Definitions

traumatic neurosis

Neuro emotional technique

NET



Neuro-Emotional Technique (NET) is an innovative, mind-body, stress reduction intervention that helps resolve dysfunctional psychophysiological states called neuro-emotional complexes (NEC’s). NEC’s originate in past anxiety-arousing events presumed to be related directly or indirectly to current psychological or physical complaints. The technique itself consists of a 15-step standard procedure designed to dissolve these long-held, dissociated neuropsychological reactions to the original triggering event. It is an amalgamation of principles and practices gleaned from Chinese medicine, chiropractic, applied kinesiology, general semantics, Pavlovian conditioning, neurophysiology and homeopathy. As such, NET is used in clinical settings primarily by chiropractors and acupuncturists who in the past have practiced without brief, effective and safe means of detecting and treating emotional components of physical complaints. NET also attracts mental health practitioners who find it useful as an adjunct to psychotherapy. As a mind-body intervention, NET has some features in common with standard cognitive behavioral treatments of traumatic stress, and fits naturally within a biopsychosocial framework.

Even though the NET procedure often begins by addressing a specific physical complaint (“body entry”), the objective of NET is to identify emotional factors (NECs) associated with the presenting complaint and, if present, to resolve them. Presenting problems that are already framed in psychological terms, e.g., “I’m afraid of asking for a raise” or “My neck pain seems worse when my wife asks me to do something for her,” can be approached by way of a “mind entry” protocol, making NET attractive to many types of psychotherapists. The available literature describing NET (see www.netmindbody.com) carefully points out that NET is not personal counseling, advice giving or psychotherapy and does not treat emotions. Nor is it a form of meditation or spiritual inquiry or a means of accessing universal intelligence. It is nevertheless a system of physiological correction and reintegration that addresses and resolves “stuck” physiological states associated with emotional trauma (see Walker 2005).

History

NET is the creation of Scott Walker, D.C., a chiropractor in Encinitas, California, where he has practiced for over 40 years. As a student of nutrition, homeopathy, traditional Chinese medicine, and applied kinesiology as well as chiropractic medicine with its own early history of recognizing and treating emotional problems associated with somatic functioning (Homewood, 1973; Quigley, 1973; Schwartz, 1973), Walker set about synthesizing these formative viewpoints, later integrating neurophysiological findings along with classical learning theory, into therapeutic strategies designed to improve bodymind functioning. He began offering informal NET seminars to fellow chiropractors in 1988. He developed and introduced a line of homeopathic remedies to be used in conjunction with NET beginning in the mid-1990’s, and has continued modifying and extending the practice of NET through the addition of specific protocols and procedures that target various somatic disorders such as chronic pain, neuromuscular complaints, and digestive disorders

Core Construct - The Neuroemotional Complex

NET’s core hypothetical construct is the neuroemotional complex (NEC), which is defined as “a subjective maladaptive syndrome adopted by the human organism in response to a real or perceived threat to any aspect of its survival” (Walker, 2005, p. 180). NEC’s are presumed to cause psychological dysfunction (anxiety, phobias, etc.), physical problems (headaches, backaches) and generalized psychosomatic complaints. The realization that physiological correlates of emotions exist not only in the brain but in the immune and endocrine systems and throughout the body (Pert, 1993, 1997) has given further credibility to Walker’s concept of the neuroemotional complex. Diagnostically, the presence of an NEC is presumed when the following psychological, physiological, and energetic phenomena coincide:

• a specific emotion;

• a conditioned response resistant to extinction;

• a usually recallable memory picture or ‘Snap Shot’ of a past significant emotional event;

• vulnerability to suppression, compulsive repetition, and reactivation, causing cyclical reinforcement;

• one or more subluxations (energetic rather than osseous);

• facilitated or inhibited muscles;

• an energetic imbalance in an acupuncture meridian; and

• an active meridian access point (MAP).

