HOW DOES BATTLE TAP WORK?

Battle Tap is composed of multiple components, including re-exposure to past events and cognitively processing its meaning etc. However, it also includes acupoint stimulation, an ancient practice that has relatively recently found its way to the Western culture. It is not known how acupoint “tapping” works exactly, but based on findings in acupuncture and neurobiology, the key mechanisms are likely to involve the human central and peripheral nervous systems as well as the endocrine system. Until research yields more definitive answers, a review of acupuncture studies can at least offer a working hypothesis.

LITERATURE REVIEW OF ACUPUNCTURE
Acupuncture has been a component of traditional Chinese medicine (TCM) used to improve health and/or treat disease for over 2,500 years. Though not in common use within the United States until the mid-1970’s, acupuncture has become an increasingly popular form of complementary and alternative medicine (CAM). In 1997 it was estimated that over 1 million persons in the U.S. each year received acupuncture, resulting in approximately 10 million treatment visits1. In 2007 the National Health Interview Survey estimated that 3.1 million U.S. adults had used acupuncture in the previous year.2 Acupuncture is provided by a broad range of practitioners, ranging from physicians to TCM practitioners, for a myriad of conditions, based upon a variety of underlying health care paradigms. There is a growing body of literature delineating various physiological effects resulting from acupuncture.

Acupuncture theory is based on the traditional Chinese medicine concept that there are channels (or “meridians”) of energy flow (“qi” pronounced ‘chee’) within the body that maintain the health of the person. Diseases and pain are seen to result from the imbalance of qi within the body. For any particular Western medically defined illness, there may be several different underlying patterns of disharmony from the acupuncture perspective. These patterns are diagnosed by signs and symptoms such as overall affect (complexion and demeanor), tongue (color, shape, coating and texture), and radial pulse (speed, depth, rhythm, shape, quality, and strength). Acupuncture is seen as a way to access the energy channels and restore balance by adding energy where it is deficient and releasing energy where it is obstructed.3 There are more than 350 acupuncture points located on meridian pathways (http://www.qi-journal.com/acumodel.asp). While stimulation of acupuncture points is most often achieved by using very thin, painless metal needles to pierce the skin over these areas, other techniques including manual pressure (“acupressure”), moxibustion4, electrical stimulation5 and lasers6 are also used.

Acupuncture originated as a broad-based health care system and is still used to treat many conditions, including chronic and acute pain, nausea, headache, heart disease, and asthma. Clinical studies have demonstrated effectiveness in some of these areas. A 1997 NIH consensus statement found “promising” results for the efficacy of acupuncture in treating adult post-operative and chemotherapy nausea and vomiting and in acute post-operative dental pain.7 It also stated that acupuncture may be useful in treating addiction, stroke rehabilitation, headache, menstrual cramps, "tennis elbow", fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma. Since this time, further studies have demonstrated the effectiveness of acupuncture in treating pain, including low back pain,8-9 and post-surgical pain.10

Several clinical trials have demonstrated the efficacy of acupuncture in reducing stress and anxiety in both healthy volunteers and in various patient populations. A study in healthy volunteers demonstrated reduction of the bispectral index (a measure of sedation and hypnosis used in the operative setting) and verbal stress scores in healthy control subjects;11 while another showed increase in vagal tone with suppression of sympathetic tone in healthy volunteers, suggesting a direct affect on central nervous system control.12 Using a sample of hospice employees in an open study, Chan et al. demonstrated a reduction in the level of subjective stress with acupuncture.13 Acupressure has reduced anxiety and stress as well as perceived pain of treatment in emergency patients being transported to the hospital via ambulance.14 Electrical stimulation of acupuncture points has been shown to increase “mental relaxation” in patients with chronic physical disorders;15 and in another controlled study of acupuncture, muscle sympathetic nerve activity was reduced in heart failure patients undergoing mental stress testing.16

Studies have addressed potential biological explanations for the treatment effects produced by acupuncture. There is evidence that electro-acupuncture may affect the pressor response, resulting in decreased oxygen demand in the presence of myocardial ischemia.17 It has been established that acupuncture stimulates the release of endogenous opioids in the body and that analgesic effects are blocked in a dose-response manner by naloxone, an opioid antagonist.18 A rapidly developing area of study is the use of functional MRI (fMRI) technology to demonstrate that stimulation of acupoints with acupuncture and acupressure results in alteration of signals associated with stress related subcortical structures and the limbic system.19-21 Cho, et al have demonstrated specifically that the cingulate gyrus and the thalamic areas, activated in the presence of applied pain stimulation, show brain activity that correlates with decreased pain sensation in human subjects.22

In summary, acupoint stimulation has thousands of years of history and a growing literature of clinical research. Over the next few years, it will become more clear if such techniques can provide relief for public service professionals who are affected by traumatic experiences in the line of duty.

REFERENCES

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22. Cho, Son, & Han. (2002). Fmri neurophysiological evidence of acupuncture mechanisms. Medical Acupuncture, 14(1), 16-22.