More than 30 million Americans have had a drug use disorder at some time in their lives. Drug overdose deaths have more than tripled since 1990. And addictions are notoriously difficult to treat. Relapse is frequent.

            A growing number of therapists and treatment facilities are finding that integrating acupoint tapping into addiction treatment improves outcomes. Treatment for substance use disorders may be done in the context of individual, group, or family therapy, inpatient or outpatient. It often requires a multimodal approach.

            For instance, a professionally-supervised intervention by family and friends may be an early step. Medication may be used to assist with withdrawal and cravings, to discourage future ingestion of the substance, or to treat psychiatric conditions not directly related to the addiction. A 12 Step or other peer-support program may be part of the treatment regime. Actions may be taken to limit access to individuals or settings that support the addiction or access to the substance itself.

            Within whatever the treatment plan, acupoint tapping protocols can be used to literally change a person’s neurological landscape in ways that rapidly reduce cravings, anxiety, depression, trauma, and self-defeating behaviors.  For instance, a pioneering brain imaging study by psychologist Peta Stapleton in Australia confirmed that after acupoint tapping for food cravings, blood flow to brain regions involved with craving were significantly reduced, in contrast to prior to the tapping treatment, when images of desired foods were presented. 

            Acupoint tapping protocols may be applied in addiction treatment specifically to:

• Address unresolved emotional issues that were precursors to the susceptibility for substance abuse.
• Instill skills for better managing pain, stress, anxiety, and cravings.
• Boost self-esteem and confidence.
• Relieve cravings and reprogram responses to triggers.

The 6 Stages of Addiction Recovery

            A six-stage model for addiction treatment and recovery was formulated in the late 1990s and is in common use in treatment settings. It tracks changes in the person’s understanding and behavior through the stages of:

            1) Precontemplation

            2) Contemplation

            3) Preparation

            4) Action

            5) Maintenance

            6) Termination

            The most important implication of this model for psychotherapists is that interventions which are matched to the person’s stage in the change process will be more effective. Of course, no descriptions of stages of human development are precise. People may move back and forth, into and out of a particular stage, or may make changes in a different order. But each stage has some requirements and understanding this can help make the therapy much more effective. Here we will explore how tapping can be applied for meeting the requirements in each stage.

1. Precontemplation

            Some addicts don’t consider their substance use to be a problem and have no interest in changing it. They may have found their way into your office because a spouse made it a condition of continuing the marriage or a judge mandated therapy after a second DUI arrest. Or maybe the person is working with you on a different issue and is in denial that addiction is a serious problem. It’s important for you to understand that there may be some good reasons for that denial. Besides anticipating the sometimes overwhelming effects that withdrawal can cause, their reasoning is generally skewed toward an overestimation of why continuing to use the substance is a positive, associated with pleasure, and an underestimation of the harm it is doing to their body, their relationships, and their future.

            The most obvious trap for the therapist at this stage is that advice or efforts at persuasion only echo what everyone else has most likely been telling the person and will fuel resistance and distrust rather than having the intended effects. In this stage, the most effective approach is to build engagement. If the person is working with you on a different issue than their addiction, you will already be demonstrating the power of acupoint tapping protocols. If they have been forced to see you, rather than insisting that the focus be on an addiction they don’t believe to be a problem, find out what does matter to them and demonstrate how tapping can help with it. This will build your credibility and their interest in what you do have to offer.

            During this “precontemplation” stage, open-ended questions, active listening, and non-judgmentally reflecting back the person’s feelings will help you identify where tapping will be effective. At the same time, it will also build rapport and plant the seeds for a productive therapeutic alliance should the person move into the “contemplation” stage.

2. Contemplation

            People in the “contemplation” stage are considering cutting down or quitting the addictive behavior. The rewards and pleasures provided by the substance may, however, continue to fuel at least some denial about the problems the addiction is creating. This produces an internal dilemma.

            Energy psychology protocols are well-equipped for helping people with this type of conflict. The “set-up” statement can concisely capture the dilemma in a self-accepting manner:

“Even though I long for the high I get from cocaine [Truth 1], I choose to recognize that it is ruining my life and that my marriage and career are worth saving [Truth 2].”

“Even though I love going out drinking with my buddies [Truth 1], I’m here paying good money for help getting over my dependence on alcohol [Truth 2].”

            Tapping statements can then explore both sides of the dilemma, go into the emotions, beliefs, and childhood roots of each side, and work toward a resolution of the conflict so that the contemplation stage can move into a commitment for change.  Once that commitment has been made, preparatory steps must be carried out if the commitment is to translate into effective action.