Basic Assumptions - The Seven Pillars

1. Neurophysiology: Emotions are physiologically based.

Walker differentiates normal emotions that produce few lasting physiological changes from emotional traumas that create maladaptive physiological patterns in the body, i.e., NECs, that do not repair themselves without outside help. NET attempts to normalize these maladaptive patterns through the use of a physiological intervention.

To further clarify his understanding of the neurophysiology of emotion, and lend scientific credence to his viewpoints, Walker routinely cites the work of Candace Pert, author of the 1999 book, The molecules of emotions, and former Chief of the Brain Biochemistry Section at the National Institute of Mental Health. She is best known as co-discoverer of the brain’s opiate receptors. She has shown that endorphins and other similar chemicals, many of which are neuropeptides originally thought to reside only in the brain, exist throughout the body. Pert argues that a variety of these neuropeptides (strings of amino acid compounds found in neural tissue) are the biochemical correlates of emotion. She states unequivocally that “emotions are neuropeptides attaching to receptors and stimulating an electrical change on neurons” (Pert, 1995, p. 25). Her work has demonstrated the existence of receptor sites for these chemical in the gastrointestinal tract from the esophagus to the anus and on various white blood cells traveling throughout the human organism (Pert, 1988), thereby providing a bit of modern support for the ancient idea of a body-wide mind (Dossey, 1989).

In addition to his considerable conceptual reliance on Candace Pert’s work, Walker also utilizes the Triune Brain Theory of neurophysiologist Paul McLean in which three interconnected brains – the reptilian, limbic, and neocortical – are described in order of their evolution. Simply put, the reptilian brain, the brain stem, includes the spinal cord, medulla, pons, midbrain, and the cerebellum, and controls basic functions such as hunger, breathing, heart rate, body temperature, reproduction, excretion and other autonomic functions. Persons grappling with reptilian brain issues are concerned with food, shelter, territory, and sexuality as instinctual responses.

The limbic or mammalian brain governs emotions, altruism, religious tendencies, sexuality intertwined with emotions, complex sensations and perception, short-term memory, and the storage of short-term memory into longer term memory, hormones, temperature control, and aggressive behavior. The mammalian brain has a “timeless” nature, with no separation of today, tomorrow, or yesterday. As a consequence, the limbic brain is thought to play a significant role in generating and maintaining inappropriate emotional patterns of response, given that it is involved in the recreation of early life experiences that may be shaping present emotional experiencing.

The neocortical or neomammalian brain includes the cerebral cortex and controls among other functions language processing, complex thinking, regulation of action and thought, perceptual processing, information exchange between the brain and body, vision, hearing, expression, and memory, and is generally considered the seat of reason, understanding and decision-making. Walker believes that the absence of effective coordination or congruence between two or more of these brains creates physiological problems that manifest as emotional conflicts that, in turn, may lead to dysfunctional behavior.

2. Chinese Medicine: Emotions have meridian system correlates.

White and Walker (2008) have written of Walker’s use of Chinese meridian system correlates, paraphrased as follows: Walker’s understanding of emotions derives also from a contemporary school of Chinese medicine known as five element acupuncture, imported in the 1950’s by British practitioner-scholar, J. R. Worsley, from his reading of extant classical texts such as The Yellow Emperor’s Classic of Internal Medicine. The five element approach is one of the most psychologically-oriented approaches in contemporary Chinese medicine. In five element acupuncture, specific emotions and subtle variations of them are linked to the 12 primary meridians, which can be accessed by certain acupuncture points on the body or via several points above the radial artery at or proximal to the wrist. While the five element association of various emotions with meridians has not been empirically validated, Chinese medicine practitioners have found these associations useful for several thousand years. NET employs traditional Chinese medical concepts of the emotions and their correlations with certain acupuncture meridians in turn associated with various pulse positions along the radial artery of the wrist to help discern which emotions the patient experiences in a given situation. NET protocol instructs patients to hold these meridian-pulse points as part of the desensitization procedure (p. 12).

