Introduction
This piece of work was done in 10 sessions funded by a veterans’ charity called Supporting Wounded Veterans https://www.supportingwoundedveterans.com/. Our sessions were online starting in February 2022 and we worked together until May 2022.
I am an advanced accredited EFT practitioner with more than 15 years’ experience and a mentor for EFT International. I’m a former nurse having last worked in palliative care. I’ve trained as a counsellor, a Health Creation Coach with the integrative cancer doctor Rosy Daniels and also trained in other psychological modalities including Internal Family Systems (IFS) and Comprehensive Resource Model (CRM). I integrate aspects of these experiences into my work but EFT always remains the shining star.
I originally wanted to write this case study for submission to a journal and explored doing so by reading Dr Elizabeth Boath’s book 1. However, I realised it wasn’t possible as I would have needed to have conceived the idea and have started preparing to do this from the beginning, gaining the necessary ethical consents, literature reviews and initiating more data collection. Instead, I have written this piece in a session by session, more relational, less scientifically academic way in the hope that it will illustrate how I have worked with a complex case which had a great outcome over 10 sessions and in a way that will be helpful to other EFT practitioners, as well as giving a flavour of my work. I have cited a few references that maybe helpful in further exploration of aspects of my approach but I am not including research references that show the evidence of efficacy of EFT as these are readily available on the EFT International website.
I do of course have the clients consent as well as his ongoing support to write this piece.
Summary
A is a 54-year-old veteran with very complex issues and long-term conditions. He found me through the veterans’ charity following an online pain management clinic he’d attended created by the charity where he’d heard about EFT. When he started his pain was largely arthritic associated in ‘all 51 joints’ and it was said to be linked to his chronic lymphocytic leukaemia. He reported his pain as varying daily between 5 and 11/10 and he was largely bedroom bound in his Devon home.
I quickly ascertained that his wartime experience of being involved in an explosion had left him with a head injury and poorly controlled epilepsy; in addition his frequent nocturnal fits hugely exacerbated his pain. He’d had Cognitive Behaviour Therapy (CBT), Eye Movement Desensitisation Reprocessing (EMDR) and Timeline Therapy for his trauma but we found through EFT’s ‘Tearless Trauma’, ‘Telling the Story and ‘Movie’ Techniques that there was plenty of intensity left in this experience. Along with achieving peace and acceptance of the experience he started tapping and imagining his brain synapses flowing smoothly and freely. A did this determinedly twice a day and since our 7th session no longer has frequent nocturnal seizures and consequently his pain is no longer aggravated by them. We finished our work together in May 2022 and his Short PTSD Rating score had reduced from 19/32 to 7.5/32.
During our time together we also explored and tapped for other issues that were limiting his well-being including a fear when being driven. In September 2022 4 months later, A was able to travel from Devon to Westminster Hall London to pay his respects and salute the coffin of ‘The Boss’ his beloved Queen as she lay in state. This involved standing and queuing with 10’s of thousands of other mourners to file pass the Queen’s body something that would have been completely impossible before his EFT sessions. So in his words ‘Without a Shadow of a doubt’ EFT made the difference.
Case Study
I have written in some detail about this case presenting important aspects of each session. The tapping techniques used were clinical EFT, and those used are be stated in the text. I found I couldn’t rush into tapping for the remaining combat trauma we found. Building rapport and safety as well as getting to know A and his needs were of the essence; we had to take our time to create the environment needed to do the deeper work. I had to stay very close to his present experience and session by session the circumstances that we needed to work and tap on naturally presented themselves.
A’s commitment to self-care and his adoption of tapping and other complimentary breathing and visualising practices made such an important contribution to the work. This was assisted by my sharing of audio examples with specific words from the sessions
A served in the RAF for 15 years from 1985-2000 serving in the first Gulf War, Northern Ireland and the war in the former Yugoslavia. He has complex issues resulting from a head injury when in a vehicle that was involved in an explosion in 1997. He developed epilepsy following that and was diagnosed with PTSD and anxiety disorder in 2005. In 2017, he developed Chronic Lymphocytic Leukaemia, in 2018 a bulging spinal disc and lower back pain and acute sciatica, Inflammatory Rheumatoid Arthritis in 2019 and Thrombocytopenia and Fibromyalgia in 2022. He was having 3-4 nocturnal seizures a week. He takes multiple medications for his conditions including 4 anti-epileptic drugs and Methotrexate a powerful anti-inflammatory agent taken weekly by injection for his arthritis which is also a form of chemotherapy that affects the immune system.
