Beyond the typical clinical tasks in the early phase of treatment, energy-oriented psychotherapy generally opens with six additional elements:

1. Establishing an energy checking procedure.
    
2. Checking for and correcting neurological disorganization.
    
3. Checking for and resolving psychological reversals.
    
4. Identifying a target problem appropriate for energy interventions.
    
5. Assessing the person’s "subjective units of distress" (SUD) and confirming this with an energy check.
    
6. Energetically locking the problem into the body (for the purposes of the treatment session).

This module addresses each of these tasks and shows how they may be integrated with more generic clinical tasks in the opening phases of treatment.

Maintaining rapport is an ongoing task and a necessary condition if psychotherapy, regardless of its orientation, is likely to be successful. Attitudes that support rapport:

1. Maintain an appreciation of the client’s individuality.

2. Stay open to your own moment-to-moment experience as you interact with this unique person.

3. Being willing to engage the client in terms of this flow of experience.

4. Use any negative responses within yourself as information about the client’s problem (while remaining open to the possibility that these reactions might also provide information about you).

5. Practice "high positive regard" of the other as your default position

In addition, and consistent with an energy approach, exploring the presenting problem in terms of its physical address helps align client and therapist. Questions such as, "Notice where in your body you hold an emotional charge about this issue," by attuning both client and therapist to the client’s felt sense of the problem, can lead the way into an energy-based approach.

Expectations the client brings to the treatment that should be explored and clarified include:

1. Where does the client place responsibility for overcoming the presenting problem (self, therapist, family members, a change in external circumstances)?
    

2. What does the client believe will be the curative elements of the treatment (advice, advocacy, emotional support, "talking out" the problem, analysis, affect release, behavioral interventions, energy work, etc.)?
    

3. Are extraneous factors influencing the client’s hopes and expectations (involvement with the legal system, strategy for establishing a disability claim, desire to please a spouse)?

In addition to providing critical treatment information, taking a psychosocial history establishes a more favorable therapeutic climate by helping to:

Taking a psychosocial history involves, of course, more than just gathering objective information, and the greater the client’s pathology, the more critical and delicate this process may become. Even though energy methods have been reported to be effective for a wide range of diagnostic categories, including serious psychiatric disorders (Gallo, 2002), special skills beyond energy methods are required in the competent treatment of personality and emotional disorders. It is far easier to learn the mechanics of energy psychology than to be an effective clinician, and there is no substitute for clinical training, particularly with clients who have a history of psychological difficulties.

Practitioners working with a generally non-psychiatric clientele, such as "life coaches" who bring energy psychology methods into business, educational, or other settings should, at a minimum, know how to gather pertinent information about a client’s past and know when it is appropriate, based on this psychosocial history and other basic indicators, to make a referral.

Because energy-based interventions can be so rapid and effective, it is not unusual for therapists who are new to energy psychology to over-apply the methods. Tentative indications and contraindications for the use of energy psychology, based on early clinical data, have been delineated and can serve as provisional guidelines. Particular caution must be applied with people who have suffered severe or multiple trauma, who have borderline or other personality disorders, who have had episodes of psychosis or dissociative identity, who have been hospitalized for other psychological problems, who have severe depression or bipolar disorder, who have not been able to form a productive working relationship with the therapist or who have a history of severe relationship disturbances, or who cannot understand their role in their problems and in the potential solution of those problems.

Another dilemma in having a method that can rapidly and effectively impact emotional problems is that psychological equilibrium may be disrupted. Symptoms have a purpose. An 11-year-old girl, a model child who causes few problems and gets little attention in a home where two other siblings are highly disturbed, develops a phobia of balloons after one she is inflating bursts. The phobia grows so intense that she resists leaving her home for fear of seeing a balloon. The therapist is quite certain that tapping treatments could rapidly ameliorate the phobia, but also suspects that if her symptoms were resolved, the therapy would end before the more pervasive family issues were addressed. Should the phobia be treated by defusing its energetic basis using primarily physical interventions? To "tap away" unwanted emotional responses or intrusive thoughts can upset a delicate psychic or interpersonal ecology.

In addition, a person’s "life lessons" or developmental steps are sometimes achieved by psychologically working through difficult feelings or thoughts. In some instances, even if the symptom can be removed through relatively mechanical procedures, the therapist must consider how and if their surgical-like removal will ultimately serve the client’s well-being and psychological development. Energy interventions can also lead to the opposite of what was intended. Such paradoxical responses are seen when procedures that begin to reduce certain feelings or thoughts have the unintended effect of reinforcing the person’s defenses involving those feelings and thoughts. While all of these dilemmas can be addressed and worked with and do not necessarily contraindicate the use of energy methods, clinical sensitivity and sophistication are obviously required.

