the client then takes home and uses. This procedure facilitates our therapy work by a multiple I can only guess at.

Another advantage of this approach is that making a Choice puts the person in the "Driver's Seat" in their life. The person making a choice is exercising their will, deciding on and committing to a course of action. I have found that this freely entered into commitment can have a powerful influence on the desired result, often making it more likely to be obtained. It doesn't by-pass the ego of the person in the manner that the traditional affirmation does, but instead it engages the ego (or self) in the process. Since it also accepts the reality of the present state of affairs, this makes for a healthy juxtaposition of present reality and desired outcome -- creating a strong pull toward the latter.

One way of using Choices -- it's a way that can also be used with traditional affirmations, although I've seldom seen this done -- is that the "tail-enders", which almost always exist as Gary points out (see Gary's article), can often be handled by the wording of the Choice itself -- built into it so to speak

A client of mine, "Judy" provides an example of this. She wanted to move into a "beautiful, sunny, spacious apartment" but had not been able to get herself to do the things required to bring about such a move. Clearly there were hidden issues blocking her, and as we tapped on "Even though I'm afraid I'll never find that great apartment", her thoughts tuned to her older sister who was resentful about having to live in her own dingy walk-up. This sister had been jealous of Judy all their lives. Judy had been prettier and more popular from day one, but had always tried to please her sister whom she had looked up to greatly as a child.

As she tapped, Judy realized that her need for her sister's love was an important factor blocking her from going all out to obtain a new apartment, and so we turned to working on this aspect:

"Even though (sister's name) will be jealous of me if I get a great apartment...."

"Even though she won't love me if I get a great apartment..."

"Even though she'll be mad at me if I get a great apartment..." etc.,

We continued until Judy's SUDS level (her emotional intensity rating on a 0-10 scale) had come down to zero. She was now able to visualize herself going out and actively seeking the apartment, and finding it.

When we came to the end of this session we formulated a Choice for her to take home and work with (I describe this process in my former post). Since the need for a family member's love is likely to have many aspects to it, some of which we had not handled as yet, I wanted to facilitate her dealing with this issue outside of therapy and so suggested that she build into her Choice a phrase that would address the potential tail-ender. The wording we settled on for her Choice was:

"I choose to feel loved while living in a beautiful, spacious, sunny apartment."

Notice that I didn't suggest she say "I choose to have my sister love me while,..etc.". We can't choose for another person how they should feel or act or be -- only for ourselves. So instead I suggested she formulate the Choice so that she would have a subjective feeling of being loved as she lived in that apartment. We can choose to have any feeling that we want.

This simultaneously addressed her wish for a lovely apartment and the tail-ender at the same time. While we had to do some more tapping on other aspects of this issue in the next therapy session, Judy was actively looking for apartments and getting the word out among friends by the time she arrived for her session. Within three weeks she had found a 'beautiful, sunny, spacious apartment' which she moved into confidently.

Of course, people sometimes find a choice such as "feeeling loved" very difficult to make. If so, then we can use EFT to deal with that issue. After removing some of the blocks, we can then help them formulate some additional all-encompassing choices such as: "I choose to feel lovable." or "I choose to feel loved.", or address deservedness issues through a Choice.

An occasional person may experience the Choice phraseology as setting the goal off in the future and therefore as less compelling than the direct traditional form of affirmation. I have rarely found this to be the case, however. My experience has been that the "subconscious" does not interpret the wording of a Choice in this manner. I can't count the number of times a Choice made by a client, or one of my friends, or me, has been realized -- whether two hours from the moment they conceived of the choice, or three weeks from the date it was first used daily, or a year, or whenever.

Much of what I've been saying about the use of affirmations with EFT applies in most cases to all affirmations, be they couched as Choices or as direct reframes of present reality as in traditional affirmations. I find that the traditional forms of affirmation can be superbly effective in certain therapeutic contexts and the method of choice for them. For example, when I use Gary's Advanced EFT intuiting technique (where he suggests progressive changes in phrasing to deal with core issues while the client taps the karate chop point) I have found that by using direct statements and affirmations, with no "frills" or anything else to impede the process, I can go right to the heart of the matter and join with the client in a deep and complete sense. It would be inappropriate to water down these powerful statements in any way.

