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Mechanism of Action Studies

Rapid Treatment of PTSD: Why Psychological Exposure with Acupoint Tapping May Be Effective
David Feinstein, PhD
Psychotherapy: Theory, Research, Practice, Training (2010).

Combining brief psychological exposure with the manual stimulation of acupuncture points (acupoints) in the treatment of post-traumatic stress disorder (PTSD) and other emotional conditions is an intervention strategy that integrates established clinical principles with methods derived from healing traditions of Eastern cultures. Two randomized controlled trials and six outcome studies using standardized pre- and post-treatment measures with military veterans, disaster survivors, and other traumatized individuals corroborate anecdotal reports and systematic clinical observation in suggesting that (a) tapping on selected acupoints (b) during imaginal exposure (c) quickly and permanently reduces maladaptive fear responses to traumatic memories and related cues. The approach has been controversial. This is in part because the mechanisms by which stimulating acupoints can contribute to the treatment of serious or longstanding psychological disorders have not been established. Speculating on such mechanisms, the current paper suggests that adding acupoint stimulation to psychological exposure is unusually effective in its speed and power because deactivating signals are sent directly to the amygdala, resulting in reciprocal inhibition and the rapid attenuation of maladaptive fear. This formulation and the preliminary evidence supporting it could, if confirmed, lead to more powerful exposure protocols for treating PTSD.

Keywords: Acupuncture, Energy Psychology, Consolidation, Exposure, PTSD. 


Modulating Gene Expression through Psychotherapy: The Contribution of Non-Invasive Somatic Interventions  

David Feinstein & Dawson Church  
Review of General Psychology, an American Psychological Association journal. (2010)

Mapping the relationship between gene expression and psychopathology is proving to be among the most promising new frontiers for advancing the understanding, treatment, and prevention of mental disorders. Each cell in the human body contains some 23,688 genes, yet only a tiny fraction of a cell’s genes are active or "expressed” at any given moment. The interactions of biochemical, psychological, and environmental factors influencing gene expression are complex, yet relatively accessible technologies for assessing gene expression have allowed the identification of specific genes implicated in a range of psychiatric disorders, including depression, anxiety, and schizophrenia. Moreover, successful psychotherapeutic interventions have been shown to shift patterns of gene expression. Five areas of biological change in successful psychotherapy that are dependent upon precise shifts in gene expression are identified in this paper. Psychotherapy ameliorates (a) exaggerated limbic system responses to innocuous stimuli, (b) distortions in learning and memory, (c) imbalances between sympathetic and parasympathetic nervous system activity, (d) elevated levels of cortisol and other stress hormones, and (e) impaired immune functioning. The thesis of this paper is that psychotherapies which utilize non-invasive somatic interventions may yield greater precision and power in bringing about therapeutically beneficial shifts in gene expression that control these biological markers. The paper examines the manual stimulation of acupuncture points during psychological exposure as an example of such a somatic intervention. For each of the five areas, a testable proposition is presented to encourage research that compares acupoint protocols with conventional therapies in catalyzing advantageous shifts in gene expression.

Keywords: Acupuncture, DNA, Epigenetics, Exposure, Gene Expression.


The Neurochemistry of Counterconditioning: Acupressure Desensitization in Psychotherapy
James Lane, PhD
Energy Psychology: Theory, Research, & Treatment, (2009), 1(1), 31-44.

A growing body of literature indicates that imaginal exposure, paired with acupressure, reduces midbrain hyperarousal and counterconditions anxiety and traumatic memories. Exposure therapies that elicit the midbrain's anxiety reflex and then replace it with a relaxation response are said to "reciprocally inhibit” anxiety. More recent research indicates that manual stimulation of acupuncture points produces opioids, serotonin, and gamma-aminobutyric acid (GABA), and regulates cortisol. These neurochemical changes reduce pain, slow the heart rate, decrease anxiety, shut off the FFF response, regulate the autonomic nervous system, and create a sense of calm. This relaxation response reciprocally inhibits anxiety and creates a rapid desensitization to traumatic stimuli. This paper explores the neurochemistry of the types of acupressure counterconditioning used in energy psychology and provides explanations for the mechanisms of actions of these therapies, based upon currently accepted paradigms of brain function, behavioral psychology, and biochemistry.

Keywords: counterconditioning, acupressure, amygdala, exposure therapies, anxiety, desensitization.


Energy Psychology in Rehabilitation: Origins, Clinical Applications, and Theory
Fred P. Gallo, PhD, University of Pittsburgh Medical Center
Energy Psychology: Theory, Research, & Treatment, (2009), 1(1), 57-72.

