Thought Field Therapy

Thought Field Therapy, or TFT, is an alternative treatment developed by an American psychologist, Roger Callahan, Ph.D. Its proponents say that it can heal of a variety of mental and physical ailments through specialized "tapping" with the fingers at meridian points on the upper body and hands.

Uses of the treatment
Callahan states that the process can relieve a wide variety of problems including psychological trauma, phobias, anxiety, panic, obsessive-compulsive disorder, addictive urges, and depression. He has also said in a recent interview on National Public Radio that "TFT can successfully treat physical illnesses such as Malaria in as little as 15 minutes". In articles on his website, Callahan has also stated that TFT can successfully prevent heart problems that may lead to sudden death, and that TFT has successfully stopped atrial fibrillation. In 1985, in his first book on TFT, he said that specific phobias could be cured in as little as five minutes (Callahan, 1985). He also asserts that his most advanced level, Voice Technology (VT) can be performed over the phone using an undisclosed "technology". The fee listed on Callahan's website for this training is $120,000. Trainees must sign a confidentiality agreement not to disclose the trade secret behind VT. Gary Craig, the first person to train in VT stated that although he paid $100,000 for the training, "I am uncomfortable, however, with the inaccurate portrayal of VT. I do not find it as advertised and I grow increasingly ill at ease with the many questions I get from the public." and "The core "secret" behind VT is in the public domain and can be learned at a weekend workshop for a few hundred dollars. Many people reading this use VT routinely without knowing it. Had I known this when I first took VT, I would have objected strenuously. As it was, it took me quite awhile before I finally learned that I had spent $100,000 for something that I now know is used routinely by many practitioners in this profession." (see http://www.emofree.com/articles/about.htm).

Less than 0.05% of the tens of thousands of TFT practitioners worldwide have chosen to train in and use VT and instead use predetermined algorithm treatments for which self-help training is available from around $250. If the common algorithms fail, individuals are encouraged to see a therapist trained in the more expensive "diagnostic" techniques that use specific individualized treatment sequences which Callahan says will help most people not helped by algorithms (Callahan & Trubo, 2001) and VT demonstrations are done at many of the algorithm trainings. If the lower level methods fail, Callahan recommends the VT.

Callahan gave his treatment the name "Thought Field Therapy" because he theorizes that when we think about an experience or thought associated with an emotional problem, we are tuning into a "thought field," which he describes as "the most fundamental concept in the TFT system" and which "...creates an imaginary, though quite real scaffold, upon which we may erect our explanatory notions" (Callahan & Callahan, 2000, p. 143). Perturbations are said to be precisely encoded information contained in the thought field, which become activated whenever a person thinks about a problem. Callahan maintains that these perturbations are the root cause of negative emotions and that each perturbation corresponds to a meridian point on the body (he calls this an isomorphism). In order to eliminate the emotional upset, Callahan says that a precise sequence of meridian points must be tapped on. He theorizes that tapping unblocks or balances the flow of Qi, a Chinese term used to describe vital life energy (Callahan & Trubo, 2001). The sequences can be determined by two of Callahan's proprietary "causal diagnostic" techniques: 1) an in-person method using muscle testing (Applied kinesiology) and 2) the Voice Technology, as described above. There is concern by clinical psychologists of the adoption of TFT as an unvalidated and pseudoscientific therapy by government bodies and the public at large [http://www.srmhp.org/0101/raison-detre.html. The British National Health Service is adopting the use of TFT into the service from 2007 as a Complementary and Alternative practice.

Inception of the therapy
The first patient Callahan tried tapping with was in 1980, on a 42 year old woman named Mary, who he reported had a lifelong severe phobia of water. Her phobia was so severe that she could only take sponge baths, experienced intense fear every time it rained, and could not bear to go near the ocean. Although he had been treating her with more conventional treatments such as systematic desensitization and hypnosis, he had been working with her for a year and a half and the only progress they had made was that she could sit at the side of a swimming pool, but her feeling of terror remained. Mary had reported that every time she thought of water, she got a horrible feeling in the pit of her stomach. Callahan, who had recently been studying a course in applied kinesiology that also covered meridian points, decided as an experiment to have her tap on the stomach meridian end point, which was under her eye. Immediately after doing so, she reported that her fear of the water was gone, and she ran out to the pool, unafraid. Later that evening it rained and she reported going to the ocean, still with no trace of her prior phobia and she reported in a video 17 years later that she had no recurrences (Callahan, 1997).

