Integrating the Complementary Therapies of Energy Psychology and Dreamwork – the Dream to Freedom Method

Robert J. Hoss ^1,2, Lynne M. Hoss ^1,†, Dawson Church ^2,†,*

1. International Association for the Study of Dreams, PO Box 206 Novato, CA 94948, USA

2. National Institute for Integrative Healthcare 3340 Fulton Rd, #442, Fulton, CA 95404

† These authors contributed equally to this work.

* Correspondence: Dawson Church

Academic Editor: Enrica Santarcangelo

Special Issue: Energy Psychology and the Future of Medicine

Received: January 25, 2022 | Accepted: June 21, 2022 | Published: July 05, 2022

OBM Integrative and Complementary Medicine 2022, Volume 7, Issue 3, doi:10.21926/obm.icm.2203024

Recommended citation: Hoss RJ, Hoss LM, Church D. Integrating the Complementary Therapies of Energy Psychology and Dreamwork – the Dream to Freedom Method. OBM Integrative and Complementary Medicine 2022; 7(3): 024; doi:10.21926/obm.icm.2203024.

© 2022 by the authors. This is an open access article distributed under the conditions of the Creative Commons by Attribution License, which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is correctly cited.

1. Introduction

Dreams preferentially focus on the emotional aspect of an event [1] and are thought to contain an emotional problem-solving function [2] aimed at processing salient or impactful unresolved emotional conflicts and memories. They are believed to place the emotional aspects of a stressful memory into context as well as to introduce and test scenarios aimed at dampening or altering the emotional response [2,3,4,5,6,7,8,9,10,11,12]. Thus, dreamwork which follows this process can not only quickly reveal the underlying emotional source of a symptom, it can also reveal potentially valuable resolution scenarios. Energy Psychology (EP), specifically Emotional Freedom Techniques (EFT), has been demonstrated in numerous large population-controlled studies [13] to reduce emotional stress quickly and effectively in a lasting way. EFT appears particularly effective when the underlying or “core” emotional issue can be identified [14,15,16]. EFT, and the reported emotional problem-solving function in dreams, appears from observation to operate on a process known as memory re-consolidation or alternatively emotional learning. This is a brain plasticity process which rapidly and permanently alters the emotional aspects of a memory and stress response by interleaving it with new information during a period when the neural circuits involved are labile [17]. The theoretical discussion and case trials referenced herein are aimed at demonstrating the viability of the following postulates:

Postulates: The synergy between combining dreamwork (specifically Gestalt Therapy based role-play) with EFT in a systematic protocol (termed Dream to Freedom or DFT) permits a rapid and effective means for: a) identifying the emotional conflict or traumatic memory underlying the stressful or debilitating symptoms; b) reducing the stress level triggered by this memory to or near zero; and c) using any apparent emotional problem-solving insight from the dream to establish useful action steps or altered viewpoints which can be shown to aid in resolution of the reported issue.

Note: Case material in this paper is summarized from Dream to Freedom: A Handbook for Integrating Dreamwork and Energy Psychology with permission from the publisher.

1.1 Nature of the Stress Response

Stressors can be an immediate physical or psychological threat where a present stimulus, sometimes also triggering a stressful memory, is expected to cause harm. The stress response is an adaptive evolutionary safety measure stimulating a quick response to avoid that harm [18]. It acts protectively before the rational mind has time to fully recognize the event and think through the most appropriate course of action [19]. While this stress response may be appropriate to the original event, repetitive or chronic stress can create lifelong problems as the emotional reaction becomes “programmed” into the amygdala and associated limbic structures. Even when a threat does not exist, the fight- flight-freeze response can be triggered whenever a fear memory is recalled or when an analogous situation triggers that memory. Non-causal aspects that are present in the immediate environment during the original event can also trigger the response. It is as if the limbic system takes a “flash photo” of the scene, including the sights, sounds, colors, tone of voice, facial expressions, etc., and integrates the associations into a “fear structure” [20], a “wired” routine designed to escape similar threats.

With chronic stress, the amygdala continues to mark certain memories as being emotionally significant, thus establishing selectivity for one memory over another. The prefrontal cortex loses the ability to extinguish fearful memories that are no longer relevant, and the function of the anterior cingulate in choosing between conflicting perceptions (fear-based misconceptions versus rational concepts) becomes diminished [21]. Another complicating factor is that each time a traumatic memory is recalled, the stress response and emotional excitement accompanies it can add strength to the response [22].

The presence of a stressor may result in a rapid activation of two brain/body networks: the SympatheticAdreno-Medullar (SAM) axis and the Hypothalamus-Pituitary-Adrenal (HPA) axis [18]. SAM is the “fast path,” which sends signals through the autonomic nerves to the adrenal glands, pumping epinephrine (adrenaline) into the bloodstream. It brings on a number of physiological changes characteristic of stress such as the fight-flight-freeze response [19]. Blood flow is routed to areas of the brain and body required for action and limited to others not required in the situation. This “fast path” happens unconsciously before the brain has had a chance to fully process what is happening. HPA is slower in activation and results in an increase in cortisol to suppress the initial hormone cascade. It continues to be activated even after the stressor has been removed and involves emotional and cognitive processing related to the stressor.

Due to increased blood flow to the midbrain, accompanied by decreased flow to the prefrontal cortex [23], this protective focus can be limited to survival. In these circumstances, the person doesn't “think” as well while in this stress response condition [24]. The brain also seems to be wired to prevent deliberate overriding of these “important” emotional memories [25]. Thus, the stress response is difficult to alter simply by cognitive intervention. A person’s actions during stress are therefore often inappropriate, and it is difficult to quickly recover a semblance of rational behavior.

