Effect of the Emotional Freedom Techniques on Anger Symptoms in Hwabyung Patients: A Comparison with the Progressive Muscle Relaxation Technique in a Pilot Randomized Controlled Trial

Kwak, Hy., Choi, E.J, Kim, J. W., Suh, H.W., Chung, S.Y. (2020) Effect of the Emotional Freedom Techniques on anger symptoms in Hwabyung patients: A comparison with the progressive muscle relaxation technique in a pilot randomized controlled trial  Explore (NY) May-Jun;16(3):170-177. doi: 10.1016/j.explore.2019.08.006. Epub 2019 Aug 24.

HIGHLIGHTS

The study was conducted to compare the effects of Emotional Freedom Technique (EFT) and Progressive Muscle Relaxation (PMR) in patients with Hwabyung. Hwabyung is a described in the study as a psychosomatic condition brought about by the suppression of anger over an extended time.

The Emotional Freedom Technique (EFT) is a meridian-based psychotherapy intervention known to support stress reduction and PTSD, and progressive muscle relaxation (PMR) is a therapeutic method that relieves physical and psychological tension by repeated tensing and relaxation of the muscles. A cohort of 40 patients were enrolled and randomized to receive 4 weeks of group sessions with either EFT (n = 20) or PMR (n = 20). Evaluations were conducted pre- and post-treatment and at 4-week and 24-week follow-ups after session end. The researchers used the following scales to gauge changes: The Hwabyung Scale, Visual Analogue Scale of Hwabyung Symptoms (VAS-HS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and State-Trait Anger Expression Inventory (STAXI) were administered as self-report tools. The analysis excluded 8 patients who never attended treatment and 1 patient meeting the exclusion criteria. Outcomes of the study included EFT (n = 15) and PMR (n = 16) improved Hwabyung symptoms (-13.95% and -11.46%, respectively), state anxiety (-12.57% and -12.64%, respectively), and depression (-32.11% and -18.68%, respectively) (p < 0.05 for all). Trait anger improved in EFT group (-13.4%, p = 0.004). There were no significant differences between the groups (p > 0.05) except for trait anger at post-treatment (p = 0.022 for between group).

No adverse events were reported during the study. This suggests that both methods reduced the symptoms of Hwaybyung, state anxiety and depression  (and trait anger for EFT treatment only reported). For Hwabyung, EFT performed better than PMR, and EFT proved much better than PMR for depression.  A small advantage for state anxiety reduction went in favour of EFT. The statistical significance of the two treatments was not highlighted in the extracts available to us. Although some randomisation occurred in the comparison groups, it is not possible to establish from the extract, if this is a true random controlled trial.

Link to study: None available

Date published: May/June 2020