Callahan then began treating his other patients who had phobias and other problems such as trauma and he reports that with most, more meridian points needed to be tapped in various sequences. He also added a procedure called “the nine gamut” which consists of tapping on the back of the hand while performing eye movements, humming, and counting, believed to balance the left and right brain and he also came up with a putative correction for recalcitrant patients who he believed had a condition called psychological reversal (Callahan & Trubo, 2001). All of his decisions on what treatments to include in the claimed advances he made were based on the clients’ reports of decreased subjective emotional distress level. He utilized the Subjective Units of Disturbance Scale (SUDS) originally developed by the psychologist Joseph Wolpe, where the person reports on their distress level on a scale of 1 to 10, where 1 represents a complete absence of distress and 10 represents the worst distress possible (alternatively a scale of 0-10 can be used). Callahan says that his further developments increased TFT's success rate, which climaxed with his development of VT, which he claims has a 97% success rate and is on a par with hard science. Callahan states:

"As I have made more discoveries over the last two decades, my success rate has been gradually increasing and getting very close to perfection. This work is now on a par with hard science, physics and chemistry.  We are no longer floundering in the wispy world of social science" (Callahan & Callahan, 2000, p. 164).

Assessments and critiques of TFT
There are two studies published in peer reviewed journals on TFT. One was an exploratory study done by Carbonell & Figley (1999) on four novel therapies, which was not designed to be a comparison study and the methodology, according to two reviews on TFT (Gaudiano & Herbert (2000), Hooke, 1998) was insufficient to demonstrate efficacy. Callahan & Trubo (2001a) say that TFT was shown to be superior to the other approaches in the Carbonell & Figley study. However, the authors' report states that their study "fell short of reaching it goals; that the nature of the study precludes comparison of the approaches, and such a comparison was never planned" and "In contrast to conventional psychotherapy research, the SCD methodology is not meant to compare the various treatments, and thus does not necessarily meet the criteria proposed for empirically validated treatments." (see full report) In a letter to the editor in response to the latter article, former TFT practitioner Monica Pignotti wrote "the bottom line for me is that TFT gives the clinician a protocol that is highly replicable. What this means is that with TFT we have a very powerful tool that can provide very real help for clients with psychological problems.(Pignotti)The second study was a controlled study on Thought Field Therapy Voice Technology published in the peer reviewed journal The Scientific Review of Mental Health Practice (TFT VT, Pignotti, 2005c) which showed no difference between the TFT VT and randomly selected tapping sequences, which provides evidence against Callahan's assertion that precise sequences derived from his claimed specialized technology make a difference in result.

The evidence adduced in support of TFT by Callahan and other proponents comes from uncontrolled case reports that were not peer reviewed. In 2001, in an unprecedented move, the Editor of the Journal of Clinical Psychology agreed to publish without peer review, five articles on TFT of Callahan’s choosing (Callahan, 2001b; 2001c; Pignotti & Steinberg, 2001; Sakai et al, 2001; Johnson et al., 2001). In lieu of peer review, critiques were published alongside each article (McNally, 2001; Kline, 2001; Herbert & Gaudiano, 2001; Lohr, 2001; Rosner, 2001). The critics agreed that each of the five studies contained serious flaws that rendered them uninterpretable by them. They pointed out flaws which included: selecting only successful cases; focusing on a diversity of problems; failure to use a control group; failure to control for placebo effect, demand characteristics, and regression to the mean; lack of valid assessment measures; use of the SUD as the only measure of efficacy other than HRV; using an out of context physiological measure (HRV) in an inappropriate manner; and lack of a credible theory. One the critics, Harvard Psychology Professor Richard J. McNally, noting the lack of evidence for TFT, stated that “Until Callahan has done his homework, psychologists are not obliged to pay any attention to TFT.” (McNally, 2001, p. 1173). Psychologist John Kline wrote that Callahan’s article “represents a disjointed series of unsubstantiated assertions, ill-defined neologisms, and far-fetched case reports that blur boundaries between farce and expository prose.” (Kline, 2001, p. 1188). One of the original authors of the non-peer reviewed studies later retracted her conclusions and has reversed her earlier favorable position on TFT(Pignotti, 2005a, b). The only other studies adduced in support of TFT are ones that were reported on in Callahan’s newsletter, The Thought Field and an uncontrolled study on Voice Technology consisting of radio show call-ins in a proprietary archive of a journal of collected papers on Applied Kinesiology. Callahan's claims about the TFT Voice Technology having unique properties and being on a par with hard science (see quote above) were not supported in a controlled experiment that used random sequences vs. TFT VT (Pignotti, 2005c).

TFT proponents assert that tens of thousands have been successfully treated with no side effects using TFT. They believe that on this basis alone scientific testing will never discredit what they assert is a phenomenal success rate. A 2006 Delphi poll of psychologists on discredited therapies, published in an APA journal, indicated that on average, participants rated TFT as "probably discredited" (Norcross, Garofalo & Koocher, 2006). The sample included both practicing clinical psychologists and academic psychologists. Devilly (2005 p.444) states that there is no evidence for the claimed efficacy of power therapies such as TFT, EFT(and others such as NLP and they exhibit the characteristics of a pseudoscience. Lilienfeld, Lynn & Lohr (2003, Chapter 1) also use TFT as an example of a therapy that contains some of the hallmark indicators of a pseudoscience. Specifically, they note its evasion of the peer review system and absence of boundary conditions.

