# Case Report: Psychological acupuncture for severe cynophobia with comorbid PTSD

## TL;DR

A 63-year-old woman with severe fear of dogs and PTSD showed significant improvement after psychological acupuncture, a non-drug therapy combining guided trauma recall and fingertip tapping.

## Contribution

This case report introduces psychological acupuncture as a novel integrative treatment for trauma-related phobias and PTSD when conventional therapies are declined.

## Key findings

- The patient's distress and PTSD scores dropped significantly after two sessions of psychological acupuncture.
- Improvements in sleep and avoidance behaviors were maintained at a 3-month follow-up.
- No adverse events were reported, suggesting the treatment is safe and well-tolerated.

## Abstract

Post-traumatic stress disorder (PTSD) with comorbid specific phobia represents a challenging clinical condition, particularly when patients decline pharmacological or trauma-focused psychotherapeutic interventions due to fear of re-traumatization or intolerance to adverse effects. This report describes a unique case of severe cynophobia with comorbid PTSD successfully treated using psychological acupuncture, an integrative intervention combining guided trauma recall with fingertip acupoint tapping.

A 63-year-old woman developed intense fear of dogs, intrusive nightmares, avoidance of outdoor activities, hypervigilance, and severe insomnia following a dog attack. The patient met DSM-5 diagnostic criteria for PTSD and specific phobia (cynophobia) and refused standard psychiatric treatments. Psychological acupuncture was administered in two 40-minute sessions over a two-week interval, incorporating relaxation training, guided trauma recall, and rhythmic fingertip tapping (4–5 Hz) on selected acupoints associated with emotional regulation. Clinical outcomes were assessed using the Subjective Units of Distress scale (SUDs), Insomnia Severity Index (ISI), and PTSD Checklist for DSM-5 (PCL-5).

Marked clinical improvement was observed following the intervention. The patient’s SUDs score decreased from 10 to 3, ISI score from 23 to 7, and PCL-5 score from 54 to 20. Improvements in fear reactivity, sleep quality, and avoidance behavior occurred rapidly after treatment and were maintained at the 3-month follow-up. No adverse events were reported.

This case suggests that psychological acupuncture may serve as a rapid, safe, and well-tolerated integrative therapeutic option for patients with trauma-related specific phobia and comorbid PTSD who decline conventional treatments. The findings highlight the potential role of combined cognitive-emotional activation and somatic modulation in alleviating trauma-related symptoms and support further investigation of this approach in controlled clinical studies.