Tearless Trauma Technique (EFT)

Presentation

The Tearless Trauma Technique is an expert-level EFT protocol developed by Gary Craig, designed for situations where other trauma treatment protocols risk triggering severe, destabilizing abreaction. It is intended for extremely charged traumatic material, patients with very low emotional regulation window tolerance, or those who have been traumatized by previous therapeutic attempts.

The founding principle of this technique is double dissociation. Simple dissociation, used in the Movie Technique, consists of being a spectator of one's own memory. Double dissociation goes further: the patient does not access the memory content at all. Instead, they imagine a secure box — a chest, a safe, a metaphorical container — in which the memory is stored. The box stays closed. It is not opened. Its contents are not viewed.

What happens is remarkable: even without accessing the memory content, the organism reacts to the idea that this memory exists. The mere notion of the box and what it contains creates measurable activation. It is this activation — already doubly dissociated — that the tapping addresses. By reducing this activation to zero, the memory is progressively "drained" of its emotional charge, without ever looking at it directly.

The clinical innovation of this technique is enabling real therapeutic work on very severe traumatic content while keeping the patient in a stable, regulated emotional state. It often serves as the essential gateway before being able to access the Movie Technique or Tell the Story for the heaviest traumas.

Core Principles

Double dissociation as shield: In trauma therapy, we distinguish association (living the memory in first person, fully immersive) from dissociation (observing the memory from a certain distance). Double dissociation creates additional distance: we do not observe the memory itself, but rather the idea that a memory exists inside a box. This extra degree of abstraction considerably reduces the accessible emotional charge, making therapeutic work possible even for the most severe content.

The estimated SUD: The key tool of this technique is the distinction between a real SUD and an estimated SUD. We do not ask the patient "what is your distress right now?" — which would force them to access the content. We ask: "If you were to look inside this box, what intensity do you estimate you would feel?" This question is hypothetical. It maintains distance while allowing the nervous system to give a reading of the stored emotional charge.

The estimation paradox: A fascinating and clinically consistent phenomenon is that patients systematically overestimate their actual SUD when imagining accessing the memory. A patient who estimated a 9 or 10 before tapping often finds, after a few rounds, that the estimate has dropped to 3-4, and that when they actually look in the box, the real intensity is even lower — sometimes 1 or 2. This paradox is itself therapeutic: it refutes the belief that the memory is untouchable.

Progressive opening: After reducing the estimate to 0-3 through tapping, the therapist invites the patient to "slightly lift the lid" — to briefly glimpse the memory without diving in. The real intensity is measured. If it stays low, one can progressively allow looking more, and transition to the Movie Technique or Tell the Story.

The container metaphor: The box is not just a technical tool — it has important symbolic value. Naming, containing, and making the memory tangible through a metaphor is itself an exercise of power over it. The patient who imagines standing before a box that they choose to open or not is in an agentive posture — unlike a patient flooded by uncontrollable intrusive images.

Technical Overview

Origin

Gary Craig, EFT Universe — for extreme traumas

Application level

Expert — reserved for experienced EFT practitioners in traumatology

Double dissociation

Level 2: not the memory, but the idea of the memory in a container

Primary indications

Extremely severe traumas, patients with very low emotional tolerance, complex chronic PTSD, traumas reactivated by previous therapies

Estimated duration

30 to 60 minutes per event, sometimes spread across multiple sessions

Measurement tool

Estimated (hypothetical) SUD — never the real SUD at protocol start

Abreaction risk

Very low if protocol is rigorously followed

Transition

This technique is a gateway — it prepares access to Movie Technique or Tell the Story protocols

Main Indications

• Complex or chronic PTSD: patients with long and entangled traumatic history, where any attempt to address memories triggers a crisis
• Extreme traumas: rape, torture, witnessing violent death, serious accidents — any content whose mere evocation triggers severe reactivation
• Patients traumatized by previous therapy: persons who experienced unmanaged emotional overflow in exposure or narrative therapy sessions — re-traumatized by treatment
• First approach to a very high-SUD trauma: when global estimated SUD is 8-10, start with Tearless Trauma to descend below 5-6 before moving to more direct protocols
• Patients with very narrow tolerance window: those who rapidly oscillate between hypoactivation (dissociation, freeze) and hyperactivation (panic, crisis)
• Dissociated traumas: fragmented, non-narrative memories that the patient "knows" they experienced but cannot form into a coherent memory
• Adolescents and vulnerable populations: with language adaptation ("treasure chest," "magic box")

Session Protocol

Step 1 — Psychoeducation and safety (10-15 min)
The therapist clearly explains the double dissociation principle and the box metaphor. The patient understands: "We will not look in the box. We will work on the fact that it exists." A global anticipatory anxiety SUD is evaluated.

Step 2 — Creating the box (5-10 min)
The therapist guides the patient to build their box in imagination. It can be wooden, metal, with a lid, a lock. It is solid and safe. The memory is symbolically placed inside. The box is closed. The patient chooses where to place it.

Step 3 — SUD on the closed box (5 min)
"When you look at this closed box, knowing something is inside, what is your intensity right now, out of 10?" This is a real SUD on the box — not yet estimated. If above 3-4, tap on this first.

Step 4 — Tapping on the memory's existence (10-20 min)
Example phrases: "Even though I know something is in this box, I deeply and completely accept myself...", "This memory that is there, stored...", "I don't need to look at it right now...". Multiple rounds until SUD on closed box drops to 0-1.

Step 5 — Estimated SUD on hypothetical opening (10-15 min)
"If you were to lift the lid now and look inside, what intensity do you estimate you would feel? This is not a real question — you are not going to actually look. Just an estimate." Patient gives a number — often very high. Tap on this estimate until it drops to 2-3.

Step 6 — First look in the box (5-10 min)
"I now invite you to slightly lift the lid and take a brief look inside. You can close it at any moment. What is the real intensity?" Often real SUD is well below the estimate. Tap on what is visible.

Step 7 — Transition to Movie Technique or Tell the Story (variable)
If real SUD at first look is ≤ 4-5, propose transitioning to Movie Technique for more complete treatment. If still elevated, continue rounds on what has been glimpsed.

Variations and Sub-techniques

Box at different distances: Modulate the box's proximity according to intensity — move it to an adjacent room, another building, a distant island. The farther the box, the deeper the dissociation. Progressively bring it closer with tapping.

Box behind a screen: Triple dissociation: the patient imagines a movie theater, sees themselves sitting in a seat, and on the screen sees a box containing the memory. Useful for extremely charged traumas.

Tearless Trauma for sensory material: When trauma manifests primarily as bodily sensations without clear narrative imagery, the box can contain a sensation rather than a memory — "the box contains this pressure in my chest."

Combination with Sneaking Up: Start with Sneaking Up to reduce global intensity with very vague formulations, then use Tearless Trauma to structure work around the box metaphor.

Contraindications

• Mild to moderate traumas: Double dissociation is unnecessarily complex for low-intensity traumas. Prefer the basic EFT protocol or Movie Technique directly.
• Patients struggling with metaphor: Some patients with very concrete thinking or mentalization difficulties struggle to "play the game" of the box. Adapt or use a different technique.
• Active psychosis: Absolute contraindication — metaphors and mental image manipulation may amplify psychotic confusion.
• Severe cognitive deficit: The protocol requires the ability to distinguish between real and estimated SUD and maintain a stable mental image.
• Patients in dissociative crisis: If the patient is already heavily dissociated, adding a layer of dissociation can be counterproductive. Priority to grounding and stabilization.
• Unsecured context: This technique must never be practiced without stable therapeutic environment, solid alliance, and clear abreaction management protocol.