OverviewThe development of Post Traumatic Stress Disorder and other psychological problems by war survivors has been well documented1. Despite substantial efforts to provide these individuals with Mental Health services, the reality is that that the services are not usually available, or are hampered by limited access and resources, differences in culture and language between the practitioners and survivors, and attitudes toward seeking help for behavioral disorders. Conventional therapy requires significant time and resources—clearly a challenge in war torn countries. Given the limitations of conventional therapy under these circumstances, identifying and implementing options for addressing the psychological consequences of war is a priority. Based upon the results from the pilot program described below in Nigeria, CLEAR is such an option.

Women for Women International (WFWI) has begun integrating CLEAR into its programming. WFWI works with women survivors of war to help them move toward economic self-sufficiency to become productive citizens. Currently, WFWI works with women in Afghanistan, Bosnia and Herzegovina, The Democratic Republic of the Congo, Iraq, Kosova, Nigeria, Rwanda, and Sudan. The participants of WFWI attend group classes throughout the year long program, and CLEAR is being included in the curriculum. Women for Women International piloted a CLEAR program in Nigeria with its staff and program participants.

CLEAR is an energy psychology method for relieving stress and trauma, which utilizes acupressure points and bi-lateral stimulation. It helps individuals get beyond fear, lack of motivation, depression, stress and anxiety and most emotions that prevent them from moving forward. There are fourteen points on the body, each associated with particular emotions. Using these points and bi-lateral stimulation, or “alternating touch” it is possible to free trauma and blocking beliefs from one’s system. Trauma gets stuck in the system because we resist it. The simple process of CLEAR allows the body to process the trauma and release it. The techniques of CLEAR involve having the person touch particular acupressure points on the face, body, and/or hands, or doing bi-lateral stimulation while thinking of the trauma or beliefs experienced. CLEAR techniques are utilized in both groups and with individuals to help individuals get beyond the trauma that may decrease their ability to move forward productively in their lives.

How CLEAR™ Works
In order to understand how CLEAR works, it is helpful to examine how trauma impacts humans. Trauma results from any experience that we want to push away from ourselves or from which we want to retreat. Trauma may result from a physical experience such as a car accident, or from an emotional incident such as being humiliated, being the victim of violence, or the loss of a loved one. It may also occur because of repetitive negative events such as being yelled at by an unhappy, emotionally unstable or angry parent. Or it may be the result of something hurtful someone once said such as declaring that you are ugly, stupid or ridiculous. When we experience trauma, we also integrate negative beliefs as a result of this trauma. For example, if I have been abused, I may integrate beliefs that I am unworthy and unsafe. If I have been humiliated, I may decide that I am stupid, undeserving and tainted. All trauma results in beliefs that impact how we function in the world.
Humans respond to negative situations with a hard-wired "fight-or-flight" response, and if we can’t fight or flee, we go into the “immobility response.” All of these responses are survival mechanisms that protect us—it is obvious how fight or flight keeps us safe—we are primed to run from or fight the danger. The immobility response protects us because it dulls our senses so that we don’t feel much during the ordeal. So if we see someone killed or we are tortured, our senses are numbed and we don’t feel the pain so intensely.
Because humans block the complete processing of the response, the “trauma” and the beliefs associated with the trauma get stuck in our body. We block the full processing of the response because we don’t want to feel vulnerable, we don’t like how we feel, and we don’t want to feel what we feel—in other words because we think. So we do something to try to remove ourselves from the situation as quickly as possible. Because the trauma is not resolved, we continue to resist the feelings associated with the trauma. When we do think about the trauma, we tend to perseverate about how we could have prevented the situation or what we can do in the future to defend ourselves. And what we resist persists.
When trauma is stuck and then we witness a situation that reminds us of this past trauma, we react as though we are actually experiencing the trauma again—with the powerful response of flight-or-fight, or with the immobility response. Once we are "triggered" by a new event that resembles an old trauma, we have very little control over our behavior because we react from the old, reptilian, survival part of the brain. Fight, flight and immobility responses bypass the cognitive mind and we react to the potential danger before we even have time to think. We have little access to our neo cortex, so both emotional intelligence and logical thought are limited and we don’t even realize how strong our reactions are.
A good indication that the past is impacting current behavior is when relationships aren’t working; when we are depressed, anxious, obsessing, stuck, addicted, fearful, overburdened, or reactive to others. If you find yourself strongly hurt, immobilized, angered, saddened by, and reacting to another’s behavior , chances are that incidents from the past are influencing the situation. This is not to say that others don’t do things that negatively impact us and create negative emotional response from us. They do. But we don’t have to personalize the behavior. And if we do, our past is impacting our feelings.
Our reactive behavior is usually a predictable response, such as withdrawing, being passive, attacking aggressively, spacing out, acting unconsciously, or disassociating. Our response, in the original traumatizing incident, helped to keep us safe. But it is a response that is not effective in the present because we are reacting from the old trauma and not to the current situation. We suffer, and our relationships suffer because we are not responding in the moment to those with whom we are interacting.
CLEAR involves having an individual touch particular acupressure points on the face, body, and/or hands while thinking of the incident he or she experienced. And it involves Bi-lateral stimulation, which is alternatively tapping on one side of the body or the other. Bilateral stimulation and acupressure points, when stimulated by touching, rubbing or tapping, transmit signals directly to the specific areas of the brain that are associated with those emotions. It is assumed that bi-lateral stimulation or the stimulation of the acupressure point inhibits the “alarm response” (fight/flight or immobility) by sending appropriate signals directly to the amygdala (the control center for emotions in the brain).
Feinstein states that the energy therapies actually help change the chemistry in the amygdala2. Ruden states that tapping on the acupressure points increases serotonin in the prefrontal cortex and the amygdala thus extinguishing fear3. Studies involving brain scans indicate significant decrease in intensity and frequency of Generalized Anxiety Disorder after acupressure treatment. It is speculated that the change results in a “clearing” that removes the automatic response to trauma so individuals are free to respond differently. And this change is permanent as long as we are not re-traumatized.
It is not necessary to re-live a trauma in order to clear it. The individual holds the acupressure points or does bi-lateral stimulation while remaining aware of physical and emotional sensations. The individual finishes processing the trauma and can thus release it from the body. This frees the individual from the alarm response of fight, flight or immobility, allowing the person to be more present to the situation at hand and respond from her full awareness.
Individuals who utilize CLEAR show a steady evolution of their goals as they eliminate issues from the past. With CLEAR, we have the power to remove the past from our systems so we can move forward productively and creatively in our lives, becoming less stressed and more peaceful and aligned.