The at-home treatment routines assigned to a growing number of people by their psychotherapists, along with a spate of self-help books and classes, are simple enough to use and yield results that are impressive enough that people are tempted to try them with family and friends. Non-licensed counselors and "coaches" are tempted to offer them to the public. But the wisdom of a century of clinical practice holds that psychological interventions which might unearth latent psychopathology or activate personality disorders require sophisticated and responsible application and are best left in the hands of professionals.

The counter-argument is that an energy-based approach to psychological problems represents a new paradigm in which people can readily influence the energies that affect their physical and mental health, and that these techniques should be widely distributed. Both positions have merit, and their inevitable dialectic will result in guidelines for both the professional and self-help oriented uses of the developing methods.

As with any new field, ethical standards for practitioners of energy psychology are evolving. The Code of Ethics that has been developed by the Association for Comprehensive Energy Psychology is posted at:

www.energypsych.org/coe.html

and their Standards of Practice statement can be found at:

www.energypsych.org/standards.html

The Code of Ethics  established by the American Psychological Association remains a model set of standards for all psychotherapists and can be found at:

www.apa.org/ethics/code.html

www.americanprofessional.com/insight.htm

Areas that should be addressed when introducing a client to an energy-based treatment approach to psychological problems:

1. Explaining the hypothesized underlying role of electromagnetic and more subtle energies in psychological problems.
    

2. The nature of energy checking and its role in assessing the energetic dimensions of psychological problems.
    

3. Unfamiliar procedures that might be used during the treatment. Name 5 of these possible procedures.
    

4. Reaching an agreement (informed consent) about proceeding with an energy approach.

Procedures that might be used as part of an energy approach to treating psychological problems:

1. Tapping or holding specific points on your body
    

2. Moving your eyes in certain directions
    

3. Assuming various physical postures
    

4. Mentally focusing on certain thoughts, feelings, or situations
    

5. Repeating specific statements or affirmations

Topics to which you have already been introduced—energy checking, neurological  disorganization, and psychological reversals—are all addressed during the opening phases of treatment.

Energy checking is often introduced as part of the explanation of an energy-based clinical approach. The first step is to "qualify" an indicator muscle. This means identifying a muscle that can be safely and reliably used in checks of the body’s overall energy system. Once the muscle has been identified, qualifying it also involves:

Neurological disorganization may be a chronic state or it may occur in response to specific situations, including those that arise during the treatment session. Because it can interfere with subsequent work, the practitioner should remain alert for neurological disorganization not only in the diagnostic phases but throughout the treatment.

An expedient way to introduce the concept of neurological disorganization while further establishing the validity of energy checking is to assess each of the five types of neurological disorganization, perform the related corrections for any that are present, and energy check again to demonstrate the effects of the correction technique.

The concept of the psychological reversal is also introduced relatively early within an energy psychology approach, although wording along the lines of "inner conflict about the treatment goal" might be preferred. Typically, this would come after introducing energy checking, after addressing neurological disorganization, and after the target problem has been articulated but prior to working with it.

Initially, the clinician would use energy checking to identify global (and "criteria-related" global) psychological reversals. Among the statements that might be energy checked, as the clinician’s intuition dictates, include:

Identifying the Target Problem: The treatment can focus on fear, phobias, panic, anxiety, anger, lack of confidence, grief, worry, jealousy, guilt, shame, obsessiveness, or any other undesired emotional response to a specific situation, thought, image, or memory. Other treatment goals are also possible, from overcoming addictions and allergies to improving athletic or professional performance, but for the purposes of this training program, the focus at this point will be limited to undesired emotional responses.

In identifying the first problem area to address using an energy-based psychological approach, the problem should be consistent with both the client’s intention and the practitioner’s sense of the next step based on:

1. The psychosocial history.
    

2. An exploration of the meaning, within the client’s worldview, of the identified problem.
    

3. An analysis of the aspects of the problem and a selection of the first aspect that must be resolved before the entire problem can be resolved.

The selection and wording of the designated problem is a significant choice, and it may be approached in various ways. A guideline for finding the "top priority issue" is called the principle of highest leverage: Which issue will yield the greatest result from the simplest intervention; which issue is going to help the client move forward most effectively?

Some practitioners begin with the presenting problem and wait to see if other aspects tied into the person’s past will surface. Others identify analogous situations from the client’s history that might have been instrumental in the formation of the current pattern. They might focus, for instance, on earlier traumas and the core beliefs that emerged from those traumas. By treating these first, and then turning to the presenting problem, the therapy is believed to be more thorough and lasting. While this is a matter of therapist preference that also varies from client to client, for the purposes of this training program, the initial focus will be placed on the presenting problem.

I want to get over this problem [or specify problem].