Three forces have dominated psychology and psychological treatment at different times since the early 1900s. The first force was Freudian psychoanalysis and its offshoots that focus on unconscious psychodynamics and developmental fixations, with principal therapeutic techniques including free association, dream analysis, interpretation, and abreaction. Second came behaviorism, spearheaded by Pavlov, Watson, and Skinner, which emphasized environmental stimuli and conditioning—its techniques including respondent and operant conditioning, exposure, desensitization, schedules of reinforcement, modeling, and more. The third force involved humanistic and transpersonal approaches that attend to values and choice, including client-centered therapy, gestalt therapy, phenomenology, and cognitive therapy, some of the principal leaders being Rogers, Maslow, Perls, Rollo May, Binswanger, and Ellis. Recently the new paradigm of energy psychology has emerged, which may be considered psychology’s fourth force. The earliest pioneers included Goodheart, Diamond, and Callahan.

This theoretical and practice approach offers the field some unique findings, as it views psychological problems as body–mind interactions and bioenergy fields, providing treatments that directly and efficiently address these substrates. Some of energy psychology’s techniques include stimulating acupoints and chakras, specific body postures, affirmations, imagery, manual muscle testing, and an emphasis on intention. This review covers energy psychology’s historical development and experimental evidence base. Case illustrations and treatment protocols are discussed for the treatment of psychological trauma and physical pain, two of the most important and ubiquitous aspects common to rehabilitation conditions. Additionally, the research on energy psychology is highlighted, and the distinction between global treatments and causal energy diagnostic-treatment approaches to treatment is addressed.

Keywords: acupuncture, research, quantum mechanics, Thought Field Therapy (TFT), Advanced Energy Psychology (AEP), Emotional Freedom Techniques (EFT), rehabilitation, pain.

Encoding States: A Model for the Origin and Treatment of Complex Psychogenic Pain
Ruden, R. A.
Traumatology, Vol. 14, No. 1, 119-126.(2008).

Pain that is "unanatomical" in distribution, for which there is no recent history of trauma, no evidence of a peripheral lesion and that resists traditional treatment, should be considered to be of psychogenic origin. The termcomplex psychogenic pain can be used when autonomic changes such as temperature abnormalities and physical findings such as tenderness accompany the pain. It is proposed that complex psychogenic pain is co-encoded centrally during a traumatizing event where the person experiences rage or fear with concomitant pain but is constrained from responding to the circumstances. Complex psychogenic pain is encoded as dissociated from the event. However, subsequent subconscious stimuli that recreate similar emotional, somatosensory, or cognitivestates can activate a re-perception of the traumatic pain and engage various vasomotor processes. It is speculated that complex psychogenic pain is generated from amygdala efferents and is encoded in such a manner that precludes simple forgetting. Therapy consists of either delinkng the amygdala-based connection between the memory of the event and the emotional/somatosensory response or directly inhibiting amygdala outflow. Successful therapy extinguishes the pain.

A Model for Disrupting an Encoded Traumatic Memory
Ruden, R. A.
Traumatology, Vol. 13, No. 1, 119-12.(2008).

Posttraumatic stress disorder (PTSD) is a chronic and sometimes progressive illness. It has been hypothesized that PTSD is encoded in such a way that retrieval of a traumatic memory not only causes the individual to experience fear but also reconsolidates the linkage between the memory and the fear response, thus preventingdesensitization. Recent work on conditioned fear, however, has shown that reactivation of these consolidated memories returns them to a protein synthetic—dependent state that makes the linkage subject to disruption. This article describes a theoretical model for the surprising effectiveness of a therapy for PTSD. It is proposed that, after activation of the fear response, tapping on certain areas of the body increases serotonin release. This increase in serotonin appears to disrupt the linkage between the thought and the emotional response. Using this approach,other disorders such as phobias, certain types of chronic pain, and other pathologically encoded negative emotive states may also be curable.

A Neurological Basis for the Observed Peripheral Sensory Modulation of Emotional Responses
Ruden, R. A.
Traumatology, Vol. 11, No. 3, 145-158.(2005).

A new therapy for phobias, PTSD, addictive behaviors and other psychological issues was first described by Dr. Roger Callahan and involves thought activation of the problem followed by tapping on certain acupoints in a specific sequence. In addition, a gamut procedure involving further tapping, eye movements and following simple commands is used. He calls his method Thought Field Therapy. In most cases, the problems were reportedly cured in a matter of minutes. We theorize re: the neuroanatomical and neurophysiological mechanisms underlying the success of this technique. We propose that tapping and other sensory stimulation procedures globally increase serotonin. The important structures specifically involved in this therapy are the prefrontal cortex and the amygdala. The success of this technique requires that glutamate first be increased in the circuit that involves the conditioning stimulus and the unconditioned stimulus. This analysis does not define sequences for tapping. We suggest the name Psychosensory Therapy to encompass this specific treatment as well as to define a broader new paradigm for the treatment of these problems.
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