The CLEAR™ Pilot Program in NigeriaThe WFWI CLEAR pilot program occurred in Jos, which is in the “Plateau” area of Nigeria. Nigeria was under military rule until 1999 when it transitioned to a civilian government. Generally, Nigeria is now peaceful, though much of the country still feels the influence of years of ethnic and religious tensions, military tension, corruption, and mismanagement of its petroleum-based economy. Electricity in Jos is rare. Those who can afford it use generators (including restaurants and hotels) to run their appliances and computers. Running water is also rare. Most people get their water from wells, which they carry to the house. In general, the living conditions in Jos are poor compared to the US.

The CLEAR training began with ten WFWI staff, all of whom speak English and are college educated. Three of the facilitators attending were from the Enugu office in Southern Nigeria and they speak Ibo and English. Those in the Jos office speak English and Hausa. The facilitators were energetic, bright, committed, and curious.

The facilitators were trained for two days in the CLEAR methodology. In this training, they learned to do sessions with a partner and by themselves. We began with an overview of why energy therapies work. Blocking beliefs and trauma were defined: a blocking belief is a thought that prevents one from moving into a desired state of being; trauma occurs from some past event that negatively influences behaviors, thoughts, and feelings. We then listed and cleared blocking beliefs of the facilitators. Next they learned bi-lateral stimulation (alternating tapping of one arm or leg), and finally the fourteen acupressure points. A demonstration with a volunteer was conducted and then the facilitators practiced CLEAR with partners and then on themselves.

The third day facilitators practiced the agenda as it would be conducted with the twenty women who are graduates and a few current participants of WFWI’s program. The process they learned was a simplified version of the method used in individual sessions. The goal was to teach the participants the simplified version so that they could use it on themselves and teach it to others. The simplified version includes:
1. An introduction to energy therapy.
2. Defining blocking beliefs
3. Listing of blocking beliefs and then clearing, using the “sore spots.”
4. Bi-lateral stimulation on the issue.
5. Clearing of all fourteen points on the same issue.

The facilitators and myself then took another day to evaluate and discuss the training, and then the facilitators translated the simplified version for the participants.

