By David Lake, MD

PART 1

Here is a simple method of beginning treatment for many conditions - especially the "difficult ones". It follows the work of Milton Erickson by "pacing" the experience of the client with a problem, and so meeting them in their view of the world; the techniques of Buddhist awareness, and the Focusing work of Eugene Gendlin (I am also indebted to David Hall of Sydney, a mind-body practitioner, for his useful suggestions). It prepares the way for real rapport with both the client and their problem. It paves the way for acceptance of the reality of the problem, and reality testing, which is often the missing link for sufferers when progress is blocked. And it can produce surprising results.

The basic principle is to pay attention to and work with what's there instead of changing it. If you try to change it, it often comes back. The solution is in the symptom, so be present to it. In essence you accept that the problem is there before anything else is changed. Then you simply add "continual tapping" into the problem pattern. Steve Wells and I have come to call this simple process "Acceptance Tapping".

In paradoxical therapeutic techniques it is common to prescribe the symptom as a means of changing the problem. In Acceptance Tapping, you work with the problem using meridian stimulation simply as an added pattern to the way the problem presents. I have taught continual tapping of any useful points (either the seven point shortcut EFT sequence, or the hand points) for the treatment of compulsive disorders and bulimia, for example. It can work with all common behaviors that we don't feel in control of. Any time you tap while the negative feelings are intense it can be disproportionately helpful.

This process can be taught simply and quickly and clients typically comply, gaining the relaxation of E.F.T. if nothing else. Paradoxically though, I have found that if you make direct suggestions to the client about change in the beginning, these usually fail. Possibly they are too difficult to achieve logically and rationally. In this variation you tend to sidestep the thinking mind and just tap.

For example, a young woman with a compulsive disorder, who was unable to leave her house in under an hour because of her extensive (life-long) compulsive, anxious routine of 'checking' every lock, window and appliance (then re-checking!), used continual tapping while she did her usual checking during the week. Note that she was not instructed to stop doing anything, merely to add in the tapping routine that I taught her. I only showed her a simple tapping variation (using her finger and hand points one-handed, using the thumb to tap on the other fingers where possible)

She found that she was much calmer generally; and that the tapping somehow interrupted her obsessive thinking to a degree, but most significantly she was able to leave the house after some 20 minutes at the end of that week. Her re-checking stopped too. This change was effortless for her and quite surprising. She has maintained these changes by using the technique a lot, and now leaves the house in 5 minutes.

In the difficult condition of bulimia, just tapping throughout the cycle of bingeing and vomiting as a new positive 'habit' can bring significant changes in the feelings around having to vomit, and focus the awareness of the client in a new way. Importantly it is a technique which can be introduced as an 'experiment' to 'see what happens' and which is a neutral, non-judgmental agreement between the helper and the sufferer. The client's usual self-criticism, judgment and self-punishment often abate a lot as well during the experiment.

When I did apply this idea to 'bulimic behavior' I found that clients could talk about their habit with much less of their usual shame. One girl, while tapping, was able to 'observe herself' getting ready for a vomiting episode, and found that she could think about doing that, and not doing that (before tapping the habit was unstoppable) although she did actually do it at that time. The difference now involved being able to think more clearly. Her 'triggers' for the frustration and anxiety were still there-mainly about feeling 'fat'-but now she could begin to see both sides of the issue more calmly: the reality (I weigh 60 kilos), and the hallucination ('I am fat').

This simple technique works equally well in mental rehearsal of a positive behavior, where presumably unconscious blocking beliefs might be an issue.

In many such situations I have found that the addition of tapping does change the routine behaviours of the problem significantly-and that kind of change is a sign we want in the beginning. It's a way of getting the client's attention in a new way, and of working creatively with the most intense part of the behavior while deciding on the best intervention, and the next part of the individual treatment.

Dr David Lake

PART 2: REPORT OF A SUCCESSFUL OBSESSIVE COMPULSIVE DISORDER TREATMENT USING ACCEPTANCE TAPPING

"Diane" was a young woman of 30 who came to see me because she wanted to become pregnant-but not while taking prescribed antidepressants. She thus wanted to be drug-free and cope with her Obsessive Compulsive Disorder (OCD) with other methods. She had been taking medication for a decade, and had never been able to relinquish it before, because of severe anxieties, and was under the care of a treating psychiatrist. She had good support and was highly motivated. I asked her to see her therapist for the relational aspects of the reassurance she needed from time to time while I attended to teaching her E.F.T.