Although the stress response itself involves many brain/body systems, it begins with activation of the limbic system in the brain. This involves the amygdala, hippocampus, thalamus, hypothalamus, and pituitary (included in the white areas in Figure 1a). The thalamus relays the threat information (visual, sensory of otherwise) along the subcortical “fast path” directly to the amygdala as well as a “slow path” which involves processing the information in the cortex before also routing the processed information to the amygdala [21]. Due to the presence of certain inhibiting or dampening structures, all threats or triggering memories do not create the same reaction. For example, there are inhibiting structures in the thalamus that set a threshold for the sensitivity depending on a person’s past experiences [26]. They engage when threats are uncertain, resulting in behavioral inhibition and risk assessment [27].

Figure 1 Comparative brain state activity during waking stress response (Figure 1a) and dream state emotional processing (Figure 1b). The white areas represent more activity, light gray areas less or neutral response and the dark gray areas (in Figure 1b, REM state dreaming) areas that are relatively inactive.

1.2 How Dreams Process Stress

In the REM dream state shown in Figure 1b [28,29], many of the structures involved in processing emotion (in white) are similar to those involved in the waking state when processing a stressor. The difference in the dream state is that all the information comes from within. Therefore, in dreams the stressor would typically be the replay of an emotionally stressful memory. As will be discussed further below, dreams are thought to also contain a specialized “emotional problem solving” [2,30] or “fear extinction” function [31] whereby emotional learning takes place to dampen or alter the response to a stressful memory. Processing a stressful memory in the REM dream state begins with that memory being re-activated in the amygdala/hippocampal network [3] which is highly active in the REM state. This is followed by a selective processing of aspects of that memory [1,30,32], which involves paralimbic system and forebrain as shown in Figure 1b [6,8,12,28,29,31,33]. For example, down regulation of the amygdala in REM sleep has been observed due to increased connectivity between the forebrain and amygdala and reduction in stress producing neurotransmitters in the forebrain [34]. As will be discussed below, this forebrain processing involves the structuring of the dream plot itself to alter the emotional perception of the event or the reaction to it – for example to fight against the event (master it) rather than flee from it.

The cognitive processing of a stressor in the waking or dream state can involve similar structures. For example, defensive actions such as avoidance are influenced by the basal ganglia and its nucleus accumbens [27] and ventral striatum, which are considered central to extinction learning [35]. The extinction of defensive responses elicited by learned threats is also regulated by connections from the ventral medial prefrontal cortex and hippocampus to the amygdala [36]. The anterior cingulate plays a major role in mediating between opposing perceptions and conflicts which accompany a stressor. It is involved in award-based decision-making [37] and, particularly in the dream state, may be involved in the creation of rewarding resolution scenarios, based on past-experience, or imagined outcomes [38]. Activity in the orbitofrontal cortex helps establish expectation [39] and provides novelty-related decision making for unexpected threats based on reward, regulating behavior accordingly [40].

1.3 Memory Re-Consolidation and Emotional Learning

Both EFT therapy and dreaming may share a common stress reduction process – that of memory reconsolidation, a process by which emotional learnings are revised. A memory trace is consolidated when it is moved from short-term into long-term memory. Memory re-consolidation involves: (a) activating a learning derived from the old memory, (b) encountering an experience that causes the old learning to be revised (a “predication error” [13]), and (c) storing (consolidating) the revised learning into long term memory, completely replacing the original learning at the neuronal level. The revised learning is put into long-term storage via a protein synthesis-dependent process similar to that used during the initial consolidation period; hence, the use of the term reconsolidation [41]. The experience bringing about the prediction error must occur within a few hours of the original learning having been activated, a period called the “reconsolidation window.” [17]. This “window” means, essentially, that after the old learning has been activated, it becomes potentially labile for change—in a state of a high degree of neural plasticity—if the prediction error occurs. At that point, the altered learning becomes restabilized or consolidated (re-consolidated).

While this has been a dominant model for how an established memory can be modified (as opposed to temporarily inhibited or extinguished), research continues as it relates to declarative versus emotional memories, the effect of the nature of the trigger cues, timing, and such [42]. But in most studies, the focus is on the presence and specific nature of an inconsistency (mismatch) between what is expected and what actually happens (prediction error). This is the essential requirement for de-consolidating all or part of an old learning.

Early on, Foa and Kozak [20,43] proposed a model termed the Emotional Processing Model. In this model anxiety is the result of forming “fear structures” in long-term memory – a networked cluster of information about the stimuli, the stress response, and the meaning of the relationships between these elements. This fear structure serves as a pre-programmed routine to escape a threat. Dysfunctional or pathological fear structures, however, contain excessive response elements, unrealistic beliefs, and misconceptions, which lead to resistance to change. Treatment consists of modifying the structure first by activating the fear structure to reveal information about the elements that make it up. Then “corrective information” is provided which is incompatible with given elements of the fear structure (again, a prediction error). This dissociates (uncouples) the stimulus and response elements, changing the meaning of the relationships, thus decreasing anxiety.

Bruce Ecker [44], has summarized this process. In a review of animal and human studies from 2004 to 2009, he identified three elements that brought about permanent change (4^th element) in emotional learning, which he called the Transformation Sequence. Summarized here they include: (1) re-trigger/re-evoke (recall) the target learning by presenting salient cues or contexts from the original learning; (2) concurrent with the reactivation, create a “mismatch schema,” an experience contradictory to that original learning (deconsolidating or rendering the memory circuits labile and susceptible to updating by new learning); (3) during a labile window of about 5 hours (before synapses re-lock) create a new learning experience that contradicts (for erasing) or supplements (for revising) the old target learning (may be the same or different from the deconsolidation mismatch); (4) when the target learning re-consolidates, it is altered by the new learning. These elements appear common to the re-consolidation and Emotional Processing models. They are also common to elements of the dreamwork and the EFT protocols that make up the DTF protocol.

