Pat Carrington's Choices Method — EFT Enhancement

Presentation

The Choices Method is a major innovation in the field of energy psychology, developed by Dr. Patricia Carrington, clinical psychologist, Professor Emerita at Princeton University, and one of the first academic psychologists to integrate EFT into clinical practice and scholarly research. Initially published in her reference work and refined through numerous clinical publications between 2006 and 2012, this method represents one of the most significant contributions to the evolution of EFT since its creation by Gary Craig in 1995.

The fundamental observation behind the Choices Method is simple yet profound: standard EFT, in its Gold Standard protocol, focuses primarily on reducing negative emotional charge — measured by the SUDS (Subjective Units of Distress Scale, from 0 to 10). The practitioner guides the patient to identify a disturbing emotion, quantify it, then perform tapping rounds with a 'reminder phrase' that maintains focus on the problem (e.g., 'this anxiety in my chest', 'this anger toward my father'). The process effectively desensitizes the emotion, but sometimes leaves an 'emotional void' — the negative charge has been reduced, but nothing positive has been installed in its place.

Patricia Carrington observed in her clinical practice that this void could cause several problems: the patient felt 'neutral' but not truly well, results were sometimes temporary because the mind tended to 'fill the void' by recreating negative thoughts, and most importantly, standard EFT did not actively engage the approach motivational system — the neurological network that drives us toward what we desire, as opposed to the avoidance system that distances us from what we fear.

The Choices Method solves this limitation by adding a proactive, intentional dimension to the EFT protocol. The word 'choice' is central: instead of passively enduring an emotional state ('I am afraid'), the patient actively affirms a desired direction ('I choose to feel confident'). This formulation activates the prefrontal cortex — the seat of planning and intention — and creates a neurological bridge between the present state and the desired state.

Founder: Dr. Patricia Carrington, PhD, Clinical Psychologist, Professor Emerita at Princeton University

Year of development: 2006, with continuous refinements through 2012

Core Principles

The Choices Method rests on several theoretical and clinical principles that distinguish it from standard EFT and make it a particularly powerful tool for personal development and lasting psychological transformation:

1. The principle of active positive installation

In neuroscience, it is well established that the brain cannot simply 'erase' a neural network — it must replace it with another. This is the principle of memory reconsolidation: when a memory is reactivated (through tapping on the negative emotion), it becomes temporarily labile and modifiable. The Choices Method exploits this reconsolidation window to actively install a new positive emotional association. Instead of letting the brain 'close' the memory in a neutral state, it offers a positive alternative to encode.

2. The power of the words 'I choose'

The formulation 'I choose to...' is psychologically far more powerful than classic positive affirmations ('I am confident', 'I am at peace'). Positive affirmations often fail because they create cognitive dissonance — the subconscious rejects a statement that contradicts its current experience. 'I am confident' is perceived as a lie by someone trembling with fear. In contrast, 'I choose to feel confident' does not describe a current state but a directional intention. The subconscious cannot contest a choice — it can contest a fact, but not an intention. This linguistic subtlety bypasses unconscious resistance and allows change to install naturally.

3. The three-phase transformation theory

Patricia Carrington structured her protocol in three distinct phases following a precise therapeutic logic:

• Phase 1 — Reduction (the negative): As in standard EFT, begin by reducing the negative emotional charge. This phase is essential because it 'prepares the neurological ground' — you cannot install a positive state on a hyperactivated nervous system. Reducing the SUDS to an acceptable level (ideally 3 or below) is the prerequisite.
• Phase 2 — Installation (the positive): Once the negative charge is sufficiently reduced, perform a complete tapping round using only the positive choice phrase. This phase activates the reward system and the prefrontal cortex, creating a new neural network associated with the stimulated meridian points.
• Phase 3 — Integration (the alternation): The most innovative phase — a round alternating one point with the negative phrase and one point with the positive phrase. This alternation creates a 'neurological bridge' between the two states, enabling the brain to associate the problematic situation with the chosen response rather than the conditioned fear response.