3. Applied Kinesiology: Muscle Testing accesses the body’s physiology. In the 1960’s a Detroit chiropractor, George Goodheart (1964), developed manual muscle testing to use in the assessment of health and illness. He named his approach Applied Kinesiology (AK) and later founded the International College of Applied Kinesiology (ICAK) for the purpose of training and certifying AK practitioners. In AK muscle testing, the practitioner applies isometric pressure to a single muscle or group of muscles to determine strength status in the face of physical pressure or verbal statements. A few years after Goodheart’s early development of AK, John Diamond (1979; 1988; 2007), an Australian psychiatrist, extended the use of muscle testing to psychiatric patients, and found that various emotions were indeed associated with different acupuncture meridians. In a further extension of AK, Walker later determined that muscle testing in conjunction with stimulation of acupuncture meridians could be utilized in assessing emotional and semantic dysfunction. His contention that deltoid muscle strength would vary depending on the “congruency” of spoken statements received moderate empirical support from results of a study by Monti, Sinnott, Marchese, Kunkel, and Greeson (1999). When subjects made “self-congruent statements” (such as saying their real name or age) their deltoid muscle strength was 17% greater than when making “incongruent statements,” (such as giving a fictitious name or age), suggesting that cognitive discrepancies can affect muscle testing.

4. State-Dependent Memory: The body replicates the physiology that occurred at the time of the original trauma.

The research of British investigators A.M. Hassan, and P. S. Ward (1991) has shown that recalling an event can and often does reactivate somatic and visceral motoric fluctuations that occurred in the original overwhelming life situation.

The role of memory in emotion can hardly be overemphasized. The perceptual process involved in emotion become part of the memory store. The recollection of perceptions, which implicates neocortical processes, may evoke (through descending connections via the limbic system, hypothalamus, brain stem, and spinal cord) the somatic and visceral motor changes which occurred in the original situation (p. 105).

Walker has been similarly impressed by the work of Ernest Rossi and David Cheeck (1988), who wrote:

Conditioning actually involves an important element of state dependent memory, learning and behavior that frequently is not recognized by researchers. The pioneers in animal conditioning during the early part of the century, for example, were not aware of the role stress hormones of parasynaptic cellular modulation played in the learned association between the sound of the bell and the shock the experimental animal received…. A psychobiological model of memory and learning that includes the state dependent nature of physiological homeostasis as well as of memory and learning will be required for a more complete understanding of the clinical phenomena of depth psychology and psychosomatic medicine” (p. 9). Walker believes that two types of memory exist – cognitive or conscious memory and somatic or non-conscious memory, and that activation of affect promotes the recall of mood-congruent memories (see Bower, 1981). This belief is consistent with the observation of Elmer Green (1977), a pioneer in the use of biofeedback to treat disease, that change in the patient’s physiological state is accompanied by a corresponding change in his or her mental or emotional state, and vice versa.

5. Pavlovian Conditioning: Behind current emotional distress is an original event in which an anxiety-provoking stimulus was paired with a neutral stimulus.

The classical conditioning paradigm of Ivan Pavlov is used by the NET founder to explain how NEC’s develop and persist, demonstrating the power of associative learning. Pavlov is best known for experiments in which dogs salivated in response to a neutral stimulus, a bell presented in association with meat (an unconditioned stimulus, UCS) which in turn elicited salivation (an unconditioned response, UCR). Subsequently, presentation of the bell alone (conditioned stimulus, CS) evoked salivation (conditioned response, CR).

In one of the early studies of anxiety that employed a Pavlovian paradigm, Diven (1937) asked subjects to give their associations to lists of words that were read to them. The word barn occurred six times and was always presented by the word red. This pairing of words was always followed by an electric shock, which caused emotional distress that produced fluctuations in a galvanometer attached to the subjects. Stimulus generalization was clearly evident when the same words were subsequently presented without the electric shock, the psychophysiological disturbance was elicited not only by the word barn but also by any words, whether from the original list or not, that had rural meanings, such as hay, pasture, cow. Words that had immediately preceded or followed the word barn also became emotionally distressing. The originally neutral word barn is equivalent to Pavlov’s bell. The electric shock equates with the meat (UCS), and the emotional response at the sound of the word (CS) compares to salivation (CR). Significantly, whether the experience was recalled or not by the subject, the emotional response remained intact and present. Diven’s experiment was later replicated in modified and methodologically improved form by Lacey & Smith in 1954, and yielded very similar results. The Pavolvian paradigm has been used often over the past ninety years by various behavior modifiers to clarify the origin of posttraumatic reactions and to explain the need for treatment models based upon principles of disinhibition and extinction (e.g., Watson, 1916; Jacobson, 1938; Salter, 1949; Wolpe, 1958; Shapiro,1995).

