Distress Protocol
When clients feel emotional distress during an EFT session, there are two ways to deal with it. The first method involves the therapist tapping on the client. Therapists can only tap on their clients if they have their permission. The second method is that the therapist taps on themselves for their client. Both ways can be a positive step forward if managed correctly.
Dealing with Distress, Tapping on the Client
When a big emotion occurs, some clients stop tapping. If the therapist has rapport with their client, they can offer to take over the tapping on their client’s behalf. Tapping involves touching the client on the hand, head, face, and upper body. No touching should occur without the client’s permission.
Instructions
1. Ask the client, “Is it OK for me to tap for you? Can I touch you?” Wait for a response.
Clients may nod their head, giving permission. In some cases, they move their hand to allow the therapist to touch it. They may also say, yes, dependent on how intense their emotional distress. All of these actions can be taken as permission. Only when this has happened should a therapist touch their client.
2. Then ask, “Can I hold your hand?” The therapist should hold their hand near to the client and wait.
3. Take the client’s hand and begin to tap on the Side of the Hand Point” and say, “all of these emotions I am feeling right now,” “these emotions, whatever they are.”
4. It is often useful to reassure the client that having a degree of distress during a session is normal and OK. Reassurance can be done subtly by saying in a calm and confident voice, “You are doing great,” also “better out than in.”
5. Before moving to the head and upper body tapping points, ask, “is it OK to tap your face?” Wait for permission, whether verbal or in gestures, and then proceed. Tapping should be done in a comfortable way for the client. It should be gentle and not be too fast in rhythm.
As the therapist moves the tapping from the hand to the head and upper body points, it is useful to keep holding the client’s hand. Holding their hand makes it easier to do continuous rounds of EFT as the therapist can move the hand seamlessly back into position for tapping.
Any points that are inaccessible because of the client’s body position should be avoided. The under the nose point should also be avoided if the client has been crying. Many people are uncomfortable with someone touching them beneath the nose, especially if they are crying, and it has been running.
If the underarm point is used, it should be accessed from the back, not the front. Accessing it this way avoids any accidental touching of the client at the front of the body. Often clients do not speak if they are experiencing a high degree of distress; this is OK. They will often join in speaking out aloud with the therapist when their emotional distress decreases.
6. When tapping on the client in this way, the therapist uses a freeform style. This version is different from the more structured and formal version of EFT. In freeform EFT, the therapist uses the EFT tapping points, which are easily accessible. It is perfectly OK to leave out the other points.
The Words
Some of the words said are “as if” the therapist is the client. Some are from the therapist’s point of view, “better out than in.” When intense emotions come to the surface, the therapist may not initially have much information about them. The therapist does not need to know.
All they need to do is keep the client feeling as safe as possible in the circumstances and then tap until the emotional distress the client is experiencing decreases to a comfortable level.
Words that are typically used are,
a. Reassurance Wording
“That is fine.”
“You are doing great.”
“Better out than in”
b. Tuning in Wording
“All of these emotions, whatever they are.”
“That I am feeling right now.”
“What if it is OK now to feel this.”
“What if it is?” (This is not a question to be answered, say it and move on)
“All of these emotions, whatever they are.”
Dealing with Distress without Touching the Client
Not every client is comfortable being touched. Without permission, the therapist cannot touch the client. The therapist should not touch children as they cannot give informed consent due to their age.
The same is true for vulnerable people. If the therapist is aware that the client is a “people pleaser” who may say “yes,” even if they are not comfortable with it, then they should not touch the client.
Again the objective here is to acknowledge, accept, and allow the distressing emotions while tapping and bring the client back to a state of calmness.
Instructions
1. The therapist should ask, “Is it OK if I touch you?” If the client says “No” or implies it in any way, then the therapist should say, “That is fine. I will tap on me for you. When you are ready to tap again, join in”.
2. The therapist should then tap on a round of EFT (a round of EFT is the Set-Up and Tapping Sequence) followed by continuous tapping through the sequence until the client’s distress is significantly reduced or gone. The tapping points used are the same as in standard EFT.
3. After a short amount of time tapping continuously through the sequence in one extended round of EFT, the client’s emotional intensity should decrease. At this point, they will start to tap and join back into the EFT session.
4. When the client’s distress clears substantially, the therapist should then say, “Tap on the Side of the Hand,” as they comply say, “What happened then?”
5. The therapist can then continue to tap using Conversational EFT and identify if any more pieces of the client’s problem need exploring.
Points
1. Avoid asking questions, especially if the distress is intense. Asking questions too early could result in them pushing the feelings back down. When the intensity is high, you get better results by helping the client stay with the distress and then tap down its intensity. The words the therapist uses at this point are just about acknowledging, accepting, and allowing what is happening at this moment.
2. Clients often attempt to push emotions down, especially if they have been given negative messages about showing emotions as a child. Words such as, “You are weak if you cry,” “Stop crying,” “You are too sensitive.” These messages can be counteracted by tapping and saying, “These are MY emotions,” “I don’t have to push this down,” “Emotions are normal.”
When clients attempt to push the emotions down or avoid them, they often hold their breath. To counteract this, the therapist can say, “And breathe.” Telling the client to breathe should only be done periodically to help release the holding pattern.
3. If the client closes their eyes and appears to be going deeper into their distress, the therapist can say, “Open your eyes, stay with me.” Saying this will help the client feel less pain.