I began treating chemically dependent clients more than 20 years ago — for 11 years I worked at an outpatient substance abuse clinic for the state of Louisiana.

Since then, I have successfully treated many traumatized CD patients, through Employee Assistance Programs and my private practice, using the Emotional Freedom Technique (EFT), developed by Gary Craig. I use it with the support of self-help meetings and other treatment programs, and in conjunction with all therapeutic measures that I have always believed to be effective with these clients.

I’ve observed, as have many other professionals in the field, that chronic relapse often occurs with clients who have a history of trauma. I knew that many clients I’ve treated harbored emotional pain that was just too great to tolerate sobriety. Through the years I have used every technique, model, theory and therapy that was known to help alleviate the torture that these clients lived with on a minute to minute basis.

I have used cognitive, behavioral, Gestalt, neuro-linguistics, journalizing, bataka bats, screaming and hosts of other approaches to reduce their obvious emotional pain. Some worked on some levels. But nothing has ever been able to reduce the emotional intensity of trauma as successfully as EFT.

Initiating EFT

Most of my clients, have multiple and severe traumas. I start EFT treatment with them after they have maintained sobriety for at least six months, but preferably a year. I require that they attend self-help meetings regularly and that they are working with a sponsor. The primary reasoning for this is that these clients are seen on an outpatient basis, and without the support of an inpatient setting, relapse can be more easily triggered.

Multiple traumas cannot be resolved in one session and, therefore, require a very good support system to allow clients the safety they need to address many “ghosts” they have denied, avoided and used for many years. It is important to understand that for these clients, there is tremendous fear in even recalling these traumas, that might include sexual abuse, physical torture and abandonment. Their memories are stored away in some remote area of the brain but live in the body’s tissues.

Unresolved feelings

I explain unresolved feelings in this way: As we grow up and have uncomfortable feelings that are not expressed or nurtured, we put them in our “garbage can.” When Mom slapped you and you felt hurt, it went in the garbage can. When Dad left and never called for your birthday, the abandonment went in the garbage can. When your wife had an affair and you were devastated, it went in the garbage can, etc. All the feelings you had, but did not express in your life, went into the garbage can. When you engage in compulsive behaviors, part of what happens is that they cover up and distract you from the feelings in the garbage can.

Another aspect of the disease is that addicts learn to numb and deny that these feelings even exist. But energy psychology teaches us that the emotions are stored in the body, that they continue to exist in the tissues, waiting for any stimulus that will awaken the pain, anxiety and anger. Many times the initial phase of treatment is to give permission for the client to feel these emotions in a safe way. Many clients feel they will be consumed by the pain and therefore avoid remembering, feeling and addressing the memories and the pain.

Trauma triggers

What happens to the client when the garbage can is full? What is commonly seen is that the client becomes triggered very easily by anything in the present that reminds them of their abuse. I use a caveman metaphor to explain this to my patients.

As a caveman walks through a jungle, he passes a big rock. As he passes the big rock, a tiger jumps out at him. When he sees the tiger, his body reacts in a way that gives him extra energy to fight the tiger or run away from him, i.e., the fight/flight reaction. At the same time, his brain memorizes all the details of the situation including the sights, sounds, emotions, thoughts and physical sensations. With the extra energy he has, he runs away from the tiger and returns to his cave. After resting for a few days, he begins to walk through the jungle again.

I ask the client, “What do you think happened when he passed a big rock? Most are able to identify that the cave man will think there will be a tiger. But how will he feel? He will feel as he did when the tiger was there. He will feel scared. He will have that same adrenaline rush of energy and he will feel the same terror as if the tiger were there, simply from the sight of the rock. I explain that with trauma, there will be the physical reaction with the fear, nervousness, anger and agitation just from the “rock” — we no longer have to fight a tiger to react.

Clients begin to understand that they, too, react to many “big rocks” in the present. Anything that may remind them of their abuse can create this trauma reaction. What is even more confusing is that it does not always consciously connect to the original trauma.

Many times, clients have blocked the trauma so efficiently that they no longer recognize that their feelings today are connected to the original problem. They are just upset or anxious without a real understanding of why. These big rock reactions are usually the cause of relapse. Treating and resolving the original trauma reaction then relieves the present day stress and the client is much more comfortable in sobriety.