Also, there are some global issues that seem to cry out for a direct statement -- they seem to be beyond choice. For example, a client of mine had been struggling with an issue of individuation -- she constantly saw herself through her mother's eyes ("What would Mom think about this?"). After she had dealt with some of the issues around her mother in therapy, she made this Choice to help her progress-- it followed from an insight that had come to her during tapping:

"The real me is known only to me and God."

It would have been inappropriate to have formulated this as a Choice as in, "I CHOOSE to have the real me known only to me and God." This client's belief system fully supported the affirmation she had made and to artificially introduce an act of choice here could have watered down the impact of the affirmation. In fact, her affirmation turned out to be extremely helpful for this young woman, reminding her repeatedly as she worked with it at home of her existence apart from her mother, in a very positive way.

It is a clinical judgment whether or not to suggest a Choice or a traditional affirmation in a given instance. While I've found that Choices are preferred most of the time, the direct reframe used in a traditional affirmation, where appropriate, can have a powerful impact often not obtainable by a Choice. I encourage you to try both approaches, and to use affirmations (whichever form) freely and creatively in your work with EFT.

With best wishes, Pat

Patricia Carrington, Ph.D.

Hi Everyone,

Dr. Patricia Carrington received substantial interest from advanced readers of this list regarding her "Choices" method for adjusting the EFT Set-Up Phrase. Accordingly, she has expanded on the idea with a third article.

Hugs, Gary

Part III

Dear List,

Never underestimate the power of the Internet -- or, for that matter, of this List! What I'm going to share with you today is a discovery that came about as a result of my posts here concerning the use of "Choices" with EFT. (Choices are affirmations which differ from the traditional ones in that the statement of desired outcome is preceded by the words, "I choose to..." instead of by a simple declarative phrase such as "I am, I have").

Several subscribers to this List wrote to thank me for suggesting that they introduce Choices into the EFT Set-Up phrase. The universe works in strange ways -- actually I had not suggested that particular use, but here were people applying it with intriguing results. Also, Christine Sutherland (Director of the Meridian Therapies List), who had not thought that I suggested it but had thought it a natural thing to try, wrote me about several successes she has had using Choices in this way. Clearly this new use for Choices was "out there in the air" for people to pick up on.

This "serendipitous" happening struck me as possibly an important lead in disguise, so I set out to investigate the use of Choices in the set-up phrase by trying this out on myself first, something I regularly do when exploring a new possibility. I was immediately impressed by its effects on me and, when I used it with my clients, I obtained similar positive results. Accordingly, I have combined the new "Choice Set-Up" with my Alternate Phrase technique, refined this approach, and mapped out guidelines for its use. I think it may be of use to us all.

In the "Choice Set-Up," you replace the self-acceptance affirmation used at the end of the EFT set-up phrase by a Choice addressing the problem at hand. The reminder phrase that follows can take several forms. Which one is selected in a particular instance is determined by the judgment of the therapist and the preferences of the client. The reminder phrase can be:

(1) Just the negative portion of the set-up phrase (the "even though" part, without the "even though"). I find this to be the best approach when a person is so overwhelmed by a negative emotion that they simply cannot contemplate anything positive at that point.

(2) Both the negative portion AND the positive portion of the set-up phrase, used with in alternate rounds of the treatment. In this method the negative portion of the set-up phrase is used throughout the first round, and the positive portion (the Choice) is used throughout the second round. The two rounds are in a sense coupled and constitute a single "treatment" sequence. If more work needs to be done, then the alternating rounds (a negative round followed by a positive round) is repeated as many times as necessary. This sequencing links up a negative cognition with a positive one, something I will talk about in a minute.

(3) Just the positive portion of the set-up phrase (that is, the Choice itself). I find this to be particularly useful when the person has already cleared out enough of their negative feelings so that they can now contemplate the positive in full force. I often use it to wind up the tapping series

Will the Choice Set-Up ever replace the valuable self-acceptance phrase which has been the mainstay of our EFT practice? Actually I do not think we need to or should choose between the two. Both approaches seem to be useful in their own right, and each can be the preferred method under certain circumstances. In a later post, I will discuss when I am finding one or the other to be more useful for a particular purpose.