A complementary model to re-consolidation, called Memory Integration [45], was proposed by Gisquet-Verrier and Riccio for explaining the embedding of new material into an already existing representation. It is based on an emotional learning process of making incremental changes versus the abrupt change of re-consolidation. Gisquet-Verrier and Ricco point to evidence where components of the original memory, that should have been eliminated by the protein-synthesis mechanism of re-consolidation theory, could still be reactivated.

Perhaps some of the confusion between these theories is that the reporting does not always distinguish between the different components of a remembered experience: the recall of the sensory event itself (episodic and/or declarative memory), the emotional perception of it, and the reaction to it. We will refer to this latter component of a memory herein as the “emotional memory” – if only to distinguish it from the more cognitive episodic or declarative components. Many studies appear to treat the memory of an event as a single memory trace, whereas a memory could perhaps consist of linked episodic and emotional traces processed in complementary memory systems. It appears from experience and observation (discussed herein) that the emotional memory of a recalled event can be processed or altered with little effect on the declarative aspects. This is perhaps dependent on the nature of the mismatch of the new learning – a somatic or emotional mismatch versus a declarative one.

Some studies [46] imply that one must look closely at the content of the recalled learning to recognize which new experiences do, and which ones do not, actually serve as a mismatch or prediction error necessary for deconsolidation. In both EFT therapy and in observations of emotional regulation during dream sleep, episodic memory is seen as remaining intact, while the emotional perception and learned response can be dramatically altered [15,47].

“Memory triage” (selective processing for creating generalizations) has been observed in dreams [29,32,48] where only a single aspect of an overall traumatic emotional memory is processed and altered in a dream. An example is the observation from a REM awakening study of a Veteran with PTSD [49,50]. In this case, the traumatic memory was of him and his buddy riding in a jeep which was blown up by a land mine, throwing him out, and killing his buddy. This was discussed with him in detail prior to sleeping in the lab, where he was then woken during each REM cycle to report any dream content. The initial REM dream was a replay of the event but selectively omitted the presence or death of his buddy. In a subsequent REM stage, the dream replayed the memory again, but this time in a manner that allowed him to emotionally master the situation. The dream introduced a predictive error by presenting the explosive as a hand grenade, which the Vet picked up and threw aside before it exploded. The emotional memory was selectively processed in an apparent attempt to dampen the impact of that one specific aspect, introducing new learning as an act of mastery. This was done without processing the other emotional aspects of the memory or altering the declarative memory.

Also, in earlier DTF trials [15], EFT was applied to create the mismatch of a calming sensation in opposition to the learned stress response. Afterwards, when subjects were asked, they could still recall and visualize the event as it was, but the emotional charge and stress response was no longer there. For example, in a case titled “Birds or Bats,” described below, once the emotional reactions to the memory was entirely diminished by application of EFT. The subject stated, “I can still recall the incident, but it just seems silly now.” This sort of shift in the incident's meaning and the subject’s emotional reaction to it was frequently observed.

Regardless of the re-consolidation or integration mechanism involved, in dreams and in the application of EFT, there appears to be an emotional learning process taking place which can dampen the emotion or alter the response to a stressful memory while leaving the declarative memory intact.

1.4 EFT and Emotional Learning

Energy Psychology is a term used to collectively describe a set of clinical and self-help approaches that integrate cognitive and exposure techniques with ancient healing methods such as acupuncture. In an assessment of over 100 peer-reviewed outcome studies—51 of which were randomized controlled trials—Feinstein concluded that “a growing body of evidence indicates that acupoint-based energy psychology protocols are rapid and effective in producing beneficial outcomes in the treatment of anxiety, depression, PTSD, and possibly other conditions” [13]. A listing of over 130 clinical trials, published in peer-reviewed journals, can be found on www.energypsych.org. One of the most well-known and effective protocols is the Emotional Freedom Techniques (EFT), derived by Gary Craig from Roger Callahan’s earlier “Thought Field Therapy” [16]. EFT has developed several major protocols, with “Clinical EFT,” developed by Dawson Church, being the format used in this study [47]. It was found to be particularly useful in reducing the emotional stress and stressful reaction brought on by a past incident or phobia.

EFT utilizes acupressure, stimulating the acupuncture points with percussion – stimulating the points by “tapping” on them with one’s fingers – instead of needles. Both acupuncture and acupressure posit a system of subtle energy pathways known as “meridians.” Individual acupoints exhibit a physical and bioelectric component. They have lower electrical impedance than points on the surrounding skin [51]. Some correspondence has been found between the conjectured meridians and the body’s interstitial connective tissue, which has semi-conductive properties in the collagen. The connective tissue may permit signals produced by stimulating acupoints to be transmitted more directly than through the synaptic nervous system [13]. Various studies using fMRI have shown that stimulation of these points directly affects the amygdala and other limbic areas of the brain associated with fear and emotional stress [52,53,54]. Others [55] have shown that tapping can send signals that directly influence brain activity in targeted ways, such as to the lateral orbitofrontal cortex, a part of the brain’s attention system. Stimulation of acupoints has been shown to result in the release of cortisol, serotonin, and other pain-reducing biochemicals which calm the midbrain and signal it to shut off the alarm response, while simultaneously inducing a relaxation response [56]. It also may directly activate stress-dampening and regulatory genes in the hippocampus and hypothalamus [57].

The Clinical EFT protocol [47] appears to work very much like the memory re-consolidation process and Ecker’s Transformation Sequence discussed above: (1) It begins with the recall and visualization of a stressful memory, an unwanted response to a trigger, a self-defeating belief, or problematic feeling or sensation (the old learning); (2) a mismatch scenario is set up by establishing an affirmation which creates a positive intention in opposition to the original stress response; (3) this is followed by tapping on acupressure points - accompanied by a reminder phrase intended to keep the stressful memory in mind or visualized - which creates the mismatch or unpredicted calming sensation contradictory to the original stress response; (4) repetitive tapping rounds juxtapose the stressful memory with a calming sensation over a period of time such that (5) the emotional response to the memory is altered (perhaps re-consolidated) with the new learning and new response – the stressful memory and emotional “tag” is now associated with calm instead of fear or threat.

