Eft3: The Tutorial - March 2012 by Marc Muret

eft3

Eft3: a dissociative EFT technique / a tutorial by Marc Muret MD, Zurich 2012

Warning: this tutorial is a condensed introduction to EFT and EFT dissociative variations (mainly eft3). I wrote it for my patients and my students. I urge any reader to use these techniques only under the supervision of a qualified therapist. I do not assume any responsibility for how the reader chooses to apply the techniques herein.

ÂŠ Marc Muret, MD - Zurich, Switzerland - March 2012

Content 04 Introduction 05 How did it start Part II: Dissociative techniques 34 Dissociation vs. association 36 Association 38 Dissociation 40 Dissociative vs. associative techniques 42 Dissociative formes of EFT 46 Non-ego-states

Part I: EFT in first-person 10 EFT in short 12 Where to tap? 13 EFT protocol 14 What is the problem? 15 Tell the story! 16 The aspects 18 Sensations 20 Emotions 21 Thoughts 23 Actions 24 Check the stress 25 Name it! 26 Psychological Reversal 27 Setup: positive affirmation 28 Mini-resource + provocative therapy 29 The sequence or the round 30 Next step 31 Treating the trauma

Part III: Eft3, a dissociative technique of EFT 50 A theory of eft3 51 Eft3 protocol 54 Affect Bridge 55 Resource work 56 Transpersonal integration 57 Recommendations

Introduction Eft3 is the most dissociative technique of EFT What is EFT? Emotional Freedom Techniques, or EFT, is a self-help healing system, based on kinesiology (acupuncture) and NLP (Neurolinguistic Programming). It combines the gentle tapping on key acupuncture points with the focusing (thinking and/or telling) about a problem. What is a dissociative technique? Dissociate, as opposite to associate, means to separate, to part, to put on distance. A dissociative technique mimics the strategy of the brain facing overwhelming horror: creating distance through detachment/numbing and protection through isolation (compartmentalization) and splitting; it allows reducing effectively the pain of negative thoughts and images. It also helps to discover the different parts of the personality and to clarify their interaction. What is eft3? Eft3 is a dissociative variant of EFT. It uses a short form of EFT, a setting (wording) in third-person and a double tapping: on the own body and on the imaginary self. Optionally, it permits the use of visual resources in order to complete the therapeutic process more easily.

How did it start? July 2011: on my fifth day of holidays in Cuba, traveling alone, I reached one of the most deserted beach of the island: Maria la Gorda. No newspaper, no TV, no disco; nothing to do other than dive. And even that was a problem. At the depth of 30 meters, I started to breath too quickly, so the diving master had to give me some oxygen from his own bottle. No problem for him, but I felt very ashamed. Really, things were not going as I had expected! Since my landing in La Havana I had been cheated two or three times and on top of that, two days earlier, my video camera had been stolen. Back in my room, I sat on my bed and started to tap on myself, saying, “Even though I’m unable to travel, even though I’m not able to breath correctly (under water), and so on…” It didn’t help. I tried to roll my eyes, to trample my feet. I said the phrases in the second person, as in “Matrix Reimprinting”. No way! Nothing worked. 5

So I decided to do something completely new: tapping in the third-person form. Without thinking much, I started to tap with my right hand on an imaginary duplicate of myself, while I was tapping on myself with my left hand. At the same time I was wording the problem in the third–person: ”Even though this man is unable to breathe, he deeply and profoundly accepts himself!”. It was pretty strange, but it seemed finally to work. After a few minutes I decided to shift my focus to the past (affect bridge). The first memory that came to my mind was a scene, at the age of twelve, taking down the sails nervously after sailing. My older brother was asking me: “Why are you doing things so hastily?” Tapping on this young boy I could see his lack of self-confidence. Suddenly, I was overwhelmed with tears, love and compassion for this “little man”. Other scenes of “failures” appeared one by one. I was witnessing, sharper than ever, all the pressure this boy was enduring, trying desperately to please his parents and to do well. In the next half hour I treated half a dozen of other past events, all linked to this feeling of being incapable. In the end, I came to a wonderful feeling of peace and self-acceptance. At that moment I felt so closer to myself than I had felt for decades. This experience impressed me very much. Today, looking back, I have the impression that from this point something radically different had started to emerge: the feeling unified in myself. To make the story short: back in Switzerland, I started to apply this technique on my patients at once. Thank to my NLP Master training, I was used to working with associative/dissociative techniques. But to combine tapping and dissociative technique: this was new! To my surprise, my patients had no difficulty in following the protocol; most of them had intense sessions with deep insights. It was confirming my own ”experience on the beach”. As I became more of an expert, the strong reactions smoothed and I learned to lead also short issue-centered sessions.

Depending on the situation I was still using alternatively the first-person setting. To trace the exact progression of my work I had to number the diverse variants of EFT. So I started to note in my files: eft1, eft3, eft0, eft4 and so on. I found it more practical to type it in low case letters. After all, I was applying a short form of EFT! During the session I was using either self-tapping (solo setting) or tapping-on-the-client (duo setting). Making eft3 public Months went by. I remember how so many times, at the end of the day, I would tell my wife – a psychotherapist – about the last surprising therapy session with a patient using eft3. I started to faithfully note down the best cases. In January 2012, when I decided to propose a workshop about eft3 at the Third Biannual International Conference of the European Society for Trauma and Dissociation (ESTD) in Berlin, I began to ask myself: “Are you sure that it is new?” Checking and rechecking books and videos on EFT, I recognized here and there some aspects of my method, but nowhere any complete system in the third form. It seemed that I had succeeded in gathering the best of NLP, EFT and Matrix Reimprinting in one beautiful bouquet … or a Swiss knife. So now it was time to teach!

Part I: EFT in first-person

EFT in short EFT is a healing technique developed in the 90ties by Cary Craig, an engineer of Stanford, California. It is based on the assumption that every negative emotion is caused by a disruption of the energy system. Through a round of tapping on specific acupuncture points AND the simultaneous telling of the problem, the balance is restored and the problem disappears. To work with eft3, one has to know EFT. This tutorial shows my personal variation of EFT in first person, thereafter noted eft1.