To give you an idea of how the Choice Set-Up works out in practice, here is how one of my clients, "Brian", used it recently. Brian was driving to an interview which was very important to him when he found himself caught in a traffic jam and realized that he was now going to be late for this appointment. Being an experienced EFTer, he decided to do some tapping on himself. Ordinarily he would have used the standard EFT Set-Up phrase, which might have gone, " Even though I feel furious and anxious about the delay, I deeply and completely accept myself." As we all know, this might well have reduced his distress. However, he decided to try the Choice Set-Up he learned from me earlier in the week, and tells me that its effect on him seems to have been even more positive than when he used the standard set-up phrase in the past.

In the Choice Set-Up, the person is to come up with a Choice which is the direct opposite of their unwanted state, in a sense an antidote to it. So Brian picked, "Even though I feel furious and anxious, I choose to have this unexpected delay work to my advantage." Of course he could just as easily have said, "I choose to be calm and confident when I walk in for the interview" or made some other Choice which could have counteracted the problem he was experiencing. The only rule he had to follow was that it would have had to be a targeted statement aimed at the specific challenge he was facing, rather than a general self-acceptance statement.

He used as his reminder phrase, "I feel furious and anxious about the delay," which was the negative portion of his set-up phrase. After tapping on this for several rounds, his SUDS level (rating of distress on a 0-10 point scale) was now almost down to a zero (the familiar EFT success story) and he felt relaxed and philosophical about his problem. However, the full effectiveness of this approach was yet to be seen. After a few more minutes of waiting, the police loudspeakers announced that all traffic was being re-routed through another town. Because this rather long detour meant adding 20 to 30 minutes to his trip, Brian was jolted out of his relaxed state. In his words his stomach "tightened as though in a vise".

What happened next is what is of special interest here. Immediately following this initial negative reaction, Brian seemed to hear the faint and muffled words in his mind. This optimistic thought seemed to pull him out of the negative state and he found himself thinking instead about how he could tell his interviewers on the cell phone about this delay in such a way that he would come across as wonderfully cool under trying circumstances, something that could only serve him well in the eventual interview.

As he drove on, he used the time to plan out how he would condense his presentation when he did arrive so that the interviewers would be impressed with his on-the-spot resourcefulness. Actually, he was so pleased with the way he was able to map this out that he entered the interview with a confidence that apparently did impress them, for he was approved for the transfer to another division of his company (which was the reason he had sought this interview).

This positive shift in attitude after using the Choice Set-Up seems to be typical of many people. Although I or others may not recall the actual words of our Choices when confronted by a later challenge as Brian did, we often find ourselves experiencing our chosen positive state when our original negative state (the "negative cognition") is set-off again by some new challenge.

But WHY should this happen? What mechanism could be at work here? This is an important question. My hunch is that the Choice Set-Up establishes a strong "link" (in psychological terms a "conditioned response") between the person's negative cognition (the "Even though...." phrase) and his or her positive cognition (the "I choose...." phrase). This link, I think, is created at a very deep level because of the highly suggestible state brought about by the tapping. EFT provides a superb condition for creating positive cognitions and deepening insights, as witness the effectiveness of Gary's Advanced EFT Techniques where the client is open to deeper and deeper insights and self-confrontations as the tapping proceeds.

Once a link is formed between a person's negative cognition and their positive Choice, the negative cognition now becomes a trigger that automatically evokes the positive Choice each time it is activated. For those familiar with Neurolinguistic Programming (NLP), the negative cognition has now become an "anchor" for that person's positive Choice, automatically calling it forth. If we think about it, what could possibly be better?

Such a process would have important implications for our lives because in most problematic situations, a negative reaction (thoughts of doom, of being trapped, of one's stomach ache, etc.) tend to occur not just once, but repeatedly. In the case of an adverse physical condition, for example, thoughts about it can occur hundreds of times in a single day as the annoying condition (such as a running nose or sore throat) intrudes itself repeatedly on our consciousness Each time it does, the positive Choice in our set-up and reminder phrases will be triggered in our minds. Do you know what repetition does to ensure that something "takes" in our psyche's? Everything!! It is an invaluable aid to change.

I find that a switch from a negative to a positive attitude tends to occur when using a Choice Set-Up (that is more specific to the problem at hand) than when we use the standard self-acceptance phrase-- except, as I said, under those circumstances which seem to respond more readily to the self-acceptance phrase (as I promised, I will address these in a future post).