1.5 Dreaming and Emotional Learning

Some consider the evolutionary purpose of dreaming as involving adaptation or “adaptive learning” [7,58]. Stewart and Koulack [59] stated that a function of dreaming is the adaptation to stress over time. In Revonsuo’s Threat Simulation Theory [7], dreams help people adapt to life by introducing and testing predictive threat simulations to better prepare for similar threats in waking life.

Other researchers postulate that dreams contain a “fear extinction function” [31]. Some consider the function of dreaming to be emotional “regulation” or “emotional problem solving” [30]. Kramer [2,30], in a series of seven studies, demonstrated that the emotionally intense experiences of the day are what appear in dreams and that the activities during sleep appear to be “corrective.” He observed that that the effectiveness of a night’s dreaming in reducing the “emotional surge,” or intensity and variability of mood occurs in about 60 percent of nights. He found that if the dream attempts to resolve the emotional problem – in a “progressive-sequential” dream pattern -- there is usually a positive change in the waking emotional state of the dreamer. He called this the “emotional problem-solving function” in dreams. He summarized, “how you feel in the morning is related to how you feel in your dreams and what happens in them” [2]. How the dream narrative pictures the emotional problem-solving function is important to the final stage of the DTF protocol in arriving at insight that might be useful to moving forward in waking life [12,15,60].

In all of these proposed theories, whether adaptive learning or emotional problem solving, the function essentially results in a “re-wiring” of one’s emotional perspective of, and/or emotional response to, a stressful event. Early on Carl Jung [61] observed that certain dreams contain a “purposeful structure.” This structure juxtaposed emotionally charged conflicted material and introduced a learning sequence aimed at resolving the conflict, in an effort to transcend one’s previous state of mind. Such a structure may be present in progressive-sequential dream plots which constitute an emotional learning process for dealing with emotionally stressful events [12]. According to Hartmann [62], this emotional learning in dreams is a critical part of a wake-dreaming-waking learning continuum.

By combining the findings of various researchers, an emotional learning process emerges for some of the more progressive-sequential or story-like dreams or dream series. Although it is rare for any one dream to follow this sequence completely, insight can be gained by exploring the dream to the degree that it contains any of the following elements:

a) The dream may begin with a reactivation [3] and “triage” [32] or selective processing [29,48] of an emotional aspect of a memory [1], which the dream pictures metaphorically. Selectivity is often based on an unresolved conflict (a mismatch) which “indexes” [3] that element for re-consolidation. 

b) The dream state, being hyperconnected [62], might then introduce past memories and compare them with the recent memory, transforming memory traces over time [4] to extract the “gist” [5], a more generalized view [6] or global context, leading to insight. 

c) A progressive-sequential dream may then introduce new associations [63], and predictively model [64] or introduce alternative emotional problem-solving scenarios [2,7]. These often appear as a mismatch element (prediction error) such as a “counterfactual” [8], a surprise, guidance, or decision point. The scenario may be structured to “master” the pictured threat [9,10] or “rescript” the perception of or response to an emotional memory. 

d) Depending on the outcome, the dream may emotionally reinforce [33,37] the new “rescripted” learning, in essence aiding the storage or re-consolidation of the emotional memory interleaved with the new learning. As Stickgold put it, “When you wake, you understand how the world works better than you did when you went to bed” [11]. 

The Dream to Freedom method, described below, first begins by exploring dream stages a and b to identify the stressful memory that the dream is dealing with. Then EFT is introduced to reduce the stress from the emotional memory that surfaced. This is then followed by a return to the dream to explore elements in stages c and d for insight, to the degree that the dream has continued an attempt at emotional problem-solving and learning.

2. The Dream to Freedom Method

The Dream to Freedom (DTF) method [14,15] provides a complementary combination of approaches drawing from the disciplines of dreamwork and Clinical EFT. It is a scripted systematic three part protocol: (1) it first incorporates a scripted Gestalt-based role-play protocol for identifying the salient emotional memory or conflict which the subconscious is dealing with in a dream; (2) the stress level triggered by that memory is given a self-reported rating, and a version of the Emotional Freedom Techniques (EFT) protocol [16,47] is applied to reduce the stress level to at or near zero, and finally (3) once the stress level is reduced (emotional barriers reduced) the dream is revisited for insight as an aid in defining what closure action the person might now take to progress beyond the situation.

2.1 DTF Part 1: Revealing the Emotional Issue from within the Dream

DTF utilizes a form of scripted role-play patterned after that used in Gestalt Therapy [65,66] which was developed by Fritz Perls, Laura Perls, and Paul Goodman. Its application to dreams is based on the hypothesis that the elements within a dream are fragments of the dreamer’s personality which remain alienated or non-integrated (outside of the dream self) due to an emotional conflict [65]. The view that dream images or elements are representations (picture metaphors) of the emotional state of the dreamer is shared by other psychologists such as Ernest Hartmann [62]. Gestalt Therapy uses the word “impasse” to describe an unresolved emotional conflict which keeps a person stuck, preventing them from moving forward or integrating these fragments with the ego self. These are often an unexpressed emotion – perhaps too hurtful to articulate as they might conflict with and shatter the person’s inner models of self and reality. A principal Gestalt Therapy process for working through such an impasse is role-play. In Fritz Perls’ words, the dreamer is to “become” that thing in the dream, “play the role” of the image, and let it speak and express its feelings [65,66]. He might have the subject play the two sides of the conflict by sequentially sitting in two opposing chairs as one side speaks to the other – expressing the deepest, most honest feelings that come up at the moment.