His home is in Devon and he lives with his partner and 2 teenage daughters the elder who is studying and training to become a nurse and the younger is at school. He joined the RAF at 17 to get away from home and his homelife and he would have had some ratings on the ACE score. At the time of the start of our work together A spent much of his time in his bedroom isolating even from extended family members because of the danger of catching the Covid 19 virus in his immunocompromised condition. He had days where he couldn’t get out of bed because of pain. His epilepsy was fairly uncontrolled; he was having seizures mostly at night several times a week which could last 30 minutes.
At the start of our work together and again at the end an assessment was made using The Short Post-Traumatic Stress Disorder Rating Interview (SPRINT). This is an 8-item self-report measure that assesses the core symptoms of PTSD (intrusion, avoidance, numbing, arousal) along with somatic malaise, stress vulnerability, and role and social functional impairment. Symptoms are rated on 5-point scales from 0 (not at all) to 4 (very much). The suggested cut-off score for this screen is 14. At the outset A’s score was 19/32 and at the end of our 10 sessions 7.5/32 so no longer in the realm of PTSD.
Session 1
A’s presenting issue was his pain and in this first session it wasn’t as bad as it often could be moving through his body like a tsunami wave starting at his hands and wrists. Today the pain there was a 5/10 but it could be at 11. He also had back pain and sciatica often and that pain would be the worst of all but was quiet today.
Our first task was to engage with and learn the tapping practice which was not straightforward. A’s use and movement of his hands and arms was very limited and he wore firm elastic circulation gloves; tapping was far from easy and he couldn’t raise his hands to his face without discomfort.
I quickly decided that we needed to explore other ways to tap with me doing surrogate tapping for him and A practising mental tapping (imagining himself tapping the points). I talked to him about the phenomenon of ‘Mirror Neurones’ and pointed him to an article to read after our session 2. Mirror neurones are a type of brain cell that responds equally when we perform an action and when we witness someone else perform the same action. They were first discovered in the early 1990s, when a team of Italian researchers found individual neurons in the brains of macaque monkeys that fired both when the monkeys grabbed an object and also when the monkeys watched another primate grab the same object. I also suggested that he could find and print out an A4 sized photograph of his head and upper body and perhaps experiment tapping on that.
In this session A managed 3 rounds of tapping and the rest of the time I tapped for him as his surrogate. After the session he practised mental tapping and quickly became proficient at it and also tried out the picture of himself tapping which he preferred less. By session 4 or 5, he was able to tap on his body for himself for good periods of our sessions together.
I also introduced A to a grounding and heart connecting breathing practice gathered from Comprehensive Resource Model 3 and from Dr Dawson Churches’s Eco meditation 4. I felt it was important that A had practices he could do easily to support himself in these early days whilst we explored how he could use tapping more effectively. He received recordings of this practice to continue using at home. Comprehensive Resource Model (CRM) founded by Dr Lisa Schwartz brings other resources alongside tapping adding more powerful levels of resource to the tapping which we know already as a powerful tool. The resources from CRM I particularly added to the tapping are an attuned relationship between therapist and client the therapist and the energy field and the client and the energy field. I find I can usually find a way to help my clients form a relationship with the energy field (which has so many different names) and its qualities, using the earths elements and the planets, stars and galaxies as my simplest way using images to support that connection. I also brought throughout our work together various breathwork skills including earth breathing and heart breathing, the safety of a special place in nature and attachment between current adult self and younger parts of self.
One particular aspect of A’s issues we tapped on during this first exploratory session was the impact of the events when first heard about his cancer diagnosis. I have worked with many clients with cancer and know that this event has a very strong ongoing impact on the nervous system and energy field creating possibly a lack of safety and a fear of dying as cancer has so many fearful associations in our culture. We tapped on the memory of firstly his GP’s words and then his hospital consultant’s words and unfortunate demeanour. A experienced his first shift. He finished the session lighter, said he loved the process, was having light bulb moments and had more flexibility in his fingers.
Session 2
A had had a night seizure 2 nights before our session and I discovered that they affected him for 3 following days giving him what he called neuro head pain and fogginess (7/10 today) and significantly aggravated arthritis pain at 7/10 too, his wrists being particularly affected. His ability to tap physically was severely limited.