I now find myself using the Choice Set-Up in EFT rather than the standard self-acceptance phrase about 90-95% of the time with myself, and about 80% of the time with my clients, probably because my extensive experience with Choices allows me to handle them more easily than others may at first. In a future post I will talk about the rules that govern effective Choice making, but since many of these are similar to the guidelines which govern effective affirmation-creating in general, you may want to review Gary's excellent discussion of these in The Palace of Possibilities (see Gary's article).

With warmest wishes,


Patricia Carrington, Ph.D.

Hi Everyone,

Dr. Patricia Carrington continues her popular series on using "Choices" within the EFT procedures. This time she gives us a two part article that displays in great detail her application of this method for a client. Please note her introduction of the "Choice Trio" and her proficient use of Dr. Carol Look's weight loss protocol.

Hugs, Gary

Part IV

Dear List,

I am becoming increasingly impressed with the potential of EFT to foster goal-directed inner growth AS WELL AS (note emphasis here!) its undeniably wonderful ability to alleviate distress. For this reason I have been looking for ways to use positive "Choices" in EFT to formulate more specific and purposeful goals for people using it. I find that healing is promoted if we have fulfillment, joy and a sense of meaning, and Choices can be used effectively to foster these attitudes.

Along these lines I'd like to share with you some recent observations I have made about the Choice process as it has been working for my client "Joan", whose story illustrates both the stress-reduction AND the personal fulfillment potentials of EFT.

Joan, has been in therapy for over a year. She originally consulted me for a weight problem coupled with a pervasive low-grade depression. Until recently, however, she has made only modest progress in her therapy despite the fact that we have used EFT extensively. We addressed some deeply troubling issues such as (1) her deep shame and hatred of her body and (2) various aspects of her father's verbal abuse of her as a child (for example, when he would refer to her, while driving, as "that fat pig in the back seat" in front of other children and her family). While there had been some useful clearing of the emotional pain around that and other incidents, the fact was that Joan was not getting significantly better.

This troubled me, and finally I reluctantly suggested that she might need to see a physician for some form of anti-depressant medication to assist her therapy along. This was because her depression was the kind that so often accompanies overweight problems (whereby food is used as a means of self-medication, helping her to avoid depression). Joan refused my suggestion to seek medication, however, stating that she wanted to handle it on her own.

Joan is a tall, heavy-boned young woman with a pretty face half hidden by cascades of almost jet black wavy hair. She is intelligent and perceptive but there is a sadness about her, and her speech is often interrupted by sighs. She has had a lifelong struggle with overweight and has worked with one support group and diet system after another in an effort to cope with it. Although she is not grossly obese, she is distinctly too heavy for her own health and her potential attractiveness is obscured by the overweight.

Little by little Joan and I have made inroads in her sense of failure and self-belittlement -- tap, tap, tap -- but often treating her has seemed as though we were managing to lift up her spirits by the end of one session, only to have her return for her next appointment with sadness and hopelessness in her eyes again. It felt as though we were trying to lift a heavy bag of sand while one side of it kept sagging back down again.

Recently, however, this discouraging situation has dramatically shifted and Joan is now making major gains in her therapy. This came about after two new ingredients were introduced into our work together. I began to use Carol Look's Weight Loss Program with Joan and I combined this approach with the use of strategic Choices in EFT designed to counteract each of the core problems that Carol identifies in her program.

This has enabled Joan to uncover a number of core issues that she had not identified before. At each session, we go through Carol's list of possible EFT phrases one by one (a few at each session), with Joan identifying those that seem to hit the spot, as well as those that appear irrelevant to her and don't "ring a bell". When we uncover a compelling issue we address it by making a custom-designed (that is, just for Joan) Choice which can counteract it.

It often takes some time for Joan and myself working together to formulate just the right positive Choice for each issue, but we have found that the time we spend honing in on the most appropriate Choices is well spent. When we hit on the phrase that is the exact opposite of the negative ( "even though ..." ) statement, it can be startlingly effective

Formulating the Choice that fits the bill takes some work on our parts because Joan, like most of us, does not always find it easy to think up a Choice about a new way of being that will represent true healing of her problem rather than be a superficial "band aid" kind of change. Most people have a very limited idea of what is possible for them and what is most desirable in the long run. Here is where another person's viewpoint, such as that of a therapist, can be extremely valuable.