Working with a dream image in this way, to reveal it’s emotional “meaning,” is in effect reversing the process by which the brain assigns meaning to an image in the waking state. In the waking state, visual images received by the primary visual cortex are assigned “meaning” through activity in the surrounding visual association cortex, which helps to form memory and emotional associations with the image. In the dream state, however, all information comes from within, so the process is reversed. It begins with the processing of an emotional memory which triggers the associative cortex and memory systems to create an image that represents the associated emotions. The image is often a pictorial combination of the various aspects of that emotional memory, hyperconnected with other like emotional memories, placing it in a broader context [62]. For example, a red car in a dream is not a “red car” as named and identified by the conscious waking mind. It is a picture representation and construct of the many feelings, memories, and concepts the dreamer personally associates with ‘red’ and with ‘car.’ So, if we ask the person who dreams the red car to “become it” and express how the red car “feels,” the person will usually voice the emotions that created the image. As the conscious mind is occupied with playing a role, the unconscious emotional associations and conflicts that created the image will most always come forth. For example, the dreamer might state, “I am a red car; I feel I am being driven too hard and fast and fear I will crash!” Thus, the unexpressed feelings of the dreamer are voiced. In this example, the dreamer might conclude, “I am driving myself too hard and fast and may be headed for a breakdown.”

Emotional expression can also be found in the color(s) the dream uses when constructing a composite image. Color psychology research has found different colors to subliminally trigger different, but relatively common, physiological and emotional responses in humans [67,68]. Research by Hoss [60] led to an understanding that the brain retains similar color to emotional associations both in the dream and waking state. Based on this premise, a Dream Color Questionnaire was created as an aid to triggering a dreamer’s emotional associations during the dreamwork session. While color information was collected in some of the cases [14], it was not directly consequential to the results and thus is not the subject of this report. The questionnaire can be found in Dream to Freedom 2^nd Edition [60] or the Clinical EFT Handbook volume 2 [14] or is available at www.dreamscience.org.

The six statements in the scripted Gestalt role-play protocol (below) are designed as 3-statement pairs to reveal 3 categories of emotional content.

1. The first statement pair, “I am…” and “my purpose is…,” is designed to explore the role of the dream element as it might relate to the role the dreamer sees for themselves in waking life. 

2. The second statement pair, “what I like about being the thing in the dream is…” and “what I dislike…,” is designed to reveal the two sides of a possible emotional conflict the subject might be stuck in. 

3. The final pair, “what I fear most is…,” and “what I desire most is…,” is designed to reveal the opposing motivating factors of fear and desire that often keep a person stuck. 

Once the role-play ends, the subject then switches perspectives and reviews the expressions as if they are also expressions of feelings or situations in their own life. The intent is to surface a memory or conflict underlying the subject’s stress response so that the stress response to that memory can be reduced using EFT.

2.2 DTF Part 2: Reducing the Stress Response with Energy Psychology

The second part of the Dream to Freedom protocol uses a version of EFT to reduce the stress level around the memory that was identified in the role-play. The EFT protocol [16,47] consists of a sequence of exercises designed to manually stimulate specific acupuncture (acupoints) by tapping on them with one’s own fingers while visualizing the specific stressful event identified in the role-play. It is important to keep the stressful incident visualized so as to juxtapose a mismatch between the expectation of a stress response from that memory, with an unpredicted calming sensation brought about by tapping on acupoints.

The tapping protocol begins by the subject picking the most emotionally charged statement voiced during the role-play, then associating it with a specific stressful waking life incident and visualizing the scene. A stress level is rated by the subject, on an 11-point Likert-type scale from zero to ten. Zero represents no emotional intensity, and ten representing the maximum possible intensity. This is also called a SUDS measurement or Subjective Units of Distress Scale [69].

The subject then sets their intention for the session by developing a “setup phrase” that pairs the negative feelings associated with the incident with a positive affirmation. A standard EFT “setup phrase” might be [16], “even though I feel…(negative feelings)…, I deeply and completely accept myself.” The DTF protocol differs from the standard EFT protocol in that it recommends using statements verbalized during the role-play to develop the “setup phrase.” This is to employ as much subconsciously derived material as possible. The negative part of the statement comes from the stressful incident that the dreamwork brings to mind, and the positive might be derived from the “I like” and the “what I desire most” role-play statements. The DTF setup statement is therefore structured as follows: “even though I feel…(negative feelings from the incident), I know that I can/I choose to…(positive intention or expectation).”

The setup phrase is used in an initial tapping exercise which is then followed by additional rounds of tapping on the various acupoints. In order to keep the stressful incident visualized during those tapping rounds, a short “reminder phrase” is extracted from the negative feelings expressed in the setup phrase and vocalized each time an acupoint is tapped. In the DTF protocol, the stimulation of acupoints is done by the subject tapping on the points themselves, about 8 to 10 times on each point, using their own fingers. The protocol used in these trials also included an optional “bridging sequence” [16] designed to stimulate alternate hemispheres in the brain.

The sequence of acupoint stimulation and the location of the specific points and elements of the bridging exercise are described in the scripted protocol below. These sequences are grouped into rounds, so that progress can determined by periodically checking the SUDS level. Once the SUDS level is reduced, using the EFT protocol, to at or near zero, then the subject is ready to return to the dream for insight that might be useful in developing action steps for progressing beyond the problem.

2.3 DTF Part 3: The Closure Protocol

Once the stress response is reduced, thus removing an emotional barrier, it is now easier to return to the dream for insight useful in establishing closure activity and progressing forward. Here we are looking for obvious or metaphoric evidence in the dream narrative as to how the dream might have been attempting to resolve the issue [2,12]. The dreaming unconscious is thought to be hyperconnected [62] to a lifetime of experiences. As such it can provide valuable clues and insight [70] as to how the dreamer might deal with any remnants of the issue in waking life, to help move forward.

