Case 1:

“Keith” was an infantry soldier for the Ninth Division in the Mekong Delta during the Vietnam War. During an initial session in April 2008, he reported that he had seen “many casualties on both sides” and was “still tormented with nightmares and repeated flashbacks . . . sometimes I think I see Viet Cong soldiers behind bushes and trees.” His severe insomnia, complicated by the nightmares, kept him fatigued and low functioning (self-rated as a 2 on a scale of 1 to 5) during the day. He had been diagnosed with PTSD and reported having “had group and individual therapy through the VA with little results.” He was also diagnosed with Parkinson’s disease and was on multiple medications for Parkinson’s, PTSD, insomnia, and depression, though they were affording little or no relief for his psychological symptoms.

Just prior to treatment, Keith completed the PCL-M, which is the military version of the PTSD Checklist (Weathers, Litz, Herman, Huska, & Keane, 1993). His score was 65. The PTSD range is 50 or above.

Keith received six sessions that combined tapping on acupoints with the mental activation of traumatic war memories and other psychological stressors. The treatments averaged about an hour each, with the first five occurring within the initial week and a follow-up session about two months later. The second session focused on Keith’s profound sadness and guilt for shooting off another man’s arm from close range while the man was probably trying to surrender. By the end of the tapping protocol, Keith was able to recall the horror of the situation with no self-reported physiological reaction. This made it possible for him to fully embrace his sadness about what he had done, recognize that it was in the context of war and it was possible that the man was not surrendering, and to ask his own internal representation of the victim for forgiveness. Following that session, Keith sent an e-mail: “Sleep is improving, no nightmares last night. My overall energy has been on an upswing. My hands still shake but not as much. I’ve been tapping on the shakes and it seems to help. I think what we’ve worked on is quite amazing.” The third session focused on Keith’s anguish and self-blame about the death of his closest friend. Even though Keith received a bronze star for his efforts to save his friend, he felt he did not deserve it since his friend did not survive and he still wept about the loss. Again, by the end of the tapping, Keith was able to access the memory without physiological distress. Following this session, he reported continued sleep improvement and feeling “much more at ease.” Subsequent sessions focused on additional combat traumas as well as incidents from his childhood and the general stress and tension in his life.

From the end of the war until he began treatment, Keith was rarely able to get more than one to two hours of sleep at a stretch, and he reported averaging about two nightmares each night. By the end of the fifth session, he was getting seven to eight hours of sleep each night and was having no nightmares. He reported at the two-month follow-up session that the improved sleep patterns remained stable and symptoms such as intrusive memories, startle reactions, and overwhelming obsessive guilt had abated. At the end of the fifth session, Keith’s PCL-M score was down from 65 to 34 (the PTSD cutoff is 50). Three months later the score had stayed stable at 34 and six months later it was 32.