The program for the women participants was an extraordinary experience. We did about a half an hour introduction to the Energy Therapies and then a one and one half hour session using the simplified process of CLEAR. The participants had many traumas. None could speak English, and most were illiterate. There were three women who had polio and were crippled. They could not use their legs, and they moved by walking on their hands (with their slippers on their hands), and dragging their bodies behind them. Two of these women had children. One of them was brought to the workshop by her son who biked miles with his mother behind him in a small three-wheeled bicycle with a place for her to sit behind him. The boy seemed to be around four or five years old. While his mother was in the workshop, the boy looked after his infant sibling.

There were participants who were HIV positive and there were women whose husbands had disappeared, providing no financial support, and women who were abused by their husbands. One woman had seen her husband and son killed in front of her. She said she didn’t know how she could go on. On day two, after one session using CLEAR, I went up to her to see how she was. She pointed to her lips and smiled and laughed and said “not before.” With the help of an interpreter, I understood that she hadn’t been able to laugh and smile in years.

At the beginning of the second day with the participants, we asked for the women’s impressions so far. Their comments were “At first I didn’t believe it.” And “I thought it was the white man bringing his rituals,” or “I thought it was child’s play, but now I see it can really help.” At the end of day two, the facilitators took notes on the participant’s evaluations. One of the physically challenged women said that she did not normally sleep well, but the night after the training she slept very well. One said, “The burden has come down.” All of them said they felt better, many said they felt calm. A few wanted to know how to explain it to others so they could share it with them. All of the participants agreed that they liked the process and would use it on themselves and family and friends.

The facilitator evaluations were very good. All of them recommended that CLEAR be added to the WFWI manual, so that all of the countries utilize the process. They witnessed the results in themselves and the women attending the program, and they felt it was important that CLEAR be added to the WFWI program.

ConclusionIndividuals experiencing the devastation of war can feel like victims with no power to change their situation. Though more time is needed to see that the effects are lasting, the results of the pilot program in Nigeria indicate CLEAR can help. CLEAR eliminates feelings of powerlessness, releasing the person from stress and immobility. Once immobility and stress are eliminated, there is freedom to face issues and take action and change one’s life, seeing clearly what can be done and moving toward a vision of a healed self and a healed society.

BIBLIOGRAPHY
1. Nirakar Man Shrestha, MD, DAB; Bhogendra Sharma, MBBS; Mark Van Ommeren, MA; Shyam Regmi, MBBS; Ramesh Makaju, MBBS; Ivan Komproe, PhD; Ganesh B. Shrestha, MBBS; Joop T. V. M. de Jong, MD, PhD, Impact of Torture on Refugees Displace within the Developing World, The Journal of the American Medical Association, 1998; 280: 443-448 1. Uganda: Kony War Victims's Stress Levels Highest, the Monitor (Kampala) 6 June, 2008, 1. Dryden-Edwards, Roxanne. "Post Traumatic Stress Disorder (PTSD)". Medicine Net. Stöppler, Melissa Conrad. 7 December 2007. 18 April 2008. 1. Sparr, Landy F & Bremner, Douglas J. "Post-traumatic Stress Disorder and Memory: Prescient Medicolegal Testimony at the International War Crime Tribunal?". Journal of the American Academy of Psychiatry and the Law. 2005: Vol. 33, no. 1, pp. 77-78. 1. Tang, Sharon S. M.S. & Fox, Steven H. Ph.D., Traumatic Experiences and the Mental Health of Senegalese Refugees, Journal of Nervous and Mental Disease. 189(8):507-512, August 2001
2. Feinstein, David, Eden, Donna, and Craig, Gary, The Promise of Energy Psychology , New York, Jeremy P. Tarcher/Penguin, 2005
3. Ruden, Ronald A., M.D., Ph.D., WHY TAPPING WORKS: Speculations from the Observable Brain,

Author's Bio: 

Biographical Summary, Julie Roberts, Ph.D.
Dr. Roberts lives in rural Pennsylvania near Philadelphia. She helps individuals to move into their full potential and overcome obstacles to productivity. She developed CLEAR™ to help individuals remove blocks and move forward in their lives. She has been trained in, TAT, Seemorg Matrix (now AIT), muscle testing, somatic experiencing, BodyTalk, the Kabbalah, Family Constellation work, Reiki, leadership and group process. She teaches graduate courses, and conducts workshops that improve leadership skills and she teaches her CLEAR energy psychology method. Dr Roberts has written a how-to book describing CLEAR, and is certified as an Energy Psychology practitioner by the Association for Comprehensive Energy Psychology. For more information, go to www.changeworksinc.com .