If these elements are not present or obvious, the dream may still be useful as a platform for creating a meaningful resolution metaphor. Using a form of Jung’s Active Imagination [61], the subject is asked to place themselves at the end of the dream, focusing on how they got there and what they are feeling. They are then asked to continue the dream by letting a spontaneous flow of images come to mind, imagining a new ending that works out positively. The new metaphor might serve as a clarifying analogy for moving forward and establishing the subject’s next steps. As with every insight, the analogy must be tested to ensure it is healthy and appropriate before taking it further into defining those next steps.

2.4 DTF: Case History

The methodology is described below using a case study to help explain each step of the protocol. References to the case example and subject’s responses are in italics. The EFT portion of the protocol was derived from the work of Craig [16], Feinstein [51], and Hoss [14,60]. The structure is systematic and purposeful, so it is recommended that one read the explanatory notes above before modifying it for a particular session.

2.4.1 DTF Part #1: Dream Exploration/Problem Identification

Part 1, Step 1 – Dream Summary: Tell the dream, or seemingly most impactful dream segment, in the first-person present tense as if you are re-experiencing it: In this example, “I am in the home I shared with my ex. looking out over trees that contained black things. My mother is there, and we are trying to decide whether they are birds or bats.”

Part 1, Step 2 – Waking Life Situation: Record any emotional situations (positive or negative) at the time of the dream and express what you were thinking and feeling at the time. In this example, “My present boyfriend has a medical procedure scheduled, and I am concerned about being nurturing and there for him.”

Explore Analogies: Although the dream may or may not be about that situation, explore analogies between the dream and the waking life situation: In this example, “None were obvious.”

Part 1, Step 3 – Chose a Dream Image or Element: Re-enter the dream perhaps at the most emotional point and look around the scene. Pick one image or element that curiously draws your interest, even though it may not dominate the dream. Choosing a thing rather than a person often works best: In this example, “A lone bird’s nest.” [Note: this was not something reported in the original narrative but only after dream re-entry]

Part 1, Step 4 – Scripted Role-play: Imagine you are that dream element [a lone bird’s nest], “become” it, and (in the first person, present tense) complete these six statements as you imagine the dream element would state them:

1) I am (name and describe yourself as the dream element and how you feel in that role)...“a lone bird’s nest, warm and enveloping.” 

2) My purpose or function is…“to provide a safe landing spot.” 

3) What I like…“is I am soft and warm.” 

4) What I dislike (the downside)…“is getting crapped on.” 

5) What I fear most is…“getting blown out of the tree.” 

6) What I desire most is…“to be there and be strong when needed.” 

Part 1, Step 5 – Waking Life Reflection: Review each statement, but now as if it is YOU saying it about a way YOU have felt lately or a situation in YOUR life. Note any statement(s) that sounds like it also describes a feeling or situation in your waking life, and maybe rephrase it to fit that situation. [Procedural note: If the subject does not make a connection, then have them go back into the dream and pick another dream element, perhaps an inanimate one that was particularly curious, and repeat steps 3 through 5.] In this example the dreamer indicated that all statements relate to her situation.

Looking at them from the standpoint of the 3-pair design, as noted previously, the relationship is clarified. The first pair often reveals the role one feels they are playing. She felt her role at the time with her present boyfriend was to be nurturing (warm and enveloping) and provide a “safe landing spot” by being supportive during his procedure. The second pair often surfaces the underlying conflict. In this case she wants to be “soft and worm” (nurturing), but in her past situation with her ex, when she put herself in that position, she was “crapped on” (taken for granted). The third pair often reveals the motivating factors (fears and desires) which leave a person stuck in the conflict. In this case the desire was “to be there and be strong when needed” which was juxtaposed with the fear of “getting blown out of the tree” (rejected, ridiculed and, in this case, divorced).

Part 1, Step 6 – Most Emotional Significance: Which statement feels most emotionally charged or relates to the most stressful waking life situation? In this example, “I dislike being taken for granted (crapped on).” [Note that although this is the most emotionally charged statement, the dreamwork resulted in a number of other statements above which appear to indicate other underlying feelings, some of which surface during subsequent rounds of the tapping as noted below].

2.4.2 DTF Case Part #2: EFT Application and Stress Reduction

Part 2, Step 1 – Describe a Specific Incident when You Felt This Way: In this example, “The moment I decided to divorce my ex. I had gone all out to help him, and he showed up two hours late and yelled at me for not having done enough.”

Part 2, Step 2 – Initial Stress Level (SUD): What is your level of distress right now (from 0-10, with 10 being the most stressful) as you think about that incident: In this example, “It is a 12!”

Part 2, Step 3 – Setup and Reminder Phrases: The Setup Phrase sets the intention with an affirmation statement that pairs the negative feelings from the stressful memory with a positive intention or expectation. The Reminder Phrase is simply a short vocalization of the negative feelings, extracted from the Setup Phrase, that is used to keep the incident visualized while going through the tapping rounds.

a) Setup Phrase: “Even though I…(negative feeling from steps #6 or #7 in Part 1), I know that I can/I choose to…” (positive intention - try positive “I like” or “I desire” statements from step #5 in Part 1). In this example, “Even though I feel taken for granted, I choose to be there and be strong.” 

b) Reminder Phrase: Select a few words from the negative part of the Setup Phrase that can be used to keep the incident in mind (visualized) during the EFT tapping sequences: In this example, “Taken for granted.” 