Following this procedure we have hit on what Joan has referred to as "real eye-openers", possibilities for new ways of being that she has not thought about before but which have turned out to be deeply healing for her. I will give some examples of this process later. But first let me share with you the protocol which I am using for the EFT Choice technique. I call it the "Choice Trio". It is turning out to be the most effective way of using the Choice method that I have yet worked with. Here is how it goes:

First take the initial SUDS rating (a measure of distress on a 0 to 10 point scale) then proceed with the following steps:

1) Identify the negative cognition (attitude) the person wants to be rid of (the same procedure as in standard EFT).

2) Next, formulate a Choice which is the exact opposite of this negative cognition For example: "I choose to feel wonderfully at ease when speaking in front of groups." would be an appropriate Choice if the negative cognition were "Even though I'm afraid of public speaking"., etc.

3) Now combine the negative cognition with the positive Choice (which is the desired outcome) to form the set-up phrase. For example,. "Even though I'm afraid of public speaking, I choose to feel wonderfully at ease when speaking in front of groups".

4) Use the standard EFT protocol of rubbing the sore spot (or tapping the Karate chop spot) three times while repeating the set-up phrase.

Follow this by the "Choice Trio" as follows:

5) Do ONE round of EFT using the negative cognition ONLY as the reminder phrase. For example, "I'm afraid of public speaking" repeated at each acupoint in the standard EFT protocol.

6) Follow this immediately (without checking SUDS or doing another set-up) by ONE round using the Choice statement ONLY as the reminder phrase. For example, "I choose to feel wonderfully at ease when speaking in front of groups.", repeated at each acupoint in the standard EFT sequence.

7) Follow this immediately (without checking Suds or doing another set-up) by ONE round using the Alternate Phrase Technique. This works as follows: At the first acupoint (Inner Eyebrow) use the negative cognition as the reminder phrase, at the next (Outer Eye) acupoint use the positive Choice as the reminder phrase, at the next (Under Eye) acupoint again use the negative cognition as the reminder phrase etc. Continue until you end at the karate chop point which allows the person to end the sequence with a positive Choice, an important factor as I will explain later. If you end the sequence at the under arm spot, the person ends up making a negative statement, an undesirable condition-- however if the EFT shortcut sequence is used just add another point at the end. For example, the person can jump from underarm spot to karate chop spot, in order for the sequence to end up with a positive Choice.

8) Retake the SUDS rating and if more work is needed, repeat the Trio (points 5, 6 and 7 above) as many times as necessary. In effect, the Trio serves as an extended "round".

This constitutes the Choice Trio. It can of course be varied according to the needs of the person. For example, if they are still too upset to contemplate using a positive Choice statement as a reminder phrase, then step 1 of the Trio (just using the negative cognition) should be repeated for several consecutive rounds until some of the charge has been taken off of it and the person is ready to proceed to the next step

I find many advantages to using the Choice Set-Up in this manner. For one thing, the initial negative round (or rounds) serve to remove the negative charge from the problem as in standard EFT, and I find that this negative charge must be removed first before any positive installation can be fully effective.

The complete round which uses only the positive Choice, (when the person is ready for it, that is) can have a profoundly stabilizing effect very early in the treatment, often serving to de-traumatize the person almost instantly concerning the problem at hand. In my observation, it serves a "rescue" function just as the Tearless Trauma Technique does because by using it the person does not have to drown in the emotional pain of the event. This fact is deeply appreciated and can make cooperation with the treatment much easier.

I find it is most important to begin with the negative reminder phrase first-- whether this occurs through the whole round of the negative Choice (Step 1 of the Trio) followed by a whole round of the Choice (Step 2 of the Trio), or if we alternate negative and positive cognitions (Step 3 of the Trio). The reason order is so important here is that one of the most essential aspects of the Choice method is to have negative cognitions (thoughts/attitudes) followed by awareness of their positive desired outcomes. This results in direct LINKING of the negative with the positive -- what NLP used to call "chaining". This is a simple and powerful device. Using it, a negative thought can become an "anchor" (NLP term for a "trigger") for a positive thought, so that in the future every time this person thinks of this negative possibility, the positive thought is likely to pop into their mind right afterwards.