EFT = tapping + wording The wording It consists of two steps, using one long affirmation (the setup) and one short affirmation (the reminder): 1. The setup, while tapping on point 1, introduces the problem in a spirit of self-acceptance: «Even though {problem}, I deeply and profoundly accept myself». 2. The reminder is a short sentence – sometimes just a word – reducing the problem to its core. The reminder is repeated one time only at points 2 to 10. Example: Setup (long sentence): «Even though I feel so stupid to have lost my keys, I deeply and profoundly accept myself». Reminder (short sentence): «I’m stupid» or just «stupid».

The tapping During the last twenty years, many EFT practitioners â&#x20AC;&#x201C; Cary Craig first - started to shorten the standard protocol in order to speed up the process. The original technique, as described in the first official Manual was about three times longer than the actual one: it included not only more points (under the breast and on 4 fingers), but also eye movements and even singing and counting. The experience shows that the short form - as shown in the last DVD of Cary Craig - offers an appreciable gain of time without any loss of efficacy. As different EFT practitioners use different point combinations, I also had to make a choice. After having tested (muscle testing) the best points to tap over a period of several months, I retained a set of ten acupuncture points (see next page). Due to my long experience with EMDR, I continued to tap with both hands.

Where to tap?

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

START: Karate chop Inside edge of the eyebrow Outside corner of the eye Under the eye Above the mouth Under the mouth Under the collarbone Under the arm Top of the head Inside part of the wrist

EFT protocol Problem 1. Choose the problem - Tell the story - Explore the aspects 2. Name it! 3. Check the stress (SUDâ&#x20AC;&#x2122;s)

Solution 6. Set-up affirmation + tapping on point 7. Reminder + tapping on points 2-10 8. Re-check the change (SUDS) 9. Next step

What is the problem? What is the problem? It’s usually easy for the patient to answer the question: “I have this fear of fire, this depression, this trauma, this headache, this bad habit of smoking, this violence in me, I want to stop it!”. Depending on how severe the problem is and how well he knows the patient, the therapist will ask for more information. By an easy problem you may just pick the first thought or emotion the client is expressing and tap! Then take the next one, and the next one, just as it comes! Work rapidly and intuitively. This way is especially useful with a physical problem (chase the pain) or in the exploring phase, when you don’t know yet exactly where the problem lies. However you will frequently need to know the whole story (see: tell the story!). You may also uncover the aspects of the problem: thoughts, emotions, internal /external sensations, and actions. This structured approach will help you to bring some more logic in your intuitive work. Here is some more advice. • Concentrate on one issue. Don’t let the patient lead you through all the gardens of his life. Avoid firmly general descriptions like: ”I have a lack of confidence”. Ask him to think of a scene, where he has been a failure and treat it together. Don’t try to cut down the whole forest with one hit. Cut one tree, than the next one. By the fifth or the tenth tree, the whole forest will collapse on itself. • Search for underlying core beliefs and hidden causes. Look for family secrets. • Look for the “crazy belief” (see: Beliefs).

Tell the story! “When did it start?” is often the magic question leading to the cause of the present problem. Sometimes the patient is able to find rapidly the starting event; sometimes it first needs some tapping rounds to let it appear. When the patient comes with a dramatic story, I rather recommend you to avoid the passive empathetic listening: actively place «security marks» (“when did it start, when was it finished”), offer to the patient a simultaneous tapping, underline the resources and praise his positive reactions. We don’t want unlimited tragedy, but active processing of the past. We have the means for that. Often the current story leads to an older one. We call it: Affect Bridge. We have to clear the older one, if we want a complete resolution of the current issue. Never believe that «telling the story» is a neutral matter. To collect information through an informal narrative may be quite an associative way to approach a memory, especially when the therapist is too pushy. Don’t wake the sleeping dogs unnecessarily! Explain to the patient that you prefer to go around the hot spots. But be aware that some patients absolutely prefer the crude words: “They killed my sister, I have been raped, I lost my eye, I’m too fat”. Some patients want to be sure that you can stand the horror. Listen to them, with a neutral attitude: you can cry and tap after the session when needed. In this part of the treatment, listening to the story is more a way to get an overview. Treating the details can happen later. I find it very useful to use the technique of «technical debriefing» (Perren-Klingler), sticking strictly to the facts, like a police officer, taking an official account of what happened. This dissociative technique helps to turn off surging emotional content; this prevents overwhelming feelings. It’s very safe and effective to work this way. In some cases, when people present a rather complicated life story, it may be necessary to spend the entire first session, or even more, to gather information about the case. We want to know first “where we should put our feet”. We will start a focused tapping in the following session.

The aspects What is better than a good movie with popcorn or ice cream! The perfect synchronic combination of the visual track and the soundtrack (music, sounds, dialogues, commentaries with an “off” voice) creates an exciting event while we relax on our couch. Movie is an excellent metaphor to understand how we perceive reality: we use a multi-track system based on multiple sensorial information that combines in the midbrain (thalamus). The amygdala (fear center) plays the music and colors our life (emotion). The pre-frontal cortex (above the eyes) makes the commentaries. Movements and reactions occur: we laugh, we sigh or we leave the room. The following diagram (the associated Self) shows this multi-track perspective. With the help of this map, we may explore systematically the different aspects of an event. For didactic reasons, I will present them separately in four sections. thoughts

emotions

actions

sensations The associated Self or “wheel of the aspects”

When working with an associative technique like EMDR (Eyes movement desensitization and reprocessing) the therapist will not start before everything is on the table: focusing on the memory, the patient must simultaneously be aware of the “cognition” (I’m this), the emotion and the body sensation. EFT allows more flexibility: it doesn’t work with one affirmation (the target), but, in contrast, skips from one aspect to the next. So we can modulate the intensity of the exposition very precisely, in order to stay in the “window of tolerance” (next figure).