Part 2, Step 4 – Round 1 – initial tapping round:

a) Tap point #8 on side of hand (either hand) with the four fingers of the other hand while vocalizing the setup phrase. Repeat this about three times tapping to a ten count each time. In this example: “Even though I feel taken for granted, I choose to be there and be strong.” 

b) Tapping with Reminder Phrase: Tap about 10 times with the balls of the fingertips of the index and middle fingers (both hands where there are two opposing points) on each meridian acupoint location #1 through #8 while repeating the reminder phrase each time. In this example: “Taken for granted.” 

c) Bridging Sequence (optional) using the reminder phrase: The bridging sequence, or “9 Gamut Procedure” [16,51], is considered optional, but it was used in these trials. In theory it exercises alternate hemispheres of the brain. It consists of tapping on the “Gamut” point (on the back of either hand a half inch toward the wrist from the point between the knuckles and the base of the ring finger and little finger – see Figure 2). While tapping on the “Gamut” point nine actions are performed: 1. close eyes; 2. open eyes; 3. shift eyes down right; 4. shift eyes down left; 5. roll eyes in a circle clockwise; 6. then counterclockwise; 7. hum a tune for two seconds (we used “happy birthday to you”); 8. count rapidly from 1 to 5, then 9. hum the tune again for another two seconds. 

d) Repeat Tapping Sequence: repeat step (b) above on points #1 through #8 while repeating reminder phrase. In this example, “Taken for granted.” 

e) Re-assess the Level of Distress (SUDS): Ask the subject to think about incident again and rate their level of distress 0 to 10. In this example, “It is a 7.” 

Figure 2 “Tapping” Points Recommended for the DTF Protocol (Source: Dream to Freedom [15]). 1. EB or eyebrow point: at the start of the eyebrow where it joins the bridge of the nose; 2. SE or side of eye: on the outside edge of the eye socket; 3. UE or under eye: on the bony ridge of the eye socket under the pupil of the eye; 4. UN or under nose: under the center of the nose, 1/3 distance between the nose and the upper lip; 5. Chin: between the lower lip and the chin, in the center; 6. CB or collarbone points: located in a small depression under each collarbone on either side of the U-shaped groove at the top of the sternum; 7. UA or underarm: about four inches below the base of each armpit and about halfway between the front and back; for women, this is where a bra strap crosses, for men even with the nipple; 8. KC or Karate Chop point: fleshy outer portion of the hand, upper middle about where the crease is; *Gamut Point (for optional bridging procedure): back of either hand a half inch toward the wrist from the point between the knuckles and the base of the ring finger and little finger.

Part 2, Step 5 – Subsequent Rounds: Assuming the SUDS level has not reached zero, adjust the setup statement and reminder phrase to include the word “still.” Continue the sequence as in step 10 until the SUDS rating is near or at zero. In this example the setup statement was adjusted to state, “Even though I still feel taken for granted … I choose to be there and be strong,” and the reminder phrase to, “still taken for granted.” The session in this example took two more rounds to bring the SUDS rating down to zero.

Part 2, Step 6 - If Another Aspect or Stressful Memory Arises: If the SUDS level begins to increase or no longer decreases, ask the subject if another stressful memory came up. If so, summarily repeat steps 7 through 11 as appropriate (bridging sequence optional) to reduce the stress level around that aspect, in order that the work can continue with the original issue.

In this example, the stress level had gone from 12 to 7, then suddenly back to 10 again. The subject stated that a feeling of guilt arose for having asked for the divorce. The setup statement was adjusted to, “Even though I feel guilty for leaving, I choose to go on.” In 2 subsequent rounds of tapping using the reminder statement “feeling guilty” the SUDS rating went from 10 to 1 to zero.

2.4.3 DTF Case Part #3: Closure Protocol

After the stressful response to the memory of the incident is reduced, the dream is revisited to determine how the dream might have been attempting to resolve the issue. It may be able to provide valuable clues and insight for moving forward in waking life.

Part 3, Step 1 – Dream Resolution: re-enter the dream, perhaps at the most emotional point, and review the storyline to the end, describing how it ended and your feelings at that point. Then note whether you observed any of the events listed below in the dream story. In this example the subject stated, “I am trying to decide [with my mother] whether the things in the trees are birds or bats.”

a) Introduction of a Resolution Scenario: Did you observe any of the following?

1. Guidance – was there a guiding figure or event: advice, action, discovery, written or verbal message? How did it change your behavior or thinking in the dream? No obvious guidance. 

2. Surprise – was there an unexpected twist, action, anomaly, discovery, insight, person or thing acting opposite to their nature? How did it differ from expectation or provide a different point of view? In this example, “the uncertainty of trying to decide whether the black things in the trees were birds or bats.” She noted she was an expert in birds. 

3. Known Person – how would they manage your waking life situation differently than you have? In this example her mother was part of the decision making (a nurturing influence). 

4. Decision - Did your dream-self (or something representing you) make a new decision, accept the guidance or reverse the prior viewpoint or action? Describe the new decision or viewpoint. “… trying to decide whether the black things were birds or bats.” 

5. Reinforcement? Did the dream reinforce a solution or your actions, by ending positively or negatively? What specifically happened to bring that about and how might that relate to waking life? She indicated that it ended “inconclusively” trying to decide birds or bats. She stated that she woke very anxious. 

Part 3, Step 2 Life Analogy: How might the results of the exercises in Part 3, Step 1 above relate as an analogy to your waking life situation, conflicts or beliefs – perhaps providing a new perspective, or possible helpful resolution to your life situation? Note that each is a metaphor, so interpret each event from the standpoint of your emotional associations – what memories does it bring to mind? In this case her answer was surprising, since one often thinks of a bat as negative. So, we asked her – what is the difference between birds and bats? She said “Bats, like birds, are free, but unlike birds, are helpful and come home to the cave at night.” Relating this then to her anxiety about nurturing her boyfriend she said: “I can be there, helpful, and still be me (free).” The dream had indeed introduced a “solution scenario” aimed at resolving the emotional conflict: a) the dream first placed her in the “emotional environment” of a time that she shared the home with and divorced her ex.; b) it next placed her in the situation of having to make a specific decision - “birds or bats” - metaphorically is she going to be a bird (leave her boyfriend and be free) or be a bat (still free but also able to come back to the “nest” and take care of her boyfriend); and c) inserting her mother as part of that decision perhaps as a nurturing influence.