3. Preparation

            Once a commitment to change has been made, the “preparation" stage focuses on the steps that will support the therapy and the intention to deal head-on with the addiction. It involves envisioning and articulating the desired changes and how the changes will be accomplished. What will be the role of therapy? What other resources will be needed? Perhaps a support group or medication to ease withdrawal will be considered. What immediate behaviors, even if in small steps, will be taken toward reaching the goal? This might involve becoming less available to friends who share the addiction or practicing greater restraint even before being able to completely discontinue the substance use. Triggers like ashtrays and lighters for a smoker might be removed, or the emptying of the liquor cabinet of a person with an addiction to alcohol. Deciding what to tell family and friends about the intention to overcome the addiction is another important element in preparation. Each step can be supported by tapping on appropriately crafted statements.

            A critical issue during the preparation stage involves the emergence of psychological reversals, internal blocks to achieving the sincerely held intention. Rather than setbacks, these need to be recognized as inescapable. The desire to change a longstanding pattern inevitably collides with the forces keeping that pattern in place. Again, set-up statements and tapping phrases that recognize, accept, and explore both sides of the internal conflict can lead to its resolution so that unconscious forces are no longer blocking effective action.

4. Action

            Once the commitment to change has been made, practical steps have been taken, and psychological reversals addressed, a spectrum of interventions may be needed for deepened therapeutic action. Targeted shifts in behavior are going to be more amenable to change if their underpinnings in the person’s responses to triggers that promote the addictive behavior are modified. Unconscious motivations that drive the addictive behavior can be defused by addressing emotional wounds from the person’s past since trauma and other adverse childhood experiences are a frequent precursor of addictive behavior. Developing skills in the self-management of stress, pain, anxiety, and cravings opens alternative ways of providing comfort for distresses the addictive behaviors may have helped alleviate. The emotional insecurity that may be temporarily masked by alcohol and drug abuse can be addressed by interventions that boost self-esteem and confidence. Progress in each of these areas may be keys in the recovery process. Here is an outline of these four broad areas in which acupoint tapping protocols can be particularly useful during this stage of therapeutic action:

• Reprogramming maladaptive emotional and behavioral responses to triggers
• Addressing unresolved emotional issues that were precursors to the susceptibility for substance abuse
• Instilling skills for better managing pain, stress, anxiety, and cravings
• Increasing self-esteem and confidence 

            As the person begins to gain control over the addictive behavior, these issues may need to be revisited any number of times. Eventually, however, time will pass since the last binge, anniversaries will be noted in weeks, then months, and talk of concluding the therapy enters the discussion. At this point the therapy turns toward maintenance of the gains that have been made.

5. Maintenance

            In order for the progress to last, issues that appear to have been resolved are tested and new behaviors and coping methods are reinforced. Tapping can be used to revisit each component of the person’s journey into recovery so any remaining issues or challenges can be addressed. The energy psychology practice of “testing the results” not only comes into play, the stakes for accomplishing it thoroughly are higher than usual. If a person’s phobia returns, another tapping session may be all that is needed.  But going off the wagon with an addiction can have far-reaching consequences for the person’s life.

            Reinforcing new behaviors and coping methods can be done by combining imagination with tapping. The person can be instructed to imagine situations where it is likely for addictive impulses to re-emerge. Effective steps for managing the impulse can be envisioned, from actions within the situation to anticipating ways of recognizing and tapping down the impulse before it has taken hold. Here are a couple of examples of imaginary situations that might be explored:

You’ve fallen off your bicycle, your knee is causing agonizing pain, and you never got rid of your last bottle of Demerol.

You just found evidence that the weekend trip your wife is on involves an illicit affair when you receive a call from an old crack buddy who is in town and wants to share some “good stuff.”

             Having clients feel deeply into the most challenging situations they can imagine and tap to reduce the impulse to abuse, along with formulating strategies, helps prepare them for whatever circumstances may come.

6. Termination

            A point comes when regularly scheduled therapy sessions are no longer needed. During this termination stage, steps are taken to anticipate the possibility of minor lapses or even a total relapse. This is often a theme in the closing sessions, along with reviewing the support systems that were put in place during the therapy, which of them are still needed, and how those that are still required will be maintained. The final therapy sessions may continue to explore situations where tapping can be usefully applied. Arrangements can also be made so the therapist can be contacted for a quick coaching session, sometimes even by e-mail or Zoom, on how to use acupoint tapping in a challenging situation that has arisen. This builds in a mechanism for mini-corrections that can prevent relapse.

Access to More Information on Tapping and Substance Abuse Disorders

            This post is based on an piece by David Feinstein, Ph.D., which appears as a chapter in Complementary and Integrative Approaches to Substance Abuse Disorders, an authoritative text on the most forward-thinking ideas from the medical and behavioral sciences for working with addictions.

            An author is usually not allowed to freely share an individual chapter as the publisher wants people to buy the book.  But the publisher, Nova, has generously agreed to allow us to post the chapter for this series. Click here for the entire chapter that is summarized by this article.

            If you have thoughts, ideas, insights, or experiences you'd like to share based on this article or the full paper, please comment below. David will regularly review the comments and reply to those that move the discussion forward. Next month's feature will focus on applications of Energy Psychology for working with trauma and PTSD.