Too much intensity: overwhelming, dissociation

Window of tolerance Too little intensity: no reaction boring, avoiding Looking for the aspects doesn’t mean that we look for the complete picture. It is rather preferable to take the aspects one by one, treating them separately. Depending on the case, we may concentrate on the emotion, the belief or the sensations. So we will possibly jump from the physical discomfort («heavy on my chest»), to sadness or shame, to some negative irrelevant belief systems and finally to a certain behavior. Any order is permitted. This «jumping» is rather intuitive and mostly based on the words the patient uses just after each round. For didactic reasons, however, I will describe the four groups/sections of aspects separately in the following pages. 17

1. Sensations External sensations The section sensations is the starting point of the «wheel of aspects». External sensations are the first way the outer world reaches our nervous system: light, forms and colors, sounds, odors, flavors and skin contact. Additionally we have extra receptors to the temperature, pressure, orientation, pain, position of the body, tension of the muscles and tendons. All those impressions are combined in the thalamus and scanned for potential danger by the amygdale (both structures of the midbrain). Through loops of feedback (brain-body-brain) the neurovegetative system furnishes a kind of visceral comment: tensions in the guts, blood flushes, heat or coldness, pains, tears. Example: A very shy teenager goes to his first party. Suddenly his heart begins to beat like mad, for no reason. This reaction happens long before he consciously notices that he is just in front of the prettiest girl of the class. Then comes joy, panic or shame: emotions. And maybe: «Oh my God, I’m in love»: thoughts, statement. Finally he acts/reacts: runs away, smiles, says hello. It could also be that the amygdala, our scanning center for new information’s, inverses the reactions. The young man could run away, before he understands what’s going on.

The mind can remain literally hooked on some detail, fully dissociated from its context: in this case it could be the red skirt of this girl, the song that was just playing, the laugh of the people, or the taste of beer in his mouth. After a traumatic event some sensorial element can be “burned” into the brain. To desensitize the patient a work of reintegration is needed. When I was in Sri Lanka in 2005, a young man told me, that since the last tsunami, the simple sound of the cars passing on the next road made him very nervous. It reminded him of the terrible sound of the waves. Similarly, a woman could still hear the screams of her neighbor’s drowning in her destroyed house. Another woman stopped treatment in my clinic, right at the second session. She told me that my aftershave produced an unbearable discomfort. Effectively, on that day, I had exceptionally used some aftershave «Eau sauvage». Bad coincidence: the man, who had abused her, also a therapist, had used the same fragrance.

Internal sensations These sensations are the daily bread of psychosomatic medicine. During a therapeutic session, patients often present various physical reactions. It is possible to treat them as they appear: ÂŤEven though I have these tensions in my stomach, this headache, this heavy feeling in the chest, ...Âť.

2. Emotions A minimalistic technique As already pointed out, EFT is mostly a rather unspectacular technique: no big emotions, no outburst of tears, no screams. Nevertheless it’s possible to perform highly effective emotional work. Emotions create blocks when they are not integrated: EFT helps to identify the underlying emotions and to regulate them. Here a personal example: One evening, after a long working day, as I was driving home with my wife, I felt angry. I couldn’t find the reason. As we arrived home, I told my wife: «don’t wait, I just need a minute». Staying in my car I started to tap: “Even though, I don’t know why I’m angry, I deeply and profoundly accept my self». Within a minute, I felt some sadness coming up, related to a critical – unjustified - remark of a patient. Instantly my anger was gone. I tapped one more minute on this issue and my sadness disappeared. The rest of my evening was saved!

It is important to clear up: what is the emotion here? Many patients are sad instead of being angry or furious. Others express a lot of rage, and they are actually simply hurt and sad. Many times at the root of some the emotional discomfort we find a wrong belief. Fictive example: Through your western style of education you have learned how important it is to look straight into someone’s eyes when communicating. Escaping eye contact is then for you a sign of deception. During a trip in Middle East, you feel very irritated when men systematically avoid looking at you when greeting you. When a friend of yours explains to you, that in the Arabic culture, direct eye contact is very impolite, all your unnecessary anger disappears.

Helplessness and revenge With many patients who have been sexual abused the issue cannot become neutral before revenge has been taken. Therapy is a process of transforming the violence. But as long as the victim stays hurt and paralyzed, the violence remains. For me, forgiving is not genuine, as long as the patient keeps his role of victim. So I typically let patients imagine different scenarios of vengeance while they tap, imagining e.g. a terrible retaliation. This procedure is mostly very short. Patients get empowered. But I warn them: do it here, in my office and don’t do it for real outside! I often let the patient describe verbally how they would proceed and then tap as usual: «Even though, I would greatly enjoy shaking my boss like a plum tree,...». «Even though I’m a bad guy, ...». It ends mostly with a lot of laughter.

3. Thoughts

Beliefs, cognitions, (self) judgment

The cognitive aspect of an event/situation («what do you think about it»), is definitively the most significant “aspect” in a EFT treatment. Why? Because our interpretation of a situation determines to a great extent what we feel and how we will react. When a patient is told that high fever is the best natural anti-cancer therapy, is he not going to accept fever with much more ease? On the other hand, when he believes that he must drink 3 liters water a day, otherwise he is in great danger, he will fall into a panic when he only drinks 2 liters. A watchman working in a large cold storage room was once accidentally locked in. He fought all the night against the cold, but in the morning was found dead. What he didn’t know was that that night, the fridge was not functioning. The temperature was above the freezing point. Voodoo curse is another negative example: when the sorcerer of the tribe condemns a member by pointing a stick or a bone in his direction and telling a curse, the poor man will then retire under his tent and in the morning he will be dead. Fundamentally there are three kinds of facts or realities: • Actual facts: “I have endless work on my table, my wife talks too much, my neighbor’s TV is too loud, …”. Mostly real fact, but you must look for the “subjective” interpretation of the situation. • Past facts: mainly traumatic issues or how a bad habit started. Often a trauma creates an unrealistic belief: “airplanes are dangerous, the sea is full of crocodiles”. • Imaginary facts: here we have not only opinions (e.g. political, cultural and religious opinions) but also distorted representations of the world (“The Map is not The Territory”).