An example of this is the case of a colleague of mine who recently contracted a bad cold two days before she was to leave for Mexico on a very important trip. She had been tapping for the cold to no avail, but when on my suggestion she formulated the set-up phrase, "Even though I have this terrible cold, I choose to be comfortable and healthy on my flight to Mexico." (and followed this by the appropriate reminder phrases and the Trio) she felt better, and by the next day had no cold symptoms AND she had a "comfortable and healthy" trip to Mexico.

What is particularly interesting though is that for the first day after the EFT treatment, whenever she found herself blowing her nose and thinking "I have this terrible cold!" thoughts of a comfortable and healthy trip to Mexico seemed to jump into her mind. This suggests that the negative cognition had begun to trigger a positive one. I believe this may be the main reason why the Choice Set-up, or any variation of it such as discussed by Mair Llewellyn-Edwards in a recent post, works so well.

How we used the Choice Trio to handle Joan's problem of depression and overweight I will discuss in my next post.

With warmest wishes,

Pat Carrington

Part IV

Dear List,

In this post I'm continuing my report on "Joan", my client who has struggled with an underlying depression, sense of hopelessness and overweight for many years.

As Joan was giving her reactions to the set-up phrases suggested in Carol Look's program, the first one that struck her as possibly applying to her situation was "Even though I feel hurt about being abandoned..." She explained that although she didn't exactly feel "abandoned", having been an "army brat" as a child had made her constantly lose contact with friends important to her. Her family had moved from one army post to another during her childhood and sometimes she had had to attend two different schools, each far distant from each other, within one year. Any friends she made had been fleeting, expendable and impermanent. Food, however, had always been there for her -- a constant, predictable and dependable thing. The statement that Joan came up with for the negative portion of her set-up phrase was:

"Even though I don't want to let go of my only dependable friend, food..."

We then searched for a positive Choice to counteract her feeling of loss of a friend if she didn't have the food she wanted. This took some work because Joan could not at first think of any phrase without the word "not" in it, and a negative Choice is not a good one. My first suggestion for a Choice for her didn't land -- it just didn't feel right to Joan -- but then she came up with the following Choice which felt very meaningful to her. It was:

"I choose to have serenity and peace within myself, no matter what."

She used this statement in what I call the "Choice Trio". As outlined in my previous post, this consists of the Choice Set-Up followed by three consecutive rounds of EFT conducted in the following way:

1. Choice Set-Up (including the negative statement, "even though", and the positive statement (Choice) -- all in one sentence.

2. One complete round of EFT using the negative statement ONLY as a reminder phrase. In this round Joan repeated "I don't want to let go of my only dependable friend, food..." while tapping at each acupoint.

3. One round using the positive statement (the Choice) ONLY as the reminder phrase, in this round Joan repeated "I choose to have serenity and peace no matter what" while tapping at each acupoint.

4. One final round using the negative statement on the first acupoint, the positive one on the next acupoint, the negative on the following acupoint etc., and alternating in this fashion for the entire round.

This strategy had an immediate positive impact on Joan who spontaneously commented, "That was very calming to me. Thinking of the lack of dependability of people in my life, it felt so good to have that choice."

Then, as happens when things start flowing in a session, she brought up another topic.

She had not been able to stick to a "Shake" diet called Metafast which she had been using successfully for over a year. It substitutes shakes for much of her food, and this had seemed to be effective and healthy for her, and much easier for her to follow than a regular diet. But now something seemed missing without the more fattening food.

To work on this issue she chose as her negative statement: "Even though I haven't been able to stick to Metafast".

The next task was to come up with a positive Choice. What could directly contradict, and potentially solve this problem for her?

After careful thought, she formulated a simple, almost obvious type of Choice, "I choose to stick with Metafast and feel comforted." It's not too often that one has to resort to such a direct opposite statement for the Choice, but when it's appropriate it can be extremely effective, even when first saying it may sound absurd to the person. But remember that the EFT default self-acceptance statement, "I deeply and profoundly accept myself", can also sound absurd to some people at first, but as it is repeated it can come to have deep meaning.