It is safe to get over this problem.

It is safe for others if I get over this problem.

I deserve to get over this problem.

I will get over this problem.

I will lose my identity if I get over this problem. (PR indicated if muscle stays firm).

I will allow myself to get over this problem.

It is possible for me to get over this problem.

I will feel deprived if I get over this problem (PR indicated if muscle stays firm).

My getting over the problem will be good for me.

It is my role to have this problem (PR indicated if muscle stays firm).

My getting over the problem will be good for others.

Others do not deserve to have me get over this problem. (PR indicated if muscle stays firm).

Subsequently, if treatment stalls, you can check for a variety of intervening psychological reversals by simply inserting the word "completely":

I want to be completely over this problem.

It is safe to be completely over . . . , etc.

Accessing the problem state is a fundamental procedure in energy-based psychotherapy. For the treatment interventions to be effective, they must be administered while the problem state is energetically "active."

Once a target problem has been identified, accessing the problem state can be as simple as bringing the problem to mind. Thinking about or imagining a situation activates the thought  field (discussed in the following module) associated with that situation, including a complex of feelings, beliefs, and responses in the meridians and other energy systems.

A firm indicator muscle will lose its firmness when this constellation is activated.

The issue of inadvertently retraumatizing a client is a concern in any treatment approach that works with severe trauma. When guiding a client to mentally access a problem state, clinical sensitivity is required to find a balance between psychologically entering the problem and not inducing further trauma.

In energy-based psychotherapy, it is neither necessary nor desirable to risk retraumatizing the person in order to apply an intervention.

Usually, asking the client to think about the problem is an appropriate way to activate a thought field strong enough that an indicator muscle loses its firmness.

If there is special concern about retraumatization with a particular client, a variety of techniques can be used to keep the memory or feeling at a distance, such as viewing seeing it through a long tunnel or thinking about "what it would be like" to think about the issue. In his Tearless Trauma technique, when asking for a rating on the amount of distress caused by a traumatic memory, Gary Craig sometimes asks the client to simply "guess at what the emotional intensity would be [on a scale of 0 to 10] if you were to vividly imagine the incident."

The practitioner can also focus the initial round of treatment on the fears the client is having about accessing the problem, which can also be a powerful affirmation of an energy-based approach. Neutralizing these fears at the outset can be comforting and reassure the client that subsequent fears that emerge will be manageable and that lifelong fears can be treated. Like all good therapeutic pacing, matching the target of the intervention with what is occurring during the treatment aligns the treatment to the client.

If the client is having difficulty accessing feelings about the problem (i.e., an indicator muscle stays firm while the problem is brought to mind), he or she can be encouraged to:

1. Take more time to focus inward while relaxing and breathing deeply;
    
2. Vividly visualize circumstances that activate the problem;
    
3. Bring to mind other sensory dimensions of those circumstances (kinesthetic, olfactory, auditory, gustatory);
    
4. Slowly and deliberately replay in the imagination a situation in which the problem was felt or imagine one in which it would be felt;
    
5. Schedule an "in vivo" session in a setting where the problem actually arises.

The level of distress associated with the problem state is given a number from 1 to 10 (the "subjective units of distress," or SUD rating), which is verified with an energy check. . With the problem state mentally activated, the client is asked to rate the level of discomfort "at this moment," with 10 being an extreme level of discomfort and 0 being no discomfort at all.

The subjective units of distress (SUD) rating provides a simple gauge for tracking progress through the treatment.

If the client is unable to translate the feeling into a number, less precise language—such as "slight," "moderate," and "extreme" distress or improvement—might be used.

While SUD ratings are subjective verbal estimates, they correlate strongly with heart rate  variability, an objective measurement that reflects activity in the autonomic nervous system. When the SUD level goes down, heart rate variability shifts in a desirable direction.

SUD ratings can also be confirmed using energy checks. Like the SUD rating, energy checks for this purpose are also named by their acronym. The energy check to corroborate a SUD rating is called a MUD (muscular units of distress) rating.

The client states the SUD level (e.g., "It’s a 5") while an indicator muscle is checked. If the muscle loses firmness, other ratings are checked (e.g., "It’s more than a 5," "It’s less than a 5," "It’s a 3"). Often the SUD and the MUD will match.

The difference between a subjective rating and an energy check can be puzzling yet ultimately informative. The client is obviously the authority on how he or she feels, but the energy check can provide information about the problem that the client cannot access consciously. When the SUD and MUD do not match, this difference simply provides new information. Often it results in the client delving more deeply into his or her experience in order to explore the discrepancy.

Also keep in mind that energy checks should always be interpreted within the context of other indicators; they are not to be relied upon as the sole source of information about a given question.