The use of imagery and acupressure

One technique that I use is a containment procedure. Craig suggests asking the client to imagine that he is creating a videotape of his traumatic history. I ask the client to envision himself putting all the abuse he’s suffered on a videotape; from beginning to end. I then ask him to name the tape. Then I ask if he would like to lock it up in any way. Sometimes, he will put a lock on it or put it in a locked box. Then I ask that he leave it on my shelf. Many clients feel a sense of relief from this process.

EFT is a very rapid way to desensitize or release the intense emotions associated with traumas, both life-threatening and life-shaping. There are some basic concepts in using this very powerful energy therapy. Craig explains that the technique works in a way that releases disruptions (emotions) in the body’s energy system. The technique requires two basic elements. First is the “tuning in,” focusing on the emotion, image or physical sensation that one wants to change or release. Secondly, it requires tapping on certain acupressure points on the body. When done expertly, this technique can eliminate, usually permanently, the feelings that have been addressed.

When there are single-episode traumas, most symptoms will dissipate within two to three 50-minute sessions.

Multiple traumas

When there is a history of multiple traumas, the time frame will definitely be longer. If a client were sexually abused over a period of several years, there are more triggers, associated images, physical sensations and beliefs. These are deeper and more ingrained in the individual and take patience and motivation on the client’s part to systematically address the major areas of concern.

A positive in this treatment is that many times there is a generalization effect. When several core issues have been desensitized, often other images melt away and no longer hold their original emotional intensity. Using this technique with CD clients may in part be effective because there is an immediate relief or change of perspective.

The instant results often serve as a motivator and offer hope that clients have never had before. They often feel they are destined to live with these emotional restraints and use chemicals to relieve the pain or “white knuckle” their sobriety. EFT fits into the immediate gratification mode that these clients have lived most of their lives. This mental framework requires thorough education on the part of the therapist to manage.

I always start with a complete trauma history. Often I ask the client to write the 10 worst things that happened to her. I ask her not to go into detail or name any feelings. This can include being raped by a neighbor or wetting the bed at a friend’s house in third grade. In this context, trauma does not have to be life-threatening to leave emotional scars and then to shape the client’s self-concept and continued pattern of behavior. With this list, I will work with the client to rank the incidents from least painful to most painful. When I begin using EFT with the person, I usually start with any present-day issues, i.e., I’m aggravated with my boss at work. By reducing and eliminating these issues the client is able to build confidence in the technique without “stirring up” more intense emotions in the garbage can.

When I feel that appropriate rapport has been established and am certain the client has a strong support system, I will begin processing the traumas, from least to worst. By doing this, clients have leaned out lots of garbage before ever approaching the most painful of memories. They also have good experience that they will be able to “go through” the emotional pain necessary to release the negatives associated with the trauma.

The other approach to systematically reducing the trauma is with the imaginary videotape. When I choose to use this technique, I will first desensitize the fact that the tape exists. This often brings up some mild emotional distress which is addressed. Then I have the client imagine she can put the videotape in a special VCR that will play the tape one frame at a time. This is especially effective in single-episode or recent traumatic memories.

Self-care

The shifts and changes that occur when using this technique are usually quiet dramatic. I urge my clients to use the technique daily, but to limit themselves to present-day issues. I suggest that they use EFT each morning before reading their daily meditation and then 10 to 15 times daily to reduce any tension or stress that they feel at that moment. Those who follow through with this begin to feel much better very quickly. It also helps to reduce anxiety related to the continued trauma work.

When working with intense traumas clients relate that they feel drained, tired or fatigued. This sometimes lasts for a few hours or even a day or two. I warn of this possibility and encourage them to take time to rest and re-balance. With less severe issues, it is common for clients to feel regenerated and energetic.

I strongly believe that EFT and other energy therapies could be a crucial element in preventing relapse in the chemically dependent population. It seems that it could be utilized earlier in recovery when the client is safe to address these traumatic issues, as when in a residential setting that could control use.

The caution is that when these emotions are brought to awareness and clients begin to feel the disturbances, their first tendency is to avoid the emotional disturbance.

The pattern they have followed in doing this is to use chemicals or other compulsive behavior to dull the pain and distract themselves from the real issue. This may also be an explanation as to the common occurrence of developing new compulsions, i.e., from substance abuse to gambling, smoking, sexual acting out, etc. EFT goes to the root of the problem very rapidly and efficiently.

Laura Campbell, BCSW, has a private practice in Houma, La.

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