I considered her request a tall order because of the severity of the condition, my limited success with severe OCD using E.F.T. and the potential complications for her. Nevertheless I thought that teaching, and her using, meridian stimulation would be worthwhile. I did not know whether Diane would be able to cease medication at all-and I told her this. I notified her psychiatrist that I was teaching her a relaxation and stress-management technique, that possibly could provide more in some cases.

Her symptoms included severe compulsive 'checking' of details about the house when going out, and re-checking in most instances as she 'forgot' whether she had really been certain of a detail. The process might take an hour. She also suffered panic attacks and generalised anxiety. She had recently developed a fear of flying and was due to fly shortly. I told her that we would make an experiment using E.F.T. and see how much benefit it returned to her.

Initially I taught her the variation of meridian stimulation I call "continual tapping" with good results. She noticed a great lessening of the compulsive urge and was particularly pleased to know a self-help technique. After a week, we began to explore her limiting beliefs about her OCD using formal E.F.T. and also using the provocative style that Steve Wells and I have found brings great focus and leverage to a problem. Some of her greatest fears were that she would never get over this and that she would have it for ever, that there was nothing she could do about it, and that it could get worse. Sometimes the fear during an anxiety attack was 'paralysing' and 'terrifying'; her ultimate fear was that 'I can't be reassured'. There were several such intense panic incidents that needed a lot of work to desensitise with tapping, using Gary's excellent "Tell The Story" technique.

Diane continued her practice at home mainly using continual tapping for convenience. She used the tapping I taught her more often and more effectively than anyone I can remember.

At the end of the third session she told me that she had ceased her medication since she felt so well using E.F.T.! I was alarmed, since these medications should be ceased gradually, but because she seemed well we pressed on. She also told me that her fear had once returned but it was manageable. She was scared but the fear did subside with the tapping after half an hour. This was a revelation to her and to me. Her fear of flying was '95% gone' because of E.F.T. treatment when she did fly around this time.

On another occasion about six weeks into our treatment, she had a panic and anxiety attack lasting many hours, which did not respond so well to E.F.T. This was a setback to her; nevertheless we continued the experiment. There was another episode like this a few weeks later.

Diane remained in control of her symptoms thereafter, using E.F.T., and had what I would call ordinary anxieties about becoming pregnant and being a good mother. Her confidence increased and she functioned with a better balance, more accepting and less self-critical. Her old checking habits and anxieties were still there in a minor way, but did not interfere with her life. We had some 3 months of E.F.T. over 6 sessions, and she became pregnant about 6 months later. During the later stage of her pregnancy she did come to see me about an anxiety she 'couldn't shake', related to whether her worrying would harm the baby, and if the baby was in fact alright. We dealt with the new fears in the same way as all her original fears and presenting worries - a lot of continual tapping and traditional E.F.T. on every specific aspect we could think of. There was also the fear of the 'unknown', of looking after a dependent baby, and whether she would cope with the responsibilities.

Considering how universal these fears are in mothers-to-be, I was struck by how 'normal' their degree was for Diane. She did not lose control and she did face up to the reality very well, learning more coping skills and just understanding how other people cope too. I don't think she will need medication in the future if she keeps up the effects of this good work.

Her progress from the beginning was very surprising to me. I have not had this kind of rapid success before in such a severe case of OCD, and with relatively few sessions. Because E.F.T. must have had a lot to do with her new balance, the practice of continual tapping at home and while 'in trouble' or while doing one of the compulsive rituals ("Acceptance Tapping") would have contributed many hours of help. As a variation of E.F.T. it could not be more simple. Diane certainly found it so. I think her main block was 'the fear of the fear' and a degree of helplessness when feeling anxious. E.F.T. has eliminated most of this block. I found that she could hold on to reassurance as well as most, despite everything.

Dr David Lake

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