Negative example: A man consults me because of burnout. After a few sessions, he tells me how he grew up in a family with much violence. Day after day, he tried to protect his mother against his brutal father. At the age of 8 he had already developed the belief that he has to be vigilant 24 hours a day. He didn’t notice that this state of arousal continued after he had left his parents’ house. Disclosing this belief was crucial to treating his burnout. Positive example: due to repeated blackouts during examinations a young lady seems unable to complete her law studies. When I ask her if anything could protect her during the examination, she mentions her dead grandmother. She believes that somehow, her soul is looking after her. I reinforce this positive belief system and two months later, she proudly announces, that she passed all the tests: with “a little help from her grandmother”.

How to ask As the client tells his story, ask him: “So what did you think then? What do you think now about yourself? What does it mean for you? What does it tell about you?” We are not looking for long description, but for short pregnant statement. Eg. :“I’m unable, I’m irresponsable, I’m unlucky, I’m a bad man, …”. Try to let the client to express it in the first-person, so he can better identify with this affirmation (but it is not a must like in EMDR). Of course, if you choose to work more on a dissociative manner, you will use a non-personal setting (e.g.«Times are difficult for single mothers») or the third-person formulation (see eft3).

4. Actions In this last section of the wheel we are concerned with actions, movements and behaviors. In response to a critical situations the center of fear (the amygdala in the midbrain) initiates not only emotional and neurovegetative reactions, but also motoric responses (over the PAG). The classic well-known trio is: fight, flight and freeze. The therapist may ask the client how he reacted in the critical situation. Many people are puzzled, confused, ashamed about their odd reactions: with reluctance they will confess, that they were actually completely paralyzed, fled, were screaming, trembling, violent, fell on the ground, fainted. In the wording, we can at once reframe this behavior: «Even though I was completely paralyzed, a very common reaction when you are face to face with a dangerous cobra, I deeply and profoundly accept myself». The reframing can go over a provocative wording: «Even though I had to cook every day for my father and brothers as an 8 year old girl, which is very normal with machos, I deeply and profoundly accept myself».

Check the stress Working with a Brief Therapy technique, it is important to check at each step, how accurate the therapeutic intervention has been. Immediately before the tapping, the patient is asked to estimate the intensity of his unpleasant feeling:

«On a scale of 0 to 10, ten being horrible and zero just normal, neutral, how much does (this thought, this memory,…) disturb you ?» This subjective measure called SUDS (subjective units of disturbance) has been borrowed from the field of Cognitive and Behavior Therapy, (CBT) where it is used to quantify every intervention. Experts call it also: calibrate. You can also quantify the stress with the hands: “Look: this (arms wide open) is very much stress. And this (bringing the hands very close to each other) is 0”. After a round of tapping, we recheck the stress. Don’t be too eager. It may need several rounds. Nevertheless, when there is no reaction, you have to modify the target (wrong aspect, affirmation, wording) or check for hidden psychological reversal (see further).

Name it! Now label the problem (or an aspect of the problem) with a few words or a complete sentence. It can be as short as: “the accident», «the tsunami». It can be much longer: «I’m ashamed of having failed, I’m the slowest boy of the whole school, I didn’t cry as my aunt was beating me” Generally we try to have a complete phrase: subject, verb and attribute. As we will see very soon, the subject can change, accordingly to the setting we choose: in first-, second-, third-person. Examples of a first-person short phrase: « I’m stupid, I’m a sad grandmother, I have this cramp in my stomach, I’m a bad teacher, I don’t deserve respect, I’m doing everything wrong, I’m ashamed to think of it…» Passing in review all the different aspects of a problem, we may follow a plan or intuitively adapt to the automatic appearing of new aspects. Here are a few cues to get better results 1. Be unspecific when the emotional charge is already very high 2. Be very specific when you want to bring more dynamic in the process and get the «real thing» 3. Surprise me! Use paradox, exaggerations, reframing, humor and love! Be spicy and funny! But keep respect and kindness. Be creative: you may create an extra long phrase, exaggerate the negative description and reframe it. 4. The reminder can be very short, just a word. 5. Some people don’t want to speak it out loud. It’s ok when they just think it.

Psychological reversal Why do we start with the setup procedure? The first chiropractors who developed this «energy psychology» used to work with the muscle test: the client is asked to hold one arm horizontally while the therapist tries to push the arm downward with a gentle but firm pressure. When the muscle resists, the muscle is told «strong», when not, the arm goes down and the muscle is told «weak». This test is the basis of the kinesiology. Normally positive pleasant thoughts («I’m healthy, capable, nice») should strengthen the muscle; unpleasant thoughts («I’m sick, inefficient, hopeless») should weaken the muscle. Some people however, show an inverted reaction: it is called psychological reversal. The psychologist Callahan, who pointed out this reversal, showed how the setup (self-acceptation affirmation with tapping) would correct the reversal at once. As Cary Craig developed the method of Callahan’s, to adapt it to a large public, he decided to shortcut the «muscle test». Instead, he started each round with the self-acceptance sentence (setup) to prevent any possible psychological reversal. This way, it is safer and quicker. It may also avoid some possible legal problems as in some US States it is not allowed for non-professionals to perform this test (only for chiropractors). The tapping was originally done above the heart (sore point): nowadays most of practitioners use the “karate chop” (point 1). The more I use this technique, for my patients and myself, the more I realize that the ultimate goal of the therapy is not about inflating the ego with success. It is more about discovering inner peace and harmony through selfacceptance and about integrating one’s own weaknesses and strengths, releasing the pressure of eagerness, cultivating humor and humility. Ultimately this procedure is a deep act of grace and compassion for the hurt self.