4. The specificity principle of the choice

Carrington emphasizes the importance of formulating a choice that is specific, realistic, and genuinely desired. A choice that is too vague ('I choose to be fine') or too ambitious ('I choose to never feel fear again') will be rejected by the subconscious. The optimal choice is progressive, credible, and motivating: 'I choose to feel a little more relaxed each day in this situation' is far more effective than 'I choose to be perfectly calm in all circumstances'.

5. Emotional alignment versus superficial positive thinking

The Choices Method is fundamentally different from 'positive thinking' or New Age affirmations. It does not ask the patient to deny their emotional reality — on the contrary, Phase 1 fully acknowledges and honors the suffering. The choice is only introduced after the negative emotion has been sufficiently processed. It is this sequence — acknowledgment then redirection — that gives the method its power and clinical credibility.

Technical Sheet

Founder

Dr. Patricia Carrington, PhD — Clinical Psychologist, Professor Emerita at Princeton University

Year of creation

2006 (continuous refinements through 2012)

Theoretical basis

EFT (Gary Craig), memory reconsolidation, affective neuroscience, positive psychology, cognitive-behavioral therapy (CBT)

Key concept

Three-phase protocol: reduction (negative) → installation (positive 'I choose') → integration (negative/positive alternation)

Required practice level

Beginner to intermediate — accessible from first EFT trainings, with an understanding of choice formulation principles

Application duration

15 to 30 minutes per issue (integrable into a standard 60-minute session)

Format

Individual session, group, or autonomous self-practice

Self-practice

Excellent method for self-practice — one of its major strengths. The 3-phase protocol is sufficiently structured to be applied independently with effectiveness

Evidence level

Carrington clinical studies (2008), integrated into EFT research protocols by Church et al. — moderate to good evidence level

Compatibility

Integrates seamlessly with EFT Gold Standard protocol, Matrix Reimprinting, Personal Peace Procedure, and classic CBT

Main Indications

The Choices Method is particularly indicated in situations where the patient needs not only to reduce a negative emotion but also to actively install a positive state or achieve a specific goal:

Personal development and life goals

• Impostor syndrome: The patient identifies the belief 'I am not legitimate' (Phase 1), then installs 'I choose to recognize my value and skills' (Phase 2), and integrates both through alternation (Phase 3).
• Exam and test preparation: The method is particularly suited for transforming performance anxiety into a flow state. Carrington reports significant results with university students.
• Public speaking: Reduction of glossophobia followed by installation of a self-image as a competent and engaging communicator.
• Professional and financial goals: Transformation of limiting beliefs related to success into aligned choices.

Self-image and self-esteem improvement

• Negative body image: Work on body shame and disgust (Phase 1) then installation of acceptance and kindness toward one's body (Phase 2).
• Disabling perfectionism: Reduction of imperfection-related anxiety followed by installing the choice to accept that best efforts are sufficient.
• Chronic self-criticism: Transformation of negative inner dialogue into a kind and encouraging internal discourse.

Stress and emotion management

• Chronic professional stress: Daily self-practice application to discharge accumulated stress and install a posture of active serenity.
• Anticipatory anxiety: Before a dreaded situation (medical appointment, job interview, flight), the 3-phase protocol transforms negative anticipation into positive anticipation.
• Anger management: Reduction of immediate anger charge followed by installation of proportionate and assertive response choices.
• Grief and loss: Accompanying the grief process while gradually opening toward living fully again.

Interpersonal relationships

• Recurring relational conflicts: Identification of emotional patterns activated in conflicts, then installation of more constructive relational choices.
• Emotional codependency: Reduction of abandonment anxiety then installation of the choice to feel complete and safe outside the relationship.
• Difficulty setting boundaries: Work on guilt associated with saying 'no' followed by installing respectful boundary choices.

Session Procedure

A session using the Choices Method follows a precise protocol with clearly defined steps:

Step 1 — Problem identification and SUDS measurement

The practitioner guides the patient to precisely identify the target emotion or situation. Specificity is essential: 'general anxiety' is insufficient — we look for 'this knot in my stomach when I think about Tuesday's presentation.' The patient evaluates intensity on the SUDS scale from 0 to 10.