6. General Semantics: The bodymind will react psycho-physiologically not only to fearful or threatening stimuli, but also to abstract representations directly related to those stimuli.

Human beings live in a universe of meanings. Human thought provides a means of adapting to a world that does not tell us what to make of it. Alfred Korzybski (1933), considered the father of general semantics, emphatically suggested that interpretations of things and events say as much about the human behind the interpretation as about the “realities” being described. Korzybski was aware that people respond physiologically to their constructions of reality, given that each human organism functions as a whole. When he used the term “semantic reaction,” he was referring to a persons’ bodymind, organism-as-a-whole response to a word, event, object or other stimulus. The mere sound of the word spider is enough to elevate the pulse rates, blood pressure and cortisol levels of some individuals who have had unpleasant run-ins with an actual spider or a frightening thing closely associated with spiders in the past. Other people, however, may appraise spiders neutrally or with affection, and remain calm at the mention of spiders. A person’s unique response to a stimulus in a given context is powerfully influenced by the personal meaning associated with that stimulus. By semantic response, Korzybski was referring to the total response of the organism-as-a-whole – behaviorally, emotionally, cognitively, physiologically – to things and events. General semantics theory and, in particular, the construct of a “semantic reaction” has become one of the cornerstones of the NET world view.

Associational learning, as evidenced in classical conditioning, exemplifies a ‘standard of evaluation’ that Korzybski called identification in which two different stimuli are perceived as absolutely the same (1933, p. 196), i.e., stimulus generalization, such that the word spider elicits the response as if it were the actual creature, spider, all of which can lead to the distressing experience of confusion. Identification, according to Korzybski, is present in all mental illnesses, each of which involves (1) a fictitious evaluation of reality at a particular moment in time and (2) physiological disturbances that lead to (3) particular semantic states. In keeping with Korzybski’s principles, NET can “enter” the subjective reality of the person at virtually any level of abstraction – physiological, affective, behavioral, and/or cognitive -- and facilitate differentiations that break down trouble-making identifications in the service of resolving semantic confusions that have created personal distress.



7. Repetition Compulsion: The “victim” of abuse is likely to act and react in a manner consistent with the original event because the dissociated traumatic memory is stored in state-dependent form (NEC).

Repetition compulsion is a metapsychological term first used by Sigmund Freud in 1920 to describe a phenomenon anticipated by Janet (1889) some thirty years earlier in his careful investigations of hypnosis, his creation of terms such as “dissociation” and “abreaction,” and his systematic study of dissociative reactions to traumatic experience. Janet is believed to be one of the first persons to associate earlier traumatic life events, i.e., original sensitizing events, with later distortions of cognitive, affective and behavioral functioning, including present-time recreations of the original trauma. He has been considered by some observers as one who set the stage for the development of psychoanalysis and the concept of repetition compulsion. Since the time of Janet and Freud, trauma theory and research have generally indicated that victims of trauma are likely to find themselves again in situations where they are victimized repeatedly … or are victimizing others. The concept of repetition compulsion, while not an essential building block of NET, served as a conceptual bridge during its early development. In the first formulations of NET, Walker (personal communication, 12/30/2007) concentrated initial NET interventions on the patient’s presenting physical complaint and determined through muscle testing whether or not the complaint had an emotional component that would lend itself to further NET intervention. After treating many patients in this manner, he recalled that Freud had said victims of childhood trauma frequently suffer similar traumas, sometimes repetitively, in and possibly throughout adulthood. The notion of repeated stagings of early traumatic insults years afterwards alerted Walker to the importance of including in the NET procedure a means of exploring an “original time” in which the person experienced a distressing event similar to the current one. Walker subsequently developed a methodology to determine if such an original event existed in the patient’s “emotional reality.” It should be noted that he has been careful not to represent such events to the patient as historical fact. The ensuing revision of the procedure was named NEAT for Neuro-Emotional Anti-Sabotage Technique.