We used the grounding and heart breathing attunement practice along with my surrogate tapping and his mental tapping (which was growing in skilfulness) to soothe the pain, as he described it and followed it. The action of breathing towards his pain from his heart connected to cosmic energy was very powerful addition and well primed by the self-compassion work he had previously done. By the end of our session the pain was a 2/10 and 3/10 respectively.
We also did some tapping together about the outbreak of war in Ukraine. He felt a strong connection of empathy towards the people as his daughters have Ukrainian ancestry as well as anger towards the aggressors and a sense of helplessness in himself. He joined the RAF to protect others and thus felt restless and so we tapped towards more acceptance and less news watching as well as practising compassionate heart breathing towards those affected, knowing that was something he could do to support.
Session 3
I was getting to know A’s way of being and why he called himself ‘Mr Tangent’, he loves to talk and tell stories. He’s a real raconteur, entertainer and good company. He had also so much to deal with and so many aspects of his mental emotional and physical health affecting him that his mind was often ‘all over the place’. I learnt that I had to gently reign him in and help him to focus on particular issues so that we could go deeper and get specific, which was all important. We made an agreement that I could call on him to focus.
Following a brief check in I would now always start the exploratory and processing parts of our session with the attunement earth and heart breathing practice, including tapping, calling in earth and cosmic resources and setting an intention; A deciding what he needed for that session. That really helped the focus and structure and I believe the outcomes of our sessions too.
We started exploring the trauma he’d had previous therapies for in a very general gentle way. He said that although he’s had powerful experiences and significant shifts to his degree of PTSD and anxiety, he felt that there was still something left that remains with him. Something he couldn’t fully be with and that he pulled back from.
He started telling the story (while I tapped as his surrogate) of waking up in an Italian hospital 3 days after being in a vehicle involved in an explosion in former Yugoslavia and following a medical evacuation. He had concussion and this eventually led to him developing epilepsy as his brain didn’t fully heal. His epilepsy was still badly controlled and I could understand how the violet shaking would seriously aggravate his arthritis pain. Could EFT and clearing perhaps what was still left in the trauma capsule ease his pain and improve his quality of life? A understood that in his brain his electrical circuits fused because his brain hadn’t fully healed causing the seizures. It seemed to me that the epilepsy and the aggravation of his arthritis pain, the neuro pain and associated cognitive impairment were very significant negative influences on his well-being and improvement here could possibly make a huge difference.
We finished session 3 with some imaginary tapping; A imagining his electrical circuits moving smoothly and easily through any scars whilst mentally tapping and heart breathing with the cosmic energies as an added supporting resource. He made the intention to carry on doing so at home supported by an audio recording of the practice sent from me.
Session 4
This session was postponed a week because of a nocturnal seizure the night preceding. A subsequently reported that he had recovered more quickly than normal and a cluster of seizures (several happening in a day) didn’t occur which sometimes could happen. He shared that he had been doing his mental tapping and imagining healthy brain circuitry.
A quickly dived into sharing that he did feel that something had been left in the head injury trauma. I asked him to create a title for the story of this event without thinking about the contents and he called it the ‘Stop’ story. Then in A’s talkative ‘Mr Tangent’ way he started telling me the background circumstances of the operational mission and I noticed he quickly became emotionally activated at an intensity of 5-6/10. I gave A my safety is paramount talk, how we needed a clinical step by step approach and then was not the time to share anymore. A described how in his ‘mind’s eye’ his memories were like a very clear video. We humans vary so much in how clearly we see our memories in our minds and when the past is recalled this clearly there can be heightened sensitivity to being emotionally triggered.
I taught him the 9-gamut procedure as I sensed it could be needed as our work progressed and practicing this a couple of times quickly took his intensity down to 0. Building focus, rapport, trust and a safe therapeutic relationship were a priority in our early sessions as we gradually created the necessary circumstances for the deeper work. We had to respectfully get to know and hold A’s ‘Mr Tangent’ part that loves to talk and share so we tapped for this part’s need to be heard.
Following A’s injury, he was medically evacuated to Italy and had woken up 3 days later in a very comfortable bed with huge pillows and attractive nurses. Despite this safety, relief and ease A quickly decided he wanted to return to the war zone as soon as possible and talked his way out of hospital after only a few days of recovery. The night time seizures started fairly soon after that.
