Case Report: Psychological acupuncture for severe cynophobia with comorbid PTSD

Objective: 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. Methods: 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). Results: 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. Conclusion: 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.