Step 2 — Complete setup phrase formulation

The setup phrase already integrates the choice, following the enriched classic EFT format: 'Even though I have this intense anxiety about my Tuesday presentation, and my stomach clenches just thinking about it, I deeply and completely accept myself, and I choose to feel calm, confident, and fully capable of delivering this presentation with ease.' This phrase is repeated three times while tapping the Karate Chop point. The setup phrase thus simultaneously contains problem acknowledgment, self-acceptance, AND the positive choice.

Step 3 — Phase 1: Negative round (reduction)

A complete tapping round on all points (top of head, eyebrow, side of eye, under eye, under nose, chin, collarbone, under arm) using only the negative reminder phrase. If the score remains high (above 4-5), additional negative rounds are performed. The crucial point: never move to the positive phase if the negative has not been sufficiently reduced.

Step 4 — Phase 2: Positive round (choice installation)

Once SUDS is sufficiently reduced (ideally 3 or below), perform a complete round with only the positive choice phrase: 'I choose to feel calm and confident,' 'I choose to be fully capable,' etc. The practitioner observes the patient's reactions — a spontaneous smile, visible relaxation, and sighs of relief are positive indicators.

Step 5 — Phase 3: Alternating round (integration)

The most original and powerful phase. Alternate on each point between the negative phrase and the positive phrase. This alternation creates what Carrington calls a 'reconsolidation bridge': the brain, by rapidly switching between states while stimulating acupressure points, learns to associate the anxiety-provoking situation with the chosen response rather than the conditioned fear response.

Step 6 — Reassessment and anchoring

After all three phases, the practitioner invites the patient to close their eyes, breathe deeply, and assess their emotional state. The SUDS is re-measured. A typical result would be a reduction from 8/10 to 1-2/10, with an active feeling of calm and confidence rather than mere neutrality.

Step 7 — Self-practice prescription

The practitioner prescribes daily repetition of the 3-phase protocol for at least one week, particularly before the anxiety-provoking situation and at bedtime.

Variations and Adaptations

• Cascading Choices: Using a series of progressively more ambitious choices, each associated with a different tapping point in the positive phase. This gentle progression respects the subconscious rhythm and avoids resistance.
• Sensory Choices: Targeting bodily sensations specifically rather than emotions or thoughts. Particularly effective for kinesthetic patients who connect more strongly with physical sensations than abstract emotional concepts.
• Paradoxical Choice: Inspired by Viktor Frankl's paradoxical intention, using an apparently contradictory choice to disarm resistance. Used with discernment by experienced practitioners.
• Integration with Matrix Reimprinting: The Choices Method combines particularly well with Karl Dawson's Matrix Reimprinting, reinforcing the anchoring of new memories after traumatic memory transformation.
• Relational Choice: Variant oriented toward interpersonal dynamics, integrating elements of Non-Violent Communication (NVC) into choice formulations.
• Identity Choices: Advanced variant targeting the patient's identity directly rather than emotions or behaviors, creating movement toward a coherent and motivating 'ideal self.'
• Daily Choices Routine: Carrington developed a specific daily self-practice format: each morning, identify the day's main challenge, formulate a choice, then perform the 3-phase protocol in 10-15 minutes.

Contraindications and Precautions

The Choices Method is considered one of the safest and most accessible EFT approaches, but certain precautions must be observed:

• Unstabilized severe trauma: The positive phase may be perceived as invalidating by a patient in acute distress. Prior stabilization with standard EFT or appropriate therapeutic support is necessary.
• Severe dissociative disorder: Patients with marked dissociation may have difficulty accessing the feeling of 'choice' — the very notion of choice presupposes a sense of agency that is often impaired in dissociative disorders.
• Unrealistic or overly ambitious choices: A choice that creates more dissonance than it resolves will be counterproductive. The practitioner must guide toward progressive, credible, and genuinely desired choices.
• Using the positive phase as avoidance: Some patients may want to 'skip' directly to Phase 2, avoiding Phase 1. This is a form of spiritual or emotional bypass — avoidance disguised as positivity. The practitioner must verify that SUDS has genuinely decreased before proceeding.
• Severe depression with anhedonia: Patients suffering from severe depression with inability to feel pleasure may find positive choice formulation particularly difficult. Begin with very modest choices.
• Not a substitute for comprehensive therapy: For complex issues (personality disorders, multiple traumas, severe addictions), the Choices Method is a useful complement but does not replace structured therapeutic support.