We finished this session with A determined to do his brain circuitry imaginal mental tapping and with me being aware that there was still plenty of intensity left in this trauma and several aspects that we needed to work on.
Session 5
A pivotal and important session. We had spent 4 sessions gradually creating the right circumstances for the deeper work to be ready to be tapped on. We had to go at A’s speed and allow him to be resourced through his own understanding and experiences of the processes used and a sense of resourcing and safety in his system. Through my study of IFS 4, I am aware of our system having many parts that can sometimes need to be met (and tapped on) before the deeper traumatised parts can be safely accessed. The understanding in IFS is that we all have a dominating part in our system called The Self (or higher self, true self) which does the deep healing and in some of us especially those with early childhood trauma, Self needs other parts to step back so it can be the internal resourced space for that healing to occur.
Today we tapped for a part that was not ready to explore the ‘Stop’ event, focussing on it, finding it through its sensations in the body, letting it share its concerns, building a curious relationship with it, befriending it and dealing with its fears. This allowed it to let go and trust our process and have more hope for a positive outcome.
The rest of the session was tapping for and exploring the part of him that decided to return to duty and the war zone so quickly after waking up from his head injury. There was internal conflict as another part now felt that if he had rested and recovered for longer his brain might have healed better and that might have changed the outcome of developing such life limiting epilepsy. The part he had conflict with was the part of A that was a young man fired up with passion and purpose to serve and make a difference (despite the comfy bed and attractive nurses). The parts made their peace and the session ended with his pain at a 2/10 and A feeling as if he had been transfused with something wonderful.
Session 6
A was tired; he’d been out walking and to the dentist with his daughter, so had had an unusually busy day the day before. He had pain in knees, hips, ankles and at its worst, in his left hip at a 5/10. We practised tapping with earth breathing and heart breathing to the pain and following the pain to soothe and be compassionate towards the pain and establish self-care skills. A could now tap much more continuously and with ease throughout our sessions.
We tapped for him being back on active duty and his minds’ conflict because as he was in the peace keeping forces, even though there were evil atrocities happening, he wasn’t able to act. We tapped for the evil forces that create human behaviour with their roots in trauma. We tapped for the emotions of his younger part sending peacefulness, love and compassion to him, the part of him that was frustrated about the lack of action, distressed about the evil, was needing to heal from a serious head injury and wanted to go home.
We also tapped for his incompletely healed brain injury, finding his younger self in ‘the matrix’ or energy field and tapping with him for accelerated healing to his brain. A renewed his commitment to doing the tapping himself for his younger part.
At the end of the session there was a big shift bringing lightening, peacefulness and also more ease to his body.
Session 7
A started the session feeling pretty good, his pain was minimal, he had no headache, his mind was clearer and less negative. He was regularly doing some tapping self-care for his younger parts, being creative and taking the audio suggestions from me and running with them. He was working visualising his younger self in the matrix. A really loves tapping and using his heart breathing to resource and amplify its effect.
A was ready for the big event, the ‘Stop’ story. The traumatic head injury had occurred during an operation in a vehicle that A was in command of and a colleague was doing the driving. The colleague turned the wrong way against A’s instructions towards the danger of an uncleared, unsafe road and an explosion happened throwing A out of the vehicle and he remained unconscious until he awoke 3 days later in the Italian hospital. We tapped using EFT’s trauma techniques, ‘Tearless Trauma’ and ‘Movie’ Technique. I find that veteran soldiers can quickly become expert at using these techniques as there is something about the clinical careful step by step titrating of the emotional and sensation sensitivity that they comprehend really easily. We tapped through many aspects of the ‘Stop’ story including being the commander, not being able to prevent it happening, having a sense of what was going to happen and what happened to the others in the vehicle. We ended the session putting any remaining emotional issues and intensity in a box and sending it out to the cosmic powers to be healed.
A now realised that there was a link between his current strong emotions when being driven the wrong way and this traumatic experience this was to be dealt with another time.
Session 8
At the start of the session his pain was an all over ache of 4-5/10. His mind he reported was no longer 100mph busy and that allowed more awareness of his underlying physical issues, particularly something he called cancer fatigue. He also reported NO seizures now for 3 weeks although he had previously had extended periods of no seizures.
A was still doing really well on the self-care particularly tapping in the matrix for his younger self and using the grounding and heart breathing along with the tapping to soothe his pain as well as imagining his brain electricity flowing smoothly.