Notes and references

 * Callahan, R.J. (1985). The Five Minute Phobia Cure.  Wilmington:  Enterprise.
 * Callahan, R.J. (1996). The Case of Mary.  Traumatology 3(5), Article 5.
 * Callahan, R.J. (1997) Videotape: Introduction to TFT, TFT Training Center, La Quinta, CA.
 * Callahan, R.J. and Callahan, J. (2000). Stop the Nightmares of Trauma. Chapel Hill:  Professional Press.
 * Callahan, R.J. and Trubo, R. (2001a). Tapping the Healer Within.  Chicago:  Contemporary Books.
 * Callahan, R.J. (2001b). The impact of thought field therapy on heart rate variability (HRV). Journal of Clinical Psychology. 57 (10), 1153-1170 (Not Peer Reviewed).
 * Callahan, R.J. (2001c). Raising and lowering heart rate variability: Some clinical findings of Thought Field Therapy. Journal of Clinical Psychology. 57 (10), 1175-1186 (Not Peer Reviewed).
 * Carbonell, J.L. & Figley, C. (1999). A systematic clinical demonstration of promising PTSD treatment approaches. Traumatology, 5(1), Article 4.  Available: http://www.fsu.edu/~trauma/promising.html
 * Craig, G. (1998) The evolution of EFT from TFTtm. EFT: Emotional Freedom Technique: A Universal Healing Aid. Available: http://www.emofree.com/articles/scien-i.htm
 * Craig, G. About Voice Technology. Available: http://www.emofree.com/articles/about.htm
 * Devilly, Grant J. Source: Australian and New Zealand Journal of Psychiatry, June 2005, vol. 39, no. 6, pp. 437-445(9)
 * Gaudiano, B. A., & Herbert, J. D. (2000a, July/August). Can we really tap our problems away?: A critical analysis of Thought Field Therapy. Skeptical Inquirer, 24, 29-36. Available:  http://www.csicop.org/si/2000-07/thought-field-therapy.html
 * Herbert, J.D. & Gaudiano, B.A. (2001). The search for the holy grail: Heart Rate Variability and Thought Field Therapy. Journal of Clinical Psychology, 57(10), 1207-1214.  Available:  http://www.psychology.drexel.edu/papers/herbert-holygrail.pdf
 * Hooke, W. (1998). A review of Thought Field Therapy. Traumatology, 3(2), Article 3. Available online: http://www.fsu.edu/~trauma/v3i2art3.html.
 * Kline, J.P. (2001). Heart Rate Variability does not tap putative efficacy of Thought Field Therapy.  Journal of Clinical Psychology. 57 (10), 1187-1192.
 * Lilienfeld, SO, Lynn, SJ, Lohr JM (eds) (2003). Science and Pseudoscience in Clinical Psychology. New York: Guilford Press.
 * McNally, R.J. (2001). Tertullian’s motto and Callahan’s method.  Journal of Clinical Psychology, 57(10) 1171-1174.
 * Norcross, J.C., Garofalo, A., Koocher, G.P. (2006). Discredited Psychological Treatments and Tests: A Delphi Poll, Professional Psychology, Reseach and Practice, 37(5), 515-522.
 * Pignotti, M., Steinberg, M., (2001). Heart rate variability as an outcome measure for Thought Field Therapy in clinical practice. Journal of Clinical Psychology, 57(10), 1193-1206.(Not Peer Reviewed) The first author published a retraction.
 * Pignotti, M. (2004, Fall/Winter). Thought Field Therapy in the media: a critical analysis of one exemplar.  The Scientific Review of Mental Health Practice, 3(2) p. 60-66.
 * Pignotti, M. (2005a). Regarding the October 2001 JCLP Special Issue on Thought Field Therapy: Retraction of conclusions in the article “Heart Rate Variability as an outcome measure for Thought Field Therapy in clinical practice.” Journal of Clinical Psychology, 61(3), 361-365.
 * Pignotti, M. (2005b). Callahan fails to meet the burden of proof for Thought Field Therapy claims: Rejoinder to Callahan. Journal of Clinical Psychology, 61(3), 251-255.
 * Pignotti, M. (2005c). Thought Field Therapy Voice Technology vs. random meridian point sequences: a single-blind controlled experiment. The Scientific Review of Mental Health Practice, 4(1), 72-81.
 * Waite, W.L. & Holder, M.D. (2003).  Assessment of the Emotional Freedom Technique: An Alternative Treatment for Fear. Scientific Review of Mental Health Practice, 2 (2), 20-26.