Since the repetition compulsion concept has been used prominently in integrating behavioral neuroscience with the early work of Janet (Van Der Kolk, 1987, 1995), and because the neuropsychological underpinnings of trauma are becoming better known (see McNally, 2003; Shull, 2003), Walker has continued using the term. In recent years, neuroscience has been reconceptualizing unconscious forces in such terms as “state dependent encoding of memory” (Rossi and Cheeck, 1988), “malignant memories” (Perry and Pate, 1994) stored in neural networks that involve neurotransmitters and subcortical structures such as the amygdale (Schwartz & Perry, 1994) in interaction with the prefrontal cortex (LeDoux, 1996), and persistent conditioned responses to stimuli associated with highly charged emotional stimuli (LeDoux, 1992) Shull (2003) summarizes as follows: The “compulsion to repeat” originates from the development of patterns of neurochemicals, particularly dopamine, noradrenalin and oxytocin, which send their messages across preferred synapses. Resistance to change occurs due to resonance and long-term potentiation driving firing across a neural circuits that connects the brainstem, amygdala, and right orbitofrontal cortex. This circuit mediates implicit emotional memories from the earliest months of life that filter perceptions in order to create emotional homeostasis. By operating in this manner, the brain compels the behaviors of coalesce into an adult repetitive experience. (Shull, 2003)

The concept of a Neuro-Emotional Complex is consistent with recent neurobiological inferences regarding repetition compulsion. NECs consequently are being conceptualized increasingly in terms of emotional memory networks and dysfunctional pattern storage.

Research

NET research began formally in 1995 (Peterson, 1995, 1996, 1997) with the publication of three outcome studies. A 1999 investigation comparing muscle testing of congruent versus incongruent self-referential statements, conducted by research psychiatrist Daniel Monti and his colleagues at the Thomas Jefferson University Medical School in Philadephia, appeared three years later (Monti, Sinnott, Marchese, Kunkel & Greeson,1999). In testing Walker's (1992) hypothesis that muscle testing responds to cognitive and emotional stimuli, Monti found significant differences in muscle test response between congruent and incongruent semantic stimuli.

The establishment by the ONE Research Foundation in 2000 of a University-based research program headed by Henry Pollard, Ph.D., D.C., an experimentalist and academician affiliated with MacQuarrie University's graduate Department of Health and Chiropractic Medicine in Sydney, NSW, Australia, has led to a succession of research articles published in respected refereed journals. Formal experimental investigations of NET have thus far been centered primarily at MacQuarrie University and secondarily at Jefferson Medical School in the U.S. Independent investigations have begun appearing elsewhere as well. A recent Masters thesis study (Jensen, 2007) at Oxford University in England addressed the use of NET in treating spider phobic students. An annotated listing of published and in-progress research using randomized controlled trials (RCTs) as well as intensive case series can be found at the ONE Research Foundation website.

Many of the investigations of NET have studied its effects in managing abnormal physical or mental states such as attention deficit and hyperactivity disorder (Karpouzis, Pollard, & Bonello, 2007a, 2007b, 2007c), chronic low back pain (Middleton & Pollard, 2005; Bablis, Pollard, & Bonello, 2007), anovulation infertility (Bablis, Pollard, & Monti, 2006), hypothyroidism (Pollard & Bablis, 2007), cancer (Monti, Stoner, Zivin, & Schlesinger, 2007) and separation anxiety disorder (Karpouzis, Pollard, & Bonello, 2006). For instance, in a recent pilot case series designed to determine the correlates of NET for cancer related traumatic stress symptoms, seven female cancer survivors showed statistically significant improvement on measures of subjective distress, post trauma stress, and physiological reactivity following three sessions of NET (Monti et al., 2007). Based on these promising results, the authors plan a further investigation using a randomized trial with a control group.