The problem state needs not only to be accessed; it must also remain active during the energy interventions designed to treat it. It is not necessary, however, to continually hold the problem in mind.

You learned the technique of using a reminder phrase in the "Basic Basics" module.

Although continually thinking about the problem, or repeating the reminder phrase, are effective ways to keep the problem state active, they require the client’s ongoing attention. It is also possible to temporarily "lock" the problem state into the client’s energy field for the purposes of the treatment. The problem state will remain energetically active, even as the client’s attention is focused on other matters.

The thought field that is associated with the problem can be energetically locked in (called resonance locking) for the purposes of the treatment using:

The Third Eye Up

          or

The Leg Lock

Based on anomalies that were discovered and are used within the field of applied kinesiology, these are tremendously valuable tools for energy psychology practitioners.

The client’s expectations about the treatment and the client’s goals for seeking treatment are typically addressed early in the treatment.

A psychosocial history: As with most forms of psychotherapy, a psychosocial history is usually taken early in the treatment. In addition to gathering information, the interview helps establish a therapeutic climate.

By focusing on the subtle energy dimension of psychological problems, energy-based approaches to treatment differ from traditional treatment models. As these concepts are unfamiliar to many people, substantial explanation of the model may be necessary.

A way to introduce some of the features of an energy-based approach to treating psychological problems is to qualify an indicator muscle, and to use it to demonstrate the relationship of mental states and the body’s energies (e.g., a firm indicator muscle instantly loses strength when a stressful memory is brought to mind).

Neurological disorganization and global psychological reversals are often assessed and corrected if present.

Yes, the problem and its wording should be formulated in a manner appropriate for an energy-based approach.

Since specific-context psychological reversals that affect the problem would interfere with treatment progress, these should be checked for and corrected. This would be followed by having the client access the problem state so the level of distress it causes can be measured.

Once the problem state has been accessed, a 0 to 10 rating of the degree of distress caused by the problem is estimated (using SUD and MUD ratings).

Another step before introducing energy-based interventions focus directly on the target problem is to lock in the problem state.

Finally, specific energy-based interventions focusing on the problem can be applied effectively!

It is worth repeating that the emphasis on steps and procedures is to help you internalize a basic structure that allows you to operate more freely within a treatment setting rather than that you be confined to a set of rules and formulas. To further internalize the structure, fill in the blanks in the following sequence of tasks that are part of the opening phases of treatment:                                                                                                                                       Jump to Answers
 

Build r______

Gather information about client’s b_________ and t_______ g____

Explain and reach i_______ c______ about using an energy-based approach

Establish a familiarity and some success with e_____ c______

Check for and correct n_______ d_____________

Check for and resolve g______ psychological r________

Formulate an appropriate t_____ p______

Check for and resolve specific c_____ psychological r_______ involved with the problem

A_____ the problem, r____ it, and "l____ it" in

Specific e_____ i__________ can now be focused directly on the target problem
 

Begin building rapport

Gather information about client’s background and treatment goals

Explain and obtain informed consent about using an energy-based approach

Establish a familiarity and some success with energy checking

Check for and correct neurological disorganization

Check for and resolve global psychological reversals

Formulate an appropriate target problem

Check for and resolve specific-context psychological reversals involved with the problem

Access the problem, rate it, and "lock it" in

Specific energy interventions can now be focused directly on the target problem

Applying specific energy interventions that are focused directly on the target problem is the topic of the following three modules.

Jump to Practice Session

Return to Flow Chart Quiz

With a colleague role-playing a client coming in with a specific problem or using an actual problem, go through each of the phases of the early part of treatment. The target problem could be a fear, phobia, anxiety, anger, lack of confidence, grief, worry, jealousy, guilt, shame, obsession, or any other undesired emotional response to a specific situation, thought, image, or memory.

Please take care that the problems you target are appropriate given the context of your practice sessions. Discuss possible areas of conflict or negative consequences in advance. If the program is being used in the context of a university or other formal training program, please be certain that its use is in compliance with Standard 7.04 of the American Psychological Association’s 2002 Ethics Code, "Student Disclosure of Personal Information." The critical word is "require"; no one should be coerced, even subtly, into working with personal issues for training purposes.

The treatment tasks to cover in this practice session are to:

Build rapport.

Gather information about the client’s background and treatment goals.

Explain and obtain informed consent about using an energy-based approach.

Establish a familiarity and some success with energy checking.

Check for and correct neurological disorganization.

Check for and resolve global psychological reversals.

Formulate an appropriate target problem.

Check for and resolve specific-context psychological reversals involved with the problem.

Access the problem, rate it, and "lock it" in.

You are now ready to begin the energy intervention phase that begins with the next module.

After this sequence, solicit feedback. Reverse roles.