Joan decided on the set-up phrase, "Even though I haven't been able to stick with Metafast, I choose to stick with Metafast and feel comforted." To measure where she stood with it, I suggested that she use a Truth rating instead of the SUDS Distress rating, also on a 10 point scale with the highest score perceived as absolutely True and the lowest (zero) as absolutely False (this procedure is derived from a somewhat similar one used in EMDR with a 7 point scale). When asked how true the positive statement (her Choice) seemed to her, Joan had only a "1" before she started tapping because it barely seemed possible to her that she could stick with the Metafast. After doing the trio, however, her confidence in the truth of that statement had risen to an 8, and she looked brighter and there was more color in her face.

She still had some concern about the fact that she had recently been "slipping" with her diet, so we addressed this directly in the next trio. Her next set-up phrase was: "Even though I've been slipping with the Metafast, I choose to stick with the Metafast and feel comforted". One more round of the trio and the positive statement was now completely believable to her -- a 10 on the "truth" scale -- and our session ended.

However, we were by no means finished with our exploration of the core issues that underlay her compulsive overeating. Although Joan returned for her next session with her spirits unusually high and was very encouraged about the progress she was making and above all about an inner feeling of optimism and well being she is now experiencing, she located another issue involving her weight problem.

"If I didn't have my weight to obsess about I'd feel bored. I'm afraid of that." she said.

We needed a Choice which could counteract boredom and together we came up with one which seemed right to her -- it was, "I Choose to find it (the lack of her usual comfort from food) an exciting opportunity to try new things", and so she used the following set-up phrase -- "Even though I would be bored if I didn't have food to obsess about, I choose to find it an exciting opportunity to try new things."

Initially this positive statement was very low on the scale of believability for her, only a 2 or 3 rating for its "truth", but after doing the trio, it felt so true to her that its truth score had risen to an 8 or 9.

"It felt so good to put those two things together, the boredom and the excitement." She said. "I got good energy from doing that. I got a feeling like 'What could I do instead that would be exciting? I think I actually might think of some exciting things!"

But right after saying this she was stopped again with the thought -- "But not eating all the time would leave a gap in my life! I think I'm afraid of that gap!" This is what we so often see with a core issue, it may seem gone at first but it really isn't yet because we've dealt with only one aspect of it. A lifelong issue tends to have many, many aspects.

We turned now to her fear of what she referred to as "the gap" that could occur in her life if she stopped over-eating. The sentence which she decided on was:

"Even though I'm afraid of the gap that might occur if I stop all that eating, I choose to have a sense of wonder and joy about life." She even smiled as she said this.

After tapping on it until those good feelings seemed "real" to her, she tried another related phrase to address some uncertainty that still lingered about thinking of things to fill the gap. Her next phrase was:

"Even though I'm uncertain about what to do about filling that gap, I choose to have a sense of wonder and joy about life.", and so on -- tap, tap, tap.

Finally Joan heaved a sigh of relief. She was now down to a 2 on the SUDS (10 point distress level), whereas she had started with a SUDS of 9 when she had thought about the gap.

As usual, I handed Joan her Choice Set-Up statements written out on 3" x 5" cards to take home and read aloud to herself twice a day, morning and night, a method I find very effective in reinforcing the impact of EFT, and she left encouraged.

Since then Joan and I have been systematically working our way through the Weight Loss Program and she has been tapping on new and liberating Choices in her sessions. She now finds herself more diligent about her diet, less fanatic and considerably less self-punishing, and she no longer finds she needs Metafast, a more moderate approach seems to be working better for her. Her weight loss support group finds her new attitude extremely positive and so do I.

But what I find even more important than her improved dieting is the fact that Joan now comes into her therapy sessions with a smile on her face. She is positive and hopeful about her life, not just about the weight loss. This indicates to me that we are making headway where it really counts. Joan's self image is changing with the EFT, and her sense of being worthwhile and able to help herself out of the emotional morass she had been in has been greatly increased. While she is not one of those clients who tend to use EFT on their own -- some do this readily and productively and others do not -- she is nevertheless able to use it superbly in her sessions, and it is exciting to watch what she is doing with it. I have an extremely good feeling about the eventual outcome of her treatment.

With warmest wishes,

Pat Carrington


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