Training and Certification

Practitioners learn Neuro-Emotional Technique by attending one to five seminars provided regularly throughout the United States, Australia and England. Workshops in other countries are given on occasion. There are currently over 4000 practitioners using NET and the number continues to increase (Walker, 2003). Entry into NET training has been cautiously controlled. Seminarians are required to hold at least a Master’s degree or its equivalent in a healing arts discipline, have a valid license to practice, and complete basic and advanced seminars before becoming eligible for NET certification. At the present time, there are approximately 300 NET Certified Practitioners throughout the world (see www.NETMindBody.com for a complete listing). Inquiries from prospective consumers in search of qualified practitioners increase yearly.

Controversy

In 2007, American Specialty Health, Inc., an insurance organization providing benefits for complementary healthcare, concluded that NET is scientifically implausible and fails to meet professionally accepted standards. They argue that “a belief, theory, or mechanism of health and disease is said to be implausible if it requires the existence of forces, mechanisms, or biological processes that are not known to exist within the existing framework of scientific knowledge” (2007). This indictment of NET as pseudoscience suggests a lack of awareness of (1) NET’s growing body of experimental studies of the efficacy of the technique, and of (2) the neurobiological underpinnings of trauma and treatment interventions as described in this paper.

A similar criticism comes from Stephen Barrett, M.D., founder of Quackwatch, who warns his readers to avoid NET because of questionable practices -- e.g., muscle testing, prescribing of homeopathic remedies and nutrition supplements, etc. -- based on highly questionable concepts and inferences – e.g., “releasing emotional blocks locked in the body’s memory” – and NET’s claims that every-body has such blocks that, if not resolved, are later replayed.

In 2005, the O.N.E. Research Foundation, the non-profit arm of NET, issued a report from its Ad Hoc Committee on Professional Ethics and Consumer Safety. The Report addresses reasonable concerns held by the larger community of consumers, practitioners and teachers of NET regarding potential harm to patients. It provides an overview of ethical principles and behaviors expected of NET practitioners, as well as concerns expressed regarding the danger of retraumatizing patients who have experienced previous overwhelming distress. It has been feared by some non-NET practitioners that a patient could become severely disorganized by a powerful emotional storm (sometimes called an “abreaction”) that would require emergency psychiatric or psychological intervention, something that very few NET practitioners are trained to provide. Interestingly, the Report indicates that there have been no known instances of such occurrences in NET’s 20 year history although there is no formal supportive evidence. Analyses based on informal discussions with experienced practitioners suggest that the structure of the NET protocol encourages continuous and cooperative interaction between the patient and the practitioner, and requires the patient to organize a non-emotive “thinking” response to questions and comments from the practitioner, thereby providing a container or “safety NET.” It appears that patient and doctor function as a mutually active, reality-checking team that prevents the patient from becoming disorganized or “out of control.” The Report recognizes that patients can be harmed by incompetent or unscrupulous practitioners, and acknowledges that reporting of possible patient harm needs to be encouraged and facilitated through all appropriate channels.

Another area of controversy has been the issue of whether or not NET is a form of psychotherapy that should not be practiced without psychological training and certification. NET materials state clearly that it is not counseling or psychotherapy. This issue may not be resolvable due to the vagaries of what constitutes psychotherapy and the “mixed breed’ nature of NET. Psychotherapists themselves do not generally regard NET as a psychotherapeutic system but see it rather as an adjunct that can be used appropriately during the course of psychotherapy as one would use hypnosis, relaxation training or systematic desensitization. As long as it’s not clear exactly how NET works, it will remain controversial. Until the neurophysiological mechanisms of its inner workings are more thoroughly understood through basic research, NET will benefit from thoughtful criticism and continuing scientific inquiry.

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