As I wrote about in my last column on the best approach for evidence-based practice, when it comes to psychological interventions (and assessment methods), the best option to use are what we call evidence-based practices (EBPs).

These are those medications and therapies that have been demonstrated to be effective via well-controlled clinical trials, reducing a problematic behavior, cognition, or emotional state more than a placebo. Thankfully there are highly effective treatments available for people suffering from problems such as depression, anxiety, fear, post-traumatic stress, and many others.

One large organization that has repeatedly stated its support for using EBP is the American Psychological Association (APA; disclaimer: I am not a member of the APA). As the largest professional organization for psychology, boasting over 100,000 members, the APA plays a huge role in shaping the image of psychology at a national and international level, as well as in lobbying efforts for the role of psychology in public policy.

They are also one of the nation’s primary credentialers for the provision of continuing education (CE) credits for psychologists.



Much like in other health professions, licensed psychologists are required to spend a certain amount of time per year engaged in continued structured learning, such as taking workshops on specific topics. Most states require twenty hours of this per year to make sure that psychologists stay up to date on new developments in therapy, assessment, and have continuing ethics training. The APA evaluates various smaller organizations and grants them the ability to be an “approved provider” of CE credits for psychologists.

Given the APA’s stated commitment to EBP (best outlined in a 2006 presidential task force paper), one could make the reasonable assumption that the APA would carefully screen potential CE providers to ensure that they are doing evidence-based trainings. However, in doing so, you would be falling prey to what my father has always told me happens when you assume: “You make an ass out of you and me.”



The Failure of the APA



Although I could list many ways in which the APA fails to live up to their stated goal of promoting EBPs, this column will focus on one in particular.

In late 2012, the APA approved the Association for Comprehensive Energy Psychology (ACEP) as a provider of CE credits for psychologists. As you might guess from their name, ACEP promotes the idea of energy psychology (EP), which they define as “a collection of mind-body approaches for understanding and improving human functioning. EP focuses on the relationship between thoughts, emotions, sensations, and behaviors, and known bioenergy systems (such as meridians and the biofield).”

They helpfully provide a list of these “EP techniques” that include Thought Field Therapy (TFT), Tapas Acupressure Technique (TAT®), Emotional Freedom Techniques (EFT), and Comprehensive Energy Psychology (CEP).

This idea of some type of “energy” that the human body emits or that you can interact with was a very popular concept in various pre-scientific modes of thinking and thoroughly permeates many of the more popular complementary and alternative medicine (CAM) practices today.

This includes chiropractic’s “innate intelligence” that is supposedly blocked by subluxations, Ch’i or Xi in acupuncture, and even in the original writings on homeopathy. Energy psychology, though, borrows more from what are often referred to as “energy therapies” or “energy medicine” than from those modalities.

In the various energy therapies, practitioners claim that some type of non-materialistic “life energy” can be directly manipulated as long as you are properly trained. Some examples of commonly practiced energy therapies include Therapeutic Touch, Reiki, biofield energy healing, crystal healing, and Qigong. As with other CAMs, the healing claims of these run the full range of conditions, from making wounds heal quicker and decreasing pain to improving carpal tunnel syndrome and causing weight gain in premature infants.

In the case of energy psychology (EP), this is extended to mental and behavioral health conditions such as depression, anxiety, post-traumatic stress, and more.

Like other energy therapies, EP has two main ideas at its core.

First is that humans have some type of “energy field” that, when disrupted, can cause numerous problems and/or disrupt the healing process in some fashion.

Second is that these supposed “energy fields” can be manipulated by properly trained individuals who can thus restore it to optimal functioning, causing mental health improvements.

The most widely known or used EP modality is called Emotional Freedom Techniques (EFT) and involves stimulating “acupressure meridian points” via repeated tapping with one’s own hands while saying certain mantras. In fact, many people who practice just call it “tapping.”

These two core ideas (that energy fields exist and can be manipulated) underlie the use of EP and the various techniques associated with it. But is there any support for these ideas?

Supporting the Claim

First one must define “energy” or “energy field.” In physics, the word energy primarily refers to the ability of a system to do work. “Work” in this case is the application of a force along the distance an object travels (force multiplied by distance), meaning that work causes a change or movement in matter. Therefore, energy is a property or condition of objects, one that can be transferred or converted into other forms, rather than an object in and of itself.

The energy of an object, then, is how much work the object can do on some other object. There are a number of different types of energy, including chemical energy, mechanical energy, nuclear energy, electrical energy, thermal energy (heat), and radiant energy (light). Each form of energy can be converted into other kinds, although the process can be complex.