Part 3, Step 3 – Closure:

a) Define a Solution: Review the waking life analogy in the previous step and use that insight to define a specific solution to your waking situation that the dream or active imagination above might be suggesting. In this case she reiterated: “I can be like the bat, be there, be helpful, and still be me (free).” 

b) Check it Out: Is this a healthy, practical solution that allows you to progress, or does it leave you stuck again? The subject stated: “Yes, it is practical and allows me to move forward.” 

c) Next Steps: If it checks out positively, then what specific steps can you take to bring it about? “I will tell my boyfriend today that I have decided to stay in the relationship.” 

d) Reminder Image (optional): It is often useful to pick an image from the positive dream ending or active imagination as a reminder of your solution when you find yourself confronted with a similar situation. She picked “a bat.” 

Postscript: after the session, her boyfriend unexpectedly entered the room. She went up to him and embraced him. She remained in a relationship with him for years thereafter.

3. Data from Seven Cases

The results herein are reported from the details of seven case studies, included in chapter 5 of Dream to Freedom: A Handbook for Integrating Dreamwork and Energy Psychology [15]. Table 1 below summarizes and compares the elements and results of each case study (with statements from the subjects shown in italics) to illustrate the application of the DTF protocol to a variety of symptoms: unknown cause of extreme anxiety, fear, guilt, self-image perception, feeling trapped or conflicted, aging anxiety, and physically debilitating chronic migraines. A summary of the results is as follows:

1. Although symptoms varied in nature and severity (anxiety, fear, guilt, conflict, migraines), three of the seven subjects entered the session with extremely debilitating symptoms that affected their daily life. 

2. All seven were able, using the scripted role-play, to recall a specific stressful memory directly related to the present-day symptom(s) 

3. All seven expressed a raised level of stress from the recalled memory, and successfully reduced their stress level significantly using the EFT tapping protocol. Stress was initially reported at SUDS levels between 10 to 7 and were in every case reduced to a SUDS level of 1 or 0. This was achieved within 3 to 6 tapping rounds. In each case the bridging sequence was only used with the initial tapping round.

4. Four of the seven had a new memory or “aspect” arise after the initial round of tapping where the SUDS level again increased to levels between 10 and 7. In each case subsequent rounds of tapping (omitting the bridge sequence) brought the new stress level to 0 within one to two rounds. 

5. In returning to the dream, in all seven cases the dream appeared to introduce some form of resolution scenario: two as a plot twist or surprise; two placed the dreamer at a decision point; three contained guiding words – either unseen voice or the dreamer’s own voice; and three introducing a known personality as an exemplary influence. 

6. In four out of the seven, insight was further clarified after applying the Active Imagination protocol to “finish the dream”. 

7. In all seven, the closure protocol resulted in defining a specific, practical (according to the subject) resolution or waking life action step or decision. These were actions which were not clear initially or contrasted with the dreamer’s initial state of mind or behavior. 

8. In a later follow-up of four out of the seven subjects, the action taken successfully resolved their stated problem up to that point. In the case of the subject who had frequent debilitating migraines, none had recurred over a 1.5-year follow-up period. 

9. All seven achieved the goals stated in the hypothesis – that of achieving stress reduction and creating helpful action steps related to the symptom and the underlying emotional issue. All were achieved in a single session, typically within a roughly 1-hour timeframe (although the migraine case required a 3-hour session). 

Table 1 Brief summary of individual case results at each stage of the DTF protocol [15].

4. Discussion

This paper outlines strengths of combining dreamwork and Clinical EFT into a therapeutic protocol called Dream to Freedom, and it proposes a theoretical basis supporting the model. These strengths are illustrated with case material from seven clients suffering from a variety of emotional difficulties, including anxiety, fear, and guilt. In all seven cases, the DTF protocol was effective in stress reduction and symptom relief. All were able to use insight from the dream (the “closure protocol”) to establish a positive action plan. In each case, this occurred within a single session. Based on the authors’ experience and the initial systematic observations, the approach appears effective in establishing insight, symptom relief, and steps for future action. Future research of this approach is recommended with larger sample sizes investigating specific clinical conditions, using short- and long-term follow-ups.

5. Conclusions

The successful outcomes in each case suggest that DTF methodology is promising in clinical settings and also warrants further study.

Author Contributions

Robert Hoss, MS, director in the International Association for the Study of Dreams and director of the DreamScience Foundation, for co-funding research grants. He developed the overall DTF protocol and originated its uniquely scripted role-play protocol based on his training with Gestalt Therapy. He also contributed the theoretical and research support to this paper. He is co-author of the book Dream to Freedom (EP Press) which contains the details of the original case studies summarized herein.

Lynne Hoss, M.A. Clinical Psychology, CEHP, is certified in EFT-ADV as an energy health practitioner by the Association for Comprehensive Energy Psychology and was formerly an Energy Psychology Program Director for Innersource, and a counselor at a substance abuse center. She was instrumental in the performance of EFT protocols in the case study trials. She is also a co-author of the book Dream to Freedom (EP Press) which contains the details of the original case studies summarized herein.

Dawson Church, PhD. is an integrative health-care researcher. He provided the design of the protocols related to Clinical EFT which is integral to the Dream to Freedom method. As corresponding author, he was the initiator of the submission and provided the initial review and manuscript correction as well as correspondence during the drafting and submission process.

Competing Interests

The authors have declared that no competing interests exist.