Setup: positive affirmation Before treating any problem (or aspect) start with the setup = tell the following affirmation, while tapping on 1. Even though I’m (the problem), I deeply and profoundly accept myself. « Even though I’m unable to solve this problem, I ... « Even though I’m very angry at my boss, I ... « Even though my stomach is constantly contracted, I ... « Event though I still smell the odor of this man, I ... If somebody doesn’t want to say this phrase, which often happens, propose another formulation: «I’m ok, I’m a good student, a good mother, I deserve respect, …». You can also use a trick: « Even though I don’t want to accept myself, I’m a good person,...».

Mini-resource and Provocative Therapy Mini-resource To reinforce the positive affirmation, I sometimes use what I call a mini-resource. While the patient is speaking the affirmation, I suddenly ask her: « At what are you especially good, …, hem, what do you like to cook, oh ... tiramisu, strawberry!». Then I repeat the phrase e.g. : »Even though I’m a very inefficient person, I deeply and profoundly accept myself and I’m the queen of the strawberry tiramisu!». Laugh and smile will always come. Make it quick and simple! Provocative Therapy (Farrelly) To play down the drama, I often use exaggeration. Truly, it is not so easy to confess one’s worst weaknesses. Why not to make a challenge of it? Example: «Even though I’m bad at, or ... let us exaggerate: all right? Even though I’m the worst worker IBM ever hired,…».

People invariably start to laugh and get distance from their own compulsive self-denigrating.

The sequence or the round Cary Craig calls this part: sequence (=following points). I often call it a round, because we go up and down, tapping and saying the reminder, like a children’s chanting round. And one more time, and one more time! Just tap the points 2 to 10, about 10-15 times at each point, while you tell the reminder once only. If necessary, you may repeat the round a few times (without setup, but with the same text). From time to time, check the SUD’s, to be sure that you are progressing, and continue. At the end, it may help to change the reminder to: «Rest of (problem)» and tap a round.

Next step Re-check the SUD’s. When the SUD is down, challenge the situation: “How is it now to think about this? Imagine you meet this person, you give this lecture and you visit this place». Let the patient scan the body feeling. It is not always possible to accomplish all the work in one session. Don’t put pressure on the patient or on yourself when you are the therapist! Find a way to close the exercise and stop the session on time. If the SUD is still high after several rounds: • Go back to the exploration of the aspects. • Explore the actual feeling of the patient, in the session. • Use the ignorance sentence: «Even though I don’t know why I’m still angry».

Treating the trauma First recommendations Through the therapeutic process the client is re-exposed to memories. This may trigger strong emotional reactions. There is a risk of a re-traumatization. The first aim of the therapy is not to harm. The client should never leave a session in a worse state than before. I don’t say that it never happens; I just say that it shouldn’t. You have to know your limits and to care for the safety of the client. Don’t treat a complex trauma if you are not trained in psychotraumatology. Ask for permission before you touch the body of the client (in some countries/states there are very strict rules about it). Caution with complex trauma: with a patient, who has experienced a massive physical attack, even the tapping on his own body may trigger. Use another technique. Structure the story. Get a good frame of time: when did it start, when did it stop (marks of security). So you suggest that the event didn’t last forever. Keep neutral. Don’t let the client start to tell the story in an emotional manner. You may ask some specific questions for clarity (e.g. how many persons were there, where was it, which year) but be neutral. Remember: we are not looking for emotions, but for self-control and «order in the head». On the other hand, some clients want to share their violent story: they will be relieved if you listen calmly and dare to ask the crucial questions. However, it is mostly better when the uncovering of the trauma is sustained with EFT

Specific EFT Techniques The two main techniques for trauma used in EFT are: Tell the story and the Movie technique (please refer to the official Manual of EFT or the books of Cary Craig). EFT specific techniques to treat the trauma When Cary Craig was working with Veterans, he used a very gentle approach. On the first day he started with general considerations (e.g. Life is not always easy, I have some problems). The next day he treated the physical and emotional reactions of the client. Only on the fourth or fifth day he treated the specific memory (critical incident) in detail. At the end he could challenge the veteran with the full impact without any traumatic reaction. Based on this experience here is what I call the Concentric Strategy: start from the (dissociative) periphery to get in progressive steps to the (associative) core. Start «general,» using unspecific sentences, with common sense, like: Life is not always easy / one has to face his fate / I had hard time in my life.

Then concentrate on the reactions of the client to the event. Treat the physical sensations, to stabilize the body. I’m always tensed / I cry a lot / I feel this knot in my throat / I cannot sleep /

Later integrate the emotions and the beliefs. I feel sad / I feel guilty / I’m a coward / I’m weak

The crude facts (actions and extern sensations) come at the end. They may be the most difficult to deal with, because they are the most associative items and therefore triggering. (War situation, at night)” just after I lit my cigarette, the head of my buddy exploded” “ On this cold day, I saw my sister disappear in this dark blue water”

Tearless Trauma Technique (Cary Craig). The client doesn’t have to visualize the scene. The therapist just asks him to name it, to GUESS the emotional intensity (on the 0-10 scale) and to tap. Tell the story and tap. When a client starts to tell the story and get very emotional (e.g. crying), ask him for permission to tap on his hand (acupressure point of the fingers). Or encourage him to tap on himself (e.g. chest). It will be very soothing. The Tap-While-You-Gripe Technique (Rick Wilkes) is similar: complain and tap.

Part II: Dissociative techniques

Dissociation vs. association Life is an alternation of association and dissociation, of creation and decreation. To understand dissociation, you must understand association. Association adds, bundles, binds and combines. Dissociation divides, separates, dissolves, isolates. Depending on the context, both of them can be positive or negative. The thesis of this tutorial is that pathologic dissociation (e.g. due to traumatic circumstances) can significantly benefit from a dissociative technique.