We reviewed the last sessions traumatic event work and tapped some more on the aspect of what happened to a colleague in the vehicle. When we had run several times through the whole story, there was absolutely no charge of emotions left.
We finished the session tapping for acknowledging an extraordinarily challenging life as a soldier how he’s embraced it, contributed so much and personally made and continues to make the best of his life. At the end A was deeply relaxed, relieved and his pain was minimal at a 2/10.
Session 9
A’s pain and discomfort in his joints and head were less than 5/10. No seizures. Feeling 10 times better, less bothered by things, using mental tapping and some physical tapping in relays. He was using imaginal tapping to heal his brain electrical circuits.
This session we revisited the Stop story again emphasising and exaggerating sounds, sights and smells. We connected the trauma to the seizures as well as head and potentially exaggerated joint pain, cutting any energetic association. We tapped and explored any downsides of having less seizures and pain and also any other possible hidden gains (we didn’t find any).
We also tapped for his challenges when in the car as a passenger with his partner and being driven the wrong way and for the anger that was easily triggered in him as a result. He made a connection between the ‘Stop’ trauma and this present-day trigger and cut the energetic ties.
We finished tapping by gathering all the knowledge and wisdom A had gained form these experiences and asking himself what he would you like to share in the world to carry this forwards.
Session 10
Pain in all areas 2/10 or less, back, head (had a bit of a cold) arthritis, and his fatigue too. No seizures (for roughly 4-5 weeks now).
He talked about how less bothersome his pain and tiredness was to him now. He had much more acceptance, his relationship to these parts had changed and he was looking at his symptoms and life very differently.
He reinforced his commitment to self-care. He still largely mentally taps and has become really proficient at this to the point where he seems to actually feel the tapping on his skin. We tapped together some more imagining the brain electrical connections and any remaining scarring. I added the use of colour as a healing resource and he chose red, blue and white.
He had yet to test the trigger of being in the car with his partner when a wrong turning might be taken but was far more confident that he understood its roots and could tap for the remaining association.
There were definitely aspects of post traumatic growth going on. He was going to his daughter’s school dance concert, the kind of event he’d normally be agitated and worried about. This time he felt excited and could see, ‘hold’ and tap for the part of himself that had some fear of catching Covid 19. He felt some inner balance and saw that continuing this was a mission for him, enjoying the ride and feeling as safe as possible looking after the fearful parts. I see these as signs of much improved resilience and ability to more fully engage in life as it is. A described EFT as a body expanding experience, how he often felt transfused with something other worldly and deeply peaceful and OK with life. This can be understood as a ‘Flow State’ as described by Dr Dawson Church.
So as I end this case study I want to really acknowledge how powerfully this work evolved in the therapeutic space between us and to give thanks to A for how determinedly he showed up, for what good fun he was to work with and for the earth and cosmic powers that supported us. I also want to thank the charity Supporting Wounded Veterans for being dedicated to pushing the established boundaries of therapy and bringing more peace to our soldiers.
Postscript
A has recently reported on his frequency of nocturnal seizures. In the summer of 2022 they were down to one a month (from 3 or 4 a week before EFT) which roughly continues. In October 2022 he started gradually reducing his epileptic medication and now he is completely off one the medications that had horrible side effects. The lack of seizures has improved his mental health enormously. Physically the lack of the additional pain caused by the seizures in his arthritic joints and head is ‘indescribable’. His arthritis does flare up and he does have ongoing pain that some days is very bad but thanks to EFT and the pain management programme too he is more resilient in dealing with it.
A is now a trained Health Connect coach for the NHS, helping people living with similar long-term conditions and symptoms. A is truly carrying forwards the knowledge and wisdom gained from these experiences.
References
- Elizabeth Boath (2022): Making the Case for EFT and Energy Psychology.
- Lean Winerman (2005): The Minds Mirror. American Psychological Association.
- Lisa Schwarz, Frank Corrigan, Alastair Hull, Rajiv Raju (2016): Comprehensive Resource Model: Effective Therapeutic Techniques for the Healing of Complex Trauma.
- Dawson Church (2020): Bliss Brain: The Neuroscience of Remodelling your Brain for Resilience, Creativity and Joy.
- Richard Schwartz (2021): No Bad Parts: Healing Trauma and Restoring Wholeness with Internal family Systems Model