Energy is, quite literally, all around us, as all matter stores energy of some type. In fact, there is a huge amount of energy in very small amounts of matter, if you just know how to convert and transfer it (which can be much easier said than done in most cases).

But the practitioners of various “energy therapies” are not quite as specific (and backed up by centuries of dedicated scientific research) as physicists and chemists. Instead of observable, measurable forms of energy (such as chemical or electrical), energy in CAM typically refers to some type of immaterial, immeasurable “force.”

These types of “energy” are often rooted in pre-scientific or religious views of the world. For instance, the Ch’i and ki concepts found in Chinese and Japanese cultures typically refer to some sort of vital, universal life force that flows through all living matter.

In the “energy therapies” this lack of definition is evidenced by repeated use of the term biogenergy on the ACEP website, with no description of what this actually is. Even the paper most commonly cited as a key research publication has no definition beyond saying “acupressure points.” Further, the terms meridians, chakras, and biofields are all used, none of which have any scientific evidence for their existence, such as being measurable and quantifiable.

Physicists and other scientists typically use joules to measure the amount of energy in an object or situation. A joule is carefully described as the amount of energy needed to produce one watt of power for one second and forms the basis for measurement of energy (and energy potential). Anyone, anywhere, can measure how many joules are contained in something or in a situation using certain kinds of equations.

Contrast this to how CAM “energy” is measured, which is purely via self-report. The practitioners claim to be able to sense or detect the so-called energy, which then allows them to manipulate it. This claim, though, can be put to the scientific test, and it was by a nine-year-old girl named Emily Rosa in the mid-1990s.

As has been well reported on elsewhere, Emily conducted a simple but elegant experiment to see if people who claimed to be able to physically feel what they called the “human energy field” could actually do so. None of those tested were able to detect this “energy” at a greater than chance level, something further replicated by others. To date, Emily is the youngest person to ever author a published, peer-reviewed journal article (Rosa et al. 1998), and in no less than the prestigious Journal of the American Medical Association.

Emily applied one of the key tools of critical thinking—falsifiability—to an extraordinary claim and showed, simply stated, that it was nonsense. This type of plausibility testing—examining if the underlying beliefs of a therapy is true—can literally dismantle all the claims of most energy therapy practitioners. After all, if a person cannot reliably and accurately detect if they are in contact with a “human energy field” (or whatever word they use), how can they possibly hope to manipulate it? It would be the equivalent of a physician attempting to do surgery without being able to tell when or if the scalpel was actually entering the body of their patient.

Ignoring these overwhelming problems, the ACEP and many individuals nonetheless tout the “Science Behind Energy Psychology.” What they focus on are publications, mostly those looking at whether or not EP is effective in treating mental health problems. Based on that, the ACEP promotes EP as being evidence-based for depression, anxiety, and more. But a careful examination of this literature yields a different story.

The biggest problem noticed across the research literature was the lack of placebo controls. Instead, most studies would compare the energy therapy to a waitlist control, or added on the energy therapy to a standard treatment to see if it had additive effects, while not comparing it to a control group with a placebo added on. For many reasons, having a randomized, placebo-controlled trial is crucial to being able to sort sense from nonsense in health care. This is especially true when examining those symptoms most likely to respond to placebos, such as pain and other subjective problems, which are coincidentally those for which EP claims the greatest benefit. At best, EP could be described as a “purple hat” therapy, similar to EMDR.

Conclusion

EP not only shows no benefit in those few well-designed trials that have been conducted, but their basic underlying principles are not supported by evidence. There is no evidence to support the existence of the human energy field, the manipulation of such a field, or the channeling of “energy” from one person into another. Further, these concepts are in direct conflict with all that we know about how physics, chemistry, and biology work.

But what does all of this have to do with the APA and its support of evidence-based practice? As widely plastered in multiple places on the ACEP website and already mentioned in this column, in 2012 “the American Psychological Association (APA) approved the Association for Comprehensive Energy Psychology (ACEP) to offer CE credit for psychologists for its Energy Psychology programs, including Emotional Freedom Techniques, Essentials of Comprehensive Energy Psychology and its Annual Conference.”

This was done, despite a complete lack of scientific plausibility for the underlying claims of EP and the numerous problems with the outcome literature on its use.

As one of the more powerful mental health groups in the United States, the APA’s seal of approval on Energy Psychology conveys to many people that this is something that works and is widely accepted by the psychological community.

In fact, nothing could be farther from the truth. Psychological scientists can clearly dismiss Energy Psychology as pseudoscientific and certainly not an evidence-based practice, and laypersons should be educated to avoid such practitioners and instead seek out those doing gold-standard mental health practice, like those I mention in my article detailing evidenced-based practices.