! 34

! Association

We usually like to go closer to pleasant things. Take a beautiful red rose. We enjoy the association of the fragrance, the fascinating color, the softness of the petals and the emotional signification (love). In the same way, a candlelight dinner may anchor the memory of a first date through the association of warm light, tasty food, perfumes, eye contact and soft music. Dissociation We definitely take a distance to unpleasant things, like excrement, vomit and garbage. We close our senses (detachment), avoid and isolate them in appropriate rooms or packages (compartmentalization). After a loss, we may «close our heart», detaching ourselves from good and bad, lost in a kind of affective numbness. Traumatic experience may create a partial loss of the sensorial (see, hear, taste,…) and emotional (joy, sadness, anger, …) perception, to cognitive (thinking) freeze or mobility blockades. Different troubles can occur: like paralysis, inability to think, calculate or speak, disturbed skin sensibility, sight or hearing. 35

Association Familiar

thoughts Future

emotions

actions Iâ&#x20AC;&#x2122;m

Past sensations

Modified model of association (after the BASK model of Braun,1988)

This model of association shows an associative perception of the world. I’m «here and now», between past and future, in a familiar frame, integrating sensations (I see, hear, feel, taste), emotions, thoughts or beliefs, and acting. All these elements are interdependent, linked as webpage’s. When you see a picture of a romantic beach, automatically you may think of sun, water, coconuts, surfing or diving. The desire for a holiday will arise in you. Pleasant associations are the motor of advertising, as we human beings are used to constantly associating impressions with congruent memories. In a pathological dissociated state, however, the patient doesn’t choose this disengagement or split. It is involuntary and mostly painful. Problems of the association When you have negative experiences, you create links (associations) between different elements of life. You learn to fear places, special days, sorts of people (of a certain sex, nationality of race). The least sensorial cue (sound or word, odor, color,...) will reactivate the whole cluster and cause pain. The patient will then try to block this associative process. In the therapeutic process, the risk of re-traumatization through critical memories is a big concern. That is why we are searching for therapeutic tools with a very low triggering potential.

Dissociation Dissociation and trauma After a traumatic event we may observe dissociative reactions like: emotional numbness, derealization («it must be a dream, it’s not real»), depersonalization («it’s not me») and amnesia. These reactions are involuntary and most of the time very unpleasant. They must not be confused with distraction or states of trance/absorption. In case of a chronic traumatization (especially with young children), dissociative troubles of identity («multiple personalities») and amnesia are frequent. Dissociative pathology: detachment and compartmentalization. The experts distinguish two kinds of dissociation. In detachment the patient loses contact with reality (derealization) or with himself (depersonalization). In compartmentalization the continuity of time (biography) or of personality (identity) is broken through amnesia, fugue or disorders of identity (DID). In the last case the patient switches involuntary from one part of personality to another. Benefit vs. disadvantage of dissociation From a positive point of view, dissociation may be seen as a protection against blank horror. Many people are luckily able to forget completely (amnesia) some terrible events of the past. Dissociation allows us to put a distance between us and our past or the tragedies of others. The incapacity to have a certain emotional distancing may cause helpers to have a burnout (secondary traumatization). The capacity to possess well-distinguished aspects of personality (e.g. young and mature, serious and humorous) may contribute to the richness of character. From a negative point of view however, dissociation means a lack of integration of traumatic experiences. When this happens early in childhood, this deficit of integration leads to disorders of personality (DID or «multiples»). Patients suffering from numbness, depersonalization or derealization, may be haunted by the desire to retrieve their real life and real self. They cannot understand these «holes» in their biography (amnesia).

Dissociative vs. associative techniques Brief Therapy offers a large panel of techniques to treat psychotraumatic issues.

! On the left we find a very associative technique, like EMDR, ÂŤIÂťcentered, and collecting a maximum of sensations, emotions and thoughts related to the event before starting. The session may become very intense. The risk of an emotional overwhelming of the patient through the confrontation must be taken into consideration. Another risk is that the patient will switch involuntary to emotional avoidance (a typical dissociative reaction) and become indifferent.

Dissociation shouldnâ&#x20AC;&#x2122;t be seen only as pathological. Patients who in the past could only protect themselves through dissociative detachment or (partial) splitting of personality in parts (diverse ages, diverse roles) may paradoxically profit from a dissociative technique. This therapeutic setting offers a controlled distance and helps to clarify the dynamic of the personality (adult, child, allies). Caution: this technique is not meant for dissociative identity disorder or DID (structural dissociation). In the middle of this panel, NLP presents a playful mix of association and dissociation. When building up a positive resource, the therapist will include and activate all the aspects (what you see, what you hear, what you feel, etc.) of a good memory. In contrary to treat a phobia, he will use double visual dissociation: the client should imagine himself in a movie arena, watching another himself watching the critical event on the screen. Through associative/dissociative exercises the client retrains his capacity to adequately associate or dissociate. NLP integrates the dynamic of association/dissociation of parts of the personality (Perls, Satir). On the right EFT, shows a maximum of dissociative potential. By choosing the right words, the therapist takes a soft start and stabilizes the patient from the beginning. The variations of EFT - eft2 and eft3 - add other dissociative dimensions

Dissociative forms of EFT Beyond EFT The standard EFT technique uses a first-person setting, with tapping on the body of the (real) client. This associated form can be modified through different «switches». EFT therapists have been exploring other points of perspective, like tapping mentally on others persons (surrogate or proxy) or tapping on oneself about the issue of someone else (borrowing benefits). Working with a second-person setup is not new. Cary Craig in «EFT for PTSD» (2008) describes the «surrogate or proxy tapping» technique using the affirmation «Even though you, ...». Before I came to eft3, I tried also to go beyond this I-centered perspective, e.g. either letting the victim take the role of the aggressor or using the second-person setting (Craig, Dawson). I Matrix Reimprinting In his book «Matrix Reimprinting using EFT» (2010) Karl Dawson narrates how he made an interesting discover in 2006: During an EFT session, one of the course attendees, who was dealing with a highly traumatic memory, stated, ‘I can see the picture of my younger self so clearly, I could tap on her (...). I encouraged her to do so, with amazing results. And so Matrix Reimprinting was born. Dawson describes the «inner child» as a real energetic entity, in a space outside of the body, called matrix. To contact this «ECHO» (Energetic Consciousness Hologram) he asks his client to imagine himself going to this child and, after having asked for permission, to tap on him.

Eft3 vs. matrix Reimprinting When I developed my own technique on a very spontaneous manner in 2011, I wasn’t too concerned whether others authors had made similar discoveries. I assumed that I was doing a kind of Matrix Work in the third person. One evening, however, re-reading «Matrix Reimprinting», I suddenly nearly jumped out of my chair, saying: «but the client doesn’t tap, here!» I realized how my own protocol was significantly different. Dawson asks the client to visualize, how he is tapping on the child: to me an unnecessary supplementary dissociation.

! The!Magic!Arm!

Patient! Double!!

Therapist!

I ask my patients to do a real movement in an associated manner. By my first «tapping on the beach» (2011) in the third-person, I automatically reached my right-hand in front of me to tap through the air, on the double. The movement of my hand was real. At the same time I tapped on myself with the left hand. Through the third form I don’t need even more distance. The process of tapping is here direct and simple. It is easy to learn the method and to apply it at home. Indeed I created the «solo» (client only) form of eft3 before the «duo form» (therapist and client). Eft3 is a therapeutic model, which allows an easy work at home. Sessions with client over the phone is also possible. Through my NLP training (2004-2005) I’m very aware of psychic «spaces and boundaries». Dissociating is basically separating and creating boundaries to protect. The eft3 client is therefore tapping out of his chair, with a «long arm» or a «magic hand» reaching up to the body of the imaginary double. The physical selftapping intends to empower the client-on-the chair.

Inner children: how real are they? Many therapists are dealing with so-called «inner children». Do they really exist? Based on different New Age or «esoteric» concepts Dawson imagines real energetic entities around us, like frozen souls (ECHO) in the surrounding field (matrix). A stimulating perspective to me, but as a scientist I prefer «brain science». To me the «inner child» is a neurophysiologic pattern: a body-mind state that is created by the activation of a specific neuronal network. New progresses in the neuroimaging techniques support this hypothesis. To switch or not to switch Ego states can be met in two ways. Dissociated persons switching from one personality to another («multiples» or DID) are completely identified with the part they embody. The new state has the “I’m” quality. They really are in another state. Their behavior and metabolism is different. New techniques of brain scanning show different parts of the brain firing then. It is the same for patients with flashbacks. With other patients, the child-state is more a diffuse feeling: somehow they still know that they are an adult person. When a patient in a therapy session is invited to feel in the first-person some past memory, it is an effort of imagination. The result is very partial and biased: the «ego» is like an elephant trying to pass the narrow door of a private house (imaginary space).

Non-ego-states? Ego-states vs. non-ego-states The majority of the clients in psychotherapy show some dissociative phenomena but don’t have the ability to complete the switch. For their own sake: to be periodically beamed into a dissociated state creates much helplessness, not to speak of many practical problems. For non-switching patients - many of them are in a state of avoidance- the only access to the past is to try to feel: the daily bread of psychotherapy! Even a deep hypnotic trance (not everybody can do it) is not identical to the past experience: it’s more a kind of interpretation, like a dream. That is why memories are -for most of usexperienced from the outside. Shouldn’t we speak then of non-ego-states? In honesty, can we really feel how it felt to be 16? Eft3 offers the possibility to work with the inner child from a distance. We have to stay outside of the scene. We just look, hear, guess ... and tap gently: like a nurse gently handling a baby in an incubator. Being your own therapist I like to explain to my patients, that it’s not me who cures them, rather, they themselves do the treatment through their tapping on the «wounded self». Using the «third dimension» - somehow anonymously gives a lot of freedom to go very deep. A new kind of relationship to the self emerges, full of compassion and support.

Part III Eft3: a dissociative technique of EFT

A theory of eft3 I, me, myself and the world “What do you feel, how is it for you?” is the standard phrase of the “shrink” in Hollywood movies (e.g. Jamie Lee Curtis in Freaky Friday). Is it really the best way to reach the past? Up today, this kind of psychotherapy, based on an “I” vision of the world, seems to be the only one. In their book “Ego States Theory and Therapy” John and Helen Watkins give an extended presentation of the work of the psychoanalyst Paul Federn. This follower of Freud was a precursor of the Ego States model; he immigrated to New York in 1938 and developed the “ego psychology”. Federn had difficulties accepting the Freudian concept of libido and created a Two Energies Theory. He conceptualized two kinds of energy (cathexis). One is an “I” energy, directed to the subject, giving the sense of self or “me-ness”. The other is an“object” energy, directed to the outer world.

Self-love vs. empathy How do you react if you see bad news on CNN? What are you doing reading about the inevitable horrors, which day after day strike “the others”. Do you try to feel their pain, full of empathy? Are you telling yourself: “Lucky me” or “Give me a break! I have enough troubles already”? Science has shown, that empathy saved mankind. Driven by the “love and tenderness hormone” called oxytocin, we care for others, especially for children. A mother under the influence of morphine, a substance blocking the oxytocin receptors in the brain, will no more react to the cries of her baby: he will be then in real danger. Many of our patients have a disturbed relationship to themselves; self-care and self-protection seems a difficult task. But they will be perfectly efficient in caring for others. Can’t we teach them to apply this altruist power to themselves? Eft3 provides the means to learning it.

eft3 protocol Problem 1. What is the problem? 2. Tell the story â&#x20AC;&#x201C; Affect Bridge 3. Create the double 4. Observe and calibrate 5. Name the problem/aspect Solution 6. Set-up: affirmation (third person) + double-tap 1 7. Sequence: Reminder + double-tap 2-10 8. Observe the change 9. Next step: new phrase? 10. Resource work + reintegration

Eft3 starts the same way as eft1. We can switch without problem from one technique to the other during the session. Just after we have identified the problem and listened to the story suggesting a bridge to the past, we suggest to the patient to create a double of himself, located in a virtual space, in front of him. Example of protocol: â&#x20AC;&#x153;O.k. Susan! You are going to create a double of yourself. (I make a movement with my hand toward the virtual space at about one meter distance). This woman is your age, looks just like you, with the same name Susan. She has the same problem, the same situation. You are going to tap on her, while Iâ&#x20AC;&#x2122;m tapping on you. May I take your hand? (I take her wrist with my right hand ready to tap with my left hand on her karate point). Look at her! How is she, how does she look? When you canâ&#x20AC;&#x2122;t imagine it, imagine that you meet somebody like you on the train (During the complete exercise I insist on keeping a dissociative distance, blocking any attempt to describe the double in a firstperson manner. Later on, however, the patient is allowed to make commentaries associated to her real life). (I start to tap on point 1). And you tap on her hand, just as I do! (Some tap in the air, exactly pointing the body of the double. Some prefer to imagine the movement. In this case I verify that they visualize only their right hand, which taps, and not their complete body. I want them to remain associated with their physical body, sitting on the chair). (While I tap, I tell the setup phrase, in a third-person form). Even though this woman is very afraid, she deeply and profoundly accepts herself. (From a movement of the head I invite Susan to repeat the sentence. We continue with the round and the reminder). Ok. Look at her, how does she look now? (I usually take the first answer and we continue with it). She is smiling? Ok. Even though she is smiling, she deeply and profoundly accepts herself. (Positive sentences are treated the same way as negative sentences, as the tapping liberates positive affirmations from blockades and empower them).

As you see here, in this therapeutic process the patient is invited to drop down his own affects (body sensations and emotions) and to concentrate fully on “there”: what does he see (hear and guess)? It is an object-centered process. It’s amazing to witness patients as they spontaneously report seeing changes. They don’t think it and they don’t feel it. Of course, at the end, they may declare: I feel better. The therapist must insist: “Look, it is like a TV: you can only watch and listen; your body, your feelings and emotions are here on this chair” and he touches them on their shoulder. He never says enough: here is the space of the reality, where we are, with our body sitting on our chair AND there is the space of imagination. Only you can see and hear what happens“.

Reintegration At the end, the therapist asks the patient to take the double (or the doubles) back. All other persons stay there. Do a movement of the hand, like this (from the virtual space to my chest), and while you inhale, bring this woman back to yourself.

The path to the inner child (Affect Bridge) As you see, we can use eft3 to work in the present time. Eft3 allows also a highly efficient and simple work with the inner child. Sometimes a scene from childhood appears; sometimes we may encourage the regression in time. Ok Susan! Look at this person. How old is she? Let her become younger and younger, up to the age where the problem started (Avoid strictly the “you started”, keep the third-form!). - How old is she? - Twelve - How does she look? - She is hiding herself - (Double tapping) Even though the young girl is hiding herself, she deeply and profoundly accepts herself Susan repeats the sentence and we make the round together - How does she look now? (Always put the accent on the visual feedback). - She is curious, who is there - (Double tapping) Even though she is curious, …

We accompany the young girl up to the point where she is smiling and is content. Susan returns her attention to herself on the chair. She feels relaxed.

Resource work Fictive example: - Ok Susan. This child seems desperate. What could help her? I wait a little bit. As nothing comes, I make a proposition: - It could be a human being, a friend, a good fairy, a nice giant, an angel, a dragon, a dog, a lion,… - A lion … he lies to the feet of the little girl and protects her. From time to time he growls - Oh, can you hear that? How does it sound? - RRRaaaah! (She smiles) In this last step, I passed from the dissociated (you can hear it) to the associated (she does herself and feel the power of the lion).

Very often I ask the patient to send an adult double “on the stage”. I let the two doubles interact, silently or in dialogue. They may first ignore each other or embrace each other; the older one can instruct the younger one. The child sometimes finds a solution to the problems of the adult. There is no limitation to how many doubles are playing there, as long the patient and the therapist keep clear control of what is happening on the stage.

Transpersonal integration The inner world is full of monsters and bad guys As we work on the inner stage in the third-person dimension (eft3!), a clear distinction between the others and the double isn’t really there. Bad guys (e.g. abusive members of the family) and monsters hauting the inner scene can be also be tapped. It‘s as if this gentle treatment would tame them. Collective tapping Some issues can take root in the “collective unconscious” (C.G. Jung). Many dark chapters of history have been repressed (by governments and even by the victims and the next generations). And the children of the aggressors bear the brunt too. Murders, rapes, torture, and racial humiliations can be a part of the history of the family or even a whole folk: e.g. pogroms and Shoah for Jews, slavery for Afro-Americans; genocides, deportations, systematic rapes, for Armenians, Korean, Native Americans, Bosnians.

The patient can “tap on a folk” (imaginary collective representation on the stage) using the plural form: “Even though we (eft4)”, “Even though you (eft5)” or “Even though they (eft6)”. We are here, of course, beyond the energetic concept of EFT. Tapping is then more a symbolic “washing of the wounds”: a transfer of healing energy from here (the chair) to there. In this procedure the patient is witnessing and acknowledging the past suffering of his group. Eft0 It can be difficult to personify a problem. I am thinking here about chronic pain (somatoform), with no name and no cause. In one case I found it very useful to tap on the bulk, as if it were a shapeless monster. Other items, like fate, weather, evil, time, and so on, can be also called on the stage. 56

Recommendations Caution! Despite its dissociative quality or maybe exactly because of it, Eft3 is a very powerful technique. I recommend having sufficient experience with EFT before starting with eft3. Similarly I would advise the therapist to always start the session with some rounds in first-person (eft1), to strengthen the associated “self on the chair”. Don’t forget: eft3 is not a therapy; it is just a tool. Experience, intuition and theoretical knowledge (particularly about trauma and dissociation) belong to a proper therapy. Speech is silver, silence is gold, the proverb says. Many patients land with experts after having been treated in an imprudent manner. Sometimes you open Pandora’s box, full of good will, and you don’t know how to close it again. If you step back from the urgent desire to go deeper and deeper and to turn up every stone, you will find the middle way. Dare to be trivial, to tap on banalities, to reinforce simple things. I often use the injunction: “Just open the door and begin to sweep the snow!” However, since I started using EFT, and even more, since working with eft3, my therapeutic work has become radically more easy, efficient and safe.